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‘I felt humiliated’: parents respond to NHS maternity care racial bias inquiry | Maternal mortality

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Feeling manipulated into having medical procedures, dismissed by professionals and labelled with racial stereotypes are among the complaints of parents who responded to a national inquiry into racial injustice in UK maternity care.

A panel established by the charity Birthrights is investigating discrimination ranging from explicit racism to racial bias and microaggressions that amount to poorer care.

It comes as parliament is due on 19 April to debate the large racial disparity in maternal mortality in British hospitals, after a petition from the campaign group Five X More gathered 187,519 signatures. Black women are four times more likely than white women to die during pregnancy or childbirth in the UK.

Testimonies include that of a British Bangladeshi woman who said her labour concerns were dismissed. “I felt unsafe and like maternity professionals are not used to being challenged by brown women,” she said. “There is a stereotype of Asian women that we are tame, quiet and compliant people who have no voice and will be obedient.

“I was treated like a vessel, not like a human. The experience left me feeling humiliated, disempowered and ashamed.”

During labour she was denied pain relief and told she must have a low pain threshold. “Manipulative and coercive language was used to force me to go along with their care plan – one doctor told me my baby would be born with cerebral palsy if I didn’t consent to a procedure and did an impression of what someone with this condition looks like,” she said.

A woman of African-Caribbean heritage said her first experience of her local maternity services was discovering that there was no category to match her ethnicity when she was filling out a form. She said she was told to “pick another one”.

After being left in a waiting room for several hours to see a consultant who had already gone home, white members of staff called her “aggressive” when she queried the appointment. “I feel like my race means I’m seen as less and meant to endure more,” she said.

Lorraine Pryce, is a trained doula – a non-medical role providing support and advocacy during pregnancy and childbirth – and a member of the Birthrights panel.

She said demand for doulas is rising due to concerns over maternal mortality data. Figures published by MBRRACE-UK found women from Asian ethnic backgrounds face twice the risk of dying in childbirth as white women.

Lorraine Pryce, a trained doula who says demand for such services is rising because of concerns over maternal mortality data.
Lorraine Pryce, doula: ‘The overriding feeling is … not being heard, believed or trusted.’ Photograph: handout

“We hear the statistics about those who have died in the worst cases but we don’t hear from all the people suffering poorer outcomes because of their race who are still living with trauma,” said Pryce. “This inquiry intends to give those people a voice.”

“The overriding feeling I get when I talk to people about their experience is something I felt when I was giving birth – that is not being heard, believed or trusted,” she said. “I’ve seen it time and time again especially with clients of colour.”

Tricia Boahene struggled to be taken seriously after her premature baby developed jaundice. “My whole family could see it but the health visitor was not convinced. She said she’d test the levels to put my mind at ease. He tested super high but she kept insisting the machine was broken.”

Eventually, the baby was referred to hospital where a doctor said the reading was alarming but agreed with the health visitor that her son did not look jaundiced apart from a “slight yellowing” in the eyes. “The white staff did not recognise jaundice in a black baby but to me he looked neon,” said Boahene. Her newborn was hospitalised for several weeks.

Pryce, who works in the north of England supporting clients in Manchester, Leeds and Bradford, said such stories are commonplace.

“It’s heartbreaking to see and hear it,” she said. “There are pockets of good practice to improve the outcomes for black, brown and mixed ethnicity people but the NHS doesn’t seem to be tackling it on a wider scale.

“There is a lot of unlearning to be done in terms of how black and brown people are perceived and some of the messages that have been passed down over the years such as our bodies don’t feel pain in the same way.”

A machine monitors the unborn baby in a hospital maternity ward, Kingston Upon Thames, Surrey, England.
A machine monitors an unborn baby in a hospital maternity ward, Kingston Upon Thames, Surrey, England. Photograph: Jeff Gilbert/Alamy

Benash Nazmeen, co-chair of the inquiry and director of the Association of South Asian Midwives, said while issues raised were very concerning there were also positives.

“Even those with very traumatic births identified at least one professional who was ‘amazing’ – whether a community midwife, health visitor or doctor. This shows good, compassionate, culturally sensitive care is possible.”

The NHS said it was taking action to level up health outcomes for mothers and their babies from black, Asian and mixed ethnicity groups through a range of initiatives including the Maternity Voices Partnership.

Jacqueline Dunkley-Bent, England’s most senior midwife, said: “We continue to tackle poorer outcomes for women from ethnic minority backgrounds … including fast-tracking our continuity of carer programme for these groups, meaning women receive care from the same midwife and team before, during and after they give birth, which we know improves experiences and outcomes.”

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