Infant death rates in Irish hospitals up to two times higher among African-born mothers, ESRI report finds

A four-bed ward at Cork University Maternity Hospital, Cork. File Picture: Denis Scannell

Hospitals must start listening to women of colour and acknowledge dangerous flaws in how they are treated, advocates have urged.

“It’s not just that we are uncomfortable in these hospitals, we are dying,” said one leading anti-racism campaigner in frustration.

Anecdotal reports from migrant women were reflected this week in a report from the Economic and Social Research Institute (ESRI) on inequalities in mortality, including perinatal mortality.

It found that stillbirth and infant death rates are up to two times higher among African-born mothers giving birth here than among mothers born in Ireland.

The report authors described it as a striking finding, which should be addressed by policy. They also found a similar gap between unemployed mothers and mothers from professional working groups.

Social worker and co-founder of Roots in Africa-Ireland, Diane Ihirwe, said these figures reflect the lived reality of migrant communities.

“It’s not just black people, brown people, and poor people complaining," she said.

It’s people dying from things that for the general population, as they say in the report, has improved for other people.

“There is no acknowledgement of the truth. This is the reality, so we need to ask: ‘what can we do?’.”

She described her own experience of giving birth in an Irish hospital as traumatic.

“If we continue to be seen as the strong black women who don’t feel pain, nothing will change," she said.

I was told I don’t feel as much pain as a white person.

“She [the midwife] actually believed that, and that made me stop looking for help when I needed it. 

"I felt clearly if I was feeling pain, it was not as much as the white person next to me, a professional qualified person told me that.” 

In her experience as a community builder, migrant women internalise criticism from healthcare workers.

She urged hospitals to take the same approach to migrant communities as was taken to improve perinatal mortality for the general population.

The ESRI found overall perinatal mortality improved from 8.3 stillbirths and infant deaths per 1,000 births in 2000 to 5.4 in 2019.

Ms Ihirwe, a sessional lecturer, said: “I do lecturing on race and women in race, and whenever I bring up statistics like this, people think I am lying," she said. 

Genuinely, [white] people don’t think this can be true.

“I think some of the people at decision-making levels in hospitals don’t believe this is true, it’s ignorance. If we are ever going to change this, we need people to understand and know that this is a reality.” 

These are problems affecting thousands of families. A European Migrant Network report said in 2020 there were almost 89,000 non-EU women and girls living in Ireland (3.5% of the resident female population).  

Ms Ihirwe said many patients are willing to share their experiences. 

“We need people to believe us now, this is happening,” she said.

We changed the mortality rate for white women, we can do it again for brown and black women. 

"That cannot happen in a vacuum, we all have to work together. We can’t focus on race only, we have to focus on class too.” 

Sociologist Dr Jo Lawless-Murphy carried out research on interactions between Irish hospitals and migrant women, including women in direct provision, almost 20 years ago.

“When we published that research, we thought it was really groundbreaking, and as a researcher, you keep thinking something will shift on this, but it doesn’t,” she said.

“We do need legislative attention paid to this, and we surely need an Oireachtas health committee into maternal health, and there has to be a specific examination on the needs of migrant women.” 

Dr Murphy-Lawless said it is well-known maternity units are operating under various pressures, and she called for more support in general for the sector.