Black women are still disproportionately failed by…

Tara Rowe-Smith
Tara joined Social Finance in 2017 and has worked in the Impact Incubator and Health + Social Care teams, building cross-sector partnerships to achieve systemic change.

Social Finance, the Caribbean and African Health Network (CAHN) and The Essential Baby Co’s haPPIE Academy are supporting Black Maternal Mental Health Awareness Week, hosted by The Motherhood Group – an organisation sharing and advocating for the Black maternal experience. The theme of this year’s campaign is Transforming and Advancing Change.

No-one wants to address the elephant in the room that post natal depression in Black mothers is 13% higher than any other race.

Black Maternal Mental Health Awareness Week 2024 video, The Motherhood Group

There’s rarely a week that passes without a story exposing how women in England are being failed in pregnancy and birth. Last week the NHS regulator condemned two-thirds of maternity services as not meeting safety standards. The week before, Lord Darzi cited maternity as a service giving him great concern in his independent investigation of the NHS. Earlier this year, The Birth Trauma Report gave voice to over 1,300 mothers sharing their traumatic birth experiences.

*We use the term ‘women’ and ‘mothers’ in the broadest sense and include any pregnant or birthing people within this regardless of their gender identity

Poor (maternity) care is normalised and women are treated as an inconvenience.

All-Party Parliamentary Group on Birth Trauma Listen to Mums: Ending the Postcode Lottery on Perinatal Care (2024) Birth Trauma Report, May 2024

Although women and families are being failed across the board in England, it is Black women who bear the heaviest burden:

Black women are 3x more likely to die during pregnancy and the following weeks compared to women from white ethnic groups.¹
Black women are up to 6x more likely to experience some of the most serious birth complications.²
The births of babies to black mothers are almost 2x as likely to be investigated for potential NHS safety failings.³
Black women are 13% more likely to have post-natal depression. They are least likely to have access to support and follow up treatment but twice as likely to be hospitalised with perinatal mental illness.⁴

Whilst we don’t fully understand the reasons for the higher incidence of maternal mental health challenges for Black women, it’s likely linked to the higher risk of experiencing a traumatic pregnancy or birth and barriers to accessing appropriate mental health care.

Addressing health inequalities is a strategic priority for Social Finance and with our partners, we are challenging the system to dismantle systemic racist structures and work with trusted community groups to deliver personalised healthcare.

That’s why Social Finance and our partners support Black Maternal Health Awareness Week and its campaign Transforming and Advancing Change.

What Social Finance is doing

Through the Maternity Transformation Partnership we will increase investment into promising clinical and social programmes that will explicitly seek to improve the access, experience and outcomes for Black and other marginalised women and babies during their maternity care.

At our proof of concept site in Oxfordshire, the partnership is developing and scaling interventions that will contribute to improved Black maternal mental health, among other person-centred outcomes.

Nurses will support families in their homes for babies who need feeding support or treatment for jaundice, promoting better mental health and essential family bonding in the first weeks of life.
OxPredict is an innovative risk assessment tool that will support clinicians to take a more intersectional view of pregnant women to assess their risks for certain pregnancy complications and adjust their care before things go wrong.
Equal Start Oxford supports migrant women in East Oxford who are at greater risk of poor outcomes to thrive in pregnancy and early parenthood. The staff and community advocate team works alongside midwives to provide vital maternity advocacy, translation services, culturally tailored antenatal classes and early years support.

It’s slightly easier now to share this burden of responsibility that we feel, having these women who are in desperate, desperate need… it’s been really nice to share and know that there’s support available for them that wasn’t there previously.

Community Midwife working with the Equal Start Oxford team

What CAHN (The Caribbean African Health Network) is doing

CAHN was setup to address longstanding health inequalities disadvantaging people of Black Caribbean and African heritage.

CAHN has setup a Parenthood & Family Hub in collaboration with Greater Manchester Mental Health NHS Trust to provide a shared solution to the lack of education, cultural resources and understanding of formal mental health providers around the needs of Black parents and infants, before, during and after pregnancy.

The Hub is proving to be a valuable place for Black women and their families to turn for professional and peer support. A lot of their work focuses on prevention. For example, Black women are more at risk of having low iron, which not only affects the growing baby in pregnancy, but also makes the mother feel exhausted, which in turn impacts their mental health. To help women understand the importance of iron in their diet, the hub holds workshops about nutrition — giving participants a basket of fresh foods rich in iron.

I am very happy that I have found a place where I can be listened to. Hearing other women’s experiences has assured me that I am not just imagining things. Up to now I thought that I was losing it.

Mother who uses CAHN’s Parenthood & Family Hub

By working together, the NHS and CAHN are able to reach women who would otherwise be reluctant to engage with health professionals. They are also identifying opportunities for health and wellness promotion (e.g. through cancer screening, blood pressure checks and more) with education, support and advocacy that is relevant to Black women’s lives — with cultural understanding and humility build into every step.

What The Essential Baby Co’s haPPIE Academy is doing

The Essential Baby Co’s haPPIE Academy unlocks the skills and potential of communities, centring the needs of Black and brown skin women and promoting them to work alongside healthcare professionals as partners in their care.

It’s vitally important that we hear directly from Black and brown skin women to better understand their experiences of healthcare and where it can improve. However this brings real risk of women being retraumatised by reliving their bad experiences without adequate support in place. This includes community leaders who have established local support groups but don’t have the infrastructure or training to deal with some of the challenges other women will bring to them, or know how to protect their own psychological safety when supporting others.

We don’t want to strip away the essence of grassroots community groups that provide vital informal support to people who feel unseen in the healthcare system. However, we must ensure group leaders are valued and recognised for their work, whilst acknowledging its impact on their mental health.

Gemma Poole, Founder, Essential Baby Co’s haPPIE Academy

Through the haPPIE Academy, healthcare professionals and community advocates have created a course to empower individuals to amplify their voices and contribute to patient and public involvement in healthcare and innovation. The training course and support platform will help participants learn how to navigate trauma, establish boundaries, strategies for self-care and know how to access appropriate support.

Moving to meaningful partnership working

Knowing how to deliver real change can feel like an overwhelming task for midwives and other maternity staff who are working tirelessly in a broken system under constant media scrutiny.

But we believe that the partnerships we are building demonstrate the real potential for us to transform and advance change for Black mothers and their infants.

Grassroots organisations, faith groups and community leaders have the cultural understanding and the relationships to start a conversation. They have deep knowledge of the problems their communities face and often, have pretty simple and low-cost solutions to address root causes and start to break the cycle of poor health outcomes.

By providing advocacy, peer support and help to navigate the NHS, community-based initiatives can provide a bridge to vital services as well as non-medical healing that can help Black women process their personal, community and intergenerational trauma. We must acknowledge the value these groups bring to supporting better health and wellbeing and ensure resources flow through the system so they are adequately supported and resourced for their contributions.

A reset in our health system that fosters meaningful, reciprocal partnerships between NHS and communities, is the only way to bring about meaningful change in our maternity services, that in turn improves outcomes for all women giving birth.