Analyzes show that black women in England suffer more serious birth complications

Black women are up to six times more likely to experience some of the most serious birth complications during a hospital birth across England than their white counterparts, with the figures described as ‘stark’ and disheartening, according to analysis.

Black women made up 26% of those who experienced the birth complication preeclampsia during labor on top of chronic hypertension, despite making up just 5% of all births in England, according to a Guardian analysis of NHS figures for 2022-2023 .

They were six times more likely to experience this pregnancy complication than their white counterparts, who made up 47.2% of these cases, despite accounting for 70% of all deliveries.

Preeclampsia is a serious pregnancy complication that causes high blood pressure and protein in the urine, and affects between 1% and 5% of pregnant women in the UK. The condition can lead to serious complications for mother and baby. Superimposed preeclampsia occurs when preeclampsia complicates another existing condition, such as high blood pressure.

Black women overall were 1.5 times more likely to develop preeclampsia than their white counterparts, and were also overrepresented in birth complications related to high blood pressure, accounting for 16% of these cases.

Globally, preeclampsia affects up to 6% of all pregnancies and causes approximately 500,000 fetal deaths and 70,000 maternal deaths annually.

Experts said that to address disparities in birth complications, existing health inequalities, such as why some ethnic groups are more likely to have pre-existing conditions such as high blood pressure, must be addressed.

Black women in Britain are almost four times more likely to die during pregnancy and childbirth than their white counterparts, while black babies are twice as likely to be stillborn.

Prof Asma Khalil, the vice-president of the Royal College of Obstetricians and Gynaecologists, said structural racism and the unconscious biases of healthcare professionals could be a factor contributing to the inequality.

“The figures are striking and show inequality, but unfortunately I am not really surprised,” says Khalil. “We know that women from black backgrounds have a higher risk of preeclampsia and high blood pressure.

“Why this is the case is multifactorial, and I am convinced that to find the solution you also need a multidisciplinary approach. Healthcare professionals and doctors cannot solve the problem alone. We need to work together with public health clinicians, policy makers, and the government needs to prioritize and invest in this.”

Bell Ribeiro-Addy, Labor MP and chair of the Black Maternal Health All Party parliamentary group, said: “These stark figures highlight the persistent inequalities black women face at every stage of the birth journey.

“Given that black mothers are 3.7 times more likely to die from pregnancy or childbirth, the government must urgently set a binding target to end this disparity in maternal mortality and health outcomes for black women in the to improve maternity care.”

Dr. Anita Banerjee, a midwife with expertise in high-risk pregnancies, said the figures were “disheartening” and that health care professionals building trust with marginalized communities was essential to reducing health inequalities.

Banerjee said: “We say the NHS is free at the point of contact and everyone should get the same. Why is it that if you are from a black background, the risk of complications seems to be higher, especially in relation to maternity for preeclampsia.”

“What we have seen during the pandemic is the importance of our cultural competency and understanding of the women we serve, and secondly, their trust in us. We cannot prevent everyone from getting preeclampsia, but there are certain people who suffer from it before.

“It’s difficult when you’re serving a population that isn’t used to receiving as much information or understanding because they don’t feel like they trust us. It can be quite difficult.”

An NHS spokesperson said: “The NHS is fully committed to ensuring that all women receive high-quality care before, during and after their pregnancy – all local maternity and neonatal systems have now put in place action plans to ensure that care is fair to all mothers. babies and families, with staff having access to inclusive clinical training resources to support the care of black and dark-skinned women and babies.

“As these figures show, further progress is needed. That’s why the NHS is investing £10 million this year to enable targeted action on inequality, including providing more holistic support for women living in the 10% most deprived areas of England we know of. are more likely to experience adverse effects during pregnancy and birth.”