The Bench Report

Fixing the Maternal Health Crisis: Black Women Face Shocking Disparities in the UK

• The Bench Report UK • Season 2 • Episode 7

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While the UK is generally safe for childbirth, persistent and deadly inequalities exist for Black and minority ethnic women. Black women are three times more likely to die during pregnancy or childbirth than white women. This critical issue demands urgent attention and action.

Key takeaways.

  • Beyond mortality, Black women face higher rates of miscarriage, preterm birth, neonatal death, and mental health struggles. Black ethnicity is now considered a risk factor for miscarriage.
  • Significant issues in antenatal care, pathology, and follow-up/reviews were identified for a higher % of Black women and babies compared to white women and babies who experienced stillbirth or neonatal death.
  • Poor care experiences are common, with 27% of Black women surveyed feeling they received "poor" or "very poor" care during pregnancy, labour, and postnatally. 42% rated childbirth care as "poor" or "very poor".
  • Contributing factors to these disparities are multifaceted, including structural racism, unconscious bias, gaps in culturally competent care, and socioeconomic inequalities. Socioeconomic deprivation doubles the maternal mortality rate for women in the most deprived areas compared to the least.
  • Institutional racism and unconscious bias within the NHS can lead to poor care, such as inaccurate assumptions about pain tolerance causing women to be denied pain relief or disbelieved when raising concerns.
  • Access to services is also unequal: Black women are 25 x less likely to access fertility treatment. Black and Asian patients had lower IVF success rates and struggled to access donor eggs.
  • There is a lack of comprehensive, dedicated medical study specifically on racial disparities in maternity care and outcomes.
  • Advocacy groups like Five X More, Mimosa Midwives, and The Motherhood Group are crucial in highlighting the issue, empowering women, offering support, and pushing for systemic change.

Source: Black Maternal Health Awareness Week
Vol 766: debated on 29 April 2025

Visit blkmaternalhealthweek.com for more information.

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No outside chatter: source material only taken from Hansard and the Parliament UK website.

Contains Parliamentary information repurposed under the Open Parliament Licence v3.0.

SPEAKER_00:

Hello and welcome again to The Bench Report. You're listening to Amy and Ivan.

SPEAKER_01:

Hello.

SPEAKER_00:

This time, we're looking closely at what Black Maternal Health Awareness Week 2025 really brought into focus.

SPEAKER_01:

That's right. And while the UK is, generally speaking, a safe place to give birth.

SPEAKER_00:

Relatively safe, yes.

SPEAKER_01:

The week really highlighted these, well, significant and persistent differences in maternity care for black and minority ethnic women.

SPEAKER_00:

It does seem contradictory, doesn't it? For a wealthy nation, you'd expect perhaps more equity across the board in health care.

SPEAKER_01:

Exactly. But the experiences we hear about and the data, well, they reveal some pretty serious problems. problems that need, frankly, urgent attention.

SPEAKER_00:

Let's maybe start with one of the most jarring statistics. Black women are three times more likely to die during pregnancy or childbirth compared to white women.

SPEAKER_01:

Three times. And for Asian women, it's double the risk.

SPEAKER_00:

These figures are just incredibly stark. They immediately tell you something is fundamentally wrong.

SPEAKER_01:

And it's not just mortality. There's also miscarriage rates. Black women experience miscarriage at a rate that's 40 percent higher.

SPEAKER_00:

Forty percent. And I understand black ethnicity is now actually considered a factor in itself.

SPEAKER_01:

Yes. Sadly, that seems to be the case. It's factored in.

SPEAKER_00:

The MBRE Race UK report, the one from 2023, digs into this a bit deeper, doesn't it? They found more issues in antenatal care.

SPEAKER_01:

They did. Considerably more, actually. For black women, issues were identified in 83% of cases they reviewed compared to 69% for white women.

SPEAKER_00:

So potential problems with spotting risks early or managing them.

SPEAKER_01:

It certainly suggests that. And the same report showed that black mothers and their babies were more likely to have significant health problems, pathology-related issues.

SPEAKER_00:

What were the numbers there?

SPEAKER_01:

It was 67% for black mothers and babies versus 46% for white.

SPEAKER_00:

That's a big gap.

SPEAKER_01:

It is. And then looking at follow-up care after the birth, again, more issues flagged for black parents, 75% compared to 66% for white parents.

SPEAKER_00:

So it's across the whole pathway, it seems, before, during, and after birth.

SPEAKER_01:

That's what the data points towards. Then you have prematurity.

SPEAKER_00:

Right. Babies born too early.

SPEAKER_01:

Black mothers, particularly those with black Caribbean heritage, are twice as likely to give birth before 37 weeks.

SPEAKER_00:

And that's a major factor in long-term health problems for the infant, isn't it?

SPEAKER_01:

Absolutely. It can lead to lifelong challenges.

SPEAKER_00:

Beyond the clinical outcomes, what about the actual experience of care, how women felt they were treated?

SPEAKER_01:

Well, the campaign group 5xMore did a survey in 2022. It found that 27% of the Black women who responded felt the care they received, pregnancy, labor, postnatal, was poor or very poor.

SPEAKER_00:

Over a quarter. That's significant.

SPEAKER_01:

And for the standard of care just during childbirth itself, that figure went up to 42%. 42%

SPEAKER_00:

rated it poor or very poor. That's deeply concerning.

SPEAKER_01:

It really is. They're running the survey again, so hopefully we'll see if things are improving. But those numbers show a real disconnect.

SPEAKER_00:

And this must link into neonatal care, too. If babies are born prematurely, for instance.

SPEAKER_01:

Precisely. The charity Bliss highlights this. Babies born to black mothers might need specialist care more often, but inequalities persist there, too.

SPEAKER_00:

In what ways?

SPEAKER_01:

In getting a admitted to neonatal units, the quality of care they receive while there, and even the outcomes after they go home.

SPEAKER_00:

Which has long-term consequences for the whole family, obviously.

SPEAKER_01:

Huge consequences. And we also need to talk about mental health postnatally.

SPEAKER_00:

Yes, that's often overlooked.

SPEAKER_01:

Women from Black, Asian, and minority ethnic backgrounds are actually more likely to suffer from common mental health conditions after birth.

SPEAKER_00:

But less likely to get help for it.

SPEAKER_01:

That's the troubling part, less likely to access treatment.

SPEAKER_00:

And tragically, mental health issues are a major cause of maternal death in the year after pregnancy.

SPEAKER_01:

Yes. The MBR Race UK data showed mental health-related causes accounted for 34% of deaths between six weeks and a year postpartum.

SPEAKER_00:

It just underscores how vital that support is, particularly if the birth experience itself was negative or traumatic.

SPEAKER_01:

Absolutely. The disparities even reach into fertility treatment.

SPEAKER_00:

How so?

SPEAKER_01:

The HFEA, the fertility regulator, found black women are much less likely to access fertility services.

SPEAKER_00:

Less likely. How much those like?

SPEAKER_01:

I think the figure mentioned was significantly less, potentially around 25 times less likely for some treatments and specifically for NHS funded IVF cycles for black patients actually dropped quite a bit between 2019 and 2021.

SPEAKER_00:

Wow. And success rates?

SPEAKER_01:

Also lower for black and Asian patients compared to white patients, even in younger age groups. Plus, there's a real shortage of black egg donors making access even harder.

SPEAKER_00:

It seems like every stage has these embedded And

SPEAKER_01:

then there's the bigger picture. The overall maternal death rate in the UK actually went up significantly between 2020 and 2022.

SPEAKER_00:

Even taking COVID-19 out of the equation?

SPEAKER_01:

Yes, even excluding COVID deaths. It's a statistically significant increase.

SPEAKER_00:

Which is worrying in itself, but likely means things could get even worse for those already facing poorer care, like black women.

SPEAKER_01:

That's the concern.

SPEAKER_00:

But what's behind all this? It can't be just one thing.

SPEAKER_01:

No, definitely not. It's complex. You're looking at a combination of, well... structural racism within the system. How does that manifest? It can be in policies, practices, how resources are allocated, but also unconscious bias from individuals providing care.

SPEAKER_00:

Like the reports you hear about assumptions made about pain tolerance.

SPEAKER_01:

Exactly. Assumptions that black women feel less pain leading to pain relief being denied or concerns being dismissed. That kind of bias, conscious or not, can have terrible outcomes.

SPEAKER_00:

And then there are gaps in what you might call culturally competent care.

SPEAKER_01:

Yes. that don't really understand or meet the specific needs of diverse groups. Plus, wider socioeconomic inequalities play a role.

SPEAKER_00:

Because we know poverty affects health outcomes across the board.

SPEAKER_01:

It does. And black and minority ethnic people are more likely to be living in relative poverty or even deep poverty. So you have this double hit socioeconomic disadvantage layered on top of potential institutional racism within health care.

SPEAKER_00:

It paints a pretty bleak picture, but there are people fighting for change.

SPEAKER_01:

Absolutely. Campaign groups are doing vital work. Five X More, who started Black Maternal Health Awareness Week itself.

SPEAKER_00:

Mimosa Midwives, focusing on culturally safe care and training.

SPEAKER_01:

And the Motherhood Group, providing peer support. They have conferences, an app for Black moms. Their work is crucial.

SPEAKER_00:

What are they calling for specifically?

SPEAKER_01:

Key things include a measurable target from the government to actually end these racial disparities in maternal deaths.

SPEAKER_00:

A concrete goal.

SPEAKER_01:

Yes. And mandatory annual surveys that specifically capture black women's experiences. Also, compulsory anti-racism and cultural competence training for everyone working in maternity care.

SPEAKER_00:

And better data.

SPEAKER_01:

Much better data collection on ethnicity and outcomes so we can actually track progress properly.

SPEAKER_00:

Is the government responding? What measures are actually in place or being developed?

SPEAKER_01:

There are things happening, local maternity systems now have to publish equity and equality action plans.

SPEAKER_00:

OK, so local accountability.

SPEAKER_01:

Version three of the Saving Babies Lives care bundle is being rolled out. There are maternal medicine networks being set up.

SPEAKER_00:

What are they?

SPEAKER_01:

Networks to improve care for women with complex medical conditions during pregnancy. The NHS also has its own overarching equality, diversity and inclusion plan.

SPEAKER_00:

And I think there was talk of a toolkit for respectful care.

SPEAKER_01:

Yes, developing a toolkit for respectful and inclusive maternity care. And we saw the independent review in Nottingham, the Offenden review.

SPEAKER_00:

Right. Into the failures there.

SPEAKER_01:

That review initially faced criticism for not engaging enough with black communities, but they did take steps to improve that engagement later on. It's kind of a real world example of the challenges and maybe the potential for change.

SPEAKER_00:

But despite those steps, campaigners and others still have questions for the government, don't they?

SPEAKER_01:

Yes, big questions remain. Will there be a full statutory inquiry into these racial disparities?

SPEAKER_00:

A formal investigation.

SPEAKER_01:

Exactly. Will there be dedicated funding for research into conditions that, despite disproportionately affect Black women, like fibroids or sickle cell.

SPEAKER_00:

What about training? Is there a call to review that?

SPEAKER_01:

Yes, commissioning a proper review of maternity training. And, crucially, will the government and the NHS openly acknowledge systemic racism as a factor and outline concrete steps to eliminate it?

SPEAKER_00:

Those are fundamental questions. Are political parties addressing this?

SPEAKER_01:

Some are. The Liberal Democrats, for example, have talked about transforming maternity services.

SPEAKER_00:

What are their proposals?

SPEAKER_01:

Things like revolutionizing perinatal mental health support, fully implementing the Elkenden recommendations across the board, having a cross-government strategy with annual reporting.

SPEAKER_00:

So joining things up more.

SPEAKER_01:

And increased funding for public health focused on inequalities, plus a dedicated unit in the Cabinet Office looking at health creation.

SPEAKER_00:

What about the current government? Have they made specific commitments on targets?

SPEAKER_01:

They have committed publicly to setting an explicit target to close the mortality gap for blacks and Asian women.

SPEAKER_00:

So that measurable target campaigners asked for.

SPEAKER_01:

Yes, though the details of what that target will be and the precise actions needed are still being worked out. Apparently,

SPEAKER_00:

it feels like a positive step, but the urgency is clear.

SPEAKER_01:

Absolutely. This goes beyond just numbers and reports. It's about the fundamental right to safe, equitable, respectful care during one of the most significant life events.

SPEAKER_00:

And the fact these disparities persist so starkly in a country like the UK really makes you think about the deeper systemic issues we still need to tackle.

SPEAKER_01:

It does. It demands comprehensive change to make sure that equitable care becomes a reality for everyone.

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