Black women are being failed by maternity services, says Sandra Igwe

Black women in the UK are being failed by maternity services — they are three times more likely to die during pregnancy and childbirth than white women, figures from the National Perinatal Epidemiology Unit based at the University of Oxford show. Black women are also 13 per cent more likely to experience postnatal depression than white women and face additional barriers to accessing care when they do.
Sandra Igwe started The Motherhood Group to change the experience of black mothers for the better. Her social enterprise is working to “bridge the gap between the community and the healthcare system” by listening to the experiences of black women, carrying out research to understand the reasons for disparities in care, and working with policymakers and maternal health services to ensure the right action happens.
The Motherhood Group is the result of Igwe’s own poor experience of care during and after the births of her three daughters — being refused the pain relief she asked for, and being told she was not a priority when she sought support for what turned out to be undiagnosed post-natal depression after her oldest daughter was born in 2016.
“All the priority patients happened to be non-black mothers,” she recalled. “I knew my race had a lot to do with the inadequate treatment. Racism doesn’t have to be harsh and overt. Many times, it is insidious and it’s hard to pinpoint because there’s no words spoken. But it’s evidently there, from the disparity in the outcomes we see.”
She initially set up a WhatsApp group with a small number of other black mothers, to share their experiences and support each other, but the group quickly grew to more than 100 people and they started holding workshops and events, drawing on the skills and knowledge of women in the group, some of whom had worked in maternity services. In 2018, after having similarly negative experiences during the birth of her second daughter, Igwe formally set up The Motherhood Group as a social enterprise.
The organisation has now worked with more than 12,000 mothers, carried out research projects for universities including Oxford, Cambridge and King’s College London, trained midwives and other practitioners for NHS trusts in London, Kent, Manchester and Liverpool, and runs events and campaigns including the Black Maternal Health Conference and an annual Black Maternal Mental Health Week. Corporate sponsors include Nike, Dove and UBS, and law firms working on medical negligence cases including Leigh Day and Irwin Mitchell.
The Motherhood Group has eight members of staff and works with around 30 more contract staff on training, conferences and peer-to-peer support, Igwe said. The organisation is based in Lambeth Town Hall in Brixton, south London.
Igwe, 35, learned more about the layers of barriers that prevent black women getting the right standard of care as co–chair of a UK-wide inquiry into racial injustice in maternity care for the charity Birthright in 2022.
“We heard from thousands of mothers that felt like they weren’t able to speak up or their concerns were dismissed and not taken seriously,” she said. “There is systemic racism and there is also a lack of cultural understanding from healthcare practitioners, they’re just not equipped. Many professionals don’t know how to spot certain signs or symptoms. For example, we’ve had many cases of jaundice not being spotted in black babies because of their darker skin tone.
“When it comes to things that are non-physiological, like perinatal mental health, women might describe themselves as feeling very tired or fatigued, or maybe overwhelmed and pressured, but not using the exact words ‘depressed’ or ’anxious’.”
Mental health is often still hard to talk about in African and Caribbean communities, Igwe added, and many black mothers are also fearful that if they do raise a concern, social services will get involved. This is a legitimate concern, she said, because “we are seeing that black and brown women are more likely to have interventions from social services unjustifiably”.
The Motherhood Group trains groups of nurses, midwives, perinatal mental health specialists, GPs, obstetricians and social workers in “how to use communication, how to use language, taking the curious approach, asking the right questions, addressing race, addressing disparities, looking at ways to remove what we call unconscious bias, but really a lot of it is conscious,” Igwe said.
She added that the organisation’s peer-to-peer support work also gives its team a good understanding of how and where black women look for community and professional support when they have maternal health concerns.
“Black mothers are not ‘hard to reach’,” she said. “That’s a term that has been coined over the past few years, and it’s very insulting because we do want to be reached. But the services have to tailor what they are delivering so that it can reach us in an effective manner.”
Sandra Igwe is a speaker at the UK Black Business Show on October 19, where The Times Enterprise Network is hosting a panel discussion