Elsie’s story

Elsie Gayle
Independent midwife, Honouring the Mother/Midwife Dyad campaign

Elsie knows a thing or two about childbirth. As a midwife, she has helped countless mothers through often difficult journeys, and herself experienced a very traumatic birth with her own baby in the late 1980s. Circumstances meant that her baby required urgent and early delivery, but her request for a caesarean section was initially declined, leading to severe complications and months of follow up care.

“I started to experience self-blame, shame and anxiety and became very seriously depressed,” says Elsie. “I kept wondering whether I could I have done more or been more assertive.”

Elsie eventually returned to midwifery, and ended up working for the NHS until 2007. It was at this point she was dismissed whilst drawing attention to questionable and unsafe practices at the Trust where she worked. For Elsie, this situation combined with her own experience of negligence during childbirth gave cause for deep reflection:

As a woman of African descent myself, I knew I had to do something to improve on the poor state of maternity care especially for women and babies from black and minority ethnic backgrounds

This is where Elsie’s campaigning journey really started. And the evidence was clear: childbearing women from African backgrounds in the UK have an 80-83% of higher risk of unexplained severe maternal morbidity when compared with white European counterparts,[1] are 50% more likely to suffer a stillbirth when compared with white mothers,[2] and at higher risk of preterm birth than their white contemporaries.[3]

The campaign
Elsie wants to bring forward the voices and needs of women, particularly those from Black and Minority Ethnic backgrounds by developing a model of patient and public involvement for maternity care that draws on established principles from the NHS Constitution and recommended practice (evidence-based care). She knows that informed choice for mothers produces the best physical, psychological and emotional outcomes, and contributes to more positive outcomes for children, families and society at large. These changes are very significant for the most vulnerable, whose voices are so often ignored.

In a recent submission to the Health Select Committee[4], it was noted by a member of the Maternity Review Panel in England that “Black and Asian women are at greater risk of losing their babies through stillbirth and to some extent maternal death. That is something we have not been able to target enough in the recommendations.”

Bringing forward the voices of those women is not an easy task. “It’s sometimes very disheartening and challenging to keep momentum,” Elsie explains. “Particularly when I meet people with the power and resources to act, but who don’t have the insight or interest to realise the importance of the issue.”

Resource is a major constraint for her work, but Elsie remains focused on the plan to gain funding to mainstream the model into NHS maternity contracts, so that it becomes part of every mother’s care plan.

Influencing Change
The 2016 Influencing Change course in Birmingham was a big step forward for Elsie. It gave her theoretical and practical insights into planning and executing a campaign, and enabled her to learn from other inspirational campaigners.

The knowledge and skills I gained were invaluable,” she says. “I started to map out what I wanted to achieve and to really think more strategically about the campaign.

Since doing the course, Elsie has formed new local partnerships, helping mothers and communities come together to discuss the issues at stake. She has already received local awards for her work, and spoken at the United Nations Committee for the Elimination of Racial Discrimination in Geneva in August 2016.

As part of a scheme developed to help NHS whistle-blowers back to work, Elsie is being supported and mentored by NHS England to mainstream a model of maternity care where the mother’s voice, choice and personalisation of maternity care is embedded. She is undertaking a Masters in Research with a view to evaluating the model, and has received an Honorary Degree from the University of Wolverhampton in recognition of her contribution towards midwifery and her commitment towards the BME community, mental health and women’s rights.

What was the best thing about the ‘Influencing Change’ course?
“All of it. I was like a sponge…”

Why would you recommend to someone else?
“The critical knowledge and skills I have developed have put me in great stead to move the campaign forward. It has helped me to think logically about campaigning and whether this was the best approach to achieve the goals I wanted to achieve.”

Your one piece of advice for someone else trying to achieve change?
“To new campaigners: get robust training. To seasoned campaigners: share your knowledge and skills”

[1] Knight et al 2014
[2] ONS data
[3] Aveyard et al; Macfarlane et al
[4] HC 276 | Published 18 Jan 2017 Q.157, p 11, 12

SMK TeamElsie’s story