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The politics of midwifery
Dr Helen ED Shallow
RM, RGN (not live) ADM, SoM (up to 2014),
MMedSci, PGCEA, PhD
Midwife, writer and presenter.
Twitter: @Helen_Shallow
Images (mostly) from Donna Nook, Lincolnshire and a New Year walk on the beach
Introduction
• My political journey: Three stories
• Outline of my interpretation of midwifery politics
• Hierarchy, or collectivity and community?
• Touching on activism and feminism
• The power of reading
• Two more stories
• Summary
• Close
Local artist needlework impression of David Hockney’s 18th VN Painting
My (her)stories of becoming political
• The story of the hoist and the director of nursing
• The incident of the hairy legs
• Refusal to play along ( the woman with red hair, and tears)
The story of the hoist and the director of nursing
How can you let this happen?
The incident of the midwife and the hairy legs
You must wear tights. Hairy legs
are unsightly
Refusing to play along: the story of the woman with the red hair, faeces and tears
What is politics?
• ‘The activities associated with the governance of a country or area, especially the debate between parties having power.’
(WIKIPEDIA)
• ‘Competition between competing interest groups or individuals for power and leadership.’
(Collins Dictionary)
Being a midwife is a political act
• Midwifery to be a feminist profession
• We work with women every day of our working lives
• Midwives to align with mothers not Trusts
• Midwives have a duty to be candid – to speak up
• Midwives have a duty to implement the evidence
Being political means stepping outside of your comfort zone
Being
• Willing to work in true partnership with mothers
• Even where their choices don’t tally with yours
• Embracing risk as well as maintaining safety
• Being open to the possibilities for learning that this creates
• Reflecting and learning from mistakes
• Be your own critic before others criticise you
• Analysing your own practice
• Know how to defend your practice
To empower mothers, midwives must release their power. - but how?
• Collective action • Talk with like minded people
• Connectivity • Attend conferences and network
• Reading widely • Share your learning with colleagues and
mothers
• Broadening your horizons • See how many roads lead to Rome
• Realise the art of the possible
The NHS is a political football held by those in power but who holds the power? Government
Regulators
Professional organisations
Civil servants
Lawyers
Hospital management teams
Team leaders
You? Mother?
We learn to be at the bottom of this hierarchy but there are far more of us than them!! This perspective is disabling
Collectivity and Community breaks free of hierarchy
We can replace the hierarchy with collectivity, respecting not just others’ roles, but valuing our role and being prepared to challenge and integrate our political will in to the discussions about our future.
Government
Regulators
You the midwife The mother The birth worker
Professional bodies
Team leaders
Managers
Civil servants
Lawyers Families
Administrators
Women & partners
Let’s build bridges not walls
• We can face the fear in midwifery and see it for what it is • a strategy to undermine and marginalise
mothers and midwifery
• The flip side to fear is understanding • what’s going on?
• We confuse fear with risk • Taking risk is balanced with judgement and
individual decision-making. Risk is personal. Fear suppresses
• Be constructive and connect with others • You are not alone
and…
Lest we forget
• Suffragettes achieved votes for women
100 years ago
• Use your voice and use your vote
Karen Guilliland
“Being a midwife is a feminist issue, so get on board with it”
Being a feminist is a political act as it opens us to different possibilities
‘Little midwives’, into great midwives grow
• Each political act becomes the sum of a bigger whole
• To empower we must find our power
• Empowerment is not a gift – it is ours to take
• Feminism is about addressing inequalities
• Addressing the imbalance of power
• Both for ourselves and…
• For women in our care
Develop your passion…and read
Read about my proposal for career pathways in midwifery post registration Midwifery Matters Issue 159 Winter
Reading by its nature is a political act
Through reading you:
• Broaden your horizons
• Discover how practice is much broader than you were ever taught
• Enables you to challenge the
• ‘This is how we do it here’ culture
• Read or listen to others’ stories
My Rolling Programme
• Teaching programme
• The ball as equipment • The ball as a tool for our tool box
• Shared understanding of how and why it works
Spreading the word was a political act
Shallow, H. (2003) My Rolling Programme The Birth Ball: 10 years experience of using a physiotherapy ball for labouring women In MIDIRS Midwifery Digest 13 (1) :28-30
Do one, see one, teach one?
And now birth balls are main stream in most
UK units
Advocacy and waterbirth
Taking ‘risks’ requires accountability
Being a woman’s advocate and accounting for your practice IS a political act
Being political
• is not about what you Should do • Should confers guilt
• is more about what you Could do • Could opens the door to possibilities
• is becoming aware & asking WHY • And developing your critical faculties
• being prepared to stand up and be counted • Compliance can lead to complacency and burn-out
• by holding on to your aspirations • Staying true to why you became a midwife
As it is, is not how it has to be
Extraordinary Damian Hurst exhibition in China 2018
Some well known strategies to tackle bullying behaviours
• “ I think you will find the mother is in charge, thank you”
• “Oh that is very interesting, thank you… No thank you”
• “If the breech is not descending don’t mess with it. Have a happy section”
• “No I am sorry I cannot do that, if you want it done, you can come and do it yourself. I will be filing an abuse claim”
• “What is your NMC/GMC registration number?”
Dedicated To Mary Cronk an authentic political Midwife
Thank you for listening
Questions Welcomed
