Video report by ITV News Correspondent Sejal Karia
An urgent inquiry to investigate how alleged systemic racism in the NHS manifests itself in maternity care has been launched.
The inquiry will examine how claimed racial injustice - from explicit racism to bias - is leading to poorer health outcomes in maternity care for ethnic minority groups.
Black women are four times more likely than their white counterparts to die in pregnancy or childbirth in the UK, while women of Asian heritage face twice the risk, data published in January by MBRRACE-UK, which examines deaths among pregnant women, new mothers and babies, found.
Sandra Igwe, one of the co-chairs of the inquiry said that during the birth of her first daughter she "felt like my words were dismissed, I didn’t receive adequate care, I was ignored, almost labelled as the ‘angry black woman’ who was hysterical and exaggerating her pain, when I didn’t, and I also felt like they were dismissing my pain because they were saying that my contractions didn’t coincide with my screams, so why am I screaming?”
The founder of the Motherhood Group, a social enterprise that supports black mothers, continued that it was only when her baby's head began crowning that medical staff believed her, "but by that point her heart rate had started to drop".
She said she was left feeling "traumatised", "saddened", "not valued" and with "undiagnosed postnatal depression".
With the birth of her second daughter, Ms Igwe said "the same thing happened" and that again she was "not believed", told she was not in labour when she was, and was not given any pain relief despite "begging" and "pleading" for it.
Ms Igwe told ITV News she believes that her "race and colour had a lot to do with my treatment" and that "there’s a perception that black and brown women have an attitude problem, that we are aggressive".
Ms Igwe believes the higher rates of death amongst black women and women of Asian heritage during pregnancy, childbirth and postnatally is due to a "subtle" and "institutionalised racism in the UK" which is "internalised" by those working in healthcare.
She continued that "there has been a longstanding issue of trust when it comes to accessing maternity services and we don’t believe at the moment we [ethnic minority women] are a priority and that of course institutionalised racism within healthcare services has a massive part to play and so of course we are trying to build that trust, but right now our priority is about getting the numbers [of women dying] down".
She added she hopes that the inquiry will allow ethnic minority women speak to frontline health care workers and decision makers “to make sure that our voices are heard and we are at the heart of this inquiry”.
The charity Birthrights, which provides advice and campaigns for safe and respectful maternity care, is supporting the inquiry.
The inquiry is being led by an expert panel made up of affected families, midwives, obstetricians, health and human rights lawyers and others working in anti-racism and health policy.
Seven years after the birth of her son, Sharmika Dockery is still in pain which she says has left her "disabled".
Riley was born via Caesarean but part of the placenta was left inside Ms Dockery, leaving her in pain.
However, she says her concerns were ignored and 11 days later she was rushed back to hospital with a life-threatening infection.
Since then she has undergone "numerous" surgeries and been left in "chronic" pain and feeling "depressed the majority of the time".
Ms Dockery believes she was not listened to properly at the time “because I was young and I was black.
"I think there could be a lot of hidden racism within the systems, where you are just ignored because you’re seen as being dramatic or exaggerating, when really it’s just what you’re going through...
“I believe if I was taken seriously in the beginning I would have got the help I needed and I wouldn’t be in pain now" and not getting help in the first few years “has led to me being disabled now”.
She told ITV News she has not had another child as she does not feel she can "trust" the NHS, she worries she would be left in further pain and and she has flashbacks to the birth of her son.
Ms Dockery said she felt "let down by the system" and hopes that by taking part in the inquiry she can “help educate health professionals who may not know about racism and bias in the health care systems and I’m hoping that it will bring about a big change".
Benash Nazmeen, director of the Association of South Asian Midwives and inquiry co-chair, told ITV News she hopes the inquiry will bring about reform as the population the NHS was set up to serve has changed, but the institution has not.
She continued that ethnic minority women must not be viewed as a "homogenous" group but as many different individuals.
"There’s so much variety and so many cultural differences we need to unpick and understand the nuances, as well as everything else that’s already been done to really understand the need from each individual voice."
She continued it is these voices that need to be listened to for the recommendations.
Ms Nazmeen continued that the NHS is trying "its best to overcome" and "deal with" the issues, and "empower" women of all backgrounds, and that rather than worry about issues, women should ask their medical professionals any questions they have.
Shaheen Rahman QC, chair of the inquiry, said: “Statistics show that black, Asian and mixed ethnicity women are more likely to die in pregnancy or childbirth than white women.
“There are also concerns around higher rates of maternal illness, worse experiences of maternity care and the fact that black and Asian pregnant women are far more likely to be admitted to hospital with Covid-19.
“We want to understand the stories behind the statistics, to examine how people can be discriminated against due to their race, and to identify ways that this inequity can be redressed.”
Olive Lewin, partner at Leigh Day law firm and member of the expert panel, said there was “an urgent need for this inquiry”.
In a statement the Chief Midwifery Officer for England said: “Everyone working in maternity services wants all women to have the safest possible care.
"We are also fast-tracking our continuity of carer programme for women from Black, Asian and ethnic minority backgrounds which will mean they receive care from the same midwife and team before, during and after they give birth."