Black women are five times more likely to die during pregnancy, according to a recent report from Mothers and Babies Reducing Risk Through Audits and Confidential Enquiries (MBRRACE-UK).
One of my immediate emotions was a sense of relief. For so long, black women in the UK have had to lean on the statistics of the US to help validate their own stories of pregnancy and childbirth, and how these compare to their white counterparts. Black women now have the data to sit alongside what we already know.
I think we are long past putting this wholly deplorable outcome on pre-pregnancy health risks and social economic circumstances. It’s time to say it like it is: this is happening due to racial bias. Since slavery the falsehood that black women can endure more pain than any other woman is a rhetoric which has been sold tirelessly. Prior to giving birth, I’d never spent any time in hospital so wouldn’t have been able to add to this conversation; but everything changed after the birth of my first child Esmé-Olivia.
Whilst the majority of the pregnancy itself was seamless, there were times I went to A&E with a feeling that something just ‘wasn’t right.’ I noticed that expectant white mothers seemed to be listened to in more depth and with a sense of empathy (and this was only in the waiting area). This seemed to be missing in my care. Despite this awareness, I didn’t have the mental capacity to give in to what I assumed was possibly my overthinking things.
But when it came to the birth, and the hazy days which followed, it became clear to me that I was being treated as if the pain I was experiencing was only in my head.
During the induction process, I was continuously told that my verbal reactions to the pain being caused by the hormone they hoped would encourage labour were ‘too much’. Conveniently it wasn’t until my husband left to run home and shower that I was told that my waters would be broken. During that process, I was not supported and had to endure the experience alone. After 19hrs of induction I only dilated to 1cm and I specifically remember hearing the surgeon ask a colleague if they could ‘hurry this along as he was supposed to be home an hour ago.’
Still, I was in no physical state to stand up for myself. It was three days after my c-section when I noticed that my c-section incision seemed to be swollen and I kept sweating through to the mattress. I was continually told that I was ‘worrying too much’ and everything would be fine. A midwife who had come on a home visit remarked: ‘Women like us have been through too much to let a little childbirth keep us down.’ By ‘us’, she meant black, and the rest of her statement was a polite ‘you really are being a bit soft’.
So as horrific as it was, when I awoke after falling asleep with Esmé on my chest to find she had wriggled down and put pressure on my c-section wound, which in turn made the 330ml worth of infected pus escape from my body, there was a sense of relief, not just physically but mentally. Finally, five days after giving birth, health care providers and professionals would be forced to admit that my feeling that things had not been ‘quite right’ weren’t only in my head. Even though I was rushed back to the hospital with acute sepsis and would be parted from my newborn far longer than expected, I felt like I had won. I now had evidence that something wasn’t right. Upon reflection, I see how lucky I am. As we now know, there are many more black women who die because when they speak about how they feel, they aren’t believed.
Whilst this has always been happening in the UK and the US, the collection and publication of data means that many voiceless women are now more able to share their stories, and they have. None more popular than Serena Williams. Here is a superstar athlete, renowned for her strength and grace on and off of the court, who found that even her celebrity and cash flow almost couldn’t prevent her from being a statistic. Having suffered from blood clots before, she knew better than anyone that something wasn’t right after giving birth to her daughter and yet she had to fight to be believed.
Celebrity aside, more often than not, I am never more than three friends away from hearing a horrific birthing experience specifically related to a black woman. One of my friend’s voices dips low as she recounts being given an episiotomy before the anaesthetic was able to work and then politely being told that they would deal with her pain later. Sadly, some black women don’t even have the weight of their newborn in their arms to quell the ill-treatment they have suffered. Another friend used her social media platform to share how she was treated poorly when she suffered a miscarriage. And on it goes.
But we are perhaps beginning to see some light at the end of the birthing tunnel. Not only do we have data to support the quiet knowledge that more black women die in childbirth in the UK than any other race, but we are now having a more public conversation about the private belief that black women don’t feel as much pain as other patients. To further understand how this notion ends up being acted upon, we must listen to those working within that system. Earlier this year Chaand Nagpaul, the first non-white doctor to lead the British Medical Association said: ‘The NHS is subconsciously racist and routinely overlooks ethnic minority doctors for senior posts’ and that ‘patients were being deprived of the most skilled clinicians because of an entrenched bias in the system.’
Now it doesn’t take a genius to work out that if this subconscious racism effects the working order of the NHS, then it is in no doubt that it in some way will also affect how doctors interact with patients.
All of these hurdles and biases leave many expectant black mothers wondering if it’s worth speaking about their worries or pain at all. Many second time black mothers labour at home as long as possible to avoid ill-treatment or unnecessary intervention. Which ironically, in turn, may result in them needing emergency treatment and intervention. Hopefully, the recent findings encourage change. Hopefully, the data helps black women make their point without being seen as problematic or needlessly complaining. Hopefully, black women get the support they so desperately need. Here’s to hoping.
Candice Brathwaite is a presenter, writer and the founder of Make Motherhood Diverse. She is also a supporter of Pregnant Then Screwed and will be speaking at their live event in January.