"Let’s hurry this one along, I should’ve been home hours ago," I heard the surgeon say, as he prepared to cut me open and retrieve my unborn child - a daughter - from my womb. If I wasn’t minutes away from becoming a mother for the first time, I might have dwelled on what he said more in the moment. But it wasn’t until I left the surgical theatre - days after my C-section, when my wound refused to heal - that his words would truly eat away at me.
Black women in Britain are five times more likely to die in childbirth and the post-partum period than their white counterparts. I know first-hand why that is, because I was nearly a part of that awful statistic.
My labour started off badly. I was overdue, and after three ‘failed’ sweeps I was admitted for further induction. Right from the very start, that first night on the maternity ward, I felt like an annoyance - but I knew better than to say anything. A friend who’d already had children had forewarned me: “Remember you’re Black. They won’t be that kind, so don’t bother making a fuss because that will only make things worse.” Her warning was at the forefront of my mind when I became frustrated at having to wait two hours for painkillers, because the staff on the maternity ward were busy.
There's an implicit assumption among society that Black women are strong. We wear this untrue stereotype like a cloak. And while, externally, it sounds positive and empowering, when it feeds subconsciously into the minds of healthcare workers, it manifests as damaging bias. A study conducted in the US in 2016 found that 40% of first and second year medical students endorsed the idea that the skin of a Black person is thicker than that of a white person – and therefore Black people are not as sensitive to pain.
In the days after my cesarean-section, three midwives came to visit me back at home. I told each one that I wasn’t feeling at all well. Every day I seemed to get worse, rather than better. I felt dizzy, nauseous and the night sweats were so prolific I found myself waking up to a mattress so soaked, actual droplets of water sprung forth when you touched it. But all three midwives told me I was overthinking it, and that it was likely just my hormones trying to regulate themselves. One even suggested I should stay off of “those mummy websites” because I was perhaps unconsciously internalising the horror stories of others. When I showed them my C-section wound, which was now hot and inflamed, I was advised that Black skin is more likely to become keloid [become a raised scar] and that perhaps that was the process it was undergoing.
But then, one afternoon, I fell asleep with my baby girl on my chest, and the weight of her tiny body burst an infected sac that was lingering beneath my wound. The real cause of my ill-health: post-partum sepsis. In the ambulance being blue lit back to hospital, where I would end up in intensive care, separated from my newborn and walking the tightrope between life and death, I actually smiled to myself in relief. They’ll have to believe me now, I thought. I finally had proof there was something wrong. Sure, it could cost me my life, but it felt vindicating that, now, someone had to listen.
If I hadn’t have fallen asleep that day with my daughter, I would have died. By the time I arrived back at hospital I was slipping into septic shock, and it took five weeks for me to be well enough to be discharged. But other Black women aren’t so lucky. As a 2018 report into national maternal, newborn and infant health services (known as the MMBRACE report) revealed, Black women are five times more likely and Asian women twice as likely to die during pregnancy or just after, compared to white women. Previous research has suggested this inequality may be partly explained by gestational diabetes, other medical illnesses, previous pregnancy problems and inadequate use of antenatal care – but none of these applied to me. “More research is needed to understand the specific causes of the deaths of women from these ethnic groups,” concludes the MMBRACE report – and I couldn’t agree more.
In July last year, after an episode of BBC Women’s Hour shared the MMBRACE report’s devastating findings with a more mainstream audience, the conversation went viral. All of a sudden, this fatal racial disparity was being pushed into the ears and minds of the white middle class. There was immediate uproar. “This is so terrible!” read one tweet. “What can be done? Something must be done?” was the sentiment of countless DMs I received. Off the back of the outrage a government petition was started, so the issue could finally be discussed where it truly matters: on the floor of Parliament. But despite all the enthusiasm and furore, the petition expired with less than half the signatures required to have it put on the government’s agenda. There have since been more petitions, but nothing as yet has been brought to the table in Parliament.
To add insult to injury, the government’s flippant response to the initial petition (in which they acknowledged there was a long-term plan in place to take a "concerted and systematic approach" to reducing health inequalities) included data which outlined that Black babies have a 121% increased risk for stillbirth, and a 50% increased risk for neonatal death (i.e. dying within 28 days after birth) compared to white babies. It was as if to suggest Black people are just more likely to die young; a fact that won’t change regardless of what’s debated in Parliament. But the way I see it, if experts suggest prior health conditions are to blame for the higher rate of Black maternal deaths, then how can you explain Black babies dying at a higher rate, too? There’s something else to it.
Intergalactic superstars like Serena Williams and Beyoncé Knowles-Carter have publicly expressed how difficult they found their maternity experiences - especially when it came to being taken seriously. And that makes me wonder; if that’s how women with their status and power feel, what on earth is happening to other Black women who dare to have children in systems that don’t appear to have been built to support or protect them?
During my first pregnancy, I was desperate to read something – anything – from someone who shared the very experience I was having. But there was nothing. This year, I filled that void myself. Prior to I Am Not Your Baby Mother, there was not one book that spoke of the Black British motherhood experience in the UK, and that’s part of the problem. If it has taken until 2020 to see the Black British motherhood experience as valid enough to have its own literature, it’s no surprise to me that we are still stagnant when it comes to being able to admit that there’s a long way to go to rid healthcare of the implicit bias and racism that hounds it. We need to start seeing Black British mothers as women worth saving.
Throughout this pandemic I’ve been reminded of our healthcare system’s bias. With reports that those from ‘British BAME’ communities were more likely to die from COVID-19, it’s a stark reminder that when it comes to most matters, the voice of Black person is usually the last to be heard. But that doesn’t mean we’ll stop shouting.
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