Thursday briefing: What new evidence tells us about the reality of racial discrimination in maternity care
Good morning. Researchers have long known that women in the UK experience very different birth outcomes depending on their ethnicity, income and physical condition. Black women, for example, are still about 2.7 times more likely to die during pregnancy or shortly after giving birth than white women. As the Guardian reported on Wednesday, a new study suggests one possible explanation: that the cumulative physiological impact of stress caused by racism and inequality may itself affect pregnancy outcomes. For today’s newsletter I spoke to Tobi Thomas, the Guardian’s UK health and inequalities correspondent, about what the study found, why it represents a shift in how researchers are approaching the issue, and whether years of reporting on the beat have left her feeling optimistic about change. First, the headlines. Five big stories UK news | Police are treating the stabbing of two men in Golders Green, north London, as terrorism, with the suspect described as having been hunting for anyone “visibly Jewish” to attack. UK politics | Nigel Farage was given £5m by the crypto billionaire Christopher Harborne shortly before announcing he would stand in the 2024 British general election. Middle East | Pete Hegseth has denied that the US-Israel war on Iran is “a quagmire” and claimed critics of the operation posed a greater threat to the US than Iran itself, as he came under pressure to set out Washington’s strategy for the conflict. UK news | Police have raided the headquarters of the Ahmadi Religion of Peace and Light following an investigation into allegations of serious sexual offences, modern slavery and forced marriage. Defence | Britain has agreed to create a unified naval force with nine European countries to deter future Russian threats from the “open sea border” to the north. In-depth: ‘It’s not just about individual bias’
Tobi Thomas has spent the past few years reporting on disparities in health outcomes, including a steady stream of evidence showing how unequal maternity care can be. Previous research has established the scale of the problem. Black women are significantly more likely to die during pregnancy or shortly afterwards; babies born to Black mothers have markedly higher risks in neonatal care; and many women from minority backgrounds report not being listened to when they raise concerns during pregnancy and labour. What has been less clear is why those disparities persist. *** What did the new study find? “What this study adds is an attempt to get at the root causes of that disparity – not just describing it, but asking why it exists,” Tobi tells me. Researchers focused on whether social and environmental stressors – including racism and inequality – could have a measurable physiological impact during pregnancy. The idea is not entirely new. “I think people have been aware for a while that it’s not just about individual bias,” Tobi says. “It’s not simply that clinicians have unconscious prejudice. There’s growing evidence across healthcare that stress from racism, deprivation, and unequal opportunities can have a real, physical effect on the body.” Researchers found evidence suggesting that the biological effects of long-term stress may contribute to poorer results for Black women, potentially helping to explain part of the gap in maternal mortality and complications. *** Why is this different from previous research? “Often, studies end with a line saying ‘more research is needed to explain why this happens’. This feels like part of that next step,” Tobi explains. It also complicates a sometimes overly simplistic narrative. While bias in healthcare settings remains a factor, the findings suggest inequality is not only about individual interactions with clinicians, but also about the cumulative physical toll of living with racism and disadvantage. “The lead researcher actually said she was surprised more work hadn’t already been done in this area,” Tobi notes. “So in that sense it is quite pioneering.” *** What action is being taken? There is increasing recognition of the scale of the problem – and some movement towards addressing it. Campaign groups such as Five X More and the Motherhood Group have pushed the issue up the agenda, while Tobi says the Royal College of Midwives and Royal College of Obstetricians and Gynaecologists “are all pushing for better training and greater awareness of racial disparities in maternity care”. At the same time, official investigations have highlighted how inequality plays out in practice. “One thing that stood out from the interim results of the maternity investigation was the role of stereotypes,” Tobi says. “Women from different backgrounds reported being treated differently by healthcare staff. For example, some Asian women said they were stereotyped as being less able to handle pain, Black women reported being seen as exaggerating or making a fuss. These accounts came directly from people contributing to the investigation.” “It’s not,” Tobi says, “about singling out individuals” because “it reflects wider societal attitudes.” *** So where does this leave things? For Tobi, the shift in research focus offers some cautious grounds for optimism. “There’s been a lot of work showing where inequalities exist,” she says. “I’ve reported stories showing that some groups of women are less likely to have their births properly investigated when something goes wrong. So there’s been a steady stream of evidence showing where inequalities exist and how they manifest in different ways. What feels different now is that researchers are starting to dig into why.” That matters, because understanding the causes of disparity is a necessary step towards fixing it. But the picture remains complex. Inequality in maternity outcomes is not driven by a single factor, and solutions are unlikely to be simple. The latest study adds an important piece to the puzzle – but it also underlines how deeply rooted the problem is. What else we’ve been reading
Sam Wollaston’s six-part series on abandoned buildings in Britain is a triumph, and the latest instalment on Hulme Hippodrome in south Manchester is excellent. Patrick Having worked in record shops during the 90s, I am no stranger to the idea the music business isn’t always quite on the level. Shaad D’Souza looks at the cynical viral campaigns giving indie bands authenticity’s veneer. Martin I was gripped by this story by Jamie Bartlett on AI jailbreakers, who are tasked with testing the safety and security of AI models. Patrick I came out of Mother Mary immediately wanting to rewatch it, while being oddly unsure whether I had even liked it. Nick Chen talks to director David Lowery about the art-pop movie. Martin Will Tucker Carlson run for president? Arwa Mahdawi has the inside story. Patrick Sport
Football | Arsenal men were denied a first-leg edge at Atlético to draw 1-1 after VAR overruled a late penalty award in a Champions League semi-final tale of three spot-kicks. Arsenal women strolled to a 7-0 win over Leicester in the WSL to maintain their pursuit of Manchester City at the top. Cricket | England’s head coach, Charlotte Edwards, announced a squad for the home T20 World Cup that starts on 12 June almost exactly the same as the one that surrendered the Ashes 15 months ago. Football | The Chelsea captain, Millie Bright, has announced her immediate retirement, ending a trophy-laden career during which she won eight Women’s Super League titles and six Women’s FA Cups at the club. The front pages
“Police declare terrorist attack after two Jewish men stabbed” – that’s the Guardian while the i paper runs with “Terror attack on UK Jews foiled by police and hero bystanders”. The Telegraph says “Jew hate ‘out of control’ in UK” and the Mail goes with “Anti-semitism is out of control in UK, warns Israel”. The Times’ version is “UK antisemitism ‘out of control’ after Jews knifed”. It’s “Terror on our streets” in the Daily Mirror and the Express has “These attacks are an attack on Britain itself”. The Metro does an organ donation story: “Bittersweet … but my Theo saved 4 lives”. Top story in the Financial Times is “Oil price surges after Trump warns he ‘does not want’ to lift blockade on Iran”. Today in Focus
Iran’s wartime executions Over the last six weeks, the Iranian regime has carried out a spate of executions of political prisoners. Guardian journalist Daniel Boffey reports Cartoon of the day | Nicola Jennings
The Upside A bit of good news to remind you that the world’s not all bad
For centuries, the dance of the mayfly has been shrouded in mystery. But finally, researchers from the University of Oxford and Imperial College London believe they have found the answer to what the thousands of winged insects are up to each spring. By studying recordings swarms of mayflies in flight, the scientists have discovered the secret to the bizarre up-and-down flight pattern that males use to find female to reproduce. Sign up here for a weekly roundup of The Upside, sent to you every Sunday Bored at work? And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow. Martin Belam’s Thursday news quiz Quick crossword Cryptic crossword Wordiply
