Written evidence submitted by Five x More (MSE0077)



Five x More Evidence Submission


Five x More is a grassroots campaign committed to changing the fact that Black women are five times more likely to die during pregnancy and after childbirth than White women. The campaign aims to:

  1. Raise awareness of the disparity between Black women and their white counterparts in their pregnancy and childbirth experiences with the NHS.
  2. Empower Black women to make informed choices throughout their pregnancies to after childbirth, and to advocate for themselves.
  3. To close the gap on maternal health experiences of Black and White Women.
  4. Amplify the Black Women perspective in the discussion of improving maternal safety.
  5. To provoke a deeper examination of the role the NHS plays in perpetuating these problems e.g. quality of treatment, institutional racism and ethnic coding.

The campaign was launched in 2019 and currently has over 30,000 Black women in support of it.

Executive Summary

-          Black women’s maternal safety does not have parity with White women’s maternal safety.

-          Special consideration must be given to addressing the experiences of Black women when looking into maternal safety.

-          Black women are not given information to raise concerns over the treatment they receive.



Statistics published by MBBRACE in 2018[1] (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) have confirmed that Black British women are five times more susceptible to implications surrounding pregnancy and childbirth in comparison to their White counterparts. This is not a new finding; MBBRACE have reported on this reality for Black women for the last 20 years.

The MBBRACE analysis[2] has also highlighted concerns with neo-natal deaths and stillbirths, by drawing attention to how Black babies have a 121% increased risk for stillbirth and a 50% increased risk of neonatal death. These risks have been exacerbated by issues surrounding poverty (deprived areas having a 30% increased risk neo-natal mortality) and racism within the healthcare system.

Five x More coordinated a consultation to help respond to the Health and Social Care Select Committee’s call for evidence, 415 women participated. The questions were focused on the advice and guidance that Black women received, and their knowledge of how to address concerns.

The majority of women (55%) felt that they were given enough advice and guidance on having a vaginal birth. However, on all the other options given, Black women reported that they were not given advice and guidance to make an informed decision about these options.  The other choices presented were:

-          Home Birth: 78% of Black women did not receive advice or guidance to make an informed decision of whether they wanted this.

-          Water Birth: 70% of Black Women did not receive advice or guidance to make an informed decision of whether they wanted this .

-          Cesarean Section: 73% of Black women were not presented this as an option/potential intervention, and did not receive advice and guidance on this to make an informed decision.

-          Assisted Birth: 85% of Black women were not given advice or guidance about having an assisted birth and so would not have been in the position to understand what this entails.

Our findings here were not surprising to us, but a clear reminder of the failings of the NHS in relational to Black women’s maternal health and safety.  Black women are not being given advice or guidance to make informed decisions about the birthing experience, suggesting that there is no parity as it relates to White women.  This further suggests that, if there is a fear of blame culture as it relates to maternal safety generally, Black women are at a greater disadvantage because they are not even being given the same level of service to begin with.

Healthcare Safety Investigation Branch

The extent to which Black women are not given advice and guidance to make informed decisions reaches to their ability to advocate for themselves. 94% of respondents were unaware of the role of the Healthcare Safety Investigation Branch. They were unsure of how to make a complaint when they had bad experiences during their pregnancies and after childbirth - even when they were at risk of losing their life because of the negligent care they received. Many of the incidents of our supporters and respondents were preventable, had they been treated with care and empowered to make informed decisions. Of our respondents who had engaged with the Health Safety Investigation Branch to raise a concern,74% did not receive any follow-up.

August 2020

15 September 2020


[1] M.Knight, K. Bunch, D.Tuffnell, H. Jayakody, J.Shakespeare, R.Kotnis, S.Kenyon and J.J Kurinczuk. Saving Lives, Improving Mothers’ Care. Oxuniprint. 2018.

[2] See footnote 1