AdvanceHE. Equality, diversity and inclusion. 2021. (accessed 28 March 2022)

Ashley W. The angry black woman: the impact of pejorative stereotypes on psychotherapy with black women. Soc Work Public Health. 2014; 29:(1)27-34

Aspinall P. BAME (black, Asian and minority ethnic): the ‘new normal’ in collective terminology. J Epidemiol Community Health. 2021; 75:(2)107-107

Barbee E. Racism in U.S. nursing. Med Anthropol Q. 1993; 7:346-362

Barefoot H, St John J, Yip A. Academic Leadership at the programme level to address the BME attainment gap.London: Leadership Foundation for Higher Education; 2018

Becares L, Nazroo J, Stafford M. The buffering effects of ethnic density on experienced racism and health. Health & Place. 2009; 15:(3)700-708

Becares L, Shaw R, Nazroo J Ethnic density effects on physical morbidity, mortality & health behaviors: a systematic review of the literature. Am J Public Health. 2012; 102:(12)E33-E66

Beckford-Procyk C. ‘Should we decolonise midwifery education?’. Pract Midwife. 2020; 23:(10)8-13

Bowler I. ‘They're not the same as us’: midwives' stereotypes of South Asian descent maternity patients. Sociol Health Illn. 1993; 15:(2)157-178

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101

Burnett A. This hurts us much more than it hurts you: the lived experiences of Black, Asian and multi-racial student midwives. Pract Midwife. 2021; 24:(2)12-15

Catling C, Reid F, Hunter B. Australian midwives' experiences of their workplace culture. Women Birth. 2017; 30:137-145

Claridge H, Stone K, Ussher M. The ethnicity attainment gap among medical and biomedical science students: a qualitative study. BMC Med Educ. 2018; 18:(325)

Cottingham M, Johnson A, Erickson R. ‘I can never be too comfortable’: race, gender and emotion at the hospital bedside. Qual Health Res. 2018; 28:(1)145-158

Beyond BAME: Rethinking the politics, construction, application and efficacy of ethnic categorization. 2021. (accessed 27 September 2021)

Data Protection Act. Data Protection Act 2018. 2018. (accessed 6 October 2021)

NHS Constitution for England.London: Gov.UK; 2012

Evans L. Cabin pressure: African American pilots, flight attendants and emotional labor.Lanham, MD: Rowman & Littlefield; 2013

Evans L, Moore W. Impossible burdens: white institutions, emotional labor, and micro-resistance. Social Problems. 2015; 62:439-454

Tackling racial harassment: universities challenged.Manchester: Equality & Human Rights Commission; 2019

Racial categorisation and terminology. 2021. (accessed 27 September 2021)

Goodwin L, Hunter B, Jones A. The midwife-woman relationship in a South Wales community: experiences of midwives and migrant Pakistani women in early pregnancy. Health Expectations. 2018; 21:(1)347-357

Guba EG, Lincoln YS. Fourth generation evaluation.California: Sage Publications Inc; 1989

Hammond J, Williams A, Walker S, Norris M. Working hard to belong: a qualitative study exploring students from black, Asian and minority ethnic backgrounds experiences of pre-registration physiotherapy education. BMC Medical Education. 2019; 19

Hamza H. Experiences of being a midwifery student during these challenging times. MIDIRS Midwifery Digest. 2021; 31:(3)297-299

Harkness M, Wallace C. Exposing racial bias in midwifery education: a content analysis of images and text in Myles Textbook for Midwives. 2021;

Henderson J, Gao H, Redshaw M. Experiencing maternity care: the care received and perceptions of women from different ethnic groups. BMC Pregnancy Childbirth. 2013; 13:(1)

Howarth C. I hope we won't have to understand racism one day: researching or reproducing race in social psychological research?. Br J Psychol. 2009; 48:407-426

Workforce race quality standard: 2020 data analysis report for NHS Trusts and Clinical Commissioning Groups. 2021. (accessed 6 October 2021)

Itzigsohn J, Brown K. Sociology & the theory of double consciousness: W.E.B Du Bois's phenomenology of racialized subjectivity. Du Bois Review Social Science Research on Race. 2015; 12:(2)231-248

Kalinoski ZT, Steele-Johnson D, Peyton EJ, Leas KA, Steinke J, Bowling NA. A meta-analytic evaluation of diversity training outcomes. J Organ Behav. 2013; 34:1076-1104

Kent J. Scapegoating the ‘angry black woman’. Group Analysis. 2021; 54:(3)354-371

Knight M, Bunch K, Tuffnell D Saving lives, improving mothers' care - lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014-16.Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2018

Knight M, Bunch K, Tuffnell D Saving lives, improving mothers' care – lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths & Morbidity 2015-2017.Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2021

Manktelow B, Smith L, Prunet C Perinatal mortality surveillance report.Leicester: MBRRACE-UK; 2015

Ménage D, Chapman M, Raynor M, Essat Z, Wells R. Decolonising midwifery education Part 2: neonatal assessment. Pract Midwife. 2021; 24:(6)

Merriam-Webster. Stereotype. 2021. (accessed 16 December 2021)

Morales D, Ali S. COVID-19 and disparities affecting ethnic minorities. Lancet. 2021; 297:(10286)1684-1685

Why creating an inclusive environment, curriculum and approach to learning and teaching will improve the performance of BAME students and close the attainment gap. 2016. (accessed 23 December 2021)

Morgan M, Bennett D. Getting off black women's backs: lover her or leave her alone. Du Bois Review. 2006; 3:(2)485-502

Morrison N, Machado M, Blackburn C. Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school. BMJ Open. 2019; 9:(11)

Motro D, Evans J, Aleksander P, Ellis L. Race and reactions to women's expressions of anger at work: examining the effects of the ‘Angry Black Woman’ stereotype. J Applied Psychol. 2021; 107:(1)142-152

Ndlovu-Gatsheni SJ. ‘Rhodes must fall:’ South African Universities as site of struggle. Tablua Rasa. 2016;

NHS. The NHS long term plan. 2019. (accessed 21 September 2021)

NHS Digital. NHS workforce statistics – March 2020. 2020. (accessed 21 September 2021)

NHS England. NHS Equality and Diversity Council Annual Report 2016/17. 2017. (accessed 11 April 2022)

The Code.London: Nursing and Midwifery Council; 2018

Standards for pre-registration midwifery programmes.London: Nursing and Midwifery Council; 2019a

Standards of proficiency for midwives.London: Nursing and Midwifery Council; 2019b

Pregnancy and ethnic factors influencing births and infant mortality: 2013.London: Office for National Statistics; 2015

Ong M. Body projects of young women of color in physics: Intersections of gender, race and science. Social Problems. 2005; 52:593-617

Paradies Y, Ben J, Denson N, Alias A, Priest N, Pieterse A. Racism as a determinant of health: a systematic review and metal-analysis. PLoS One. 2015; 10:(9)

Pendleton J. The experiences of black and minority ethnic nurses working in the UK. Br J Nurs. 2017; 26:(1)37-42

Perez Huber L, Solorzano D. Racial microaggressions as a tool for critical race research. Race, Ethnicity & Education. 2015; 18:(3)297-320

Pierce C. Offensive mechanisms. In: Barbour F (ed). Boston, MA: Porter Sargent; 1970

Polit DF, Beck CT. Essentials of nursing research: appraising evidence for nursing practice.Philadelphia: Wolters Kluwer; 2022

Maternity high impact area: reducing the inequality of outcomes for women from Black, Asian and Minority Ethnic (BAME) communities and their babies.London: Public Health England; 2020

Raynor M, Essat Z, Ménage D, Chapman M, Gregory B. Decolonising midwifery education part 1: how colour aware are you when assessing women with darker skin tones in midwifery practice?. Pract Midwife. 2021; 24:(6)

Reay D. Race and elite universities in the UK. In: Arday J, Mirza H (eds). Cham: Palgrave Macmillan; 2018

Ross S, Jabbal J, Chauhan K, Maguire D, Randhawa M, Dahir S. Workforce race inequalities and inclusion in NHS providers.London: The Kings Fund; 2020

Sandelowski M. Using qualitative research. Qual Health Res. 2004; 14:(10)1366-1386

Sandelowski M. What's in a name? Qualitative description revisited. Res Nurs Health. 2010; 33:(1)77-84

Seston EM, Fegan T, Hassell K, Schafheutle EI. Black and minority ethnic pharmacists' treatment in the UK: a systematic review. Res Soc Admin Pharmacy. 2015; 11:(6)749-768

Universities and College Admissions Service. Entry rates into higher education: UCAS End of Cycle Report 2020. 2020. (accessed 11 April 2022)

Tackling racial harassment in higher education.London: Universities UK; 2020

Black, Asian and minority ethnic student attainment at UK universities: #closing the gap.London: Universities UK/National Union of Students; 2019

Wallace S, Nazroo J, Becares L. Cumulative effect of racial discrimination on the mental health of ethnic minorities in the United Kingdom. Am J Public Health. 2016; 106:(7)1294-1300

‘Why is my Curriculum White?’ collective. 8 reasons the curriculum is white. 2015. (accessed 6 October 2021)

Wingfield A. Are some emotions marked ‘whites only’? Racialized feeling rules in professional workplaces. Social Problems. 2010; 57:251-268

The experiences of black, Asian and minority ethnic student midwives at a UK university

02 May 2022
Volume 30 · Issue 5



Evidence acknowledges inequalities to progression and achievement for black, Asian and minority ethnic students within higher education, as well as barriers for promotion of black, Asian and minority ethnic staff within the NHS. In the UK, legislation and regulatory guidance requires students studying undergraduate midwifery to undertake their programme across both these institutions.


To understand the experiences of black, Asian and minority ethnic students studying undergraduate midwifery at a UK university.


This qualitative study used semi-structured interviews with five student midwives who identified as black, Asian or minority ethnic from a university, conducted by a peer researcher. Thematic analysis was used to analyse anonymised transcript data.


Three key themes were identified: ‘invisibility’, ‘emerging visibility’ and ‘managing visibility’. Participants experienced a monocultural focus in the curriculum and in practice and were exposed to racist behaviours, causing them to modify behaviours.


A need for diverse teaching materials and cultural inclusivity across institutions was identified to help combat outdated systemic Eurocentric practices and support the implementation of recently published midwifery standards.

The ‘closing the gap’ report highlighted that ‘42% of [black, Asian and minority ethnic] students did not feel that the curriculum reflected issues of diversity, equality and discrimination reporting a lack of [black, Asian and minority ethnic] specific content as a mainstream way of thinking’ (Universities UK and National Union of Students, 2019). The report highlighted that black, Asian and minority ethnic students continue to be 13% less likely to be awarded a first- or upper-second class degree than white students (Universities UK and National Union of Students, 2019). A quarter of black, Asian and minority ethnic staff working in UK universities reported that they had experienced racism and one in 20 black, Asian and minority ethnic students cited racial harassment as the reason for leaving their studies (Equality and Human Rights Commission, 2019).

Of the 1.3 million people employed within the NHS, less than a quarter of staff (22.1%) are from black, Asian and minority ethnicities (NHS Digital, 2020). Workforce race equality standards capture key performance indicators for equality, diversity and inclusion and a recent comparison of data over the past 5 years shows limited progress in the NHS's ambitions to drive down systemic inequalities between white and black, Asian and minority ethnic staff (Issar, 2021). Against some indicators, the situation for black, Asian and minority ethnic staff has even seen a deterioration, highlighting the fact that inequalities persist (Pendleton, 2017; Ross et al, 2020) and in some cases are widening.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month