A new report from Five x More shares the experiences of over 1,100 Black and Black mixed-heritage women who accessed NHS maternity services between July 2021 and March 2025. Covering antenatal, labour and birth, and postnatal care, the findings show that despite increased awareness, Black women continue to face racism and poorer care.
Key issues include unjustified high-risk categorisation, racist comments, poor communication around additional scans, and a lack of empathy - particularly regarding pain management. Many women described missed opportunities for preventative care and a need to advocate for themselves, often feeling forced to “fight for everything.” Key recommendations include strengthening clinical knowledge, resources, and training on conditions that disproportionately affect Black women, improving awareness of maternity rights and supporting informed consent and access to pain relief.
Responding to the report, Professor Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said:
“Five X More’s new report puts Black women’s voices right at the centre of calls to improve maternity care in the UK and I was honoured to be invited to speak at its launch today. No woman should feel they have to fight for safe, personalised and respectful care during their pregnancy and birth, but the accounts shared in this powerful report shows this is the case far too often for Black women.
“Change has been too slow and we must confront that. Collectively, we must work together to build culture where every woman feels seen and supported. We must be inquisitive about what matters most to the women we care for and support each woman to make informed choices about their own pregnancy. We must all call out poor behaviour and racism where we see it and respond openly and with compassion if harm has occurred.
“The Secretary of State for Health and Social Care has confirmed his personal commitment to a radical new approach to maternity safety, and the RCOG is committed to playing our role in supporting rapid progress. Improving outcomes and ending racial disparities in maternity care is possible – but requires coordinated leadership, investment in the maternity workforce and estates, and a real focus on the systemic drivers of inequality.”
The RCOG is committed to supporting high-quality maternity care for all women and pregnant people and is actively working to reduce inequalities affecting minority ethnic women and disadvantaged groups. We deliver this through our role as an educator, developing the curriculum, producing clinical guidance supporting clinicians’ professional development through exams and training. The College also advocates for change through parliamentary engagement and public health campaigns, and via national groups such as the Maternity Disparities Taskforce.
The RCOG also collaborates on research, audit and quality improvement programmes, including exploring underlying causes of inequalities through the National Maternity and Perinatal Audit. The The RCOG is committed to supporting high-quality maternity care for all women and pregnant people and is actively working to reduce inequalities affecting minority ethnic women and disadvantaged groups. The voices of those with lived experience are central to this work, including in co-producing resources like the Five Steps for Healthcare Professionals with Five X More.
- Read the full report here.
- Read our Racial and ethnic equality and women’s health policy position here.
- Read more our Race equity in O&G project here.
- Access our co-produced resource Five Steps for Healthcare Professionals here.
For media enquiries please contact the RCOG press office on +44 (0)7740 175342 or email pressoffice@rcog.org.uk.