Disability History Month — Tina’s story
As part of Disability History Month, Tina Popoola, an Infant Feeding Coordinator at University College London Hospitals NHS Trust, shared her story of becoming a midwife and how her birth has influenced her journey.
Tina was born with Erb’s Palsy as the result of a difficult birth but has used her journey with a disability to shape how she provides care to mothers and their children during her time as a midwife.
Your birth experience influenced your decision to become a midwife. Tell us about that experience.
My mother went into labour at home and went into a hospital nearby in south London, where I was born on a Wednesday in April. The labour was not progressing after some time, and she was not having contractions so went into an induced labour. A cardiotocography result showed signs of foetal distress, so her providers carried out an episiotomy, a procedure performed to enlarge the vaginal opening. The delivery was quite difficult, and my left shoulder got stuck against my mother’s pelvic bone. It took 5 minutes to deliver my body after my head had been delivered. After birth, I was floppy, and my initial Apgar score, a quick test performed on a newborn baby at 1 minute and 5 minutes after birth to assess their overall health and determine if any immediate medical intervention is needed, was a 4 out of 10. I was taken out of the delivery room to be examined by the neonatal team at delivery and a medical team. They identified that my left arm wasn’t moving the way the right was. My mother asked about it and was told I had Erb’s Palsy, a condition caused by injury to the brachial plexus, a network of nerves near the neck that control the muscles of the shoulder, arm, and hand. This type of injury occurs when excessive force is applied to the baby’s neck or shoulder. It affects about 1 in every 2,300 births in the UK.
I only found out that the post-delivery care we were offered was poor as an adult when I joined the Erb’s Palsy Society. I discovered when I listened to others of a similar age as me living with the condition, that there were stark inequalities in the early intervention that I was offered by health professionals. I was never offered the same level occupational physiotherapy or surgical interventions that had helped others improve their quality of life until I was much older and requested for it myself.
The Erb’s Palsy Society has been a major source of educational and emotional support. Their support has helped me better understand my condition, which has given me confidence in advocating for myself and the encouragement has been invaluable both professionally and personally.
What was it like to grow up with Erb’s palsy? How old were you when you realised you had it?
I was a happy child and met my developmental milestones as expected, including walking by the time I was 9 months. My mum never made me feel that I was different. I would always have a go at activities that required me to use both arms. If I could not do something properly, I would try an alternative, sometimes deciding that some tasks were just not for me. Erb’s Palsy is often treated with surgery to repair the nerve damage. I had two surgeries, one at about age four and a second at 16 during college leading me to repeat an academic year.
I looked slightly different as a child than other children, but I did not see myself as dissimilar or thought of myself as having a disability, but nevertheless, I was bullied at school. I could not do some PE activities at times and teachers weren’t always great at normalising the re-direction to another task, which made me feel quite awkward. This is the point I started realising I was different but did not yet identify with having a disability.
The first time I was confronted with having to identify as having a disability was when I enrolled in my midwifery course and was asked to declare any disabilities on the application form. The label felt alien at the time, although I had come to accept that I needed reasonable adjustments.
What led you to become a midwife and how has having EP shaped your midwifery practice?
I had a helpful disposition as a child and always knew I wanted to help others through my work. I was also interested in pregnancy and birth, so I knew from an early age that I wanted to become a midwife. I knew that as a young, Black, disabled woman I had something to say to those trying to find their own voice and purpose.
Having a disability caused by birth trauma has profoundly shaped how I work with mothers, birthing people, and babies and although the prevalence of Erb’s Palsy has decreased through breakthroughs in medicine, I have a heightened sense of alertness when I see the labour is not going to plan.
One of my professional goals and a key driver for staying in midwifery is working to reduce variation and tackle health inequalities in the provision of maternity care on the frontline. I want to ensure that we are working to develop pathways that ensure equitable and personalised care for women and birthing people of all backgrounds. A few years ago, my own experience of pregnancy was positive because my healthcare providers took a holistic approach to my pregnancy and delivery. Every person deserves that level of care.
What has that been like to be open about your disability at work? How have others responded?
Disclosing my disability has not been a straight-forward journey. I have encountered people who have discouraged me about becoming a midwife due to my EP, without giving me the benefit of the doubt. But I have also found others who saw my commitment and potential and invested in me with support and guidance.
I have seen a rise in inclusion and in making reasonable adjustments for people with disabilities since I started. I have found that the Education Team Clinical Practice Facilitators are responsive to student needs and so are the Professional Midwifery Advocates, Occupation Health (OH) and Inclusion Specialists I have worked with. Line managers are always the first port of call for someone working with a disability so it is important that they get the training and guidance they may need to appropriately support a member of staff with additional needs. My current line manager has taken the time to understand my needs and has supported me in making the adjustments needed to meet the job requirements. The OH team has also been fantastic.
In 2022, I took part Capital Midwife Fellowship Programme, and that experience was incredibly valuable. It allowed me to reflect on what it means to practice midwifery as ethnic minority and about the intersectionality of living with a disability as a Black woman. The group created a space for me to feel that I not only fit in into my profession but belong to it as I provide care during one of the most important moments in the life of a woman, birthing person, and their baby.
