The Black Maternity Matters collaborative welcomes the Care Quality Commission (CQC) report on its national review of maternity services in England, 2022 to 2024.
One of the report findings is that the CQC remains concerned about “the inherent inequalities in access to maternity services, experience and outcomes for women, and the safety risks this presents.”
The report highlights that compared with women from White ethnic groups, Black women were 2.8 times more likely to die during or up to six weeks after pregnancy, and Asian women were 1.7 more times likely to die during the same period. The CQC inspection programme highlighted that while some trusts are taking action to address issues with inequality, much more needs to be done to ensure maternity services are accessible and meet people’s needs at all stages of pregnancy and birth, stating: “Everyone deserves safe care and the inherent inequalities faced by some groups are unacceptable.”
As always, at Black Maternity Matters, we honour and pay respect to the contribution of women, families and colleagues racialised as Black who continue to share their traumatic experiences at psychological cost to their wellbeing so they might help to make significant change to the way perinatal care is provided through the NHS.
As is universally accepted, Black women in the UK still face significant disparities in maternal and neonatal health outcomes, experiencing higher mortality and stillbirth rates compared to their white counterparts. These disparities are rooted in systemic biases, structural racism, and a lack of anti-racist education and practice within perinatal services.
To address these issues, we launched the Black Maternity Matters initiative in 2021, focusing on targeted anti-racism education, peer support, and quality improvement (QI) transformation projects for perinatal staff across the West of England. We are now developing a Perinatal Anti-Racist Care Bundle, building on the expertise and experience of the Black Maternity Matters collaborative.
Black Maternity Matters has foundations built on the acknowledgement of the harm caused by systemic, scientific and structural racism within perinatal services and strives to take NHS staff on a sustained period of introspection and learning to reduce the harm experienced by women, families and babies racialised as Black and Brown. The burden of responsibility for this harm has fallen for too long on the bodies of Black and Brown women and families and Black Maternity Matters encourages the explicit acknowledgement of the role of the system and individuals in perpetuating unsafe perinatal care due to racism.
We are committed to transforming services into anti-racist, race trauma-informed centres of excellence, which allow all women, families and staff to experience dignity, compassion and respect. We elevate the disparity of harm to that of a serious patient safety concern and unapologetically address anti-blackness throughout our educational experience.
We are pleased to see that, in addition to setting out a series of recommendations to help address the inequalities in maternity service access and delivery, the CQC has also published a range of improvement resources alongside the report, with a section on ‘good practice in healthcare equity’ which cites Black Maternity Matters under ‘Training Staff’.
It is clear that individuals, teams and systems must invest in a sustained, collaborative programme such as Black Maternity Matters, building communities of practice led by anti-racist theory and practice educators, in order to transform the way care is provided and to address this patient safety issue.
Black Maternity Matters operates on the theory of change that system-wide and individual-targeted anti-racism training (through an anti-Blackness lens) for perinatal care, coterminous with a community of practice results in:
- Individual and system-level transformation, and a reduction in unconscious and conscious expression of racism in perinatal care
- Reduction of unconscious and conscious incidences of racism and a reduction in harm to Black women, people and babies within perinatal systems
- Reduction in expression of unconscious and conscious incidences of racism between team members
- Improved team dynamic and psychological safety in perinatal teams because of the transformation to anti-racist organisations.
The Black Maternity Matters collaborative would welcome the adoption and spread of this model of anti-racist practice and theory and the rollout of the new Black Maternity Matters Perinatal Anti-Racist Care Bundle to address the patient safety issues identified in the CQC Report. Whilst we understand the importance of gathering evidence in this area, we now call for energy to be directed toward action and offer our experience and programme as a mechanism to do just this.
The Black Maternity Matters collaborative was formed in 2021 by Health Innovation West of England, Representation Matters, BCohCo and Black Mothers Matter, working in partnership with our local maternity and neonatal systems and hospital trusts. Find out more here, including our evaluation reports.
A further evaluation on the impact of the programme on the outcomes and experiences of women, families and babies racialised as Black is underway with NIHR ARC West.
Posted on September 19, 2024
