Black Women and the NHS: Who will protect them?
Posted on 04 Feb 2021 by Shamar Gunning
Disclaimer: The views expressed below are that of the individual author.
In November 2020, the British Parliament’s Joint Committee on Human Rights published a formal report entitled “Black people, racism, and human rights.” Amongst a slew of other grievances, the report found that Black women are currently five times more likely to die in childbirth than White women in the UK. The report admits that “the reasons for this disparity are not fully understood”, however “socio-economic and physiological factors may be at play”. The mystification surrounding the reasons for such a wide disparity can be dispelled by consulting Black women who work within the British medical profession themselves.
Dr Christine Ekechi, a consultant obstetrician at Imperial College London, is at the forefront of conversations on this topic. She has posited institutional racism within the medical profession as a foundational reason for the disparity in maternal mortality. Dr Ekechi is quoted as saying “people think of racism in an overt, aggressive way. But that’s not always what it is. It’s about biased assumptions—and we doctors have the same biases as anyone else.” Her quote reflects a continuing struggle between respecting the knowledge of doctors and medical professionals and recognising them as fallible in their work. Particularly, by excluding medical professionals from being capable of racial bias we disallow Black women the same access as their white counterparts to medical care. This is not a new phenomenon. The report adds that this data has been available since at least 2013. Nevertheless, little decisive action has been taken, by members of the medical profession or the legislative who are tasked with protecting these women, to rectify the issue.
The findings of the report speak directly to misogynoir, a socio-political theory termed by Moya Bailey to describe the unique discrimination faced by Black women; an intersection of race and gender. Misogynoir has a dark history within medical academia. The “Father of Modern Gynecology” James Marion Sims conducted large amounts of his medical ‘research’ on fully conscious enslaved black women, citing the belief that Black people did not feel pain. Furthermore, the case of Henrietta Lacks, a Black woman whose cells were taken without her consent and later used to establish one of the most important cell lines in medical research, shows how little regard has been shown for Black Women’s body autonomy. Today Black Women remain affected by the very same ‘pain myth’ that Sims himself cited. As recently as 2020 it was found that “half of white medical trainees believe such myths as black people have thicker skin or less sensitive nerve endings than white people”.[1] This myth translates dangerously within the maternity profession where the pain tolerance of Black women may still be misconstrued as higher than white women, leading them to be denied medication and attention when needed during labour.
However, resolution of the issue is multi-layered with many students reporting they are still not taught how to examine and diagnose all ethnicities. It seems in the medical field, as in many others, being white is the default - a position that is detrimental to Black women’s health. Of course, this is a particularly controversial issue to address - everyone is aware of the many strains the NHS is under and how difficult it is becoming to sustain it. Traditionally, the judiciary has been reluctant to intervene in the medical practice [perhaps the most dramatic instance of this was in the infamous Montgomery case of 2015]. However, if the NHS continues to sideline this issue it is indubitable that cases of medical negligence will continue to arise and will repeatedly place the courts in the unfavourable position of presiding on actions within the medical field. The reported disparity directly conflicts with Article 2 and Article 14 of the ECHR which allows for the right to life and non-discrimination, as well as the Equality Act 2010 which prohibits direct and indirect discrimination with the public sector.
Importantly the report finds that “Black pregnant women are eight times more likely to be admitted to hospital with Covid-19, while Asian women are four times as likely.” This means as we continue into 2021, the NHS must urgently address medical racism, which has only been further exacerbated by the pandemic.
Conclusion:
The report calls for a new body to be instated- similar to the Commission for Racial Equality, a non-departmental public body created in 1976 but taken over by the Equality and Human Rights Commission in 2007. The disbandment of the CRE shows how damaging a readiness by the government to “resolve racism”, without properly attacking the systemic issue, can be. Fundamentally, it is important to acknowledge the very real loss of lives caused by systemic racism. Despite willingness to centre the issues of Black people by the EHRC, the report also held “in terms of its ability to act as a vocal champion for the Black community, witnesses told us that the EHRC compares unfavourably with the Commission for Racial Equality (CRE)”. If this is correct, it appears a new body focusing specifically on race will need to be established to protect Black people, and in particular Black mothers. Outside of government bodies Black women have been advocating for themselves for a long time, with the FIVEXMORE campaign creating petitions and raising awareness on the issue within the UK. Unfortunately, closing this gap will take the work of more than just Black women, but every available ally that is willing to help.
The report states that “the failure to act in response to reports and inquiries erodes the trust of Black people in the state and further compounds the impact of discrimination and denial of human rights.” It is critical to stress the importance of human rights regarding maternal mortality and disparities within the healthcare system. We must return agency to Black people and Black mothers by holding the Government to account of its promise to treat us all equally.
**REPORT: **https://committees.parliament.uk/publications/3376/documents/32359/default/
[1] https://www.aamc.org/news-insights/how-we-fail-black-patients-pain
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misogynoir
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medical_law
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