Commons Sense

House of Commons · Westminster Hall

Black Maternal Healthcare and Mortality — [Sir Gary Streeter in the Chair]

19 April 2021 · 18 other contributors · 13,283 words

Opened by Catherine McKinnell Lab Newcastle upon Tyne North

Responding minister: Nadine Dorries

NHS

Summarised by AI from the official record, so it can contain mistakes.

Read the full transcript on Parliament.uk

At a glance

Catherine McKinnell raised concerns about black maternal healthcare and mortality — [sir gary streeter in the chair] in Westminster Hall. A government minister responded.

Key points

  • Catherine McKinnell highlighted that black women are more than four times as likely to die during pregnancy or postpartum compared to white women.
  • McKinnell noted that Asian women face twice the risk of death compared to white women during pregnancy or postpartum.
  • McKinnell asked the Minister to commit to setting a firm target to end disparity in maternal deaths and to address data gaps in medical research.

Key requests to Government

McKinnell asked the Minister to reiterate whether the Government agrees with setting a firm target to end disparity in maternal deaths. She also enquired about addressing the data gap in medical research within the upcoming women's health strategy.

How the debate unfolded

MPs spoke in turn to share their views and ask questions. Here's what each person said.

Opened the debate

Catherine McKinnell Lab Newcastle upon Tyne North

Catherine McKinnell highlighted the racial health inequalities in maternal mortality, noting that black women are more than four times as likely to die during pregnancy or postpartum compared to white women. She also pointed out that Asian women face twice the risk of death compared to their white counterparts. The data masks underlying shocking inequalities, with no Government target set to eliminate these disparities. She mentioned pre-existing health conditions and complications such as heart disease and high blood pressure among black women, which are more prevalent due to existing social and economic inequalities.

Other contributors (18)
  • Abena Oppong-Asare Lab Erith and Thamesmead

    She highlighted the tragic statistics showing black women are four times more likely to die during pregnancy or postpartum, with mixed heritage women three times as likely and Asian women twice as likely. She stressed the need for an independent review and commitment to look into how such disparities persist despite understanding social factors contributing to them.

  • Angela Rayner Lab Ashton-under-Lyne

    I am concerned about the shocking disparities in maternal mortality and morbidity rates for Black women. The statistics show that Black mothers are four times more likely to die during childbirth than white mothers.

  • Anne McLaughlin SNP Glasgow East

    She expressed concern about the structural inequalities in maternal healthcare that disproportionately affect black women, noting that they are four times more likely to die during pregnancy or shortly after giving birth compared to white women. Anne McLaughlin highlighted the need for free and accessible maternity care for migrants and called for an end to no recourse to public funds rules. She also suggested adopting a universal baby box program similar to Scotland's model, which promotes health and supports mental well-being for new mothers.

  • Bell Ribeiro-Addy Lab Clapham and Brixton Hill

    Bell Ribeiro-Addy shared her personal experience of racial discrimination during pregnancy, highlighting that black women are four times more likely to die in childbirth. She cited the high percentage of near misses for African origin women at 83% and Caribbean women at 80%, emphasizing a lack of target to address this disparity.

  • Claudia Webbe

    Webbe highlighted that black women are five times more likely to die during pregnancy or shortly after childbirth compared to white women, with no target set to address this disparity. She also pointed out the disproportionate impact of the coronavirus pandemic on women from African, Caribbean, Asian and minority ethnic backgrounds.

  • Florence Eshalomi Lab Co-op Vauxhall and Camberwell Green

    The MP highlighted the higher maternal mortality rates for black women, noting that deaths in childbirth are five times more common than for white women. She emphasized the importance of addressing structural racism within healthcare institutions which can lead to inadequate care due to unconscious biases and microaggressions.

  • Harriet Harman Lab Co-op Camberwell and Peckham

    The MP highlighted that her constituency contributed the second highest number of signatures to the petition. She proposed four initiatives: clear and public monitoring, targets for reducing black maternal mortality gap, addressing health and income inequalities, and improving the delivery of care.

  • Helen Hayes Lab Dulwich and West Norwood

    Ms Hayes emphasized the shocking statistics on maternal mortality, noting black women are over four times more likely to die during pregnancy or childbirth compared to white women. She called for an independent review of ethnic disparity in maternal mortality and immediate actions such as extending maternity rights and health protections to all workers regardless of employment status. Ms Hayes also stressed the importance of addressing barriers to healthcare access for asylum seekers and women with no recourse to public funds, advocating for community-based midwifery teams.

  • Janet Daby Lab Lewisham East

    She expressed distress over the unacceptable disparity in maternal mortality rates between women from different ethnic backgrounds, citing specific statistics and calling for immediate interim changes and safeguards to protect vulnerable pregnant women. She urged the Government to implement recommendations from the Joint Committee on Human Rights report.

  • Kate Osamor Lab Co-op Edmonton and Winchmore Hill

    The MP commended the founders of Five X More on their efforts to change black women's maternal health outcomes. She noted that a black woman is four times more likely than a white woman to die during pregnancy or childbirth, underlining the need for better care and addressing racial disparities.

  • Kim Johnson Lab Liverpool Riverside

    The MP highlighted the fivefold higher maternal mortality rate for black mothers compared to white mothers, and a 121% increased risk of stillbirth. She called for urgent action from the Government to introduce an NHS target to eliminate racial disparities in maternal healthcare, including halving the number of black maternal deaths by 2023. The MP also raised concerns about pre-existing health conditions among black women, attributing these to social determinants like poverty and deprivation.

  • Lilian Greenwood Lab Nottingham South

    The stark disparity in mortality rates between black and white mothers is unacceptable. We must urgently address the systemic issues leading to this inequality by increasing funding for targeted interventions and enhancing cultural competency training in healthcare settings.

  • Marsha de Cordova Lab Battersea

    Ms Marsha de Cordova highlighted the petition that received over 180,000 signatures and expressed concern about structural racism in the health service which affects black women's treatment. She urged the Minister to address these issues by providing cultural competency and unconscious bias training for healthcare professionals, committing to improve data recording practices, and collecting maternal near-miss data by ethnicity. There is a need for a target to work towards reducing black maternal mortality rates. The Minister mentioned difficulty in recording figures by ethnicity, and Marsha asked the Minister to explain why this would be challenging.

  • Naseem Shah Lab Bradford West

    The disparity in maternity care outcomes is well known, with black women four to five times more likely than white women to die during pregnancy and postpartum periods. Naseem Shah asked why these disparities exist despite the Government's claim that structural racism does not play a role.

  • Sarah Owen Lab Luton North

    The MP stressed that black women are four times more likely to die during pregnancy or childbirth compared to other groups. She discussed the institutional nature of this problem and called for better data collection on near misses, morbidity, illnesses, and poor outcomes for black women. The MP also mentioned her efforts to support a constituent who lost his wife due to complications arising from childbirth.

  • Shaun Bailey Con Harlesden

    We need to address the systemic issues contributing to higher mortality rates among Black mothers, including socioeconomic factors and racial bias in healthcare provision. The NHS must implement culturally competent care strategies.

  • Vicky Ford Con Chelmsford

    While I acknowledge the challenges faced by black mothers, it is crucial that we also consider the broader context of maternal health across all demographics. We need a comprehensive approach that includes better training for healthcare professionals and greater investment in community-based support.

  • Wera Hobhouse Lib Dem Bath

    Ms Hobhouse highlighted the disparity in maternal health outcomes between black and Asian women and white women, citing statistics from the MBRRACE report. She expressed concern over how race affects healthcare treatment and advocated for specific targets to halve the disparity in maternal deaths among black women within five years. Ms Hobhouse also urged the Government to improve investigations into maternal death, ensure national accreditation for language support providers in maternity care, and address societal inequalities such as insecure employment that exacerbate health risks. Wera pointed out that there is evidence suggesting black women and those from ethnic minorities feel the healthcare system does not adequately communicate, leading them to miss crucial information about their health choices.

Government Response

Nadine Dorries

I thank all Members of the House who have taken the time to attend and speak in today's debate, and particularly the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for having secured the debate. Along with everyone else, I also thank the co-founders of the Five X More campaign, Clo and Tinuke, for their incredible work. Their petition to Parliament has generated a huge amount of interest and support, and their work to improve maternity mortality rates and healthcare outcomes for black British women is inspiring and brings this deeply important issue the attention it deserves. Every woman deserves to have safe care, to feel that her voice has been heard and to be an informed decision maker in her own care. The NHS is one of the safest places in the world to have a baby. Few women in the UK die during childbirth. Between 2016 and 2018, 217 out of 2.2 million women died during, or up to six weeks after, pregnancy from causes associated with their pregnancy. That equates to 9.7 maternal deaths per 100,000 pregnancies. We also know from the MBRRACE-UK maternal mortality reports that some of these deaths could have been prevented. Sadly, evidence shows that, currently, there remains a more than fourfold difference between maternal mortality rates among women from black ethnic backgrounds and among white women in England. There also remains an almost twofold difference between women from Asian ethnic backgrounds and white women. Those disparities are worrying and must be addressed, and I have heard all of the calls to do that today. However, let me address the points that have been raised by speakers today—many of which have been raised repeatedly—beginning with the right hon. and learned Member for Camberwell and Peckham (Ms Harman). We need to fundamentally understand why this issue occurs and why we have these disparities. The statistics tell only part of the story: the lived experiences of black women need to be understood, appreciated and heard for us to really gain an understanding of the full picture. That is why, last month, I announced that the Government are embarking on the first women's health strategy for England. That strategy is, first and foremost, about listening to women's voices. The call for evidence that launched on International Women's Day seeks to understand women's experience of the health and care system, and we have already seen an incredible response to it. However, women from black and other ethnic minority groups are under-represented in the responses we have received so far, and today's debate has reiterated just how important it is to ensure that the health and care system is listening to women of all backgrounds. I encourage any woman listening to this debate, and in particular women from black and ethnic minority groups, to come forward and have their voice heard. Disparities in maternal mortality rates among women from different ethnic groups have been well documented for many years. The numbers are just not acceptable, and the Government are committed to reducing those inequalities. We know that for every woman who dies, 100 women have a severe pregnancy complication or a near miss. When that woman survives, she will often have long-term health problems. Disparities in the number of women experiencing a near miss also exist between women from different ethnic groups. Because near misses are more common than maternal deaths, we can investigate those disparities at local and regional level, to better understand the reasons for disparity, to assess local variation and to identify areas with less disparity and, hence, best practice. We have commissioned the policy research unit in maternal and neonatal health and care at the University of Oxford to undertake research into the disparities in the near misses, and to develop an English maternal morbidity outcome indicator. The research will explore whether the indicator is sufficiently sensitive to detect whether the changes made to clinical care are resulting in better health outcomes. We are putting the research in. We have found a way to look at the research in order to make the differences that need to be made. We can do that by examining the near misses. What happened in those cases and in those women's experiences? What went wrong? Do the women feel that they were not listened to? Was it a matter of treatment? Was it a lack of understanding? We are committed to reducing inequalities and to improving outcomes for black women—we work at that daily. I established the maternity inequalities oversight forum to focus on inequalities so that we in Government understand what the problems are. The Cabinet Office Race Disparity Unit has also supported the Department of Health and Social Care in driving positive actions through a number of interventions on maternity mortality from an equalities perspective.

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