Critique of healthcare provided to black and Asian mothers

A recent review has raised concerns about the treatment of black and Asian women in hospital maternity services. NHS England published an equality and diversity assessment of maternity and neonatal care at St James's University Hospital and Leeds General Infirmary this week.

The review revealed that babies from black and ethnic minority backgrounds were more likely to be born prematurely and require neonatal unit care. Meanwhile, new mothers reported feeling "traumatised," and staff experienced bullying and discrimination within Leeds Teaching Hospitals NHS Trust.

The trust, currently under an independent investigation into maternity standards, has issued an apology and pledged to implement "cultural change."

"Maternal outcomes for black and Asian women continue to lag behind those for white women, reflecting national patterns," the report stated. Women seeking asylum were also highlighted as facing challenges, including poor communication, insufficient cultural awareness, and difficulties navigating the healthcare system.

The review noted a lack of breastfeeding support on postnatal wards and the occasional unavailability of translation services, forcing relatives to interpret. "Many women feel traumatised due to inadequate aftercare and a lack of debriefing," it said. Additionally, despite the overrepresentation of black and Asian babies in neonatal units, the report criticized the absence of diverse imagery, with walls displaying only pictures of white infants.

National evidence cited in the report indicates that black women are up to three times more likely to die during or after pregnancy than white women.

In Leeds, women could raise concerns via the Maternity and Neonatal Voices Partnership (MNVP), but only one MNVP staff member was assigned across both hospitals. This contributed to many women feeling unheard, resulting in generally negative experiences.

Overburdened staff reported a "culture of blame," and employees from ethnically diverse backgrounds were underrepresented in senior positions. "Staff survey data indicates higher levels of discrimination, bullying, and harassment among black and Asian staff compared to white colleagues," the report added. Staff also reported feeling there was no safe space to raise concerns.

The review, conducted in July under NHS England's Maternity Safety Support Programme, included recommendations such as enhanced staff training, updating diversity policies, and improving communication.

Leeds Teaching Hospitals announced the launch of an Inclusion and Belonging Plan outlining immediate steps for improvement. Chief nurse Beverley Geary described the report's findings as "difficult to read" and acknowledged, "We know that we have not always delivered the care every family deserves and we are truly sorry for this."

Author's Commentary: Addressing Inequalities in Maternity Care

The recent NHS England review highlights persistent disparities in maternity outcomes for black and Asian women. The findings at St James's University Hospital and Leeds General Infirmary confirm what national data has long indicated: ethnic minority women face higher risks during pregnancy and childbirth, including premature births and increased neonatal unit admissions.

The report also exposes systemic issues affecting both patients and staff. Women reported inadequate postnatal support, lack of debriefing, and insufficient translation services, while staff experienced discrimination, bullying, and underrepresentation in senior roles. These challenges contribute to a culture where both patients and employees feel unheard and unsupported.

Leeds Teaching Hospitals NHS Trust has pledged cultural and procedural changes through its Inclusion and Belonging Plan. Immediate priorities include enhanced staff training, updating diversity policies, and improving communication with patients, particularly those seeking asylum. While these steps are necessary, the findings underscore the urgent need for sustained accountability and monitoring to ensure equitable care for all families.

Ultimately, this review is a reminder that addressing healthcare inequalities requires systemic action. Ensuring that outcomes for black and Asian women match those of their white counterparts will demand both organizational commitment and community engagement, alongside ongoing evaluation of progress.

Sources:

• Report criticises care for black and Asian mothers