Joining the Circus

I have a friend who is pregnant with her first baby.

In the last few weeks I have been thinking about what books would be helpful for her to read in preparation for motherhood.

So I read a few.

To be honest there were few such books around that I thought would be helpful at all. My first child was born 16 years ago, but I have been working and thinking (!) as a midwife since then, and there seem to have been few bright moments in the Transition to Motherhood genre.

The books I have just read were a mixed bunch.

I think I can envisage the editorial meetings – “maybe a few more funny stories about the [INSERT: ridiculous health professional] who tried to help you to breastfeed/get your baby to sleep/push your baby out of your vagina/join a parents group”….never mind how hard people may have worked to help you.

Many of the writers who share their stories of becoming a mother oscillate between themes of “I’m special because this is what happened to me” and “my experience is an archetype of what becoming a mother is”.

Most worrying is the theme of belittling health professionals and structured support systems as being “not for them”.

“I’m not much of a joiner”.

What does that even mean?

Several writers talked about their reluctance to join a new parents group where the only thing members had in common was the lottery of giving birth. What was the reason for their reluctance?

New parents groups are a phenomenon of living in the Maternal and Child Health system of the People’s Republic of Victoria, and are also present in other states of Australia.

Maternal and Child Health Nurses, who work for local councils, organise groups for parents to meet when their babies are between 6 weeks and 3 months old. Usually there are structured meetings for 6 weeks or so at the Centre. After that groups may continue to meet informally at members’ homes or playgrounds or community centres or playgroups.

Research about mothers and parents and playgroups indicates the strong social role that such groups play in a context where isolation is more prevalent – especially for mothers and children. These groups have also been found to provide, at the basic level, an opportunity for mothers and families to receive care – different to other modes such as clinic or home visits.

What worries me is that prospective mothers reading these books get the idea that these groups are daggy or a waste of time – especially if they aspire to be the uber cool inner city types that these authors often are.

I also worry that these attitudes add to the ongoing narrative of:  “we only like to hang out with people who are like us”.

Isn’t this the narrative of an oppressed group?

My own involvement with the Australian Breastfeeding Association came about at least partly in order to deal with general societal ambivalence about breastfeeding. ABA meetings were a haven where you could breastfeed your older toddler with freedom.  [*sorry freaked-out new mums].

Not that my mother’s group were anti-breastfeeding. But I guess I had a bigger aspiration to be involved in community-based breastfeeding support.  The added benefit of these meetings was that there were women with babies and children of all different ages attending. Having a child who didn’t walk until he was almost two and breastfed for several years longer than that was definitely less of a drama at ABA meetings.

Grassroots groups like mother’s groups or playgroups are inherently subversive. I wanted to be a part of that – an autonomous collective of sleep-deprived nobodies – no-one could control us (not even the maternal and child health nurse once we busted out of her centre).  No-one was interested in us except us.  But we were building the sorts of networks that help you when you have another baby or go through IVF or you need a job locally or need someone to have a cup of tea with when these kids finally and suddenly have their first day at school.

Why wouldn’t you want to be a part of that?

Not a joiner? That’s ok. But your child will need other kids at some point – they can’t play with you in the café for ever.

Nor should they.

 

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August Sander’s People of the 20th Century.

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The Roar Behind the Silence: book review

Soo Downe and Sheena Byrom are midwives from the UK with long and illustrious clinical careers in midwifery and also many midwifery research projects and publications to their names.

This year they published an edited collection of brief, sharply edited chapters written by 50 (count ’em) different authors.

The topic that the book deals with is the need for maternity services to be based on a philosophy of kindness and compassion: [back cover blurb]

For many years there has been growing concern about the culture of fear that is penetrating maternity services throughout the world, and that the fear felt by maternity care workers is directly and indirectly being transferred to the women and families they serve.

The consequences of fear include increased risk of defensive practice, where the childbearing woman and her family become potential enemies to those providing her care. In addition, the prevailing risk management and ‘tick box’ culture in maternity services encourages maternity workers to give priority to the records instead of the woman. These factors contribute to the dissatisfaction felt by those using and providing maternity services. There is however increasing evidence that kindness, compassion and mutual respect improve efficiency, effectiveness, experience and staff morale within healthcare settings.

The book is divided into three sections:

1. Stories and perspectives from maternity care.

2. Principles and theories.

3. Making it happen: solutions from around the world.

This is an action manual for creating change.

These are issues that are not only for the UK to be concerned with –  in Australia we have important problems to address with regard to how maternity care is provided, how women are respected within particular models of care and, of course, with regard to rising caesarean section rates and the consequences of this.

The chapters in the book are written by people as diverse as…

Kirsten Uvnäs Moberg:  a medical doctor and author of two books on the physiology of oxytocin. Her take on the impact of intervention on the action of oxytocin should make us reconsider the “safety” of many interventions which effectively block the action of the hormone.

Alison Barrett: an obstetrician who practises in New Zealand, and talks about how motherhood is not valued in western culture, “which is a nice way of saying that our culture (still) hates women” (page 63). She describes how every woman in the maternity system deserves the Best of Care. Every woman. She invites us to examine the barriers in our own minds that prevent us from providing this.

Milli Hill:  is a writer and campaigner and author of a book on water birth. She is the founder of the Positive Birth Movement – a grassroots organisation designed to promote discussion amongst women about positive birth. It emerged as an antidote to the widespread cultural fear of childbirth. As she says: “women in the PBM network consistently report that being treated and spoken to with kindness and respect is at the heart of a positive birth experience” (page 189).

Anna Byrom: is a midwifery lecturer who has used drama through Progress Theatre to explore issues through critical reflection and discussion and debate in maternity and general healthcare services. The chapter, co-written with Adele Stanley, Gemma Boyd and Kirsten Baker, outlines how their methods have enabled understanding of different participants’ experiences in healthcare settings as well as personal development – with a view to providing compassionate care.

Mavis Kirkham:  is a midwifery researcher who has written about and researched midwifery for 40 years. Her work has often focussed on the context of midwifery work and what kind of care this produces. Her chapter argues that  the NHS maternity care system is a powerful shaper of how midwifery care is delivered. We can’t ignore the impact that a system which oppresses midwives has on the way care is given.

Hannah Dahlen: is an Australian midwife researcher and practising midwife who is a professor of midwifery at Western Sydney University. Her research has covered topics such as episiotomy rates, perineal safety during birth and the impacts of place of birth and antenatal care on birth outcomes. Her chapter in the book (co-authored with Kathryn Gutteridge) looks at how the fear of midwives impacts on the experience of women during pregnancy and birth – how models of care based on risk alone take so much away from the the miracle of the
experience…and also the joy of doing midwives’ work.
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Maybe you don’t usually read books about midwifery?

That’s ok.

This is unlike any midwifery text I’ve read – the chapters are readable, understandable, distinctly lacking in researcher or academic jargon, and contain many stories.  They are also SHORT, concise and written in such a way that if you want to find out more about a particular person’s work or point of view, you can easily do so by looking at the reference list for each chapter or googling the organisations and publications referred to.

It is also a great way to find out the names of people who are doing interesting and stimulating work in our profession.

The other amazing thing is that at the end of each chapter there are summaries of key messages, and then a list of action points: what you can do – as a midwife.

I’m excited about this book because it has the potential to enliven and excite our profession towards change – a change that is centred on kindness and compassion for the women and families in our care.

The book is available for purchase online (for less than 20 bucks) via Amazon or Book Depository or locally through Capers: http://www.capersbookstore.com.au

Do yourself a favour.

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How do Lactation Consultants support women to breastfeed?

I had the good fortune this week to attend the International Institute for Qualitative Research’s 2015 conference in Melbourne.

I plan to share more about the week’s highlights in the coming days (yes, you are going to be part of my processing the experience…not what you signed up for? Sorry.)

Here’s a copy of the poster I displayed about my beginning PhD research.

Special thanks for Wade Kelly from Charles Sturt University in Wagga Wagga for running a great session last Sunday on “presenting your research”.

I attended. I was inspired by his suggestions. This is what resulted.

Not perfect. But sssssooooo much better than what would have been on the wall without his generous sharing of knowledge. Now to tackle haiku deck.

Hopefully you can read the text by double clicking on the image to enlarge it … this worked on my desktop at least.

Feedback welcome. Also questions.

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