Benash Nazmeen

Ex Specialist Cultural Liaison Midwife, soon to be Midwifery Educator

I’ve read that your grandmother was a village midwife in Kashmir. Could you tell me more about this?

In some communities, pregnancy is disguised or hidden, but in my family, it wasn’t. I saw pregnant women, postnatal women, breastfeeding, I saw the normality around it all. I never talked about birth and I wasn’t close to anyone who was pregnant for a long time. But conversations about cramps, bloating, herbal remedies and so on were talked about, and would have been things my Grandma would have talked about and treated. My family background helped me to normalise birth and healing, and that meant, one day when I read about midwifery in a Prospectus, it made sense. The normality and the fact it was a woman’s thing made sense to me, that’s what I’d seen and witnessed.

Can you tell me how your career took you to your current role?

Well, as a band six midwife I hit burnout. This came after working in a big tertiary unit where I felt I was just a number rather than a person. I think the realities of trying to get supported in CPD were becoming apparent too. I was keen for it but I had colleagues who didn’t look like me who were given funding and support, and I wasn’t. When I eventually broke down and cried in front of my manager, all she said was ‘I think you need to go and compose yourself’. In the end, I funded my own CPD, which was difficult, because I was often working 48, occaisonally 60 hours a week as a midwife. I worked for a while overseas, in Abu Dhabi. When I got back I wanted to progress in my career and I did five or more band 7 interviews before being given a position as a labour ward coordinator. I went back to my old trust thinking, things will change now. But I was still being treated differently, I wasn’t given support and I needed to work things out on my own. In that band 7 coordinator position, as black and brown midwives became more comfortable with me they started to mention how when I was on they knew they would be allocated work fairly. They mentioned how they would generally be assigned more complex or bigger workloads, they were not given breaks, they were telling me about all these things which I previously  thought were just happening to me. 

Other structural problems were things like, white midwives would open their arms and hug and kiss people who looked like them, and you know, bring them into the fold in the central hub of conversation at the work desk, during handover. Whereas black and Asian midwives were sometimes acknowledged, but often in a lukewarm way,mostly they entered unwelcomed and they’d be on the outskirts. All this started to needle me more, and then my Dad passed away. I re-evaluated my whole life at that point. I'd already been talking to the friends I had who were in wider healthcare circles, and we’d been talking about inequalities, and a job opportunity came up for something called ‘BAME’ lead midwife, so I went for it.

Could you tell me about that role, and how you wanted to change it?

It was originally advertised as both Community Lead and BAME midwife. I wasn’t too interested in the community part and also, they were two completely different roles and whoever got the position wouldn’t be able to give 100% to either. I went into the interview thinking, I’ve already hit my goal, I’m a band 7 coordinator, so if I get this job, great, and if not, it’s not meant to be. That mentality meant I was able to be a lot more critical of the situation. I was open about the issues that were being faced by the community. When I got asked questions around equity, I was talking about the fact that, you know, the services we provide are troublesome and not necessarily equitable, and I could offer examples. Towards the end, they said, have you got a question? And I said very much so - where do you see this job going? Because if I was taking it, I’m coming from a completely different place and I’d have to learn two different roles, two completely different hats. And I’ve got to be honest, I’ve come here because I’m interested in making access to maternity services much more equitable, and improving outcomes, because of the concerns MBRRACE has highlighted since 2013. Everyone seems to be quoting 2017 at the moment, but the evidence has been highlighted since the early 1990s and then again in the 2000s, inequities have been around for a very long time, so really, what are we going to do differently? How are we going to invest?

I didn’t think I was going to get the job because I thought I’d been too frank. But I felt happy saying what I needed to say, because hopefully, the challenge would be to at least consider and look at things in a different way when whoever got the job got started. And it turned out, they completely agreed, and I got the job.

Can you tell me how you approached the role once you’d been hired?

I have a brilliant head and deputy head of midwifery. On my first day at work, the head of midwifery said, okay, we’ve changed the job completely. You have three months to just scope out the service, do audits, understand the data, and then after three months, we’ll review and you’re going to make a plan. I rewrote the role and my JD.

That’s amazing. You’ve faced a lot of adversity in getting to this point, do you have any advice for anyone who might be in a similar position?

I didn't come into my own until I gained confidence in myself, which helped me gain clarity in what I wanted to do, and what my purpose is. And up until that point, I knew there was something I wanted to do, but I couldn’t quite put my finger on it. If you do what you love, and share your passion, you can get people on your side, and you can explain the realities and issues in a way that they cannot refute. But being able to get to that point is hard. If you’re not in a space that nurtures you to become that person, you have to go above and beyond.

The reason we set up the Association of South Asian Midwives is so we can support marginalised midwives. We set it up knowing that there are midwives who are not getting the mentoring, the pushing, or the support, and so they are not able to map their careers. These midwives have not had the same experience in previous careers, and they haven’t been in spaces where such skill have been discussed. There are soft skills that are not necessarily evident to people from certain communities. I have a friend who is white British, she’s my best friend and closest ally, but she says things like I grew up in Devon, and I had to get rid of my twang. My parents made sure I went to this one specific school, so I could learn to debate and write applications and go on to further my life and career. I didn’t get this help. If you’re from marginalised communities, it might be that your parents are just trying to survive and dont know how to navigate the education systems to get the best out of it for their children. The attainment gap in education is very real. From the very beginning, we are taught to minimise ourselves, like my name Benash but it’s often edited to  ‘Ben-ash’. It's anglicized, so you're taught to edit yourself for the comfort of others. And it's not specific to marginalised communities, but we face it and have to deal with it in a different way. 

If you’re female, you’re facing gender bias, and then you’re facing racial bias, and if your religion is shown outwardly, you’re facing Islamophobia or other religious biogtry. You’re taught ‘things that are important to me need to be edited to be accepted within the majority’. I had to dilute myself to be accepted. But that was the worst thing I could have done. Because only when I was authentically myself, opening up conversations and using my voice, did people start to listen.

Can you tell me how you gained the maths skills you needed for this role?

I hate Excel and I hated numbers so I didn’t think it was going to be my thing. I also have dyslexia and it affects my maths skills. But I just started doing it, and I was actively involved because it meant something to me. I learnt the skills I needed on the job. My Masters starts next week and that means I will become even better at audit. But I figured it out, trial and error is a great method. And the fact is, we have so many resources at a click of a button, you can teach yourself things.

What would you advise for midwives who don’t find maths easy but who would like to take on a specialist role?

I would advise them to do an audit in an area that interests them. If you want to go into clinical leadership, having those skills is great, especially to get people investing in your work. Break it down and do the audit yourself and you’ll gain the skillset.

Could you tell us how you might deal with vicarious trauma situations in midwifery?

I have coping mechanisms, and some recent ones are from therapy. I know something is bad when I'm reverting back to old coping habits. And those habits come from a time where I needed to survive. For a very long part of my life, I lived in a dissociative behavior state to protect myself. And that once that starts to creep in, and I start to disassociate and my emotions start to disconnect, I know I need help. That's when my alarm bells are ringing and I’m seeking help, I'm going to my therapist, my friends, I'm reaching out to my network. For a very long time, I wouldn't speak to anyone about it. But now I'm speaking to people, and talking can be helpful, art can be helpful. Or looking after my beautiful plants, seeing the leaves growing. It’s knowing the things you enjoy and also remembering the things that you enjoyed as a child and have stopped doing. 

Is there anything else you think I should ask you?

If this is about development, what I would say to a junior black or brown midwife, what I would say to a young me when I started is you are not alone, you are not on your own. There are people out there who will completely understand exactly what you're feeling. And there are ways and means to connect with them. We're now in a virtual world. That means that you can connect with people like you. But if nothing else, you can reach out to ASAM and we will definitely try to support and get you that mentorship and that sounding board.