I recently attended a very interesting lecture about unconscious bias, presented by our programme leader Georgina Sims. It made me realise that we often make instinctive decisions about other people that are not really based on facts, but are instead influenced by hidden thoughts and feelings we're not even aware of. Every time we interact with women and their families in our care, we make rapid judgements about them without having time to process in detail everything about the individual and context. This unconscious process may have an impact on the quality of care we provide. Therefore, I felt we should explore this further.
The Equality Challenge Unit (2013: 3) defines unconscious bias as
‘a bias that we are unaware of, and which happens outside of our control. It is a bias that happens automatically and is triggered by our brain making quick judgements and assessments of people and situations, influenced by our background, cultural environment and personal experiences.’
Information about people is compressed and organised into categories in our brains. This enables us to make rapid judgements about new people and situations. Social psychologists call this process ‘social categorisation’, where we sort people into groups rather than think of each person as unique (Tajfel and Turner, 1979). The advantage of categorisation is that it allows us to save time and effort when processing information about others. However, social categorisation also brings with it stereotyping and bias. This can be particularly damaging when we are judging people categorised as part of our ‘out-group’ compared with those categorised as part of our ‘in-group (Crisp and Meleady, 2012).
So why is this important? Shire Professional (2010) states that although unconscious biases operate in the unconscious mind, they can have significant real-world effects. There is a growing body of scientific evidence to suggest that our unconscious biases play a significant part in the way we engage with people and the decisions we make about them. Empirical research shows that automatic bias plays an important role in producing discriminatory behaviour and judgements, and that measures of implicit bias are significant predictors of the level of discriminatory behaviours and judgements.
Knowing that unconsciously we process around 200 000 times more information each second than we do consciously (Shire Professional, 2010)—and that bias is natural, largely unavoidable and affects our behaviour in unintentional ways—what action should we take?
Some of the recommendations from Shire Professional (2010) are:
Ultimately, it's important that you remind yourself of the need to be fair and objective, and walk in someone else's shoes. As midwives we have a privilege to be with women and families during the most intimate times of their lives. Becoming aware of your unconscious bias and how your background and personal experiences may affect an interaction with women and their families is the first step to providing well-balanced and unconditional maternity care.
To help you to identify your biases, this exercise will enable you to establish your cultural norms:
Dig deep; think about your childhood, people you have met, and situations you have encountered that have shaped you as a person. Consider not only the impact that these sources have had on you, but also how this can impact on those around you. This is the first step to uncovering, and trying to overcome, your unconscious bias.