The politics of midwifery: Looking to the future - Dr Helen ED Shallow Midwife, writer and presenter. and Accidental Activist ...
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The politics of midwifery:
Looking to the future
Dr Helen ED Shallow
Midwife, writer and presenter.
and Accidental Activist
helen.shallow@btinternet.com
Twitter: @Helen_Shallow
Maternity Festival Leicester April 2019
Context Matters
Introduction
• My political journey: Some stories
• Interpretation of midwifery politics
• Hierarchy, or collectivity and
community?
• Touching on activism and feminism
• The power of reading
• Moving forward
• 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
• The woman with red hair
• My Rolling Program
• Advocacy My last working day at Scunthorpe
as a labour ward co-ordinator & AMP
Moved on to consultant midwife post
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
The story of the woman with the red hair, faeces and tears
My Rolling Programme
Do one, see one, teach one?
• Teaching programme And now birth
• The ball as equipment balls are main
stream in most
• The ball as a tool for our tool box UK units
• 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
• ‘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.’
What is politics? (Collins Dictionary)Advocacy and waterbirth
Taking ‘risks’ requires accountability
Being a woman’s advocate
and accounting
for your practice
IS a political actThe NHS is a political football, used by those in
power; but who holds the power?
Government
Regulators
Professional organisations
Civil servants
Lawyers
Doctors
Hospital management
Team leaders
You? Mother?
We learn to be at the bottom of this hierarchy but there are far
more of us than them!! Hierarchies are disablingCollectivity and Community breaks free of
hierarchy
You the midwife
Civil servants women as mothers
Administrators
birth workers
Regulators partners
Professional Government
bodies
Team leaders
Managers
Families
Lawyers
Doctors
We can replace the hierarchy with collectivity, respecting not just others’ roles, but
valuing each others’ role and being prepared to challenge and integrate our political
will in to the discussions about our future. We are a part of the WHOLEBeing a midwife is
a political act:
Imagine-
• Midwifery as 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 evidenceKaren Guilliland “Being a midwife is a feminist issue, so get on board with it” To be ‘feminist’ in any authentic sense of the term is to want for all people, female and male, liberation from sexist role patterns, domination, and oppression.” bell hooks Being a feminist is a political act as it opens us to different possibilities
Effecting change through a feminist lens
‘…to achieve meaningful change, actions must be
directed at transforming the systems that women
(midwives) work within—making approaches informed
by feminist analyses essential’.
‘Gender equity is not only a matter of justice and rights,
it is crucial for producing the best research and
providing the best care to patients [Women]’.
(Lancet Commentary 2019)Being Political means stepping
out of your comfort zone
Being
• Willing to work in 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
Philomena Canning RIPTo 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 possibleLet’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…Let us not forget
• Use your voice and use your vote
• College elections
• Local council elections
• National elections
• Lobbying your MP about local
services
• Commenting on consultations‘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
Midwives cannot be
Preceptorship
‘Jill of all trades’ Work in all areas
But together we COULD provide Equal weighting to all models.
Continuity of care Choose your career pathway
Develop the ‘additional
needs’ competencies
Keep the complex
Pre registration For post-reg on going
Focus on the mother, development
babies and families
Relationships
Continuity of care
Recognition and
Referral The Continuity of The acute
1st line emergencies care midwife obstetric midwife
Complex Partners in care Complex medical
Social skills Not rivals obstetric skills
Mutual respectDevelop your passion…and read
Read more about my proposal
for career pathways in
midwifery post registration
Midwifery Matters Issue 159 Winter 2018Reading by its nature is a political act Through reading you: • Broaden your horizons • Discover how practice is more varied than you were ever taught • Enables you to challenge the ‘This is how we do it here’ culture • Read or listen to others’ stories
Moving Forward
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 2018Some 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?”
• Do you know how that makes me feel?
‘Saying NO TO BULLYING’ is a political actDedicated To Mary
Cronk an authentic
political Midwife
Thank you for listening
Questions Welcomed
helen.shallow@btinternet.comYou can also read
