Black maternal mental health is a patient safety issue

Summary

Sandra Igwe MBE is the Founder and CEO of The Motherhood Group and Mumbrite, author of My Black Motherhood, and a Topic leader for Patient Safety Learning’s online platform, the hub. In this blog Sandra draws on her own personal and professional experiences to illustrate why Black maternal mental health is a patient safety issue.

Content

When a mother says that something is wrong, safety begins with believing her.

That sentence sounds simple. Yet for too many Black mothers, being heard, believed and supported at the right time is still not guaranteed. Concerns can be minimised. Pain can be underestimated. Anxiety or depression can be hidden behind the expectation that Black women should remain strong. Referrals can come late, after distress has intensified. Cultural context can be misunderstood or ignored altogether.

These are not only questions of experience, representation or inclusion. They are patient safety issues.

The latest MBRRACE-UK data for 2022–24 show that women from Black ethnic backgrounds in England had a risk of maternal death nearly three times that of White women. The 2025 MBRRACE-UK report also found that psychiatric causes accounted for 34% of maternal deaths occurring between six weeks and one year after the end of pregnancy. Maternal physical health and maternal mental health cannot be separated. Safe maternity care must recognise both.

Why this is personal

I founded The Motherhood Group because I know what it feels like to enter motherhood feeling vulnerable, unheard and alone.

My own experiences of pregnancy, birth and the postnatal period included trauma, anxiety, loneliness and a struggle to find support that understood both my mental health and my identity as a Black woman. I came to understand how racism, stigma, cultural expectations and a lack of trust in services can combine to stop a mother asking for help, or prevent her from receiving the right help when she does.

I wrote My Black Motherhood: Mental Health, Stigma, Racism and the System to tell that truth. I wanted to challenge the myth of the endlessly resilient “strong Black woman” and make room for vulnerability, honesty and care. I also wanted Black mothers to know that they were not imagining their experiences and were not alone in them.

But Black motherhood must not be discussed only through trauma and disparity. It also contains joy, tenderness, power, identity, community, resistance and hope. That is why our theme for Black Maternal Mental Health Week UK 2026 is Joy • Justice • Journey.

Listening is an essential safety intervention

Patient safety is sometimes described through policies, reporting systems and clinical processes. Those mechanisms matter, but safety is also shaped in ordinary human encounters.

It is shaped when a professional asks a mother what she is experiencing and allows enough time to hear the answer. It is shaped when a mother’s description of pain or distress is taken seriously rather than filtered through assumptions about race, strength or coping. It is shaped when an interpreter is available, when information is understandable, when a referral is timely and when a mother knows what will happen next.

It is also shaped by trust. If previous contact with services has felt dismissive, discriminatory or unsafe, asking for help again can require enormous courage. A service cannot simply label a community “hard to reach” without asking whether the service itself has been difficult to trust, enter or navigate.

Culturally competent care is, therefore, not an optional extra. It is part of safe care. It means understanding how racism, migration, faith, family expectations, language, stigma and previous experiences of services can affect whether a mother discloses distress and accepts support. It also means recognising that no two Black mothers are the same. Cultural competence should deepen curiosity and humility, not replace one stereotype with another.

Healthcare organisations can make this practical by:

• treating lived experience as evidence and involving Black mothers in the design, delivery and evaluation of services

• training staff to recognise bias, racism, trauma and culturally specific barriers to seeking help

• making referral routes clear, timely and easy to navigate

• offering a genuine choice of support, including culturally informed talking therapies and trusted community-based provision

• connecting maternity, primary care, health visiting and perinatal mental health services so that mothers are not lost between teams

• collecting and acting on data by ethnicity, while looking beyond numbers to understand the stories and system conditions behind them

• responding to concerns with openness, accountability and learning rather than defensiveness.

Community support does not replace clinical care, safeguarding or emergency services. It can, however, provide an earlier and more trusted route into help. It can reduce isolation, create the conditions for honest disclosure, support a mother to understand her options, and help her feel confident enough to seek professional care. When community organisations and statutory services work respectfully together, they can close dangerous gaps.

Further reading on the hub:

• From a WhatsApp group to a national platform: digital and community provision is part of the wider safety ecosystem

• Black Maternal Mental Health Week UK 2026