When colour really matters: Addressing inequalities in maternity care for women from Black and Asian minority ethnic communities

Aideen Grimley, Gail Anderson*

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review


The UK has seen major demographic changes in its population profile since 2001 with upwards of 14% of its populations now from Black and Asian Minority ethnic communities. The World Health Organisation recently recommended operating ‘culturally appropriate’ maternity care services accounting for cultural aspirations and preferences among minority communities to improve maternal and infant health outcomes. An understanding of the cultural practices, risk factors and preferences among pregnant women from minority communities is key to engaging women with maternity services and providing maternity care which is closely matched to meet the needs of each individual woman. Research shows that severe maternal morbidities are significantly more common among BAME groups than in white women in the UK, occurring twice as often among black African/Caribbean women and one and a half times more in Pakistani women. A pattern that reinforces the ethnic differences in maternal death rates reported in the last two Confidential Enquiries into Maternal and Child Health.
Women from BAME communities often suffer multiple complex social issues and so are less likely to access maternity care, or will access it late. They often arrive in the UK following difficulties in their home country or on their journey whilst seeking asylum. On arrival they may face further difficulties such as poverty, poor housing and isolation.
Ethnic diversity in the UK has proven to be a major challenge, with women from BAME communities generally feeling fear and distrust in maternity services. Many felt excluded from decision-making and while they wanted to be asked about their personal situations, many were not reinforcing the need for tailored, culturally sensitive maternity services.
The Haamla Service forms part of the Leeds Teaching Hospitals maternity services, in which a specialised group of midwives work with diversity in maternity services, in particular women from BAME communities who are considered vulnerable, to address maternity inequalities among the rising BAME population in Leeds. They provide maternity care in women’s homes or community centres with the aim of engaging women from BAME communities in maternity care. Haamla Midwives work closely with a multi-disciplinary team to provide an individualised spectrum of care, which empowers women with information and choice through culturally sensitive services such as women-led ante natal classes, bi-lingual staff, continuity of care, home visits, ward visits, FGM clinics, feeding support and extended agency support.

Service users have reported their satisfaction with the service and the sense of safety and support felt when cared for by Hammla Services . Many now volunteer as part of the befriending service and some have trained as Doulas and in feeding support. Surveys completed at stakeholder events suggest healthcare professionals and service users alike rate the Haamla service as invaluable but suggest there is a need to increase capacity so that Haamla can reach more women and respond further to their goals of improving outcomes for mothers and infants.

Whilst no official evaluation has been completed, the Haamla Service has evolved since its origin in 1994 to cater for the specific cultural needs and issues of BAME women in the UK incorporating a wide scope of practice to ensure equity of maternity care amongst this vulnerable population and strives to meet the standards recommended by The World Health Organisation.
Original languageEnglish
Publication statusPublished - 05 Nov 2020
EventAll Ireland Annual Midwifery Conference: ‘Midwifery – adaptable and responsive during a crisis’ - online, Ireland
Duration: 05 Nov 202005 Nov 2020


ConferenceAll Ireland Annual Midwifery Conference
Internet address


  • Inequalities, Ethnic Minorities, Midwifery, Public Health


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