I. Reproductive Justice and Black Maternal Health: An Introduction and My Inspiration
Did you know that Black maternal health disparities in the UK mean that Black mums are 2 to 4 times more likely to die from childbirth complications than White mums? These disparities are not just limited to the UK-Black moms in the U.S. face a similarly tragic reality, contributing to alarmingly high maternal mortality rates in both countries. The United States has one of the highest maternal mortality rates among high-income nations worldwide. Together, we must tackle the systemic barriers that drive these staggering maternal mortality rates by adopting a reproductive justice framework. I will also propose practical solutions to combat this crisis. Your insights and involvement are invaluable in this movement.
Reproductive justice (RJ) is a grassroots movement that champions human rights and social justice. It asserts the fundamental human right of women, girls, and non-binary individuals to make and uphold their own sexual and reproductive choices without coercion or fear of retaliation from institutions, the government, or other individuals. Furthermore, the RJ framework examines systemic and environmental factors preventing mothers from raising their families with dignity. A prime example of a systemic barrier is institutional racism. It plays a huge part in perpetuating Black maternal health disparities, which directly undermines reproductive justice for Black mothers globally.
One of the key figures in this movement is scholar and activist Loretta Ross, who is often credited with bringing the term "reproductive justice" into the mainstream lexicon. In the summer of 1994, she and a group of Black women activists came together to launch the RJ movement, which aimed to raise awareness of and uplift the unique lived experiences of Black women in America. Reproductive justice is a framework that is founded on the core belief that Black women and girls have the right to bodily autonomy and consent, the right to have or not have children, and to be equipped with the necessary material support to parent and raise their families in safe, healthy, and sustainable communities. Learn more about the history of reproductive justice here.
My main inspiration for exploring the maternal health landscape in the United Kingdom is my love for the BBC/Netflix series "Call the Midwife." The series is adapted from Jennifer Worth's memoirs of the same name. The show portrays the professional and personal experiences of a group of midwives and nuns caring for mothers in East London during the post-World War II era. Furthermore, it poignantly explores a wide range of social issues, including abortion, adoption, racism, and domestic violence. The show's emotional storytelling and social relevance deeply resonate with me. I love this show so doggone much that I'm rewatching it from the beginning!
a. Why Reproductive Justice Matters in the UK?
The UK has a robust legal framework for human rights, exemplified by several key laws, including the Human Rights Act of 1998. This law outlines the fundamental human rights granted to residents of the United Kingdom, including England, Scotland, Wales, and Northern Ireland. The act consists of 18 articles, each addressing specific rights. For example, Article 2 pertains to the right to life, ensuring that the lives of Black mothers are protected at all times. No one should be deprived of life without lawful justification. Article 3 further prohibits torture, inhuman or degrading treatment, or punishment, which is especially relevant in the context of reproductive justice, as Black mothers frequently encounter mistreatment in healthcare settings.
Furthermore, Article 8 grants individuals the right to privacy, including bodily autonomy and consent, a central tenet of reproductive justice. Finally, Article 14 explicitly forbids discrimination based on personal characteristics at both the individual and institutional levels, ensuring legal protection against bias in all forms.
The takeaway is that these laws are vital for Black women and in the context of reproductive justice, as they provide a legal foundation for individuals to challenge human rights violations in the court system.
II. Systemic Barriers in Maternal Healthcare: Challenges Facing Black and Brown Mothers
Similar to the United States, Black mothers in the United Kingdom face systemic racism at both individual and institutional levels. This bias is a significant factor in the subpar healthcare they often receive. The roots of this issue stem from colonialism and anti-Black racism, during which Black people, namely Black women, were viewed as inferior and subordinate. Harmful stereotypes, such as the belief that Black women are strong and can endure pain, result in their concerns being dismissed or downplayed by healthcare providers. This stereotype perpetuates a toxic cycle of systemic racism and institutional neglect, compromising the quality of care they receive.
According to research compiled by MBRRACE-UK, a UK-based nonprofit research organization, blood clots were the leading cause of maternal death in the UK between 2021 and 2023, with a rate of 2.1 per 100,000 pregnancies. Cardiac disease was the second leading cause of maternal death during the same period, with a rate of 1.5 per 100,000 births, followed by COVID-19, with a rate of 1.45 per 100,000 pregnancies. Additionally, neurological conditions were another leading cause of death among mothers, with a rate of 1.3 per 100,000 pregnancies, followed by sepsis, which claimed the lives of pregnant women at a rate of 1.25 per 100,000 births. What's even more disturbing is that Black mothers during this period were twice as likely to die from pregnancy-related complications compared to White British mums. In 2022 alone, Black women died at a rate of 28.21 per 100,000 pregnancies, whereas White British moms died at a rate of just 12.2 per 100,000 pregnancies.
I reviewed and analyzed compelling anecdotal evidence that supports my argument during my research. The UK maternity care organization, Birthrights, compiled a 2022 report entitled "Systemic racism, not broken bodies, which is both timely and eye-opening. To be candid, the material was heavy for me to read, as it highlighted the unnecessary anguish and trauma these Black mothers endured. Birthrights, in collaboration with a diverse team of experts from various sectors and policy fields, conducted a comprehensive study to understand the maternity care experiences of Black Asian, and Mixed-Ethnicity women with over 300 participants. Approximately two-thirds (66%) of the participants disclosed that they did not feel safe in maternity care settings, which is deeply alarming. Many of the participants attributed this to their race or ethnicity. Common themes that emerged from the research included discomfort in seeking help and services for fear of being a burden, being discredited by medical providers, receiving negligent care and treatment, and enduring racism. This is extremely upsetting to hear.
a. Anecdotal evidence: Black Mothers' Experience in Maternal Healthcare
Jaundice was not detected promptly in Black infants. A participant from the Birthrights research study stated that her medical provider dismissed her concerns when she noticed symptoms of jaundice in her newborn son. The provider insisted that her infant's abnormal vital levels were due to faulty machinery. The provider begrudingly agreed to check the newborn's levels to appease the mother. Another research participant raised similar concerns about her newborn daughter exhibiting signs of jaundice. A healthcare provider dismissed the participant's concerns. Tragically, the baby developed brain damage and cerebral palsy.
These scenarios exemplify indoctrination, a form of institutional racism, within the healthcare system. Since the beginning of history, our society has conditioned our minds to believe that Eurocentric features are the typical beauty standard. Another striking example of indoctrination mentioned in the report is when a midwife stated that she was taught in school that an "African pelvis" exists, which reinforces the erroneous claim that Black women's bodies are inherently flawed. The reality is that the healthcare system and the broader social determinants of health harm Black women. Women are not the problem at all!
The majority of research participants reported being ignored or having their pain dismissed by midwives, sometimes to the extent of being denied pain relief. Another pervasive issue highlighted in the Birthrights report is the dehumanization and undignified treatment Black mothers endured. Many were left in pain without assistance, denied support, subjected to neglectful care, and in some tragic cases, downright abuse. These are all clear violations of Article 3 of the Human Rights Act of 1998, which prohibits inhumane, degrading treatment. Additionally, many of the women lacked informed consent. They were not equipped with adequate knowledge regarding their medical care, which violates Article 8 of the Human Rights Act of 1998.
III. How the UK is Addressing Black Maternal Health Disparities?
Several UK-based organizations, including the National Health Service (NHS) and healthcare experts, have sounded the alarm on this public health crisis and social injustice. The Royal College of Midwives has acknowledged the dire need for change and is committed to overhauling the midwifery curriculum. They aim to decolonize training programs to ensure that current and future midwives are better equipped to provide equitable care.
The NHS has outlined a five-year roadmap to improve health outcomes for Black, Asian, and Mixed-ethnicity communities. One key initiative is to ensure that, by 2024, 75% of mothers from these backgrounds receive consistent care from the same midwife through pregnancy and delivery; this model is also known as "continuity of carer". While this is an admirable goal, staff must receive comprehensive training on implicit bias and anti-racism. Without this, even the most compassionate midwife may unintentionally perpetuate harmful stereotypes in care delivery.
However, there are concerns that NHS and national initiatives might be falling short in addressing maternal health inequities. Notably, NHS has yet to establish a clear, measurable target for reducing the disproportionately high maternal mortality rates among Black mothers. Addressing these disparities requires a multidisciplinary approach, evidence-based solutions, innovative policies, and sustainable funding to drive meaningful change.
VI: Solutions: How can you participate in the movement to combat maternal health disparities?
There are several ways you can take action to improve maternal health outcomes for Black mothers in both the UK and the U.S.:
Advocacy: Contact local government officials to raise awareness about this public health issue and advocate for policies promoting equitable maternity care.
Support local organizations: Follow and engage with UK-based organizations like Five x More, Birthrights, and Maternal Mental Health Alliance, which work tirelessly to improve health outcomes and fight for maternity rights.
Donate to Maternal Health Initiatives: Support charities and advocacy groups dedicated to closing racial disparities in maternity care.
Knowledge is power: Learn about the root causes of maternal health disparities and challenge your implicit bias. Conversations can spark change!
Volunteer with maternal health organizations by offering your time and skills. You can do this through fundraising, community outreach, or social media awareness.
In conclusion, these actions can contribute to the fight for maternal health equity. If we work together, we can all push for systemic change and ensure that all mothers receive the quality care they deserve.
In closing, I've curated a special Apple Music Playlist to complement this piece. It features a collection of songs that celebrate women's empowerment, femininity, and culture.
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