Race still matters

By Jo Tanner, RCM Director of Communications and engagement on 31 March 2021

According to a report from the Government’s Commission on Race and Ethnic Disparities this week, structural and institutional racism doesn’t exist in the UK. It’s other determinants, not race, according to the Commission, that decide how well a person does socially, economically and in terms of their health. When I heard this reported on the radio, I did a double take, not sure I’d heard correctly. Because the findings of this report simply do not chime with pretty much any other report published over the past decade, or even the past year.

In maternity services, we know that there is a disparity of experience, whether you’re a member of staff or a pregnant woman, if you are Black, Asian or from another ethnic background. As a Black or Asian midwife, you are more likely to be referred by your employer to the Nursing and Midwifery Council than your white colleagues – and you’re more likely to be sanctioned. As a Black woman, you are more than four times more likely to die in pregnancy or childbirth than a white woman, as highlighted this week in Channel 4’s Dispatches. And, of course, over the past year, we’ve seen that Black and Asian men and women are more likely to die as a result of COVID-19 than their white counterparts.

Of course there are factors other than race: poverty, poor housing, poor access to education to name but a few. But while these factors impact white people too, being Black or brown exacerbates that impact.

Disparities in maternal and infant mortality are deep rooted in racism. Structural racism in health care and social and public health service delivery indicates that women from Black, Asian and other ethnic groups often receive poorer quality care than white women. The denial or substandard level of care some of these women means that providers fail to treat them with dignity and respect. The repeated exposure to socioeconomic adversity, political marginalisation, sexism and perpetual discrimination can trigger a chain of biological processes, known as weathering, which can undermine the physical and mental health of Black, Asian and other ethnic groups.

Last year, we, as the professional organisation and trade union for midwives and maternity support workers, committed to doing what we can to tackle racial disparity – and yes, let’s speak plainly – overt and covert racism that exists in our maternity services. We also acknowledged that we should have done more. Our Race Matters programme seeks to address the issues faced by our members and would-be members and by the women in their care. As well as providing more and better training around equality and diversity for our staff, activists and workplace representatives, we are developing ways of providing better support for our members of colour, working with organisations like Turning the Tide, set up by Dr Gloria Rowland. That is why we are currently recruiting a project worker in London, where we have the most ethnically diverse workforce.

We are also using our position to lobby and influence NHS bodies, government departments across all four nations of the UK and other public bodies. Some of this work focuses on the collection of data. Too often, those from minority ethnic backgrounds are simply lumped together as if they are a homogenous group. That just isn’t the reality. For example, there is a big difference between the educational experience of boys from a South Asian background and that of Black Caribbean boys. The first group, taken as a whole, seems to thrive in schools, while the second is three times more likely to be excluded.

This is an area where we can agree with the Commission on Race and Ethnic Disparities. The use of the term BAME – shorthand for Black, Asian and minority ethnic – is lazy and doesn’t treat any group with respect. Because it’s often used in the collection of official data, it means that the needs of different groups, of individuals, are missed. We will continue to work with government and public bodies to change the use of language and, in the meantime, will no longer use such language in our own publications, except where we are using official data that does not yet reflect this.

The language we use matters – and, regardless of what this Government report says, race still matters.