Once when I was a student midwife on labour ward, I was reading a leaflet trying to entice junior doctors to go into obstetrics. The leaflet was talking about the blend of medical and surgical skills, young patients, the challenge of emergency situations and the rewards of working with new families.
But for me, there was a spark missing.
Then I realised what was wrong: there was nothing about advocating for women. In fact, the leaflet didn’t mention the word 'women' once.
Obstetricians do an amazing job and I feel hugely privileged to be in a country where their treatment is (for the most part) free. But midwives offer something completely different.
Of course, I’ve known amazing obstetricians who offer brilliant, respectful care for women but with a huge workload and an emphasis on saving lives, their key focus isn’t often on a woman’s right to choose.
In contrast, The Lancet has this line in their definition of a midwife:
"Respecting women’s individual circumstances and views, and working in partnership with women to strengthen women’s own capabilities to care for themselves and their families."
A quote that relates to this is, "Birth is not only about making babies. Birth is about making mothers - strong, competent, capable mothers who trust themselves and know their inner strength." -Barbara Katz Rothman
A perfect example of this midwifery philosophy is a story that made me weep in public when I first heard it.
There is an amazing artist whose work name is Miss Aniela, her real first name is Natalie.
Her work is strange, beautiful and complex and has been displayed in the Saatchi Gallery and the Houses of Parliament, amongst other venues.
Natalie has had her share of difficult life experiences. Her first baby, Evan died shortly before birth due to a condition called bilateral renal agenesis.
This is a woman with fierce intelligence and strength of character.
The obstetric/hospital advice to Natalie on finding out about her baby’s condition was for termination of pregnancy.
The midwifery care offered was different. Natalie had chosen continuity of care and had a midwife who was there for her during diagnosis and everything that followed.
The space her midwife held for her allowed Natalie to make her own decision about terminating her pregnancy and having her labour induced.
Natalie opted to not be induced. She chose a homebirth. From this, she gained an extra eleven weeks being pregnant, i.e. time with her baby.
She also had a normal vaginal birth - with all the positives aspects that experience can come with but also helping prime her for good outcomes for the future.
From her writing, it’s clear that a homebirth was the right choice for her. I’ve seen Natalie talk in person about this situation. The strength she has gained from making her own decision and approaching her grief on her own terms is palpable.
What would have happened if she had not been encouraged to use her intelligence and instincts about her path?
I could be wrong but I think the very best outcome we could hope for when infant loss is part of a woman’s life is that she owns her story. As Brene Brown would tell us, having acceptance of what has made us most vulnerable in life is the definition of strength.
And in this world we need strong women.
This kind of care also has an important trickle-down effect.
Now the story is in MIDIRS and on a public blog the option of having a homebirth though a baby has died is out there for women to choose. And choice is everything when it comes to owning our life experiences.
The midwife involved in this trail blazing care is Virginia Howes: she is an independent midwife in the UK.
Unfortunately, UK independent midwives are not allowed to practice right now.
It’s a complex situation but essentially the NMC (the governing body for midwives) has deemed independent midwives’ long-standing insurance as ‘unsuitable’. This insurance is in case of a claim being made if a baby or mother was hurt due to negligence during labour or birth. (*Thanks Ayesha for reminding me in the comments of best phrasing of this concept!)
I have reason to believe that the indemnity scheme in place for independent midwives was fully tested by actuaries, covering catastrophic events, but that the NMC didn't or couldn't find the time to do the same tests. They deemed the insurance as unsuitable anyway.
I think this is awful.
This situation was debated in the House of Lords last week and I hope against hope it will be resolved soon.
If I want children in future I'll want to be able to make a choice about having an independent midwife. How about you?
And NHS midwives are impacted by independent midwives not being able to practice because they’ve lost their trail blazers (like Natalie's midwife, Virginia Howes).
This is an important fight for woman's rights in the UK. You can help, if you'd like by doing the following:
Share this post, leave a comment, generally cause a riot on social media
Check out #savethemidwife
Most importantly: join the independent midwife organisation IMUK: you’ll get the newsletter and updates that come out via email – it’s just £20 for a whole year, you’ll get discounts on any independent midwife conferences and the money will go straight to legal fees as you better believe that independent midwives are fighting for their right to practice!
I'd also like to know:
What was the most important insight you gained from today's post and from Natalie and Evan's story? Leave a comment below, your thoughts might be exactly what someone else needs to hear to make the insights stick.
Thanks so much for reading.
Have a wonderful week, Ellie x