There are too many startling statistics where Black mothers fare far worse than their white counterparts in the UK.
Alarmingly, we know that Black women are 3.7 times more likely to die during, or in the first year after, pregnancy than white women – and suicide continues to be the leading cause of direct maternal death between six weeks and 12 months after birth.
Black mums are also twice as likely to be hospitalised with perinatal mental illness than white mums.
There are a plethora of barriers stopping new mothers from asking for mental health help, but more so for Black women. And even when they do pluck up the courage to ask for help, the question remains: will they be heard?
For Dr Zoe Williams – a mother and NHS doctor – these statistics are damning.
“There’s a real feeling of injustice, which makes me feel so sad and disappointed,” she tells HuffPost UK.
“I think myself, as a Black woman who is somebody who works in the NHS and is very proud to work in the NHS – the fact we’re failing Black women in this way, it’s very disappointing.”
What needs to change?
Dr Zoe stresses that “irrespective of skin colour or ethnicity” we know that pregnancy, childbirth and the period after having a baby is difficult for everybody. In the same interview, the 44-year-old revealed to HuffPost UK that she experienced postnatal anxiety after the birth of her son in 2021.
But we also know, from the data, that Black mums are more likely to struggle and that’s “because of a number of factors”, says the doctor, citing two in particular: socioeconomic factors and systemic racism within healthcare and wider society.
Dr Zoe recently spoke to Five X More, an organisation focused on Black maternal health; as well as mental health advocates at the Motivational Mum’s Club and the Maternal Mental Health Alliance (MMHA) about the difficulties Black women face in accessing support.
According to the Mental Health Foundation, one in five Black mothers said they didn’t visit a healthcare professional when feeling low mood or depression. Common barriers to seeking help include mental health stigma and feeling judged or unheard.
And Dr Zoe says that when Black women do find the courage to reach out for support for their mental health, “it seems they’re more likely to be dismissed or discouraged or treated in a way that makes them feel fearful to share the full picture”.
“There’s really something about the way in which healthcare is delivered which isn’t culturally appropriate or sensitive,” says the healthcare professional, who’s currently working with Tommee Tippee.
Then there’s the terminology. Experts are now questioning whether “mental health” is even the right term to use in postpartum appointments.
“Do we need, or culturally have the same understanding of, the term ‘mental health’?” asks Dr Zoe.
“People from certain backgrounds, when they hear the term ‘mental health’, they might think of an image in their mind of somebody who is severely unwell … that term might not necessarily resonate with them.”
She suggests language like “feeling low” or “feeling down” could be more appropriate.
“We, as healthcare professionals, are using the term ‘mental health’, which to one group of people might mean one thing and it might mean something else to a different person,” she explains.
One option to encourage new mums to reach out for support, she suggests, could be for doctors to have a standard, non-judgmental question they can ask Black mothers, “so women know they’re going to be asked that and they know the answer will be acted upon if they’re struggling”, says Dr Zoe.
There is also the matter of the six-week check. After a woman gives birth, she is invited for a check up with a GP to chat about her recovery. Of late, there have been more and more calls for an extra GP check so that women who are struggling don’t slip through the cracks.
“I’ve always thought the six-week check is not enough – but having had my own baby and becoming a mother and experiencing firsthand just what transitions your body goes through, but more than that the transitions we go through mentally, I’m certain that it’s not enough,” says Dr Zoe.
She notes that one of the downsides of the check is that it’s usually done in the appointment after or directly before the baby’s check – “and I think both the mother and the doctor are more concerned with the health of the baby,” she adds.
“You have this double appointment – half for the baby, half for the mum – you end up using most of it for the baby and you’re left with just enough time to ask two standard questions to mum.
“And it’s not enough – and we are very heavily dependent on the mum to really raise any issues, which, especially if it’s mental health, she might not have the opportunities to do.
“And if we’re just asking one simple question: how are you feeling? How’s your mental health? In that moment, under pressure, especially if they feel in any way judged – which as a mum, I think we all feel judged, especially by healthcare professionals and people who’ve done it before – then the chances are you might just say, ‘yeah I’m fine’.”
For Black women in particular, especially when we look at the startling statistics around Black mums and their experience of pregnancy, birth and the fourth trimester, the doctor stresses “there needs to be a space that is created for that patient to be asked in a culturally competent manner how they’re managing from a mental health point of view”.
“And if they say that they’re struggling, they must be believed – and they must be supported,” she adds.
We can all offer better support to parents after birth
It’s not just on healthcare professionals, so many of us can be doing more to better support friends, colleagues and loved ones after they’ve given birth.
As Dr Zoe puts it: “Your assumption should always be that someone isn’t coping… because who has a baby and copes?”
She points to some African cultures where women are expected to rest and solely focus on the baby after birth, while the community is there to look after the mother.
“It’s the mother’s job to look after the baby and everyone else looks after the mother,” she explains.
In British culture, you might ring up your friend who’s had a baby and ask: How’s the baby doing? Is the baby eating? Is the baby sleeping? But this isn’t the right approach, says the expert.
“No, ring up the mother,” she continues. “How are you doing? Are you eating? Are you sleeping? Can I bring you some shopping? Can I give you a cuddle? Can I take your rubbish bins out?
“If we look after the mothers we enable the mothers to look after the babies – and that’s where we’ve got it wrong in our culture, everyone is focused on the baby.”
Five X More is currently calling on Black and Black mixed-heritage women and birthing people in the UK to share their maternity experiences by completing the Black Maternity Experience Survey.
