Coffee Stories: Black Midwifery
This week I have the great pleasure of introducing you to the lovely Dumebi Pemberton - a mama of two littles (including a baby girl born in 2020, mid-pandemic), a registered midwife AND a registered nurse (with a background in gynaecology nursing).
She is passionate about women’s health as well as ensuring black mothers can find themselves represented out there in the online pregnancy space. With this in mind, she launched Black Midwifery (you can check out her brilliant page here and follow her on Instagram here) in early 2020 to provide maternal health information to everyone from expectant parents to care providers, to empower and inform them on their journeys.
I hope you enjoy our chat as much as I did, and if you are currently expecting I would highly recommend giving her a follow for some brilliant resources and information.
So without further ado…
Hello! How are you? Am also going to apologise in advance for the baby sounds in the background!!
I am fine thanks! And oh me too! I have mine here, so that’s fine. She’s four months now!!
Mamas making it work! Mine is seven months, what strange times for maternity leave!
Could you briefly introduce yourself, and tell us a little bit about your Black Midwifery site and Instagram community?
Of course! My name is Dumebi and I am a practicing midwife. I've been a midwife for over six years and am currently on maternity leave.
I've got a background working in labour ward and antenatal clinics in one of London's teaching NHS hospitals and I also have a background in nursing. So, I was a nurse before I became a midwife and I worked in a gynaecology unit.
I mean, I've worked in various units, but the last thing I was doing was gynaecology.
I'm all for women's health. I'm a big champion in women's health. It's a passion of mine. And that's why I later went on to explore the midwifery field.
And Black Midwifery is my baby. It's a platform that I built to allow pregnant women, or should I say expectant parents as well as new parents, basically to advocate for themselves by equipping them with the information about maternal health, so that they can have a bit more control of their care, just because I feel the more informed you are, the better choices or decisions you'll make in regards to your health care.
That’s so interesting as well that you have a background in Nursing and in particular having worked with Gynaecology as well. That must be really useful as a midwife, having those experiences and having potentially seen that other side of it too?
Definitely, definitely, it gave me the whole picture.
So, you know, midwifery, or should I say maternity care, is a part of it. You know, you're not ill when you go into maternity care you're expecting a baby. But it's nice to have an overall picture because I can understand if a woman has had any gynaecology operations before. Like I know, I know the history a little bit more compared to somebody who probably doesn't have that background.
I was really curious as well – and not necessarily just now with the pandemic backdrop – about how having gone through pregnancy yourself has impacted your work, if at all. Do you feel it has changed your approach to midwifery in any way?
Yes, so my maternity leaves have almost been back to back because I had returned to work from my first pregnancy in January 2020, and I fell pregnant again that January. And then I had hyperemesis. So, I stopped working quite early in March, but I did return to work in July, and I was on the labour ward before I started to work from home, because of me being in my third trimester in the pandemic.
But it definitely made me a little bit more aware of the care that I was giving to women and just making sure that I am listening to everything. I think it's allowed me now that I have had these babies of my own and gone through pregnancy to understand that it's more than just clinical.
So, of course having a look at the notes and, you know, knowing what stage a lady is in, but really listening to her as well.
On that.. How did you find being pregnant during Covid AND being a midwife yourself, coming in as the expectant mother for check-ups during that time?
I was really happy. Right in the beginning I was booked over the telephone, which, you know, is a new thing that was happening.
What month was that? Maybe March, April, I think it was… So, it was a telephone call, but it was pretty much what you would have expected if you'd gone into hospital, just without having my blood pressure checked and, um, having my blood taken. They took extensive notes when it came to my history, and I didn't feel like they left anything out.
And I also needed consultant care as well. And they made sure they put everything in place. I didn't feel… They made sure I had everything that I needed. And I will say even with the obstetric care… Again, that was a telephone call and I actually missed the consultant's phone call twice.
And, you know, you could imagine, you would have thought that maybe they'll just end up referring me back to my GP or like it might cause a delay in my care, or something would get missed because unfortunately I was missing a consultant's phone call. But it didn't stop there.
She still reached out to me again, once I spoke to my midwife and said, “I've missed the call, I've not been reviewed”. The consultant still gave me a call back for a third time. And, you know, I was fortunately able to answer that call and she was able to review me and we were able to discuss the next steps. I would have expected that I would have a gap or some sort of, you know, miscommunication, but not at all.
Once I spoke to my midwife. She was able to get in contact with the consultant and the consultant was able to return that call and get back to me.
That’s great, and I think it is an important reminder for anyone currently expecting that their midwives and care providers are always there and to get in touch if they have any questions at all, at any stage. It may look slightly different right now but everyone is still very much there to offer that support.
Moving on to your brilliant page, which is BlackMidwifery.co… I would love to hear a bit more about how you came to run your page and any plans you might have for the future with regards to it?
I guess the aim of the page, like I said, was, you know… We're in the age of social media, and there's Google, but I think a lot of people nowadays are on Instagram having a look at health pages and what doctors are posting and really engaging with the content.
So, I thought I might as well put this information out there.
I've had a lot of friends in the past that have been like “Oh, I really wanted to call you in regards to X and Y of my pregnancy, but I didn't want to disturb you.” And I was like “Oh my God”, like, you know, I'm here to help, like come to me, anything you want!
But I realize people can be a bit hesitant and sometimes it could be that, you know, they don't want you to know certain things about their pregnancies or some people don't necessarily want to tell you that they are pregnant.
So I said, well, I could do something to help all these people. So I started a page to put the information out there so that it was accessible for everybody. You know, getting this knowledge. So that was the aim of the page.
And you might have noticed the focus of black midwifery is to show a lot of black representation.
When I was pregnant the first time around, whenever I would look online I wasn't seeing pictures of black women. I wasn't really seeing a lot of things that represented black parents. Just the knowledge, the knowledge was out there but the representation was very obviously lacking. Should I say the misrepresentation?
So yeah, the information is universal it's for everyone, but research shows that representation matters.
It is SO important, and sadly still so noticable across the board.
You also mention empowering women with knowledge, and I personally found one of the best pieces of advice in my first pregnancy was to ensure I had the tools to not only advocate for myself but ensure my birth partner could do so on my behalf as well. Because not only are those really vulnerable and intense situations during labour (and pregnancy in general), there is also this general normalisation and dismissive approach to women’s pain and health as a whole. Then, looking at expectant black mothers in particular we obviously have this horrifying Five x More statistics (read more here).
Do you have any general advice or specific tools that you are hoping to convey to expectant parents around what they can/should learn about in order to effectively advocate for their care?
@BlackMidwifery, and so many other pages on social media, are really putting information and content out there for pregnant people to consume. So, I think it's really important that if you are expecting, or you're planning to expect, to engage with the content that's out there. But most important is taking agency of that care. So, if you have any questions, don't hesitate to speak up to your health care professionals. There's no such thing as a silly question.
If you're not sure about something, you don't understand a term that was written down or don't understand the plan of care that has been devised, it is really important that you speak to your healthcare professionals.
So, if it's your midwife or your consultant, ask the questions, make sure that you and they are aware of your plan.
So, if they've made a plan for you that you're going to see a consultant or they're referring you to a specialist, you know, ask the questions; “Oh, what does that mean? What are the next steps? How can I be involved in my care?”
I think really just engaging in the services. So, we did have a clubhouse chat with the women and just basically giving some advice to pregnant women... And one of the things that was highlighted was, you know, a lack of communication between healthcare provider and the expectant woman or expectant couple.
We were just advising them, don't walk away from an appointment confused or feeling that, you know, you don't understand something. Don’t walk away saying, Oh, you know, I don't really know what happens next. When do you have that appointment? That is YOUR appointment!
You HAVE to ask the questions if you're not sure, don't be afraid to ask those questions.
Something I’m only thinking about just now – even after having gone through this twice myself – would be… If you are, for whatever reason, not feeling heard or ‘cllicking’ with your midwife or care-provider, is there a way to speak to someone else? How would you go about that?
So yes, you can ask your midwife that you'd like a second opinion or that you would like to speak to someone else.
There is always someone senior, so you might come in and, you know… It might not be a consultant. You might see a junior doctor. If you're not happy or you feel as though something hasn't been explained to your preference, you can always request to speak to someone senior. Just ask Can I speak to a senior doctor? Can I speak to a consultant?
That whole process – before and after – of birth is such a powerful and vulnerable situation. I remember having read an interview with Serena Williams where she had continuously been telling her doctors something wasn’t right, but just kept getting dismissed and wasn’t listened to properly. Do you have any advice, in particular for women of colour and black women specifically who are known to be at higher risk of not being heard in those circumstances, of what to do if they feel dismissed. Or perhaps what their birth partners can do for them?
Okay. In terms of what you can do, I would always advise women to keep on speaking up for themselves. If you're able to, it's really important that you do speak up and don't be afraid to escalate.
So, if you're not happy with what the midwife is telling you, for example, you can be on the labour-ward and you're not happy and you want to speak to someone senior, that will be a labour ward coordinator who is a senior midwife. Just ask “Can I speak to the coordinator?”
And the coordinator, it's her duty to make sure that whatever you've asked for is answered. If not, she will then go on and ask maybe the consultant or the senior registrar to come in and explain whatever it is that needs to be explained in terms in regards to your care.
So always escalate.
The midwife is there in the room with you, but there are other people on the ward who are more senior and are involved in your care.
In terms of a Birth partner… We did raise this topic before. In your pregnancy, when we start thinking about your birth plan and that's where you, you know, state down who your partner is… And once you've done that, it's really important to get your birth partner involved in your plan.
They should know what your birth preferences are in terms of, if I'm unable to speak at this point in time, maybe I might be dealing with a contraction, I want to do this. Do you understand what I mean in terms of, you know, saying this is what I (the pregnant woman) want.
They should be aware of what you want so that they can be a voice for you when you're not able to speak.
And they can also advocate for you when you're. you know… Giving birth is one of the most vulnerable moments in a woman's life. And it's just so important to have someone there…So when you're thinking about your birth partner, you have that in mind that you want someone who's going to be able to speak up for you when you are at that vulnerable point.
Absolutely!
Now, obviously the reality is that far wider systemic change is required to address this issue, BUT… In terms of care providers and midwifery in particular, is there any specific change terms of care or the approach to care that you would hope to see, in particular when it comes to tackling these statistics around the lack of appropriate support and care for women of colour?
I think the best care is patient-centered care. So, individualised care for that woman's needs… You know what suits one lady is not necessarily going to suit the other women coming in with different conditions.
Women are coming in with many different, for example, risks. You're going to have women with high risk pregnancies and women who are low risk, across different backgrounds.
Women are different. They cannot be treated the same, but what we CAN do as healthcare professionals is LISTEN to women.
I think essentially that's where it starts, by listening to women and making sure that women are involved in their care. That we are bringing women in and making sure women are the centre of that care.
For a lot of women, like I said earlier, we're talking about miscommunication... You know, we have to just make sure that we are involving these women in their care. And I think if we make sure that we're doing that and every woman feels HEARD and women are happy with the care, and empowered to engage more in their own care, we'll be working together as a multidisciplinary team.
You know, those are the best care plans, when everybody is working together as a team. So, doctors and midwives and whatever specialists they need, but also women as well, because they are a part of their care.
I love what you said about women being the centre of their care. That's so important. And, again, it all comes back to empowering them to actively advocate for and feel involved in their own care, like you say. And to me, I guess this is where these virtual communities and sources of information can play an important role, especially now during the pandemic.
Yeah, well, I definitely feel they're important and useful, and they're really accessible. I do believe that they will be just as impactful after COVID as well. Just because of the Social Media age that we're in. Everybody has a smartphone, a lot of people have Instagram and access to the internet and they want something that is readily available and something that is appealing and, you know, basically content that they can engage with.
So, I definitely feel like post COVID, they will be just as popular, but, at the same time… Sometimes I do get some DMs from ladies and I do have to refer them back to their healthcare provider. So as long as people do realize the information is there, but these creators slash Healthcare professionals are not there to diagnose you or, you know, it's not personal.
Absolutely. Now, I have to say a huge congrats on launching your website in these current times, with two kids as well! What can we look forward to seeing on there?
Oh, thank you so much. Thank you so much. It's a passion of mine and something that I have been trying to do for a while. Yeah. I'm happy that it's out there now. And I'm planning on working on it a bit more.
I did have a bit of a break last year when I was hit with the hyperemesis, but yes… Back now and many more exciting things to come.
I am working on my blog, and currently working on a breastfeeding post, which will be talking about breastfeeding and formula feeding, and my experience with – I have to say in inverted commas “mixed feeding”… It hasn’t been much of a mixed feeding journey for be, but I do know that a lot of women relate with the infant feeding situation. So I just want to put something out there for them.
I also do have a birth plan guide coming out shortly. And yes, it's really just to help women get ready for you and your partner to devise a birth plan.
So looking forward to reading these!! Is there anything else you would like to add?
Yeah. What I would say is, um, if anybody is pregnant and possibly reading this just to not panic, although we're in a pandemic.
There are women out there receiving really good care. You know, don't be afraid that you're having a baby in a pandemic. You are still being looked after and, you know, there are a lot of positive birth stories coming in from women delivering during the pandemic.
And again, not to be afraid to speak up and ask questions because there's no such thing as a silly question. If you're not sure about something, you can always ask your midwife or your obstetrician.
On that… The fourth trimester – do you have any advice if women are potentially not feeling to confident around reaching out right now?
In the fourth trimester, you still are engaged in, I guess, with your health visitor in regards to the baby. Are you talking about in regards to baby, or are you talking about maternal health?
I would say more mum and mamas health, because I get the feeling that post-birth that can sort of fall by the way-side a little even in the best of times…
I would say, to liaise with the GP. You know, you've got the six-week postnatal check and that is standard. physical and mental health as well. At that point, if they needed to refer you or you wanted to be referred to any health services, they're able to do that in that appointment, but it's not just that appointment.
At any time postnatally, if you're not feeling all right, you are to liaise with your GP, especially if you've been discharged from your community midwife services your GP is supposed to be able to signpost you to any relevant service that you require.
Because I know a lot of women tend to not engage with GP and healthcare services until they get pregnant. So they might not be used to visit the GP, but after you've had a baby it's really important to put like what you said… If you're feeling any sort of way, physically or mentally, to use the GP and get yourself reviewed.
So the GPs there for that. Yeah. That's a very good basically the first point of call.
Great advice!! And thank you SO much for taking the time to join for this chat! I would encourage everyone who is currently expecting to visit your Instagram and website.
If you are currently expecting, and/or looking to learn more about black motherhood specifically do check out the below resources:
Five x More (**trigger warning, relates to the abysmal statistics around maternal health for black mothers, important reading but may be distressing if you are currently pregnant)