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The Independent
22-07-2025
- Health
- The Independent
Ask any Black woman – we get second-class NHS treatment
When I gave birth for the first time, my concerns were dismissed by my medical care providers. I put it down to my age, as I was only 18 at the time, rather than my skin colour. But as a new survey finds that a quarter of Black women experience discrimination in the NHS – how, in particular, on maternity wards, Black mothers are denied the pain relief, such as epidurals, routinely given to our white counterparts, and that we are up to four times more likely to die in childbirth – I'm not so sure. I'd wager that every Black mother I know has her own little NHS horror story. I remember a midwife telling me that I was putting on too much weight, and asking sarcastically if I had ever heard of salad. I already felt bad about myself, as I'd developed cankles for the first time. When I was later diagnosed with edema, which led to pre-eclampsia, my labour had to be induced several days early. Looking back, I didn't receive a lot of pain relief, even though I was in so much pain, I kicked the footboard at the bottom of the bed clean off. I was so traumatised by the experience that I never had another natural childbirth again, both other times opting for an elective C-section. The second time I gave birth, five years later, I had planned to have a general anaesthetic. I didn't want to be awake for any of it. Two hours before the operation, I had a visit from a member of the medical team who asked if I minded having an epidural instead, because the anaesthetist wanted to go home, and it was only me keeping him there. I felt horrible refusing, and spent the final two hours of my pregnancy scared that they would 'accidentally' give me too much medication, and I would die on the operating table. I still can't believe the maternity unit had the audacity to put that amount of pressure on me – but it seems I'm not alone. According to a survey of more than 1,000 Black and mixed-race women by Five X More – a grassroots women's health organisation which takes its name from the statistic that Black women are five times more likely to die during childbirth that their white counterparts – half of all Black women did not receive pain relief when they requested it. It all seems to stem from a misplaced – and let's call it what it is: racist – mindset among midwives and doctors that 'strong Black women' simply don't need as much help as other patients. I mean, our ancestors were happy pushing out their progeny without modern medicine – they gave birth on their own, while standing up, didn't they? Wouldn't we prefer to just get on with it without gas and air? A friend of mine, who is now a senior cardiologist, told me: 'At med school in the 90s, we were taught that Black women had a higher pain threshold during labour, so they didn't usually ask for pain relief.' There have long been serious concerns in the Black community about the treatment Black women receive during maternal health care. It was the subject of a Dispatches documentary in 2021, presented by Rochelle Hulme. The myth of the 'strong black woman' is also partly a legacy of slavery. Medical historians point a finger at Dr J Marion Sims, the 19th-century physician who became known as the 'father of modern gynecology', having invented the vaginal speculum – but whose pioneering surgical techniques were practiced on enslaved women. His statue in Central Park was pulled down in 2018. Even more shocking to me is that medical racism within the NHS doesn't just exist in maternity care, I believe it's pervasive across the entire service. I know a woman who has been battling the NHS – and been belittled by it – ever since she was a girl, when she was diagnosed with a chronic autoimmune disease that causes muscle weakness and tiredness. 'I used to fall asleep in lessons, but was told by teachers there was nothing wrong with me, that I was attention-seeking, that I was a liar and fake. At 11, I was diagnosed with Myasthenia gravis, symptoms for which I had shown since the age of 4.' Today, she needs regular plasma transfusions, so spends a lot of time receiving medical care. 'I've had so many bad experiences, panic attacks thinking I was going to die,' she tells me, 'and yet white people with the same condition tell me they have not suffered.' Once, while having antibiotics administered intravenously, she was left unable to speak – yet her nurses ignored her obvious distress. 'All I could do was point to the cannula and whisper 'Out…'. When two policemen walked past, they pointed and laughed at me, acting as though I was a mental health patient. The nurses joined in laughing and joking.' I know that the plural of anecdote isn't data, but Black people do have a rougher ride at the hands of our medical profession. Certainly, health campaigns for conditions that disproportionately affect the Black community, such as sickle cell anaemia and prostate cancer, don't seem to get the same profile as others. When it comes to ensuring the NHS is more attuned to the needs of Black patients, I won't hold my breath – because if I did, they might just leave me to suffocate.
Forbes
09-05-2025
- General
- Forbes
Tina Knowles On Black Motherhood As Leadership, Legacy, And Economic Power
New data from the U.S. Bureau of Labor Statistics reveals a troubling trend: unemployment among Black workers is on the rise, particularly for Black women. In April 2024, the jobless rate for Black women climbed to 6.1%, up from 5.1% in March, a full percentage point increase in just one month. By comparison, unemployment rates for other groups remained steady at 3.3% for White women and 4.6% for Hispanic women. This disparity reflects deeper, systemic barriers Black women continue to face in the labor market. Unlike Black women, other demographic groups are less likely to encounter the compounded effects of both racial and gender discrimination, a key issue behind the widening gap in job security. These inequities don't end at the workplace. They extend into the home, where caregiving responsibilities, often unrecognized and unpaid, diminish long-term financial security. According to multiple economic studies, caregiving mothers can lose nearly $300,000 in lifetime earnings due to these systemic burdens. That figure, while staggering, only begins to capture the emotional, cultural, and entrepreneurial contributions Black mothers make daily. Their paid and unpaid labor has sustained families, fueled communities, and shaped industries. Black motherhood is frequently framed through narratives of sacrifice. However, Black women are increasingly reframing it as a strategy, an act of legacy-building and leadership. Despite economic headwinds, many Black mothers have transformed necessity into innovation, creating impact far beyond the home. One such figure is Tina Knowles. In our second conversation (and just before Mother's Day), Knowles spoke about the personal and professional experiences that shaped her new memoir, Matriarch. Through stories of entrepreneurship, motherhood, and healing, she offered a portrait of resilience and reinvention that positions Black motherhood as both powerful and strategic. Christine Michel Carter: In Matriarch, you write about doing hair to support your family and making costumes late into the night as labors of love that helped build your family's legacy. How did you view those moments at the time? Were they acts of necessity, opportunity, or both? Tina Knowles: Every career change I've had has been completely organic and came from a place of seeing it as an opportunity. And I think those are two different things, one doing hair to help support my family's dream was something that I did out of necessity. Making the costumes, on the other hand, was a great career change opportunity for me, so personally, I don't know that I would need to reframe it. Carter: From launching your salon to founding House of Deréon, you've made entrepreneurship a family legacy. How did business ownership shape your identity as a mother, and how did motherhood shape your identity as a businesswoman? Knowles: Entrepreneurship shaped me as a mother by giving me confidence and the knowledge that I could financially care for my children. Being a mother motivated me to be successful… to leave a legacy for them, setting an example of a strong work ethic. Carter: Caregiving mothers lose nearly $300,000 in lifetime earnings due to systemic inequities and caregiving responsibilities. What conversations should Black families have about financial independence, legacy planning, and generational wealth, especially for mothers? Knowles: It's really important that you spend the time to learn about financial planning. I remember being very young and just having my first child when my friend who became a financial planner educated me on the things that I needed to do to create financial security for my children… like a college fund, making a will, insurance annuities for retirement, emergency funds and those are all things that we should learn about and do. It doesn't cost that much, and it comes in handy once they grow up and decide to go to college or pursue other career opportunities. I even encouraged that friend to write a book called "Real Lives, Real Money," a simple guide to financial planning and generational wealth. Carter: Black women are overrepresented in roles with low pay, minimal leave, and little flexibility, often limiting advancement. Based on your experience navigating both creative and corporate spaces, how can Black mothers remain visible, promotable, and empowered in systems not built for them? Knowles: Black mothers have to be conscious of taking space for themselves, being more vocal about their contributions, and not feeling like it's okay not to be recognized or seen. Overall, there must be unity among Black women, and we must be more deliberate in supporting each other. There is power in numbers. Carter: You shared your breast cancer journey with incredible transparency. For many Black women, 'being strong' becomes a survival mode. How do you balance grace with grit, and what does healing look like when strength is expected but rest is required? Knowles: In my journey of healing, I had to learn that 'no' is a complete sentence. It was an important realization that I had to focus on self-care and take the rest I required to heal and not feel guilty about it.
