Midwife Evi K.

Apr 15, 2021

Racial Discrimination in Midwifery and Maternity Care

It is no secret that racial discrimination is not absent in the fields of Maternity Care. It may be conscious or unconscious, but it surely is condemnable. We wanted to provide you more information on the topic and I decided to contact the “Play the Race Card” team. One of the Co-Founders, Mars Lord, decided to create the article for us to feature on the “Being a Midwife” blog.

“Play the Race Card” is a project that aims to help and support midwives and health care professionals to improve outcomes for black and brown families. Their vision is for those professionals to carry a set of “Play the Race Card” and use them to reflect and remind themselves about the specific Challenges that black and brown families face. These cards encourage us to consider our stereotypes and to ensure they do not stop us from equally supporting all families.

Enjoy Mars’s article!

Whenever we talk about racism, racial discrimination and unconscious bias etc., the defense mechanisms come rushing out.

There has to come to a point where the initial reaction is tempered with some slow breathing, a pause, a time to listen and a time of self-reflection.

What I'm about to talk about in this article is going to cause some to reach for the age-old:

"But I'm not.."

"How dare you call me..." etc., etc.

So, let's take a moment before we get into it. I would really like for you to take a few deep breaths and be conscious of where you are. Then I would love it if you could bring awareness to your body. What comes up for you when these discussions, articles, points of view are shared? How can you be a place to listen to hear, before listening to act? Remind yourself that we are talking about racial discrimination in midwifery and maternity care. You might also like to acknowledge that you want more education about this and decide where you will go for that.

Okay… breathe out again. And let’s go.

It took 8 minutes and 46 seconds before collective white consciousness recognized the realities of racism. There seemed to be an opening of hearts and minds that summer. Black and Brown people were smiled at, spoken to, asked how they were doing. Black squares were posted on social media. Statements of support were shared. For some, marches were attended for the first time. Attention began to turn towards the inequalities, particularly within health. The information about the rates at which Black and Brown women were dying in comparison to their white peers was beginning to be acknowledged and talked out. Cultural Competency workshops began to fill.

And then it was September.

The smiling was replaced with suspicion. The conversation dried up and people questioned why Black and Brown people were getting so much attention and calls were made to see ‘normal’ families on television and within media. Whilst all of this was happening, Black women continued to die and their many near misses were not recorded.

In recent months the Government has released some race reports. One notes the maternal mortality disparities and states that it has no targets to end them. The most recent report states that Institutional racism does not exist.

What does this mean for Black and Brown women and birthing people? It means that where there was a moment to take action, many will now simply turn their backs and say,

“See? Told you it was nonsense. No one sees colour or discriminates. It’s all stuff and nonsense”

And so Black and Brown women continue to die.

When you look at the way that you were trained, when you think about the supervision and mentorship you were given, how many times did you see Black and Brown imagery in your texts and resources? How often were you taught to look at the different skin hues and to differentiate between how different symptoms show up and present? What did you learn about observing babies and their state of health? How many times did you hear the phrase, repeat the phrase

“The baby is pinking up nicely”?

When you consider the birthing parents and their partners, do you recognize when the societal narratives override your desire to serve and support people at this most vulnerable and intimate time? It is easy to be caught up in the box-ticking exercises and getting through your shift. These are people who may never birth again. It could be the first of many.

I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. Maya Angelou

The narratives that you carry within yourselves about the people that you are working with, will determine how you treat them. Even when you say, with confidence, that you don’t discriminate and treat everyone equally. Does that equality also mean that you treat them with equity?

Here are some things that Black and Brown birthing people have told me, or I have witnessed, over the years about their birthing experiences:

‘You’ve been in the birth centre for 4 hours. It’s time to transfer you. There may be an obstruction of labour’

‘You won’t need breastfeeding support. You’ll be fine.’

[overheard] ‘There’s a right Asian Princess in that room’

‘You have to do this. There are no options’

‘You’re not really in pain. It’ll get much worse than this. You’re strong. You can do it.

‘Where is the father?’

‘Why are you being so aggressive?’

Now think about your colleagues. What is the ethnic make up of the management of your Trust? How many Black and Brown Band 7 midwives do you know? What about Band 8s? What about in the upper echelons?

Did you know that Black and Brown midwives are the most likely to have complaints made against them, from the people they are serving as well as their colleagues? They are the most likely to be suspended and yet, when it comes to the point of being struck off, they are less likely than their white colleagues to have this happen.

We know that one of the biggest worries for midwives is that they may lose their PIN. That they won’t be able to work again as midwives. Consider how you act within your work knowing this. Now consider again, what it means to hold white body privilege at these times. There is enormous pressure put on our wonderful midwives, so it’s time to think about what happens when you add Black or Brown to the mix.

Here are some things that Black and Brown midwives have said:

Coming on to a shift even if the board is empty, you'll be the one given the one labouring woman

I won't get to go on a break because I will have been forgotten

On a busy shift, I'll get the least support despite being given the most complex case

No one on my management team looks like me

I'm not going to progress in my place of work as I'm not considered of value, my face doesn't fit

I know my colleagues speak about clients in stereo-assumptive ways, in front of me...

They've spoken about me and my race in a non-pleasant way

Black and Brown midwives are often worried/scared about going in to work after ‘terrorist attacks’. They know that they face judgment, colleagues wanting to ‘reassure them’ that they are not racist. The emotional toll is high, but very very few ever say:

“What do you need?”

It’s as simple as that. No loading of thoughts, presumptions and opinions. Just a simple question so that they know people care for the emotional trauma that continues to be piled on them, in addition to the weight that you all already carry.

Play The Race Card is a simple resource to remind you about the people in front of you. They remind you to do what I was taught as a child when it came to road safety.

Stop.

Look.

Listen.

You see, we challenge our personal and societal narratives when we interrupt our thinking. We begin to genuinely see the person in front of us. We begin to do the work that we dreamed of doing. We love people. We serve them.

What one action can you do to change things within your own life, to start that journey of anti-racism? Now think about what you can do in your place of work. It would be wonderful if we could close the gap and look back on our careers knowing that we made a difference.

I invite you again, to take stock of where you are. To breathe and become aware of your body. Where is the tension living? What has come up in the reading? Breathe out. Shake it off. Make a decision and act. Lives, all lives, depend on it.

Prejudice is a burden that confuses the past, threatens the future and renders the present inaccessible. Maya Angelou

I truly believe that this article of Mars is extremely inspiring.

We all need to constantly remind ourselves to treat everyone equally. Black and brown families deserve our respect and thoughtful actions. Same as all races and ethnic backgrounds. In addition to that, it would be even better if we would try and inform our colleagues too. Health care should be given with understanding. Especially when it comes to Midwifery.

What are your thoughts? Do you have any concerns? Have you faced any difficulties during caregiving?

We strongly encourage you to contact us in whatever way suits you and discuss the article, suggest ideas for upcoming content, tell us your strong and emotional stories or for any other reason you would like.

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