As Hannah Dahlen so passionately said, ‘Midwives ARE the balance. We will no longer be ignored and we will win this battle.’ From the Lancet series on Midwifery (2014) to many more published papers, research has proved time and again that midwifery works. As far back as 1987 research has shown that continuity of midwifery care can effectively
- reduce the use of interventions
- reduce stillbirth rates
- reduce premature birth rates
- increase breastfeeding rates
Yet despite the evidence, we are still fighting to preserve the role of midwives in many countries around the world, while the use of interventions of questionable benefit, such as continuous monitoring grow in use, with caesarean sections and inductions also increasing.
The conference brought us together to examine how we as midwives have are key to the wellbeing of women and babies, and how we can be courageous and step forward to make change happen.
And wow! What a day we had. The 600 mile round trip from Cornwall to Nottigham was certainly worth it and if you ever want to feel inspired, need a boost to uplift you, and find likeminded folk then you must make space for an event like this every year.
For me the themes of the day included:
- Birth is THE feminist issue
- Midwives are key to preventative healthcare
- We each have a part to play
This is even more dramatic in areas of socio-economic deprivation. Yet we live in a society that values technology over social models of care. As Professor Mavis Kirkham, midwife researcher and author, explained, midwifery should be recignised as part of preventative and long term healthcare. Through relationships, nurturing and support health we may be able to prevent problems, such as small for gestational age babies (SGA) which is linked to stillbirth, before they arise rather than wait to diagnose a problem (McRae et al, 2018).
Claire Goggin, mother, writer and activist for positive caesarean, moved everyone to tears with her story of a disempowered caesarean, and the subsequent change in attitude when, on requiring a second emergency CS birth, they respected her wishes and birth plan, creating a more a gentle caesrean. She didn’t know her midwife at the birth and although it wasn’t perfect, the midwife “She put me first and did what she could.” This is all women ask, to be listened to, have their wishes respected, and that the midwife is an advocate for them at a vulnerable time.
On Being Brave
As midwives determined to retain autonomous practice, supporting the interests of those in our care, promoting normal birth even when guidelines say otherwise, valuing the right of informed consent and choice, respecting the right to informed refusal, we risk the wrath of the system. And when you are vocal on social media platforms then you risk this even more. Sheena Byrom spoke about her personal experiences of this, which I remember well. Simply advocating for ‘normal birth’ became a dirty word, teaching and sharing her vast knowledge and experience was challenged by those with their own agenda and she was at the receiving end of personal attacks. When you have experienced bullying of any kind, those feelings of anxiety and fear can stay with you, and I have definitely felt afraid to expose my stance on normal birth in social media. But as Sheena says we need to stand together, don’t be afraid to speak what is the truth and walk away from the trolls.
“We all lose if we don’t keep going.”
I cannot count how many times I heard the phrase ‘sticking my head above the parapet’. A sad indication of the many midwives who have been at the recieving end of the negative consequences of standing up for women, or the right to practice autonomously.
However as Professor Lesley Page so eloquently said at the opening of the day
“To keep and preserve the balance may in the short term mean actually disturbing the balance.”
If you’re ok with the rising caesarean and induction rate, the tidal wave of women experiencing a traumatic birth, the shortage of midwives and the rate of burnout (WHELM study, 2018) then this won’t apply to you. But if not…
What will you do to disturb the balance?
I first discovered them before I became a student and they have continued to remind me that I am part of something bigger and I’m not mad in my continued drive to improve experiences for women and midwives. Midwifery Matters, their quarterly journal strives to share midwifery knowledge that is more than simply research, and includes stories and empirical knowledge, poetry, photos and artwork. Look at their objectives and tell me this is not where we should be heading to improve maternity care…
PS. My next step is to start and ARM group here in Cornwall. #findyourtribe
And we end with a little selfie vidlet..