MBRRACE 2019

So, the MBRRACE report was finally released after being put in ‘purdah’ (a problematic phrase – think appropriation) and having an embargo on the results. 

What we’ve learned is that things are not improving for Black women and their babies. In fact, things are worsening with Black babies and their outcomes.

So, once again, the caveat. The rates of maternal mortality are very low, but within that, the rates for Black and Asian women are higher than those for white women. By now, you should know that Black women are five times more likely to die than white women. 

What I’ve read in the report is a shifting away from racial bias. Now, we all know that that is not the whole issue, but it is an important one. We need to remain clear about the intersection of bias, care and pre-existing health conditions. If we know about the pre-dispositions, what are we going to do about them? Once again there is a call for more research to see what’s going on. This is great, but we have lots of research and we have not begun to act on the results. I do question the lens through which we do the research. If the implicit bias isn’t confronted and dealt with, what new information with the research bring us. We will remain in the ‘blaming of Black bodies’ mindset and nothing will change.

We are looking to continuity of care. Funny how it’s taken a decade to acknowledge how incredible the Albany Midwifery Practice was and to decide to put its principles into place. Whilst continuity of care is important, for all women, how will it help Black and Asian women when their care has the nuance of implicit bias?

I recently supported a couple who called me to sit by the bedside for the entire shift of their named midwife. The midwife did not hide her disdain for my client, who had birthed her baby the night before, until I arrived. That’s not a situation any person should be in. These were those first hours of parenthood. They should have been about snuggling with the baby and learning to become a new family. Love, care and dignity should have been what she received from the midwife. It took the best part of ten hours before a nice word came from the midwife’s mouth. 

This is why continuity of carer, without implicit bias training, may not work and is something that we need to remain aware of.

The report shows us that cardiac disease is the highest cause of death and suicide is second. These, rightly, need investigating, alongside the reasons why Black and Asian women are at higher risk than white women. We cannot ignore this, and we do need to take action. 

As we move into 2020, we see that there is still a lot of work to do. For you, that might mean more listening and learning, or it may mean becoming a louder voice and joining with other activists. Whatever it means to you, you have to act. Black women are dying and it remains unacceptable.