The power of language

In response to the growing commitment in the region to work together to address inequality and inequity within maternity and neonatal services the Regional Perinatal Equity Network was launched in July 2021 by the West of England and South West Academic Health Science Networks. In this blog, Katie Donovan Adekanmbi, Inclusion and Cohesion Specialist from BCohCo talks about her experience of attending the Network to discuss the power of language…

Not knowing what to say and how to say it when discussing Diversity, Inclusion, Cohesion and Equity (DICE) can make for an uncomfortable conversation. Bumbling over our words revealing our lack of vocabulary and confusing schools of thought when discussing protected communities can provoke a level of anxiety high enough for some to justify avoiding ‘the conversation’ completely. However, I am here to tell you that ‘unless it feels uncomfortable you are probably not doing it right’.

One trait of an inclusive leader is an insatiable curiosity for difference. So, I’m inviting you, as I did with attendees of the April Regional Perinatal Equity Network (RPEN), to lean in rather than out when your discomfort is activated…

What I have found to be true – as a woman of dual heritage, thriving with neuro divergency and proud of her working-class roots – is that we aren’t going to build cohesive communities by avoiding the difficult conversations. We won’t swim in the sea of creativity and innovation should we choose our comfort over discomfort and vulnerability any longer.

In my experience, navigating the ambiguous states of mixed ethnicities, neuro-divergence and class has created a resilience I never knew possible. So here’s my confession, never have I achieved more learning than when putting my preverbal size nines in it.

Getting to work

The reality is we are always combating bias, prejudice and discrimination. Organisations dress it up in the positive packaging that is Diversity & Inclusivity or DICE but make no mistake the reason we are fighting for DICE is because the playing field is not even and bias shows up everywhere. I feel very assured by the fact that everyone has biases. No one has made it to a ‘perfect’ bias-free status. We all have work to do, and the work is continuous.

The Covid pandemic exasperated inequalities and left us no choice but to face some serious disparities and biases in our society. Those in care homes initially left out of contingency plans; people trapped in poverty without their support services; those facing domestic abuse. The exam results scandal revealing postcode and class bias. People of colour disproportionately affected by Covid19 and the Black Lives Matters protests erupting on the international stage.

Why focus on maternal inequity?

When focusing on maternity we now know that Black women are 4 times more likely to die during pregnancy or in the postnatal period than white women (Knight et al 2019 MBRRACE-UK). Stillbirth rates of Black and Black British babies are over twice those for White babies (Muglu et al 2019).

In addition, it is accepted that there are inevitable “near misses”, experiences of poor care and psychological impact that have not yet been a focus of research, further adding to the burden of trauma carried by Black women.

The reasons for the disparity are described as a “constellation of biases” (Knight 2020); systemic biases preventing women with complex / multiple problems receiving the care they need ante- and postnatally. What is clear is the diminishing tolerance to the impact of unconscious bias, stereotyping and lack of diversity competency that result in health services that are not safe for all.

Now professionals want to have the uncomfortable conversation, in fact they need to have the conversation. Whether regarding Race, LGBTQ+ or Disability to name a few. Professionals need to know how to better serve their colleagues, patients and team. Whatever your area of expertise we are fast realising that bias shows up everywhere.

So why focus on language?

‘Language is the mirror to our values and principals’ so ensuring that we are using the right language is essential. As this can reveal quite quickly where we stand on an issue, what our personal and private views, opinions or even politics are.

As individuals we need to get cross culturally literate as an essential core competency. Equal in importance to communication, negotiation and safeguarding skills.

If equality is treating everyone the same and equity is assessing individual need to socially prescribe, then there is permission in equity to ask the questions needed to better serve patients. Ask the necessary questions to serve patients effectively. However, know why you are avoiding awkward moments or questions. Marginalised groups have had information extracted for the comfort and convenience of professionals and the system for too long. The acronym BAME being an example of lumping the ‘global majority’ into a four-letter acronym for convenience despite it being reductive and damaging.

My work with the AHSN on projects such as Regional Perinatal Equity Network and Black Maternity Matters will continue, and as part of that we’ll continue to explore the power of language and why it is so important in starting and continuing the conversation to ultimately improve patient safety and care.

Join the next Regional Perinatal Equity Network on 14 July.

Find out more and book your space.

Posted on June 1, 2022 by Katie Donovan Adekanmbi, Inclusion and Cohesion Specialist from BCohCo Ltd

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