Abuelgasim E, Saw LJ, Shirke M, Zeinah M, Harky A. COVID-19: Unique public health issues facing Black, Asian and minority ethnic communities. Current Problems in Cardiology. 2020; 45:(8)

Aldridge RW, Lewer D, Katikireddi SV Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data. Wellcome Open Research. 2020; 5

Atchison CJ, Bowman L, Vrinten C Perceptions and behavioural responses of the general public during the COVID-19 pandemic: A cross-sectional survey of UK Adults. 2020;

Berger ZD, Evans NG, Phelan AL, Silverman RD. Covid-19: control measures must be equitable and inclusive. BMJ. 2020;

What Price Safe Motherhood? Maternity Action. 2018. (accessed 8 September 2020)

Dryhurst S, Schneider CR, Kerr J Risk perceptions of COVID-19 around the world. Journal of Risk Research. 2020;

Esegbona-Adeigbe S. The impact of Covid-19 on antenatal care provision. Eur J Midwifery. 2020; 4

Gausman J, Langer A. Sex and gender disparities in the COVID-19 pandemic. Journal of Women's Health. 2020; 29:(4)465-466

Goodnight WH, Soper DE. Pneumonia in pregnancy. Critical care medicine. 2005; 33:(10)S390-S397

Hall KS, Samari G, Garbers S Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet. 2020; 395:(10231)1175-7

Haroon SM, Barbosa GP, Saunders PJ. The determinants of health-seeking behaviour during the A/H1N1 influenza pandemic: an ecological study. Journal of Public Health. 2011; 33:(4)503-510

Hussein J. COVID-19: What implications for sexual and reproductive health and rights globally?. 2020; 28:(1)1-4

Intensive Care National Audit and Research Centre. ICNARC COVID-19 study case mix programme. 2020. (accessed 18 September 2020)

Kirby T. Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities. The Lancet Respiratory Medicine. 2020; 8:(6)547-548

Knight M. The findings of the MBRRACE-UK confidential enquiry into maternal deaths and morbidity. Obstetrics, Gynaecology & Reproductive Medicine. 2019; 29:(1)21-23

Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS). 2020. (accessed 20 May 2020)

Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. 2020; 277:5-13

Nair M, Kurinczuk JJ, Knight M. Ethnic variations in severe maternal morbidity in the UK–a case control study. PLoS One. 2014; 9:(4)

Office for National Statistics. Coronavirus (COVID-19) related deaths by ethnic group. 2020. (accessed 11 May 2020)

Paton A, Fooks G, Maestri G, Lowe P. Submission of evidence on the disproportionate impact of COVID 19, and the UK government response, on ethnic minorities and women in the UK. 2020;

Pareek M, Bangash MN, Pareek N Ethnicity and COVID-19: an urgent public health research priority. The Lancet. 2020; 395:(10234)1421-1422

Prats-Uribe A, Paredes R, Prieto-Alhambra D. Ethnicity, comorbidity, socioeconomic status, and their associations with COVID-19 infection in England: a cohort analysis of UK Biobank data. 2020;

Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal Of Obstetrics And Gynecology. 2020; 222:(5)415-426

Renfrew M J, Cheyne H, Craig J Sustaining quality midwifery care in a pandemic and beyond. Midwifery. 2020; 88

Royal College of Obstetricians and Gynaecologists, Royal College of Midwives. Coronavirus (COVID-19) Infection in Pregnancy. 2020. (accessed 21 April 2020)

Rubin GJ, Amlôt R, Page L, Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. BMJ. 2009; 339

Ryean GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on COVID-19 in pregnancy: A review article. Journal of Obstetrics and Gynaecology Research. 2020; 46:(8)

Smith S, Gilbert S, Ariyo K Multidisciplinary research priorities for the COVID-19 pandemic. The Lancet Psychiatry. 2020; 7:(7)

Taylor S. The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease.Cambridge, UK: Cambridge Scholars Publishing; 2019

Tingle J. COVID-19 safety in maternity care: lessons for the whole NHS. British Journal of Nursing. 2020; 29:(8)486-487

United Nations. Impact of Covid 19 on Women. 2020. (accessed 8 September 2020)

Wu C, Chen X, Cai Y Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA internal medicine. 2020; 180:(7)1-11

Yates T, Razieh C, Zaccardi F, Davies M J, Khunti K. Obesity and risk of COVID-19: analysis of UK Biobank. Primary Care Diabetes. 2020;

Zaigham M, Andersson O. Maternal and Perinatal Outcomes with COVID-19: a systematic review of 108 pregnancies. Acta obstetricia et gynecologica Scandinavica. 2020; 99:(7)823-829

COVID-19 and the risk to black, Asian and minority ethnic women during pregnancy

02 October 2020
Volume 28 · Issue 10
 The COVID-19 pandemic has drawn attention to the health disparities that black, Asian and minority ethnic women face during pregnancy and in midwifery care
The COVID-19 pandemic has drawn attention to the health disparities that black, Asian and minority ethnic women face during pregnancy and in midwifery care


Black, Asian and minority ethnic (BAME) women in the UK have increased maternal mortality rates compared to other groups of women. Unfortunately, according to preliminary findings, the COVID-19 pandemic has contributed to mortality rates for BAME women, raising concerns that pregnant BAME women are facing greater health disparities during the pandemic. A review of 427 pregnant women admitted to hospital in the UK with confirmed COVID-19 infection found that over half (56%) were from black or other ethnic minority groups. How BAME women navigate maternity services during the COVID-19 pandemic requires a vigilant review of their needs on an individual basis. This is particularly relevant for hard-to-reach women, such as recent immigrants and asylum seekers, who may encounter difficulties accessing or engaging with maternity services. Therefore, it is imperative to reassess and highlight the challenges faced by pregnant BAME women during the pandemic. The disruption of maternity services and diversion of resources away from essential pregnancy care because of prioritising the COVID-19 response is expected to increase risks of maternal mortality.

Recently, concerns have been raised about a possible association between ethnicity and incidence and outcomes of COVID-19, following observational data released from the Intensive Care National Audit and Research Centre (ICNARC, 2020), published on 10 April 2020. The data showed that of 3883 patients with confirmed COVID-19, 14% (486) were Asian and 12% (402) were black, demonstrating a high prevalence in these ethnic minority groups (Abuelgasim et al, 2020).

The evidence of increased risks of COVID-19 in BAME groups is concerning. In a cohort study of UK biobank data including 415 582 participants with 2 886 tested and 1 039 positive for COVID-19, it was found that rates in England were higher in BAME communities and in those living in deprived areas (Prats-Uribe et al, 2020).

There is also startling evidence of the high risk of BAME individuals contracting COVID-19 because of pre-existing health conditions, which is the case for all individuals. However, BAME individuals are prone to higher rates of hypertension, cardiovascular disease and diabetes and are subject to adverse healthcare disparities, compared to their white counterparts (Abuelgasim et al, 2020). Multiple studies have confirmed that the most common comorbidities associated with severe cases of COVID-19 are hypertension, cardiovascular disease, diabetes (Wu et al, 2020) and obesity (Yates et al, 2020), establishing the link between underlying health conditions and COVID-19. In addition, BAME individuals are more likely to die after contracting COVID-19; as shown in the UK Institute for Fiscal Studies reports, which stated that the death rate for people of black African descent was 3.5 times higher than for white British people, while for those of black Caribbean and Pakistani descent, death rates were 1.7 and 2.7 times higher, respectively (Kirby, 2020).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month