THE Black Maternal Health report, published this month, looked at ‘Disparities in outcomes for ethnic mothers’. Any study that looks for ways to improve health services, and any investigations that try to determine causes for high mortality rates, are commendable and welcome. It is important, however, that the findings and conclusions are aimed at increasing and optimising positive outcomes and are not, instead, wielded as big, accusatory, race-coloured sticks to beat the health service with.Unfortunately for the NHS and the public, newspapers, TV stations and social media rushed headlong down a race-lined rabbit hole when discussing the report. Media spin was, frankly, irresponsible and divisive. It gave more importance to skin colour and accusations of racism than discussions about the practical steps urgently required to improve maternity care for all. A loss is a loss, whatever your skin colour.Figures in the report showed that improvement was needed. But, an important 43-page document was reduced to sound bites, hand-wringing and finger-pointing in the search for headlines and sensationalism. While figures and stats were quoted in the media, accompanying facts did not receive the same attention. One of these facts stated that “1 in 9 of the women who died during or up to a year after pregnancy in the UK were at severe and multiple disadvantage. The main elements of multiple disadvantage were a mental health diagnosis, substance use and domestic abuse”. Another stated that “60% of women who died in 2018–20 during, or up to six weeks after the end of, pregnancy had pre-existing and medical problems. Black and Asian with pre-existing conditions were over-represented in that group”.
There were also findings that pointed to “Women living in the most deprived areas continue to have the highest maternal mortality rates”. Another found that “Cardiac disease remains the largest single cause of indirect maternal deaths, followed by neurological causes (epilepsy and stroke)”. See how it works? Anyone can pick and choose statements to highlight, and which ones to ignore. If you are going to accuse an organisation of structural racism, expect some pushback from those of us who prefer to see the whole picture, and not just the edited black and white bits.Pre-existing medical problems play a huge part in hospital procedures. When you add, into the mix, the physical strain and mental stress of carrying a foetus to full term, onto women who are medically compromised, problems ensue. Dr Matthew Jolly said in the report that “there were certain genetic predispositions to some conditions. He also pointed out that “many of these factors were beyond the scope of what maternity services alone could act on”. Were these statements amplified after publication of the report? In short, no. Did anyone in the media look at, or talk about, whether women who have had multiple pregnancies face increased risks pre-and-post natal? Again, no.What we heard, instead, over and over again, was that Black women faced systemic racism. Painkillers not administered? Structural racism. Explanations not immediately forthcoming? Racism. Many of the hospital staff in our big cities could be described as non-white and, in some wards, they outnumber staff who are white. Which begs the question, where is the racism coming from? Are we calling them racists? I know of many wonderful, dedicated and hardworking doctors, nurses and midwives, of all colours and creeds who, first and foremost, see the person and not their colour. Apparently, it should now be race and colour first.The report is a mixed bag. The various discussions about its findings, unfortunately, gives the impression that the causes for miscarriages, and the loss of loved ones, in white families have not been included in the study. Yes, I know, the clue is in the name of the report. But, if you put race front and centre, expect those who feel ignored and overlooked to believe that the focus and attention is taking a direction that is heading away from them.Texts in the report that says “there were some areas where the NHS as an organisation could be considered structurally racist [….] medical understanding of women’s bodies was based around a European white woman’s body as being the default, and that teaching around recognising health conditions in babies was too white-centric” are counterproductive and have a whiff of censure about them. In case it slipped everyone’s mind, we happen to LIVE in a EUROPEAN country where the majority of the population is white and authors of medical books are white. Complaining that teaching is “too white-centric” is divisive and damaging – the antithesis of the colourblind anti-racism approach recommended by Don’t Divide Us. It also insults the intelligence of those who have spent years studying, training and working. They are fully aware that pictures of human bodies in medical books are a guide. If our Universities and hospitals have chosen candidates based solely on merit, and not race or sex, then these professionals have fought off tough competition to gain entry to an intensive training programme.How many races and ethnicities are medical professionals supposed to expertly recognise? There is a bottomless DNA pool that awaits anyone who talks loftily about ‘white-centric’ thinking and structural racism. Or are we supposed to lump all non-whites into two blocs, i.e. Black and Ethnic, to fit the narrative? It is imperative that the media stops zeroing in on just colour, race and religion when discussing a report that is trying to help the vulnerable.As an Asian immigrant, ex-nurse and mother, I find the constant barrage of accusations about systemic racism depressing and unhelpful. If we genuinely want an outcome that will help all pregnant women, we have to get the right message across, be wary of the language used, look deeper into the stats and ensure that guests, invited to discuss findings, are not just there to bang the race drum. Pregnant women and babies are depending on all of us to work harmoniously together. Let’s give the shoulders a break and leave those big chips in the sluice room where they belong.
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