November 05, 2002

Childbirth education and midwives attitudes

A fascinating day today. I am facilitating a “Teaching Skills” workshop for prenatal educators in Perth, Scotland. Once again I discovered that programs in this area are very restricted - typically just four sessions of 2 hours with an extra breastfeeding workshop in some cases. Once again I heard that midwives are often doing it “because it is part of the job” and that a number felt they had to do it, even though they didn’t like this aspect of their work. At one point someone said that “women in Scotland are different” and I have to agree with them..... a lot of very definite views were expressed that would have clearly conflicted with the aim of providing women with “freedom of choice”!

There is a distinct culture of “telling women” here and very little interaction in their groups. Men are often completely excluded or else viewed with deep suspicion. Many educators complained of the difficulty of getting people to participate, yet it was revealed that they don’t provide name tags for people and don’t do any warm up or introduction activities “because they themselves don’t like them”! Very few evaluate their classes - they might be surprised to discover what people think of them.

Several times arguments broke out about what constituted “informed choice”. It seems that it is considered quite acceptable to only mention those options that fit with hospital services and protocols on the basis that if women wanted something else they would have gone somewhere else by the time they arrived at the classes in the late stages of their pregnancy. Never mind that women may not have known of any other options because they had not been given the information or that the system actively discourages women moving about from one hospital or service to another. Homebirth was disliked by well over half of the group and water birth... forget it, women were not going to be given ideas about these possibilities. The view was that until the system was prepared to support these options women would not be told about them, and when I suggested that it has been women themselves who drive such changes once they know of alternatives, there was frank disbelief.

After listening to midwives all day using words like “delivery”, “confinement”, “letting her...”, “”allow” etc I finally could take no more and raised the issue of the language we use in our programs (you know what a passion I have about this...!). I was surprised at the attitudes of several midwives, who were vehement in their opposition to changing the way they talk to women, because they believed that what they were saying was acceptable. They were unwilling to see how influential our words might be in shaping beliefs and attitudes amongst pregnant women. Fascinating stuff!

I’m starting to think that midwives would benefit from “getting out more” to visit other parts of the country where different ways of working can be found. When it is as parochial and incestuous as this, it is hampering progress towards the empowerment of women and the elevation of midwifery. I am hoping that a good night’s sleep with enable them to see things in a slightly different way.

Posted by andrea at November 05, 2002 03:38 AM

Comments

As someone who attended this workshop and witnessed the behaviour Andrea describes and whether I agree or disagree with her points, I am disappointed to read her account of this workshop.We were assured that whatever we said in the workshop was confidential and to read it spread all over the net on an Australian site is at least, unprofessional.

Hello,

Yes, we did agree that the group would maintain confidentiality and therefore I have not named anyone or any place or even described in detail what went on in this group. The workshop was based in Perth, but the group members came from a number of different units.

It was a shame that the behaviour and attitudes of a few affected the rest of the group do badly - the evaluations relfected this. I know that others were interested and keen but much time was spent on managing the group when we could have spent iton trying a number of different activities. Let's hope that you felt it was not all a complete waste of time.....

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