Transforming Birth Cultures ? Getting to a group yes……..

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.  

  

‘Are Our ‘Presuppositions’Driving The Bus’?

We have a history of just not getting on, any group that is seeking to be run by consensus will tell you it’s not always easy.

In the U.K. We have a parliamentary structure that is adversarial, our judicial system is likewise based on similar presuppositions. 

There in lies the ‘rub’, for human beings it seems that what is ‘presupposed’ directs the attention of our meaning making.
  

We are just bombarded by so much sensory data every second of the day, there is just no way we can ‘make sense’ of it all😔
 
  
Thankfully much of our meaning making work is taken care of by unconscious processes, phew. If that wasn’t the case we would be completely overwhelmed. 

Having said that the process works well, one caveat that needs to be highlighted is the power our ‘unconscious presuppositions’ can have over our ability to ‘truly’ understand the perspective of someone who disagrees with us. 

A question I often ask myself when I notice how strongly I disagree with someone is : 

‘what could some of my presuppositions be, that I am not consciously aware of, that are driving my strong feeling’?

And a follow up question:

‘And what are potentially some of hers/his’ unconscious presuppositions’?

I tend to find loads of fertile ‘self discovery’ in the answers and more consensus in my relationships as a result.  
  

‘Money ball’ The Film: What Does It Teach Us About ‘The Maternity Review? ☺️

Billy Bean, played by Brad Pit has just taken a baseball side beyond what it ‘should’ have been capable of accomplishing.

He has done it using a ‘way of thinking’ that, until this point, had never been applied to baseball before.

The clip below is him being offered a ‘big money’ opportunity to take his ‘system’ of management to the highest level.

Have you watched it? If not do it now! The rest of this blog will make more sense.

What, I hear you saying has the Baroness and Brad Pitt got in common?

The Baroness was certainly one of the ‘first through the wall’, way back in the early 90’s she headed a review committee that recommended ‘continuity of known midwife’ for women who were pregnant, some of you probably remember it? Right? Changing Childbirth.

I remember being so excited about the fruit of her work back then and it spawned a wealth of innovative projects designed to achieve what women were asking for.

I was deeply involved with a case load bearing experiment that culminated in a home birth rate of 18% locally and women getting what they had said they wanted regarding knowing their midwife as they gave birth

In the years that followed things didn’t work as we all expected, and baroness Cumberledges’ vision experienced ‘bloody teeth’, being the ‘first through the wall’, she paved the way.

With the publication of the recent ‘maternity review’ report she has demonstrated her heroic commitment to pregnant women and their families. She has wiped the blood from her mouth, and come out swinging.

The report leads with what seems to be a deeply felt need of pregnant women to be given choice, and for that choice to be expressed through a growing relationship with a midwife she knows and trusts.

All of this leads me to ask the question, what stopped her 20 year old report from having the impact that we hoped for, bearing in mind that this 2016 report seems to echo many of her early 90’s insights?

The ‘moneyball’ clips hints at what some of the reasons might be.

What the report is doing is ‘threatening the game’ of how birthing structures are set up currently, and those in power will probably respond, (of course on the surface based on what they ‘perceive’ are the needs of pregnant women ), defensively, why?

Because at a deeply unconscious level they are afraid, this fear, the fruit of millions of years  of evolvolutionary adaptation has been tested over time, and it has worked perfectly; we are alive aren’t we?

It’s deeply rooted in the human animals need to survive.

I’ve watched the debate on Twitter and Facebook with a painful recognition of this pattern out working, the personally focused attacks made by both sides of this polarised subject bear sad testimony to the ‘fact’….😔

Nothing new with come of this fabulous report if we all don’t learn from the ‘truths’ expressed in the film clip you have just watched.

It’s time for a root and branch transformation of how our institutions support women and their families in this country.

Will we, as a professional birth community, have the insight into, what is a visceral human response?

Will we stop long enough to really hear what those who oppose us are saying?

Only then will we be able to move forward together, into a period of time where birthing women are offered the kind of service that truly honors the brilliance that resides inside them.

Birthing woman have ‘inside out’ power, and we professionals have the awesome privilege of ‘just’ pointing in the direction of that innate genius☺️

Do You Love Money Or Hate It With Passion? Financial Confessions Of A Birthworker…..

I realised recently if I treated my loved ones like I treated ‘money’, they wouldn’t want to be around me😔.

If I imagine for a moment that ‘money’ was a person, I have said ‘I hate you’, ‘you make me do things I don’t want too’, ‘you control my life’, you are dirty and do bad things’, ‘secretly I want you and I’m ashamed’, ‘I’ll do this or that, but it’s not for your sake’, these are some of the ways I’ve behaved towards ‘money’.

What if I loved ‘money’ like a friend? How would ‘money’ like to be treated? What ways of behaving encourage it to spend time with me? What does it like? Etc etc, you get the idea right?

Then I thought, when ‘money’ likes to be around me, when I truly ‘love money’, what could we do together? What experiences could we create to benefit ourselves and others? 

Well, we could feed the poor, support our loved ones and our extended family (the world), create a butt kicking birth worker awards event and we could go on holiday……☺️

I love money, but this love is morphing into a love of my family (the world), for too long others who understand how money likes to be treated have been hoarding the benefits of having it to themselves.

  

Language Power: The Inocent Miss Use By Birth Proffesionals…..😔

‘You did very well indeed’, ‘it’s just that you ‘failed to progress”.

What? ‘Failed to progress’!!? 

Please forgive my use of exclamation marks this Monday morning. I am a little tired after a wonderful day in Bristol hanging out with midwives, student midwives, doulas and antenatal teachers, tired but tiredness tinged with elation, I’m going to miss these workshops for sure. 

It’s hard to believe that knowing what we do about how the words we use have the potential to direct another’s internal ‘meaning making journey’, to even ‘shape’ the ‘story’ she lives in as she cares for her new born, we still have ‘phrases’ like ‘failed to progress’ in our obstetric vocabulary? 

When you consider the hormonal imperative for nurturing and supporting that ‘shy’ hormone oxytocin, and the links that there seem to be between the intimate context ‘required’ for women to be able to ‘release’ herself into orgasm and the ‘birthing process’ working well, to even suggest that woman a woman ‘failed to progress’ is nothing short of a scandle. 

Charles Darwin, when speaking of poverty said :

‘If the misery of the poor be caused not by the laws of nature, but by our institutions, great is our sin’.

As I reflect upon his words it occurs to me that in some ways it is too often the failing of our ‘birth institutions’ to create suitable environments for birth that are the ’causes’ of a woman’s birthing experience to be less than optimum. 

‘Failure to progress’? 

No! Our response should be ‘sorry’, ‘we failed you’😔.

  

Habits? If I could stop doing it ‘consciously’ I would have stopped already, right? 

If wasn’t ‘weight loss’ it was a tendency to drink too much or smoke (and now ‘vape’), or become so irate about midwifery ‘practice issues’ that I looked and sounded aggressive. 

Each of these areas of my life over the years has caused me and others pain, at times my life was coloured by them and I felt deeply that I wanted to change, I tried loads of ways of ‘being’ different and time and time again I ‘failed’. 

No mater how hard I tried ‘consciously’ and how many ‘self help’ techniques I learned, that sense of being trapped inside behaviours that just wouldn’t go away seemed to be the ‘colour wash’ of my life. 

So, 27 stone later, widowed, and depressed I hit what felt to me ‘rock bottom’. 

It was around this time some 8 years ago, ‘I’ kind of ‘woke up’, and it took the human being I loved the most in the world at the time, breathing her last in my arms. 

I’ve realised since that ‘waking up’ to what’s really running our lives doesn’t have to take a sledge hammer, who knew? 

An ‘insight’ will do it, a moment of ‘awareness’; for me it was noticing that my ‘internal conversation’ or ‘thinking’ had a mind of its own, I didn’t need to ‘will’ my thoughts into being, they just happened. 

If you don’t believe me test it out, sit for 10 minutes and just count your breaths to 10, ‘try’ to stay with the count only, and see what happens? 

All communication between human beings is driven by unconscious process and our most fundamental relationship, the one we have with ourselves is no different. 

I came to understand that my life was almost being lived ‘automatically’ based on these less than conscious internal ‘conversations’, which in turn, had feeder ‘stories’ which I had been retelling myself for years and years. 

The starting place for crafting a ‘story’ I wanted to ‘live in’ began when I started to notice the power of my less than conscious mind to to create a kind of ‘direction’ for the focus of my life………bringing ‘conscious and less than conscious process’ into harmony is a life long ‘event’.

Habits you wanna change? My starting point was noticing the internal ‘stories’, that felt real, but only really existed in my ‘head’. 

Who knew?

  

Theory Practice Gap: Myth or reality? 

I was chatting to a group of student midwives recently, and casually asked, have you ever experienced practice in the ‘clinical areas’ which just didn’t fit with the stuff you have been taught at university? 

The answer was quick in coming: ‘have we ever’!? One of the 3rd years almost shouted, ‘on a daily basis’! The group went on to recount episode after episode of encounters where mentors had behaved in a way that directly contradicted what they had been reading and learning from lecturers.

To be honest I was not surprised, when I qualified in 1994 we where having the same conversations, if it wasn’t ‘coaching pushing with breath holding’ it was using the ‘lithotomy position’ to speed up the birth.  
What is going on? 

When will this mad ‘theory practice gap’ be bridged? When will newly qualified midwives enter practice confident that they won’t have to ‘battle’ out dated practices that they know are, if not wrong, not the best we could be offering pregnant women and their families? 

Seems obvious to me, because of the way we are ‘wired’ to learn mentors in the clinical areas have more power to influence the practice and learning of student midwives than academics. 

It’s simple really if we reflect on our own experience of learning, I hate to say it but my children are walking in the footsteps I thought I covered up. 

All learning is a deeply unconscious process, we watch, we listen, we imitate, our behaviours are the outflow of what we have modelled from those around whose opinions are important for our survival.  

Hey, I know getting on with your mentor is not a ‘life or death’ issue, but when you’re a student it feels like it right? 
If you are going to survive the course and at some point fit into the workforce your behaviours have to become consistent with the spoken and unspoken rules of the institution. 

What is the answer to the ‘theory practice gap’? 
I’m guessing there isn’t one answer, but seeking to point midwifery education in the direction of the ‘old paths’ would be a good place to start; an apprentice model rather than a purely academic one. 

‘Wise woman, with wise woman’, the lecturer being in practice with a ‘caseload’ of pregnant women and small group of students that they work with day to day. 
The students are guided in their reading and reflection outside of the times when they are just being with their midwife/educator/mentor, no separation between what they are learning and what they are seeing, hearing, experiencing every day as they ‘become’ midwives. 

Imagine many, many, birth educator/practitioners each with a small group of students, little or no classroom work, yes, lots of study, writing and reflection but outside of the times that students are just with women as they birth, learning from their ‘wise woman midwife’. 

Mad? Maybe, unworkable? Probably, but something needs to be done, if the current situation is to be reversed.