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How To Win Midwifery Debates Online

How To Win Midwifery Debates Online

The image for this blog is me moderating, in a heatwave. I run The Secret Community for Midwives in the Making, the 20,000+ member Facebook group that discusses all things midwifery.

We’re having some challenges at the moment. I've needed several glasses of wine and long runs. Don't feel sorry for me - I chose this job and for the most part I love it. But I have some things to say.

Topics like breastfeeding, abortion, circumcision and vaccination frequently come up. While this is brilliant and we get to hear opinions and stories from across the planet, they’re also subjects that make us vulnerable.

Often debates turn into anger. As the group grows, this is getting more common.

I’m aware that some people can campaign for better care using anger – but I’ve never been that person. I’ve always been quick to cry when I’m angry and that’s not a very persuasive place to start debating from.

In the Secret Community, we have one main rule which is that every post and comment has to be written in an overtly kind way.

Passionate debate is fine but anger or contempt directed at someone isn’t.

The reason for this emphasis on kindness is that I’m at the helm. I didn’t think for a moment that The Secret Community would end up this big but it has, and because I’m in charge, we’re going to have to do things my way.

This means being extravagantly kind, even when you disagree with who you’re debating with. Even if what they are saying is in your opinion, unsafe or disrespectful. Contact a mod by all means and we'll follow our procedure, we sometimes get in touch with trusts or universities and we have a policy for what to do if someone's letting us know they want to hurt or kill themselves (it happens).

But don't start or engage in a fight about midwifery issues.

This rule is because, in my experience, an angry debate in an online setting doesn’t usually change anyone’s mind.

People typically have one response to anger and that’s to get angry back. Even if they agree with you in principle, if you have fighting energy they will likely have a similar response and you’ll get nowhere.

Think about it – when was the last time someone was shouting at you and you listened and changed your mind?

People don’t say ‘oh yes, you’re quite right. There is something fundamentally wrong with me as a human and mother. I’ll change that at once!’

They just think, what a horrible person for making me feel this way.

What might be better is staying calm, or if you can, using humour? Not sarcasm directed at the person but just something to get rid of the tension. It often builds bridges and then you can teach.

This is why I often start my moderation posts with something like ‘oof, G and T time for the mods!’

It helps get us back to human communication.

Notice I'm not saying 'keep your opinions to yourself'.

I'm saying be kind.

I know. It’s not perfect.

Many of you will be saying that nothing will stop you fighting for the rights of women. That if we can’t handle flashes of anger then we can’t be good midwives and censorship of any kind is wrong.

But the internet has some dark holes of horrible comments and threads which make most of us lose faith in humans. I’ve seen these in the context of midwifery and I’m not willing to be responsible for a community doing this, especially not one debating such important subjects.

If I and the mods stopped moderating, the community would go feral, you know it would.

In the Secret Community, if our policy of kindness means removing members, even if they’re esteemed midwives who we really respect, we have to do it.

It's 'just' a Facebook group. But everyone gets to have their own corner of the social media world and this is ours. If you'd prefer a different kind of moderation, please set up your own group for angry debates. I'd totally support it if you can find a way to get it working!

We have a truly amazing moderator team who do so much behind the scenes and I can’t let them down either.

Keep it kind, everyone, please. Online midwifery will be better for it.

Much Love and RESPECT to all x

(This post was directly inspired by Caitlin Moran, one of my feminist idols, and Reni Eddo-Lodge, who wrote ‘Why I’m No Longer Talking To White People About Race' – both are angry at injustice, both using techniques other than anger to teach and change things).

P.S. Let me know your thoughts in the comments.

August 8, 2018 1

Women With Big Families – do we unthinkingly offend them?

Women With Big Families – do we unthinkingly offend them?

Would you know what to say to a woman with four or five, or even ten or more children?

Finding the courage to speak up about something isn’t easy. Today’s post is from Rosie Brown, mum of five, who's expecting number six. She's an aspiring midwife and her open letter to women and midwives is about having a large family and some of the comments she’s received from medical professionals.

'Dear Ladies and Gents,

Would you take a moment to listen? I promise you will be a blessing to others like me.

I'm an aspiring midwife and now I guess I am a 'Grand Multigravida' too.

I've had something on my weighing on my heart for a while and it's been stirred by the opening scenes of One Born Every Minute series 11.

There's a lady expecting her 6th baby and the midwife says something along the lines of "haven't you worked out what's causing it?"

Future and current midwives. We might laugh it off and make a funny come back like we don't care, but do you know how exhausting this is?

Every day, every week when we are out with our children, here is what we encounter, from complete strangers.

"Don't you know what causes that?"

"Don't you own a TV?"

"Aren't you a glutton for punishment."

"Wow, how old are you?"

"Do they all have the same dad ?"

"Don't you know what birth control is?"

"Are you done?'

And then to have your midwife or health care assistant do the same when you are vulnerable can be overwhelming.

We sit on a ward listening to midwives go to other couples with 1 or 2, even 3 kids, and there are sweet and reassuring comments.

And then it's our turn.

For whatever reason, parents with big families don't get reassured.

Last week I was in A&E and a health care assistant was taking me for a test, and do you know how relieved I was when he said "Oh how lovely! Your house must be full of fun! Did you always want a big family?"

Us proud mums will probably answer willingly all the above as we chat about our kids, but this question was the correct one to ask.

Personally, we are Byzantine Catholic and my husband is training to be a priest and yes we did always want a big family, and I'm happy to tell you that. But 'Are you done?'.... that's an immediate judgement and I suddenly feel like as you check my cervix I have to justify my entire life, my religion and my sanity.

Please take a moment when encountering a big family to think about your words.

Just because this is our 6th or 10th baby, doesn't mean we aren't every bit as delighted and excited as if it was our first baby. Whether you agree or not, we come for support. Not to be shamed.

Thank you for listening if you made it this far :)'

 

I personally don’t believe any midwife will mean to be unkind but in our society, we tend to comment on mothers and their choices. Especially if there’s something unusual about them.

Seeing things from a woman’s point of view amidst busy practice and the rocky terrain of trying to keep humour and connection front and center is hard.

I think Rosie’s post contains valuable insight. Especially about the healthcare assistant with the kind and thoughtful comment, this is a great example of being with woman, understanding what it must be like to lead her life and talking with her accordingly.

As Rosie says, thanks so much for reading this!

And thanks to Rosie for writing it, it's brave and how gorgeous is her family?!

Do you have anything to add – have you cared for a woman with a big family? How did you talk about it? Or are you from a big family, is there anything else we should know?

Leave a comment below.

Much love xx

 

August 1, 2018 3

A New Way to Train as a Student Midwife in the UK

A New Way to Train as a Student Midwife in the UK

Not to sound like mystic meg, but I knew something like this would happen.

After the bursary went, I think many of us thought it was only a matter of time before midwifery applicant numbers went down. And the obvious solution to that is to provide some more funding to get midwives into the profession.

I’ve been stalking the RCM website for news about this situation and of course, up popped a post on ‘Midwifery Apprenticeships’. These courses are currently being created, looking to take their first midwifery candidates in 2019.

It’s big news for anyone wanting to become a midwife in the UK.

Apprenticeships train you while working and the government pay course fees while you receive a wage.

I love the idea – you shouldn’t have to pay for your qualification and getting a wage on the job is an even bigger endorsement of the importance of midwives

But I’m gutted for the students currently getting a midwifery degree and paying for their course fees as well as taking out a big loan so they can live.

The course fees only disappeared in 2016/7 and at the time the government seemed to think they’d get even more midwives applying. Something about student midwives being able to borrow more money so they’d be more solvent while training.

I don’t think anyone was fooled by the concept of having more debt being better for us, but regardless some aspiring midwives love the profession so much they chose to train regardless.

But some couldn’t, for financial reasons.

There is the argument that a midwifery degree is a higher qualification worth paying for. An apprenticeship might not open up as many options, especially if you want a Masters or to go into research.

But as a route to becoming a practising midwife, it’s a solid option.

In terms of whether midwives need to be academic and have a degree, there are a few ways of looking at it.

A degree can give you the skills to assess research and this is needed to practice with critical awareness. But frankly I have a degree and the most I’ve understood on this subject has been from Ben Goldacre’s ‘Bad Science’ and there excellent free podcasts and blogs that can teach you this stuff if you’re motivated.

There are plenty of midwifery mentors out there who don’t have a degree or a diploma and they seem amazing at their jobs.

I suspect that different strengths on the shop floor is a good idea; if some midwives come from apprenticeships and they’re amazing at co-ordinating a busy ward and dextrous at tricky clinical skills, and some midwives come from degrees with advanced knowledge of research, women will get better care overall. Different training options might help us play to our strengths.

So good might come out of this situation yet.

I can’t help but be frustrated about the government taking away the bursary and then having to address the lack of candidates with an apprenticeship. Could they not have just listened and left things as they were?

Adapting to the political situation has always been part of a midwifery role, however 🙂

What are your thoughts?

Are apprenticeships a good idea, helping bring practically minded midwives into the profession?

Or is it unjust to the midwives currently training and paying for their courses?

Let me know in the comments!

Much Love, Ellie x

P.S. Yesterday my novel 'New Walk' went to print.

I spent four years working on it.

I'm so grateful to have been able to complete it, for the experiences that led to it, for the guts and soul of midwifery that I was able to spend time with while writing, for Pinter & Martin deciding it had a place on their list.

I'm a little sorrowful that I don't get to spend time writing inside this book anymore but mostly joyful.

Thanks for your giant-hearted support.

Time for a glass of wine ?

Links for New Walk:

Available for preorder from: https://goo.gl/iV9z6C

Kindle version available for preorder at: https://goo.gl/nJJ1WK

July 25, 2018 26

‘Look at my face, not my uterus’ – Your No Guilt Pregnancy Plan

‘Look at my face, not my uterus’ – Your No Guilt Pregnancy Plan

I’ve read quite a lot of pregnancy guides and I wasn’t sure there was much call for another one.

With the burst of amazing writers releasing things like ‘Birthing for Blokes’ and ‘The Positive Birth Book’ I thought it was covered.

I was completely wrong.

This particular birth book is designed for any pregnant woman who feels like a bit of iron filing caught between two magnets.

Rebecca Schiller is a doula, journalist and campaigner for women’s birth rights.

The book is snappy and balanced and talks to women like they’re intelligent. Not that other books don’t, but it prioritises making the reader feel in control.

It gets into the choices that need to be made in pregnancy and how they can impact us mentally. Overall it has a kind approach that fosters sensible self-belief and it focuses on preventing guilt.

It made me sad to recognise how crucial addressing guilt is.

But it’s a strong and unusual woman who manages to avoid feeling bad about her choices as she becomes a mother.

According to our society, ‘successful’ women are supposed to be thin, pretty and accommodating of others’ needs (study). The scope for us feeling bad is pretty big even before pregnancy.

I believe that pregnancy can hothouse shame because of the physical and personal needs that conflict with how women ‘should’ look and how they should feel about their child.

Self-care is something we talk about but it’s a hard concept to get to work in real life when we’re all so busy and focused on the people we love.

Rebecca’s book covers all the standard information needed. From screening to cord clamping to infant feeding, the facts have been collected and presented well, with resources for those who want to assess the science further.

Mental illness is addressed and it’s great to see the unspoken fear tackled – many women who suffer from depression worry about having their baby taken away and so don’t ask for help. But as Rebecca mentions, the odds of a child being removed purely because of depression are next to zero.

I won’t go into every topic mentioned but I was impressed by the breadth. The only thing missing is race – women from black and ethnic minority backgrounds experience a different story in pregnancy which ultimately puts them at higher risk. It would have been great to see this addressed in detail (I’ve become more aware of this social injustice problem in the birth world recently).

My way of telling if a pregnancy book is successful or not overall is ‘would I send this to my sister (a neuroscientist researcher) if she was pregnant again?’

I absolutely would – it’s more like a letter from a well-informed best friend than a pregnancy guide. And the vignettes included from the experiences of women help illustrate how different we all are. From those who wanted an epidural, to those who find masturbation in labour helpful.

The weird thing was, 'Your No Guilt Pregnancy Plan' was even useful for me personally. I’m not pregnant but everyone needs reassurance about trusting yourself when overwhelmed with options and choices.

I suspect that we all have these mental hurdles. It’s just that in pregnancy they’re more intense.

I enjoyed the way Rebecca presented it all as a challenge to develop self-trust, not an ordeal.

Now I’d love to hear from you.

Have you read this book? What did you think?

Do you think women face guilt in pregnancy? How do you address this as a student or midwife?

Leave a comment below!

July 19, 2018 0

Why I’m No Longer Ignoring Racism As A White Person

Why I’m No Longer Ignoring Racism As A White Person

You know those books that you read and feel yourself being changed? I think it's called 'internalisation'.


This is one of those. Especially if you're white.

Reni Eddo-Lodge is a journalist and author who wrote the book 'Why I’m No Longer Talking to White People About Race'.

Her work focuses on racism and feminism. I think it's the exhaustion in her tone that gets me.

Did you know:
  • A slogan put about by the Conservative government was 'if you want a nigger as your neighbour, vote labour' - this was 1985
  • Children of colour get marked down in school
  • But when their work is assessed independently under a white British sounding name, they get the grades they deserve
  • Bristol was a slave port and the UK has a lot of its wealth from black slavery
  • Black and ethnic minority women are three times more likely to die during childbearing.

It's a hard one. If you're white, you might be thinking 'well I'm not racist'.

I believe you. But we live in a society that's got racism baked into it. Not our fault. Still our responsibility.

Reverse racism hits the news sometimes. White people being at a disadvantage because people from a black or ethnic minority group are discriminating against them.

The problem is that reverse racism doesn't happen in a way that takes meaningful power away from white people.

White people might find themselves in a single situation - say working for an ethnic minority family who pass them over for a promotion in favour of someone from their own background - but that white person will have more many opportunities over the course of their lifetime based on their ethnicity.

Ethnic minority groups literally do not have enough people in positions of power to even begin to level the playing field.

I think it's so important for midwives and students to be aware of the tension and inequality that black and ethnic minority people face.

 

I'm not saying white people don't have adversity or don't work hard. I had my first job at age 12 and I've worked ever since then. My family was often financially insecure when me and my siblings were growing up.  I've faced sexism as well, in a workplace that still thought the men were more likely to be correct than the women.

 

It's just that there's a huge bias that black and ethnic minority people have to fight against all the time. You can't really fight against sexism without understanding racism. You miss so much of the picture.

The problem is to understand race as a white person, you need to put your own way of seeing the world on hold. This is pretty much impossible. The only way to do it is to think of a time when you've been so frustrated that someone couldn't see the inequality in a situation.

For instance, many women will have had a conversation with someone who doesn't see the point of International Women's Day as there's no International Men's Day.

I've been in a situation where I've been frustrated to tears trying to get a guy to understand why International Women's Day is important.

The risk of FGM, pay differences, the tension women face balancing having children and a career etc. It falls on deaf ears. It's like it doesn't even exist.

This is what black and ethnic minority people are trying to tell us. There's a whole existence in parallel with ours as white people. We're blind to it.

It's not for me to tell anyone what to do but I'd encourage you to read Reni Eddo-Lodge's book, listen to her podcast, or listen to Sprogcast, the episode with Doula Mars Lord.

Listening and understanding is only fair.

But also, if like me, the best bit of midwifery or caring for others is the privilege of understanding their stories: there is so much more to learn.

So many more ways of existing in the world to get to know.

I find this exciting.

Now I'd love to hear from you.

Please comment, especially if you're from a black or minority ethnic group, especially if you think I've left anything out!

Or if you're white - do you already know this?

Much Love,

p.s. I don't feel wise enough to write this. But I have a platform and I'm white. Even if I get it wrong I need to be trying. Feel free to correct me and please know - if I have made mistakes or caused offence, this is due to my ignorance, not malice. I'll keep learning, I'm sorry I and others haven't noticed in a meaningful way until now and I'm LISTENING.

July 11, 2018 6

Being a Doula with 4 Kids, How to Cope and Birth Magic [Audio]

Being a Doula with 4 Kids, How to Cope and Birth Magic [Audio]

'When I walk in it's like a part of me extends to her. I put my own stuff in a box. It's like my heart grows for her.'

I spotted Doula Katy Hemmus leaving wise and insightful comments about birth in The Secret Community. After following a few threads knew I wanted to talk to her properly.

The way she describes entering the birth space is so inspiring - Katy doesn't use the phrase 'birth magic' but the way she talks about supporting labouring women makes it clear it's transcendent for her.

(more…)

July 4, 2018 0

‘New Walk’ – My Midwifery Novel

‘New Walk’ – My Midwifery Novel

Fiction and autobiography were what made me realise midwifery was what I wanted to do.

But, much as I love Call the Midwife, I wanted to read a modern NHS novel. Something that showed the hang-on-for-dear-life pressure of being a student midwife in the contemporary UK. I couldn't find it, so I started writing. An hour a day, almost every morning, usually around 5am in a state of high caffeination, for four years.

(more…)

June 28, 2018 46

Some Thoughts on Infant Loss from an Incredible Dad (Fathers Day Post 2018)

Some Thoughts on Infant Loss from an Incredible Dad (Fathers Day Post 2018)

I was not at all experienced when I first cared for a family whose baby had died.

 I can remember crying my eyes out in the middle of labour ward because it was just too painful. Luckily, I had an amazing manager who gave me continuity with the family in question and I was able to follow them for 3 days worth of shifts. Their little boy had been stillborn after a complicated labour.

(more…)

June 13, 2018 1

8 Responses

  1. Hi I’m 12 and hope to become a midwife when I am older do you have any tips or know anything I could work on now towards it??

    • Hi Katie, thanks for you comment, wow you’re very focused at such a young age! I would come and subscribe to midwifediaries.com for free blog posts on midwifery which are up to date, I have fun with them too so they’re good to read! Volunteering with people is always a good thing to do to develop your transferrable skills, could you get involved via your school with any caring volunteer positions? I’d also start to read everything you can get your hands on midwifery wise, and perhaps come over to the Secret Community for Midwives in the Making on Facebook for an idea of what midwives talk about x

  2. I love your blog and am currently reading your book. Unfortunately, I am from the US so the educational path and such is much different than what you describe in the UK. Do you know of any American midwife blogs? I’ve tried searching online but most are very, very established in their careers and the things they write about are so far off from where I am in my journey to be a midwife.

    • Hi Alicia,

      Great question! I don’t know many American midwife blogs sadly, though MidwifeThinking is a great Australian one, and SaraWickham.com is one of my favourite UK ones. Please do let me know if you find any good American midwife blogs, I’m always on the lookout! x

  3. Hi Ellie,
    I just wanted to share a bit of the furore that is occurring in the Queensland state of Australia. Obstetricians are moaning about the poor outcomes etc etc of midwifery led care. http://www.couriermail.com.au/news/queensland/ama-queensland-seeks-urgent-change-to-way-maternal-services-delivered-in-queensland/news-story/5fa372d6478e4cdbba9de7977df224e1
    I thought we were passed all this but apparently not.

  4. Pille

    Hi Ellie,
    I’m a first year student midwife, and would eventually like to work as a midwife on First Nations reserves in Canada. Do you have any contacts who have trained as a midwife in the uk and moved over to Canada? Or do you yourself have any idea how the transfer would work?

    • Rachel Wild

      Hi Ellie – if you particularly want to work for First Nations’ families I would first contact some of the Aboriginal health organisations or governance bodies to scope out how they would see a midwife from the UK working out. Perhaps you have First Nations/ Aboriginal heritage yourself, but if not you’d need to consider the implications of working as a outsider in communities that have a history of colonialism harming their existing birth cultures. e.g. http://www.naho.ca/midwifery/ also your immigration and work visa would be through the Canadian government but perhaps you could also ask permission of First Nation government for the area you’d like to practice in?

  5. Miroslava

    Hi Ellie, i am a second year student of midwifery in Slovakia.
    I would like to ask you, what’s your posture for needs of women who are in puerperium ? What is your opinion for lactation and sports activities in postpartal period?

    Thanks, for answer 🙂

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