On 11 November, at almost 1am, the House of Commons and House of Lords Joint Committee on Human Rights released a report on racism in the UK. The report, titled: ‘Black People, Racism and Human Rights’, presents the findings of an inquiry spurred on by the Black Lives Matter protests after the tragic killing of George Floyd in the U.S. The report covers a wide range of racial inequalities present in the UK, including the issue of maternal mortality among BAME women.
According to the report, the death rate for black women in childbirth is five times higher than for white women. Mixed ethnicity women are over three times more likely to die in childbirth and Asian women are two times more likely – and these rates appear to be increasing year on year.
The report also points out that despite the fact that these disparities have been visible in the data since at least 2013, in terms of policy, appropriate attention has only been paid to them recently.
The NHS’ Maternity Transformation Programme Better Births that began in 2016 included no commitments to better support women from Black, Asian and ethnic minority (BAME) backgrounds. It wasn’t until 2019 when the NHS Long Term Plan was published that commitments were finally made ensuring that by 2024 three quarters of pregnant women from BAME backgrounds would receive care from the same midwife before, during and after they gave birth. In March this year, this commitment was repeated in the review of the Better Births programme – however it was the only specific recommendation made to help BAME women.
The COVID-19 pandemic has only highlighted these pre-existing inequalities for pregnant BAME women and the Chief Midwifery Officer, Professor Jacqueline Dunkley-Bent, has formulated a four-point action plan to provide additional support for pregnant BAME women during the pandemic and has requested that these actions be implemented urgently.
One of the main problems recognised as contributing to the disparity in maternal mortality is the lack of representation of BAME individuals in clinical research trials. Historically, white males have been used as the default subjects – leading to culturally incompetent diagnostic tests, services and treatments. However, the lack of representation in clinical trials contrasts tellingly with the high prevalence of black and other ethnic minority women used in exploitative medical research.
Dr James Marion Sims, considered to be the ‘Father of Modern Gynaecology’, carried out his experiments in gynaecology, including the testing of the vaginal speculum, on enslaved black women without the use of anaesthesia throughout the 19thCentury. Then in the 1970s, Harvey Karman developed the ‘super coil abortion’ method in which coils were inserted into the uterus causing an irritation that would lead to the expulsion of the foetus. The first trials of this method were carried out on Bangladeshi rape victims, sponsored by the International Planned Parenthood Federation and generally resulted in high rates of injury to the patients.
And the list goes on – these are just some examples of the medical profession’s progress at the expense of vulnerable populations. In an article published by the British Medical Journal, Professor Gurch Randhawa said that: “unless all ethnic communities are included in research, the medical profession will never be able to develop culturally competent diagnostic tests and services – and therefore can’t deliver true equity in healthcare”.
To read the full report visit: https://committees.parliament.uk/publications/3376/documents/32359/default/