#Fivexmore: Addressing the Maternal Mortality Disparities for Black Women in the UK

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AIMS Journal, 2020, Vol 32, No 3

By Tinuke Awe & Clotilde Rebecca Abe

“I felt like I wasn’t listened to”. Why must Black women demand to be listened to in order to receive fair and equal treatment in maternity care? The colour of our skin shouldn’t determine the level of care we receive.

Tinuke and Clotilde Rebecca started the Five X More campaign in an attempt to raise awareness of the shocking disparities in maternal outcomes for Black women as a response to the MBRRACE 2018 report¹ which highlighted that Black women in the UK are five times more likely to die in pregnancy and the six weeks after childbirth in comparison to a white woman.

It's important to note at this point that the UK has one of the lowest maternal mortality rates in the world and it’s very safe to give birth in the UK, however there is a huge disparity in the rates and that is what this campaign seeks to address. These statistics are not new and in fact the problem has been going on for decades. In the early 90s we saw that Black women had a higher risk of dying during pregnancy and childbirth in the UK than white women. Fast forward to now and we can see that Black women only account for 4% of births yet are five times more likely to die than white women (MBRRACE 2018¹ and MBRACE 2019²).

Tinuke runs an on and offline social platform for Black mothers and found that a lot of women echo her own birth experience with her first pregnancy. Many Black women she speaks to have had terrible experiences when giving birth. They felt like they were not being listened to, their pain was not taken seriously, or they were not given pain medication on time as a result. This forced Tinuke to join forces with her friend Clotilde Rebecca, who runs Prosperitys, a social enterprise specifically designed to support Black and South Asian pregnant women, to create the #fivexmore campaign. They are two Black mothers who have had to take matters into their own hands after feeling like nothing was being done about this issue over the years; an issue which was clear in the confidential enquires as early as 2007 (CMACH 2007³)

The #fivexmore campaign isn’t designed to scare women, but rather empower them with knowledge and support them through five recommended steps. The steps are, speak up, find an advocate for you, seek a second opinion, trust your gut feelings and body and do your research. They also launched the #fivexmore selfie as a way to increase awareness and bring this matter to the forefront using the power of social media.

In March 2020 they launched a petition asking for the government to improve maternal mortality rates and health outcomes for Black women. The petition asked for specific research to be done into the statistics to find out what in particular Black women are dying from as well as recommendations to improve healthcare outcomes for Black women. The petition exceeded the 100,000 signatures needed to be considered for debate in parliament.

A response from the government was given on 26 June 2020 in which they committed to funding the necessary research into factors associated with the higher risk of maternal death for Black and South Asian women which is greatly welcomed. The response also recommended that the ‘Continuity of Carer’ model should be in place for 2024 as part of the long-term NHS plan for ‘BAME’ women and women from deprived areas. This part of the response is very disappointing for us as campaigners, as the petition asked for urgent action and recommendations for Black women specifically and the response was a very general one targeted at ‘BAME’ women. The use of the word BAME puts all women who are not white under the same category and fails to highlight the differences in outcomes within this group. The rates of death compared to white women are double for Asian women, triple for mixed race women and five times as many for Black women. Specific and immediate action is needed to address these disparities.

The #fivexmore campaign have also asked members of the public to continue showing their support by writing letters to their local MP’s to urge the department of health to give a revised response that addresses the concerns of the original petition and to give a solution outside of the one suggested that will be in place for 2024.

We are so grateful to AIMS for giving us the opportunity to speak about the campaign because while the campaign is getting popular via social media and the petition has over 186,000 signatures, a lot of people still do not know that these disparities exist.

If you would like to support us, you can:

• Sign the petition
• Write letters to your local MP
• Share your own #fivexmore selfie on social media
• Find out more www.fivexmore.org
• Continue to have discussions to raise awareness about this shocking disparity.

Tinuke Awe is the founder of Mums and Tea, holding fun events and meet-ups for mothers. She is mum to two children aged 2 and 3 months old. She works in HR and is currently on maternity leave.

Clotilde Rebecca Abe is the founder of Prosperity. Prosperity is a maternal wellbeing social enterprise which supports Black and South Asian pregnant women. She is mum to two boys aged 7 and 4 and she works full time in a South London hospital in the fetal medicine and day assessment unit. She’s also the co-chair of Lambeth and St Thomas hospital MVP.

1 www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202018%20-%20Web%20Version.pdf
2 www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202019%20-%20WEB%20VERSION.pdf
3 www.publichealth.hscni.net/sites/default/files/Saving%20Mothers'%20Lives%202003-05%20.pdf