Bullying, Crap care, And Pigmy Leaders…

I wept today, I am feeling a little tired for sure and maybe it’s the cold that’s coming, but I think it’s the radio 4 interview with a midwife talking about her long career working in the NHS (through an actress due to a fear of being bullied).

In the stilted words of the actress I recognised my own experience of an environment ‘over’ managed by deeply flawed managers, true embodiments of the ‘Peter principle’, promoted beyond their level of competence, desperately struggling to keep their heads above water as the rising tide of audit paper threatens to drown them.

Over the years I have been told that things will get better, there will be more midwives (nurses etc) and in truth nothing really seems to change in terms of the raising demands upon the service not really being met with increased resources.

So often the governments response seems to be to ‘inspect’, or ‘audit’. When will we wake up and realise that culture and moral can not be managed from the out side in.

The values that took most of us midwives into the work are a long way from the profit driven motives of the market. We didn’t do it for the money and we still don’t, we just want to make a difference to the birth experience of those women we are with.

Yet I have heard midwives speak in horrendous ways to labouring women, I have seen managers seem to turn a blind eye to desperate staff shortages, I have talked to newly qualified staff who are leaving within a year of graduation to pursue different work. Some thing is desperately wrong and appointing a new hospital head of ‘Inspectors’ is definitively not the way forward.

Some one told me that some universities screen their applicants for the midwifery course with a maths test, the pass mark can be as high as 100%!

That got me thinking, maybe we have created methods for whittling down the thousands of applicants that leave those with the empathic skills required to ‘be with woman’ unable to proceed to interview?

My humble suggestion, first ask those who applied because of watching ‘call the midwife’, get rid of those who raise their hand. Then ask, who thinks ‘one born every minute’ show good levels of communication skills and care? Those who say yes, we say good bye to, and finally any one who gets over 80% in the maths test are on their bike as well.

I know some people think Odent is extreme when he suggests that only women who have had a good experience of the birthing process should be midwives and obstetricians, but he could have a point. At least lets discuss how we can attract and recruit compassionate people with values the underpin our age old commitment to be with women as they birth.

The Shy Hormone

He calls it the ‘shy hormone’, that quirky French genius, who’s steadfast commitment to celebrating a woman’s innate birthing brilliance has been a constant inspiration to me through out my career.

Most obstetricians I have worked with probably only consider it when ‘labour dystocia’ is present! The hormone with the mostest when it comes to allowing the birthing process to move forward to an empowering climax…is oxytocin.

We know a lot about what encourages oxytocin to be present in a woman’s body in abundance, just as we understand what can inhibit its flow.

A list of oxy-pro factors:

Being warm
Being private
Not talking
Feeling safe and loved
Dark environments
Familiar places
Deep relaxation

A list of oxy-antagonist:

Unfamiliar places
Tense body postures
Being inhibited regarding movement
Bright lights
Answering questions
Chit chat

That’s right, both lists are not exhaustive, you can add to them because you get the idea. Now think about arriving at hospital, knowing that your birthing is under way……..and suddenly it becomes VERY clear why the use of ‘synthetic’ oxytocin is on the increase (more about that in a longer post later).

Knowing these basic things about how our bodies have worked for thousands of years should inform our behaviour right? Hey, evolution is no slouch when it comes to efficacy!

Midwives knowing this CAN make a MASSIVE difference, birthing partners deeply understanding these ‘facts’ will know how to behave around their loved ones, I find a sense of hope rises up in me when I consider how simple it will be to facilitate ‘wickedly’ enriching birth experiences.

Men: when the woman you love is being taken over by an oxytocin fuelled trip,you are going to become an adrenalin factory! Why? Because when we were hunter gathers she needed protecting. She still DOES!

The difference now is that ‘fighting’ or ‘fleeing’ is not an option. Being present, as a protective ‘force-field’ of lovingkindness is your job, understanding what’s going on will help.