What to do about bad midwife experience?

[NotAgainPleased]

Tricky and sensitive situation.

I’m a woman in a same sex relationship and am currently pregnant with our second child.

Wife had the first baby, at a big London teaching hospital where the care was generally really good, aside from the fact that it was covid and restrictions around going for appointments together etc applied. We did however have a few incidents of staff being clearly homophobic and I’m feeling quite scared that this is going to happen again with me and worried it will make what is already going to be a stressy birth (Im classed as high risk because of a medical condition) a really traumatic experience. The complicating factor is that the three staff who gave us a difficult time were all West African, and I know homophobia is more of an issue in parts of West Africa than it is here, so it feels like a bit of a common denominator. (Yes I do know they were West African, I’ve lived in Liberia and Ghana for a few months each, and I know the accents. Had an amazing time, aside from having to stay back in the closet.)

The worst incident was with one of the midwives who looked after us during my wife’s labour. She was only with us for two hours as was covering a break. A few examples of what happened though, firstly she asked me twice who I was and why I was there and once where the father was, despite me explaining that I was DW’s wife and the soon to arrive baby’s other parent and that there was no father. She said after each time I explained “I don’t know what you mean” then afterwards referred to me as DW’s friend or helper. Lots of dark looks when I was holding DW’s hand. And most upsetting of all when I was helping DW by changing the bed pad things they put under you to catch the amniotic fluid she actually physically knocked my hand away from DW, and snapped “I am the midwife, I look after the mother, you go and stand up there at other end by her head.” This last bit was so upsetting I had to quickly dash to the bathroom for a two minute cry, which I didn’t want to do in front of DW, before returning. We had both been awake for two days by this point, so the crying was unavoidable and I stopped very quickly and went back to DW. Had I been less tired / not where we were I might have pointed out that I was pretty well acquainted with DW’s nether regions and did not need to stay up by her head. Didn’t say anything at the time as she was only covering someone’s break and I didn’t want her to stop caring for DW somehow and soon we were being looked after by someone else who took us through to the end and was amazing.

Other incidents we had were with two staff members on the front desk of the maternity unit. (this was covid so for scans etc the pregnant one went up, waited to be called while partner hovered. Pregnant one then texted partner when called for appointment saying come up now at which point you went up to the front desk staff and signed in and got a pass). We saw both these two staff members twice for different scans and check ups and both got visibly confused when I had to go up to the desk and explain that my wife was upstairs waiting for her scan, and yes I was her wife not a sister. Cue the staff saying “I don’t understand who are you?” “If you are the wife why are you not upstairs getting the scan?” and “Fathers and partners only allowed upstairs.”

I’m worried something like this will happen again, but don’t really know how to try to preempt it without saying something that could come across as pretty racist. All three staff that gave us a hard time were definitely West African, and I know, from the news, as well as from having lived there that homophobia is a big thing. Not at all saying all first gen West Africans are homophobic or that no white people / people from other backgrounds are, but the reality is that was our experience and I don’t want a repeat of it while I’m in labour.

So what the bloody hell do I do? Nothing and hope for the best? Say something general about having had a bad experience with some seemingly prejudiced staff last time and not mention why or who?

The hospital should be noting the names of both parents as a safeguarding measure, make sure your name is included, and also make sure it's noted if you also have legal Parental Responsibility.

If you wife is in agreement then I would also ask it to be recorded that you had a bad experience of homophobia during your previous pregnancy.
NHS hospitals have policy against homophobia as does the NMC, if you experience any problems then please do involve PALS.

@Suzi888 apart from how dismissive and problematic what you said is, would you be up for pretending your DH is your brother during labour?

The OP wasn't racist at all.

File a complaint with PALS. I had a bad experience with a midwife (she gave me a non-consensual sweep) and my complaint was quickly followed up and the staff given training.

If the NHS is so hot on calling women "birthing parents" and "people with a cervix", surely their stance on LGBTQ is strong enough to come down on any homophobic midwives like a ton of bricks. I hate Stonewall with a passion, but it might be worth flagging it with them and making a fuss.

OP have you considered a doula or even a private midwife if this is something you could afford?

I think it's really important you feel safe and comfortable so that you can have a good experience.

Is Homebirth an option for you?

Where do you live? Is there a choice of hospitals? What sort of birth are you anticipating?

I think race and culture is neither here or there. Homophobia is not acceptable and working in the UK means you have to accept that sexuality is protected under the equality act. Your midwives displaying homophobia for whatever reason is no more acceptable than a teacher or police officer doing the same. A teacher or police officer would be facing an investigation and disciplinary under these circumstances. Make a complaint (but as above, leave race and culture out of it.)

@BeanieTeen why leave culture out of it though? Its well known that homophobia is rife in Western Africa. Highlighting this to the NHS may just trigger targeted training. There is no benefit to pretending cultural differences do not exist - they absolutely do and sometimes those differences contradict the core values of British culture so should be identified and addressed.

Wow it’s shit that in this day and age people think like that, especially in the NHS when we all have to have diversity training as mandatory. It’s not something I’ve witnessed in practice but I don’t live in a very diverse ethic area.

I would go with an open mind and if the conversation arises be very explicit in who you are and the situation and if it’s still not sinking in ask to speak to the nurse/midwife in charge but it’s unacceptable.

As I read this, I read the midwife in my mothers voice, west African. It is a cultural/religious thing. You'd get similar as a single mother, unmarried etc. However, agree with others not to mention it and have an open mind going in. Maybe other midwives will be more tolerant even if they disagree.

Re your previous experience:
Make a complaint via PALS
Copy in the Maternity Voices Partnership (find their details on the National Maternity Voices website)

For this birth:
Speak to the consultant midwife (or head of midwifery if they don't have one) in advance and explain your concerns. They can then flag it.

It's awful you had that experience, I hope this time is much better.

To clarify, don't mention the cultural aspect! Nothing wrong with voicing concerns!

Feedback/complain about your previous experiences, mention the staff by name if you know it, but leave your perceptions or assumptions about their race, nationality or cultural background out of it. Stick to the facts of what happened.

I agree with those suggesting you speak to the head of midwifery at your hospital now to ensure you don't encounter issues again.

There is a choice of hospitals but for medical reasons it’s best that I go for this hospital. I have a condition that gets me classed as high risk and there are more specialised specialists in this hospital. In the vast majority of cases my condition actually has no impact on pregnancy or birth, and the only restriction it should put on me is that I’ll be unlikely to be allowed to be allowed to give birth on the labour ward where the care is consultant led and more medicalised than on a midwife led unit. Plus I’ll probably have one midwife with me all the time, hence not wanting to end up with one like the one we briefly had last time.

I’m not actually that worried about my condition, but as I’m going to get specialists dictating part of my care, I want them to be the best specialists who will be able to make nuanced decisions and who won’t do things like insist on a medically unnecessary caesarean because they aren’t familiar with handling labouring women with my condition and want to minimise risks that aren’t really there. If that makes sense.

Besides which, our choices would just be another London hospital, and I don’t think the issues we had were specific to the hospital, more to the staff we encountered.

Who do you want the NHS to 'target' training at?
All black staff?
All staff born abroad?
Staff with West African surnames?
Staff with West African parents?

I guess it's lucky that no one else is homophobic...

Ridiculous to think you can target training at particular cultural or ethnic group.

@Marvellousmadness

so what you’re saying is op should just accept and tolerate homophobia?!

why the fuck should she?!

you sound like one of those people who say to women who have birth injuries “you’ve got a healthy baby, that’s all that matters”

A healthy baby is NOT all that matters. It’s mother matters just as much

and how was OP racist exactly?

You need to somehow alert the hospital to this previous bad experience. Not in a report necessarily but in a this happened to us before and we would like reassurances that it won't happen again, and please tell us how you'll be preventing such incidents. Practically I don't know what that would look like. I changed hospital and got on a known midwife scheme after a bad experience - is anything like that available?

We had similar but it was the very white receptionist who couldn't accept I was the partner and my wife's brother wasn't the dad. I also generally felt quite ostracised from the birth, same sort of thing as being told to basically get out of the way at times. Although I suspect this would have been the same for any dads I was very sensitive to it and to be honest would have appreciated a bit of sensitivity from the midwives.
I spoke to the hospital afterwards, talked through my experience and am hoping it will be better this time when our no.2 is born. I would try and get the email address for someone in charge of midwifery stuff like the Director of Midwifery if they have one. Or see if they're on Twitter as a lot of hospital execs are on there and you can message them directly. I know a lot of hospitals are actively trying to address homophobia and if they can identify a cohort of staff such as midwives who need a bit more training or awareness raising then they can do some targeted training.
Hope your next experience is better

Definitely not all Black staff or staff with West African surnames, that would be horrendously racist and unjust. Neither I or the OP suggested this was a racial issue so not sure why you’ve suggested all Black staff? Yes most people from West Africa are Black but not all Black people are West Africa.

I’m not a policy maker so in hindsight targeted training would be extremely difficult to distinguish who to train and who not to train so that’s probably not the best move, but ignoring huge cultural differences is harmful to our core British values of inclusivity and acception. It clearly is a cultural issue, so why ignore it?

@chocolatesand basic diversity training is pretty commonplace now, I’m sure the NHS is no different. If that’s not enough to get a pretty simple message of not discriminating against gay patients or making them feel uncomfortable across, then perhaps a disciplinary will.
I don’t see why more intense training for something so basic should be arrange for many due to the ignorant attitudes of just a few. Seems like a massive waste of time and resources.

I wonder if you taking the pad away was seen as a risk, as the midwife needs to know what’s ‘coming out’. Idk. But other behaviour unacceptable.

@Poppyblush no, the pads were being regularly changed, and after her comment the midwife then went ahead and changed it herself.

She could have hypothetically meant something like “there’s no need for you to do that, it’s my job don’t trouble yourself” which would have been fine but from the way she said it and the way she slapped my hand away, she definitely meant something nastier and more disapproving.

This was very clear cut homophobia, but even with more nuanced / minor incidents of it, where what someone said might have sounded fine on paper, when it’s targeted at you, you know what it is. You can feel the disapproval and uncomfortableness. I’ve been lucky that it hasn’t happened to me / my partner too often, we live in a pretty tolerant area and both look quite straight (whatever that means) but when it does happen, there is no mistaking it.

Complain to PALS, it is unacceptable to be treated like that. I would mention names (if you know them) or the time you were in but wouldn't mention their race as you are assuming it's relevant. It might be, it might not be. The important thing is that the hospital are made aware of this behaviour and will deal with it how they see fit. From experience complaints via PALS are taken seriously. As for ensuring you aren't cared for by them again, you can request a different healthcare professional in any scenario, but whether this can be facilitated at the moment due to the chronic staff shortages is another matter.

Thanks all for the advice / empathy. I think I will try to mention it, probably without referencing culture or backgrounds, but just in a “this happened, I don’t know if you’ll have a record of which staff member this was anymore, but can you let me know what steps you can take to make sure we don’t have to deal with any more “confused” or homophobic staff this time” sort of way. Will think about who to speak to and when.

I’m not too sure it will make a difference really as labour wards are understaffed and chaotic and you don’t know in advance who will be in charge of the ward when you do end up going in. So generally you just end up getting the staff you get and it’ll probably be down to luck.

I can see now that it would probably have helped to have complained then, both because the midwife might have been picked up on her behaviour and because we’d have it on record. At the time though I was just relieved when the midwife left, and we got someone great
to cover the next shift. Also felt a bit nervous about complaining during it all and then having to potentially go through loads of explanations while wife needed me and then having to still be on the ward and be treated by staff who know you’ve complained.

Oh you should definitely do this and do loads of snogging! !freak them out!