Untold stories: the 'Strong' Black women in childbirth

Black women are four times more likely to die during childbirth, pregnancy and after birth than their White counterparts. However, Black women only make up four per cent out of over 2.2 million women giving birth in the UK each year, according to the latest MBRRACE-UK report 2020 (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries). Three Black women share their journeys within pregnancy and childbirth, with one of the women talking about losing her friend. What is the government doing to support this group? Is it getting better or worse? Deborah Brown investigates.

By Deborah Brown

Being pregnant and giving birth has its risks and complications with some of those risks leading to an unfortunate death among mothers. Although, Black women have the highest rate. Many factors affect the high mortality rates among Black women in the UK. One of the issues is biases in the healthcare system towards this group due to racism, being female and stereotypical beliefs. Other issues involve high blood pressure, obesity, social-economic status, and diabetes which are prevalent within Black women and Black people as a whole.

The ‘strong Black women’ is a stereotypical term that means Black women are strong enough to go through anything. This term originates from decades of stereotyping within television and books. Although it could come across as a positive connotation it can have its negative impact as well. This is because in scenarios where Black women’s lives are at risk and in need of support it does not benefit them if professionals have that perception at the back of their minds.

During the 18^th century, enslaved Black women’s bodies were used involuntarily to test medical practices in gynaecology by Dr James Simms known as the ‘father of modern gynaecology.’ This is because it was believed that Black women did not feel pain so during that time procedures were performed on Black women without anaesthetic and once anaesthetic was finally introduced Simms would then perform on White women also. Simms invented the vaginal speculum which is a tool used for dilation to examine the vagina.

Although not every Black woman has had a terrible experience with healthcare professionals it is evident that there is a history to the treatment towards Black women.

According to the MBRRACE-UK 2020 report, Marian Knight, lead author for MBRRACE-UK and professor of maternal and child population health at the University of Oxford said:

“Systemic biases prevent women with complex and multiple problems from receiving the care they need. This needs to be addressed urgently, particularly since the impacts of social and ethnic inequalities, multiple disadvantages, and epilepsy are likely to have been amplified during the covid-19 pandemic.”
Data supplied by MBRRACE-UK report 2020.

Idiel Muse

“Make sure to do research, trust yourself and if something’s wrong go and check it out because we should not be dismissing anything.”

The 24-year-old, full-time mum, online business owner, Idiel Muse comes from Djibouti and lives in London with her partner and 19-month-old daughter, Cataleya.

Muse’s Ghanaian friend from school named Shirlene died at the age of 21 at Northwick Park hospital in London after giving birth.

In 2017, she had her child by a Caesarean section. After birth, she started to develop a migraine and she was not able to see. When Shirlene got to the hospital she was in a coma, and it led to her death. The care she was receiving from the Midwives Idiel described as “wild”. Idiel said Shirlene had always had migraines, but it had gotten worse and when she would report it to the medical professionals, they gave her tablets but did not investigate it.

Idiel expressed: “If they listened to what she was saying and took the MRI scan and found the issue before then this whole situation wouldn’t have happened.

“It was scary how fast it happened when my friend called me and informed me that she was in a coma, but she died before I had a chance to see her.

“It was very heart-breaking and didn’t seem real. I was in denial but when I saw her in the casket on the day of the funeral my mind was gone.”

The mother of Shirlene filed a case to sue the hospital and won.

Idiel shares how she is scared to get too close to people but she is trying to heal.

Idiel described Shirlene as “hilarious, perfectionist and spontaneous.”

Idiel shares her experience

Sharron Owusu

“Motherhood was such a lonely place for me, didn’t feel like I had much support. I lacked that so I tried to recreate that by sharing my experiences.”

The 26-year-old, Ghana-born, Sharron Owusu has a child named Avi who is 6 years old. Owusu graduated with her first degree in Education and Social Policy and is currently a Student Midwife. She is also a makeup artist and established the Mother’s Room page on Instagram in 2019.

The single mother said at 19-years-old she found out she was expecting whilst she was in her first year of university. Owusu arrived at her exam way before the time, so she decided to take a pregnancy test as she noticed she had not had her period in a while and then found out she was pregnant. Owusu said:

“My mind literally went blank. It was a crazy experience.”

The pregnancy was kept a secret from her family and friends and only her boyfriend knew at the time. She made excuses as to why she was in and out of the hospital and what made it easier was that her family travelled back to Ghana without her due to her regular hospital appointments.

She felt she had an understanding with her Midwife because she also came from an African background.

Owusu expressed she felt her pregnancy was a mistake due to the pressures of her reality and the idea of there being “no room for error”. She came from a Christian background and her parents expected a certain level from her to get good grades, go to university and she was the first out of her siblings to attend.

“I felt like I was undermined and that a lot of the doctors would look at my age and presume that I don’t know what I’m doing or that I was of a lower reading level.

“Imagine something’s happening in your body and the doctor isn’t telling you.

She was told that everything is in her notes but a lot of the time she could not understand it because the writing looked like “gibberish”.

The doctors found out her daughter had a heart condition, so her care was transferred to Great Ormand Street in Central London for scans once a week to check the progress of her heart.

“I don’t believe I received adequate care. The first couple of days was fine and I was put on the antenatal ward. They would come around to check my blood pressure but not tell me information apart from them saying her heart was beating fast.

“They would tell me to get ready and pack my stuff for labour ward and due to my daughter’s condition, they wanted to deliver her at 32 weeks. I would come down with all my stuff and get told it’s fine now we’re going to wait.

“I was given medication to help her lungs develop quicker. I was in limbo. Her heart rate was so unstable. That continued for five to six weeks. I had to drop out of uni as I couldn’t continue with 2^nd year.”

Owusu expressed that it was a depressing time and after two weeks of being in the hospital she had difficulty breathing, started to get a cold which included a chest infection and a fever. She was moved to intensive care but was not made aware.

“I felt like I was going to die. A nurse said we are going to give your medication and hopefully, your pneumonia is going to get better, so I contracted pneumonia from being in the hospital.

No one disclosed to her what the condition was. A nurse in passing told her. There were times the needle in her wrist needed changing at the appointed time, but it would go over.

“That point I realised these people don’t care about my welfare and me. I was in the hospital surrounded by people and around doctors, but I felt like I was on my own. When I was in intensive care, I spent hours in a room by myself.

“Being a young black girl, they probably had a stereotype of me in their mind. I cannot sit here and say to you that if I wasn’t a married, middle-class white lady something would have been done by now, what makes me less important? After those experiences, increased my determination to work in the NHS and hopefully improve these statistics.

“As a student midwife, I’ve had the privilege to work on the frontline. I think culture plays a big part, women have said they don’t believe in going to the hospital/medical convention, language barriers and trust issues between people from ethnic backgrounds and the NHS.”

Owusu attend a hospital out of the area because she had family who worked in the hospital close to home.

In November 2014 Owusu could not hold onto the secret any longer and Avi was due in January 2015. She realised it was time to tell her parents and spoke with regret:

“My parents were disappointed that I felt I had to keep it from them. There were things in my pregnancy I could have learned from my mum.”

When Avi was 8 months old, Owusu went back to university to finish her degree and continue her journey to becoming a Midwife.

Morenike Okoma

“It was only until I gave birth I really thought about my experience and realised that I was mistreated.”

Newlywed, 23-year-old, Content Creator, Morenike Okoma from East London had her baby, Amara, last May during the pandemic.

Okoma had to attend to frequent hospital visits due to having a small bump as she did not start showing until 8 months within her pregnancy. Okoma said: “The nurses were attentive and curious about things.” They thought she was too small so that is why she had regular check-ups.

Leading up to her labour experience was fine but as she got into and during the delivery, she began to question what was going on. Okoma expressed: “It was a lot harder because I had to do it by myself and during my labour experience I wasn’t actually heard.” Okoma’s birth was during the pandemic at her home so nurses could not stay in the room with their patients.

Okoma was induced due to her baby being two weeks late and her waters broke a few hours later.

“I was explaining I was in a lot of pain but each time I’d explain it they said it’s fine just breath through it and relax.” She would ask for pain medication but received it two hours later. They firstly gave her paracetamol, but she was already beyond the pain by the time they came back with the painkillers, so it was not enough for her.

“When you’re in pain there’s only so much you can verbally say because when it comes to contractions the pain is unbearable especially when you’re doing it without help medically wise.”

The 23-year-old articulated how it was difficult to communicate how she felt and what she wanted as she felt “unheard throughout the whole experience.

“It was a lot harder because I had to do it by myself and during my labour experience I wasn’t actually heard.”

Four to five hours after they gave her an injection to calm the pain.

Okoma went to the toilet and thought she was defecating but didn’t know it was Amara coming out. The student midwife checked her pulse and told her it was the baby coming.

Okoma was then told to hold the pushes and the nurses called her husband down then 30 minutes later and she arrived.

“It was only until I gave birth I really thought about my experience and realised that I was mistreated.

“If a pregnant woman who is in labour is telling you she is in pain, it’s not something you brush over it’s something you paid attention to.”

Okoma was not given any gas and air or had the opportunity of getting an epidural and in her birth plan, she specifically said she wanted an epidural. She was told to eat even though she expressed she physically cannot, but the nurse was persistent and when she ate the chip Okoma vomited immediately.

Zeenath Uddin, Head of Quality and Safety at the Royal College of Midwives (RCM) and leader of RCM’s Race Matters campaign shares her knowledge, views, and experience on Black and ethnic minority women’s treatment within the maternity wards and why Black women have an increased mortality rate compared to their counterparts. Uddin is of Asian descent, has been a Midwife for 16 years and has worked in all areas of Midwifery.

The government has made their steps by introducing the NHS long term plan to reduce health equalities and to improve equity for BAME women. They aim to understand why mortality rates are higher and consider how to lower the rates for a better outcome for Black and Asian women. By 2024, the government aims for 75% of women from BAME backgrounds and those living in deprived areas to receive a continuity of care from their Midwives. By 2025, the government hopes to achieve 50% reductions in maternal mortality.

There has been a slight improvement because in the MBRRACE 2018 and 2019 report Black women were five times more likely to die compared to White women. This clearly demonstrates a step in the right direction and with the government plans and support by community groups and campaigners coming together, it shows a benefit of the change to dig deep into the root of why Black women have a higher rate of maternal death.

The Race Equality Taskforce is a campaign organised by the Royal College of Obstetricians and Gynaecologists (RCOG) in collaboration with campaigners who are dedicated to supporting Black women, Five X More launched their five steps for health care professionals to eliminate the disparities between within maternal health. The task force aims to improve policy, RCOG products and address the inequalities in the UK by covering the impacts of bias and racism.

The government has also introduced the Coronavirus Community Support Fund and has helped community groups such as Black Motherhood to establish virtual sessions to create a space for Black and ethnic minority mothers to advise and support during this difficult time.

The UK Obstetric Surveillance System (UKOSS) conducted a study in May 2020 on 427 women that found 55% of pregnant women admitted to hospital with Coronavirus were of BAME background.