Anti-racism midwifery training ‘helping to open eyes’

NHS leaders, midwives and women with lived experience gathered today at the NHS Confederation Expo, being held in Manchester, to discuss how to improve outcomes in Black maternity care.

“The courage came from the participants to actually come along, to be open to learning [and] to be open to unlearning”

Ann Remmers

It comes as the latest MBRRACE-UK report into maternal deaths in the UK, published earlier this year, found that Black mothers remained almost three times more likely to die during the perinatal period compared to White mothers.

Work has been undertaken in some parts of the country to tackle this issue.

Today, the NHS Race and Health Observatory spotlighted the work that it had been doing with non-profit organisation Black Mothers Matter, to improve midwifery education around equitable maternity care.

One of the projects to develop from this partnership is called Black Maternity Matters, which has offered midwives and maternity healthcare support workers in the West of England educational sessions and peer-to-peer support on anti-racism.

Sonah Paton, co-founder of Black Mothers Matter, told the conference that the training was launched to tackle the “gap in the skills, competencies or confidence of the workforce to reduce racial disparities” for Black women in maternity care.

“The fact remains that there was still a huge risk that, as a Black woman, [I] could not manage or mitigate,” she explained.

“Even if I attended all of my antenatal appointments, ate well through pregnancy, stayed active, attended 100 hours of antenatal education, the fact remains that my safety ultimately lies in the hands of the healthcare professionals that I meet on my journey.”

Since the project launched, Ms Paton said you could already “feel the effects trickling down into the community”.

She added: “There’s definitely an increased level of trust within services and more of a willingness to lean into statutory services, knowing that actually within your area, within the setting that you’re going to give birth, there are these healthcare professionals who have been on this journey and are committed to doing the right thing for you.”

The Black Maternity Matters programme has been rolled out by Health Innovation West of England.

Ann Remmers, maternal and neonatal clinical lead at Health Innovation West of England, said all the organisations involved in the project were looking to implement something that was going to “radically try and make a difference to these poor outcomes”.

She added: “[We thought] how we could improve the understanding of maternity staff to such a level that those interactions which we know, and those microaggressions that can make such a difference and create a negative outcome, would be more positive.

“So it was really an education programme, but more than that.”

Panel on Black maternity care at NHS Confederation Expo 2024

Initially, the pilot was offered to midwives and support staff across North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust, who were were enrolled on a course where they participated in anti-racism sessions over a six-month period in 2022.

Following the success of this, the initiative delivered further training in 2023 to other groups of midwifery staff in Somerset, Wiltshire and Gloucestershire.

This year, it is running training for four further cohorts, including one involving senior leaders in health and care organisations.

“This is about building a community, building a movement, and really helping to support the staff to make some changes when they go back to work,” said Ms Remmers, who is a midwife.

“The courage came from the participants to actually come along, to be open to learning [and] to be open to unlearning.”

Ms Remmers said the Black Maternity Matters initiative was teaching midwives and other clinicians working across maternity things she wished she had known when she was training.

She added: “I think everybody who’s training in the health service should know the history of where things come from, because unless you understand that you don’t really know why somebody’s experiences are so poor.

“It’s a lot of opening your eyes, and once your eyes open you can’t unsee anymore.”

During the session, a midwife who had undertaken the course said there were “lots of really positive conversations” that happened among maternity staff following the training.

“We only know what we know, and culturally there’s a huge shift that needs to change,” she argued.

“During this training, [it] actually provided psychological safety to have these conversations [and then] you take it back to practice and you start teaching students the right things.

“The training has been phenomenal.”