Black Maternal Health Awareness Week
Natasha Irons Excerpts(2 days, 11 hours ago)
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Bell Ribeiro-Addy
I thank my hon. Friend for his intervention; he is absolutely right. I re-emphasise the point that black, Asian and minority ethnic women are more likely to suffer from common mental health disorders, yet are less likely to access treatment. According to MBRRACE-UK’s “Saving Lives, Improving Mothers’ Care” report from last October, deaths from mental health-related causes accounted for 34% of deaths occurring between six weeks and a year after the end of pregnancy. It is vital that all those who experience pregnancy and childbirth receive mental health support, even if they do not necessarily present as struggling with their mental health; but that is especially true of black, Asian and minority ethnic women, who are more likely to have a negative experience during pregnancy and childbirth. Some of these women’s experiences are deeply traumatic and scarring, and can lead to several mental health problems. Despite that, they are less likely to access mental health support, so they are left to try to recover mentally from the experience on their own.
That disparity exists beyond pregnancy and childbirth, and even before conception. According to the Human Fertilisation and Embryology Authority, black women are 25 times less likely to access fertility treatment, and NHS-funded in vitro fertilisation cycles among black patients decreased from 60% in 2019 to 41% in 2021. Black and Asian patients aged 18 to 37 had the lowest IVF success rates compared with white patients in 2020-21, and non-white groups also struggled to access donor eggs, with 89% of egg donors being white, 4% Asian, 3% of mixed heritage and only 3% black.
During the International Women’s Day debate, I highlighted the latest MBRRACE-UK data, which showed a statistically significant increase in the UK’s maternal death rate in the years 2020 to 2022, even when excluding deaths caused by covid-19. Put plainly, more women and babies of all races are dying in the UK now than in the past two decades. This is incredibly worrying, and it means that black women, who often face the worst care, are likely to experience even further deterioration.
When I was researching the latest statistics and figures for this debate, it became increasingly apparent that the data on racial disparities in maternity care is limited and scattered. The data I have cited comes from a collection of reports by various medical bodies and advocacy organisations. Racial disparities are often identified as part of broader studies but, as far as I know, to date there has been no comprehensive medical study dedicated exclusively to racial disparities in maternity care and outcomes, despite the statistics consistently showing how bad things are becoming.
The Lancet’s recent study on maternal mortality and MBRRACE-UK’s reports do include racial breakdowns, but they are based on the data that they have, not the data that they need. A single, dedicated study is yet to be conducted. The lack of comprehensive research makes it incredibly difficult to see a full picture of what is happening, so I hope that the Minister will address that point and highlight what the Government are doing to get a clearer picture of the state of maternity care.
There is no one driver of the racial disparities in maternity care and outcomes. The causes are multifaceted, but overwhelmingly they are the result of a combination of structural racism, unconscious bias, gaps in culturally competent care and socioeconomic inequalities. The first two are incredibly important to highlight. Without acknowledging that the NHS has an issue with institutional racism and unconscious bias, we cannot address the problem. Those issues feed into the quality of care being delivered for black mothers and their babies. The inaccurate and dog-whistle assumptions around black women’s pain tolerance, for example, can lead to women being denied pain medication during childbirth, or misbelieved when raising concerns about pain felt that signals a severe medical condition. Those beliefs are not taught in medical school or during training, yet so many black women have come across a nurse, midwife or doctor who holds them. They are a direct result of institutional racism in the NHS and have a direct impact on the care that women receive.
It is important to note that, although racial disparities in maternity care are experienced regardless of class, occupation, education or geography, socioeconomic inequalities are still a very important factor in determining health outcomes and experiences. Women living in the most deprived areas have a maternal mortality rate more than twice that of women living in the least deprived areas. Black and minority ethnic people are 2.5 times more likely to be in relative poverty and 2.2 times more likely to live in deep poverty.
The combination of socioeconomic inequalities and institutional racism in the NHS is having a dual impact on black mothers’ experiences of maternity care and health outcomes. Much of the previous Government’s work to improve maternity care was focused on co-morbidities and socioeconomic drivers of poor health. Indeed, it is crucial that those areas are addressed, but without looking at the structural racism and unconscious bias in the NHS, the problems will persist.
I want to recognise the campaign groups that are pushing the issue up the political agenda. In the absence of concrete Government or NHS action, advocacy groups have stepped in to offer their solutions and recommendations. Where they can, they also offer alternative care and training. First—always first—I commend Five X More, which established Black Maternal Health Awareness Week in 2019. Its work empowers black women to make informed decisions during pregnancy, and it advocates for systemic change. It is currently conducting its second national survey, building on its impactful 2022 research.
Five X More is calling for a measurable Government target to end racial disparities in maternal death, a commitment that the Labour Government support but have yet to implement. I hope that the Minister will confirm today whether such a target will be set, how it will be measured and when we can expect it. Five X More also advocates for mandatory annual maternity surveys focused on black women’s experiences, compulsory anti-racism and cultural competence training for all maternity professionals, and improved data collection on ethnicity and outcomes.
Natasha Irons (Croydon East) (Lab)
I thank my hon. Friend for securing this important debate. Given the complexities and interchangeable disparities that affect maternal health for black women, does she agree that without a national target or framework we are doomed to make the same mistakes again and again? This travesty needs to end, because no mother or child’s health outcome should be determined by the colour of their skin.
Bell Ribeiro-Addy
My hon. Friend is absolutely right. These figures have been circulating for decades, but it was only after a successful parliamentary petition launched by Five X More that we first debated them in the House. We are now five or six years on and we are still in the same situation. Things have to change.
I will continue to pay tribute to the amazing groups that have been pushing for decades to put the issue on the agenda. Mimosa Midwives is another remarkable group that offers culturally safe, continuous maternity care. It campaigns for a culturally appropriate care model in the NHS and for inclusive training in midwifery education to reflect diverse maternal experiences, because much of our medical training remains centred on white women.
The Motherhood Group is a social enterprise supporting black mothers with peer-led services, training workshops and national campaigns. Its annual black maternal health conference brings together researchers, clinicians and service users to tackle disparities. It also launched the Blackmums app to connect mothers navigating similar challenges.
Other charities such as Bliss, Tommy’s, Birthrights and the Royal College of Midwives also highlight racial disparities in their broader efforts to improve maternity care. Where the Government and the NHS have fallen short, they have taken the time to campaign and to step in.
I will, however, acknowledge the positive steps that the new Government and the NHS have taken. In response to my written parliamentary questions last month, the Government outlined some ongoing measures. Every local maternity system must now publish an equity and equality action plan that sets out tailored actions to reduce disparities, especially for ethnic minority women and those in deprived areas. I welcome the roll-out of version 3 of the Saving Babies’ Lives care bundle, which aims to reduce stillbirth, neonatal death, pre-term birth and brain injury.
Maternal medicine networks are being established to ensure equitable access to specialist care for women at heightened risk. Those efforts are supported by the NHS equality, diversity and inclusion improvement plan, which was launched in 2023. That plan requires NHS organisations to tackle workforce discrimination, improve leadership accountability and foster an inclusive, harassment-free environment. I am also pleased to note that NHS England is developing a respectful and inclusive maternity care toolkit to support inclusive and culturally competent practice. Those are all really welcome developments, but much more is needed.
I will close with four questions for the Minister. First, will the Government commit to a statutory inquiry into racial disparities in maternity care, including testimony from affected families and frontline providers? Secondly, will the Government fund dedicated research into the medical complications disproportionately affecting black women during pregnancy and childbirth? Thirdly, will the Government commission a review of maternity training across all medical professions, to better equip practitioners in recognising complications and symptoms in black women and babies? Finally, do the Government acknowledge the presence of systemic racism within the NHS? If so, what steps are being taken to confront and eliminate it? It is good that in the past few years, the House has taken the time to acknowledge these issues and allow us to debate them, but even though the Government stated in their manifesto that a target will be set, we now need to see action. We cannot continue to see gaping inequalities in maternal outcomes.
Oral Answers to Questions
Natasha Irons Excerpts(3 months, 3 weeks ago)
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Wes Streeting
Yes, I or the Minister of State for Health would be delighted to meet the hon. Member. She is right to describe the scale of challenge in urgent and emergency care. Of course, there are other challenges in east Kent, particularly in maternity services, which I am acutely aware of too, and I would be delighted to work with her to help solve some of those challenges in her community.
Natasha Irons (Croydon East) (Lab)
Stephen Kinnock
My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.
Access to Primary Healthcare
Natasha Irons Excerpts(6 months, 2 weeks ago)
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Natasha Irons (Croydon East) (Lab)
Of all our public services, our NHS is the one that unites us the most. It is in the room that our children our born in. It is there when our parents get old and when we receive the worst possible news. It is there for us no matter who we are, what we do or what we earn. Our NHS belongs to us all. The previous Government inherited an NHS that was working, with the highest satisfaction levels and lowest waiting times in its history. The state of the NHS today, where 2.8 million people struggle to contact a GP every month, demonstrates their utter contempt not just for this precious institution, but for the people it serves.
There can be no greater example of the previous Government’s failure than the declining health of our young people. Last year, the number of under 18-year-olds on waiting lists for paediatric care in England soared to a record high of over 400,000. As Lord Darzi’s report shows, our children are some of the sickest in Europe, with the highest rates of obesity, diabetes, and poor oral and mental health. Under the previous Government’s watch, 40% of children lost regular access to a dentist, the number of children waiting more than 52 weeks for community health services hit 94% in just two years, and one in 5 children is estimated to have a mental health problem but is unable to access the right treatment.
The previous Government failed our children from head to toe. That is reflected in the experience of young people in my constituency, where they and their families wait months and sometimes even years for support. Parents are desperate for help, young people are desperate for healthcare and everyone is desperate for hope.
Labour has fixed our NHS before and under this Government we will fix it again. Following Lord Darzi’s report, the Prime Minister has recognised the need to change our health service, and has set out this Government’s intention for a 10-year plan to change our NHS. Our Health Secretary has already committed to putting in the extra resources we desperately need for primary care, including £82 million of investment to recruit 1,000 newly qualified GPS, and to finally reform the broken dental contract to get more dentists into the communities that need them.
Unlike the previous Government, we will fight for our NHS. We will not allow primary care services to continue to be overwhelmed. We will not leave patients rotting on waiting lists, and we will not let our children be the sickest in Europe. We will fix our NHS. We have fixed it before, and we will fix it again.
NHS: Independent Investigation
Natasha Irons Excerpts(7 months, 2 weeks ago)
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Wes Streeting
I like the hon. Gentleman very much, but what audacity to criticise this Government for cleaning up the Conservatives’ mess. He fails to acknowledge the cost to the Exchequer and to patients in delayed and cancelled operations, appointments and procedures. More than £1 billion has been lost and more than 1 million appointments cancelled because of the Conservatives’ gross incompetence and failure to understand the difference—they are penny-wise and pound-foolish. That is why they have been sent into opposition and Labour has been trusted to clean up their mess.
Natasha Irons (Croydon East) (Lab)
There can be no greater example of the previous Government’s failure than the shocking outcomes for our children and young people, as Lord Darzi’s report highlights. Our children now have some of the worst health outcomes in Europe, with higher rates of obesity, diabetes and asthma, and poor oral and mental health. From head to toe, they have been failed. Will the Secretary of State ensure that the Government’s long-term plan for our NHS will give young people’s health the priority that it deserves?
Wes Streeting
I am delighted to see my hon. Friend in her place. She might be from the wrong side of the river, but she is absolutely right about the importance of prioritising children’s health. As the Prime Minister said this morning, it is shocking that the No. 1 cause of hospital admission among children aged between six and 10 is tooth decay. I was criticised by the shadow Secretary of State, who said that I called our children “short and fat”; she is more outraged by my calling out the scourge of childhood obesity that her Government fuelled than she is by the scourge of child obesity itself. That is why we will act and why the Conservatives failed.