There's a concept which has given me a big fat headache for a few days now. But it’s also fascinating.
It’s called "historical disappointment".
The idea is based around practices that used to be culturally acceptable, like slavery, that we now consider offensive. These days we realise how evil slavery is. But if we’d have been brought up in Roman, Egyptian or Viking times, it’s likely we’d have not even questioned the idea that some humans had no rights at all.
We're all prisoners of our own time.
Then I got thinking into more uncomfortable territory.
We think the "midwifery model" is perfect.
I’m not talking about midwifery as it is at the moment – staff crises, medicalisation, and reduced resources mean there’s a lot that could be improved!
But the midwifery utopian dream of caseload, one-on-one, women centred care is considered a "perfect" model.
I’ve never heard anyone question that this kind of holistic care could be improved upon.
And yet -- nothing in the history of humanity has been beyond criticism.
So I have a question for you.
What about our midwifery model might be considered historically disappointing by midwives of the future?
• Use of resources – in our midwifery model, we aim to give women informed choice above all else, arguably even above ensuring all women have a reasonable quality of life. Shop floor example: NICE promote informed choice around type of birth, to the point of women being able to choose a caesarean with no medical indication (as long as good information and support is given). A caesarean often costs £1000 more than a normal birth. This amount of money would make a huge difference to a woman and child living on a food budget of £4.56 a week
• Dads not being able to stay overnight – some places offer this, but most hospitals do not. There’s strong evidence to suggest men go through massive hormonal shifts when having a baby too – what are we doing to this process by separating them from their partner and baby? I understand the logistical issues...but will we be viewed as wrong for not prioritising this more?
• Male circumcision – at the moment, midwives don’t have the right to conscientiously object to this. We have to refer to a safe doctor if parents request it.
I don’t mean to sound like I’m arguing for change in these areas (Though, if you're asking, I do believe male circumcision is wrong, though I realise this is my opinion, and the arguments are more complex than they first appear. I also would like birth partners to stay. Not sure about the elective caesarean point).
I’m "just" trying to guess what future generations of midwives might think. I’ll almost certainly be off the mark.
But it does fill me with exhilaration that I might get a whisper of future ideas.
Because morality doesn’t change inevitably, or by chance.
It changes through people thinking very hard about right and wrong.
As a midwife, you can feel powerless to change things. But actually, being present during the biggest experiences of human life is a pretty good starting place to break cultural conditioning and get to the truth.
See midwife Mary Cronk for one of my favourite examples of this 😀
The thought that current midwifery could be one day viewed as historically disappointing makes me uncomfortable. But it’s also undeniably true, and exciting.
Your thoughts matter. Your ideas matter. You are worth it.
And once you've noticed something that needs changing, the odds are you won't be alone.
I’d so love to hear from you on this.
- What about the midwifery model do you think will be viewed as "historically disappointing" in the future?
- Does this make you feel sad? Or excited?
- This post is a bit experimental. Would you rather I got back to discussing midwifery techniques/tactics? (I’ll always do this anyway 🙂 ) But I wondered whether you found this kind of midwifery philosophy interesting?
As always, thanks so much for reading with an open mind, and for any comments – YOU’RE THE BEST!
With much love and appreciation, Ellie xxx