Report unveils stark racial disparities in pre-pregnancy experiences demands immediate reforms for improved maternal outcomes in Black, Asian, and minority ethnic women
CREATE Health Foundation, a leading women’s health charity, has today launched new research into the pre-pregnancy experiences of Black and Asian women. The report sets out evidence-based recommendations to improve the pregnancy outcomes and maternal healthcare experiences of Black and Asian women.
The report, Understanding the pre-pregnancy experiences of Black and Asian women, investigates the extent of racial inequalities and disparities that exist in pre-pregnancy information, preparation, and care, and identifies improvements in public healthcare to tackle maternal healthcare inequalities.
With research from MBRRACE in 2022 showing that maternal mortality rates are nearly four times higher in Black women and nearly twice as high in Asian women than white women, CREATE Health Foundation’s report highlights racial disparities across journeys to motherhood in the UK and the steps to tackle them. By reviewing existing research and surveying women from white, Black and Asian backgrounds to understand firsthand experiences, the research found that:
- Black and Asian women were 1.5 times more likely to report having had an experience of feeling discriminated against by healthcare professionals than White women
- White women reported trust in the overall health services in the UK at a higher rate (78%) than Asian Women (61%) and Black women (63%)
- More Asian (74%) and Black (58%) women than White women (45%) believe that more knowledge of pre-pregnancy services would have helped them have a better pregnancy
The research also conducted interviews with predominantly Black and Asian women, which further highlighted the barriers faced in their ability to understand, access, and communicate their options when using healthcare services: 10 out of the 15 women interviewed reported feeling discriminated against, judged, or otherwise treated differently by healthcare staff due in part to their race at some point in their pregnancy journey.
One Black woman interviewed in the research reported that she found healthcare staff were less receptive to her exercising agency over her own pregnancy, stating that “it’s always a fight”. Another woman stated that she felt her experience with pain was dismissed by her midwife: “they think I’m a lunatic”.
In light of these findings, the report suggests a number of recommendations to improve pre-pregnancy provision based on the three core principles, awareness, access, and care. These include:
- Develop NICE guidelines for pre-pregnancy advice and support specifically for Black and Asian women
- Deliver ethnically specific and culturally sensitive pre-pregnancy advice
- Launch an educational campaign to raise awareness of guidelines and services via community and faith groups
- Educate healthcare professionals on how to provide culturally unbiased conversations and choices for pre-pregnancy and wider maternity care
- Lobby the government to secure improved funding for pre-pregnancy services
- Improve national data collection to understand the link between women’s holistic pregnancy experience and maternity outcomes
Professor Geeta Nargund and Praful Nargund, Trustees of CREATE Health Foundation, commented: “Our report adds to the body of evidence demonstrating unequal experiences of pre-pregnancy and maternal care for Black and Asian women. This is a call for urgent action to address these systemic inequalities and biases, and to take forward the evidence-based recommendations to ultimately improve maternal outcomes. It is unacceptable that in the 21st century, Black and Asian women in Britain are describing their experiences of health services as ‘always a fight’. We must create a healthcare system which works for Black and Asian women during their pregnancy journeys rather than against them: the time for action is now.”
Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said:
“The report highlights the need for personalised care and information, which can help ensure that women get support that is tailored to their health. It also recognises that challenges to accessing information can accumulate over time and result in lack of consultation and collaborative decision making closer to birth.”
“It is vital that women are listened to and feel safe before, during and after their pregnancy. As a College, we are committed to working collaboratively with stakeholders to ensure better outcomes for all women and reducing inequalities in care for those from a Black, Asian and minority ethnic background.”
