04 May 2018

ICM Midwifery Leaders Showcase: Felicity Ukoko — The Healer

By Scarlett Hawkins | Advocacy Manager | International Confederation of Midwives

Felicity Ukoko passed away unexpectedly at the end of 2017. In this Midwifery Leaders Showcase profile, Scarlett Hawkins remembers Ukoko as a phenomenal midwife and friend, hearing Ukoko’s story in her own words through an as-yet unreleased interview from 2016.

Though the word ‘midwife’ means ‘with woman’, there are many ways to be with a woman. No two midwives are the same in their practice: some are defined by gentleness, others by stoicism. Some are enthusiastic, assertive, any number of combinations—and for every midwife who provides respectful maternity care, there is at least one woman and one newborn who thrives as a result.

Felicity Ukoko’s midwifery style was apparent to even those whom she’d never provided care. With a wry, knowing smile and a measured voice, Felicity was the exact person – both soothing and authoritative—one would want to have with them during pregnancy and childbirth. She laughed often, championed the importance of compassionate midwifery care in her practise, and relished learning everything she could to promote better birth outcomes for mothers and newborns.

Felicity’s impact on the lives of others was profound and far-reaching. Born in Zimbabwe, Felicity trained as a nurse only to experience postpartum haemorrhage during the birth of her first child. Fortunately, she survived, but when she had her second child—this time in a London hospital—her experience was vastly more positive.

“The midwife was kind and respectful. She did little things that meant a lot, like sit down, explain things, and give information. She removed my sutures with care,” she said, “I made a decision then that this was what I going to do for the rest of my life: help other mothers.”

Felicity trained at St George’s Hospital in London, where she was deeply inspired. Of this period of her life, she said: “It made me truly understand what it means to be ‘with woman’.” This passion for woman-centred care permeated her entire career, which spanned over 20 years. From working as a Specialist Midwife for pregnant asylum seekers at Guys and St Thomas Hospital, helping to deliver the Sure Start government programme in the U.K. which focused on providing a range of maternity services for vulnerable pregnant women and their babies, and being a founding member of White Ribbon Alliance Zimbabwe, Felicity always sought work that would enable her to help make a positive impact on the lives of as many people as possible—even receiving the British Journal of Midwifery’s Community Midwife of the Year award in 2005.

Felicity was a trailblazer in advocating for respectful maternity care in the U.K. She was a fierce proponent of the importance of midwives giving compassionate and well-informed care to women who, in some of their more vulnerable moments, are especially in need of kindness. As the Head of Midwifery Programmes at Wellbeing Foundation Africa, she developed the MamaCare Antenatal Education Programme, which provides education to expectant mothers and their partners on the realities of pregnancy and childbirth. Felicity believed that an informed mother would be better able to tap into her own intuition about her body and her baby, and make the best decisions for their health care.

Felicity was an effusive story-teller: She spoke with a cadence that made you feel like you were being invited to share a delicious secret. There was a sense of intimacy to the stories she told. In them, the women and midwives were always the protagonists through long labours and interventions and miraculous births. Even when it was clear—usually from a skimmed-over remark—that Felicity’s own quick action had saved a life, or many lives, she was quick to deflect praise. It was the work she loved—the women, the families, her fellow midwives, the beauty of pregnancy and childbirth—not the glory.

“So many births have inspired me,” she said, “But there is one in particular; a homebirth. I was the midwife on-call and when I walked into the woman’s house I was met by a room full of relatives and friends: uncles, aunties, a grandmother, a sister. They were all there, keeping the woman company. They said it was a way to distract her from the pain. It was an obviously a close-knit family. I examined her and she was[dilated to] 4 centimetres. She asked me to run a bath. After an hour, she wanted to push. I told her to relax, breathe and pant as the head was delivered. The baby was delivered, placed onto her tummy and both mother and baby were fine.”

This story, she explained, stood out because it expressed the significance of a calm, relaxed environment during childbirth.

“A relaxed woman in labour, in tune with her body, is less likely to need pain relief or intervention and will have a shortened labour. I totally believe in that. Pregnancy and giving birth can be an overwhelming experience for most women; there is the feeling of anticipation, excitement, fear and joy. The midwife is the most critical person for effective care at the time of birth.”

This, she believed, was universal. Having worked in all settings, Felicity was firm that midwives today face more challenges than ever before. Though vastly different from Zimbabwe, the United Kingdom was not exempt from its own major issues in maternity services—namely, the overloading of midwives and increasingly complex births. In low- and mid-resource settings, midwives suffering from lack of resources, support and opportunities for professional development. The global shortage of midwives is a serious problem, and one that she felt needed a more collaborative approach between midwives, women and policymakers.

“We need to believe in the cause: Identify key players and decision-makers and work with them, galvanise support and ensure everyone understands what is to be achieved, be positive and have gallons of enthusiasm. When we all come together, we can do anything.”

Felicity was a proud advocate for partnership – she did not believe that anybody could make real impact on their own. She understood the importance of a united voice, with midwives supporting each other to influence others to action. Midwives had to stand for what they believed in and understand their right, with sound education and knowledge that could enable them to articulate a compelling argument with facts that could see them defend their positions when required. But for all her affability, she was not afraid to fight for her profession. When asked what her one decree would be if she were Prime Minister or President, she said: “Invest in the midwifery workforce. Equate the role of a midwife to that of a soldier going out to defend your country: ensure the midwives are trained, equipped and paid, and retain them so that our mothers and babies survive.” She believed in pushing for accountability, for being assertive, for leveraging the influence of social media, with the command: “Speak up, midwives. Let your voices be heard!”

Despite the numerous challenges the profession faced in the United Kingdom, Zimbabwe and beyond, Felicity was always very optimistic about the future of midwifery. She considered it a rewarding profession that needed more recognition and respect so that midwives could continue to save lives. She believed in the tenacity of midwives to make those changes possible.

One of my favourite stories about Felicity which captured the essence of who she was when, attending a conference, a colleague of hers broke their only pair of shoes on the second day of what was to be a whirlwind five. With limited time to purchase another pair, the colleague accidentally picked up a pair made with painful, stiff leather. Felicity politely—but firmly—insisted that she wear the shoes all day to break them in, and her colleague would borrow the pair she was wearing at that very moment. No matter how much the colleague protested, the day ended with Felicity triumphantly returning the shoes saying, “Now they are broken in.” to the pathetically grateful colleague. And I should know—the colleague was me.

Such was Felicity’s way—she could convince just about anybody to do what she wanted with such graciousness that before long, they would almost thank her for allowing them to do so.

The passing of Felicity at the age of 51 was a grave loss to the midwifery community, the International Development sector, and her friends and family. The programmes she developed, the initiatives she spearheaded and the confidence she instilled in her fellow midwives and women lives on, where her influence continues to grow and spread as more people benefit from her teachings, her mentorship, her light. She was an authentic and earnest person with an inescapable allure: the ideal midwife to be with woman.

In the notes of her initial interview, there is just one concluding remark. It is unrelated to the answer that comes before it. Three words, no context, no embellishment:

Midwives are special.

Originally published here on 30 April 2018.

This is the third interview of the Midwifery Leaders Showcase—a series of featured interviews with midwives from all 6 of ICM’s regions.

These interviews showcase the dynamic and diverse role that midwives play in shaping policy, leading civil society organisations, influencing professional practice and creating a better and brighter future for women, newborns and their families. With each new application of their knowledge, these midwives are ‘game changers’ in sexual, reproductive, maternal and newborn health and rights.