“I had a nightmare during my pregnancy and I will give birth knowing full well that as a brunette woman I face significant prejudice from health professionals,” says Mariam *, 41, writer South Asian from London. .
Mariam is not alone in this feeling. According to a report by the Muslim Women’s Network and All-Party Parliamentary Group (APPG), one in five Muslim women say their maternity care is very poor, leading to a “culture of maternal abuse”.
During the research, 1,022 Muslim women responded to an online survey, 37 women gave in-depth interviews, and a focus group was held with Somali women.
The study suggests that Muslim women’s labor and delivery is over-medicalized. The women said they were ‘bullied’ into having labor inductions, without ‘reasonable medical justification’.
When the experiments were compared to national average statistics, the data showed that Muslim women from racialized minority communities were 1.6 times more likely to have their labor induced and 1.4 times more likely to have a clamp or a suction cup used to assist in childbirth.
They are also 1.5 times less likely to receive an epidural for pain relief and 2.1 times more likely to be in prolonged labor, with a 2.4% higher risk of postpartum hemorrhage.
There was also evidence of bias against women from specific sub-ethnic groups, such as Bangladeshi, Arab, and black women and other Asian women.
This is something that worries Mariam, as she is nearing the end of her pregnancy.
She tells the – UK: “I dread the job. I keep hearing that I’m “high risk” because of my ethnicity, which makes me cringe.
“I was put on all sorts of random drugs. For example, they ask me to inject blood thinners twice a day because they are worried that I will develop a blood clot due to family history.
“Even though I tried to resist it, they insisted that I take them…at one point the doctor called my husband’s number and complained that I was not following the medical advice he was given. they offered!”
Mariam understands that this may be partly due to age, but worries that as an Asian woman she is also over-medicalized.
The research comes at a time when failures in maternity care have been in the headlines. It follows the Ockenden Inquiry into the maternity scandal at Shrewsbury and Telford Hospital NHS Trust, which revealed a ‘chain of failures’ – including at least 304 cases where there was ‘avoidable harm’. Louise Barnett, the trust’s chief executive, said she believed “the services are safe”, but the report will be used to guide future action.
Elsewhere, campaign groups including Five X More have continued to petition against the maternal discrimination faced by black mothers, particularly the fact that they are more likely to die in childbirth than their white counterparts. The group claims that the grouping of black women under the label ‘BAME’ masks the problem and is costing women their lives.
The latest report also flagged problems with the BAME label, suggesting it may hide crucial differences in care and treatment between groups.
For example, in the study, Arab women were among the groups with the worst experiences and most likely to have prolonged labor and vaginal tears. Among the South Asian group, Bangladeshi women were the most likely to have had their labor induced, instrumental delivery, emergency caesarean section and to have suffered from postpartum infection.
Pakistani women were among the most likely to experience excessive blood loss. Black women of all backgrounds were the least likely to receive pain relief. Black people have also long been thought to have a higher pain tolerance, which can be fatal.
Additionally, Somali women provided the most unfavorable assessments of health professionals, with some even describing motherhood experiences as “horror stories”, calling care “dangerous” and expressing that they “felt lucky to be alive.”
They described being treated as “less than human” and spoke of excessive use of physical force. For example, one woman said she felt like her whole belly had been ripped out.
Baroness Shaista Gohir, author of the report, said: “Each year, thousands of Muslim women go through traumatic experiences and are placed in life-threatening situations that are preventable.
“Substandard motherhood undoubtedly contributes to maternal mortality, neonatal deaths and stillbirths. The lack of compassion, respect and dignity that women sometimes show is also shocking.
“Such appalling treatment during such a traumatic time is unacceptable.”
Biased attitudes could also stem from a phenomenon dubbed Bibi syndrome – stereotypes that assume South Asian women exaggerate their health issues.
Baroness Gohir added: “To effectively address inequalities in maternity care, there is a need to better understand how multiple forms of intersecting discrimination are associated with poor maternity outcomes. Urgent action must therefore involve a cultural shift in attitudes towards how ethnic minority pregnant women are viewed, cared for, informed about motherhood, involved in decisions about their bodies, and studied in data on maternity – this will prevent preventable deaths.
The report’s findings were presented to the Maternity Disparities Task Force, which was launched in February 2022 to explore inequalities in maternity care and identify how the government can improve outcomes for women from ethnic communities. minorities and those living in the most disadvantaged areas.
Responding to the findings, Minister for Patient Safety and Primary Care, James Morris, said: ‘We are committed to making the NHS the safest place in the world to give birth, regardless of religion or ethnicity. someone’s ethnicity.
“I would like to thank the Muslim Women’s Network and Birthrights for sharing invaluable insight into the motherhood experiences of Muslim and ethnic minority women, and I look forward to working with the system to define actions on how we can ensure better care for all women. .
“At the same time, we are investing £95m to hire an additional 1,200 midwives and 100 consultant obstetricians, as well as an additional £127m to help improve maternity services.”