To All My Black and Brown Sisters, let us tell our stories
The story of Black and Brown midwives within UK maternity services is one of profound contribution, persistent marginalisation, and a long‑standing struggle to be heard within a system that has never fully recognised their value. My own journey as a midwife, beginning in the early 1990s, has unfolded against this backdrop of structural inequity. Over the years, I have witnessed the gradual erosion of a midwifery tradition that was once grounded in deep ancestral and cultural knowledge, clinical intuition, and a strong sense of professional autonomy, much of it carried by the older generation of Black and Brown midwives who shaped the profession long before I entered it (Nicole Adrews et al 2017 ).
When I trained as a midwife, the workforce looked very different from what it is today. Many of my mentors were women of the Windrush generation who had migrated to the UK specifically to work in maternity services. These midwives were the backbone of the profession: highly skilled, deeply experienced, and profoundly committed to the well-being of mothers and babies. Their understanding of Black and Brown women’s bodies, cultural practices, and birthing experiences was unparalleled. They were the quiet experts who held maternity units together, often doing the work of several junior staff members with competence and grace (Christa Craven, Mara Gietel, 2010).
Yet despite their expertise, these midwives were consistently marginalised. Their ways of working did not align with the colonial frameworks that had long defined midwifery education and leadership in the UK. Their communication styles, accents, and cultural perspectives were misunderstood or dismissed. Their contributions were undervalued, and their leadership potential was overlooked. Over time, I witnessed many of these women step aside, not because they lacked ability, but because the system refused to make space for them. The result was a generation of midwives left with damaged perceptions of their own professionalism and limited progression opportunities (Waters, Adele, 2022).
This loss has had far‑reaching consequences. With the removal of this experienced cohort, maternity services have been left without the depth of clinical wisdom and cultural competence required to challenge the increasingly dominant obstetric model of care. The system has shifted towards intervention‑driven, risk‑averse practice, fuelled in part by rising litigation costs, £3.1 billion in claims, with 60% related to obstetrics. Defensive 1practice has become the norm, and midwifery autonomy has been steadily eroded. What we are witnessing is not progress but regression: a return to a model in which midwives are marginalised, their voices diminished, and their professional identity reduced to that of assistants within an obstetric‑led hierarchy (Shuby Pathusery et al 2010).
This is not the midwifery landscape I entered. As a junior midwife in central London, I saw midwives who were confident, vocal, and respected. They challenged decisions, advocated for women, and shaped the direction of care. Today, that collective voice has been weakened. Without the grounding presence of those older Black and Brown midwives, women who understood both the science and the soul of midwifery, the profession has struggled to maintain its footing. The system feels increasingly disconnected from its roots, and the consequences are felt most acutely by Black and Brown women, whose needs remain poorly understood and frequently overlooked (Carastathis, Anna 2014 ).
The challenges faced by Black and Brown midwives extend beyond clinical practice into academia. Many of us who sought to pursue advanced study, including PhD research, encountered institutional barriers that made progression difficult. Our intellectual labour was undervalued, our research interests dismissed, and our presence in academic spaces treated as an anomaly rather than an asset. The experiences of Black and Brown PhD students mirror those of Black and Brown midwives in clinical settings: silencing, gatekeeping, and persistent resistance to our voices. These barriers not only hinder individual careers but also limit the profession’s ability to generate knowledge that reflects the realities of Black and Brown women’s experiences (C. Craven and M. Glatzel
2010).
The racialised silencing of Black and Brown midwives is a systemic issue. The profession is overwhelmingly female, yet this does not translate into solidarity. Instead, many maternity units are characterised by lateral violence, bullying, and a culture that resists difference. Black and Brown midwives must continually prove their competence, defend their decisions, and justify their presence. Each barrier overcome is followed by another, until the cumulative weight begins to erode one’s health and sense of belonging. For many, the cost becomes too high, and they step back, not because they lack ability, but because the system refuses to allow them to thrive (Cross- Sudworth, F 2007).
Despite these challenges, the legacy of Black and Brown midwives endures. Their contributions have shaped the profession in ways that are rarely acknowledged but deeply felt. What is needed now is a reclamation of that legacy: a deliberate effort to bring back the voices, stories, and expertise of those who were pushed aside. Their perspectives are essential to rebuilding a maternity system that has been allowed to deteriorate with alarming speed. Restoring their presence is not merely an act of remembrance; it is a necessary step toward creating a system capable of serving all women with dignity, safety, and cultural competence (Douglas, J, 2022).
To my Black and Brown sisters working within these systems: I see you. I hear you. I honour the strength, resilience, and brilliance you bring to this profession. I hope that these reflections resonate, not only by naming the painful memories many of us carry, but also by celebrating the moments of solidarity and excellence that have sustained us. Our stories matter, and they deserve to be told with honesty, dignity, and power.
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