The latest episode of Channel 4’s Dispatches investigates the reasons why Black women are four times more likely to die during or soon after childbirth compared to white women, and questions what can be done to change the statistics.
The moment a woman goes into labour is as exhilarating as it is complicated, in that it represents a stark set of potential outcomes, both for the mother and for the child being born. This is because despite Britain being a relatively safe country in which to have a baby (fewer than 1 in 10,000 women die in labour), there are few things in life less predictable than childbirth and the myriad complications it can present. And while we always hope for the best case scenario, the reality is that things can take an unexpected turn at any moment, meaning that in the very worst case scenarios the mother or child doesn’t survive.
The former, defined as maternal death (or maternal mortality), has occupied a high-profile spot under the microscope over the past year or so. This gathered momentum after a 2019 study revealed that Black women were then five times more likely to die in childbirth than white women. But this wasn’t new information.
Previous statistics published by MBRACE-UK – the research team that collects the country’s maternal death data – had consistently found that Black women were at higher risk of maternal mortality, as evidenced in its 2017 and 2018 reports.
But by the time the Joint Committee on Human Rights published its Black People, Racism And Human Rights’ study in November 2020, after the killing of George Floyd and the subsequent resurgence of the Black Lives Matter movement, things were different. Mainstream media outlets were amplifying Black voices and publicising race-related issues in a way they hadn’t before.
Demands for the government to provide answers as to why there’s such a glaring racial disparity in maternal deaths, and the slew of headlines that followed, are likely responsible for Channel 4’s latest Dispatches episode, The Black Maternity Scandal, being greenlit. After all, it’s hard enough convincing people to take action on women’s rights issues that affect all ethnicities, meaning Black and Asian women are often left fighting losing battles when problems are unique to their communities.
The film, presented by mother-of-three Rochelle Humes, provides a tip-of-the-iceberg-look into the maternal deaths and near deaths of Black women in the UK. The caveat being there’s only so much you can pack into a 30-minute show without diluting the message.
One of the first people Humes speaks to is a woman called Naomi, whose sister Natalie passed away, aged 35, shortly after giving birth and suffering from a rare condition called amniotic fluid embolism. Despite being identified as one of the leading causes of direct maternal deaths globally, medical professionals aren’t clear what causes it or how to prevent it.
“She’s my soulmate and I won’t find anything to replace that relationship we had,” says Naomi.
“There is a lack of support for brown, Black and marginalised communities. The system isn’t built for that support. The data doesn’t lie. She’s part of those statistics now, so there’s something going on.”
Jade, 31, from Essex, who nearly died after having an elective caesarean to deliver her twin daughters, is also featured in the programme. Her story echoes those of countless other Black women and their families who feel they weren’t listened to either before, during or after labour. Despite her husband repeatedly telling doctors that something was wrong, and Jade’s complaints of severe back and abdominal pain, it was 12 hours before she was given a scan which revealed she had litres of blood in her stomach following from her C-section.
Jade tells Stylist: “[My husband] raised the alarm several times. He spoke to the midwife and said, ‘Look, I think there’s something wrong with my wife. She isn’t really responding to me and she hasn’t eaten’. The doctor just said, ‘Imagine she’d been out drinking the night before and she’s sort of hungover. That’s the effect that the morphine is having on her’. Eventually the midwives realised that this wasn’t normal.”
The common complaint that Black women are too often denied their autonomy during childbirth was expounded on by Mars Lord, who is a doula (somebody who provides ’physical, emotional, and informational support to women before, during and after childbirth’).
“Black women aren’t given choices in the same way,” she says. “They’re told, ‘I’m just going to do this’. Whereas with my white clients [it’s], ‘I’m just going to do this. Is this OK?’ Or ‘This is what I’d like to do’, and that’s the difference.” She continues: “If white women were dying at these rates they would damn well do something about it, and they’d do something about it now.”
The documentary questions what it is about the way Black women encounter maternal healthcare that has led to the unequal outcomes we see today, citing a 2016 American study which concluded some US medics believe Black people can bear more pain than white people.
Dr Christine Ekechi, who specialises in early pregnancy and acute gynaecology care, presents another explanation. “What tends to be offered as a reason is that Black women are more likely to have the health conditions that put them at greater risk. They’re more likely to be overweight, for example. They’re more likely to have hypertension. So we tend not to actually ask ‘why?’. Often the answer is that being racialised in society means that it’s the lower rungs of society [who are worst affected], which means [Black women] are more likely to have these conditions.”
Though Dispatches also highlights the compounding issue of maternal near misses among Black women, which Oxford University professor Marian Knight says she “just got permission” to include as part of MBRACE-UK’s research, there’s more yet to be unearthed.
According to the latest data, Asian women are nearly twice as likely to suffer maternal death during pregnancy and up to six weeks after birth; mixed ethnicity women are three times as likely and Black women are just over four times more likely. Stories like Jade’s aren’t unique – and even after experiencing such significant trauma, she feels the level of aftercare she received was far from satisfactory.
“In terms of support, if I’m honest, it was just terrible,” she tells Stylist. “I feel like there was a strong feeling of relief on [the hospital’s] side due to the fact that I recovered so quickly because they were able to brush it under the carpet. And my story is just one story. Something has to change. I’ll be damned if my daughters decide to have children and those statistics are still there. Nobody is asking for specialist care – just bridge that gap and let us have a level playing field.”
Reactions to the documentary online
The Black Maternity Scandal is now available on demand on All4
Images: © 2021 Channel 4