Wednesday, 23 October 2013

Sharing the knowledge: let us begin.

Midwifery is one of those professions where you develop your skills over time; always learning, always discovering something new, remembering something forgotten, and gleaning knowledge from many sources.

To qualify as a midwife in the UK, you undertake a 3 year full-time course, with a roughly 50% split of theory and practice (practice taking place within the NHS).  You learn drills, you read books, write essays, 'deliver' babies, watch caesarean sections, 'help' women to breastfeed and 'learn' the day-to-day skills of midwifery in the NHS.  This is normally under the watchful eye of a mentor, an experienced midwife who guides you along the way (assuming of course there is not a huge theory-practice gap with what that mentor is teaching you).

Throughout my 3 years as a student I learnt huge amounts, but (as with most professions) many of the skills I have learnt have come with the experience of serving women in childbirth, watching women labour in their own environment without the time constraints of unit policies, and learning to trust even more that the less I 'do', the better the outcome*.  Much of this knowledge was not 'taught' in my training and I believe there is such a strong culture of fear around childbirth, that we tie ourselves up in knots to address unit policies, many of which are not based on the evidence.

So how do we share and spread that innate midwifery knowledge that respects women and the natural process of childbirth, when the practice we are exposed to within the training may (or may not) often sit within the medical mode of childbirth.  How do we give student midwives and newly qualified midwives a glimpse into a different way of approaching birth?  I believe we need to be writing about it, shouting about it, talking about it, and sharing, sharing, sharing.  Of course, this then exposes us to the risk or being 'ridiculed', or worse, intensively scrutinised in our practice; this then moves this innate knowledge back into the 'secret' side of midwifery, and does not enable policies (such as arbitrary time limits in the 2nd stage of labour) to be challenged.

I am planning to 'put myself out there' a bit and start to write about skills and ideas, such as:

  • confirming the onset of labour without vaginal examinations
  • assessing labour progress without vaginal examinations
  • auscultation using a Pinnards or fetoscope
  • facilitating spontaneous 2nd stage without directing women on 'how' to push
  • water birth
  • physiological 3rd stage
  • the effects of energy on the labouring woman
  • assisting a woman with a mal-positioned baby

I invite questions or suggestions for topics, and I am inviting guest blogging midwives to share their knowledge too.  Along with this I also need to add in that 'disclaimer'; that is to say that I am not saying this is the only way to practice, or that it is always appropriate to the woman you are caring for, or that it will sit easily within the trust you may be working within.

I do hope you will enjoy these blogs, and and share and talk about skills with your colleagues, and ultimately develop your own practice in a way that keeps the woman and the process of normal birth central to your care.

angela x

*doing less is of course not to ignore a woman whose labour is changing and will perhaps require help in another way.

“Be the change that you wish to see in the world.”― Mahatma Gandhi

1 comment:

  1. Rock on Angela! I am right with you. Time this knowledge was documented and out there to be debated. This is why I wrote my Birth Noises article for EM.