Hi everyone, I'm Aisia, the founder of Anatome and I was lucky enough to interview Gemma Poole, who is the founder of the Essential Baby Company. Below you can read the transcript of our interview, or if you’d prefer, you can listen to it here.
Aisia: Do you still practice as a midwife?
Gemma: Yes, I do and I support women throughout, antenatal, through the birth and postnatally as well.
Do you want to tell us a bit more about the Essential Baby Company and how it came to be and what you do?
Well, thank you so much for asking me actually. It's a question that I have been asked quite a few times. Like you said, I'm originally a midwife, but I was a mature midwife and a mature student. So before I became a midwife, I'll take you right back. So I grew up, I don't know if any of the listeners or anybody that's watching this would know Nottingham, but if they don't, then there is a really depra area called Hyson Green. I grew up in Heisen Green. I was the first person in my family to ever go to college to do an academic subject. So I want to just have that as a backdrop, that university, having your own business, and having a profession that you had to go to university for was never on the cards for me or anybody in my family or anybody who lived on my street or went to my school. It was just not a done thing. But as it happens, you know, a lot of investment was pumped into that area because it was depraved, and it still is the 11th most depraved area in England.
No investment, poor outcomes for people who live in that area. I grew up in a school where having white skin was a minority. In my friends predominantly English was their second language. They all, the majority of my friends had brown or black skin. And we all lived in an area where we all struggled. It wasn't a place coming from a place of privilege, you know, it was coming from a place of humble beginnings. So how I got here? It's really important that I say that because of the journey that I had from there to here.
I want it to inspire people and I want it to be a journey that anybody can do. It's not just about people who have parents who have gone to university or gone to college. It's for people who want to do something, who's always had a dream but never thought that could get there.
I think that's so important as well for people to hear that, to show them that they can do it.
Yeah, and it's not just you read it in books or you see people, influencers on Instagram, and you think it's really hard to do that or achieve that and their story's so out there, it's not personal or achievable or in reach.
I started, I went to college to do health and social care because I always wanted to be a midwife. And I knew that I needed some experience. I went to the local hospital and I did, I was a dinner lady at a local antenatal ward, as it was. And that was my first kind of job. It was really good insight of maternity and how it worked.
There was a midwife there who said: “if you want to do midwifery, go and get some life experience and you'll always come back to it because when you get into this, it's overwhelming, you won't get out of it”. So I did that. I wanted to do good, but I didn't know exactly how. So I started my own business with the knowledge of supporting older people to remain independent in their own home for as long as possible. And how I came into that, that's another story. But I got some funding from the government to do that.
I soon realized that the older people were in these homes and sheltered housing complexes because of a fall. They have fallen over, they had reduced the movement, they had broken the hip and and shuffle now and then all of a sudden, their independence has dwindled down to go into the community rand that's it. They don't get out and about. What I did is I took that and I wanted to help to prevent that. I qualified as a gym instructor and I specialized in chair-based exercise for older people.
It can be really debilitating, when that happens.
I did like sessions of chair-based exercises and I did my own little circuit around Nottingham and I had lots of customers. And then I was approached by a gentleman who was employed by the local college. There were two major colleges in Nottingham. One at that time was called Castle College. And he approached me and he said: “every time I go to an older people's home, your name comes up, and we want to get into there. Is there any chance that you can do exactly the same as what you're doing but we would put you through university and we will pay for your university to become a lecturer?”
Wow, that's a great opportunity!
Absolutely fantastic opportunity. I said yes of course because like I said from the beginning university was never on the cards for me, never. You know, I couldn't afford it, my parents couldn't afford it, it was never an opportunity that I wanted to get into. I knew that going into maternity and being a midwife I would have had to go to university but I didn't quite know how. So this was a really, like you said, a really good opportunity. So, I did that and I became a teacher. And that's how my career progressed. I developed long and short courses, but for cohorts of the society that were underserved and underrepresented. My specialist areas were English as a second of a language, supporting domestic violence survivors, supporting refugees, and supporting male, teenage males, who have been excluded from school. So as you can see, it's those kind of underserved communities that I was supporting to try and get them back into education because they're being deemed as hard to reach. And I hate that term, but I was kind of given that as a goal to try and get them attain a qualification which I was really successful with.
I was successful because I co-produced and that just means that I did it with them so I would say to them what do you want me to do, how should I make this course to make you want to come and sit an exam and to pass the exam?
As I went to university to become a midwife, I would be sitting in that lecture theatre thinking: “at one point they're going to tell us how to communicate with people who don't have English as their first language. At one point they're going to tell us what jaundice looks like on a brown baby.”
And it never came. It absolutely never came - and remember my background is supporting these underrepresented and underserved communities so I wasn't actually asking for me, I was asking for them because I knew that they had always been overlooked. So when I didn't get the answers, alarm bells started to ring because if we're not learning that in the classroom, how can then we as practitioners support the communities that are coming through the door effectively and equitably? We can't because you're not telling me.
Exactly. Because that's what people learn. People learn at university. And when you're at university, you don't have that much time to go out and find all these extra resources and compile them altogether yourself. You expect that your course teaches you everything that you should need to know to teach the population. But unfortunately, we’re not doing it as well as we perhaps could be.
Absolutely! Well, we didn't drop onto the face of the earth yesterday. Come on. It's not like they haven't had the chance to implement this a long time ago. So as a student midwife, some people may not know, but six weeks into your course, you are out in practice. So it was very apparent that what we're learning in that classroom is not what is happening in practice or it is what is happening at practice, meaning that we're not serving the communities with the exact same outcomes and that was very evident in the outcomes and the statistics that we see.
It's represented in government data.
Yeah, it's not it's not a coincidence that we see the lack of learning and the representation in medical education and our medical health professional education and the lack of representation and equitable care in practice.
So, I came home with all these frustrations and just wrote everything down. And then I laid them over all the policies or the strategic strategies that had come out of the NHS and other organisations. And I kind of laid them up against each other going, wow, there's huge gaps in here. We're saying that we need better outcomes by 2025, but we're not teaching the workforce how to get there. There's still this black hole of educational needs here. There's nobody's addressing the issue at the start of the problem, but we're only focusing on the end.
Yeah, they're saying we need to do it, but how? No one's doing it.
Yeah, nobody's doing it. And I think that's the ignorance that comes along with thinking that it's already been done, because nobody can actually fathom that this still happens in 2023. We're still learning only on white skin tones. The dolls that you see is only on white skin tones. The examples that the teachers give is only representative on light or white skin tones. So people can't understand that the lack of representation is still happening - they just bypass that.
“And when you tell people these statistics and people are like; “Oh, how can black mothers be at such an increased risk of death in childbirth?” And people are like, no, surely not, surely that's not happening. But it is happening and it's happening now. And, yeah, you would think we're too far too advanced to allow skin tone to be a determining factor in your health outcomes. But, unfortunately it is.”
It is and it's so upsetting and how the Essential Baby Company was birthed, excuse the pun, is because while I was doing all this research in the background, my nephew was born and he has brown skin tone, darker than me.
His outcome was determined by his skin colour. He had really, really, high levels of bilirubin in his blood. He wasn’t jaundiced, but really high levels of bilirubin. And that wasn't picked up by the healthcare professional, not because of incompetence, but because she didn't know, because nobody had said: “This is what jaundice looks like on brown baby.” Everybody, including me, was taught that jaundice looks yellow on babies. But we know that yellow doesn't represent on darker skinned babies. And all you get from the books is it may be a different color on a darker skinned baby.
They may not have yellow colour, but there's no then further education to say this is what you should look out for. It's just one little disclaimer sentence, this may not be apparent on dark skin tones. The policy at that time was if the parents or if the healthcare professional was concerned that the baby had jaundice, you strip the baby off and you eyeballed that baby so it's just a visual aspect. I know, I know, it’s crazy. Crazy. He's four so it wasn't even that long ago.
I can't believe that!
Yeah. So basically you just held the baby up to the window and then you eyeballed this baby and if it didn't look yellow then it was fine. And then but this you can see where the flaws come in and you can see where the gaps and the inconsistencies and the inequalities can play a role.
I watched this play out as a student midwife and I was a third year at that time and the look on my brother and my sister-in-law's face when my nephew was in intensive care, neonatal intensive care was enough for me to say enoughs enough. I still get goosebumps just thinking about it today. They were newly parents, their life had been turned upside down purely because of the lack of understanding and the lack of representation in education. That was it. It was nothing to do with them. It was nothing to do with the baby. It was purely the system's fault.
Because like you said, it's not incompetence on the practitioner’s behalf because if you're not taught something, how are you supposed to know? You expect your education to provide you with everything you need for clinical practice, but it’s just saying always it will look different on dark skin tones. Okay, show me what that looks like then. Show me how to identify it. Don't just tell me it's different. Show me what I need to look for.
Exactly, and not just, because what happens in practice, and I've learned this very quickly, is then when soon as you're qualified, you are that responsible practitioner for two lives, the mother and the baby. And even though that midwife doesn't have the clear understanding of the education to make sure that they can make an informed decision about the care that they give. It's still upon that midwife's pin. And it's the midwife, if a bad outcome happens, it's on that individual midwife and not the system, which is awful, absolutely awful. And I didn't think that was right because myself as a midwife and my colleagues were then held to a higher standard than the system that had brought them to this kind of platform, if you like. They were set up to fail. And we are set up to fail, in my eyes. If you're not giving them the right tools and resources to support everybody in the community that crosses your threshold, then we cannot be held accountable as a medical professional.
We don't have that knowledge. And there was something wrong with that. So the Essential Baby Company knew that there had to be a bridge between a marginalised birthing community and maternity care. And that's what we do is we span our unique way of engaging marginalised communities to identify the gaps in knowledge for both health professionals and black and brown skin communities. And we bridge that with my knowledge of creating long and short courses with underserved and underrepresented communities. I bring education and that knowledge down to really understandable, accessible, relevant, but evidence-based information to the people that need it the most.
And it's co-produced. Before I was talking about my experience of being a teacher and learning very quickly that I had to co-produce courses, I still use and utilize that experience within my work now. So I go to and I immerse myself within the diverse communities. And I say, how do you want this information presented to you?
And then I will do that according to what their needs are, rather than at this moment in time, you will find that information is on a boring leaflet with really complex words on them, which I struggled to understand some of the jargon before I came into maternity or had my baby. I'd never heard of the word preeclampsia or abruption.
There are words that we use in maternity that are totally out of context in the everyday living world, never mind a depraved area. So what the Essential Baby Company does is we understand that community and we are at the beating heart within that community. And we use their strengths to then formulate and facilitate the development of inclusive tools and resources.
Not only are we educating and advocating for diverse communities to optimize their health within the perinatal period, we are also bridging that gap within the healthcare system because we're using the words and the people within those diverse communities to directly inform training for healthcare professionals. It's from their mouth.
You know, it's from the beating heart of the community, right the way to the training for healthcare professionals within that facility. It's locality-based. It's not like a national thing. This particular training course will be developed for that workforce. And with my knowledge and understanding on how to build training courses and educational platforms.
We just utilise that. It's not rocket science, what we do, but what we do really transcends and it really makes a difference to both the individual person on the ground and my colleagues as well working in maternity.
I think it's so nice hearing your story and I know you didn't have the conventional kind of journey to becoming a midwife, but I think all the experiences you had before that allowed you to do something really incredible, and really make a difference, which you may not have done if you hadn't had the upbringing that you had, or if you hadn't faced certain barriers and certain challenges. So even though it might have been a bit difficult it just goes to show that you can use your experiences whether good or bad or hard to do something really amazing, which is what I love.
Yeah, absolutely, absolutely. And that's the tone. And I think I've gone about it the long way, but I wanted people to understand that you don't need to be conventional. You don't need to have this straight cut: “I've gone into the NHS and I want to make a change, so I have to go up the ladder to get there.” Actually, you can do it! You know, a girl from Hyson Green that has severe dyslexia that could never imagine to be sitting here talking to you today, did it, but I've gone around the houses to get there, but every single experience that I have been exposed to has all led to this, which is really, really strange because all the skills and attributes that I have collated along the way is everything that the Essential Baby Company is and what we stand for.
You’ve got your courses that you developed kind of while you were teaching, you've brought that in. I think it's just amazing to see like how holistic things can be and how you can bring all these experiences that you have in different facets of your life into one thing that you're really passionate about, which I think is just really great to see.
Thank you. And I hope it inspires people as well. And what I want to do is to, and what I do already is mentor, especially women and girls from depraved areas, because I think just voicing another option is enough for people to go: “I can do this and I can have the option, if I don't have to go to university straight away after college”, or, “just because my mom and dad has never been to university doesn't mean that I can't have my own business in the future.” It all comes down to where your passions lie and taking every opportunity, every opportunity. And one thing that I am really hot on is collaborating because I haven't just landed here on my own. I land here because of mentors that have supported me but also collaborating and working with other people as well. Like-minded people that have the same outlook on life, is really important as well and I know that's something that you're looking at.
No, definitely. I'm the first one in my family to go to university. And like you said, you don't know something's possible until someone's told you it because I was lucky - I did get into medicine the first time. You put your four medicine options and then you have biomedical sciences, the one people tell you to go for as your fifth option. I never wanted to do biomedical science. I never wanted to do that.
And then at a conference someone was like: “I didn't get into medicine first time, so I went into midwifery.” And I was like: “why didn't I ever think to do that?”. Because I'd still be doing something patient-facing, medicine-based, but doing it in a different way. But I never thought that because no one ever told me that. And no one ever showed me the different routes. I know for a lot of young people, it's like, if you don't get into med school or you don't get into midwifery or nursing the first time, that's the end. And you're just like, I'll just do something else
Nut you can do so many different things and still get back to that point. Even if you can't do it the first time around, you can keep trying. If it's something you're really passionate about and seeing people like you do such inspiring things is amazing. And also having people like you come and talk to students and other people and uplift them, I think is so important because there's no point doing all of these positive things if it's just you at the end of it. You want to take other people with you and see them improve too, cause that's how we improve the community and the healthcare system as a whole, I think.
Absolutely, and it comes to that fact that you can't do it on your own you have to collaborate. Like you said ,you have to bring people with you. I think the old view on equity, diversity and inclusion is just having the token brown or black face within a board or you know it was never attainable but now I think people are starting to realise you don't need validation from anybody or anything. You can just be around people and then lift them with you and take them with you. And then, all of a sudden, you're all going in the same direction. You don't need to wait for a title or a position to become the change, you know, just like what you're doing. It's absolutely incredible and equally inspiring.
Thank you so much. It's been so nice to hear all the things you've done with the Essential Baby Company. Do you know what your future plans are and what you want to develop going forward? What are your plans at the moment?
As much as I talk about the Essential Baby Company and how I go about the way that we produce the inclusive tools and resources, so many people will come to me and say, “how can I help? I want to be involved.” And it's like what we were saying, we all come together and we just sweep the country of all the like-minded people.
So I want to, in the future, I want to create a safe space for us, like a membership, where we can all come with our ideas and once a month or a couple of times a month, we can just talk and we can just go, right, I've done this, who else is doing the same? And then we have a platform to collaborate with people to then push your innovation or idea or project forward because we are scattered around the country and we're all probably doing similar stuff but in silos and in different areas so bringing that collaborative effect and feel is where I want to take the Essential Baby Company because I also want to house the passionate into a space where lots of health professionals can then come and use them. I don't want it just to be a Nottingham thing or a Birmingham thing or you know a somewhere else thing. I want this to be a national open free-to-use resource but it's generated purely from the hearts and the minds of diverse communities. So that's the future.
I think that sounds great. Like you said, there's so many people who are doing so many amazing things, just all dotted around. You just happen to scroll past them on LinkedIn or scroll past them on Instagram. But it'd be so nice if you could say, I've got this idea, this is what I want to do. Do you know someone who wants to be involved? Do you know someone who can help me? Because people know people, but it's about getting everyone together. So, I think that's a great idea. And also getting different healthcare professionals together.
When you're on certain courses, you might not have that much exposure to, for example, midwives or nurses or HCAs. It's nice to just get to know what they’re experiencing and what's going on there? How does that relate to my experience and how can we work on something together? Because at the end of the day, healthcare is the MDT, isn't it? There's loads of people working together. So that should be represented in the diverse groups that we're engaging with.
Absolutely. And if you think about the front line, so who's the front line? Paramedics. Like, what do they have? What gaps in their knowledge do they have? There's no point of having secondary care that is really, really good and we're investing lots of time in. Who are the people who are coming across diverse communities day in and day out?
That is them that need to know, and it's them that need to inform us of the gaps that they have, so then we can bridge that gap. I totally understand, and I agree, it has to be that multidisciplinary team approach where if we get like a story from somebody from a diverse community or deprivated community, and we go, right, from start to finish, who did you come across, and what did you encounter?
And then we build it up from their perspective. So they phoned 111, you know, so what can we do with 111? Let's see what their perspective is. Do they need to know X, Y and Z and where are the gaps? According to the story of this person in that diverse community. It has to work in tandem.
And I think the only way that we can do this is through talking and through being really brave and not being scared of saying something that we think is not quite right or not politically correct. We need to stop these barriers of communication and go, okay if this level of trust within this platform, this is, you know, the terms of reference in here.
Everybody is respected, you come here to learn but you also come here to collaborate and it's a give and take. So you don't ever feel like you can't be yourself or you can't give a hundred percent because you're scared that you're going to offend somebody or you're scared that you might have said something wrong and it's all about educating and it's all about learning. We don't know all the answers do we?
I definitely think that because I think it's about intent as well. You know, it's different if you're going out and you're saying things with the intent to hurt people or to upset people. But if you're genuinely there to learn and understand, I think why not educate? Because I think when you educate someone, it's a much more positive impact than, you know, just. shouting at them, arguing with them, ostracising them, because education is how we carry things forward because just if someone says something incorrect and you just shun them immediately, they're never going to learn and they're going to go carry on doing that incorrect thing. Whereas if you educate them with compassion I think that's a better way to go.
It is, it is. And that's the feeling I get when we do training with healthcare professionals is that they don't feel able to then learn and increase their knowledge because they're so fretful of saying something wrong and they don't want to expose their ignorance.
They don't want to upset anybody. But like you said, it's their intent. So if they are going out to upset people and they're intending to be racist or intending to make sure that they don't give equitable care, then that's a different story. You know, we can highlight them, but they're taking our focus away from actually getting to where we need to be, which is improving health outcomes. We can report them, we can get them off and we can make sure that they don't support our communities, but we have to be 100% focused on why we are doing this. We're doing this to improve outcomes and to make sure we can bridge that gap.
And we can only do that with that like-minded people and have a safe space to be vulnerable. Because that's what we're talking about, is being vulnerable, isn't it? Being empathetic within that space as well. We can't say these things and then recommend somebody for doing the thing that we're telling them that it's okay to do. That being said, we need to see action.
We absolutely need to see action. I take the lack of action, and think “that's an intent.” You intend to harm a cohort of society through negligence. And they are being highlighted through organizations like the NHS Race and Health Observatory which is the workforce equity, that look after the NHS and the workforce and to make sure that it's equity based. There are organisations that have got a handle on that and a finger on the pulse there. Can we improve? We can always improve. But we need now for people like myself and you and everybody else thinking about the future to then leave that to one side and then just go straight ahead and do it ourselves because we're not waiting for them.
If you're always waiting on other people, then things don't happen. Sometimes, even if it's difficult, you have to do it yourself and bring people along with you for the ride.
Definitely, definitely.
It's been absolutely lovely talking to you, I'm very inspired, you've given me lots of ideas and it's been lovely to hear your story. How can people contact you if they want to ask you any questions or get in touch?
So, likewise, being very, very inspirational and I've really enjoyed this. So, if people want to continue the conversation or get in touch with me or collaborate, then they can go to our website, which is www.theessentialbabyco.com. There's a participant form that you can fill in, or there's other pages on there where you can request a 30 minute chat or request the time. You can also find me on LinkedIn at Gemma Poole or the Essential Baby Company or Instagram @essentialbabyco and Facebook is the same: Essential Baby Co. There's also, if you go onto those social media handles, you'll also find the website and email addresses and phone numbers if you did want to contact me.
I really, really have enjoyed my time and thank you so much for giving me this platform. To just hear my story and I hope it's inspired others to get into whatever they want to, if they've got something in their head that they think that they want to do.
I hope it inspires them to go out and just do it. But also the platform to say, if anybody wants to collaborate, it doesn't matter where you are in your journey, I will utilize you in whatever capacity that is. And even if you don't know how you can collaborate, but you want to get involved, then you can get involved in what we call the Happy Research Group, which uses your voices in research and product design and service delivery. So you can still shape the future of maternity care for your children's children, or the future of your own children as well.
Find Gemma on LinkedIn: https://uk.linkedin.com/in/gemma-poole-07600ab4
Find the Essential Baby Company on LinkedIn: https://uk.linkedin.com/company/the-essential-baby-company
Find the Essential Baby Company on Instagram: @essentialbabyco
Find the Essential Baby Company on Facebook: https://www.facebook.com/essentialbabyco/
Website: https://www.theessentialbabyco.com/
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