Adebisi: dignity, consent and assumptions in maternity care
Setting: Maternity care: first trimester ultrasound scan.
Context
Adebisi is a senior midwife from a Black ethnic background within the organisation. When she attends her 12-week scan, she does not want colleagues to know she is pregnant, so she books confidentially through the normal system and attends the fetal medicine unit as any other woman would.
What happened
Adebisi is called into a room. Five or six doctors enter. One looks at her and asks: “English?” Adebisi replies: “Yes.” The doctor then says: “OK then, we are all doctors in here,” lifts Adebisi’s top, pulls down her skirt, puts gel on her abdomen and starts scanning.
Adebisi is too shocked to move or speak. She focuses on her baby on the screen while feeling humiliated and ignored. For several minutes, the doctor scans in silence. Adebisi asks whether everything is OK.
One of the doctors replies: “We are looking,” but does not explain what they are looking for. Around ten minutes into the scan, a consultant obstetrician who knows Adebisi from work enters the room without knocking. On seeing her, the consultant says: “Oh hello, I didn’t know you were pregnant!” The consultant then turns to the doctors and says: “This is one of our senior midwives.”
Once Adebisi is recognised as a senior member of staff, the doctors’ behaviour changes. They introduce themselves individually, ask questions about her obstetric history and explain the remaining parts of the scan.
Impact
Adebisi feels humiliated, intimidated and ignored. She is particularly distressed by the sudden change in behaviour when staff realise she has professional status.
She escalates the poor behaviour to the Medical Director because she is concerned that women who look like her, or who do not speak English, may be experiencing similar treatment but may not feel able to challenge it.
The experience demonstrates how bias can shape who is treated as worthy of respect.
What anti-racist practice should look like
Every person receiving care is entitled to dignity, privacy, consent and explanation. Respect should not depend on perceived language ability, ethnicity, professional status or confidence to complain. Staff should introduce themselves, seek consent before touch, explain procedures and protect confidentiality.
Key learning points
- Every person in our care is worthy of respect
- Consent must be sought before examination, touch or exposure
- Staff should introduce themselves and explain why others are present
- Privacy and confidentiality should be protected, including for staff receiving care within their own organisation
- Assumptions about language, ethnicity or status can lead to disrespectful and unsafe care
- Interrupting bias is essential to caring with equity
- Staff should reflect on how behaviour changes when they perceive someone as powerful, educated, fluent in English or professionally connected
- Equitable care requires dignity, explanation and respect for everyone, every time.
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