Nothing has changed much in 20 years really. Feels a little harsh saying that, but looking back we still have home birth rates under 5 %, there are still women told to hold their breath and push as their legs are put into the lithotomy position.
As I read that last paragraph I realise that what I call positive change, another midwife might not.
I speak to enough student midwives to know that all the practices I considered out dated back in 1991 are still going on, ‘guarding the perineum’, ‘flexing the head’, ‘breath holding with pushing’ ‘episiotomy to avoid an extensive tear’ etc etc etc
Firstly, I notice that the measures I use to decide how far our birth culture has moved are rooted in my own beliefs about what’s ‘good’ and ‘right’ midwifery practice.
That’s right, I believe in them.
‘Evidence’ in the world of health care is never to be beloved, it’s to be tested. The fruit of a robustly designed RCT never arrives at ‘True’, the best that can be expected is a ‘finding’ that points to ‘correlation’ between effects.
When ‘evidence’ is ‘believed’ there is always the possibility of the ‘faith’ in the ‘evidence’ morphing into a polarisation of the arguments, resulting in deep listening becoming impossible.
When faith replaces testing as a response to evidence, moralising is not a giant step away, and the resulting personal attacks on those who differ from us is a natural progression.
What could some of the answers be to this dilemma that we find ourselves in?
Few birth professional would disagree that our birth culture needs transformation.
I know in my own experience, that becoming aware of those areas of ‘professional birth practice’ where I have developed a ‘belief’ are a good place to start a self reflection practice.
When some one says or does something that causes a visceral response in me, you know the experience, you read a tweet, watch a Facebook link and feel like you want to punch someone in the mouth😔, those experiences have become like ‘flashing lights on the dash board’ to me.
I have a list of them, my powerful response has become a prompt to look deeper, what are they saying that I have missed?
I’m not a Micheal Jackson fan, but he wasn’t far wrong when he pointed us to the mirror as our starting place.