November 06, 2002

Unmotivated educators

I am glad that the Perth workshop is over. It was a difficult group - a mix of people who were, on the whole, reluctant to join in (the Scots can be very reticent and shy) dominated (intimidated?) by a group of midwives/educators who were very disruptive. I was able to give a lot of on-the-job training in how to handle negative, opinionated people as the group struggled to imagine how people with such dogmatic and rigid views could be let loose on unsuspecting parents!

I took a couple of them aside and suggested that if this program had proven to them that really didn’t like this work then that was a positive outcome, especially if they accepted that fact and resigned from the education team.

Whether this will happen will be down to their managers and administration. I was told that their attitude is that presenting the classes is a part of the midwife’s job and that anyone can do it. I am not sure whom they think will benefit from this approach - certainly the parents should not be subjected to a program that is presented by the untrained, unwilling and hostile staff they may now encounter.

All of these negative people worked togther, which makes things worse. They have no evaluation processes in place for their classes (just as well!) and were adamant that they get no negative feedback and that people still keep coming along. That parents accept this state of affairs either says that they have very low expectations or that they are desperate and will put up with educators like these to get any shreds of information that may be useful.

It’s a sad situation all round really.

Posted by andrea at November 06, 2002 06:10 AM

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Good points, that ring true to my experience. I'm an Australian, now living in Scotland, and a couple of us fathers (who also happen to be health professionals) got some funding from the Scottish government to trial male facilitators in some of the sessions that you met the midwives from in Perth, and nearby Dundee. These sessions were really interesting, with both men and women evaluating the inclusion of a bloke as a leader very positively.

I really had a shock when I came to Scotland to find things so far behind what I had left in Australia. Scottish men really don't want to be at the "classes" (they still use that term, and that is what they are), but we had some really good discussion, and they liked to talk.

The midwives have a long way to go before prenatal education is a major thing. But it doesn't get much support from on high.

And it seems to be a British thing to accept the status quo.

Hello John,

The involvement of a local father in presenting classes in the Perth area was mentioned at the workshop. It was therefore interesting to hear from you and to get your perspective.

Whilst the Scots may be shy and reluctant to join is, I do believe that given the right support and encouragement they will not only benefit from participation but really enjoy having the chance to explore their feelings with others (especially the men). What a shame that your project was not able to continue.....

Posted by: John Lee on November 8, 2002 07:33 AM

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I am sad that you appeared to have such a negative experience in Perth. I was not in attendance (I have previously attended your workshops and enjoyed them) however, I feel your portrayal of Perth is somewhat inaccurate, probably clouded by those individuals you say were 'difficult and reluctant to join in'. Most Perth midwives are degree educated, and taught to 'question' - is that 'difficult? Also not all delegates were from Perth.
We have some excellent motivated midwives who take great pride in offering interactive, parent led classes. Our classes are constantly evaluated, and have just been re-designed in response to client suggestions. We have 4 evening, one afternoon, and one post natal class, everyone, including fathers/birth partners are welcome to attend. We do address fathers needs, and took part in research re 'fathercraft' See John Lee above. We also offer refresher classes, one-to-one sessions, Twin classes, Aquanatal and exercise classes.(2 midwives are also fitness instructors). Parenting and birth issues are discussed at these contacts. Post birth, all women are invited to participate in a birth review, to discuss any apsect of their ante/intra natal care. Post natal women are also catered for with postnatal exercise classes, baby massage classes, breastfeeding groups, post natal classes, and reunions. We update our classes in response to client demand.
Yes there are some 'internal politics' aren't there always. However, please do not leave with the impressions we are all didactic teachers simply 'telling' women how it is. I am currently writing a research proposal looking at consumer expectations of childbirth classes - hardly an opinionated, reluctant, de-motivated midwife.
There are innovative people working in Perth, we were the first hospital in Scotland to achieve Baby friendly status, our breastfeeding rates are consistently high and we have developed multi-disciplinary training programmes for staff to keep up-to-date with current breastfeeding practice. We also provide midwife-led care, and have a low intervention rate.
We all have to work within 'constraints' of policies and protocols whether we like it or not, yes it would be wonderful to have a free reign. Sadly this is the real world, where women's decisions are often deeply rooted before we have a chance to speak to them. As with breastfeeding, we(the professionals and society) have undermined womens' belief in themselves. Many women in spite of our best attempts want a pain free labour. That will not change overnight, but many of us, myself included are motivated and open to suggestions of how to improve practice.
Finally, I am disappointed that you have painted such a negative picture based on the 'difficult' individuals, especially as your workshops are 'confidential'
Audrey McIntyre-Miller (antenatal health education co-ordiantor)

Posted by: audrey mcintyre-miller on November 8, 2002 07:49 PM

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Interesting comments Audrey and Andrea.

It was really interesting for me to come from Australia to Scotland, with an interest in breastfeeding promotion, and to have to re-evaluate my preconceptions about what an "acceptable" breastfeeding rate would be. In Australia we would probably expect 90% on leaving hospital, and 50% at 6 months, where as in Scotland, 50% at 6 weeks would be great in some areas. I went from being a health "professional" in one context to a health "amateur" in another.

I wonder where that leave the discussion about the offering of choices. Should we offer as an alternative something that is not available?

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