Posted on May 2, 2025
The Black Maternity Matters programme is a collaboration aimed at reducing inequitable maternity outcomes faced by Black mothers and their babies, supporting perinatal teams to offer safer, equitable care.
The six-month programme delivers in-depth, anti-racist training to multidisciplinary clinicians and senior leaders within the West of England. This training is delivered through in-person sessions and is supplemented by book clubs to embed learning.
A key component involves encouraging participants to develop quality improvement (QI) projects to transform perinatal services. The programme also fosters an ongoing community for continued learning and support.
On-going evaluation of the programme demonstrates increased awareness, knowledge, and skills associated with anti-racist competency among maternity and neonatal staff. Participants report feeling more confident in talking about racism and its impacts and demonstrate a greater willingness to intervene against discriminatory behaviour.
The programme’s approach is described as transformational, focusing on anti-racist action to address racism within NHS systems.
By the end of 2025, 10 perinatal cohorts across the three local maternity and neonatal systems in the West of England and three cohorts of senior leaders will have completed the Black Maternity Matters programme. That’s 300+ graduates – and counting.
Ann Remmers, Maternity and Neonatal Clinical Lead, Health Innovation West of England, said: “Everybody that comes on the Black Maternity Matters programme… I’m doing it myself at the moment. I’m currently one of the participants and it is a total transformation. You are learning so much and you’re unlearning a lot as well.”
The challenge
Black Maternity Matters has been designed to help tackle the significant and unacceptable disparities in maternal health outcomes faced by Black mothers and their babies in the UK.
Specifically, the programme addresses the fact that Black women are four times more likely to die during pregnancy or in the postnatal period than White women, while stillbirth rates for Black babies are over twice those for White babies. This is a major patient safety issue.
These poor outcomes, including higher mortality, stillbirth rates, traumatic births, and poor perinatal mental health, are linked to a “constellation of biases” and systemic racism within NHS systems.
Black Maternity Matters aims to confront these inequalities by providing anti-racist training and support to perinatal staff, empowering them to deliver safer, more equitable care and ultimately reduce these life-threatening disparities.
Our approach
Health Innovation West of England (HIWE) has played a vital role in both the development and delivery of the Black Maternity Matters programme.
In 2021, Health Innovation West of England established the Black Maternity Matters collaborative with Representation Matters, BCohCo and Black Mothers Matter.
Through engagement with community-based organisations and activists in Bristol, HIWE identified the shocking inequity of outcomes faced by Black families as an urgent patient safety issue, requiring a strategic and sustained response.
HIWE recognised the opportunity to take advantage of its privileged position to broker relationships across different sectors, bringing together the experts with lived experience to design a solution with health and care professionals.
The collaborative has coproduced the Black Maternity Matters training and education programme, with HIWE leading on the quality improvement aspects, as well as providing project management, organisational and communications expertise.
Furthermore, HIWE is responsible for evaluating the programme’s impact and progress. They also secured funding for the initial pilot from the Health Foundation and are now working to formalise the programme’s work into an actionable framework with the NHS Race and Health Observatory.
Hear Sonah Paton of Black Mothers Matter talk about the support from HIWE.
Impacts to date
Black Maternity Matters’ unique anti-racist approach is demonstrating a significant impact in several areas.
Evaluation of the pilot phase showed a successful increase in the cultural competency of maternity staff, evidenced by participant feedback and resulting actions. Participants increased their understanding of how racism impacts health inequalities and were able to transfer this knowledge to their work context. The programme has been described as ground-breaking and influencing real behaviour change.
The evaluation of the second cohort further supports these findings, demonstrating increased knowledge, skills, and confidence for maternity and neonatal staff to understand the impacts of racism.
Staff reported an increased ability to implement anti-racist practice and felt more motivated and psychologically able to do so. The training has empowered staff to have better conversations about racism with colleagues and patients and to initiate change within their practice. There is also evidence of an increase in staff reporting they would intervene if they saw racist or discriminatory behaviour and being actively involved in anti-racist initiatives.
Each cohort undergoes thorough evaluation, with improvements implemented in subsequent rollouts. In 2025, the evaluation focus is being expanded to include a rigorous analysis of clinical indicators for women and babies racialised as Black.
Maria Kane, Joint Chief Executive of North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust, commented: “This course turned my life upside down. I was overwhelmed but engaged.”
Health and care system success
The Black Maternity Matters programme has evolved iteratively in response to learning and insights gathered from participants and course leaders during each phase.
In 2024 a specific cohort for senior leaders was introduced, recognising that healthcare professionals are limited to how much change they can activate without senior leadership advocacy. This includes but is not limited to chief executives, chief nursing officers, medical directors, heads of midwifery, and integrated care board (ICB) leads.
This element of the programme has been a gamechanger for Black Maternity Matters in catalysing wider cultural ‘acceptance’ and a broader understanding of the need for an anti-racist approach and methodology to achieving long-term change.
As a result of senior leaders attending the programme, a bespoke version of the Black Maternity Matters model is now being delivered by the collaborative for all staff at North Bristol NHS Trust as part of a wider package of commitments to tackling institutional racism with their organisations.
Listen to senior NHS leaders’ talk about how Black Maternity Matters has impacted them both personally and professionally, and how they are taking this learning back to their organisations and networks.
Steve Hams, Chief Nursing Officer, North Bristol NHS Trust, said: “This has been the most transformative six months. It’s an immersive programme where you truly get to experience what it’s like.”
Patient and Public Involvement and Engagement
Patient and public involvement and engagement is integral to Black Maternity Matters. It is not just a token gesture but is embedded through active partnerships with community organisations like Black Mothers Matter and Maternity Voices Partnerships, a commitment to centring lived experiences, and a reliance on the expertise and insights of people racialised as Black to inform the programme’s development and delivery.
The programme’s foundation is rooted in the lived experiences and concerns of the Black community, inspired by the vision of one its founding members that one day Black mothers will no longer be disproportionately in danger during pregnancy and the first year after birth.
The Black Maternity Matters collaborative includes community organisations, whose leadership and active involvement ensures that the programme is informed by the perspectives and needs of Black mothers.
Recognition of the need for a sustained, anti-racist approach came from an understanding articulated by community partners that traditional approaches to equity, diversity, and inclusion training are insufficient and do not translate into tangible improvements. This is why Black Maternity Matters actively seeks and values the expertise and insights of organisations representing Black mothers in shaping its approach.
Aisha Thomas, Educator, Representation Matters, commented: “It hasn’t been about tick box exercises. It hasn’t been about painting by numbers and putting people in front of a computer screen. It’s been about holding people. It’s been about honesty. It’s been about connection and it’s been about changing people’s lives.”
Spread and adoption methodology used
There has been a great interest in the work of the Black Maternity Matters collaborative from outside of the West of England and avenues for wider spread and adoption are currently being explored.
HIWE is currently working with the NHS Race and Health Observatory to formalise the wide range of work into key themes and an actionable framework. This formalisation could create a structure and guidance that would facilitate adoption by other regions or organisations.
How to spread and adopt the Black Maternity Matters model so as not to lose its essential components is likely to prove one of the most innovative aspects of this programme, and it is likely that further pilots in other parts of the country will be required as a series of tests of change.
The success of the programme to date is largely attributable to its collaborative approach, with the Health Innovation Network working in close partnership with local community organisations and anti-racist educational experts. This partnership model, where different organisations bring their expertise, as well as an understanding of local geographies and communities, will need to be considered as a transferable element for wider adoption.
Next steps
The collaborative is continuing to deliver Black Maternity Matters across the West of England. During 2025 they will carry out a comprehensive evaluation of the impact on women and families’ experiences and outcomes.
There has been a great interest in this work from other parts of the country and avenues for wider spread and adoption are being explored.
The success of Black Maternity Matters to date was recognised at the Black Maternal Health Awards in March 2025, where the collaborative won the award for community project impact.
Based on the success of the PERIPrem care bundle for preterm babies, Health Innovation West of England is now also developing a clinical perinatal anti-racism bundle to optimise outcomes and experiences for women and babies racialised as Black.
