GUEST BLOG - My mothers, sisters, aunts and daughters are dying

In today's guest blog doula extraordinaire and leader of Cultural Competency workshops for birth workers, , talks about diversity, racism and inequality in maternity care and representations of motherhood.

"In April this year, 11th-17th to be exact, we had the first Black Maternal Health Week. I can hear the sighs. Another black week? Surely women are women and maternal health is important for all. It’s about pregnancy, birth and the postnatal period. All have the same goal. Healthy pregnancy, labour and birth. So why do we need, yet again, to separate people out because of their ethnicity? It’s simple really. Black women are THREE times more likely to die in childbirth than white women.

Shocking statistic isn’t it? A 2014 study shows Ethnic Variations in Severe Maternal Morbidity in the UK. And this is why you may begin to hear voices rising. I know that mine certainly is. I’m a great believer in women’s rights in childbirth, but that has to be all women. When we neglect the specific set of circumstances that are causing such disparities in the maternal and neonatal morbidity rates, we do not, as we claim, believe in women’s childbirth rights.

So what is it that is causing this disparity? To be clear, it is not race. Most of the work has been done across The Pond as for some reason, we are hesitant to look at these things over here. Must be our reluctance to engage with our implicit and explicit racial bias. What we’ve learned from across the way is that it is not a genetic issue, therefore it is not about race. It is not a socio economic issue. Serena Williams is a case in point. The day after her daughter was born by caesarean, Serena went to see the nurse to explain how unwell she was feeling, to talk about her history with pulmonary embolism and to ask for a CT scan and a heparin drip. The nurse decided that it was probably the medication she was on that was talking. After insisting on seeing a doctor, one finally came that used a doppler on her legs and didn’t want to hear her when she again said that she needed a CT scan and to be put on the drip. Eventually another doctor came and agreed that she should have the scan, which then showed several clots in her lungs. Serena Williams is arguably one of the most famous black women on the planet. She is also incredibly wealthy. She wasn’t listened to initially. Now imagine a black woman with less agency than her. No matter what a black woman’s socio economic status, her risk of dying in childbirth and before her child’s first birthday is 3 in 10, rising in some hospitals to 12 in 10.  Over here we black women are three times more likely to die.

If it’s not race, genetics or socio economic reasons that cause the disparities, that leaves us with generational, systemic, structural racism. It wasn’t that long ago (2017) that a textbook for nurses/medics - Nursing: A Concept-Based Approach to Learning came out that stated the difference in pain levels and response of different ethnic groups. This would allow nurses etc to decide how and what pain management to offer. All of this has roots in eugenics. I was astounded to learn that UCLH hospital is the home of the eugenics library. A eugenics conference was hosted there in 2017 and for the three previous years.

When we look through the birthing world, the vast majority of the imagery around birth is white. The black images are normally situated within the negative imagery of birth. A cursory look through websites, birth organisations and birth workers social media accounts, the birth, pregnancy and parenting books show the ‘normality of white’. People won’t look to change their imagery because it doesn’t fit or suit their brand. They are happy with what they see, because they see themselves.

It is time to colour in the landscape of birth. It is time to understand why Black Maternal Health week exists. We do not have the time or luxury of hiding behind the ‘it doesn’t affect me or my clientele’ rhetoric or cheap online courses that last less than an hour, and we definitely need to see colour. My mothers, sisters, aunts and daughters are dying. It is time to hold up the mirror to see ourselves. To find our way to true cultural competency and claim the birthrights of all."

About Mars Lord:
Award winning doula and birth activist Mars Lord has been a birth keeper for over a decade. After attending the Paramana Doula course with Michel Odent and Lilliana Lammers, a spark was lit within her and the passion that she discovered for birth and supporting women has fired her soul ever since. She has had the privilege of working with hundreds of women, with a particular interest in multiple mums. A birth activist, with a desire to see the 'colouring in of the landscape of birth' and finding out the reasons for the maternal and neonatal morbidity rates amongst the BAME community, Mars created Abuela Doulas a doula preparation course primarily, but not exclusively, for women of colour. Her desire for reproductive justice led to the creation of the ‘Reproductive Justice Retreat’.

As a founding member of Birth In The City alongside Maisie Hill and Nicola Mahdiyyah Goodall, she delights in working with other doulas and sharing our collective stories and skills. 

Her work with pregnant women and their families has led her to speak at conferences and to lead workshops, namely Loving The Multiple Mamas and Cultural Competency. She has had the privilege of speaking at Mumsnet’s Bumpfest, twice, the Doula UK Conference (2016) and Feminism In London, twice. 

Mars is a mother of five that includes twins.

Letters to my Fanny

When Cherry Healey and I talked all things motherhood, birth, sex, doula, human rights (etc. etc.) it got gritty pretty fast. If you want a sweary introduction to the work of this fanny warrior (sorry) check out Cherry's brilliant podcast and grab a copy of her book (and mine!) while you're at it. 

And if you need persuading here's what lovely Cherry says about it all:

"In light of the backlash against Kate Hudson's comment (which I'm sure was entirely a joke but the reaction is definitely interesting) that the laziest thing she's ever done is to have a c-section, I chat to the brilliant CEO of Birthrights, Rebecca Schiller.

She has a MA in war studies. Yeah. Her passion for human rights and, after years of being a doula, she realised that there were some series issues around women, birth and human rights. After too many stories of women feeling a lack of power or respect she decided to do something about it. I highly recommend reading the articles on www.birthrights.org.uk.

We also move, somehow, onto the subject of women being pigeon holed. The working mum, the organic mum, the stay at home mum. And how we get pitted against each other. And wouldn't it be fun if we could just be women, 360 degree women that change and are layered and are not defined by whether we have children or not, whether we bottle or breastfeed, or if we decide we want to give birth through the love tunnel or the sun roof. Perhaps we can be a chardonnay drinking, homework nailing, organic pie making, sex fiend woman and break all the stereotypes. And I realised I was an organic cucumber, cesarean sex fiend. And we might even do t-shirts. We cannot be defined as simply as society would like. But we do deserve all the information and the respect that we can make strong decisions.

She's also written an absolutely brilliant book called Why Human Rights in Childbirth Matter, that the Chief Executive of the Royal College of Midwives said 'should become essential reading for all maternity professionals'.

I can't wait to read Rebecca's new book coming out in April. I promise to do another interview with her, partly so she'll bring me more duck eggs from her home, and also because I think she is so wonderfully balanced, informed, highly respectful and compassionate.

In a sea of layered, complicated, important and sometimes angry debate around childbirth, she is a mast to hold onto."