As both a woman of colour who has received maternity care from the NHS, and as a midwife who advocates for justice and dignity for marginalised women, I have always been keen on investigative documentaries that expose institutional injustices. I therefore anticipated watching <a href="https://www.channel4.com/programmes/the-black-maternity-scandal-dispatches">The Black Maternity Scandal</a><a href="https://www.channel4.com/programmes/the-black-maternity-scandal-dispatches"> by Channel 4 Dispatches</a> to see the metaphorical glass ceiling being broken by words and actions of truth. Keen public interest in maternity care has always been present due to the vivid experience the majority of women face when giving birth, tying all mothers together through a sense of shared humanity regardless of race. After all, birth is possibly the most intensely emotional, spiritual and physical experience of a woman’s and birthing person’s life.
The comfort of having access to the NHS in a high income country means we often take live births for granted; any deviations from this expectation appear to be relegated to a long lost pre-anaesthesia past, or across some far away border in a country seemingly too poor and undeveloped to help itself. But negative birth experiences, even traumatic ones, are very much present in modern, high income countries too. Although maternal mortality rates are significantly lower in the UK than in countries still suffering the ischaemic insults of colonialism, a <a href="https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202019%20-%20WEB%20VERSION.pdf">report by MBRRACE UK</a> published in 2019 that collected data on all reported maternity incidents between 2015 and 2017 in the UK, exposed a shocking statistic: that Black women were five times more likely than white women to die as a consequence of pregnancy and childbirth. This statistic raised many eyebrows in the UK as such an indication of inequality was not thought possible in a society that considers itself post-racial.
More recently, The Lancet released a systematic review of nine studies <a href="https://www.thelancet.com/series/miscarriage">analysing miscarriage in Europe and Northern America</a>, and concluded in their key findings that Black women were more likely to experience miscarriage in comparison to white women. The study did not expand on why this has arisen, but added that risk factors included stress from night shift work and environmental factors such as ingesting pesticides. These are more likely to affect impoverished communities which largely include people of colour. The study thereby reflects social neglect of Black women in relation to their wellbeing and reproductive health.
Though the UK’s maternal mortality inequality was known in 2019, and many were advocating for change around race in maternity and healthcare, it was only after the murder of <a href="https://www.platformonline.uk/tag/george-floyd/">George Floyd</a>, the most viewed public lynching in history, and the subsequent anti-racism campaign, that institutions were shocked into holding conversations about the racial disparities they housed. A consequence of this activism led to Channel 4’s The Black Maternity Scandal, a 30-minute documentary, which bravely delves into this racial disparity.
Presented by Rochelle Humes, a singer and TV presenter of mixed white and Afro-Caribbean heritage, the documentary did well in bringing to the forefront the bitter inequality of Black women suffering higher maternal mortality than every other ethnic group, but unfortunately, it did little to address the true source of these disparities.
The documentary did include well-known professionals in the maternity world such as Mars Lord (Activist and Doula) and Professor Marian Knight whose name is first on the authors list of the MBRRACE UK report. The inclusion of these voices added credibility to the investigation, and well-complimented the anecdotes of other women interviewed about their respective harrowing experiences in facing maternal mortality and morbidity, which worked to solidly humanise the people behind the statistics. This was a much-needed element in the discourse around this unjust topic.
As a midwife, I understand the instinct we sometimes have to defend our work and colleagues when confronted by media that calls into question our practices and clinical outcomes, but this confrontation is vital in building partnerships with the women we serve, to develop care for all, and to tackle inequality. The documentary did well to highlight the NHS’ responsibility to Black mothers, one that it is evidently not upholding, but it did not even scratch the surface of institutional racism, the effect of colonial history, or actually even mention the word ‘racism’, which insinuates a hesitancy in the editing, and belies the urgency of its opening message.
Though The Black Maternity Scandal did mention that ‘the system’ is biased against women with social complexities, and fleetingly touched upon class, there was very little discussion that unpacked these multi-layered components which lead to the shocking and important disparities in maternal mortality in terms of race. It can be argued that 30 minutes was not enough time to enter such a thickly complex topic, but this proved to be the documentary’s most potent handicap. The need for more time meant that discussions around unconscious/racial bias, the role of poverty, migrant experiences, mental health complexities, difficulty accessing healthcare and austerity were left wanting. These conversations, had they happened, could have been contrasted to the experiences of affluent white women to reflect inequality not just in healthcare but in all fabrics of society.
This silence on institutional racism runs in parallel to the recently released <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/974507/20210331_-_CRED_Report_-_FINAL_-_Web_Accessible.pdf">Sewell report</a> by the UK government’s ‘independent’ committee on race and ethnic disparities. The document gallingly declared that there was categorically no systemic racism in the UK, that minorities experience poorer outcomes derived from their cultural ‘attitudes’ rather than any misdemeanour the British may have imbued in their systems, and that remarkably, the UK is a beacon example for racial equality which European countries should endeavour to replicate. Not only is this negated by the findings of the MBBRACE report, but it is also a concrete insult to women of colour who face very real threats by our current healthcare systems.
On the subject of class in particular, I was expecting more commentary, as the UK is persistently classist and class is profoundly predictive on a child’s prospects, but unfortunately the issue of class seemed to be blanketed over by the notion that it didn’t matter all that much – that a Black middle class woman would be just as affected by racial disparities as a Black woman from a working class background. I strenuously disagree because, from my experience, the impact of institutional racism is more severe and insidious for working class Black women. This is reflected in my own work in healthcare, where Black working class women are more likely assumed to be ‘difficult’ or uneducated, and is explored further in an article by <a href="https://www.theguardian.com/commentisfree/2016/nov/28/toxic-concoction-women-colour-pay-highest-price-austerity">Maya Goodfellow that describes the extra burden</a> working class women of colour face through austerity. By neglecting to address the extra burdens of Black working class women and their maternal health outcomes, the narrative of the documentary held a very middle class gaze.
Though I appreciated the documentary attempting to conclude with remedial actions to correct the racial disparities, such as ‘Continuity of Carer’ also known as case-loading, I was frustrated by the brevity with which it was mentioned. Continuity of Carer is a model of work which ensures that a pregnant woman or birthing person receives the majority of their care through one midwife. This enables good relationship-building, less room for inconsistencies, and is a <a href="https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf?PDFPATHWAY=PDF">proven method</a> to protect health and promote dignity. However, it is a model of work that is not feasible for all midwives and is often employed by staff without children of their own, as the work requires high availability and commitment to many on-call shifts through the night and day. Of course, having children is not needed to be a good midwife, but considering the forcefully female dominion of midwifery, many of the workforce continue to have children of their own (such as myself) making work as a continuity of carer midwife incompatible with having a family, and calling into question the longevity of the plan. The documentary visited Newham Hospital and briefly interviewed a continuity midwife and her client, who both expressed positivity, and though this was encouraging to the viewer, lacked much needed fibre to fully understand the benefits and difficulties of the continuity model in our current healthcare system.
Midwifery professionals of colour also face disparities in the workplace, which was just jointly reported on by the <a href="https://static1.squarespace.com/static/5fc52bcaf7cf8c754046992e/t/6092d7853bb4505b999ac766/1620236167034/What+we+need+to+thrive_+ASAM+and+SoAC+report+2021+%283%29.pdf">Association of South Asian Midwives and the Society of African &amp; Caribbean Midwives</a>. The report displays the shocking treatment these staff face, and if staff are not well supported in the NHS, then women and birthing people will undoubtedly be inhibited from accessing the best care the NHS could give.
Overall, the documentary is a decent watch for advocates against racial disparities in health, as it does bring to the forefront of societal awareness the appalling racial inequality and indignity faced by Black women in the UK, which is certainly needed in order to bring about change. The documentary was not long enough to do justice to the ‘whys and hows’ of this racial disparity, which was unfortunate and frustrating, but it inspired hope that change, or at least awareness, is on the horizon. What is now needed is for institutions, organisations and government to take heed of these warnings, commit to further research into the effects of institutional racism, and step up to the responsibility they hold, in protecting the lives and wellbeing of the most vulnerable women in our society. This they can do by critiquing their own established systems which metastasise institutional racism, and holding the people within those systems to account.

Black Maternity Scandal

Channel 4’s Dispatches missed out important factors on class and institutional racism in its brief exploration of maternity care experienced by Black women.

The Black Maternity Scandal: A Lens on Racial Disparity in Healthcare

Oz Arshad’s <a href="http://www.findingfatimahmovie.com/">new film</a> is a refreshing picture of the trials which often accompany the quest for love among British Muslims 
After a quarter of a century of people spelling my name wrong, it was explosively satisfying to watch a film where they got it right. Finding Fatimah is a British Muslim film, set in Manchester and written by Muslims, three of who are BBC writers. 
Directed by Oz Arshad, Finding Fatimah is about a 30-year-old divorcee (Shahed, played by Danny Ashok) and a doctor with anger management issues (Fatimah, played by Asmara Gabrielle), who look for love online when subjects found offline didn’t make the cut. Shahed’s life is crumbling bit by bit as his business collapses, his ex-wife returns, and his chances of winning a talent show as a comedian are damaged by tabloid PR. Whereas Fatimah’s life is a vicious circle of falling for men of low fidelity. 
The film does not shy away from looking at issues which commonly crop up within the Muslim marriage scene, where a significant number of marriages are arranged by families. It explores the challenge of the divorce stigma and how this affects the second search for a spouse (especially as Shahed declines to be transparent about this on his initial dates with Fatimah). Racism in Muslim spheres is also comically poked into discussion, as exemplified when Fatimah withholds from Shahed the fact that her Pakistani father would not accept a Bangladeshi, or any other kind of non-Pakistani man for his daughters. Themes of the so-called ‘tick box marriage’ pop up when Fatimah’s sister describes the state of her marriage, initiated mostly for money and status. 
Courageously, the film explores Islamic masculinities during a scene where Shahed cries on his mother’s lap while reflecting on the loss of his father. The range of macho characters with vulnerabilities, and Fatimah’s higher financial status, were refreshing to watch as they challenged the stereotype of masculinity that presides not only globally, but also potently within British Muslim communities. 
The film unravels to present nuanced characters, and on the whole, manages to go beyond Muslim caricatures. There were, however, some disappointments. Shahed’s divorce story centred on the ‘psycho chav’ as the ex-wife, and failed to represent the complexities around relationships and marital collapse. 
The romance bordered on vomit-inducing cliché and some scenes were incredibly unrealistic, especially when many Muslim communities struggle with the idea of love and romance before marriage. Having said that, the portrayal of family life was honest – they were realistically dysfunctional, rather than idealised visions of harmony. But the film did not do justice to the difficulties of the intrusive and controlling aspects of many Muslim households, especially when a son or daughter tries to convince the parents about their choice of a spouse. 
Finding Fatimah is a relevant film for our times. There were many simplicities to enjoy: there were no terrorists, no bombs, no forced marriages, no domestic abuse, no forced prayer scenes, no hijab versus hair debates. Just normal Muslims with normal problems. 
The tasteful comedy, with genuine characters and an amalgamation of Asian culture with abject Britishness, makes Finding Fatimah a pleasure – but more importantly, a welcome breath of fresh air. It is a film that should have been made a decade ago, and is a welcome release to the tension the media have contributed to propagating about Muslims. With patience and practice, more films like Finding Fatimah will, inshallah, hopefully, be produced. 
Finding Fatimah is out in cinemas on 21st April 2017. 
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<pre>Photo Credit: Finding Fatimah</pre>

Finding Fatimah: Muslim Rom-Com Without Explosives

The <a href="https://www.southbankcentre.co.uk/whats-on/festivals-series/women-of-the-world">Women of the World (WOW)</a> festival played host to a highly anticipated discussion titled <a href="https://www.southbankcentre.co.uk/whats-on/120470-what-does-brexit-mean-women-2017">‘What does Brexit mean for women?’</a> It wasn’t very good at answering its question, but it did boil many emotions into (and evaporate confidence in) the nature of political discourse itself.
Like misbehaving children at a playground gathered to testify to their disciplinarian, <a href="https://twitter.com/stellacreasy">MP Stella Creasy</a> (Labour), <a href="https://twitter.com/GreenJennyJones">Baroness Jenny Jones</a> (Green Party), <a href="https://twitter.com/SuellaFernandes">MP Suella Fernandes</a> (Conservative) and <a href="https://twitter.com/joannamaycock">Joanna Maycock</a> (secretary general of the European Women’s Lobby) all gave their statements revolving around the hovering uncertainty of the Brexit deal and how it would affect women.
Except that wasn’t really what happened.
The Green Party’s Jenny Jones bravely admitted she had voted Brexit against her party’s position. Soon after the result of the referendum was revealed, she realised the <a href="http://www.the-platform.org.uk/2016/06/17/a-rejection-of-brexit-and-relentless-prejudice/">darker side of her choice</a> like many other Brexit voters, including some of those from ethnic minority backgrounds. This caused Jones to align with her party’s ‘Remain’ position. She declared that Britain had always been a driver for gender equality and a bastion of civil liberties and civil rights, but <a href="http://www.huffingtonpost.co.uk/jude-kirtondarling/international-womens-day_b_6825856.html">“the EU has done something for us”</a> by helping to raise working conditions for mothers and pregnant women. She also noted that women were not well represented on either side of the debate. She closed her statement by mentioning how this split in opinion has wounded Britain though wounds can heal.
A more robust picture of the contributions of the EU was illustrated by Joanna Maycock from the Europeans Women’s Lobby. She highlighted the EU’s efforts to include women in its parliament and provide rights to part-time workers. A certainty in the fog became clear to the audience – that we don’t actually know what will happen to such progressive rights, but it is important to understand where we are now so we can campaign to ensure that benefits will not be altered. Maycock was courageous enough to stress that Brexit will be most disadvantageous to women and children, hitting them the hardest. Her final remarks about the importance of uniting feminists and other members of the community against the divide that Brexit has caused was militantly disavowed by Tory MP Suella Fernandes.
I was angered that MP Fernandes began her speech by saying that Britain was a place where <a href="https://www.youtube.com/watch?v=eF209M2aJiw">“if you work hard you can get anywhere”</a> and the audience reacted in a similar way. The statement was oblivious to the systemic injustices many face in Britain, especially ethnic minorities and the disabled. Even more astonishing was Fernandes’ commemoration of <a href="http://www.the-platform.org.uk/2013/04/17/what-did-maggie-thatcher-do-for-women/">Margaret Thatcher</a>, whose policies were famously damaging to the poor and underprivileged. It was a bad move, and the audience grumbled loudly as if they were in the House of Commons.
Nonetheless, Fernandes ploughed on, heating the room by calling it a fallacy that women’s rights have greatly improved due to EU membership, soliciting some kind of proof in stating that women had maternity leave before joining the EU. She further went on to state that the EU had failed the UK, making it more undemocratic, bureaucratic and expensive. Exactly how, she did not say. Perhaps most importantly, and most disparagingly, was her belief that immigration was out of control – a control, it seems, which should belong to Britain and no one else. This highlighted, to me, the crux of the issue behind Brexit.
Juxtaposed for maximum dramatic effect, but a welcome return to common sense, was Labour MP Stella Creasy’s speech. It raised my spirits to hear the list of benefits that the EU pursued for women, but I felt sad that such benefits were even up for debate. These include protection from maternal discrimination at work, blunting the blades of FGM, and putting women firmly on the agenda. MP Creasy also fired up an answer to the original question (finally!) by logically noting that goods with tariffs will cost more and hit women harder, as women are the victims of the gender pay gap and the traditional consumers of such goods. It was refreshing to hear her calling for pragmatic action, providing suggestions for everyday women in how to deal with the current uncertainty. These include the demand for clarity so that one knows what they are dealing with, demand that Britain leads not follows (as is a possibility with the new Trump administration), and not to allow Brexit to be an excuse for rising inequality. She closed with the summative statement: “Europe, you don’t have it, you will miss it.”
It was disappointing to note that there was no mention by any of the panellists about women with disabilities and the impact Brexit will have on them. Nor was there humility shown by the Brexit-voting side to better understand the deep concern and anxiety many people in the country face regarding the febrile economy that took so long to recover from the crash in 2008. These financial worries are not baseless when many government-funded programs will no longer be supported due to endless orders for cuts to budgets. <a href="http://www.the-platform.org.uk/2016/04/30/fighting-for-our-libraries-in-lambeth/">Lambeth Council</a> recently reported <a href="https://www.theguardian.com/public-leaders-network/2016/feb/26/lambeth-council-cuts-london-chief-executive">budget changes</a> amounting to a £183 million reduction. The council also expects to magically lose a further £55 million for undisclosed purposes.
The debate was certainly polarising. Nevertheless, it was both shocking and appalling that members of parliament from two distinct parties were interrupting each other, talking over each other and, most importantly, not listening to each other. This added more embarrassment beyond what Brexit has already made acutely apparent.
Abhorrently, MP Fernandes’ lies and unsubstantiated statements shed light on the negotiation of the Brexit deal, and indeed, to the lack of integrity in the whole of political discourse. Her language represented skewed and dangerous ideas, particularly those pertaining to immigration control.
The recent <a href="https://www.theguardian.com/media/2017/mar/28/theresa-may-refuses-to-comment-on-daily-mail-legs-it-front-page">controversial cover of the Daily Mail</a>, assessing the legs of Nicola Sturgeon and Theresa May, is an exasperating reminder of the great volume of work still needed to truly vanquish the trivialisation of women and gendered discrimination, as well as sexual objectification in political discourse.
This event took place on 10th March 2017. You can view a clip from the discussion below.
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Brexit risks undoing many positive steps taken to secure women’s rights as discussed by this WOW festival panel

Fatimah Mohamied