A report published today following a year-long inquiry into racial injustice has asked for systemic changes at the root – within education, workforce culture, and policies. The inquiry led by Birthrights heard from women and birthing people accessing care, health professionals providing care, and lawyers who listen when there have been failings in care.
The inquiry comes as there is an overdue and important spotlight on inequities in care for different ethnic groups, something which has been highlighted for many years. Black women in the UK are four times more likely to die in pregnancy and childbirth than white women, and Asian and mixed race women twice as likely. Sandra Igwe, co-chair of the inquiry and a member of Baby Lifeline’s Family Voices Group wrote in the report:
“Structural racism and issues surrounding Black women accessing care had a massive impact on my journey. The UK system is structured such that public policies, institutional practices and cultural representations work to reinforce and perpetuate racial inequity.”
The report highlighted five calls to action for the maternity system:
- Commit to be an anti-racist organisation
- Decolonise maternity curriculums and guidance
- Make Black and Brown women and birthing people decision-makers in their care and the wider maternity system
- Create safe, inclusive workforce cultures
- Dismantle structural barriers to racial equity through national policy change
The findings of the inquiry mirror our own findings in last year’s ‘Mind the Gap 2021‘ report, which looked at training offered to frontline professionals in maternity in 2020/21. Both reports found that the education offered to health professionals did not represent all of those who access care. The Birthrights report cited examples of systemic racism in relation to education being:
- White bodies as the ‘norm’ or default
- Failure to recognise particular conditions (e.g. jaundice, sepsis)
- Lack of cultural understanding
"My baby was immediately hospitalised for several weeks. The white staff did not recognise jaundice in a Black baby."
“...the system was not built to support Black and Brown people, from the education to the imagery, to the understanding of race and culture”.
Gaps in training to achieve equity and equality
Baby Lifeline’s ‘Mind the Gap 2021‘ research looked at education in relation to NHS England’s ‘Equity and Equality’ guidance. Only one NHS organisation provided their frontline professionals with training related to the guidance.
Of significance, we also looked at training in clinical signs in Black and Brown skin – fewer than one-third of providers included this in their Emergency skills and drills training.
In addition, fewer than a quarter of providers included scenarios involving women whose first language was not English. Cultural competency was also provided by fewer than one-third of maternity service providers.
The system needs to support frontline professionals to give better and safer care in the Black and Brown populations, as well as understanding the cultural context for all women and birthing people accessing care. It’s undoubtedly complex but, as a minimum, the system should be set up to be representative in education, policies, and the workforce.
by Sara Ledger
Head of Research and Development
Baby Lifeline