Exposing racial bias in midwifery education: a content analysis of images and text in Myles Textbook for Midwives

Objective To determine how people of different races and skin colours are represented within Myles Textbook for Midwives and whether the identified content is clinically relevant to people of all skin colours. Design Content analysis of text and images in Myles Textbook for Midwives 17th Edition, 2020 Findings The images overwhelmingly depict light skinned people of White European appearance. When people of colour are shown they are more likely to be positioned in prominent imagery without specific link to the chapter topic. Descriptions of skin colour in the context of clinical assessment and/or treatment often applied mostly or solely to people with light colour skin. This included text referring to serious conditions or situations associated with severe morbidity or mortality. Key conclusions Myles Textbook for Midwives presents a light skinned White European norm and often fails to include information that is clinically relevant to the assessment and treatment of people with darker skin colours. This may lead to disparity in midwifery education and contribute to poorer outcomes for women and babies. Implications for practice Concrete efforts are required to identify and root out racial bias at all levels of midwifery education. This needs to happen alongside addressing current lack of good quality evidence required to support practice.