Black Maternity Matters

Black Maternity Matters is a ground-breaking collaboration, supporting midwives to reduce the inequitable maternity outcomes faced by Black mothers* and their babies. It will support maternity systems to offer safer, equitable care for all.

Did you know?

Black women are four times more likely to die during pregnancy or in the postnatal period than White women.¹
Stillbirth rates of Black and Black British babies are over twice those for White babies.²

It is also widely accepted that there are inevitable ‘near misses’, instances of poor care and psychological impact that have not yet been a focus of research, which add to the negative experience of many Black women during pregnancy and post-natal care.

While there are examples of excellent work happening around the country, the West of England has not yet developed a targeted, unified strategy to improve outcomes for Black pregnant women and their babies. Where training and education is offered, maternity staff are often left with no clear steps on how to introduce and test potential changes and improvements.

By setting up a supportive collaborative for maternity staff, offering peer support, education and training, and coaching in quality improvement (QI), our Black Maternity Matters project seeks to change this.

Statistics show that as a Black woman you are four times more likely to die in childbirth than a White woman. Therefore we have to confront the uncomfortable truths and challenge the inequalities in the structures that are impacting on Black children and their mothers before they are born.

Aisha Thomas, Founder of Representation Matters

About the project

Inspired by Black Mothers Matter’s vision that one day Black mothers will no longer be disproportionately in danger during pregnancy and the first year after birth, the Black Maternity Matters project has been developed by Health Innovation West of England in partnership with Representation Matters and BCohCo.

Read the evaluation summary of our initial pilot in Bristol here.

In the pilot, which launched in 2022, midwives, maternity healthcare support workers and maternity care assistants from across the West of England came together to form a regional collaborative, providing psychological safety and peer support in which to explore the issues facing Black mothers and what changes can be made in how we provide maternity services and care.

Leading the group of learners, our two midwife champions, Angie Griffiths and Laura Lewinson, provided peer support and leadership to those taking part in the training. They are also key team members of the collaborative in designing and delivering the pilot, providing midwifery clinical content and context to support the design and delivery of the training.

The work of the collaborative was informed by local parent partners who shared their lived experience of maternity services to help shape the training and education, as well as the subsequent improvement projects.

Education and training

Members of the collaborative took part in an innovative six-month anti-racism education and training programme, examining a range of topics including unconscious biases and the role of the individual in perpetuating unsafe systems of care for Black women.

The training programme aimed to take participants on a personal learning journey, developing their understanding of racism and the way this results in risk to the health and wellbeing of women racialised as Black within the health system and beyond. The course contains a focus on Black history within health services and the role of society in perpetuating myths and untruths that impact outcomes and experiences for people racialised as Black in the UK. Centred around three themes of pregnancy and birth – antenatal, intrapartum and postnatal – the learning generates insight, opportunities to explore current practices and identify where change is necessary.

Training is focused on growing competencies and embedding learning, resourcing the participants to take back and share their learning with colleagues in their own maternity units.

Quality improvement

Participants were supported to develop as quality improvement (QI) practitioners. Using the learning and insights they gained and with ongoing support from the wider collaborative, they received training and coaching to help them design and implement QI projects in their own hospitals, running small tests of change aimed at improving experiences and outcomes for Black women.

Participants were offered the opportunity to join the Health Foundation’s Q community, and we are developing Q Special Interest Group to maximise learning and wider QI coaching.

The pilot project

The Black Maternity Matters pilot was one of nine projects around the country to be awarded funding from the Health Foundation through its Q Supporting local learning funding programme.

Between May and December 2022, 14 midwives and maternity support workers from North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust took part in the pilot project. They participated in six facilitated sessions with two specialist trainers from the independent sector. Three anti-racism training sessions were delivered face-to-face, alongside three online ‘book club’ sessions.

Working with Unity Insights, Health Innovation West of England has completed an evaluation of the pilot phase of Black Maternity Matters:

Evaluation summary of the Black Maternity Matters pilot

Black Maternity Matters pilot evaluation – bitesize version

Black Maternity Matters evidence synthesis (NIHR ARC West)

Next steps

Informed by the evaluation of the pilot phase, the Black Maternity Matters collaborative will deliver two further programmes of the Black Maternity Matters training in Bath and North East Somerset, Swindon and Wiltshire, and in Gloucestershire, as well as another programme in Bristol, North Somerset and South Gloucestershire.

We are recruiting up to 60 participants (maternity and neonatal staff, as well as perinatal mental health teams and health visitors) to participate in a six-month programme of anti-racist education and quality improvement starting in May 2023.

In addition, we are providing a further six months of support to the original pilot cohort in Bristol.

Health Innovation West of England will carry out a qualitative and quantitative evaluation of the approach to identify both enablers and barriers in using QI to improve equity.

We will share learning regionally and nationally to inform the potential scale-up of this programme and to influence similar initiatives aimed at reducing inequity for other populations within and outside the maternity system.

If you are interested in taking part in the next phase of Black Maternity Matters training, please email us to find out more: healthinnowest.transformation@nhs.net.

We are honoured to have been invited to collaborate on such an important initiative, integral to the future of Black women and children’s health and wellbeing.

Katie Donovan-Adekanmbi, Inclusion and Cohesion Specialist at BCohCo

We are so pleased to have this fantastic opportunity to develop this innovative programme to use a QI approach to deliver meaningful, actionable improvements to reduce inequity of outcomes for Black women within maternity systems.

Ann Remmers, Maternity and Neonatal Clinical Lead for Health Innovation West of England

Who is involved in the project?

Representatives of these organisations explain what it means to be involved in this groundbreaking project:

Aisha Thomas, founder of Representation Matters: “Statistics show that as a Black woman you are four times more likely to die in childbirth than a White woman. Therefore we have to confront the uncomfortable truths and challenge the inequalities in the structures that are impacting on Black children and their mothers before they are born.

“We are delighted to partner on this project to ensure that through this pilot midwives are able to enhance their knowledge, tackle their bias and prejudice, and become more equipped so that we can ensure that all children are able to enter into the world safely, irrespective of the colour of their skin.”

Aisha Davies, Founder and Director of Black Mothers Matter: “We are excited to start work on a project that centres Black birthers and their experiences. From our work, we know that this project being led by Black birthers for Black birthers is absolutely vital.

“We will be able to harness our experiences as Black women alongside voices from our community, and professional knowledge that comes from working within the NHS, to create something that has the potential to contribute to real and meaningful change as well as start to unpick the systemic inequalities faced by Black women.

“Overall, we believe a new approach to correcting the inequalities that we and our community face during pregnancy is vital, and this project goes a long way to helping that vision.”

Katie Donovan-Adekanmbi, Inclusion and Cohesion Specialist at BCohCo: “At BCohCo our mission is in our name – Building Cohesive Communities. We are honoured to have been invited to collaborate on such an important initiative, integral to the future of Black women and children’s health and wellbeing.

“Many attitudinal and organisational barriers currently exist within maternity spaces and services. We will be taking a deep dive into the biases faced by women of colour, working together to stimulate the innovation and creativity required to build the change. We are really looking forward to the journey.”

Ann Remmers, Maternity and Neonatal Clinical Lead at Health Innovation West of England: “We are so pleased to have this fantastic opportunity to develop this innovative programme to use a QI approach to deliver meaningful, actionable improvements to reduce inequity of outcomes for Black women within maternity systems.

“It is a national priority for maternity systems to develop equity plans to address inequalities in maternity care and to improve outcomes. This pilot will support maternity services locally and regionally to develop these plans led by Black mothers.”

Contact us

If you would like to get involved in Black Maternity Matter or want to find out more about the project, please email us at healthinnowest.transformation@nhs.net.

References

* The words women and mothers have been used throughout our website content as this is the way that the majority of those who are pregnant and having a baby will identify. It also includes people whose gender identity does not correspond with their birth sex or who may have a non-binary identity.