‘Fix it for Black women, fix it for all’: What UK maternity services must do next

Here’s what mums should know.

Why we still need this conversation in 2025

Black women in the UK remain 2.9 times more likely to die during pregnancy or in the weeks after birth than white women.

While some policy efforts have tried to improve things, including government taskforces and parliamentary inquiries, the women themselves say their lived experiences aren’t changing fast enough.

“Our sentiment is clear,” say Five X More co-founders Atinuke Awe and Clotilde Abe. “Fix it for Black women, fix it for all women.”

Their 2025 report, based on the experiences of 845 Black and Black mixed-heritage women, outlines six actions that NHS trusts, clinicians, and policymakers must take.

1. Make it easier to speak up

Only 1 in 5 Black women were told how to make a complaint about their maternity care, and just 8% pursued a formal complaint.

Why this matters: When women don’t feel confident raising concerns, unsafe care goes unchallenged. The report recommends better access to Patient Advice and Liaison Services (PALS) and clearer signposting on how to raise complaints.

2. Train staff on conditions that affect Black women

Conditions like fibroids, sickle cell trait and high blood pressure can be more common in Black women, yet many respondents said their symptoms were ignored or mismanaged.

Why this matters: Better clinical training will lead to faster diagnoses, safer outcomes and fewer assumptions based on race instead of real health needs.

3. Mandate explanations for denied pain relief

Almost a quarter of women said they didn’t get the pain relief they requested, and 40% of those said no explanation was given.

Why this matters: Informed consent isn’t just a legal requirement — it’s basic respect. Five X More is calling for a Mandatory Pain Relief Explanation Policy across all NHS maternity settings.

4. Make maternity rights visible, literally

Posters, leaflets and in-app messages outlining your rights and care options should be standard across antenatal clinics, postnatal wards and digital maternity systems.

Why this matters: Women can only advocate for themselves if they know what they’re entitled to.

5. Offer culturally relevant, easy-to-access info

Only 39% of Black women were spoken to about nutrition in pregnancy, and just 27% about exercise. For many, antenatal information felt generic or dismissive of cultural nuance.

Why this matters: Creating a national digital pack, like the Five X More app, could help close this gap in a trusted, accessible way.

6. Ensure joined-up, personalised care

The NHS has already trialled models like Continuity of Carer, which pairs women with one midwife or a small team throughout pregnancy. These models improve trust, safety and outcomes, especially for women from marginalised communities.

Why this matters: The report confirms that where continuity was achieved, experiences were overwhelmingly positive. But these cases were still rare.

What this means for all mums

Every woman, no matter her background, benefits when maternity care is informed, consistent and culturally safe. From clearer communication and better clinical training to stronger complaints processes, these aren’t just race-specific reforms. They’re universal improvements.

The work of Five X More highlights the gaps with urgency, but also offers real, workable solutions. And the takeaway is simple: when Black women are safe, listened to and respected in birth, everyone is.

Read more:

• ‘I felt invisible’: Black mums say maternity care still failing to listen
• ‘They owe it to families’: Midwives question if government’s new health plan will fix maternity care crisis
• ‘Incredibly concerned’: experts slam government’s 10-Year Health Plan for ignoring birth trauma and consent