The modern midwife

By Aviva Attias on 24 November 2017 Midwives Magazine RCM Annual Conference Midwifery

This is the first of a four-part series in which we take a closer look at the Question Time-style sessions from this year’s RCM annual conference. 

What does it mean to be a practising midwife in 2017? How do people outside the profession, including the women cared for, perceive midwives? Just how big a part does the media play in the portrayal of the profession? And, vitally, how can all this inform midwifery of the future?

These were some of the opening questions put forward by Mandy Forrester, RCM head of quality and standards, who chaired the Question Time-style session, ‘The modern midwife’, at the 2017 RCM annual conference on 1 November.

Human values 

First to speak on how midwives are portrayed in the public arena was Stephen McGann, star of Call the midwife. ‘What a pleasure it is to speak to real midwives!’ he told a packed auditorium. He spoke fresh from completing filming for series seven of the popular BBC One drama, expected to air early next year. 

Stephen believes it’s not the medical accuracy that makes Call the midwife such a huge hit (10.5 million viewers a week), nor the actors, but real midwives. ‘The key to the show’s success is not me, but you [midwives] and what you represent to people,’ he said.

He believes the warm public response to the TV series also reveals what people want from midwives and wider healthcare – a focus on compassion and human values. ‘The heart of what makes both good midwifery practice and a successful midwifery drama... it’s love expressed through the compassion of medical care,’ he said.

Stephen also spoke of the healthcare profession’s response to the show. He recounted a recent occasion when he asked a trainee paramedic what single thing in Call the midwife most connected with him as a medical practitioner. The student answered: ‘Love.’ Stephen also recalled a book-signing when a student told him how she changed her university course to midwifery after becoming hooked on the show because ‘she wanted to be a hand held out in life’s most crucial moment, to show care through genuine compassion, and love through expert medicine’.

Media matters 

Ellie Durant, midwifery author and blogger at Midwife diaries (midwifediaries.com), spoke about the media portrayal of midwives. 

‘The issues to do with how the media portray midwifery first came to my attention via the Kirkup report,’ she said. ‘Underfunding, understaffing and lack of communication between teams [were all factors], and yet the one thing the media focused on was the midwifery side of things.’ 

‘Midwives are so important, they’re present during those moments of formative human experience. I think that’s what causes a polarised view in the media.’

Joshua Downey, midwife at Nottingham University Hospitals NHS Trust, said he was interested in the public perception of male midwives. He is one of ‘113 male midwives in the UK’, and believes this small number is both ‘media and culturally driven’. 

But Joshua didn’t think about his gender when entering midwifery, simply that ‘I wanted to care’. He said: ‘I’m a midwife, regardless of my gender. I feel I can empathise with the women in my care, as I’ve shared so many experiences over my career... and some enjoy a male perspective.’

When women do decline male care, he said he never takes it personally. ‘I do feel slightly under the spotlight sometimes, but my work is no different.’ 

The voice of women

Finally, Justine Roberts, CEO of Mumsnet, revealed the results of their recent survey of more than 1200 women who’d given birth in the UK, and their experience of postnatal care. 

While around 75% stated they had a positive experience, Justine explained that for the minority who didn’t – it stayed with them. For that minority, the basics of care were not happening. 

Among those who stayed in hospital after giving birth, many reported that it was sometimes difficult to access food (61%), pain relief (45%), drinking water (22%) and washing facilities (19%). 

That said, women understand the strain that midwives are under, which is likely why ‘88% of those who had a bad experience didn’t report it’, revealed Justine. 

Great expectations

Impassioned questions from delegates followed, with an evident ‘energy in the room’, as Mandy described it.

One midwife asked: ‘Do you think programmes such as Call the midwife set expectations higher than we can realistically achieve?’

Stephen replied: ‘I don’t think we’re responsible for the expectations that then go on for women in the health service. I think that at the heart of the relationship between our audience and ourselves – like that between mothers and midwives – is an emotional contract, not simply a medical one. I think if there’s an emotional expectation, it can be realised.’ 

Some questions centred on the expectations of women when they come to hospital to give birth. Justine pointed out that women just want clarifications on what they can expect, whether it’s when food might be served, what they should bring themselves, and so on.  

Another thread of questions was on how midwives can change the conversation and get their voices heard. Justine replied: ‘We need to join forces and say enough is enough.’ She said the messages needed to be passed on to government.

As well as the need to get together with communicators to ensure midwives’ voices are heard, the strong feeling about midwife shortages and its impact was clear. As one delegate put it: ‘How is the modern midwife feeling? Knackered!’

Mandy drew the session to a close, reflecting on the comments and saying: ‘Together we can make changes and bring midwifery forward.’


Tell us what you think

What are your views on how midwifery is portrayed in the public arena, whether midwives’ voices are being heard through the noise, and what needs to happen to ensure midwives have all the tools and resources they need? Contact us at [email protected]

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