Don’t Suffer in Silence: Advocating for Yourself During Pregnancy

Silence can look like strength, but in pregnancy it can be a serious risk. We sit down with Olamide Shalanke, a nurse, midwife of 15+ years, and senior lecturer in the East Midlands, to talk about what she sees too often in UK maternity care: Black women and other ethnic minority women pushing through pain, fear, and emotional strain because they feel they have to be the “strong one”. 

We unpack why pain is not just “discomfort” but clinical information that helps clinicians spot danger signs such as pre-eclampsia, blood clots, bleeding, or placental abruption. Olamide explains how communication changes outcomes, what it means to advocate for yourself in real time, and how to escalate if you feel unheard, including asking for the shift co-ordinator and using Martha’s Rule to request a second opinion when you feel unsafe. We also talk about birth plans: why the key conversations should happen around 34 to 36 weeks, how to think through place of birth and pain relief options, and why flexibility matters when labour does not follow the script. 

The second half goes deep on perinatal mental health, from common warning signs like severe sleep loss and not eating, to more serious risks such as postnatal psychosis and maternal death linked to mental health. We cover support routes after traumatic birth, miscarriage, or bereavement, including hospital debriefs, specialist bereavement midwives, GP talking therapies and CBT, and occupational health for counselling and reasonable adjustments when returning to work. If you’ve ever felt pressure to cope quietly, this conversation gives you language, options, and permission to ask for help early. 

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Transcript

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Welcome And Guest Introduction

SPEAKER_02 0:00

Hello and welcome to Authentic Podcast again this week. And I've got with me a very interesting guest. But before I do, if you're new to this program, my name is Abia Sonia. Authentic Podcast is about discussing issues that will potentially affect our mental health. So we draw awareness, talk about family, talk about finance, talk about different things. So today I'm going to allow my guests to introduce herself because I don't think I'll be able to introduce her properly if I try to. So thank you so much, Olame Day, for accepting to speak to Russ today. Please can you introduce yourself?

SPEAKER_01 0:38

Thank you. So as she said, my name is Olamide Shalanke. So I am initially, I initially trained as a nurse, but I've been working as a midwife for over 15 years clinically. And in the past five to six years, I've been working mainly in higher education. So I'm currently a senior lecturer at a university in the East Midlands. And I dabble in different things. I would say that my area of specialists would be providing care to mothers and neonates with additional care concerns, as well as universal care needs. So that just means basically any pregnant woman and any newborn with normal needs, universal care needs and additional care needs. And I do other things as well. As I said, I work in a university, so a lot to do with education, reducing disparities within the education system, and reducing disparities and raising awareness about inequities for women of certain ethnicities in the UK. So that's a bit about me.

SPEAKER_02 1:43

Fantastic. You can already tell the reason why I invited her. She's multi-faced. I say she's she is really good at what she does. I invited to come and speak because when I listened to you speak, the passion that you have for what you do was just so glaring. So please, in terms of, I know a lot of things, once a woman is pregnant, a lot of things happen. The woman wants to ensure that the baby is well, she herself is well. But there are so many things that hinders us as a result of our cultural belief, our religious belief, and things like that. So would you like to speak more on when a woman, an African woman precisely, or a woman from ethnic minority is pregnant, what are the things that you have noticed that they do not prioritize, but they should prioritize?

The Strong Black Woman Myth

SPEAKER_01 2:36

Okay, so um, women of our ethnicity, we have this perception about the strong black woman. So this perception means that we do a lot of things that we should not be doing. There's a lot of literature out there, so for anyone interested, I would say literally type in those term into the internet and see what comes up. So over decades, over centuries, we've been conditioned to believe in the stereotype of the strong black woman. And we believe that this is a good thing. It's a coping mechanism. When you're strong, you can go, you know, leave work, go and bear the babies, have the baby, get straight back into work, being a housewife, being mother. Um and it's something that is constantly perpetuated and we support it, but actually, that's a maladaptive coping mechanism. It is a poor coping mechanism because that as a result of this thrombac woman um, you know, stereotype, we continue to do things that we shouldn't do. So, in its essence, for example, what we tend to see um in the maternal side, we see a woman, um, maybe she's having pains in the antenator period, maybe she's having calf pain or she's having headaches. But because of this coping mechanism, we think, oh, I don't need to tell anyone, I just need to be strong, I just need to be, you know, to bear the pain. But what that woman does not realize is that might be a warning sign for preclampsia, which is a which is a big obstetric emergency. But because we've been conditioned to think that it's normal, you just have to get on with it, we ignore it. It could be signs of a blood clot, which is prevalent in pregnancy. Um, let's say, for example, this woman goes to give birth. Um, we have we know the labor is painful. We know, you know, we it's painful, it is contractions, it is your muscles um contracting and retracting. But in the same manner, because of this strong black woman stereotype, we think we don't need to have pain relief. So women suffer unnecessarily through labor. From a healthcare perspective, from a clinician's perspective, pain is not normal. Pain is a warning sign that there's something wrong. So if as a black woman you go into these scenarios and you think I have to hold the pain, I must not show the pain because I'm a strong black woman, yeah, you're not helping us clinically. Because pain is an abnormal sign that something is wrong. So if you are not showing your pain, we think everything is normal, that pain could be a sign of bleeding, it could be a sign of placenta abruption, that the placenta has come away. But once again, if women hold us pain, we don't know that there is something wrong. So that's one of the ways that I mean it's a maladaptive coping mechanism. We we need women to let us know when they're in pain. There's a lot of reports and there's a lot of research that shows that black women, um, Asian women in the UK, they have poor experiences of child care. They do not access pain relief. So there's research and literature to back back this up as well.

Pain As A Clinical Warning

SPEAKER_01 5:45

You mentioned mental health. Once a baby is then born, so we've talked a little bit about antenatal care, the period and the labor um person period. So once the baby is born, there's a lot of changes that happen. There's a lot of hormonal changes the woman has to go through in the body. There's a lot of clinical, physiological changes. And what literature has shown us is that this is a time when women are more likely to be affected negatively with the mental health. So in UK, um, in the in obstetrics and in maternity, we track um what are the biggest concerns that we have to focus on. So the past report is called the Embrace Report. So the Embrace Report in the past year, it lists the five main emergencies that we have to be concerned about, one of which is poor um perinatal mental health. In the past, we used to call it the baby blues or pregnant, you know, poor mental health in pregnancy or antenatal depression. But because we recognize it can happen at any point during pregnancy or following pregnancy, we call it perinatal mental health. So, what's happening in the United Kingdom now is that poor um perinatal mental health is a high contributory factor to maternal death. Women are dying because of poor mental health, and it's one of the top five killers in the UK. So let's bring back this phenomenon, which is a strong black woman. So you've managed to get through the antenator period, you had pain, you didn't tell anyone, but we managed, we went through labor. Now we're in the postnatal period, so you have a woman who is juggling physiological changes in her body, juggling baby. Um they may have tricked an age at home, you have a partner that you're caring for, you might have extended family members that you're caring for. There is a high chance that your mental health may be affected as well. But for the strong black woman, which we already said is a poor coping mechanism, you don't speak up, you don't tell anyone because you believe you just have to get on with it. Yes, you don't tell anyone. The danger is that this is actually a chance, this is a risk for mortality. It's one of the top five killers in the UK. So in the postpartum period, um, we say that um we say up to sort of a year following the postpartum, um the report I mentioned earlier, the Embrace report. It looks at women that have died, why they've died, and it looks up to one year postpartum. So, as I mentioned, poor perinator mental health was one of the top five killers. About 188 women died. Um, and I think about two-thirds of them died due to suicide, so they took their own lives because of poor mental health. So that strong black woman, you need to you need to let the clinician know when there's a problem. You're not expected to be perfect, you're not expected to be able to juggle everything. But because women don't speak up, then we have women that are taking their lives. There's just so much to it. But to kind of sum up the question that you've asked me, yeah, the strong black woman, it is a poor coping mechanism that is causing death. As clinicians, we need to know when something deviates from normality. Pain is one of the ways in which we know that something is not normal. So if the black woman, the Asian woman, is holding it in, thinking they have to be strong, and they do not tell us when they're in pain, we've already missed the first sign. When it comes to um mental health in pregnancy, we know it's one of the biggest um killers. So we need women to speak to us. We can talk more about how we identify um poor um mental health in pregnancy. Sometimes it's obvious, sometimes it's not obvious, um, but we need women to trust more in the system and to speak to us and seek help when they notice deviations from normality, when they notice they're not doing things they usually do, they're not enjoying life how they used to do not sleeping well, they're not eating well, they don't want to hold the baby. These are abnormalities, and they need to tell us because the earlier we know, the quicker we can do something. Just like every other um, every condition, poor mental health has stages. You may have a baby blues, you may have a bit of anxiety, depression, but at its worst, it could become quite serious. It could um result in postpartum psychosis, it could result in the numbers I talked about women abusing substances, women dying from suicide. So the earlier we know, the earlier we can do something as clinicians.

SPEAKER_02 10:29

Wow, I told you she's so passionate about what she does. You've said so many things. I'm just gonna try and unpick it. There are so many women, especially black women, they have high pain threshold. Very high pain threshold. These are the women that will be in labor, they will not cry. These are the women that will be in labor, they will be walking around and you wouldn't know that they're in labor because their pain threshold is really high. And now you're telling us that pain is an abnormality. But some people like that, they see it as a discomfort, at least. They don't see it as like it's just a discomfort that I'll put up with it, you know. So you're trying to tell us now that that's a danger because when we are saying the earth people, um, people in the health sector, they are not taking us seriously because we are not presenting right to them. That's what I heard. Correct.

SPEAKER_01 11:20

Correct.

SPEAKER_02 11:20

Wow.

SPEAKER_01 11:21

Now I'm not saying it's okay to have a high pain threshold. There is something we can call like um normal pain and abnormal pain. Say, as a pregnant woman, you come to me and you tell me you have a headache. If I give you pain relief, I expect that headache to be reduced in terms of the pain intensity. If it is not reduced, then I know that this could be a sign of something else, pre-clampsia, for example. But if you feel I have a high pain threshold, it's okay, I will hold the pain. How as a clinician can I know what is normal or abnormal if you're holding the pain? So it's okay to have the high pain threshold, but communication and empowerment is one thing that I want to do more with our society and our communities to empower people to know what is normal and abnormal and to speak up more.

SPEAKER_02 12:08

Yeah, yeah.

Self-Advocacy And Being Heard

SPEAKER_02 12:10

So for listeners out there, this is very important. I'm gonna sit here a bit. It doesn't matter whether your threshold of pain is high, just speak up. Because she said now pain is a message, it's an information. And if you do not communicate that information, the earth people they are not psychic, they are not mind-readers, they cannot read your mind. So you need to tell them, and there's no such thing as that you're complaining too much, it doesn't matter, let it be the one to decide that. It's very, very important that you advocate for yourself and you speak up, and there is no talk that is too much, there is nothing that just keep repeating it. Repetition is how we learn. You tell, um, let's say, for example, someone is attending to you, you tell her, and then the next person you tell them, the next person you tell them, then they are just gonna maybe they'll go and they're talking to one another. Well, she told me she's got headache, and then the other one she goes, she told me she's got stomach pain, and collectively, oh, this is not right, so they can easily see to you. So it is so important that you just say it the way it is and don't feel like you're disturbing anybody because that's what they are there for. That you're disturbing them.

SPEAKER_01 13:16

It's very important that we speak up, and it's your life, so you have to advocate who's the best advocate for yourself, if not you. Now, I'm not, I mean, there's a there's a lot of issues with the health system, so I'm not saying the health system is perfect, it may be that you speak to someone and you don't feel heard. We can talk about that as well. There are channels that you can go through. The the book doesn't stop with someone. So if you were to speak to someone and you feel like you're not being heard, you can speak to someone else. There is always someone else that you can speak to. So it's escalation. If you give someone a message, I have this concern, there's something wrong, you should expect a response. So you should say to them, what should I expect to hear back? Or what should I what are my expectations? If they don't meet that expectation, then you know you need to escalate at a given time.

SPEAKER_02 14:02

Well, Lamire, when a woman is having a baby, the process is quite fast. It can be. How do we then do that? Because that escalation, there might not be time for that.

SPEAKER_01 14:12

Okay, so that's a great

Birth Plans Before Labour

SPEAKER_01 14:14

question. So, really, that's something that should be done before. Unfortunately, it doesn't always happen in our communities. So, when a woman is about 34, 36 weeks pregnant, they will usually see the midwife if they're having universal care in the community. If they're having additional care, they may see an obstetrician in the hospital as well as a midwife. So, between that 34, 36 weeks, there's a conversation that needs to be had. That conversation needs to be around the choice, um, the environment of birth. So, where do you want to birth your baby? Am I having the baby at home in the hospital? Um, am I having the baby on the mid-refree led unit or in the obstetration units? How do I want my birth? So essentially, it is at this 36-week um period. This is when a woman and a partner makes up the birthing plan. So it's not when you get to the hospital that you start talking about this is the pain relief that I want, because as you said, there is no time sometimes.

SPEAKER_03 15:13

Yeah.

SPEAKER_01 15:14

At times you you don't have that luxury of time. So this conversation needs to be had before. And usually, so we have um we have certain guidelines that we work to as clinicians and midwives. Um, so the antenator guideline that we work towards, it says that at 36 weeks thereabouts, this is when we have these conversations about a birthing plan. Who initiate this discussion, the midwife or you? So it shouldn't be the midwife that initiates the conversation. But if the midwife does it, when we talk about empowerment, know what you are entitled to and advocate for yourself. So the midwife should initiate the conversation, but if they don't, then of course the most important person here is the woman and the baby. So you have to have that information to you know to advocate for yourself. Okay, old media.

SPEAKER_02 16:05

I'm going to publicly say something right now. I'm gonna publicly just rope you into this. Can you just go ahead and go ahead and do some snippet of things? You know, sometimes we think there's such information that is universal or common knowledge, but it's not. Is it possible for you to do like a snippet, even if it's just five minutes, three minutes of things you should know as a woman from birth to giving birth? Is it possible for you to do something like that for us, maybe on YouTube or maybe on your social media? And I know you're a very busy woman, but is it possible for you to just do that snippet ever so often and just drop it so that leaves we can sign post you know, people to that to that to that?

SPEAKER_01 16:47

Yes, I could do and because it's yes, I could do because it is really important, and like I could I could work with you in terms of okay, what do we want because I mean there is so much, but we could work together. Like, what do you want me to focus on? We could have maybe have a series, but one of the I mean, thinking just right on my feet now. One of the things I would say before when you're about to either a midwife or an obturition about what your birth should look like. So, what I'm saying is have a birth plan. Now, there's a slight caveat to that, a slight asterisk. The best planned births don't go as planned. Yes, so you have to be flexible. So I'm not saying make a plan and you're gonna stick to the plan, like, okay, this is what I'm doing. No, you have to be flexible based on what's going on at the time. But one of the things you should do before going into labor is make a plan. What is labor going to look like? Do I want to have the injection to birth deplacenta? Do I want to have oxytocin? Do I want to have a petroleum? What you know, what options for pain relief are there? What position do I want to be? So women can start to think around this. What is a birth plan? Go on the internet, do some research, speak to your midwife. So I'll leave, I'll leave us with that for now, and then we can talk about what other information we may want to share, maybe in a series, etc.

SPEAKER_02 18:11

Yeah, I think that'll be really good. I'm gonna owe you accountable to it. Thank you so much.

SPEAKER_03 18:19

Yeah, of course.

Support Services And Subscribe

SPEAKER_02 18:20

Okay, this episode is also by step consultation. If you're ready to write away from the depression, for you to move from surviving to thriving. Why don't you visit our website www.asebconsultancy.com. We'll support you through counseling, life coaching, and other trauma recovery programs, grief courses, and we even offer one at a time therapy. All of these services is available virtually, so you do not even have any excuse of saying you do not want to leave your home. You have everything from the comfort of your home will support you to move from surviving to thriving. Before you go, have you subscribed yet? Like, share, and comment on what resonates with you so far on this episode. If you have not done so, why don't you just click that button now? Thank you. Back to the program now.

Perinatal Mental Health Warning Signs

SPEAKER_02 19:31

Okay, so when you were talking, you mentioned four stages, and you said something about um nature psychosis. Can you run us through those stages, stages, the signs that people should watch out for?

SPEAKER_01 19:42

The possible I'm really, really passionate about perinatal mental health, and it's because I know people that have been affected by it. Okay, so not that there are stages per se, but what I mean is that you could have mild, you could have moderate, or it could be quite severe. So, what should happen is in the postpartum period, every time a woman sees the midwife, the midwife should ask questions about their well-being. So we talk about things from a holistic perspective. For example, they'll say, How is the breastfeeding going? They may check your blood pressure, those are physical signs. Yes, but then they should also ask questions about your mental well-being. Questions like, are you sleeping well? Are you eating well? I'm not saying that this always happens. So sometimes the midwife might not ask that question. Okay, what are some warning signs? Is what you asked me for. Sometimes we know when we're not ourselves, but it's more difficult when we don't know. When you've just had a baby, there's a lot of changes. The warning signs I would be saying to my patient or I would be saying to someone to look out for is sleep is really important. It is difficult to sleep when you've got a newborn, but how much are you sleeping? Because that is one of the first signs. If you manage to get sleep to cope, okay, of course, not getting any sleep, that could be one of the first things that starts to tip you over mentally.

SPEAKER_03 21:11

Sleep.

SPEAKER_01 21:12

The next thing I would say is food. How well are you eating? Are you managing to have any meals? Because usually, I mean, holistically, these things they do interlink with each other. Yeah, by the time your mental well-being goes, it may be that you've been suffering physically for a while. You know, it I mean, it it in my in my brain, in my head, it it all makes sense. You just had a baby, you're anemic, already you've got less oxygen carrying ability in your body, you're more likely to be tired, then you're not sleeping, then you're not eating. It's only a matter of time before it affects your well-being, your mental well being. So a woman that's really not getting enough sleep, it's not gonna be like before, but if the sleep is quite severe, that's a warning sign. Not eating as they usually do. Someone that doesn't want to hold the baby as much, I would say, is maybe something I'd be looking out for as well. And this is where we also depend on the partners, on the husbands, and the family members. Like, have you noticed these things in the woman? Someone who they don't they're not holding the baby, they don't seem to want to interact with the baby. Yes. Another thing which might sound a bit odd is going into a home for the first time. Say I'm a community midwife and I'm going in to do a postpartum, a post NATO check, and the house looks absolutely perfect. I would be, that would make me want to ask questions because if the house looks perfect and you don't have a maid or leaving nanny, how are you sleeping? How are you eating? Caring for the newborn and the house looks absolutely perfect. That means that something is lacking somewhere. It could be because you're not sleeping, you're not eating, and you're focusing all your energy there. Um, those are some things I might look out for. Then there's the more obvious signs. If a woman is saying to you that um she feels anxious, she feels very tearful, and it's not going away, she feels like she doesn't enjoy anything, these are warning signs as well. These are textbook things I'm saying. So it may be different in this, you know, in the actual situation, but a woman that also you have to give people the chance to speak. Yes. So if you say, if you ask closed questions, are you okay? They're gonna say, I'm okay. Are you fine? Are you all right? I'm fine. But if you give people the chance to speak up as well, so how are you feeling? What's going on? Tell me how your day has been. So that's another way you can get information about that person. Open questions, open questions about that person's well-being. Yes.

SPEAKER_02 23:47

Yeah, okay. That's absolutely fantastic.

Burnout Story And Sleep Deprivation

SPEAKER_02 23:50

Um, I remember when I had my first child, that was the first time I was burnout. I experienced what is called burnout. Just like you described, I was not sleeping well. But then I would say I was even doing too much. My mom was around, I was supposed to let her look after that child. But I was like an oak, just overing around her. When she's sleeping, I want to check that she's okay. I was, I think in reflection, I think I was scared of caught death as well. Because when we went for the training, they told us if I caught that, make sure nothing, the airway is clear. So when she's sleeping, I'm looking. Hope she's not rolling to a funny side and all of that stuff. So when she's sleeping, I was supposed to be catching up on sleep. I wasn't. And the sleep, the lack of sleep was building up and building up. And one night I woke up with hives, I was itching like mad from my head to my feet. So when different parts are itching, I took a brush, I was crushing my skin, and even though it was bleedy, I did not, I was so oblivious of it. I was just crashing everywhere. I was crying because my mom was around. You know, African mothers are spiritually, they have calm. She started, she started praying and all that.

SPEAKER_01 25:00

But that lack of sleep, you know, how the mental well-being and the physical sort of thing.

SPEAKER_02 25:05

Yeah, so in the end, it disappeared. You know, the way eyes behave, it disappear. So in the morning, while I'm going to see the GP, I have no evidence to show them. All that was left was the um the the code, the information from scratch exactly. And it's like, what is this? I didn't know. So one day it happened several times, and then one day I just thought, no, I told my mom, get a camera because phone did not have it, it's not like now where you have phone. That was like 18 years ago. It is not like now where you have phones everywhere, and all of this stuff. I told my mom to use the Kodak phone, uh, Kodak camera and capture it.

SPEAKER_01 25:39

But you developed the film.

SPEAKER_02 25:43

I took the camera itself to the GP and I said, This is what I've been trying to discuss. Oh, this is high, Sonia. Oh, he said you are tired. He said the stress, your stress level is high, and this is why your body is coming up with this. So the body is melting, yeah. It was creamy. So that was what I knew. I was toasted. I need to take a step back and just and to make it worse, I can't sleep in the afternoon. I have to sleep inside the day. So I have to reset my brain, like help yourself, this woman. Even if I'm not sleeping, I just lie down there, and sometimes I end up catching a bit of nap here and there, and I started helping myself, but I was really, really tired, and I was anemic as well. My anger was really low all through the pregnancy, so it was really, really bad. But one thing I had to communicate with them often that when I wake up, I'm feeling really light-headed, like I'm gonna pass out, and I constantly was giving them feedback as to how I was feeling, and they were able to help me. So I do understand that communication bit you were talking about.

SPEAKER_03 26:49

Yeah, it helped me quite a lot because I didn't visit the doctor almost every week.

SPEAKER_02 26:53

I was there, I didn't care, I was shamelessly going back, but I go help, I go help the fact that you need your help, yeah. And my health visitor was also very, very nice, you know. She was coming to check on me and things like that, but again, speaking with her will help her, you know, um know what is going on with me. You said something about, you know, I've heard of women just carrying their baby and just leaving the baby somewhere, and they don't even realize that they are mothers. That is that is the extreme. It is the extreme. Have you got anything you want to uh say to that how we can support someone like that? Yeah, to just to you know to catch those. Did you catch that?

SPEAKER_01 27:42

Yeah, so without knowing the case in detail, I think I caught some of it. So you said about there's some cases, severe cases, where moms would actually leave their baby somewhere not realizing that they're a mother. So that to me sounds like a case of pulpera or post-natal psychosis. It is that far advanced that you're actually now in a psychotic state. You don't know what is real from what is not real. Now, I'm not a mental health specialist midwife, but that we do so we have units um in the UK. We have mother and baby units whereby when we know that someone is actually at that point at risk or suffering from severe personality health, they will be referred to a consultant, psychiatrist, they'll have care from the midwife, the obstetrician, it's a multidisciplinary team approach, and they can go into these mother and baby units, so they're not separate, that's another thing, they're not separated from their baby, but they're in a place where they can get the care that they need. Because as you said, it it can't get to that point. And I wanted to draw something out. You said that um when you had your baby, you know, so many years ago, you noticed that you went, you use yourself and you went to ask for help. Now imagine if you were leaned into the strong black woman and you didn't ask for help. You said you were going to your GP every week and they helped you. So imagine if you didn't, and there are so many women they do not ask for help, they just hold it in, and then things can get to the point where you now get to the psychotic, you don't know what is real, what is not real, you just want to escape reality. So I just wanted to refer back to that that what you did there was absolutely right. Go and ask for help. And I must say, I know it's easier said than done, but when the baby's sleeping, that's your time to sleep as well. Especially if you have help. Lean into the help. When my sister had a baby, I literally took the baby's cot into my room. Um, and I said to my sister, you go get your sleep, and we will take turns in caring for the baby every other night. So when you have help, utilize that help. You don't need to check on the babies are stronger than we think. Not having padding or whatever around the, you know, you're reducing the risk factor. So we don't necessarily need to watch the babies as they breathe. Um, so you did the right thing there, and I would encourage people to continue to do that.

SPEAKER_02 30:04

Wow, fantastic.

Accessing NHS Care Without Fear

SPEAKER_02 30:06

So I know we've we've discussed about knowing what to do and all of that stuff, but I also noticed that sometimes when in a new country, especially those that just come into the country, what are the things that they are really entitled to? Because I know a lot of people do like, oh, um, my visa, I have no recourse to public phone and things like that. Is there anything you can throw light on there on how they can get more information on this?

SPEAKER_01 30:34

Okay, so unfortunately, I'm not a specialist in terms of like um migrant women and things like that. However, um, because we do have the NHS, one of the things I would say, and from the perspective where I come from as a midwife, when you go, the way the NHS works, you may get a bill at the end of it, but you don't get the bill at the start. So that is not preventing you from accessing health. So if you're in the country and you need medical help or you need maternal care, you have to go because this is your life at stake. A lot of people take it for granted. You know, they think the labor is fine, pregnancy is fine, but it's fine when everything goes well. But when there's a problem, the mother's life, the baby's life is at risk. Um, so what I would say is anyone in that situation that feels like, oh, I don't know what I'm entitled to, my visa, my this, that comes later. That is secondary. Your life and your baby's life is primary. That's the principal thing. So you need to access care. So when you go to access care from a GP, for example, they're not gonna ask you, they're not gonna ask you to pay upfront for your visa details. If you come into the hospital, you're bleeding, even if you're not bleeding, but you need to be, you know, registered with care, they're not gonna be asking you at that point for the bill or whatever. So the most important thing is your health and the baby's health. So your status should not stop you from accessing care.

SPEAKER_02 32:01

Okay, right. This is so important, it's very, very important because I've heard of people saying they did not go to the hospital because of SYZ, because of my other status. Are you listening? We are in the UK, they don't do that. And even if the bill comes, I'm sure there's an arrangement that you can come with them, arrange with them, and they'll be able to solder. So please do not just live your life and put it in danger, and the work could have just taken a little bit of care. We extend into things that could potentially be very,

Complaints, Escalation And Martha’s Rule

SPEAKER_02 32:30

very dangerous. Thank you so much, Alana. Now, one more question I want to ask is that you know, with the um what do you call it now, with the pregnancy, sometimes a lot of people have done all of these things we've spoken about, and that was an issue. How could people follow up on it to ensure that, like you said, because they are Iraqi today, so how to address this, how do they go through that if they have a grievance that you want to raise?

SPEAKER_01 33:00

So it depends on where you are. So say, and correct me if I don't get the if I haven't got the question quite right, but say, for example, I was um still in the pregnancy period, so antenator period, and I was not happy with my midwife in the community, I felt like maybe the midwife is not listening to me, etc. The first thing you would need to do is when you pregnancy, you're given a list of contact numbers. So you would be giving like a list of the emergency triage number. You would also be given a contact number for the community midwives. So if I'm unhappy with my particular community midwives, I would get so the community midwives, they work from Hub and they have a community midwife manager, and I would get through to the community midwife manager to express my concerns. Yeah, so that's one of the ways I would do it if I was still in the antenator period. Um, the other thing I would say is about timeline. So say for um the NHS um healthcare services, they have the timeline for grievances. I don't know exactly what they are, but say, for example, I contact the community manager and say, I'm not happy with my midwife, I don't feel like I'm being listened to. You need to know what do you expect at the end of this conversation? Is it that you wish to go to a different hub? What are you expecting? So you kind of go with a solution and you also have your expectations. So you would be saying something like, Okay, what are my other options? Can I see another midwife? Is there another clinic that I can go to? And you would have a timeline. You would be saying to the manager, for example, when should I expect this change to occur? You don't leave it blank. You know, the NHS isn't perfect, the managers aren't perfect. So you also have to advocate for yourself. So say what you want, the intended outcome, and also include a timeline. So are there any other clinics I can go to? Can I go to the hospital instead? And when can this happen? Is it one week? Is it two weeks? That's if I'm in the antenator period. If I was in labor at the hospital and say that um a midwife came in to care for me, or say I've been on the antenator ward, I'm having an induction, and a midwife came to care for me, and I didn't like this midwife, I feel like I wasn't being listened to or whatever, then you can ask for who's coordinating. So there's always a coordinator um um in the hospital, and it doesn't stop with a coordinator. The coordinator, you don't need to worry about this, but it might be a band six, but it will be a band seven, and there will be a band eight as well. So if you feel like you're not being listened to at one step, you can go one step further.

SPEAKER_03 35:37

Yeah.

SPEAKER_01 35:38

I mean, sometimes it can be trickier. Say I was in labor and a woman and the midwife was looking after me, and it's been two, four, five hours, and I don't feel safe, I expect that woman to speak up. Why is it that you don't feel safe? And you can ask to speak to the coordinator of the shift, tell them you don't feel safe with wife. Now, there's like the NHS is imperfect. So you could at that point request a change in midwife, but because of the situation, it may be that there's no other midwife available that might be possible. Um, in which case, you know, I would expect the coordinators to sort of take an interest, see what's happening, and support you until another midwife is available. Alternatively, if another midwife is available, I would expect them to provide you with that other midwife. There's also something called Martha's rule that I didn't mention previously. Martha's rule came about um when um uh very sadly an 11-year-old girl died in NHS services. So, Martha's rule is basically a team that are dedicated to giving a second opinion. So, say you were in hospital, you were not happy with a midwife or with an obstetrician, you felt you needed a second rule, you could say, can I please apply Martha's rule and have another team come and assess me? As I'm saying, none of these things are perfect because in obstetrics maternity, say there's um two emergencies ongoing and we have two teams in the theaters, they're doing emergencies, they're in sections or whatever. It may be that there is no immediate obstetric team to attend, but on a good day, if they're not occupied, you can apply Martha's rule and ask second opinion. So the point is you don't have to feel stuck where you are. If you feel unsafe and you feel unheard, escalate to someone, tell them what you intend should happen, yeah, and ask about the timelines as well.

SPEAKER_02 37:34

Fantastic. Thank you so much. That's very valuable information. If we are to empower our people, we also have to give them the right information so that they can leverage on it because ignorance can be very, very costly sometimes. You I just want

Counselling After Miscarriage Or Trauma

SPEAKER_02 37:49

to ask this. I don't know if you'll be able to speak on it, but I'll ask anyway. So when a woman has been through miscarriage or a woman has been through traumatic birthing experience, how can a woman request for counseling? Is it through the NHS or through the GP?

SPEAKER_01 38:07

It's more likely to be through the GP. So say you've gone, say a woman is gone through a traumatic birth. What should happen um immediately after the birth? Let's use a let's use an example. Say a woman has gone through uh bereavement. Um of the, you know, it could be a late uh late fetal bereavement or a neonated bereavement. What should happen is they should have a debrief within the hospital. So the debrief would typically include members of the multidisciplinary team, the obstetrician, the midwife, etc. So they would have that initially. Now with bereavement, we have specialist bereavement midwives. So that bereavement midwife is able to provide signposting and services to the woman.

SPEAKER_03 38:53

Right.

SPEAKER_01 38:53

Um on discharge, most of the counseling that would that is like you still have contact with the hospital, but most of the counseling is possibly likely through the GP. With the GP, I mean, in the past few years, the GP they've extended their services. So they have you know talking therapies, they have CBT. Um, so it depends on the kind of traumatic event. So, in that kind of case, if it was a bereavement, I would expect input from from the bereavement midwife for a few weeks, and I would also expect input from the GP. If it's something like um not a bereavement or maybe something that was just traumatic, you may not have certain services within the hospital, in which case you would have to go via primary care, which is your GP.

SPEAKER_02 39:40

Right, right, fantastic. Okay, right, that's good. Now to wrap this all up, thank you so much, Olamidi.

SPEAKER_01 39:46

You oh, can I just add one thing, one thing

Occupational Health And Work Adjustments

SPEAKER_01 39:49

to that as well? Please, please. Um I was gonna add occupational health. So a lot of people they don't always make use of occupational health services within their employment. So every employer is um has a responsibility towards your well-being as well. So, say a woman has gone through a post, you know, traumatic birth for whatever, they can also contact occupational health, which is usually a referral from the work manager to occupational health, and they could also um access counseling um services via that field as well. Sometimes counseling, you need to try different things and different counselors or psychologists to find what works for you. So you can also access counseling services via your employment.

SPEAKER_02 40:28

Right, fantastic. That's good. So let's say a woman had issues after having the baby and they want to return to work. Can occupational therapists also help with that as occupational health, yes, they can to see if they need any um adjustments, reasonable adjustments.

SPEAKER_01 40:47

Yeah, that's what occupational health is all about. What reasonable adjustments do you require for you to be able to do your job properly? So that's what occupational health is about. So when you're coming from maternity leave, you can tap into that. Of course, yes. Uh-huh. Well, actually, what should happen is when you return from maternity leave, you should actually, I mean, every company is different, but you should actually have an occupational health referral because your health is not what it was before you left. So you should actually have a referral to see that everything has gone back to normal. Um, in our cases, when midwives come back to work, yeah, they would have occupational health referral. So that's something you can tap into naturally postnatally.

SPEAKER_02 41:25

Okay, that's so interesting. That's such a good information.

SPEAKER_01 41:28

Or even antenatally, if you have synthesis pubic disorder and you've got a lot of pain in your pelvis and you find that, oh, you can't walk as much as you used to before you were pregnant. You need the occupational health referral to see what adjustments can be made. You may be temporarily move into a different part of your employer, um, employment because you need to sit down more or whatever. So you can tap into that at any point in your pregnancy in your world.

SPEAKER_02 41:52

Lavity, where were you when I needed it? I had perfect pain. We have to have my first one, the second one. And because I was lifting that up, so the GP asked me. I went back again to my lovely GP and then he referred me to psycho um physics, what do you call it now? Um physiotherapist? Physiotherapy that's the one. He referred me and they they showed me certain things I need to do and and all of that. But I didn't know at work they could I could make reasonable adjustments because I was doing the job where I was walking around quite a job that's right. Yeah, okay. I didn't know that. Right. Last but not the least question is for in order for us to prevent all

Small Habits That Protect Mental Health

SPEAKER_02 42:31

of this. I'm very, very into post-psychology whereby the preventative is better than the reactive, right? So, what are the things that a woman could do that will help to boost their mental health? It doesn't matter how small it is, let's just you know those little things that you drop into your job bucket, and then it's put holes into the stress bucket and just escalate it. What are the little things that it can do?

SPEAKER_01 42:56

I mean, I guess this is now generic.

SPEAKER_02 42:58

So you're talking about women in general, women in general, or even a woman that is into uh since we are we are talking about a dinata and the woman that is pregnant and all of that. Yeah, what can we do? Okay, so not that I'm pregnant anyway. I'm just okay.

SPEAKER_01 43:15

I can be your midvite here. Um healthcare and well-being is so important. I would say maybe some sometimes what you need to do is sit and think about what are the things that make you feel lighter? What are the things that make you feel better? So you might not even know what those things like I know for myself because I've had to do that exercise. So a good starting point would be what are the things that make me feel like me? What are the things that make me feel like I'm at my best? Is it going, you know, sometimes you may, I'm gonna make it a little bit more difficult, but you might know those what those things are already. So if you know what those things are already, then you just basically need to make time for it. We we have to make time for these things, we can't say there's no time, there's no No time because when you keep giving and giving to others, are you giving from an empty cup? So you have to feel self to be able to continue to do what you need to do. So I would say sometimes maybe it starts with an exercise. What are the things that I need to be me? Now it may be that you don't know what those things are. So if you don't know what those things are, still do the exercise, except yours will be like, okay, I'm gonna try different things. I'm gonna try reading a book, joining a book club, and I'll see if that actually makes me feel better. If it doesn't, I'm gonna try walking for 30 minutes in the evening or in the morning. I'm gonna see how that makes me feel. Okay, maybe that's not it. Is there something I've always wanted to do? Have I, you know, do I not know how to swim and I've always wanted to learn how to swim? Okay, I'm gonna find my local health club. I'm gonna go there, learn how to swim. Um, you know, even if it means just sitting in the sauna, you know, sit. So if you know, sit with yourself and think about those things that you could do. If you don't know what those things are, try different things. Ultimately, it's about what are the things that you need to do that keeps you you. I know for me, I need to get my sleep. If I don't get good sleep, I'm not me. I'm not me. I know I need to eat well, I know I need to try to get to the gym. When you're at the gym, it's so hard to find time for exercise. But when you're there, natural hormones and pheromones are released that make you feel good. So it's about what do I need basically for self-care to be me? And it's tapping into those things and filling your own cup.

SPEAKER_02 45:30

I love the way you answer that, Olavidi. I really love it because what you've done, you've made it so personal. Without specifically dictating to us, do this, do that, do that. I love it because the question is it's time for you to not go back and reflect and say, what are the things that I do that fill me with joy that helps me relax. Exactly. You know, for me, being in the nature, I'm just like a toddler. I'm I'm just moving around, and I always tell I said the fresh air over there is different from the polluted one that you guys are just surrounding yourself with. There's just something about nature, the trees, the colors. I don't know. This it's just like home.

SPEAKER_01 46:11

I know what you mean. I love it as well.

SPEAKER_02 46:13

Just going there and just seeing as I'm gonna go for a walk after this. I'm taking the kids to the park after this, so yeah. You know, just think about for some people, it might just be sitting there listening to good music. So go back, reflect, yeah, and start exploring until you find things. For some people, it might you might love it, but it's not something you want to do again. So every now and then you deepen and deep out. Let's we are our biggest investments, yes.

SPEAKER_01 46:44

Yes, some people they don't sleep well, they say they don't have time to sleep. But those things that you're putting your energy to, they will suffer ultimately if you don't understand yourself.

SPEAKER_02 46:56

Absolutely, absolutely. So please just remember you are worth

Staying Authentic Through Faith And Care

SPEAKER_02 47:01

it. Now, the last question I normally ask guys is Olamiri, how do you remain authentic to yourself? How do you what are the things that you do that keep Olamide authentic and grounded?

SPEAKER_01 47:16

That's a big question. That is a very, very big question. Um the first thing that comes, it's a big question because I'm duty, it's easier for me to preach, and I also need to sit back and you know reflect and do that thing that you need to do, Ola. Um, but the first thing that came to my mind is faith. So I am a person of faith, I do have a belief in God, and see, many things change, people change, yes, relationships change, the way that I feel change. I might feel good in the morning, I might feel good in the evening, you know, not feel good in the evening. So things are always changing, but one thing that is always the same is that belief in God. When I say that believing God, what I mean is actually that God doesn't change. So for me, having something that doesn't change, that is always stable and the same, that helps me and brings me back to it, it keeps me grounded. I would say that's one of the key things. Um, the other things that make me um help me be authentic is you already asked about self-care, looking after yourself. When I'm able to truly look after myself, I don't believe it's selfish if I do things for myself. No, I'm not a machine. I will not when I do things that bring about self-care and good well-being for me, helps me. I know I function better. So I would say investing in myself also helps me stay grounded and being authentic to myself. Those are the two things I can think of.

SPEAKER_02 48:46

Wow, that is I can relate. I can definitely relate. Thank you so much, Alavidi, for your time. You have been an absolutely lovely and insightful guest. Thank you so much. It's gone quickly. I didn't think it would go right.

Final Reflections And Goodbye

SPEAKER_02 49:03

Thank you so much for listening to us today. I would love to hear from you. Don't just listen, please share with your family, your friends, and also comment below in the chat box what's stood out for you and what are the things you're gonna go away and implement right away. Until I come your way again. I remain Abisonia, your host. Thank you so much, and God bless you.