Black maternal health is not a niche issue or a conversation for Black families alone. It is a test of whether our maternity, mental health and neonatal systems listen, respond and care equitably.
For more than a decade, I have listened to Black mothers describe the same painful pattern: they knew something was wrong, they asked for help, and they were not heard early enough. The statistics matter, but behind every number is a mother, a baby and a family whose experience deserves to count.
When I became a mother, I quickly understood how vulnerable the journey into motherhood can feel. There is joy, love and hope, but there can also be fear, uncertainty and the exhausting sense that you must stay alert in a system that may not always see you clearly. That understanding shaped my book, My Black Motherhood, and it is why I founded The Motherhood Group in 2016.
Since then, we have supported more than 18,000 Black and Global Majority mothers through community programmes, peer support, research, advocacy and training. Again and again, mothers tell us that the hardest part was not only the medical complication or mental health struggle itself. It was having to prove that their pain was real, explain their culture, push for a referral or find support only after they had reached crisis point.
Black maternal health covers pregnancy, birth and the postnatal period. It includes physical safety, emotional wellbeing, the health of our babies, the way symptoms are recognised on darker skin, and whether care is respectful and culturally responsive. Here are five things everyone should know.
1. Black mothers still face a higher risk of dying during and after pregnancy
The latest MBRRACE-UK report examined maternal deaths between 2021 and 2023. It found that Black women died during pregnancy or within six weeks of the end of pregnancy at 2.3 times the rate of White women. The recorded rates were 28.21 deaths per 100,000 women giving birth for Black women, compared with 12.44 for White women.
Maternal deaths are rare in the UK, and it is important to say that clearly. But rarity does not make an unequal risk acceptable. The ratio has fallen from 3.7 in the previous reporting period, yet Parliament's 2025 inquiry warned that the reduction partly reflected worsening outcomes for other ethnic groups, rather than a large improvement in care for Black women. Progress cannot mean the gap looks smaller because somebody else's outcome has deteriorated.
These figures should never be used simply to frighten Black mothers. They should create urgency among the people and institutions responsible for safe care. Black women are not biologically destined to have worse outcomes. The question is what happens around us: how risk is assessed, whether symptoms are recognised, how quickly concerns are escalated, and whether bias shapes the response.
2. Maternal mental health is part of maternal health, not an afterthought
Pregnancy and birth do not end when a baby arrives, and neither should care. Perinatal mental health refers to mental health during pregnancy and in the period after birth. It can include depression, anxiety, trauma, obsessive thoughts, severe mental illness and postpartum psychosis. Government estimates suggest that more than a quarter of women giving birth in England may need some form of perinatal mental health support across the perinatal period.
A 2024 analysis of NHS hospital data found that Black mothers were more than twice as likely as White mothers to be admitted to hospital with perinatal mental illness, and more than three times as likely to be admitted for severe mental illness after birth. Hospital admission data cannot tell us the whole story or explain the cause. It may reflect a combination of greater exposure to racism, trauma, deprivation and isolation, barriers to early help, mistrust of services, and distress being recognised only once it becomes severe.
At The Motherhood Group, mothers have told us about trying to carry on because they feared being judged, misunderstood or seen as an unfit parent. Some did not see themselves reflected in the language or imagery used by services. Others were offered support that did not understand the role of faith, family, culture, racism or the expectation to be the 'strong Black woman'. This is why culturally safe peer support and accessible early intervention matter. No mother should have to reach breaking point before somebody listens.
3. The inequality also affects Black babies
Black maternal health includes the health and survival of our babies. The Office for National Statistics reported that in England and Wales in 2024, infants from Black ethnic groups continued to have the highest infant mortality rate. This has been a consistent pattern across the data, not a one-year anomaly.
That does not mean every Black baby is at high risk, nor can one statistic explain every loss. Gestational age, birthweight, deprivation, maternal health and access to timely care all matter. But when the same ethnic inequality persists year after year, it must be investigated and acted upon. We need better-quality ethnicity data, transparent local reporting and services designed around the communities experiencing the poorest outcomes.
Most importantly, families who experience baby loss or neonatal illness need compassionate, culturally responsive bereavement and mental health support. A mother should never have to navigate grief while also teaching professionals how to understand her identity or community.
4. Some clinical signs are harder to recognise on darker skin
Clinical education and visual reference materials have often treated White skin as the default. The NHS Race and Health Observatory found that commonly used newborn assessments, including visual checks involved in identifying jaundice and cyanosis, can disadvantage Black, Asian and other minority ethnic babies. Its review said some assessments are limited and not fit for purpose across different skin tones.
This is not a cosmetic issue. Jaundice can be harder to see on Black or brown skin, while changes may be more visible in the whites of the eyes, gums, palms or soles. The NHS advises parents to seek urgent advice from a GP, midwife or NHS 111 if they think a baby over 24 hours old has jaundice, and to get emergency help when jaundice is accompanied by serious symptoms such as unusual sleepiness, poor feeding, breathing difficulty or an abnormal temperature. Jaundice in the first 24 hours also needs immediate assessment.
Parents should not carry the responsibility for correcting gaps in clinical training. The system must provide representative teaching materials, use objective measurement where appropriate and ensure professionals can recognise signs of illness in every skin tone. Better representation in textbooks and training is a patient-safety intervention.
5. Being listened to and receiving culturally responsive care can affect safety
Listening is not simply about making a mother feel better. It can determine whether a warning sign is investigated, whether pain is treated and whether help arrives before a crisis. Parliament's 2025 inquiry heard that Black women faced particular challenges in being believed, including stereotypes that Black women have a higher pain tolerance or greater emotional resilience. It linked these assumptions to delays in appropriate care.
As I write in My Black Motherhood: Mental Health, Stigma, Racism and the System, "Trust has to be earned." In maternity care, that trust is built when women are listened to, believed and treated with dignity from the first interaction.
The inquiry heard repeatedly that racism is one of the core drivers of poor maternal outcomes and called it indefensible that cultural competency training remained optional for NHS maternity staff and leaders. It recommended mandatory, ongoing training for midwives, informed by co-production with Black women, alongside updated materials that meet the needs of every ethnic group.
Cultural responsiveness is not about memorising a list of customs. It means being curious rather than assuming, asking what matters to each woman, recognising how racism and past experiences may shape trust, providing interpreters where needed, and adapting communication without lowering clinical standards. It also means involving Black mothers in designing, delivering and evaluating services, and paying them properly for that expertise.
What should happen next?
Black mothers should feel able to ask questions, bring somebody they trust to appointments, request that concerns are documented and seek another review when something does not feel right. But self-advocacy must never become a substitute for safe care. The burden cannot sit with mothers to protect themselves from the very system that should protect them.
Professionals and services must listen the first time, challenge racial stereotypes, improve postnatal follow-up, recognise illness across all skin tones and provide timely routes into culturally safe mental health support. Leaders must measure outcomes by ethnicity, act on local disparities and fund community organisations as delivery partners, not as an afterthought.
For everyone else, the first step is to understand that Black maternal health is not only a Black issue. Partners, relatives, employers, commissioners, researchers and allies all influence whether mothers are supported. Learn the evidence, believe Black women when they describe their experiences, amplify trusted organisations and ask what action follows each new report.
I want Black motherhood to be spoken about with honesty, but also with hope. Black mothers are not statistics. We are whole people carrying joy, ambition, culture, faith, fear and love. We deserve care that sees all of us, support that reaches us early and systems willing to change. Awareness matters, but awareness without action is not enough.
Continue the conversation by listening to Tommee Tippee's "Being heard: The Black maternal health gap" podcast episode.
You can also connect with The Motherhood Group for trusted Black maternal health information and community-led support, and explore Mumbrite for culturally inclusive maternal wellbeing, expert-led sessions and peer connection.
Research and support
- MBRRACE-UK, Saving Lives, Improving Mothers' Care 2025. UK maternal mortality surveillance for 2021 to 2023.
- House of Commons Health and Social Care Committee, Black Maternal Health. Published September 2025, with findings on racism, listening, training and accountability.
- Sandra Igwe, My Black Motherhood: Mental Health, Stigma, Racism and the System. Jessica Kingsley Publishers, 2022.
- Office for National Statistics, Child and infant mortality in England and Wales: 2024. Published May 2026.
- NHS Race and Health Observatory, Review of Neonatal Assessment and Practice. Evidence on Apgar scoring, cyanosis and jaundice across skin tones.
- NHS, Jaundice in babies. Symptoms and urgent advice for parents and carers.
- NHS, Postnatal depression. Signs, support and urgent mental health guidance.
- GOV.UK, Estimated prevalence of perinatal mental health conditions in England. Official estimate of support needs across the perinatal period.
- The Guardian, NHS data analysis on perinatal mental health admissions. Published May 2024. This is an analysis of NHS hospital data, not a prevalence study.
- The Motherhood Group, Black Maternal Mental Health Project. Community-led research on barriers, trust and culturally safe support.
- Mumbrite, Find Support. Culturally inclusive maternal wellbeing, peer support and specialist connection.
