(Un)safe Motherhood? Inclusivity and diversity in maternal care in multi-ethnic Britain 

Staff: Nadine Beckmann and Lia Betti 

This project will investigate whether current maternal care training and guidelines in Great Britain, which were developed largely on white women’s physiology, unintentionally discriminate against non-white women, thus potentially contributing to their higher rates of maternal mortality and morbidity. Black women in Britain are five times more likely to die in childbirth than white women, and substantial ethnic gaps in severe maternal morbidity have also been reported in the UK, and in other high-income countries. These have been linked to differences in socio-economic status, access to and quality of prenatal care, medical co-morbidities, environmental exposure, and overall structural racism. However, a large portion of the ethnic gap remains unexplained. One potential factor is that obstetric care has been modelled on white women’s physiology, disregarding the evidence of ethnic differences in the length of labour, in birth weight, and in the most common presentation of the baby at birth, the latter probably due to well-established ethnic differences in the shape of the pelvis.  

Grounded in a critical biocultural approach to medical anthropology, the project combines interviews with maternal care providers (midwives and obstetricians), participant observation in hospital settings, and quantitative analyses of hospital data to investigate levels and awareness of ethnic variation in childbirth, and explore how current models of “normal” birth and the use of standardised guidelines impact women of non-white ethnicity. The longer-term aim is to broaden the range of women on whom maternity care guidelines are based, to ensure that they are inclusive and reflect the diversity of women’s experiences in our multi-ethnic society.