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Content Article
Sandra Igwe is the Founder and CEO of The Motherhood Group and author of the bestselling book "My Black Motherhood: Mental Health, Stigma, Racism and the System". She served as Co-chair for the National Inquiry into Racial Injustice in Maternity Care and is also a Topic leader for Patient Safety Learning’s hub, with a focus on Black Maternal Mental Health. In this interview Sandra tells us about a new partnership project, bringing together The Motherhood Group, Centre for Mental Health, and the Maternal Mental Health Alliance to address critical gaps in Black maternal mental healthcare. Sandra, you are a Founder and CEO of The Motherhood Group and author of a bestselling book "My Black Motherhood: Mental Health, Stigma, Racism and the System". You served as Co-chair for the National Inquiry into Racial Injustice in Maternity Care and Partner for the Mayor of London's Anti-Racism Hub. And you are, of course, a Topic leader for Patient Safety Learning’s hub. Can you tell us any more about yourself and what motivates you? I am a proud mum to three beautiful girls - an eight-year-old, a six-year-old, and an almost nine-month-old baby. I'm deeply passionate about bridging the gaps between Black mothers and the healthcare system, using my voice in any capacity to improve maternal health outcomes in the UK. At my core, I'm simply a driven mum who can't stand injustice, who loves creating safe spaces for other mothers, and who's brave enough to say the things many Black mothers want to, but are too afraid to voice. Why was The Motherhood Group founded? The Motherhood Group was founded in response to the stark disparities in maternal health outcomes for Black women in the UK. Research consistently shows that Black women are four times more likely to die during pregnancy and childbirth compared to white women, while experiencing higher rates of complications and poorer mental health outcomes. These disparities stem from systemic issues including lack of culturally competent care, implicit bias in healthcare settings, and barriers to accessing mental health support. We established The Motherhood Group to create a comprehensive support system that addresses these critical patient safety issues through advocacy, education, and direct support. Our approach focuses on both supporting Black mothers and educating healthcare providers to deliver more culturally competent care. What have been your key achievements since The Motherhood Group was established? Our achievements demonstrate our commitment to improving patient safety and maternal health outcomes: Reached and supported 12,721 Black mothers through our events, workshops, and peer support sessions. Delivered cultural competency training to 2,991 healthcare professionals, improving their ability to provide safe and appropriate care. Facilitated 742 peer support events and projects. Established partnerships with 3,088 organisations and charities. Coordinated five annual Black Maternal Mental Health Week UK campaigns, with our most recent event attracting over 1,200 registrations. Commissioned by Southwark Maternity Commission to engage with over 750 Black mothers and healthcare practitioners on improving outcomes. Successfully launched the Black Maternal Health Conference UK, consistently drawing over 1,000+ attendees. Can you tell us more about your new partnership project? We're thrilled to announce our Black Maternal Mental Health Project. This ground-breaking partnership brings together The Motherhood Group, Centre for Mental Health, and the Maternal Mental Health Alliance to address critical gaps in Black maternal mental healthcare. Our vision is to delve deeper into the mental health aspects of Black motherhood than ever before. We aim to uncover and address the complex intersections between racial trauma, systemic barriers, and maternal mental health. This includes creating safe spaces where Black mothers can openly discuss mental health challenges without fear of judgment or stigma. We're particularly focused on developing culturally responsive mental health support pathways that acknowledge the unique experiences of Black mothers. By bridging the trust gap between healthcare systems and Black mothers through evidence-based interventions, we hope to transform how perinatal mental health services engage with and support Black mothers. Our comprehensive approach will demonstrate impact across community engagement, healthcare provider education, policy influence, cultural competency enhancement, and peer support network development. Through this work, we aim to create lasting systemic change that improves the mental health outcomes for Black mothers across the UK. What will be your areas of focus? Through this project, we will conduct comprehensive research exploring multiple dimensions of Black maternal mental health: We will investigate the profound impact of pregnancy loss on mental health through our collaboration with Tommy's Miscarriage Support Tool, examining how we can better support Black mothers through these challenging experiences. Our partnership with South East London Mind will enable us to explore how creative expressions through music and art can serve as powerful therapeutic tools for Black mothers' mental wellbeing, providing alternative pathways for emotional healing and community connection. Through our Black Maternal Mental Health Week webinar series, we're creating platforms for open dialogue about mental health challenges specific to Black mothers, while our Black Maternal Health Conference outcomes provide crucial insights into systemic barriers and potential solutions. The Black Mums Connect co-production phase will ensure that our support services are directly shaped by the voices and experiences of Black mothers, while our Southwark Maternity Commission engagement allows us to influence policy at a local level. Our collaboration with Genomics England brings a vital scientific perspective to understanding maternal health disparities, and our training delivery with multiple NHS Perinatal Teams helps embed cultural competency directly into healthcare services. The project aims to engage with 1,000 Black mothers and healthcare professionals across all programmes in its first year, demonstrating our commitment to substantial community impact. Will you keep us posted on the outcomes and activity of the Black Maternal Mental Health Project? Absolutely. Transparency and data-driven evaluation are central to our work. We will be documenting our journey and will have our report for Black Maternal Health Conference UK and Black Maternal Mental Health Week UK in September 2025. We're committed to sharing both quantitative metrics and qualitative feedback to demonstrate how our work is improving maternal health outcomes and patient safety for Black mothers. If you would like to keep up to date with the work of the Motherhood Group, the Black Maternal Mental Health Project and details of their upcoming conferences, you can visit the following websites and social media pages: X(Twitter): @motherhoodgroup Instagram: @sandeeigwe @themotherhoodgroup Websites: Black Maternal Mental Health Project - The Motherhood Group - partnership page www.themotherhoodgroup.org www.sandraigwe.com Related hub content Racial disparities in postnatal mental health: An interview with Sandra Igwe the Founder of The Motherhood Group My Black Motherhood: Mental Health, Stigma, Racism and the System (by Sandra Igwe) Saving lives, improving mothers’ care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2020-22 (MBRRACE-UK, October 2024) Five X More report - The black maternity experiences survey: A nationwide study of black women's experiences of maternity services in the United Kingdom (24 May 2022) Muslim Women's Network UK - Maternity experiences of Muslim women from racialised minority communities (12 July 2022) -
News Article
NI 'needs mother and baby mental health unit'
Patient Safety Learning posted a news article in News
An appeal to establish a dedicated Mother and Baby Perinatal Mental Health Unit will be delivered to the Nothern Ireland health minister later. Individual women, charities and other organisations will hand over a public letter urging Robin Swann to act. Northern Ireland is the only place in the UK which has no dedicated in-patient service for women with serious post-partum mental health issues. The units admit mothers with their babies so that they can be with them. About 70 women a year in Northern Ireland are admitted to hospital with post-partum psychosis. The health minister approved some funding for perinatal mental health last year. However, no decision has been made on in-patient services. Read full story Source: BBC, 10 October 2022 -
Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explores the issues associated with the assessment of risk factors for venous thrombosis in pregnancy and the first six weeks after birth. Venous thrombosis occurs when a blood clot forms and causes a blockage in a person’s vein. This can lead to venous thromboembolism (VTE), when part of the clot breaks off and travels through the bloodstream, blocking a blood vessel elsewhere in the body. Pregnant women and pregnant people are at greater risk of developing a venous thrombosis than those who are of the same age and not pregnant. Because of the increased risk, healthcare staff assess a pregnant woman’s risk factors for VTE at key stages before and after the birth, so that they can be given preventative treatment if necessary. While rare, in the UK venous thrombosis and VTE is the leading direct cause of death of pregnant women during pregnancy or up to six weeks after the end of pregnancy. Reference event The reference event for this investigation was the case of Alice, who was 26 years old and was pregnant with her second child. A VTE risk assessment was completed for Alice at her first antenatal appointment, when she was admitted to hospital for the birth of her child, and 24 hours after admission. Her score was zero each time, meaning no risk factors were identified for VTE. During her pregnancy Alice reported experiencing some pain in her calf; she was examined by a doctor who referred her for a scan. This ruled out a deep vein thrombosis (DVT). After giving birth by caesarean section, Alice's risk assessment was repeated, and as it indicated that medication was required, a preventative dose of low-molecular-weight heparin was prescribed and Alice was discharged. Eleven days after the birth of her baby, Alice was taken by ambulance to the emergency department with chest pain, shortness of breath and leg cramps. She was diagnosed with a pulmonary embolism (PE) and was started on a treatment dose of blood-thinning injections. Following investigation, it was found that Alice may not have received an appropriate preventative dose of low-molecular-weight heparin to help prevent the VTE. Findings For healthcare staff, carrying out a robust assessment of risk factors for VTE is challenging, particularly in the complex and busy environment of antenatal clinics, the labour ward and on postnatal wards. Multiple competing demands, exacerbated by distractions and interruptions, mean healthcare professionals are constantly having to balance risk and safety for the pregnant women/pregnant people they care for and are trading off the thoroughness of assessments to improve efficiency. Midwives are asked to complete a number of risk assessments and screening tools to assess pregnant women’s/pregnant people’s risk at their first antenatal appointment (known as the booking appointment). However, the time needed to carry out these risks assessments may not be reflected in the time allocated for appointments. Risk assessments and screening tools are not all designed and presented in a consistent and logical way that would aid staff in completing the task. Assessment of VTE risk factors should take place routinely due to body changes in pregnancy and increased risk of VTE. Although assessing VTE risk is important, it is a relatively rare condition and there are a number of other competing risks that may take priority. Staff do not always involve pregnant women and pregnant people in, or discuss with them, the assessment of their risk factors for VTE. This means pregnant women and pregnant people may not be aware of the signs and symptoms of a possible VTE. The importance of knowing the signs and symptoms of VTE may not be fully understood or prioritised by pregnant women and pregnant people who may have other competing concerns and questions about their antenatal and postnatal care. National guidance recommends that assessment of VTE risk factors should be repeated when a pregnant woman/pregnant person presents with an ‘intercurrent problem’ (a new health issue which may or may not be related to the pregnancy). However, not all healthcare professionals understand the meaning of ‘intercurrent problem’ and therefore opportunities to reassess risk factors are missed. There is a mix of paper-based and electronic record keeping in antenatal and postnatal care. Electronic records systems may lack interoperability and suffer from poor connectivity which limits the ability of staff to access all the data, information, and knowledge they need at the time of assessment. Recommendations by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) for the development of a tool to make the current assessment of VTE risk factors simpler and more reproducible, have not been acted on. Safety observations It may be beneficial for organisations to consider guidance, such as the ‘principles for effectiveness and usability’ provided by the Chartered Institute of Ergonomics and Human Factors, when developing risk assessment tools. The aim being to ensure assessments are simple to use and therefore staff being more likely to do them thoroughly and avoid tick-box fatigue. It may be beneficial for organisations that make recommendations to improve the safety and care of pregnant women and pregnant people during their pregnancy and up to 6 weeks after birth, to have a process for reporting on responses to their recommendations. This would support transparency, making it easy to see what has been achieved and what remains outstanding. The aim being to enable tracking of the implementation of actions designed to improve safety and outcomes to ensure they happen. It may be beneficial if future research or funding is directed towards identifying the evidence base for the prescribing of low-molecular-weight heparin for venous thromboembolism risk in pregnancy and the first 6 weeks after birth. This will support the production of evidence-based clinical guidelines for the care and treatment of pregnant women and pregnant people at risk of VTE to ensure it is safe and effective.
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Content ArticleIn this Guardian article, Sarah Kendell describes her experience of maternity care in Australia, highlighting the stark difference in care offered before and after a woman has given birth. She says "at the most difficult transition of our lives–after childbirth–the healthcare system leaves us to fend for ourselves," and argues that the impact this can have on the health and wellbeing of women and their babies needs to be considered. She asks whether reallocating some resource from antenatal care to postnatal care would produce health benefits for new mothers and babies.
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Content ArticleThis article from the Transforming Maternity Care Collaborative discusses midwifery a public health strategy, highlighting midwives in continuity of care models, evidence on midwifery public health interventions, and how the COVID-19 pandemic has shown the importance of investing in public health care to meet population health needs.
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Content ArticlePatient Safety Movement Foundation is joined in this video by Kourtney Wilson, Clinical Practice Consultant, Regional Patient Care Services, Maternal Child Health-Obstetrical Concentration, Kaiser Permanente, to discuss the need for standardised massive transfusion protocols in the context of postpartum haemorrhage (PPH) and the common barriers hospitals face in effectively establishing these protocols.
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Content ArticleWomen can be left in severe pain and at risk of infection if swabs and tampons used after childbirth are accidentally left in the vagina. That’s the safety risk the Healthcare Safety Investigation Branch (HSIB) highlights in this report. Vaginal swabs and surgical tampons (larger than tampons used by women during their menstrual cycle) are used to absorb bodily fluids in a number of procedures both in delivery suites and surgical theatres on maternity wards. They are intended to be removed once a procedure is complete. Retained vaginal swabs are classed as a ‘never event’. A never event is a serious incident that is entirely preventable. Data compiled by NHS England/Improvement shows that accidental retention of vaginal swabs is the most common in the ‘retained foreign objects’ category. The report sets out the case of Christine, a 30-year-old woman who had a surgical tampon inserted after the birth of her first child. It was left in and not discovered until five days after leaving hospital. Whilst being in immense pain throughout, Christine saw the community midwife and GP twice before going back to hospital where the swab was found. Safety recommendations HSIB made the following safety recommendation to NHS England and NHS Improvement as a result of this investigation. It is recommended that NHS England/Improvement carries out its intention to commission and publish an independent evaluation of its alternative design for swabs and tampons. The evaluation should also consider other solutions or technologies and include usability, cost/benefit analysis and the impact on reducing harm. NHS England and NHS Improvement response The Patient Safety team at NHS England and NHS Improvement is pleased to confirm that in line with its stated intention it had already commissioned a first stage independent evaluation of a proposed new design for swabs and tampons used in healthcare maternity services. Whilst it would not be feasible to commission an evaluation of other solutions or technologies that have not yet been well developed, further independent evaluation to compare this proposed design with other available solutions, and to evaluate potential cost benefit and impact analyses will be considered, conducted and published, should final prototypes prove possible to manufacture to the required specification and standards, and before any staged roll-out is considered. This response was received on 15 July 2020.
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Content ArticleThis article is written by Ryan Van Lieshout, Canada Research Chair in the Perinatal Programming of Mental Disorder. He looks at the mental health challenges new mums are facing during the coronavirus pandemic and highlights the importance of self-care, with particular reference to 'NEST-S' (nutrition, exercise, sleep, time for self, supports).
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News ArticleWomen are being "failed at every stage" when it comes to maternity care, say campaigners, as they call for more support for those experiencing traumatic births. Mumsnet found 79% of the 1,000 women who answered their questionnaire had experienced some form of birth trauma, with 53% saying it had put them off from having more children. And according to the snapshot of UK mothers, 44% also said healthcare professionals had used language implying they were "a failure or to blame" for what happened. Conservative MP Theo Clarke is leading calls for more action after her own experience, where she thought she was "going to die" after suffering a third degree tear and needing emergency surgery. Now, she has set up an all party parliamentary group on birth trauma. She said: "[It is] clear that more compassion, education and better after-care for mothers who suffer birth trauma are desperately needed if we are to see an improvement in mums' physical wellbeing and mental health. "It is vitally important women receive the help and support they deserve." Chief executive of Mumsnet, Justine Roberts, said the trauma had "long-lasting effects", adding: "It's clear that women are being failed at every stage of the maternity care process - with too little information provided beforehand, a lack of compassion from staff during birth, and substandard postnatal care for mothers' physical and mental health." Read full story Source: Sky News, 15 September 2023
