Maternity & Midwifery Forum
Midwifery Feature Articles Midwifery News

Black Maternity Matters: maternity care improvement project

By Ann Remmers

Last week two important reports demonstrating racism across UK Maternity services were released. In this week’s article Ann Remmers, Maternal and Neonatal Clinical lead, West of England Academic Health Science Network, shares a co-produced project to improve the care of Black women in the South West Region.



 In May Birthrights UK published the findings of their year-long inquiry into racial injustice and human rights in UK maternity care, ‘Systemic racism, not broken bodies’.

“The report uncovers the stories behind the statistics and demonstrates that it is racism, not broken bodies, that is at the root of many inequities in maternity outcomes and experiences.”

Listening to testimony from Black and Brown women and birthing people, as well as lawyers and health care professionals, they conclude that systemic racism in maternity care exists and set out a call to action to all parts of the maternity system.

The findings will come as no surprise to many maternity care providers where the evidence has been clear for some time that Black and Brown women and birthing people experience disproportionately poorer outcomes than their white counterparts (MBRRACE, 2018).

Two weeks ago our perinatal team at the West of England Academic Health Science Network held a very special event as we launched our Black Maternity Matters project .   Inspired by the vision that one day Black mothers will no longer be disproportionately in danger during pregnancy and the first year after birth, Black Maternity Matters is a partnership between our organisation and some amazing people who are leading the way in making a significant difference to the lives of Black people and their experiences of maternity care. As a team who are working on the national Maternity and Neonatal Safety Improvement Programme, we are supporting organisations to improve safety for Black and Brown women and families to reverse the stark statistics on outcomes.  Black women are four times more likely to die during pregnancy or in the postnatal period than White women, while stillbirth rates of Black and Black British babies are over twice those for White babies (MBRRACE, 2021).

We wanted to find a way to make a tangible difference to improving outcomes for Black women and birthing people and had an idea to form a collaborative of maternity organisations and health care professionals to develop bespoke cultural competency training for midwives and maternity support workers in co-production with partner organisations.

Sonah Paton and Aisha Davies

It was important to us to involve people with lived experience of the issues we wanted to address. Fortuitously my colleague, Noshin Menzies and I met Sonah Paton and Aisha Davies from Black Mothers Matter in 2021.  Together with their friend Yomi Oluwatudimu they decided to form Black Mothers Matter following their own experiences during pregnancy and childbirth with the “vision that one day Black mothers are no longer disproportionately in danger during pregnancy and the first year after birth.”

Listening to Sonah and Aisha’s stories was very moving for us and highlighted the racial discrimination that sadly exists and impacts on childbirth experience as well as outcomes. These three friends are incredible women who set about supporting other Black women through childbirth.

Sadly, when they approached local maternity units for support their emails were never answered. As a midwife I found this so upsetting but it highlighted to me how difficult it can be for those who are not given a voice to make themselves heard.

We asked Sonah and Aisha what they would like to happen if we could “wave a magic wand”. They told us that we needed to go further than providing training, by supporting professionals to make real change and giving them the confidence to be allies and support other staff in their learning about the impact of racism.

This led us to develop our project idea further to include quality improvement support for the participating midwives to enable them to translate their learning into action. By being part of a learning collaborative participants would be able to support each other through a frank and honest journey to implement lasting and meaningful change.

Through the luck of good timing, we were very fortunate to have the opportunity to apply to the Health Foundation for funding to support local learning initiatives as part of the Q community. We felt we had hit the jackpot when we were awarded £20,000 towards funding for our Black Maternity Matters project. This enabled us to fund the training package, engage some fantastic experts and provide some protected time for our midwife champions.

We approached Bristol, North Somerset and South Gloucestershire (BNSSG) Local Maternity and Neonatal Systems (LMNS), , and not only were they keen to take part in supporting the pilot but they also successfully bid to their Integrated Care System (ICS) for additional funding. This has enabled 17 midwives and maternity support workers to be released to attend the six-month programme, and more time for our midwife champions.

The training programme has been developed and is led by two people with a proven track record of providing excellent cultural competency training, Katie Donovan-Adekanmbi from BCohCo and Aisha Thomas from

We cannot believe how incredibly lucky we were to meet these two inspiring women with all their experience, and for them to want to work with us on this project was just what we needed.

As soon as we set up the project, we wanted to involve two of our local trusts to take part in our pilot programme. We really hoped that they would want to be involved and agree to support their maternity staff to take part in the programme. We talked to the leads from the Local Maternity and Neonatal System and the two Heads of Midwifery from the two trusts, University Hospitals Bristol and Weston NHS Foundation Trust and North Bristol NHS Trust.  We listened to any questions or concerns they had about the project. It was key that it worked for both maternity services and engaged their staff to want to take part in the programme. If we could not convince them, then the project may fail.

While they fully supported what we were trying to do, there was an understandable concern about releasing staff to take part. This was at a very difficult time for maternity units who were experiencing major staff shortages due to the Covid pandemic. The timing was right though as there was a real desire to address health inequities, particularly in maternity care, and we were able to make changes to the delivery of the project without compromising on the content or length.

The national Maternity Equity strategy  and the NHS Core20Plus5 approach had also just been launched and trusts and LMNSs were developing their own equity plans and submitting them to the Regional Maternity and Perinatal Network. The Black Maternity Matters collaboration was able to support this momentum by bringing together people who really want to make a positive difference to the maternity experience and outcomes for Black families.

Our training kicked off in early May and takes the participants through exploring their own feelings and background, examining their unconscious biases and how those impact on others. Our midwife champions both work for the trusts involved and have put themselves forward to take an active and leading role in the programme and bring with them an enthusiasm and passion for the programme. They will be working with the trainers to ensure that the programme reflects the issues facing maternity staff daily.

We are also recruiting Black parents to join our programme to ensure that real life experiences are used to further shape the training and that the participants are fully supported in their development and learning. A book club and action learning set provide support and interaction in between each of the three training days. The programme is flexible to allow learning amongst the participants to influence the programme as it develops.

The Black Lives Matter movement brought into sharp focus the shocking inequalities experienced by people based on the colour of their skin. It not only raised awareness but led some of us to examine our own prejudices, which we may previously have been unaware of. These words by George Floyd’s brother really resonated with me: “educate yourself”. Our outlook on the world is based on our personal experiences, race, ethnicity, socio-economic background. As a starting point we can look at ourselves, our identity, and our influences and how this may impact on others.

Opening our eyes to racism and the part we all play in this is the first place to start. “But I’m not racist” is often said when faced with the stark reality. But I have learnt that first you must look at yourself, your experiences, your background to find out what is influencing the way you view racism. It is not an easy journey but if you are prepared to start it you will be rewarded with knowing that you will make an impact on reducing the disadvantages of racism.

My own learning began when I attended a weekend workshop last year accredited by the Royal College of Midwives (RCM) and run by the Sheffield Maternity Cooperative. This was the start of my journey of learning about racism and how I could make a difference and I will be forever grateful to them for this.

I have had the privilege of meeting some incredible Black and Brown women who have taught me so much. I feel saddened by hearing of their experiences and how they have been made to feel less important and less special at such a unique and significant time in their lives when they are becoming a mother.  Now is the time for all of us, particularly from within maternity services to ensure that the voices of Black and Brown women and families are heard, and that we take up the mantle as professionals to advocate for and ease the burden and trauma on those brave enough to speak out.

It is time to dismantle the systemic racism within our NHS.

This is why I’m so proud of our new project, which brings together midwives and maternity staff from across two Bristol maternity services with a shared ambition to improve outcomes for Black women and birthing people and their babies.

As a local collaborative, the project provides psychological safety and peer support where the midwives and maternity support workers can explore the issues and what changes can be made in how we provide more equitable maternity services and care. Our vision is that as the programme develops, we will undoubtedly learn more and will be able to share our learning to enable wider participation. Translating learning into improving quality of care to benefit everyone involved, carers and families, values the significance of addressing racism.

Ultimately our goal is to support maternity organisations to be anti-racist and for outcomes and experience for all Black and Brown women and birthing people to be better.


Ann Remmers,

Maternal and Neonatal Clinical lead, West of England Academic Health Science Network,

May 2022


Find out more about the Black Maternity Matters project at