You don't recognise the words coming out of your mouth. You've done or said something really stupid and you just wish you could turn back time.
Ever been there?
I have. Once upon a time I saw really poor care. I approached the staff member, but she didn't see an issue. So I went through proper channels, for safety and support. The air was clear between us and I felt mutual respect.
But back on shift, I was accused of being involved with the poor practice. A bossy midwife gave me a tongue lashing -- and the little monster in me came out and explained the other staff member had made the error, making damn sure I wasn't blamed.
Afterwards, I felt like I'd been punched in the gut.
I'd insulted another's practice and started gossip. The very things I hated most about hospital culture, I'd contributed to myself.
These days, I'm glad of this experience because it showed me how affected by culture I am.
I wrote about the Morecambe Bay Report last week - this is part 2 of my take on it (see here for part 1 and a nutshell summary).
In the report, there are accounts of awful care practices.
(There seem to be some political elements to the Morecambe Bay Report – and we have to remember that every government document will contain some bias.)
But every maternal or neonatal death is a tragedy, preventable ones even more so.
It's really easy to shut off and say ''I'm not capable of acting like that''.
But -- we're all a product of culture.
Don’t believe me?
An experiment in the '80s studied young men from a top US university. Psychologists created a ‘'power'’ culture. Some of the men were ''guards'’ and some were ‘'prisoners'’.
Within 48 hours these men, chosen because they were the nicest, most psychologically normal people, were getting the ‘'prisoners'’ to simulate sodomy and clean toilet bowls with their bare hands.
It’s not nice to think about. But this experiment has been repeated hundreds of times in different ways and it always finds good people do bad things in the wrong culture.
This sounds like I'm saying midwives have no choice about how they act.
Nothing could be further from the truth.
But I believe we need more stories of midwife heroes to educate and empower us to know that anyone can stop poor culture.
To echo psychologist Philip Zimbardo, we need to know ''We are all heroes in waiting''.
Every day midwives wrestle to promote normal birth, keep things healthy, and whistleblow when a colleague, or system is not right. It's so hard and takes tremendous personal compassion and courage (to name just 2 of the 6Cs).
Without these stories embedded into midwifery, we're not protecting against the natural human tendency to keep your head down and join in.
Midwives who refuse to do this are heroes. We should hear from them more often.
These are everyday, domestic acts of heroism:
- Mary Cronk, who refused to do unnecessary episiotomies because 'iron had entered her soul'
- Jenny Clarke, who wrote on a theatre wall to promote skin to skin
- My friend who we'll call Rosemary, who aged 22 and not even one year qualified, stood up to a lead consultant who ''wasn’t being part of the team'’
I believe if I'd been surrounded by stories of strong midwives doing the right thing, I'd have handled my whistleblowing situation with much more intelligence and grace.
I strongly believe to avoid what's documented in the Morecambe Bay Report, we need to celebrate these stories.
Now, I'd love to hear from you - can you share a midwife hero story in the comments below? Have you, a student, or a colleague done something extraordinary that perhaps wasn't recognised at the time?
This is a really important post to me. If it's important to you too, I'd love it if you shared it with a midwifery mate 🙂
Ellie x
Both articles on the Morecambe Bay report have been brilliant. I think the most difficult thing is to put a name on things when you have a “bad culture” in general, a toxic atmosphere that doesn’t engender respect and kindness. Whistleblowing is one thing, but how do you change culture?. I think your idea of sharing midwifery hero stories is a fabulous one, and is giving a positive spin to the Kirkup and Francis reports situations. Kudos.
Thanks, that’s really good to hear, for sure it is a massive challenge! I think better breaks and work conditions for midwives would change the culture well as a starting point…again, very difficult to achieve x
I look forward to reading midwife hero stories to help empower all midwives (including students) to have a voice when they need it. As an aspiring midwife about to become a student, one of my concerns is how to deal with any evidence of poor culture.