Fighting maternal health inequality: A helpline for black women

Amina Hatia, Midwifery Manager at the baby and pregnancy charity Tommy’s, explains why they collaborated with Five X More to develop a specialist helpline to support Black and Black Mixed-Heritage people through all stages of pregnancy.

Evidence shows that Black women in the UK are 2.9 times more likely to experience adverse pregnancy outcomes, and over twice as likely to suffer baby loss compared to white women. While some contributing health conditions are more common in this group, we also know that systemic inequalities and racism in healthcare are significant  factors.

This is why Tommy’s, in collaboration with Five X More which is a grassroots organisation committed to improving maternal outcomes for Black women, developed a specialist helpline for Black and Black Mixed-Heritage women and people who can get pregnant in direct response to unacceptable inequalities in maternal health outcomes. This partnership allows us to extend the reach of our expert midwifery support and impact by directly connecting with the communities most affected.

A tailored and trustworthy service

The helpline offers support across the full maternity journey, from preconception (including sexual health) to the fourth trimester, including pregnancy after baby loss. 

What distinguishes this helpline is the focus on culturally safe, specialist support. Addressing inequity is at the core of Tommy’s values, strategy and team of midwives who provide compassionate, person-centred expertise. To date, we have had over 875 callback requests. And feedback shows the value of the service: 

• 97% found speaking to a Tommy’s midwife helpful 
• 91% felt empowered to take the next steps in their care 
• 100% would recommend the service to others 

This reinforces the importance of providing dedicated, identity-affirming care to communities often under-represented in mainstream health services.

Responding to fear and mistrust

A recurring theme in our conversations has been the sense of fear and mistrust experienced by many Black and Black Mixed-Heritage women within the maternity system. Many have reported being dismissed, misunderstood, or pressured into decisions without discussion. The helpline offers space for unhurried, respectful, and honest conversation, which is something that can be difficult to access elsewhere. 

One service user shared:

“It’s so nice to be able to talk to you and not feel like I’m wasting your time… being able to just say it out aloud helped so much.” 

Another said: 
“I feel so much more confident in advocating for myself and in knowing what to expect with my care going forward.” 

Case study: Shamaila

Shamaila contacted the helpline at 38 weeks pregnant after being advised to undergo an induction due to a small-for-gestational-age baby. She had previously had a traumatic labour ending in emergency caesarean following induction and was distressed by the prospect of going through that again. 

She felt her concerns were being dismissed, possibly influenced by her being a visibly Muslim, mixed-heritage woman with a non-European accent. And despite her background as a research scientist, she felt she was not being taken seriously. 

However, during her initial call with a Tommy’s midwife, her concerns were fully heard. They discussed her options, including the possibility of additional monitoring rather than immediate induction. With new clarity and confidence, Shamaila arranged another consultation and agreed a revised care plan involving additional Cardiotocography/CTG monitoring and follow-up scans. 

She remained in contact with the same Tommy’s midwife for five follow-up calls, which focused on her wellbeing and decision-making support. She later gave birth naturally at 41+5 weeks and described the experience as empowering because it happened on her terms. 

Her message to us:

“You provided me with the knowledge and understanding to take the right decisions for myself and my baby. I can’t say enough thanks. Your organisation is a great support for those who need it during challenging times.” 

Building confidence and improving outcomes

It’s important to note, this helpline does not replace NHS care. Instead, it enhances it by building confidence, fostering understanding, and equipping women and people experiencing pregnancy to ask the right questions. Calls average 1.5 hours, and continuity of care is prioritised. When requested, users can speak to the same midwife across multiple calls, helping build trust and avoiding repetition. 

We’ve also partnered with Petals to offer bereavement counselling, recognising the ongoing impact of baby loss and pregnancy complications. 

You can book a call with Tommy’s specialist Black and Black-Mixed Heritage Helpline, here.  You can also call 9am–5pm, Monday to Friday on 0800 0147 800 or email them at midwife@tommys.org.