2021 Conference speaker series

Wendy Olayiwola, National Maternity Lead for Equality for NHS England and NHS Improvement

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Promoting cultural safety and cultural intelligence – dismantling racism in maternity care: 2021 Annual Conference guest speaker Wendy Olayiwola discusses equity in care provision

Wendy Olayiwola, BEM, FRSA, MSc, Public Health, BA (Hons), RN, BSc (Hons), RM, ILM is the National Maternity Lead for Equality for NHS England and NHS Improvement.

For over two decades, I have worked as a registered nurse and practicing midwife across all levels of the maternity system in England. I also held the special role of being the very first black Bereavement Specialist Midwife in the country.

This unique position has enabled me to gain a greater understanding of women’s lived experiences of pregnancy and loss and has opened my eyes to the tendencies of some maternity services to adopt a ‘one size fits all’ approach when providing care to its ethnically diverse communities. This has been a journey in my career that I can never forget, and it has helped shape where I am today.

As the National Maternity Lead for Equality, NHS England and NHS Improvement, I support and work alongside maternity systems to achieve equity in all provisions of care and to ensure that this is achieved for Black, Asian, and mixed ethnicity women, and those living in the most deprived areas.

Women enter maternity services with their own unique needs, values, cultural identities and experiences. These women deserve a culturally competent workforce who are also culturally sensitive and able to provide personalised care to bridge the wide gap in support which currently exists.

Topics like this can be uncomfortable, nevertheless, the workforce needs an enabling environment to engage in uncomfortable conversations in order to provide each woman with access to a culturally safe setting that supports excellent care and optimal outcomes.

In addition to striving for equity in care provision, it is also vital to champion equality improvement amongst maternity staff.

Evidence shows us that the experience of ethnic minority midwives has not been as good as that of their white colleagues. We also know that if we have a happy, motivated workforce, this positive experience will extend into the care that is provided to mothers, babies, and their families.

It is therefore clear that the workforce – and the leadership – must better reflect our uniquely diverse population. We must lean into our emotional and cultural intelligence to guide us in shaping local and national maternity policy so that the best care possible can be provided to our most at-risk families.

So how do we change the narrative?

First, we must start by making equity and equality everybody’s business. We must envision an environment where everyone can flourish and where everyone feels welcome. This will only be achieved once we recognise our unconscious biases, challenge bad behaviours, and engage in uncomfortable conversations.

The NHS Long Term Plan committed to the implementation of enhanced and targeted continuity of carer for BAME women, and those who live in the most deprived areas. When implemented, women are 16% less likely to lose their baby, 19% less likely to lose their baby before 24 weeks and 24% less likely to experience pre-term birth. By 2024, 75% of BAME women will receive continuity of care from their midwife throughout pregnancy, labour and the postnatal period, with additional midwifery time where needed.”-Implementing Better Births

By looking beyond the first nine months of a mother’s experience and ensuring continuity of care in the long-term, we will be able to support all mothers to engage in trusting, lasting relationships with their healthcare providers which are recognisant of their cultures, values, and personal needs.

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