The war between Midwives and women detracts from the real demon: the system itself.
Before I became a Midwife, I heard a lot of Midwife bashing; negative attitudes towards Midwives that largely came from Doulas and Mums who were angry at the maternity system, and therefore angry at Midwives who were part of it.
Now I am both a Midwife and a Doula (and at some point in the next few years hoping to be a mum!) I can empathise fully with both sides of the argument.
However, women turning against one another serves no positive purpose. We need to understand that the same system that quashes women also quashes Midwives. In-fighting merely detracts from the real, and urgent, debate: maternity care needs to be a public priority and higher up on the government agenda.
We are all aware of the profound, far-reaching, long-term benefits of investing in maternal and child health, and yet it continues to be put on the backburner of government agenda.
We know that when women suffer poor care this impacts upon, and filters into, all aspects of the health and wellbeing of both them and their families.
Primal health research also increasingly points to the importance of the ‘primal period’ (fetal life, perinatal period, and the first year of an infant’s life) in shaping the future health, wellbeing and character of future generations.
The issue is thus not WHAT will make things better for women and Midwives, we already know this. The question is HOW to make those changes a reality.
In politicising this campaign we will be stronger if we stand as a united voice; Midwives, Mothers, Doulas…
For anyone who talks about birth as part of the feminist agenda: Remember, Midwives are women too. The fact that Midwives still work in a system that devalues the work that we do, and provides substandard working conditions, is symptomatic of the same culture that devalues and underfunds women’s maternity care.
All of this in a profession which employs almost exclusively women, in a service destined entirely to serve women...seem surprising? No, and arguably men would not put up with it.
Midwives across the UK regularly work 12-hour shifts without a break to even eat. They work those same 12 hour shifts days, nights and weekends. They have families, partners and dreams of their own and yet they put other women’s need constantly before their own, day in, day out…
Staff shortages, and the proliferating fear culture within maternity care means that increasing demands are being put on Midwives, resulting in them being unable to spend as much time ‘with women,’ as they might wish.
Or, as Mavis Kirkham puts it “Midwives cannot empower women until they themselves are empowered.”
We are losing some of our most experienced and best Midwives due to expanding pressures, and difficult working conditions. We increasingly hear in the press, of Midwives who say they have chosen to leave the profession not because they don’t care about women, but because they care too much, to continue to struggle within the existing maternity framework.
I am not saying the standard of care we give in Britain is not good, quite the contrary. The majority of Midwives are doing the best possible job they can for women under the current system. What I am saying that things could be better.
However, women turning against one other will not further the cause.
We ALL want to make birth better, but when Midwives and women fight each other we lose track of the common cause: we all want to see maternity services improved, both for women, and for Midwives.
We do not lack the evidence, or the skills to make birth better. What we lack are the resources and strategic backing to make these changes a reality.
A good example of this is the resistance to expanding the caseloading/continuity of care model (where a woman see’s the same midwife/small group of midwives throughout her pregnancy), throughout the UK. All of the evidence we have about the caseloading model points to women being more satisfied with their care and better outcomes for women and babies. This is the model of care which most Midwives want to give and most women want to receive, and yet the RCM still face barriers to making this the predominant maternity care framework throughout the UK. (See the RCM better births website for more details on the benefits of this model)
Incidentally, this gold standard of caseload care does actually exist all over the UK: it’s called an Independent Midwife. But you have to pay for it.
Here in the UK we can be grateful for the fact that we have a strong and autonomous midwifery profession. In many respects we are still leaps and bounds ahead of many countries across the world, where women do not receive one-to-one care from a Midwife in labour, homebirth is still illegal and intervention rates are much higher than in the UK.
I was speaking with a Colombian Doctor friend of mine a few weeks ago who didn’t understand what a Midwife was; they do not exist in Columbia. Like in many other countries a General physician will ‘deliver’ all women, in lithotomy position, whilst a general nurse assists the Doctor.
However, despite our comparative advantage in the UK, there is still plenty of work to be done to continue to improve maternity care.
As Louise Silverton, director of Midwifery at the RCM commented yesterday:
"We remain around 2600 full-time midwives short in England. Midwives cannot deliver high quality care if there are not enough of them."
So Yes we should be angry. But the current climate of Midwifery and Obstetrics is bigger than any one individual. What women are really angry at is the status quo, and its inability to provide them with the quality of care that they know they deserve.
We need to continue to campaign and make our voices heard. But lets not waste those voices shouting at each other.