I was an eager mother when it came to attending midwife appointments for my firstborn, Miah. I went without my partner once when he was working, and the midwife asked, “Is he in jail?”
She didn’t say this spitefully. As a midwife today, I often witness health care workers voice these sort of microaggressions, but I don’t believe it is to deliberately cause harm. But the fact that it was asked so clinically exposes the deep-seated implicit bias in our health system toward First Nations people.
It may not manifest in what is spoken. Miah’s father and I were excited about a birthing class run by a major public hospital in Sydney. We were the only Koori people in the circle of parents. All the slides, booklets and posters showed photos of white families. It told us that this was the ‘norm’. So what were we?
Being teenagers at the time (I was 19) also made us subject to intense questioning by the other parents. Maybe the class didn’t get many young parents and they were just curious? For Aboriginal people, we have our babies on average at younger ages, but we also die a lot younger, so we aren’t often waiting until we are 30 with thriving careers before having our first baby.
Miah’s father and I suddenly felt very small, and after 15 minutes we quietly left. My mother gave me a pregnancy book, and I studied this intensely, though sometimes I would wonder what the other parents were learning in that class.
I buried myself in its pages over my next two pregnancies, and my desperation grew for culturally safe antenatal care. During my third pregnancy, I had become a student midwife. At the hospital, I found I wasn’t excluded as much ― was this because I was now an educated Black woman with a profession?
During my days as a student midwife, I witnessed nurses having hushed conversations about other Black women. I witnessed professionals making racist assumptions about people of colour both behind closed doors and out in the open.
I once observed a midwife ask a young Aboriginal mother who was pre-labouring on the other side of the desk, “Where are your other kids?” And without checking the woman’s file, another midwife quipped, “They’re probably in child services.”
My daughter Miah is nearly 18 years old now. While no one else has assumed her siblings’ father was in jail if he didn’t attend appointments, as a midwife today, I still witness the disparities in quality of care.
A client of mine who rescheduled a hospital appointment because of work commitments was immediately told, “We’re going to have to involve child services because this is the third time you’re rescheduling.” My client was a social worker. She had been removed from her parents as a 12-year-old girl.
She was so deflated by the racist comments that, when it came time to give birth, she found another hospital where she felt comfortable.
Another Indigenous client was sent to a clinic because she was experiencing complications. She greeted the midwife and was ignored for two hours until another patient told her she was being treated unfairly.
Another pre-labouring client was taken out of the room by the midwife and told, “Don’t expect to get special treatment because you’re Aboriginal.” She had only asked for pain relief.
What I first witnessed 18 years ago is still happening even though there are more culturally-safe health workers than ever. This is because the issue does not lie with individuals. It lies within societal structures that say, “You are the Other. You don’t know enough to look after yourself. Look at the issues you face,” overlooking the fact that many issues Aboriginal women confront are the result of intergenerational and historical trauma inflicted by colonisation.
For many mothers, pregnancy is an empowering experience. It should never require women to fight to be valued.
Angela Coe is an Aboriginal registered midwife in Redfern, Sydney. This story has been written by Seraphina Seow.