Jane: responding to racist requests in maternity care
Setting: Maternity care: labour ward.
Context
Jane is a Black midwife working on the labour ward during a Saturday afternoon shift. Seven midwives are on duty: five are Black and two are White. One of the White midwives is coordinating the shift. Following allocation, Jane goes to take over care of a White woman in labour with her second baby.
What happened
Jane receives handover from the previous midwife, who is also White. She introduces herself to the woman, explains that she will be caring for her that afternoon and says she is looking forward to welcoming her baby. The woman responds: “Hi, aren’t there any White midwives?” Jane asks whether the woman would prefer a White midwife to look after her. The woman says “yeah” and turns onto her side, facing away from Jane. Jane finds the midwife in charge and explains the situation.
The midwife in charge asks Jane whether she would be happy to stay until the other White midwife finishes in theatre. Jane explains that she is reluctant to do so because the woman is in labour, needs to feel safe with the person providing care, and Jane also needs to be able to practise in an environment that respects her dignity.
The midwife in charge agrees to swap duties with Jane until the other White midwife becomes available about an hour later. The woman later gives birth and is happy with her care.
Impact
The immediate situation is managed in a way that maintains care for the woman, but no debrief or support is offered to Jane.
The incident is not clearly documented as racism towards staff and there is no evidence of organisational learning.
Jane is left to carry the emotional impact of the interaction while continuing to work professionally.
What anti-racist practice should look like
Person-centred care must not mean normalising racism. In urgent or intimate care situations, staff may need to make pragmatic decisions to maintain safety, but organisations should have clear processes for responding to racist requests, supporting affected staff and reviewing what happened.
Key learning points
- Racist requests from patients or families should be recognised and named, even where immediate care needs are complex
- Person-centred care must be balanced with staff dignity, safety and anti-discriminatory practice
- Managers should support staff in the moment and offer a debrief afterwards
- Incidents of racism towards staff should be documented and reviewed
- Organisations should provide clear guidance for patient or family requests based on race, ethnicity, religion or other protected characteristics
- Pragmatic short-term decisions should not become a culture of accommodating discrimination
- Anti-racist practice requires care for both the person receiving care and the staff member affected by racism
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