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Horizontal violence in midwifery

The issue of horizontal violence in midwifery units has again surfaced, as it does from time to time. In the UK there have been several enquiries and some useful research done to investigate ways of attracting newcomers into midwifery and maintaining midwives in the workforce, as falling numbers and the rising average age of midwifery staff start to ring alarm bells.

The telling outcome of these studies is the main reason that midwives leave their chosen profession is a lack of job satisfaction and recognition for the work they do. Many midwives cite a lack of support from management and poor relationships amongst their peers as underlying their decision to move on. Much of the behaviour they have suffered would be classified as “horizontal violence” and it seems that nursing and midwifery are particularly prone to this terrible phenomenon.

Many midwives struggle in unhealthy, unrewarding workplaces, and many cave in and leave, in the hope of finding more success elsewhere. As they depart, the work falls on fewer shoulders, adding further strains to the stretched services, and the cycle continues.

Many of those who remain are older and have developed ways of surviving in this socially toxic environment. They become hardened and withdrawn, going through the motions of “getting the job done” with little regard to the needs of women or their colleagues. Others become bullies, taking out their own frustrations and insecurities on others, who then have to find ways of dealing with the abuse or (more likely) dodge the issue by leaving.

It is a real problem and one that takes strong management and sensitive handling to eradicate. Good team work and the building of a strong shared goals and vision are important. There are midwifery units where these conditions have been developed with great success and unsurprisingly, these are usually the units where birth outcomes are also good, reflecting the way that happy staff have more time and energy to create happy birth places for the women they are serving.

For those who are interested in reading more about these issue, I can recommend these articles from our website:

Dying for the Cause by Carolyn Hastie

Horizontal Violence in the Workplace by Carolyn Hastie

Both explore the issue in depth and offer suggestions for ways of overcoming this insidious problem that in many ways is hampering the birth reform movement for women and their midwives.

Posted by andrea at January 15, 2007 08:56 AM