How to Be Heard: The Maternal Health Crisis
THE WOMEN'S HANDBOOK | SHOW NOTES
How to Be Heard: The Maternal Health Crisis
With Dr Jacqueline Bamfo, Consultant Obstetrician and Maternal Fetal Medicine Specialist
Episode Introduction
If you’re pregnant, or hoping to be, the headlines about maternal deaths can be frightening to read. Many women are asking the same quiet question: will I be safe?
In the UK, maternal mortality is now around 20% higher than it was fifteen years ago and the reasons for that are complex. More women are entering pregnancy with long-term health conditions. Services are stretched, care before and after pregnancy is patchy, and too many women describe raising concerns that were not taken seriously.
The risk is also unequal. Black women are almost three times more likely to die in pregnancy or the year after birth than White women, and women in the most deprived areas face around double the risk. The UK is not alone in this. Similar inequalities are seen in other high-income countries, including the United States.
In this episode I speak with Dr Jacqueline Bamfo, consultant obstetrician and maternal fetal medicine specialist, about what is driving these figures and what you can do about them. We cover the conditions to know, the warning signs to act on, and practical ways to make sure your voice is heard before, during and after pregnancy.
Guest Bio
Dr Jacqueline Bamfo is a Consultant Obstetrician and subspecialist in Maternal Fetal Medicine at Luton and Dunstable University Hospital, where she leads the fetal medicine, antenatal screening and preterm birth services. With 25 years in obstetrics and a decade as a consultant, her clinical interests include high-risk pregnancy, preterm birth and fetal growth.
What We Cover
02:39 Why are maternal deaths rising?
• The factors that may sit behind the UK's worsening figures
• Why comparing countries is more complicated than it looks
04:31 The appointment before the pregnancy
• Pre-pregnancy counselling, and who would benefit most from it
• Why Jacqueline calls the booking appointment the jewel of antenatal care
07:26 The gap after the six-week check
• Why postnatal support varies so much depending on where you live
• What to do if you’re struggling after birth and do not know where to turn
11:01 Why the risk is not equally shared
• The leading causes of maternal death, and how risks build on one another
• Where deprivation, ethnicity and bias fit into the picture
13:23 Inside a stretched system
• How the women arriving on the labour ward have changed over two decades
• Burnout, staffing and what it would take to keep midwives and doctors
18:28 The conditions every pregnant woman should know about
• Blood clots, high blood pressure and pre-eclampsia, explained
• The weathering hypothesis and how chronic stress may affect the body
23:37 How to be heard
• Why even Serena Williams struggled to be listened to
• The questions to ask, when to seek a second opinion, and why antenatal classes matter
28:08 Is the gap really narrowing?
• What the improving figures for Black women may and may not mean
• The role community campaigns have played in amplifying women's voices
29:27 Continuity of care, doulas and free birthing
• How to get consistent care when you see a different person each time
• Jacqueline's view on doulas, and what she would say to women considering free birth
36:54 Practical advice for every stage
• What to do before pregnancy, at your booking appointment and at your postnatal check
• Why the time between pregnancies matters more than many women realise
What You Will Learn
• Why are maternal deaths rising in the UK?
• What are the most common causes of death in pregnancy and after birth?
• Why are Black women more likely to die in pregnancy?
• How can I get my body ready for pregnancy?
• What happens at the first antenatal booking appointment?
• What are the warning signs of pre-eclampsia?
• What are the symptoms of a blood clot in pregnancy?
• How do I make sure my doctor or midwife listens to me during pregnancy?
• Can I ask for a second opinion when I am pregnant?
Key Takeaways
• Prepare before you are pregnant. If you have a long-term condition, a previous complicated pregnancy or a history of mental illness, ask your doctor to help you get as well as possible first.
• Know the warning signs. If something does not feel right at any stage, call your midwife or maternity unit and advocate for yourself.
• Ask questions and escalate when you need to. You are entitled to a second opinion, and bringing someone you trust to appointments can help.
• Pay attention to the year after birth. Tell someone how you are really feeling, and if a pregnancy condition needs monitoring, do not wait until the six-week check.
Further Resources and Support
Pregnancy information and warning signs
• Tommy's: Evidence-based pregnancy information, including planning for pregnancy and symptoms not to ignore.
• Royal College of Obstetricians and Gynaecologists: Patient information leaflets on pregnancy conditions and birth.
• American College of Obstetricians and Gynecologists: Patient guides covering pregnancy, labour and postpartum care.
Pre-eclampsia and blood clots
• Action on Pre-eclampsia: Information and a helpline for women affected by pre-eclampsia.
• Preeclampsia Foundation: International patient education and support on hypertensive disorders of pregnancy.
• Thrombosis UK: Information on blood clots, including risk and symptoms in pregnancy.
Black maternal health and equity
• Five X More: Campaign and charity working to improve maternal outcomes for Black women.
• Black Mamas Matter Alliance: US-based alliance advocating for Black maternal health, rights and justice.
Perinatal mental health
• Postpartum Support International: Helpline, peer support and a directory of perinatal mental health support worldwide.
• Action on Postpartum Psychosis: Information and peer support for women and families affected by postpartum psychosis.
• PANDAS Foundation: Support for parents experiencing perinatal mental illness.
Birth rights, advocacy and support
• Birthrights: Information on your rights and choices in pregnancy and childbirth.
• Make Birth Better: Support and resources for anyone affected by birth trauma.
Disclaimer
This episode and these show notes are for general information and education only and do not constitute medical advice. Every pregnancy is different. Please speak to your own doctor, midwife or healthcare provider about your individual circumstances. If you are worried about your health or your baby's health, contact your maternity unit or seek urgent medical care. In an emergency, call your local emergency number.
