A few months ago, a little add popped up on my computer. I clicked it away without a thought. A little later it popped up again; again, I clicked it away, thinking nothing of it other than it 'being annoying'. A few days later, sure enough the advert appeared again.... and again.... and again. I 'quickly' clicked them away and carried on with my work. Slowly, over time, these adverts became a regular part of my day, and I stopped really thinking about them. Just methodically removed them and carried on with my tasks: pop - click - pop - click - pop - click (getting the picture). (If you are wondering what this has to do with midwifery - bare with me, it will make sense.)
Two weeks ago, my computer needed an overhaul; those annoying little ads had grown so much, that I could no longer log on to my blog (hence no posts for a while), I could not move on the internet without being directed to sites I did not wish to visit (er, no I do not need Viagra thank you) and my working time at the computer ground to a halt.
Reflecting on this (and here is the midwifery link) made me think about how small interventions in midwifery practise have become a routine part of our care. Let's take the vaginal examination (VE) for example; these are now so routine that we no longer even see them as an intervention, and yet, they can interfere so much in a woman's birth that they can slow and grind a labour down to a halt (see what I did there?).
As midwives, we are considered 'autonomous practitioners'; this means that we work to evidence base and to the woman's needs. There is no evidence to support routine vaginal examinations and whilst they can help understand the progress in labour, most women find them invasive and unpleasant. Encouraging the woman to 'pop' onto the bed, the 'quick' VE, the repeat of this process at routine intervals, in my opinion, slowly interferes with the midwives care and her understanding of 'normal' progress in labour, and most significantly affects the woman's trust in her body, until eventually the labour grinds to a halt and needs an overhaul (or caesarean) - just like my computer.
This year I have been blessed to attended 15 women in labour: only 6 of those women required a VE to support plans around their labour and birth. I promised to 'share the skills' previously, but the problems with my computer jaded my work, distracted me from writing and prevented me for being 'with computer'. Yet it took a real crisis before I addressed and faced up to the problem: it was just easier to keep pushing the problem away. Sound familiar?
2013 has been a year of facing up to a huge problem: the demise of Independent Midwifery. Over the past 12 months, I have been involved in the odious task of campaigning to save IMs, to save my livelihood, to save choice for women and to save a group of midwives who believe in true autonomy. It was a problem I did not want to face up to: it is a problem that many midwives are not facing up to, and it is a problem that the Government does not wish to face (I think they hope we will all just go away).
If midwifery is to remain a strong profession, then we need midwives to have the choice to work independently. As we enter 2014, I feel optimistic and positive that this year will herald a change for Midwifery and that midwives will reclaim their profession. I feel confident that I will be able to continue to practise in a way that supports women without the routine use of interventions, and that working in this way will not 'grind to a halt'. And mostly, I look forward to not campaigning anymore - but rather to getting back to what I love most. Being 'With Woman'.
What will your 2014 pop-up for you?