I know this is a highly controversial topic and many people have strong views. But can we talk about midwife uniforms?
Many midwives love them; they give you professionalism, make infection control easier, and make you feel part of the team - and I used to feel that way too.
When I first qualified we had these gorgeous white uniforms with ornate silver belts that drew our waists in. We looked flash.
But then, after shift, in that blissful silent moment taking off my uniform, I thought about it. And I realised I was getting a different reaction from women when I went on to labour ward in my own clothes.
I got more hugs.
I got more emotional information up front. I was feeling different, like I could be more empathetic.
And this was reinforced when I went to work in New Zealand where there are a lot of independent midwives and so hospitals don’t enforce uniform policies. This meant as long as I looked professional, I could dress however I wanted.
I went for black trousers and bright coloured tops and I felt more like me. I was still professional but I brought myself to work. I think it made me a better listener, and more empathetic.
Because to be empathetic you have to let yourself be vulnerable. You have to feel what the other person is feeling.
Can midwife uniforms can be a boundary to relationships?
I’d argue yes, especially for women and families who react strongly to authority. Many birth centres in the UK don't have uniforms for this reason.
I just watched this Nursing Council Debate on uniforms, and found out 75% of the nurses who took part wanted every NHS clinician in a standard uniform.
I feel this is a bit oppressive. I'm not sure uniforms are always appropriate for modern caring professions.
Nurses uniforms originally developed from the Nun’s habit and I don’t need to tell you how strange this is in a modern day context.
When the army first came up with uniforms it was so they could identify people deserting, or to intimidate other forces. Later on they used uniforms for camouflage, and I’ve yet to come across a midwifery situation where camouflage would improve things!
I know there are arguments about not being able to spot a nurse/midwife very easily if staff aren’t in uniform – but I think big, visible name badges and clear, large IDs would be a good way to get around that.
People also argue uniforms gives a sense of professionalism and show we’re organised. But I’d argue we achieve that quality just fine by acting with professionalism and actually being organised.
If midwives didn’t have a uniform, we’d end up with staff who acted and looked professional (as there’d still be a dress code), but who felt like themselves, were dressed in things that actually fit them, and who weren’t...conforming.
In fact, it’s all said in that poem ‘When I’m An Old Midwife I’ll Wear Purple’ – it talks about being standardised by uniforms.
As midwives we’re supposed to speak up when things go wrong, and advocate, not just go with the flow. Isn’t an enforced uniform at odds with this?
Back to how it felt in New Zealand - the culture of the care was different, because you’d be dressed in a way which said ‘I’m here with you. I’m not standing above you because of my practice. It’s a partnership.’
I believe even the few midwives who chose to wear uniform benefitted from this.
Maybe in nursing, or other professions it’s more important to have a uniform to make sure there’s that professional boundary (and slight authority?). I honestly don’t know.
But I think in midwifery, the vast majority of women want to have a partnership with the practitioners looking after them.
They’re healthy and normal, they just want to process a huge life event.
I think care could be more compassionate if we were allowed to wear our own clothes.
The final thing to say is I realise this would be difficult to implement, because you do have to have high standards, wash clothes at a high temperature, take them straight off after shift, etc.
But it could be done! It might look like student midwives having a clothing allowance with certain suggestions. Short sleeved tops, nothing that caught, and nothing that transmitted diseases easily. And I think scrubs have their place in theatre, or as a back up if you’ve got mucky on shift.
Surely what we're learning in this century is that empathy and compassion are all important. I think you can achieve that better when you’re feeling human and like you’re relating to somebody on a personal level.
Of course, I’d love to hear what you think. Do you believe midwife uniforms make a difference in forming partnerships with women? Do you think they're important for safety and infection reasons? Or do you think uniforms are outdated?
As always, thank you so much for reading, commenting and adding your experience and understanding to the conversation. I hope everything is good with you and yours.
Ellie xx
I think that uniforms are outdated, maybe not in other health care professions but definitely in nursing because as you said, as a midwife you are working in partnership with a woman, which should mean that they do not feel you have higher authority than them. I think that a smart, comfortable dress code, obviously suited to the work a midwife does, would be more appropriate to enable the woman and midwife to feel equal and would most probably make women feel comfortable in expressing themselves which would be to their benefit. Great post Ellie 🙂 got me thinking xx
Hi, years back I began working in the Trust from where I recently retired. At this time midwives didn’t have to wear uniform and to be honest I always preferred this, as it seemed more relaxed with the women and they would often discuss things easier.
One of my objections to uniforms is that these are women who have given birth and for the most part were well ans should be regarded as clients not patients. As for infection control, it is no different wearing a uniform or a smart top and skirt or trousers. Hand washing remains the same regardless as does universal guidelines and funnily enough there are aprons, which should be changed between clients anyway…..Does that happen in practice?
It was a gradual change over a few years and apparently came from the medical teams complaining that they didn’t know who the midwives were, yeah right!!! Later a new HOM was employed and she insisted on uniforms also.
So uniforms became the norm in hospital, but if working as a CMW, it was personal choice to wear one or not.
Uniforms, I admit do often look smart, but a uniform doesn’t dictate whether you are a caring, compassionate midwife or not or that you are good at your job and I feel it can create a barrier to open communication with clients as mentioned above and in fact for the minority of midwives, it becomes about power who then can dis-empower women during the process of labour and birth and leaves them vulnerable afterwards, particularly if they have dealt with or dealing with a traumatic experience.
No doubt, I have put the cat amongst the pigeons.
It is an interesting point and one which has been brought up in every role I have been involved in that had uniforms, so just to throw a bone to the argument, I find wearing a uniform saves me from worrying what message my clothes might give, especially in hospital scenario. I also have very little cash and therefore very few clothes and shoes . If there is a dress code, even though not uniform it would involve a large outlay which is also not tax deductable . Also how would women feel if their midwife turns up with clean, serviceable but obviously old clothes and shoes?
This might seem daft but the first thing that came to mind if I were to wear something other than my uniforms is what would I do without all my pockets! My current student uniform has 6 proper pockets plus 3 pen pockets and means I can easily always have pens and my notebook to hand but also things that keep me comfortable on shift like my hand cream and lip balm. Women’s clothes don’t generally have many useful pockets so unless combat style trousers similar to the ones I already wear were okay I’d need to come up with a another solution for keeping certain items with me on shift. I do agree with the psychological element you’re talking about and it is creating a barrier between women and midwives if midwives are somewhat hidden behind their uniforms. I do find it slightly odd that cmw in my area wear uniforms and think they should have the option not to. I’m wondering if for in the hospital there could be a halfway point between uniforms and own clothes while still being recognisable. Maybe particular tool belt type things to replace all those lost pockets (!) or tabards over your own clothes.
It’s who you are and how you treat people that counts. Wearing a uniform or your own clothes does not make you a better midwife. I preferred wearing a uniform as it seperated my home life from my work life and I do not feel that the women I cared for saw the uniform as a barrier. Its all about compassion, communication, caring and being a good midwife, not what you wear.
I can understand that wearing a uniform might place a communication barrier for some people, but I would feel proud to wear one . The training is hard and people earn their title. Showing what they are by wearing a uniform should be embraced, and communication can be overcome with trust and surely you would trust a midwife in a uniform more than a normal dressed person with a badge. But I do understand why some would prefer not to wear one.
I personally think the idea of uniforms is great, although depending on the organisation you are working at uniforms can be an issue as some fits, materials, colours & styles may not be appropriate for the midwifery profession.
Having been a patient & birthing woman myself I prefer the uniform so I know who I’m looking for & who is actually employed by the hospital. I’ve also seen junior staff wearing all sorts of in my opinion inappropriate clothing, from short dresses to low cut shirts & some strange looking “latest fashion” outfits. I’ve personally felt in these instances that if that person were taking care of me I wouldn’t be able to take them seriously.
Uniform brings everyone together as a team in the eyes of the patient. It stops any differences in socioeconomic status being evident as everyone has to wear the same outfit. It also gives some level of authority. I only say this because these days there are so many social issues in health & violence against health workers, where I think a uniform would benefit in putting a professional boundary there.
I’m a self employed midwife in New Zealand and I would never wear a uniform. My behaviour, skill and relationship with the women and my colleagues determine my professionalism. She doesn’t require that I wear a large name tag as continuity of care means she knows who I am.
The poem bought a tear to my eye…..must have struck a deep chord!!
It’s one of my favourites Jayne, glad you enjoyed finding it!
I completely agree with this article that in a uniform somehow you don’t come across as being so approachable, and women are put off showing more their emotional side at a birth. I have worked in places where you are in uniforms, and in places where you don’t and definitely, the relationship that you have with the women when not in uniform is more personal, emotional and sincere, I find. So, an advocate of not being in uniforms here!
Uniforms are outdated and oppressive . Doctors manage very nicely in their own clothes and are not deemed less professional or less respected. There are sufficient protective clothes available to cover your clothes when needed. I think patients look at the ability of the midwife and her professionalism not what she is wearing !
I believe that uniforms set a boundary especially within the health care sector, mostly midwifery. They come across to me as I’m in charge, ill tell you how to do things and how to birth this child instead of I’m here to help, your in charge I’m just here to assist. Uniforms are abrupt and do give off the impression of honest and trustworthy but more of an authority figure. Whenever I think uniform I think of the police, not a nice thought when your in labour. I say scrap the uniforms, get rid of the boundary.
Uniforms are appropriate for working on labour ward. I’ve worked in birth centres without a uniform, and got soaked/ blood/ mec/ liquor on my own clothes, which I then have to carry on wearing. Even scrubs do.
Also, I’m poor, I can’t afford good quality clothes. I don’t want my clients to judge me/ feel sorry for me.
I don’t agree that uniforms are a barrier to good care. Women who are listened to, nurtured and given informed choices get good care. This doesn’t matter if you’re wearing your navy blues.
My only hesitation when wearing my uniform in the community is being identifyable on your lunch break/ before and after a shift when going to the shops, petrol station, etc. Most people are positive and friendly, but some aren’t. I’ve never felt that my personal safety was in jeopardy but I’ve heard colleagues who have felt vulnerable.
I am on the other side; I like my uniform. Yes, there is the infection control aspect of it, and let’s be honest if you wear trousers and a top, isn’t it more tempting to pop into the supermarket on your way home from work?
It also means that I can take my uniform off when I get home and leave my work at work. I don’t always; I love my job and talk about it often! But there are also days when I’ve had an IUD/TOP, or an intense social case that I want to be able to put that aside at the end of the day, removing my uniform helps with that mindset.
I also think a uniform is a leveller. To my women I am someone there in the background of their birthing story, someone to aid and encourage when needs be. It’s not my story, it’s their’s, and I should blend into the background in their minds. My choice of top might make me look like an old fuddy-duddy to younger women, or too trendy and fashion conscious to more mature women, for them to look past my clothing and see me as the capable professional Midwife that I am. In my uniform I could be an opera lover or a rock chick. I can be whoever they need me to be.
Finally, I work in an area of high social service involvement. Sometimes I have to be authoritive, sometimes I need that boundary between us. If they reveal something to me I may have to pass that on to social services as is my professional duty. I do not want that to be seen as a betrayal.
By my actions and questions my women know they can trust me, they can be open with me and I have never found that they hold back, but they also need to be aware that there is a professional boundary there which protects us all. I love the connections I can have with my women, I love being with them and supporting them through (usually) the most amazing time of their life. I love that look when they realise that they’ve done it all themselves, that like Dorothy they’ve had the power all along. And I love the fact that I will blend into the background for them, that they won’t remember my face or my voice or my clothes. Because I am not their friend, I am their midwife.
As a founder member of Neighbourhood Midwives, an employee owned midwifery social enterprise, we are committed to being an ‘evolutionary teal’ organisation. If you haven’t heard of this and are interested to know more, google it or read Frederic Laloux’s book ‘Reinventing Organisations’ … it might just blow your mind as it did mine.
For us, being a Teal organisation has the potential to lead to fundamental sustainable and scaleable change within midwifery provision in this country. The reason it links to a discussion on whether or not to wear a uniform is because one of the three principal tenents of the concept is ‘wholeness’ at work. The others are self-management and evolutionary purpose. Together they describe an organisation as a ‘living system’ – able to adapt, be flexible and respond to changes in a naturally organic and fluid way… as opposed to seeing/being an organisation more like a machine, with top down rigid hierarchies, rules and management structures imposed on employees.
Wholeness is about turning up to work as a complete person – not just the professional ‘self’ with everything else ‘left at the door’. That is not to say you aren’t ‘professional’. There are a set of practices and principles to work too, but they support us to bring along our spiritual, emotional and intuitive parts which are recognised and respected as being just as important. For me not wearing a uniform is an important part of my ‘wholeness’, it enables me to be who I really am in each and every encounter through my working day.