Black, Asian and Minority Ethnic maternal women are dying during the perinatal period at an alarming rate. Their voices and experiences need to be quantified in order to make changes that keep them and their infants safe.
Maternity engagement strategies rarely do what it is they say they are doing – that is engagement. If they were reaching the most vulnerable, we would not be appalled by the statistics that came out of the recent MBRRACE report (2018) that Black women are 5 x more likely to die in child birth than a white woman and Asian women are 3 x more likely to die and that suicide is one of the leading causes as to why women are dying during the perinatal phase.
The recent MBRRACE-UK report (2018) states that Black women are 5 x more likely to die in child birth than a white woman and Asian women are 3 x more likely to die and that suicide is one of the leading reasons why women are dying during the perinatal phase.
Real maternity engagement can help bring real experiences to the statistics
What does this mean? Why is this happening? I hear professionals cry out in their professional spaces. I have yet to hear them say ‘let’s do something about this, let’s really find out why and address this. I have heard them say things like – maybe its where they come from, maybe it’s their lifestyle before and during pregnancy that has this effect. They are overweight, they are smoking, they are in domestic violence relationships. While this may be true of some BAME women it begs the question as to why BAME women, who were essentially healthy pre-conception and during their pregnancies are showing up in the same statistics alongside the fact that BAME women with higher socio-economic status are also in these stats
This thinking in professional spaces basically blames the women and takes the focus away from really interrogating the data – just going out and asking them what is happening, what their experiences are of maternity care as well as getting the health professionals to question themselves as to the kind of care they are giving is there any bias based on their own isms? We need to work honestly and collectively to get these statistics reversed instead of increasing each time the report comes out.
It really is as simple as going out and asking women about their maternity experience. Go to where they are, don’t invite them to your hospital meetings for “You cannot heal in the same place you got sick” – Unknown. Don’t ask them as soon as they have had their baby or even up to 6 weeks after for their honest opinions – for some women it takes a bit of time to process a whole experience and this is when they are at their most vulnerable. As I said, go and find them wherever they are, make it a useful experience – give them some hope that things will get better.
“You cannot heal in the same place you got sick” – Unknown.
I urge Clinical Commissioning Group’s and Hospital Trust’s to do some real engagement – don’t just tick a box!
I am a community engagement specialist – I spent most of my career in NHS and Local Authority with a community engagement remit and yes, at times it was a tick box exercise. Tick boxing is the best way to disempower communities and lose their trust in the same structures set up to support them.
This is my basic manifesto to the CCG’s and Hospital Trusts as well as Social Care working with women and families in the perinatal phase. Even with Maternity Voices Partnerships (MVPs) there is much more to be done.
· Go to where they are
· Give them a reason to engage
· Use local skilled up women to assist you
· Collect their experiences and match it with the numerical data
· Don’t make a report that sits on a shelf gathering dust - do something with it
· Create policies around the experiences through co-creation and co-production
· Do some work with health professionals on racial and cultural bias
· Create culturally safe work environments that support staff to do the best they can
What am I doing about this?
I am a doula and perinatal engagement specialist, as well as a Mental Health First Aid Instructor and a health promotion activist. I have trained with a Reproductive Justice specialist Abeula Doulas and Birth Educators Red Tent Doulas. Each time I see something wrong, be it a poster or text, each time I hear a story of mistreatment of BAME or vulnerable women I write to the trust or I gather a group of women to lobby. I can no longer just sit back and watch these things happening to maternal women. There has to be better engagement.
I have set up the Maternity Engagement Action programme. Action denoting that the situation is urgent and immediate action is needed.
What can you do?
Please come and join the Maternity Engagement Revolution – help spread the word, if you see it call it out. Ask a new mom how she’s really feeling, don’t be judgmental, be patient and give her practical help. Above all show her you love her and you care about her.
If you have a pregnancy, birth or postnatal story or you want to do some engagement with BAME perinatal women and families please get in touch.