Episode 136 It's OK to Ask

This week I am chatting to Teri Gavin-Jones about her work on health inequality and her journey with community partners resulting in a fantastic resource of cultural curiosity films titled 'It's Ok to ask'. I hope you enjoy this conversation as much as I did.

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Transcript

Its Ok to Ask

Florence: [00:00:00] I'm welcoming today to the podcast. Teri Gavin Jones and Teri um, got in touch about a series of brilliant films and really interesting work that she has been doing. So Teri, perhaps you can just tell people a little bit about yourself and your role to start off with. 

Teri: Thanks, Florence. Yeah, so hi everybody.

My name's Teri Gavin-Jones. I am a midwife first and foremost. Um, but my title is Senior Clinical Lead for Maternity and I work across an LMNS and. If you don't know what an LMNS is, because we like a lot of acronyms in the nhs, it's a local maternity and neonatal system. So I cover three different maternity units and that's um, two in Suffolk, so Ipswich and West Suffolk, and one in Colchester.

Florence: fantastic. And you got in touch with me [00:01:00] because you had made these films and the films immediately grabbed me because the title was, it's Okay To Ask. Mm-hmm. and I, I like the comedy show, the Last Leg. I dunno if you've watched that. Yeah, I know it. Yes. And they have a hashtag. Is it okay. And I really like that because you are allowed to ask all the stupid questions that might be offensive or difficult to ask.

Ah, so when you sent me these films saying It's okay to ask my interest was immediately peaked. Yes. And I thought this could be good. And um, definitely I I, I've really enjoyed watching them. But what I wanted to understand before we move on to the films is a little bit. Of background. So they're cultural curiosity films.

Yes. Um, aimed at educating or getting us to question and think [00:02:00] about the different cultures that we see within maternity care. So, would you like to tell us a bit about how this came about? 

I'd 

Teri: love to. So I, I really, you know, want to highlight the, the terminology and the language. So we've used cultural curiosity quite deliberately.

I think there's a lot of different phrases banded around, and a lot of it tends to be about cultural awareness training or cultural competency, which, um, really scares me if I'm honest, because I just don't feel qualified to be culturally competent. And that's not to say that I'm always striving to be it without a doubt.

But it, it terrifies me that I could do some e-learning and tick a box and be culturally competent. Yes. Because for me it's a journey, isn't it? It's just evolving the whole time. Yes. So, so I think the cultural curiosity is about us opening a conversation with [00:03:00] somebody else to say, actually, I know a bit, but I really don't know very much and I'm really relying on you to share and, and tell me your story.

So that's the first thing to say about this. And for the background, we had to submit a five year equity plan to NHS England last year. Um, every LMNS in the country did so, and you, and probably lots of your listeners will be really aware of all of the data that's coming out of Mbrrace around the Health inequalities

yes. You know, the, the disparities are quite stark and, and really startling and I know for us as maternity services, we are genuinely worried about it. And, and, and, but genuinely saying this is complicated. There's not one thing that we could do to fix it. It's multifaceted. There are many, many things. So we had to start, and where I started with was with an equity forum.

So I gathered together the leaders of our local, voluntary and community sector [00:04:00] and I said, would you come and meet with me monthly And, and just. Let the whole process be driven by you. Tell us what we're doing, just tell us and, and what we're doing wrong actually, and where are we going wrong. Mm-hmm.

that was the start of it, really. And we've got a really diverse equity forum, and we do all get together once a month and, and we meet and I say to them that, you know, I'll, I'll throw a topic out and they'll, they'll come back and talk about their community's experience within that. So that was important, I think, to, to hear and, and to learn about their voices.

And, and through that journey, uh, as a maternity service, we decided to invest some money in the voluntary and community sector. And I, I found, um, six organizations that we wanted to partner with. And we put it out to tender and we said if we, if we gave you some money and if we partnered with you, what could you do in terms of, I, I suppose lifting the profile of maternity and, and, and us engaging with that community.

We talk about those kind of [00:05:00] hard to reach or seldom heard communities. Yeah. Which again are just, uh, statements. Really upset me. You know, they, their seldom listened to is what I've discovered on this journey. So it was those communities that I went to and, and naively on the staff of this, honestly, Florence, I was so naive around, um, what I knew and, and still what I know.

And I went to one organization, which is called African Families in the uk and they're an amazing organization out in Colchester. And I met with their, um, leader, uh, she's an, a wonderful woman called Rachel Walton. And I sat down and I said, look, we know that maternity services are not doing a good job for your community.

How can we make this better? Can I come and can I survey your. Hmm. How I ask them what we could do better? Can I sit with them and ask them questions and take the survey results and get some work done around this? And she looked at me and she looked me in the eye and she said, no. No, you cannot do that.

[00:06:00] She said, you have surveyed our women nationally. You understand that black women are dying. Yes. You know that. Stop asking questions. Why don't you just start doing something about it? , lovely. Love it. I love, I I immediately loved her. I'm going to be really honest. I, I could get it. Although it set me with fear because coming from a background where we ask questions and survey people, um, You know, I, I, I, I, I said to her, well, well, what should I do?

She said, come and spend time with the community. Walk with them. Yes. Eat with them. Yes. Share their stories. You know, they wanna feel heard. Yeah. That's how I started. So I sent an email to my boss saying, if you need me, I'll be out with the African families in the uk . So, um, so we started this journey and it's a real, a real collaboration and in my head I thought if I'm really honest, that I'm the clinician, I'm gonna go to the African families in the UK and to the five other organizations cuz there are six of them.

And what I'm gonna do is [00:07:00] teach them maternity. I'm, I'm gonna, I'm gonna give them a bit of an update on maternity. Yeah. How it works. Bearing in, in mind that they work with, um, some of the organizations work with refugees and people seeking sanctuary often. Um, some of the people cannot speak English as a first language, so, so there are some real marginalized and diverse groups.

I thought, oh, I'll go, I'll go and teach them maternity. That's what I'll do, because that's my thing. Yeah. So, so I rock up to teach them maternity. Again, naive and stupid, if I'm really honest. And I completely underestimated a how, uh, amazing they all are. And be my knowledge in, in terms of I had to sit and listen and learn before I could really share any of my skills or experience with them.

Yes. And that's, that's been profound. They taught me so much. Um, and you know, the, it's, it's about taking maternity as I know it. And turn it on its head and saying, right, well you drive it, then what, what do you need? And, and let's listen to [00:08:00] you. So that was a real journey. Um, there's another organization in Ipswich that I'm working with called Phoebe and Phoebe work with.

Um, they're a feminist organization. They work with black and brown women who, as they describe, are on the margins of society, right. Lots of these, um, women have left abusive relationships. Lots of them are here in this country, a country on a spouse's visa, so with no paperwork of their own. Many of them can't speak English, so.

They are, they are people often pregnant or with small children, but they are women on their own and they've been through the system in, in the UK where they've found no help and Phoebe's often the last place that they go for some refuge, right? Phoebe's are their advocacy service as well. So I started to work with Phoebe again.

I thought, do you know what? I'll work with your, because what they've done is work up ambassadors and advocates [00:09:00] for us. Phoebe said, right. We'll give you advocates and those advocates will work in the community with our women, but you can work with the advocates to update them on maternity. So that's that.

I thought, great, that I'll do that. So I met with the advocates and I went with my midwife brain. And as a midwife, I'm all about choice and personalization. So I said to them, look, let's, um, let's talk about the choices that, that women in the UK and birthing people have today. Let's talk about the fact that if they want to birth at home or in a birthing center, they have those choices.

Let's talk about if intervention is suggested that they can question it. They can ask for a. Second opinion, they can make a birth plan that suits them and it went really quiet. And I knew I'd just, I'd said something horribly wrong, but I just didn't know what I'd said. Yeah. . And they said to me, you really do not understand our women and our culture.

These are women who have come from areas in the world [00:10:00] where medical services are really rare. Um, they are not gonna question a doctor. They're not gonna ask you not to induce them or not to have a cesarean birth. This, this is not. What we need. Yes. We need you to understand the context and the background of this they are

grateful. Yes. And so there was a whole conversation, a, a reset in my mind where I, I I kind of mind blown thinking, I have just been doing this so wrong for so many years. Yes, yes. Does 

Florence: that make sense? It does. And I, I, I think that's really valuable what you are saying actually, because I think I've been part of things where it.

Let's go out and talk to this, that, and the other, um, community group. And what I'm taking from what you are saying is, is not only gonna say stop surveying because we know what the problem is. Yeah. But also the thing of actually we just need to [00:11:00] go out and build relationships and take that time. Yes. And I think that is a challenge, isn't it?

for you to say to your boss, well actually I'm gonna be out with the African families. Mm-hmm. , they've got to realize that that is valuable. Yes. And actually more valuable than you saying, oh, I'm surveying 200 people, or doing this, that, and the other. Analysis. Yeah. Um, so actually being able to go and spend that time and then.

For it to start opening your eyes is, is a really big deal. And I think that's quite a big shift because in the N H s we like to be able to kind of check off and tick, we've done whatever, um, task. . Um, yes, we've done our equality engagement as, or impact assessment. Yes. Tick Mm-hmm. [00:12:00] rather than actually doing something much more meaningful, but is much harder to put in a box and say, yeah, we've done it.

Teri: And, and in reality, you know who, we all know how pressured maternity is. We all know the staffing capacities, the national shortage of midwives. How, how lucky am I to be in a role that actually I've had the capacity to go and do this, and I, so I, I do get the challenges of. An organization trying to work up their services to meet those needs.

Um, I'll tell you the story that Rachel Walton told me the first day I met her after she'd scared the life out of me cuz she's, she's a fierce woman. You know, , she said to me, I, I'm gonna tell you this story. She said, I used to work for a charity. And don't quote me. I think it was in Rwanda. I could be wrong.

But anyway, she worked for a charity, she said, and it was really interesting because the village that I was working in, she said the nearest clean drinking water was five kilometers away. Right. So every [00:13:00] morning the women would get up and they would walk the five kilometers to the taps where they could access drinking water.

Um, and they would bring it back to, uh, the rest of the village. And she said it was interesting cause the charity came in and looked at this situation. and said, no, no, no. This is, this is not acceptable. So we're going to, we're gonna stop by putting taps in right on the edge of the village so that you don't have to walk the five k

and that's exactly what they did. And they were very, very pleased with themselves. And the women used the taps for a few days, maybe a week, and they noticed that on the second week, the women walked straight past the taps and continued to walk the 5K to get their water. Um, and this just, yeah, this just ca continued and carried on.

And when they were questioned about it, the women. When we get up in the morning and we walk our 5k, the time is for ourselves. Um, the small ba the babies come with us, but the men and the teenagers, they all stay in the village. It's too long a walk. We get time to talk about our [00:14:00] lives and our emotions and our wellbeing.

And when you put the taps at the edge of the village, the men came, the teenagers came. We had no time for ourselves. You didn't ask. if we wanted taps. Yes. You just put them in because, and I think I, it's, that really struck me as something we do in the NHS over and over again. Yes. We see a problem and we say, right.

We're gonna fix it. Let's put some taps in. Yeah. And we don't ask the community if that's the way that they'd like to go, or if it would benefit them. We just do it. 

Florence: Yes. Yeah, we make a massive assumption the whole time, 

Teri: don't we? Yeah, yeah. This is about not making assumptions. So that was one of, again, I've, I, I've, in terms of my partnership with these organizations, I have grown and learned so much more than they could ever.

Yes. Gained from me, uh, if I'm really honest. So we started to talk. We, and, and so this has involved a whole year of me meeting with them, usually monthly. Yes. I go and meet with different organizations. It's been really interesting. [00:15:00] So the Phoebe organization have worked out something that they call the grandmother's group.

Florence: Brilliant. Tell us about the grandmother's group. 

Teri: Well, so when I was having a meeting with them, we, I did with the leaders, I did, I did a kind of zoom meeting via a screen, and, um, and I said to them, can, can you ask again? I was still in my NHS midwife brain saying, can you ask, can you ask your women about this?

Can you ask them about that? Can I tell them this and that? We were talking about birth plans, actually at the time. I love our birth plan as a midwife, you know? Yeah. All over that. They looked at me again. I knew I'd said something wrong, and she said, I don't understand the birth plan. I don't, I we don't get this because where we come from, you don't write a birth plan.

You just don't. Yeah. And I said, well, how, how do the women in your community then, how do they understand ways of giving birth? And, and how do they then communicate that to the rest of us? Yes, she says, she said, when, when somebody gets pregnant in our community, there is an [00:16:00] innate birthing wisdom. And that wisdom is passed from that woman's mother and her grandmother down.

Yes. They talk, they talk a lot. She said that the grandmother in our community is revered and her word actually is law. And then again, she looked me in the eye cuz she's quite a scary woman and she said, We are going to accept what you tell us, Teri because you are a midwife and we respect you. She said, but to, for us to change our ways, the information that we take on board has to be wiser than the grandmothers' information.

And she looked at me and she said, you are not wiser than the grandmothers 

Florence: wow. That, that's a high bar, isn't it? 

Teri: Yeah. But you know, challenge accepted. I thought, well, Good. Okay. I accept that. I ex completely, so, so the next question is then if the grandmothers are so influential in this society,

Then we have [00:17:00] to educate the grandmothers surely , we have to link with them. so Phoebe said right we have a lot of women that come from other countries they have left their social networks behind 

would you come and work with the grandmothers? So I said, yeah, yeah, that'll be great. Um, so I walked into a room. There were 21 of. Amazing. Most of them over the age of 70, and quite a lot of them interestingly, are retired midwives from, um, Rwanda and Zimbabwe. Um, and, and they were fierce? All of them. Yes.

They, they, they had an attitude of, okay, well, Come on, then impress, impress us. with your silly midwife. brain. Yes. , impress us. So again, I went in and I'd l I'd learned quite, I, I felt a bit more learned by the time I got to the grandmother's. Thank goodness. So again, I will go and meet and I meet with them, um, on the first Monday of every month.

And I really look forward to my grandmother's meeting. And then, and each time there are more of [00:18:00] them. There were 31 the last time, last month when I went there. Amazing. I 

Florence: know, but you must be doing something right. Then. Honestly, you're drawing in more grandmothers. 

Teri: Well, they stare at me the whole time and they, they've, but they're very interactive.

They ask some hard questions and at the end, at the end of it, I'm always a little bit unsure if I've kind of met their brief and Yes. But the, a couple of months ago, um, and it was just before Christmas, I said, right, well, that's the end of our session and, and it'll be probably the new year before I see you.

And one of them, she said, you are coming back though, aren't you? When will we see you again? Oh, ok. And I thought, Okay. I'm doing something right. So we, some of the topics we've talked about. Um, so Waterbirth, one of them, interestingly, they could not understand why anybody would want to submerge their body into a bath of water to give birth.

Just did not laughed like drains when I told them that waterbirth was a thing. Okay. So then we talked about the physiology though of, of waterbirth and, and the relaxation of muscles. Yes. And the, uh, the gate control [00:19:00] theory and the oxytocin levels. And they were very, very interested the changes of positions that you can adopt in water birth.

Yes. And at the end of it, I mean, they're such an amazing group of women because at the end of it, they were saying, we absolutely get it. We get it if it's appropriate and if it's possible, let's, let's recommend waterbirth. We, we can see the benefits. So, so these are the conversations I'm having. One of the biggest things for me has been to talk about the birth herbs.

Because I've learned from the grandmothers that every time a woman goes into labor from their community, they, they take some birth herbs and they make a tea, and they drink this tea. Okay, interesting. I've, I've been a midwife for, oh, 106 years, I think, and I've never heard , long time, never heard of the birth herbs.

Never. But what I found out, and I've asked a lot of my communities, . All of the women take the birth herbs. They just don't tell the midwives. They don't tell them, oh, 

Florence: so what are the birth herbs? I'm now interested, I've never heard of this. Yeah, 

Teri: I was gonna say as, as [00:20:00] an obstetrician, have you ever heard the birth herbs?

No. No. me either educate me. I can't because they won't tell me what's in them. They dunno. They're secret. Oh, okay. A lot of the time the women in this country receive the birth herbs from their country of origin through the post. When I ask them what's in it, they don't. Oh. But they do know that it's grandmother's wisdom and it's going to be useful.

Now, as a clinician, I start to get a bit sweaty about . I'm sure you are as well. Oh, I dunno. But I think this whole process has taught me that this has been going on for years and years and years and I've not been aware. Yeah. And this is cultural, traditional wisdom and knowledge. Yes. And who am I, uh, midwife?

Yes. To come in and say, please don't take the birth herbs it's not my job. No. So that's about letting go and accepting and, and respecting. That actually it's important in that community. Yes. Yeah. So we've had conversations around the herbs. I still dunno what's in them. It's [00:21:00] not my job to know, but we do have to accept that that is something that happens in, in some communities for sure.

We, we had a conversation one month about labia pulling, which was very interesting to me. And, and again, some, you know, I've seen a million labias years. I'm sure you have as well. Yes. Yeah. But what, um, what I've found is, and not in all cultures, but in a, uh, some specific cultures as a girl, um, has her first period, she's taught by her mother to stretch her labia because it's seen as something very attractive to her, a prospective husband long labia, right.

Oh, okay. Yeah. Did not know that. No. Yeah. I've learned, yes, yes. And, and information and knowledge that has only come with building relationships. And partnerships obviously. So this is the context around the films. And if I'm gonna come back to the films, um, because I've digressed, but one of the, what we know is that at the same time I was, I was doing all of this, I was also going out to [00:22:00] some of the midwives who I work with, who I did survey Cause Yes.

You know, they're quite used to surveying. And in the survey, I, and it was a small survey, but I said to them, do you talk to people who come into your service about the effects and the risks of ethnicity? Yes. So we know that they're at higher risk. Um, if you are black or brown, you are absolutely at a higher risk than a white woman.

So do you have those conversations? Do you open those? And the the answer was mostly no, no. Or sometimes, well, we had less than 50% of, of midwives said Yes, I do have those conversations, but over 50% either were a no. Or sometimes, and when I dug a bit deeper, the, it wasn't that people don't want to have these conversations, it's they just didn't know how to open that dialogue.

Yes. They were afraid of offending, of appearing ignorant and, and having no, again, it's the cultural understanding or awareness. Yes. [00:23:00] Yeah. So there's a real gap, isn't 

there? 

Florence: I think so, because I feel also it's, it's difficult to know. How to say you are in a group that we know it has a higher chance of complications and problems.

Yes. Because is that higher chance because of inbuilt systemic racism? Yes. Or, and therefore, if I say, You are in that group? Am I immediately making assumptions and being racist? Oh yeah, this, am I gonna, am I gonna frighten the woman because there's nothing she can do about her ethnicity or cultural background.

Um, it's a bit like when we were. Um, there was a guidance for morbidly obese women that we should tell them that they're at higher risk of this, that, and the other. And I would have poor women come to see me and, and cry and say, the midwife [00:24:00] said, I'm in a high risk group for this, that, and the other, and I've got to come and see you.

But you know, I, I'm pregnant. There's nothing I can do, or very limited amount I can do at this point. Um, I'm in this situation and you're just frightening me. So I think there's that, that. And then the other thing is, if I don't raise it, , which I must admit, I'm not embarrassed to say I, I often don't.

Mm-hmm. , I am sitting there thinking, right. I've got to be really conscious and really listen to what this woman in front of me is telling me and make sure that I'm putting to one side my assumptions or my yes, possible inherent bias. And I've gotta really think, because she is, More at risk than someone else.

So maybe I've got to do more investigations or take her more seriously Yes. Than I might imagine [00:25:00] so that I don't miss something. Yeah. So I, I tend to, to that. Rather than, 

Teri: but without maybe sharing. Yeah, exactly. So you're not sharing your concerns with her. And I think again, that's, no, it's quite a paternalistic, it's mod model of care, isn't it?

Um, and I, I completely get what you're saying because I think this is what I'm hearing from. From lots of staff is, well, she can't change the color of her skin or her ethnicity, so why would I frighten her? But again, is is it for us to own that information, not to share it? I think from the people that I've talked to in our community, they have said, It reassures me that you are going to take more care of me.

I feel reassured that you are, um, being more protective, that you, you are monitoring me in because, because of my ethnicity, right? I think, you know, it is, it is diverse and, and the reasons for the poorer outcomes, as you say, are [00:26:00] multifaceted. And, and there is something about institutionalized racism within maternity services.

I, we cannot shy away from that conversation and about our attitudes about, um, black women don't feel pain in the same way as white women and, and, and about the offer of care that we give to some people. I, all of that comes into it. Um, You know, it might be a translation service or a communication problem.

Yes. Yeah. I just, there it is such a, a multifaceted thing that I think we have to be really careful, but I, I, I have come to the conclusion that, uh, people should absolutely be involved in that care and involved in those decisions, and yes, we have to share that information and stop being so paternalistic about it.

Florence: Yeah. No, I completely see what you're saying and I, and I agree, and I think, like you were saying earlier about. everything being a journey and you can't be culturally competent because that suggests you can't. You're done. You nailed it. . Yes. [00:27:00] And And you're not going to do that. It's a bit like all my work with women on women's experience in maternity care.

Mm-hmm. , I thought I was quite a good doctor to start off with, but now if I look back, I think, well, I'm definitely a way better doctor. Hopefully in the future I'll be even better and more able to have these conversations and, and judge it. Right. But I'm, I'm not competent, I'm incompetent. No, and, and I haven't got it right yet.

So I, I think, um, that was then listening to the films and exploring the films. , it kind of made me think, oh my God, there's loads here that I didn't know. I'm really ignorant. 

Teri: me. Well, me too, Flo, honestly. 

Florence: And, and then I was thinking if I've learned that much from watching a 10 minute film on, you know, whichever topic.

Mm, this is a whole fantastic range you've produced, then imagine what I could learn [00:28:00] from even more or yes. Um, and, and I. There's a slight fear of, oh my God, now I've understood the depths of my ignorance. Mm. But you have to do that to start learning, don't you? I mean, I'm ashamed to say so. So you've done 11 films?

Yes, and I, I think I could safely say I probably learned something from almost all of them. I think I did slightly better on the film about. Women Seeking Sanctuary simply because I've done a podcast on that recently. , right. Ok. . Um, but I mean, even something as basic as. There's a film on the Roma community.

Yes. And then a film on the traveler or gypsy community. And for me to understand that those are distinctly different groups, not absolutely not ashamed to say, when I first glanced, I thought, [00:29:00] Why are there two films on that? Yeah. And then when I watched the films, I thought, oh my God. Yeah. I've been making an assumption.

This is the same group of people. Yes. For my whole life. So, you know. Yes. Even those 10 minutes or even the titles, yes opened my eyes to something new. 

Teri: Uh, and I agree completely. You know, I've learned so much. I really wanted, and I wanted for the staff that I work with, the title of It's okay to Ask. It's okay to say, I dunno much about your community.

I dunno much about the Roma community. So please tell me everything you know and, and I will then go away and educate myself. But let's start somewhere. And with that acknowledgement that actually we, we cannot be culturally competent and it's okay not to know, but it's not okay not to ask. It really isn't Okay not to ask.

Yes. And you know, working with the black and African family, um, film, you hear Joyce in the film who is, who is an amazing woman, and she [00:30:00] says, ask me about my color. Ask me about my heritage. We, we, we are proud. We want to talk about where we come from and the color of our skin, and that leads you into a conversation about those risks that we are really reluctant to talk about.

You know, she, she, she said something really profound in our film, which really struck me. She said, We have naming ceremonies in our culture. Mm-hmm. We, we, names are really important. If you can't pronounce my name, don't just say, oh, can I call you this? Which is a, a westernized, um, you know, shortened version of my name.

That's not acceptable. And, and again, she said, I don't mind how many times I have to repeat my name. And you have to repeat it to get the pronunciation right. Yes. But it's really important to me and my culture that you say my name. Correctly. Yes. And, and I've learned so much from that. And, and I feel foolish now to think I, I've, I've avoided saying [00:31:00] somebody's name because it was hard, you know, it was hard.

And now I will just go over and over and over it. So, yes, I've learned, I've learned so much. One, one of the things that the, the equity Forum said when we were talking about how do we educate midwives, not just midwives. Public health and, and social services and health visitors and obstetricians. These are films for everybody.

They said, we want to share our stories. We want to tell them how it feels. Yes. And that's how the films came about. They wanted to share that knowledge and those stories with us because they felt it was more powerful to hear it, rather than us producing another e-learning. Yes. And ticking the box to say you're culturally 

Florence: competent.

Yes. And I liked the films because you had. People speaking about their own individual experience, but you also had someone from that kind of cultural group in the community that you were working with that could kind of give [00:32:00] a, a broader context as well. And I thought that worked really well, having those different voices and different views.

Yeah. Um, Were, yeah, really helpful and I definitely felt like for all of them, there was something that I took away and I'm kind of thinking I need to go back and watch them again. Because I think you watch them and then you think you've taken away maybe one or two messages from that and you've gone and d digested it.

And now I'm almost thinking, ah, but I can't remember this, that, and the other. I, I, I would think that there'd be a resource that I could come back to. Yes, I agree again and again and again actually. And also it made me think. about the communities that are in my local area. For example, we have quite a big, um, cor Korean community.

Yes. And I'm [00:33:00] thinking, I don't think we've done, we did do, at one point, the, the mvp, we did a little bit of work with the Korean community, but nothing like the sort of depth that you are describing. And really, 

Teri: why haven't we, you know that I think it's time, resources, capacity. Yes, exactly. But it's a poor excuse, 

Florence: isn't it?

It's, it's completely so. I, I think you've, you've produced something really valuable to me. It was much more useful, like you say, the e-learning, I've done the n h s cultural competency. Yes. Whatever. E-learning. So basic, and so, I mean, I suppose you've got to start somewhere, but really I didn't feel it educated me.

I mean, essentially what it was saying is, , don't be biased. Don't discriminate. And, and it, and we'll, you know, I'm not stupid. I'm an educated professional, I know that. Mm-hmm. , but I have got, I've got [00:34:00] understand that there's unconscious bias and that there's making that connection with that woman or family.

and understanding them a bit might help me help them with their health. Yeah, because I can then, like you say, Put what I'm saying in the context that will be meaningful to them. 

Teri: Yeah. I, and I think, you know, stories are always more powerful than an e-learning or somebody, uh, lecturing to you. So I think it's really important that we hear people's voices and, and that's exactly what this has done.

So each time I've listened to them and they are only six or seven minutes, I've learned something new and I have seen them a lot now. I, I had no understanding that. Um, a lot of, uh, people seeking sanctuary refugees and we've got a lot of those in our area at the moment who were put up in, in hotels. Yes.

And that it comes, [00:35:00] comes with a package, it's a food package as well. They get their breakfast, their lunch, and their dinner. And it was only until I watched the film of a professional saying, if you book that person an appointment, over lunchtime, they will have to choose whether they come to their antenatal appointment and see you or whether they miss their lunch and.

You know, that really resonated. I had not thought about small things like that. So there is a myriad of learning, I think, that we can all take away from each of those films. 

Florence: Yeah, I, I completely agree with you and, and that's really why I wanted to get you on today and, and talk because I wanted people to, to realize that this resource is there and.

go and use it and spread it. And because you've put, you and the communities you're working with have put so much time and effort and energy into producing what is such a fabulous set of films. 

Teri: [00:36:00] Yeah, I would've, I would hate for. Us to have just completed another tick box where I've said, right, well, I've created 11 films, and then they sit on a virtual platform somewhere and nobody watches them.

Yes. What a, what a shame, what a waste of our community's voices. So, yes. Yeah. Really, if, if we can get people to go and they're free to watch, you can, you can have the whole showcase of 11 films. And I've had lots of universities using them and student updates, um, and social services. The ambulance service, actually, yesterday contacting meetings that they're using them in their training, really happy for anybody to take them, share them, use them, because I think the learning is, is broader. 

Florence: That sort of brings us to zesty bit in terms of what we want people to take away from the conversation. Definitely I will put a link to the films thank you in, in the program notes, and I would really encourage people to go and explore the films.

Like we've said, they're, they're quite short, five or 10 [00:37:00] minutes, and I would actually say probably, Take them one at a time because I must admit, I slightly binge watched them, and that means some of them have slightly blurred into one another, which I think I need to watch them separately, um, over a slightly longer period of time.

But, , go pick, pick one, explore it, listen to it. Maybe even, uh, look at it as a group and yes, yes, you know, whether that's at work or you know, with a bunch of friends or whatever. Just to have someone else to discuss it with and, and chat about it and reflect a bit afterwards. And also use them to hopefully start being.

Sort of brave enough to start having these conversations. Yeah, so kind of, I think for me, my takeaway is to move away from that paternalistic thing and, and to actually say to women, [00:38:00] actually, tell me a bit about what happens in your culture or. , does what I'm saying make sense to you? Or actually, is this so alien and different to what you are expecting that I'm, I need to think about it in a different way for you and also talking to people about, Actually, I am taking particular care of you cuz I, I know the stats and I am particularly concerned, I guess.

Um, the other thing is if you are, um, a pregnant, um, woman, a new family listening to this, um, about getting your voice heard. Um, and, and that, and that's hard because that's expecting you to come and do stuff on our terms, whether that's friends and family or maternity voice partnerships. Um, but I guess there's also a mechanism there within your community, um, of your talking within your community.

If we put the [00:39:00] onus on us to come out to those community voluntary groups, um, Making sure that those conversations are happening. Oh, I dunno. Teri, have you got suggestions about how we make things or how women can easily make their voice heard? 

Teri: I don't think there's any easy, if I'm really, if I'm being really, really honest about this, I don't think it's gonna be easy.

I, I think we've created a system in maternity that is a, a complete, um, shape and we try to just fit everybody into that shape. Yes. And we've, we've been cramming them through the round peg or the square peg, and of course, most people don't. But what, what happens is that they don't say they don't fit because this is the system and we can't change it.

And we come with these expectations that it's a, it's fine. It's, it's, it's, it's alright. It's a bit flawed, but this is what it is. And I, I think it's unacceptable. We've [00:40:00] got to start hearing the voices of people. So, so my message to anybody who's pregnant and watching this is maybe take one of those films and, and know that we're starting, maybe you could take the film and watch it in your community or, Send it to your, um, midwife or your obstetric team and say, what do you think about this?

Yes. And if the care that we're offering isn't suitable, if it's culturally inappropriate or it doesn't fit with your expectations. Yes. There's nothing wrong with advocacy, and it might be a, a voluntary or community sector advocate. It might not be a healthcare professional because the, the odds are not stacked in people's favor.

We make the hierarchy, the language. Each, the whole system feels that the power base is with us. Yes. And it's not it, it really isn't, but it feels that way. Yes. So we, you know, there is, this is 11 films is, has not even scratched the surface. Yes, let's be honest, because the [00:41:00] hierarchy and the power base still sits in our organization and this really must change for us to improve outcomes.

So, so I urge pregnant people. Right across the country to get a bit more vocal if they can, to find some advocacy, to have really honest conversations with us, to say, actually, you are not meeting my needs and, and it's not acceptable anymore. 

Florence: I think that is. Brilliant. I love that idea actually, of watch a film and send it to your midwife or bring it up in an appointment or, yes.

Yeah, I, I think that's a really good way in and yes, tell us, tell us if you are missing a meal or. No, we are trying to fit you in a hole that you don't fit. I, yeah, I totally agree. I think that's a brilliant place to end. 

Teri: Me too. 

Florence: Me too. Thank you so much. Thanks for having me, not only for coming on today, but for sending me a message and, [00:42:00] and drawing my attention to the films in the first place.

Thank you. And, and, um, I really hope that we can get more people watching them and spread the message because Yeah, me too. You and the communities you're working with are doing a phenomenal job. 

Teri: Just the start, there'll be, there'll be more work. I'm, I'm filming 24 new films on antenatal education. I know, and a whole model, a whole model of antenatal education.

I'll let you know when that's done. That'll be weird 

Florence: Towards the end of the year, I think you might have to come back and do another episode. 

Teri: That would be amazing. Uh, there's lots and lots of things to, to discuss and talk about and, you know, one of, one of my big things is about nice guidance and, and again, that paternalistic kind of Yes.

Yeah. Stuff. The offer. . Yes. So yeah, let's, let's have some more conversations. But thank you for sharing. It's such an important topic. It really is. I'm so glad that you found that you have a voice that you could share it. Yeah. Nice. Really pleased.
 Florence:
Its fantastic thank you so much
Teri:
Thank you Florence