Maternity and Midwifery Hour is a regular weekly online event available live and on-demand, discussing all things midwifery! It is now entering its ninth season. Sue Macdonald, as curator for both the Maternity and Midwifery festivals and Midwifery Hour, reflects on the last year, and the one just beginning.
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“Cheers to a new year and another chance for us to get it right”
– Oprah Winfrey
Well, the New Year is here…. and as one gets older, the years seem to fly by with increasing rapidity. As I began to think about writing this piece, I started by reflecting on the last year, and then looked at what I wrote last year.
When I looked at the year that we have just said goodbye to, there were a few tasks I never did get round to… and others I had to do more quickly than I would have liked… and there were people that I was not able to get to see as often or spend as much time with as I had planned.
On the larger scale, it seems that the hopes of last January have not been realised – that there might be an end to conflict and war, less hatred, intolerance and racism. The war in Ukraine continues, with more loss of life, life changing injuries, and destruction of homes and country. The events in Israel and Gaza have been horrifying and difficult to comprehend. The unimaginable acts of murder, torture and kidnap of 7 October, which have been followed by so much death, destruction and injury in Gaza. As a midwife my thoughts are with women who are pregnant and childbearing and so vulnerable, having their babies in such a dangerous place, and unable to protect themselves or their families from the conflict, the bombing and the resulting wasteland of their former homes. I can only imagine being a midwife in such a challenging environment, and I give thanks that in so many part of the world, our midwife sisters, and sometimes brothers are out there, providing care, and trying to ensure mothers and babies are as safe as possible.
I have also been disturbed by the hatred that overspills in my own homeland and city, as well as on social media, with a lack of willingness to fight for peace, for love and understanding, and often espousing racist and antisemitic views.
To more domestic concerns, many people are still having to balance their household budgets just to get by. Some have had to resort to using foodbanks and charity, and reduce treats and luxuries for their families, just to keep afloat.
Our public services, including the NHS, are under tremendous pressure, and few would disagree have been starved of resources and support over the past few years at the same time as they faced the challenges of the pandemic. I am personally surprised that the intense shock of the pandemic has not resulted in better understanding of the impact of poverty and disadvantage and does not appear to have resulted in a resolve to increase spending on the nation’s health.
So, what will this year bring and how should we, as midwives, students or those within the maternity services face it and prosper?
There is debate on the apparent reduction in the UK birth rate (The Telegraph 23rd December: Miles, 2023), which may impact on the expressed need for more midwives. However, discussions over t M he last year on the impact of birth trauma, and the stress described by midwives and student midwives highlight that, though the crude birth rate may be falling, pregnancy, childbirth and the perinatal period have become more complex, while maternity services are busier and more challenging.
Many of you will recall the first few ‘Maternity and Midwifery Hours’ at the beginning of the pandemic, which we developed to inform, support and link student midwives and midwives at a time when there were no study day/conference or face to face opportunities. We were so lucky to have wonderful midwives, doctors and service users, so generous with their time and expertise. This has continued over the last three years. Having a great team to ensure that each session is produced and recorded has been superb, which means that sessions can be accessed as needed. Perfect for busy practitioners.
Right at the beginning, I recall ‘Jenny the Midwife’ suggesting that in times of stress we all needed a sanctuary box… a set of things that made us feel better, and more able to cope with events. In my sanctuary box, as well as the scented candles and comfy slippers, I think we need the following in our personal sanctuary box: Self-care and supportive environments for staff; kindness and compassion; exceptional listening skills; reflective and self development tools; cultural awareness and sensitivity; self-awareness, and taking some mind of some discussions over the last year, let’s include love and care. This is a large and special box!!
I think we need to call for some of the changes introduced over the Covid-19 pandemic that helped, to be retained. For example… I recall the ‘wobble rooms’ in each unit, a small room was set aside, with a few resources – a couple of comfy chairs, a kettle.. some tea etc, somewhere to go if you just needed a quiet space to think, reflect or just take your breath.. I suspect that many of these little spaces have reverted to their original use, but maybe we need them back!
We all certainly need to be kind and compassionate… to our colleagues, students, clients and families and, of course, ourselves.
The other important addition to our sanctuary box is ‘me-time’ – ensuring that each of us can recharge our personal midwifery batteries.
I talked last year about recapturing and celebrating why you came into midwifery. It is so easy with the barrage of reports and critical media attention to forget the huge pride and joy of being a student midwife and then a midwife. Remembering why you came into it… and the wonderful and privileged role you have, plus the good days, does, I think, help you cope with the days that are stressful and/or not so good. So a little reflective tool, or reflective journal might just be useful in helping to undertake the recapture and celebration process.
This is not to ignore when we get things wrong, and, above all, we always need to be seeking to learn, and develop our knowledge and practice. So can I add to this that each one of us needs to remember to truly listen to women, their babies and their families. Always remember that the maternity service that we are used to and take for granted, whether in hospital, birth centre or community, may be a new and scary experiences for some women and families. In our sanctuary box we need to value our ability to reflect on our experience, our knowledge, and an ability to put ourselves in others’ shoes. Add to this practice in good listening skills, avoiding assumptions, and making time to listen.
Covid-19 brought the potential impact of disadvantage and deprivation on morbidity and mortality to the fore, and reports including the MBRRACE report continue to highlight that there is still a huge amount of work to be done. In the UK black women and babies are 3.7 times more likely to die giving birth than white women, while for brown or Asian women the figure is 1.8 times. Though these disparities have begun to reduce, every one of us needs to ensure the highest possible standard of care, is provided to all women and families, with equity and cultural sensitivity.
In our sanctuary box, therefore, we must include self-awareness and a commitment to call out unacceptable behaviours – including bullying. A recent publication #Saynotobullyininmidwifery highlighted that bullying is still a major issue within maternity services and can impact on all staff including student midwives and midwives, leading to stress, burnout, and to people leaving the service.
Over 2023 The Maternity and Midwifery Festivals have attracted increasing numbers of aspiring student midwives, students, midwives and consumers coming together – face to face and online. The Festivals are provided all over the UK and Ireland, from Edinburgh to Cardiff…Dublin, Manchester and Leicester. These continue to be exciting and enjoyable events, well evaluated by speakers and participants, and of course all recorded and available after the event, truly the best of hybrid events!
As I plan out the programmes and content for the 2024 calendar, which will continue to be provided all over the UK, plus Ireland, and available online, I want to say a huge thank you to those of you who have attended the Festivals… whether face to face or online, and those of you who tune into the MM Hour every week. That includes a sincere warm thank you to you for what each of you do, and contribute, and for the highly active participation. I personally love the buzz of the Festivals, when we get amazing questions, discussions and debate, during sessions and through to the breaks.
We continue to work on ways to make the online experience even more like the face to face … but if you can, come along in person, even if it is just for a morning or afternoon. The exhibition includes many companies and groups relevant to maternity services, and we do try to include other activities including Reiki and well-being and also a bookstall.
The Maternity and Midwifery Hour is now entering season 12 (4th year!) – starting back on the 17th January, still offered for free on Wednesday evening 7-8pm. At this point I must say that our wonderful speakers for the Maternity and Midwifery Hour have not only been generous with their time, but continue to provide exciting, challenging, and moving presentations. I am privileged to work with a great team led by Neil and Karen Stewart, and including Dr Jenny Hall, Debra Murray, Paul Rushworth, Hilary , and Anjelo Leeson, additionally supported by the Maternity and Midwifery Forum Advisory group. If you haven’t tried out the MM Hour, take a look at the top ten from 2023 first!!
The MM Hour does make me feel as though I am having a cosy midwifery zoom meeting with my friends, talking about midwifery issues, and trying to find solutions and ideas for getting things even better. Over the last year, topics have been fascinating and challenging and have included: the psychological challenges of being a midwife; examination of the newborn; the added benefits of continuity of care; spirituality in midwifery and obstetric violence to name a few of our ‘Top Ten’ . We have also looked at the use of Entonox, sterile water injections as pain relief for back pain during labour; black baby loss awareness week and support for bereaved parents; baby communication; the student midwife as advocate; breastfeeding and perinatal mental health… Our wonderful audience (yes that’s you!) participate brilliantly, engaging in discussion and coming up with great questions, as well as ideas for future sessions. This continues to give me a wonderful feeling that my midwifery friends are very much part of this team… so please carry on. And if you have a project or piece of research you are working on, or if you have something you think needs saying, do get in touch.
I hope that you all got a proper break over Christmas and the New Year, and will look forward to the next season with you, in the meantime, have a think about your personal sanctuary box, and how you can best fill it with the tools, and skills to start this new year! All of the resources I identified as being needed to be placed in the sanctuary box require commitment, and above all love – for yourself, the people around you, and the women, babies and families in your care.
Love Sue
Sue Macdonald,
Curator Maternity and Midwifery Festivals and Midwifery Hour
January 2024
References
Knight M, Bunch K, Felker A, Patel R, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. (2023) Saving Lives, Improving Mothers’ Care Core Report – Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2019-21. Oxford: National Perinatal Epidemiology Unit, University of Oxford https://www.npeu.ox.ac.uk/mbrrace-uk/reports
Matflix (2020) Maternity and Midwifery Hour: Episode 1: Wellbeing Matters https://www.matflix.co.uk/the-highlights-wellbeing-matters-podcast/
Miles, D (2023) “Macroeconomic Impacts of Changes in Life Expectancy and Fertility Imperial College London). https://www.imperial.ac.uk/business-school/ib-knowledge/finance/ageing-populations-and-declining-birth-rates-are-they-really-such-catastrophe