Midwives Leading the Way
Recently, we were fortunate to hear about an initiative to combat racism and system oppression.
It was being led by Claire Ramlogan-Salanga and Natasha Singleton-Bassaragh, and their goal was to support the IBPOC (Indigenous, Black, People of Colour) Midwifery community.
We had a chance to chat with them at the annual Canadian Association of Midwives Conference.
How did you come to work on this initiative?
The IBPOC Peer Review was established as a response to a need from the IBPOC midwifery community to address the racism that we witnessed and experienced in our profession and society.
Both Claire and I saw ourselves, and our other IBPOC colleagues, being pushed to the margins in professional spaces due to systemic racial oppressions.
We knew that there needed to be a remedy of sorts for Indigenous, Black and People of Colour (racialized, IBPOC) midwives.
One where we were safe to learn, share, and develop our clinic acumen, without the pressure of being performative or fearing backlash.
What were the steps you took to get it started?
It was quite simple actually, it all started from an idea. We wanted to have a space where racialized midwives and students could come together and discuss clinical cases without the worry of having to code switch our language or behaviours in order to be taken seriously. We wanted to just be ourselves and discuss the social and clinical complexities of our cases.
We started the IBPOC Peer Review in late 2019 with five other midwives. Our humble beginnings were inspired by the concept of concordant care and its related positive outcomes. In retrospect, the space had many intangible characteristics and qualities that defy description; a subtle appeal that encouraged candor and liberty.
Attendance was open to anyone who self-identified as racialized and was a midwife or student midwife in Ontario. The pandemic forced the peer review to shift to an exclusively online platform which increased accessibility and consequently, attendance.
As our attendance grew, we recruited two more IBPOC colleagues who helped create the Terms of Reference, later to be renamed our Guiding Principles.
This document was community vetted and described:
- what our aim was,
- who the space was for,
- the agreed upon customs, and courtesy, and
- introduced the idea that any participant could facilitate the peer review.
At this point, we were about two years into our peer review and we started to feel that our space was taking shape - we were building community.
How was the initiative received?
Attendance grew in our province, which led us to think bigger and aim to offer the peer review to midwives across the country. Capitalizing on the networks already established by the Association of Ontario Midwives (AOM) and the Canadian Association of Midwives (CAM), we advertised our sessions using our own branding in their member communications.
We invited racialized midwives and students to join our peer review from across the country, and attendance grew to over one hundred participants. We knew intuitively that the IBPOC Peer Review was enjoyed by participants because each session was well attended. However, we didn’t actually have any proof to support our intuition.
To confirm what we believed to be true, we administered an annual quality improvement survey to take a pulse check from our community and gather insights. It was through this informal survey that we learned how valuable the peer space was to our racialized community.
What are some learnings from everything you’ve done so far?
One of the lessons learned from building this initiative is that there is no perfect time to start a project like this. Meaning, the stars don’t need to align in order to get started. We began with just a few colleagues, they invited other peers, and eventually the word spread, and now we have a community.
Another lesson learned is about leadership and consistency when building a community of trust and cultural safety. At the beginning, it is especially important to show up for your community. This means that your leadership team needs to remain consistent with messaging, support, and structure. Participants need to know what the spirit of the space is and that their voices count.
Furthermore, we know that we will not be at the helm forever, and that this space is not just for now, but for future generations of racialized midwives. This means that we need to purposefully encourage leadership skills and self-confidence within our community to hopefully have others step forward to lead this Peer Review. Therefore, the lesson learned here is to avoid gatekeeping, and to remember that the space you are building is a community space.
Along the way we’ve also learned about missteps. Sometimes words are spoken in a moment of vulnerability that are hurtful to another participant or profession. As leaders of the Peer Review, we know it is our responsibility to make sure to circle back and address the issue with the individual and as a group. Modelling humility and providing grace to those within the community is how we continue to remember our humanity, especially in healthcare, where forgiveness is quickly forgotten and often lacking.
Another lesson learned is to keep things organized. Excel is your friend! We built a database that we guard ferociously. This database helps us know who has attended and who we need to provide attendance receipts to, as our peer reviews count towards meeting College quality assurance requirements.
What’s next for the initiative?
In the spring of 2023, the Toronto Birth Centre (TBC) was developing a Cultural Safety Peer Review Guideline to better integrate cultural safety and anti-racism practices into their own peer reviews to guide midwives' self-reflection and praxis. It was here that the TBC recognized and acknowledged that affiliated racialized midwives should have options for where they attend peer review and present cases in fulfillment of this important initiative.
Their administration identified the IBPOC Peer Review as a space where they might offer choice to their IBPOC midwives; this is where a collaboration was envisioned. We now have a working relationship with the TBC that also includes a source of funding. The financial support that they have committed allows us to be able to provide honorariums to our administrators, facilitators, and presenters. This collaboration is allyship in action!
In the future we would like to increase access to the Peer Review for IBPOC Francophone midwives & students - either by accessing French translation services in our existing monthly sessions, or by sharing our model so it can be replicated in Francophone spaces.
Along the same lines, we would also like to expand our reach to include IBPOC midwives in Northern and Eastern provinces and territories.
After our first in-person IBPOC Peer Review in Ottawa at the annual CAM Conference this past October, we realize that there is almost nothing more powerful and uplifting than seeing our IBPOC peers face to face in clinical spaces. Therefore, our last goal at this point would be to obtain funding to support us in hosting in-person peer reviews in different provinces.
If you’d like to collaborate with Claire and Natasha, reach out to us at communications@hiroc.com.
More about Claire and Natasha
Claire Ramlogan-Salanga is Canadian born of Indo-Caribbean ancestry. She is a Registered Midwife and Assistant Professor in the Midwifery Education Program at McMaster University. She has a Master’s degree in Health Professions Education (McMaster) and has started a PhD in Global Health (McMaster) in September 2023. Her research focuses on health professions regulation, social justice curriculum, leadership, and equitable access to sexual and reproductive health care.
Natasha Singleton-Bassaragh is a second generation Canadian of Afro-Caribbean ancestry. She is a Registered Midwife in Ontario and holds a Bachelor’s degree in Psychology (York), as well as a Bachelor of Science in Midwifery (Toronto Metropolitan). She currently serves as Secretary for the Board of Directors at the Association of Ontario Midwives (AOM). Her professional interests focus on disability equity for midwives, sustainability in Ontario midwifery, and empowering new parents.