The solicitor representing the family of a 35-year-old black woman who died after childbirth has said ‘racial bias needs to be addressed’.
In October, an inquest concluded that tangible missed opportunities contributed to the death of Aayan Waeys, after the first-time mother died in St. Thomas’ hospital from a brain haemorrhage 14 days after her stillbirth which was two months before her due date.
The inquest comes after the Health and Social Care Committee’s latest report on black maternal health concluded that black women in England continue to face disproportionately poor outcomes in maternity care.
Data from the report reveals black women are 2.3 times more likely to die in childbirth than white women.
On 1 November 2022, Waeys attended the maternity assessment unit (MAU) at St Thomas’ for a routine appointment and displayed symptoms of pre-eclampsia — a serious pregnancy complication involving high blood pressure and protein in the urine.
Although Guy’s and St Thomas’ NHS Trust’s guidelines required Waeys to be referred to a consultant obstetrician, no such review took place. Instead, Waeys was retested and sent home before the new results became available.
She later returned to the hospital in labour at 36 weeks, but her unborn baby girl had already died.
Due to bleeding an excessive 2.5 litres, Waeys suffered a catastrophic brain haemorrhage and was placed into a medically-induced coma. She remained in the coma for two weeks until she died on 16 November 2022.
Firdous Ibrahim — who was the Waeys family’s solicitor for the inquest — is a senior associate solicitor in the medical negligence department at Leigh Day.
Ibrahim said: “From the evidence heard at the inquest, it was apparent that there was a concerning lack of obstetric-led care and continuity in the clinical management of Ayaan’s pregnancy from the outset.
“Evidence provided by Ayaan’s family showed that they felt her symptoms were not being taken seriously, which in my experience is often a running theme that black women raise as an issue in their care.”
During the inquest, expert evidence from consultant obstetrician Dr. Edwards Mullins concluded that the failure to admit Waeys’ when she first displayed pre-eclampsia symptoms ’caused or contributed to her death.’
Ibrahim said: “[Waeys’] tragedy underscores the importance of early intervention and culturally competent care that recognises and responds to the specific needs of black women.”
Though the National Midwifery Council states that midwives should respect cultural beliefs, there are no requirements for training on racism.
Instead, individual NHS Trusts are responsible for organising specific training programmes and where they do exist, the Health Committee concluded that these programmes are often limited in scope and poorly embedded.
Ibrahim said: “To protect black women’s maternity care, we need meaningful, systemic change which has already been advocated for many years by various stakeholders.
“This starts with addressing racial bias within healthcare systems. It means creating policies and programs that not only raise awareness about the specific health risks black women face, but also actively implement practices to reduce those risks.”
Though the black maternal health report shows that black women are 2.3 times more likely to die from childbirth than white women — down from four times more likely — London MP Ben Coleman, a member of the Health and Social Care committee, argues that this decreased figure is misleading.
He told The Londoners: “The only reason that the number appears to be better for black women is because it’s actually got worse for white women. There is a challenge for maternity services across the country which needs to be addressed.”
During the committee’s inquiry, Coleman was particularly struck by the impact racism is having on the maternity care black women receive within the NHS.
The MP for Chelsea and Fulham added: “I thought things were a lot better than they are in terms of racism and people being treated equally no matter what the colour of the skin and where they came from.
“The more I spoke to people about [their experiences] the more I understood that if you’re told to trust the NHS when it’s telling you it’s safe even though the people you know have had a lifetime of getting less good access to the health services, you won’t start with the same level of trust that other people might have.”
The committee — which examines the policy and administration of the Department of Health and Social Care — concluded that the NHS has a culture of not listening to or taking the concerns of black women seriously.
One NHS staff member is reported to have told a pregnant woman that as a ‘big and strong’ black woman, she could ‘handle the pain,’ even as she was losing a concerning amount of blood.
Another woman was told that in Africa they let their women die, so it was lucky she had the care she did in the UK.
Coleman said: “What came across for me, and I’m talking personally because this isn’t one of the particular findings from the report, was that there was a lack of respect and lack of trust that people might actually know their own bodies the best.
“So it seems to me that the NHS has quite a lot of work to do to build trust with people from black and minority ethnic backgrounds.”
The NHS has faced an estimated £27.4billion bill for medical negligence in England since 2019 which puts England’s maternity services in a state of crisis.
Coleman said: “I think there’s a challenge with the NHS. There is still a lot of doing things to people rather than with them.”
In April, the government cut the Maternity Service Development Fund from £95million to just £2million for 2025-26.
Aduragbemi Banke-Thomas — an associate professor at the London School of Hygiene and Tropical Medicine — believes women’s maternal health has been deprioritised around the world.
The co-director of the Centre for Maternal Adolescent Reproductive and Child Health (MARCH) said that there are three delays that contribute to maternal deaths: delays in decisions to seek care, delays in travelling to reach maternal care facilities and delays in receiving care upon arrival.
Banke-Thomas said: “How do we ensure that, when women get to facilities, their care is prioritised and that healthcare providers actually give them the care they need?
”Healthcare workers are overburdened so even if you come in for an emergency, there are other emergencies that need attention.
“So it’s not a one-size-fits-all in terms of how we approach addressing maternal mortality. It has to be tailored. It has to be context specific.”
Though there have been recruitment increases in midwifery and obstetrics in England, the black maternal health report found that there are still workforce shortages causing major barriers to safe maternity care.
Dr. Gabrielle Macaulay, known as Dr. Gabi, is a GP with 15 years of dedicated experience in the medical industry and a commitment to women’s reproductive health.
Dr. Gabi said: “I think that it’s important that women have access to speak to an obstetric team easily throughout the pregnancy so that it’s not just in the third trimester of the second trimester.
“The one thing I would recommend is for women not to be scared to get a second opinion. If they feel like the management plan they’ve been given doesn’t meet their expectations or their concerns, definitely get a second opinion whether it be from another clinic at the GP practice or another gynaecologist.”
Guys’ and St. Thomas’ NHS Foundation Trust was contacted for comment.
Featured Image Credit: Family of Ayaan Waeys
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