The fifth annual MBRRACE-UK report: Saving Lives, Improving Mothers’ Care was published this month.
While the number of women dying as a consequence of complications during or after pregnancy remains low in the UK (fewer than 10 of every 100,000 pregnant women die in pregnancy or around childbirth), the report highlighted striking inequalities: black women are five times and Asian women two times more likely to die as a result of complications in pregnancy than white women and urgent research and action to understand these disparities is needed.
Failure to provide equal care for women from these groups was identified as far back as 2008, when the Health Care Commission’s report Towards Better Births showed that women of Black and Asian origins were less likely to be booked within 12 weeks, they felt they had less choice as to where to have their baby and they were less likely to have a scan at 20 weeks. Furthermore, ‘they had less confidence in the staff during labour and birth and were more likely to be left alone and worried by it.’ (Healthcare Commission, 2008 pp. 78).
Organisations such as the BME Health Forum undertook to explore these inequalities, but a cohesive national strategy was not implemented.
In 2016 the National Maternity Review culminated in the publication of the Better Births report, which again highlighted disparities in care, and made a series of recommendations, which have not to date been universally implemented.
As doulas we support all birth choices and work in all birth and postnatal settings, with families from all backgrounds and walks of life.
As an organisation Doula UK has acknowledged its own shortcomings around understanding unconscious bias and issues of prejudice in our ranks. It is our commitment as we enter our eighteenth year in 2019 to train our volunteers and educate our wider membership so that we can all identify and challenge unacceptable or inadequate treatment and shortcomings in clinical and social care whenever we encounter it, in our privileged position of being with families throughout pregnancy, labour and childbirth, and postnatally.