As we approach the birth of Meghan Markle's child, let's remember the massive disparity in healthcare and birth trauma between white and black women

It is an area of study that has remained neglected by the health community

In a world where healthcare is easier to access than ever before, personal stories such as “I almost died giving birth” and “my health and my babies were in danger” may seem like extreme circumstances. They’re not, however. The world of maternal mortality is closer than it may appear – especially for black women. These are not the words of someone who gave birth without NHS support or without a midwife, but the experiences of two of the most successful women in the world – women with access to the best healthcare available.

In February and September last year, tennis player Serena Williams and artist Beyoncé Knowles-Carter respectively penned essays discussing the trauma of giving birth, both touching on the difficulties of becoming a mother in the public eye. The women were rightly hailed as brave for sharing their stories, yet when the Duchess of Sussex, Meghan Markle, announced her decision to opt for a birth away from the prying eyes of the press, she faced furious backlash. It may have been a coincidence that one of Britain’s most visible black female figures would be at the centre of another pregnancy-related firestorm on the same day that Black Maternal Health Week began, but the timing is pertinent. We find ourselves in one of the most significant health crises of our time; why are so many black mothers dying in childbirth, and why don’t doctors seem to care?

In November last year, a report by the national programme, Mothers and Babies: Reducing Risks Through Audits and Confidential Enquiries across the UK (MBRRACE UK) found that black women in the UK are five times more likely to die in childbirth than white women. The report did not investigate the cause of this disparity, but it is an alarming trend across the western world that black women and health officials have been aware of for many years. Similarly, in the US, maternal mortality rates for black women are three to four times higher than that of white women; a figure that hasn’t changed since 1979, and recent reports have found that middle-class black women are more likely to die in childbirth than working-class white women.

The disparity in care between white and black women has also had alarming effects on the health of black babies. In the UK, one study found that black premature babies were more likely to be put in lower-quality neonatal intensive care units than white babies, and government statistics show that black babies have the highest infant mortality rates out of any ethnic group. In the US, black infants are twice as likely to die as white infants. The New York Times reported last year that this racial disparity is now higher than it was in 1850, 15 years before the end of slavery.

Despite the fact that these statistics are now widely known, it is an area of study that has remained neglected by the health community.

The last major study was conducted over 10 years ago, in 2008. This study uncovered that the care given to women from ethnic minority backgrounds was substandard, concluding that “despite limited and good-quality evidence there are consistent messages that suggest that black and ethnic minority women do not access or receive optimal care”.

In fact, the study found that black women were 8 per cent more likely to receive substandard obstetric care. For most black women, this won’t be a surprise. When the documentary Being Serena was aired in May 2018, it revealed that the grand slam champion hadn’t just had to fight for her life, she had had to fight for the right to be heard by her doctors when she knew something was wrong. Many black women report similar stories of feeling like they are not being listened to, and despite being the ones who know their bodies best, report that doctors often ignore their concerns. These stories are alarming, not only because they demonstrate the country’s prevalence of racism and misogyny in the healthcare sector, but that a mother’s agency should be at the very centre of any such care.

The entitlement of media junkets demanding a front-row seat to the birth of Meghan Markle’s child is not shocking; women’s, and especially black women’s bodies, have always been seen as disposable. The difference is, it may actually be killing them.