About The Project
In Nottingham, the mortality rates for infants aged 0-4 is 9.73 times greater in Black and Asian compared to White population in Nottingham and Nottinghamshire (Midlands Scoreboard, ICS 2022). Furthermore, Black and brown skin community are disproportionately represented in maternity Serious Incidents at Nottingham University Hospital despite only 34.5% of births registered to Black and ethnic minority (BME) mothers in 2020/2021. These outcomes are reflective of national data which state maternal mortality rates are 4 times greater in Black women, 3 times greater for mixed race women and twice greater in Asian women in the UK (Knight, et al. 2021).
The reasons for these discrepancies have yet to be established, though are likely attributable to a combination of lack of appropriate local provision, differential treatment of these communities by their maternity services as well as unequal uptake of services among these demographic groups within Nottingham. This lack of clarity is due to Black and brown skin women’s voices being marginalised within statutory service providers, community services and the evidence-based practice to which health professionals hold themselves accountable. It is evident that the experiences of these underrepresented communities are currently not being adequately captured or incorporated into service development.
The need for a life course approach to inequalities has been highlighted by the Health Inequalities: main report (2021). This highlights the range of social determinants of health, psycho-social factors and health behaviours which erode an individual’s health and wellbeing and points to the need to undertake research which captures the lived experience of marginalised groups in order to redress these factors. In terms of maternal health, research into real-life, identity-based interactions between women/birthing people and service providers is essential to fully understand how these encounters may enact exclusion and reproduce health inequalities.
Specifically, the experience of stigma and discrimination among Black and brown skin users of Nottingham’s maternity services needs to be ascertained in order to challenge discriminatory practices among the statutory service providers and services who provide the daily context for maternal and foetal health and wellbeing. To overcome apprehension and reluctance among service users, these findings then need to be communicated to the community itself, such that the Black and brown population will expect fair and respectful treatment in maternity services. In the longer term, attempting to rebuild a shared identity between service providers and a marginalised community to co-produce inclusive tools and resources to empower citizens of Nottingham to have safer pregnancies and healthy babies.
Project Aims
This project aims to explore the link between the identity-based interactional dynamics of maternity service use among Black and brown skin women and their wider personal, social and healthcare consequences in Nottingham and Nottinghamshire. This will inform best practice and design more engaging and more effective local service provision for Black and brown skin populations who are underrepresented and underserved in maternity services.
The Project Team
- PhD Candidate: Rachel Ibikunle
- Lead Supervisor: Prof Catrin Evans, UoN
- Co-supervisor: Dr Niamh McNamara, NTU