Black and Asian maternal health: knowing the facts and advocating for yourself

In the UK, Black women are around four times more likely, and Asian women around twice as likely, to die in pregnancy, birth, or the weeks after, compared with white women. These figures are shocking, and they are not your fault, they reflect gaps in how care is given, listened to, and followed up, not anything about you or your body. Most pregnancies in every group are safe. But knowing the facts helps you stay alert and advocate for yourself, which is exactly what the Five X More campaign encourages.

Five X More's core message is simple and powerful: know your body, trust your instincts, and speak up. If something doesn't feel right, say so, clearly, more than once if you need to, and to whoever is caring for you. You are not being a nuisance. Keep a note of your symptoms and the answers you're given, and if you're worried you're not being taken seriously, ask to speak to a senior midwife or doctor, or bring an advocate with you.

Some warning signs are visible on the skin, and it's important to know how they show on brown and Black skin, because they are too often missed. Jaundice (a sign that can matter for you and your baby) may not look obviously 'yellow' on darker skin, check the whites of the eyes, the gums, the palms, and the soles of the feet, which can look yellow even when the skin doesn't. Pallor (paleness from blood loss or anaemia) won't show as a pale face on darker skin, instead look at the inner lips, gums, the lining inside the lower eyelid, and the palms, which can look unusually pale or greyish.

With skin changes, a rash or pre-eclampsia-related issues, the same applies. A rash may look red on pale skin but purple, brown, or simply darker than the surrounding skin on Black and brown skin, and it may be easier to feel than to see, so trust your fingertips. Skin that looks 'flushed' may instead feel hot or look ashen or greyish. If you're ever told you 'look fine' but you don't feel fine, say that the usual signs can be harder to see on your skin and ask to be properly checked.

Know the serious symptoms that always need urgent attention, whatever your skin tone: a bad headache that won't go away, vision changes or flashing lights, sudden swelling of your face, hands or feet, pain just under your ribs, your baby moving less or differently than usual, heavy bleeding, or a high temperature. Don't wait to see if it passes, contact your midwife, maternity unit, or 999 straight away. It is always better to be checked.

You have every right to be listened to, examined thoroughly, and taken seriously at every appointment. Bring someone with you, write things down, ask for a second opinion, and repeat your concerns until they're addressed. Five X More also offers a free advocacy resource and a 'speaking up' guide to help you prepare. Your voice matters, and using it is one of the most powerful things you can do for your safety and your baby's.