Does this happen to you (or around you)? Exposing discrimination in maternity care – the 2025 toolkit

When you attend fertility or prenatal care, labor or postnatal visits, you expect safety, dignity and respect. But for black women in the UK, this expectation is repeatedly shattered. THE latest evidence states it unequivocally: discrimination in health care and social services, especially in the maternity wardremains omnipresent. And it kills confidence, harms health and too often costs lives.

This feature is for Black moms, birthing people, and medical professionals who refuse to gaslight themselves or others. It gives you up-to-date language, a framework, and a no-BS toolkit: how to know when discrimination is occurring (against you or in your area of ​​care), how to report it, and how to advance treatment.

Definitions are crucial, so we’ll start there.

What East discrimination in the field of health and social services?

At its core, discrimination occurs when a person or group is treated less favorably than others because of who they are. This may include their race, gender, maternity status, disability, religion, sexual orientation or any other protected characteristic. Check Acas to learn more about this.

In the field of health and social services, discrimination can manifest itself by:

• Negative assumptions, rejections, or stereotypes based on identity (e.g. “Black women tolerate pain better“) – read our article covering Naga Munchetty’s experiences and GP navigation tips for actionable details
  
• Failure to provide equitable access to services
  
• Inadequate communication, refusal of appropriate care or unfounded refusal of requested interventions
  
• Systemic policies or practices that systematically disadvantage a group

Discrimination in health care does not require malicious intent. It can be subtle, unconscious and/or normalized, but that doesn’t make it any less harmful.

Under UK law (Equality Act 2010), discrimination in the provision of services, public office and healthcare is illegal when it involves “less favorable treatment” on the basis of a protected characteristic.

Protected characteristics include race, pregnancy and maternity, gender, disability, religion, sexual orientation, age, gender reassignment and marital status.

Direct, indirect and positive discrimination – definition

To name the shape of the problem, you need the right terms:

Direct discrimination

This is the clearest: treating someone worse because of a protected characteristic.

• Example: Denying pain relief to a black woman during labor, while providing it to white patients in a similar situation.
• Example: Telling a pregnant patient that she is “too emotional” and dismissing the complaints, when others’ complaints would be taken seriously.

If there is a causal link between your identity (the cause) and the worst treatment (the effect) is direct discrimination.

Indirect discrimination

It’s more insidious. This occurs when a policy, practice or neutral criterion disproportionately disadvantages people with a protected characteristic, unless this can be objectively justified.

• Example: Prenatal consultations are organized only during working hours, which disadvantages working women who do not have flexibility.
• Example: Generic risk-scoring tools that do not account for racial or ethnic differences, leading to over- or under-labeling of Black women as “high risk.”

If the policy is disproportionate and lacks justification, it may be illicit.

Affirmative discrimination (and affirmative action)

Sometimes called “affirmative action,” affirmative action involves taking steps to improve the situation of protected groups. In health and social care, this is permitted under Equality Act in certain contexts (called “affirmative action”), and not as general preferential treatment.

• For example: targeted funding for black maternal health programmes, or training to improve cultural competence in trusts serving a large black population.

Care must always be fair and proportionate.

Positive action is not the same as unfair preferential treatment. It must be justified, proportionate and aim to remedy real inequalities.

Why maternity care data is urgent

We have new evidence from the Five Times More Survey on Black Motherhood Experiences 2025covering more than 1,100 black or mixed race women who gave birth between July 2021 and March 2025.

Main conclusions:

• 28% of respondents said discrimination during their maternity care. Of these, 25% thought it was due to race.
• 54% encountered “challenges” or conflict with health professionals.
• In labor or birth45% raised concerns and 49% said those concerns had not been properly addressed.
• 23% said they had not received the pain relief they asked for it and 40% of them received no explanation.
• Only 39% had been recommended on nutrition (27% on exercise) upon booking.
• Only 20% were informed how to complainwhile only 8% filed a formal complaint.

Across the UK, media coverage reported horrific stories – of women calling themselves “strong black women” or being pressured to feel “grateful” for their care, compared to the care they had received. ‘could enter Africa’.

Meanwhile, a recent Goalkeeper Analysis warns that half of black women who raised concerns during labor said they did not receive appropriate help.

In Parliament, the Health and Social Services Committee declared systemic racism in maternity services “indefensible,” noting that black women remain twice as likely to die in childbirth as white women, and that their babies face a higher risk of stillbirth.

This is not an anecdote, it is a crisis. And it continues to wiggle.

Know it when it happens (to you or in your department)

If you’re a Black mother, a person giving birth, or a healthcare professional committed to justice, here’s how to spot discrimination, in no uncertain terms.

Red flags (for patients or service users)

• You express a concern (e.g. pain, monitoring, changes) and are ignored or dismissed.
• You are told that your symptoms are “just anxiety,” “emotional,” or “normal for black women.”
• You are refused treatment that you requested, without explanation.
• You see that a person in a neighboring bay suffering from the same problem is treated more quickly.
• You repeatedly have to advocate for yourself or call on a support person just to get basic attention.
• You are given conflicting or changing justifications for your interventions.
• Staff refer to stereotypes: “You have a high pain threshold,” “You will get through it,” or make comparisons based on race.
  

Red flags (for healthcare workers or management)

• In your department, certain groups are over-represented in adverse outcomes, complaints, delays.
• You observe staff systematically dismissing or downplaying rates of pain or discomfort among Black patients.
• Risk protocols are applied simplistically without considering racial, social, or cultural context.
• Complaints from minority patients are no longer a priority or the trends are not reported.
• No or limited training in cultural competency, implicit bias, or anti-racism – or token training.
• Lack of transparency or tracking of data by ethnicity for maternity outcomes.

When you see them, call him. Don’t accept gaslighting, silencing, or shifting blame.

A pragmatic toolbox: how to denounce it and advance treatment

Identify? Implement one of these next steps, depending on your situation and whether escalation is necessary.

1. Document everything, in the moment.

• Keep a journal (date, time, names of staff, what was said, your requests) or ask your birthing partner to do so.
• If possible, ask a support person to witness or confirm times and names.

2. Ask direct, clarifying questions.

Again, this is an action that your birthing partner can absolutely support.

• “Can you explain why this intervention is necessary? »
• “Is this decision standard or is it influenced by my identity?
• “If I were white or another ethnicity, would your response be different? »

3. Use the language of your rights

• “Under the Equality Act, I should not be treated less favorably because of my race and/or maternity status. »
• “I think this is discriminatory. Please raise or document my concern.”
• Demand your right to complain and ask them to record your objection in your notes.

4. Insist on escalation or a second opinion

• Ask to speak with the lead consultant, clinical governance, patient liaison or advocacy services.
• Ask for a second opinion, even if you have to insist on getting it.

5. File a grievance or formal complaint

• Ask about the complaints procedure – check the different routes inside and outside your NHS trust.
• Use independent bodies like the Equality and Human Rights Commission (EHRC) or Citizens Advice.
• Obtain legal advice as early as possible if necessary – templates strengthen cases.
  

6. Mobilize support networks and advocacy

• Bring a birth partner, doula, or advocate who can resist.
• Share your experiences through patient groups or advocacy organizations (e.g. Five X More).
  

Use social media strategically and legally to seek accountability and solidarity.
Fund and resource Black Maternal Health Units, support groups, peer support.

Final word – we are past excuses

In 2025Black women still die in childbirth at twice the rate of white women. Systemic racism, institutional denial, data blindness and culture wars within trusts all conspire to silence evil.

It is no longer acceptable to call this “implicit bias” or “training gaps.” We demand justice, security and structural change. If you are a Black mother or birthing person, take home and share this toolkit. If you are a healthcare professional or leader, act now and be part of the solution, not the continuation of the problem.

Listen to this next – I highly recommend listening Candice Braithwaite talk about and engage with your writing and content. His own experiences are more than relevant and powerful to rely on.