In 2018, we learned that Black women were five times more likely to die in childbirth than their white counterparts. Five years on, the data hasn’t changed much. Now, we are almost four times more likely to die, according to the findings of a new report by the women and equalities committee.
Ministers had failed to tackle “appalling” and “glaring” racial disparities in maternal health over a number of years, the authors found. This comes as little surprise to me. Every year, I and other Black commentators who feel passionately about these disgusting racial disparities in maternal outcomes are rolled out to condemn the latest figures that point to Black women dying at disproportionate rates. I wish I could still feel shocked. But, if I can be frank, I’m just bored.
So why is change happening so slowly? As we look down the barrel of time, I find myself wondering where all these studies and warnings are leading us. The UK is very good at producing reports, but in the meantime, Black women are dying. Will I still be shouting about this when my own daughter has children? Will I have to warn her of her increased risk?
The latest report identifies pre-existing conditions as being risk factors for poor maternal outcomes, along with socioeconomic factors and attitudes that affect the quality of care women receive, which include ignorance, bias, microaggressions and racism.
If we want to make any meaningful change to maternal outcomes, we must first accept that these issues extend far beyond the maternity ward. Black women are at greater risk of late cancer diagnosis compared to white women. Cancer Research UK found ethnicity to be a “significant factor in stage of diagnosis” for women in England with breast, ovarian, uterine, and non-small cell lung cancer. Does that come as a surprise to you? We know Black women in pain are often not believed. Tropes still abound about black skin being thicker than white; that Black people don’t need as much pain relief as our white counterparts.
Black women are still too often struggling to be heard in healthcare settings. I have had two children and have seen these attitudes at first-hand. But they are not just confined to the NHS. Systemic racism has been allowed to thrive in our public institutions, from the Metropolitan police to our education system. Short of these institutions being pulled down and rebuilt, I have lost hope that this will be stamped out within my lifetime.
But what we can do is question what it is that affords these attitudes safe harbour. I know many great women dedicated to anti-racism who want to be midwives who are quitting because they cannot afford to live on a midwife’s salary. As the cost of living continues to rise, it is becoming unaffordable to live on a public sector salary. This cannot continue. We must support Black people into these professions by encouraging equal access to education, and supporting them with a fair and decent wage when they are in the job.
Getting more Black people into senior roles is fundamental, too. Black people are still far less likely to progress through the workplace than their white counterparts. And Black women are the least likely to be among the UK’s top earners compared to any other racial or gender group, according to a report by the London School of Economics. And yet, seeing more of our own faces in spaces where we are vulnerable would allow us to nip microaggressions and racist behaviours in the bud – and to influence attitudes that have been proven time and time again to harm us. If we are serious about improving maternal outcomes for Black women, we must evaluate all the forces at play. That solution won’t happen overnight. But we must work towards a world that looks like that. We simply can’t afford not to.
Candice Brathwaite is a journalist and author of I Am Not Your Baby Mother, Sister Sista and Cuts Both Ways. As told to Lucy Pasha-Robinson
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