In the UK, Black women are three times more likely to die during pregnancy and childbirth than their white counterparts. Despite widespread awareness of this racial disparity among academics and healthcare institutions, little progress has been made to improve outcomes for Black mothers.
Developing a solution starts as it always does: uncovering the cause. Researchers have identified the ‘‘three pillars’ of Black maternal mortality.
Pre-existing cardiovascular issues are the leading cause of poor pregnancy outcomes, leaving Black patients at a much greater risk than those of other ethnic backgrounds. More than 50% of Black women ages 20 and over have a cardiovascular disease. Medical racism compounds this disparity, presenting as delayed diagnoses, mismanagement of symptoms, and inadequate care. Jyoti Madhusoodanan discusses this in her article, ‘Discrimination Is Breaking People’s Hearts’, stating that “women in cardiac distress are less likely to be noticed or given timely care.”
This neglect increases the likelihood of traumatic pregnancies and contributes to the long-term development of cardiovascular disease, perpetuating the cycle of maternal morbidity.
The final pillar — arguably the most damning — links to the inequity seen across healthcare in the past and present day. The bias of those in trusted positions, who have sworn the age-old Hippocratic Oath, causes more harm to Black mothers than any other factor. From disregarding reports of pain to negligence during critical procedures, there continue to be constant examples of medical racism.
To address this, the outdated teachings that have led to these biases must be displaced. Only then can we be sure that Black families will be able to expand without the loss of their heart and soul — our mothers.
Paying the price of history
Our history continues to tax a heavy toll on our present day. With race understood to be a ‘social construct,’ inconsistencies in maternal outcomes can only be a direct consequence of structural racism.
The maltreatment of Black women dates back to the beginnings of the United States. In other words, it dates back to slavery. Physicians from all over the world travelled to the US with the goal of experimenting on enslaved women and their reproductive systems. Many of these experiments, including caesarean surgeries, were conducted without anaesthesia — with many doctors operating under the belief that Black people do not feel pain.
Benjamin Moseley, a British physician based in Jamaica in the late 1700s, claimed, “What would be the cause of insupportable pain to a white man, a negro would almost disregard.”
A childbirth pain relief study conducted by Cambridge University Hospitals revealed staggering inequalities. From 2.7 million births, Caribbean-British women were less likely to receive an epidural. Black women were also approximately 40% less likely to have an assisted vaginal birth. This includes both forceps and suction delivery, methods used to provide support in the final stages of labour.
Though decades passed, physicians upheld damaging beliefs and unethical practices. The infamous case of Fannie Lou Hamer was an unfortunate example of this. Hamer was one of the most powerful voices in the civil rights movement of the 1960s. The incident that gave her that voice occurred in a doctor’s office when she was sterilised without her knowledge or consent during an appointment for a minor surgery. This violation of human rights is now known as a ‘Mississippi Appendectomy’ and still occurs to this day.
The legacy of these practices still impacts the experiences and opinions of Black mothers today. For example, mistrust in healthcare professionals. A survey commissioned by the Joint Committee of Human Rights found that 78% of Black women don’t believe the NHS equally protects their health compared to white people.
For Black women, by Black women
Despite the systemic challenges, our community continues to tackle the issue head-on. There are a number of astute organisations fighting the good fight, many of which are led by Black women.
Elizabeth Idowu, popularly known as Mamadinya, has captured audiences across social media with her content focused on antenatal best practices.
As a midwife on the frontlines, Mamadinya is no stranger to the perils pregnant women often face. Speaking to The Science Gap, she reflected on what first drew her to midwifery.
“It sounds really cringy, but honestly, I had a very vivid dream of a woman giving birth, and I decided to study midwifery. It didn’t take much to convince me, but what has kept me in midwifery is my love and passion for pregnant women and their health,” she told us.
“It’s simple: I’m Black, so I want the best for other Black people. It scares me that the only thing ensuring I receive great care is my education about health, so knowing what could happen to those who aren’t educated about their health and rights is enough to drive my dedication.”
Black doulas and midwives play a crucial role in not only maternal health outcomes but also newborn survival. A 2019 study led by Rachel Hardman found that Black newborns were one-third more likely to survive when cared for by Black physicians rather than white physicians.
This is precisely why initiatives like Mamadinya’s are so vital. Her online content is “tailored to creating a safe space for Black families where they can learn from a healthcare professional who looks and sounds like them.” She continued, “With so many statistics flying around, the space I’ve created online is specifically dedicated to celebrating and educating them—something Black families, unfortunately, aren’t so used to.”
This has extended further than TikTok and Instagram. Building on her passion, she launched Mama Classes—an antenatal programme designed specifically for Black women. It provides a safe space for those who often feel unheard and unsupported in traditional healthcare settings.
“[Mama Classes] teaches women their rights, educates them about their bodies, and shows them when and, more importantly, how to speak up. It also provides a community where they feel safe enough to express their concerns,” Mamadinya told The Science Gap.
Black practitioners’ ability to provide culturally competent and empathetic care, recognise complications early, and truly listen to patients plays a crucial role in reducing negative health outcomes.
When asked what needs to change, Mamadinya was unequivocal: ‘Listen.’ Her words cut to the heart of the issue. ‘A lot of women aren’t listened to, and it’s devastating. Let’s listen, regroup, and replan because clearly, a lot of what we are doing isn’t working.’”
By Nnenna Ohaka
Connect with MamaDinya
Instagram: https://www.instagram.com/mamadinya/
Tiktok: https://www.tiktok.com/@mamadinya
Mama Classes: https://www.mamasclasses.com/
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