Uni academic calls for change in maternity care to address inequalities

Women from BAME backgrounds experience obstacles during pregnancy and birth finds new research by midwifery lecturer Sarah Chitongo

AT THE end of 2018, Sarah Chitongo was just one of six people in the UK to win a Mary Seacole Award. The only midwife amongst the six winners, Chitongo used her award to investigate the experiences of midwives caring for women from black Asian ethnic minority groups (BAME) in high dependency units within London hospitals.

Her research, which was published earlier this week (Oct 1) finds that BAME women experience many challenges when they are pregnant and major changes are needed to address this.

The difficulties are mainly attributed to lack of continuity of care, stereotyping, ineffective translation services, difficulty in accessing services and a lack of cultural competency training.

“Being pregnant and having a baby should be a joyous time and in a highly developed country like the UK it is not acceptable that a specific group of women should be at such a disadvantage,” said Chitongo,.

The qualitative study explores midwives’ experiences of caring for high risk BAME women against a backdrop of evidence that reveal that this group have significantly higher maternal and perinatal mortality rates compared to their white British counterparts. 

A 2018 study concluded that overall 40% (5 times higher than in white British women) all direct maternal deaths occurred in women from BAME groups. This is especially worrying given they accounted for less than 20% of residents in England and Wales during the same time period. Along with an increased risk of maternal death a study conducted in 2013 concluded that mothers of black ethnic origin were twice as likely to have a stillbirth than mothers of white ethnic origin.

The study involved interviews with twenty midwives who had recent experience of caring for women from BAME groups who were at high risk.

While the research was undertaken at just one NHS Trust and will not represent all midwives, it does provide invaluable insight into the experiences of women whose voices often go unheard.

BAME communities now make up 14% of the UK population and non-UK-born communities continue to grow within the United Kingdom, increasing the ethnic diversity of the general population. In 2017, there were 486,417 live births to women born in the UK and 192,651 live births to women born outside the UK.

Commenting on the study, Chitongo said: “Given the number of BAME women who will give birth here is likely to rise it is essential that the disparity in their maternity related health outcomes are addressed. We need to be proactive to ensure their health and their babies’ health is protected.

“Investment is urgently needed to improve continuity of care and translation services. It is also essential that cultural safety and unconscious bias training is provided for all staff along with the development of community hubs. I have put these recommendations forward to the Chair of the Women’s Health Select Committee, Rt Hon Maria Miller MP. Hopefully this report will revise policy and be disseminated widely.

“Being pregnant and having a baby should be a joyous time and in a highly developed country like the UK it is not acceptable that a specific group of women should be at such a disadvantage.”

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