A major UK study has shed light on persistent and troubling inequalities in maternity care received by Black women. The report—based on responses from more than 1,000 Black and mixed-race individuals pregnant between July 2021 and March 2025—reveals systemic failings across the antenatal, labour, and postnatal stages.
Key Findings of the Study
Half of concerns ignored during labour: 45% of participants said they voiced worries during labour. Of those, nearly 50% felt their concerns were inadequately addressed.
Pain relief frequently denied without explanation: 23% requested pain relief but were refused, and 40% of them received no justification.
Widespread challenges in professional interactions: 54% encountered issues communicating with maternity staff .
Low quality care ratings and reported discrimination: Only 60% rated antenatal care as good or high quality; nearly one-third (28%) reported discrimination; only 20% were informed about how to complain .
A heartbreaking testimony underlines the urgency of reform: a mother, after undergoing an emergency C‑section, woke in excruciating pain that persisted for over 13 hours—she said she received “more support from other mothers and their partners … than from the midwives” .
Why This Matters
Black women in the UK are statistically at much higher risk when giving birth—up to four times more likely to die during childbirth and suffering higher levels of birth complications and perinatal mental health issues.
These disparities are stark and enduring:
MBRRACE-UK data shows Black women are four times more likely to die in pregnancy or postpartum compared to white women.
Institutional racism and implicit biases—such as stereotypes about pain tolerance—continue to shape care decisions and overall treatment .
The Emotional and Systemic Toll
The study’s co-founders, Tinuke Awe and Clotilde Abe of Five X More, describe the findings as a “call to action”. They highlight that Black women often bear the emotional weight of self-advocacy amid a backdrop of distrust and inconsistent care.
They note that persistent issues raised in previous years—such as ignored pain and poor health-worker understanding of Black women’s bodies—are still prevalent. However, new themes like emotional exhaustion from constant self-advocacy are now also emerging.
Political and Institutional Response
Parliamentary scrutiny: The Health and Social Care Committee is currently investigating Black maternal health. The Health Secretary has confirmed a national maternity investigation .
Political reaction: MP Paulette Hamilton (Birmingham Erdington), chair of the All‑Party Parliamentary Group on Black Health, called the findings “deeply troubling, but sadly not surprising”, demanding improved training, accountability, and culturally appropriate care.
Government commitment: The Department of Health and Social Care labelled the findings “unacceptable”, pledging that addressing these inequalities will be central to the upcoming investigation, with the aim to ensure safe and compassionate maternity care for all women.
What Needs to Change
Five X More offers several key recommendations:
- Implement an annual maternity survey targeting Black women.
- Improve training to recognise and diagnose conditions affecting Black women.
- Enhance the quality and consistency of ethnic coding in health records.
- Promote community-focused care models.
- Create accessible and transparent systems for feedback and complaints.
- Ensure better cultural competence in healthcare training
A Call to Action
Black women deserve respectful, empathetic, and clinically sound maternity care. The persistent disparities—borne from institutional bias, inadequate communication, and dismissal—reflect a deeply flawed system. Reform should centre on deliberately amplifying Black women’s voices, embedding equity into training, and fully holding healthcare institutions accountable.
This investigation isn’t just data—it represents real mothers and babies facing unnecessary hardship, pain, and risk. The challenge now is transforming commitments into tangible actions—revised protocols, staff training, and continuous monitoring—to ensure that every mother receives the competent and compassionate care she deserves.
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