Being seen, being heard: Improving maternity care for black women
There is a disparity in the care given and received by black women. It’s there because there is a lack of trust between black women, healthcare services and the Government. Running The Motherhood Group, a platform where black and ethnic minority women talk and receive support in parenting, mental health and share challenges, the experiences I hear daily from hundreds of black women have echoed my personal experience too.
Many of the women in the network feel they have been judged by the colour of their skin when accessing healthcare services, both during and after their pregnancy. Consequently they believe they have received a second-class service. Although they are all too aware of the institutional racism that exists in the UK, these women are understandably shaken when they experience discrimination first-hand at such a vulnerable time as during pregnancy, labour or postnatally.
Personally, I have had experiences of clinicians withholding epidurals for hours and being dismissive of my pain because my screams didn’t 'coincide' with contractions. There is a fundamental, widespread distrust in what most see as a white system for white people. I don’t believe that black women are always offered the support or encouragement they need to be able to talk about their pregnancy, birthing fears or mental health problems. Speaking from my own experience, from the pregnancy appointments to the six-week postnatal check, it felt like more of a tick box exercise with no time to fully respond or share any challenges at that time. There is a cultural assumption sometimes that black women are very strong, that we don't feel physical or emotional pain, but we do. The myth of the superpowered black woman needs to end as it is killing us, literally. This kind of bias has infiltrated into the healthcare system which has caused real harm for black women.
There needs to be better training for clinicians around unconscious bias, to better understand how black women respond to pain, to not pass it off as 'having an attitude' or 'being aggressive' but to fully comprehend our emotions, complications and individual circumstances for what they actually stand for. Unfortunately, unconscious bias exists in every part of society, but in healthcare it can have dangerous consequences.
We need to see more diversity in the resources and support groups available too. I tried to attend mum and baby groups but found that I was often the only black woman in the room so I was unable to connect. On social media, most of the mum groups and bloggers and vloggers are white, middle class women too. The parenting industry as a whole is the same. It gives the message that we are not part of it, not included or in need of support.
There also needs to be proportionate repercussions when patients suffer unfair or negligent treatment. So far, all we see are letters of apology. What we need to see is justice served, every time a mother - specifically black mother - isn't given the care they deserve during such a vulnerable time of their life.
The Motherhood Group has given women of colour a voice and a safe space through events, workshops and digital spaces. People are beginning to value our experience and ask for our input into research projects around maternal mortality and mental health. This has increased since the Black Lives Matter movement, but black mothers have been dying at a disportionate rate for years, so why now?
This is a bittersweet moment. Black women need to continue to be loud and to be heard and to support each other as we face the challenges of motherhood, pre and postnatally. Raising awareness has been an important first step in the journey. Now we need to make sure that we are also part of the solution.
Sandra Igwe is the founder of the Motherhood Group, a support network to help black and ethnic minority women talk about parenting, mental health challenges with maternity services.