Saturday, April 26, 2008

Who is the midwife who inspires you?

Image: Salisbury Hospital (Florence Nightingale once worked here) where I did my nurse training - is now a block of luxury flats.

One of the things we are doing to celebrate International Day of the Midwife on 5th May is to have an Otago Polytechnic School of Midwifery lunch. The theme for the lunch is: which midwifery character, figure or personality inspires you?

Who inspires me?
I have a long list of midwives who inspire me including the wonderful team of midwifery lecturers I work with. But I have whittled my list down to five midwives, although I been inspired by many wonderful midwives over the years, and to them - thank you.

Sister Butcher: love and compassion
When I left school I went and did my nurse training at Salisbury Hospital in Salisbury, UK in 1980. During my training I did a short four week placement on the maternity unit at Odstock Hospital, which is now the Salisbury District Hospital. During that placement I spent some shifts working on a post natal ward managed by Sister Butcher. Those were the 'good old days' when first time mums stayed in hospital for eight days after giving birth and babies were kept in the nursery at night. So the post natal wards had a much stronger community feel than they have now, but that is another story.

Sister Butcher would probably be considered 'old school' now with her crisp navy blue uniform, cap and bright red lip stick. She could be quite fierce and she had a reputation for taking no nonsense. And some of the students were a little frightened by her. So I was rather daunted at the thought of doing an evening shift with her, all by myself. We were not very busy and I had the job of feeding a baby in the nursery. Sister Butcher came and talked to me as I was cuddling the baby for what felt like hours, and we had the most amazing discussion about life, midwifery, babies, pregnancy, women and midwives. I was so deeply moved not only by what she said, but the love with which she said it that I cried (and am crying now as I remember this). And it was at that moment that I knew I wanted to be a midwife. If I could be half as strong, thoughtful and loving as a midwife as Sister Butcher was, I knew I would be a great midwife. As soon as I completed my nurse training in 1984 I went on to train as a midwife at Odstock/Salisbury where I stayed until 1996 when I moved to a job as community midwifery sister in Basingstoke.

Sister Newland: midwifery assessment and actions
Sister Newland was one of the lead midwives on the labour ward (sorry about the terminology, but that is what we used to call it) at Odstock Hospital - I think she is retired now. She was incredibly knowledgeable, skilled and experienced. I had the privilege of working with her throughout my time at Salisbury from 1984 until 1996 when I moved to another job.

Sister Newland...how does the saying go... had forgotten more about childbirth than I have had hot dinners. She was the one you would go to for tips and advice. She would know exactly what to do in any emergency. She was a true mentor. In particular, I remember her as the one who taught me the vital importance of assessment - if you do not thoroughly assess what is happening, then you cannot make an accurate judgment about your midwifery actions. And it was her skill of using her hands, heart and brain that made her such a brilliant midwife - she didn't need to rely on machines or doctors. Now I am not saying that I agreed with everything she did or said, but even after all these years I always think of her whenever I am with a woman in labour. I try to emulate her ability to assess, act and document, and also pass on my knowledge to students as she did to me when I was a junior midwife.

Glynis: questioning practice
Glynis was a student midwife I worked with in the early 1990s - I cannot remember her surname. My particular memory of Glynis was when I was working with her on the labour ward and she was 'conducting' a birth - don't even ask me about the terrible terminology, it is too embarrassing! In other words, she was making the decisions and I was supporting her. The woman was birthing the baby but instead of the mantra I used (because that was how I was trained) of 'take a deep breathe, push for as long as you can and do it three times with each contraction', Glynis was quietly supporting the woman without saying much. The room was quiet and calm - it didn't feel like the finishing post at a racetrack. And the woman was doing her own thing and very happily birthed her baby without any interference from us.

I was gobsmacked to say the least. And when I talked to Glynis about this afterwards she told me about what she was learning and that there was no evidence to support directed pushing and time limits in the second stage of labour. So it was Glynis who inspired me to think about my practice, what I do and why I do it. Do I do something because that was what I was taught and is the routine or is it based on the evidence of research and my own personal investigations - in other other words, do I have an evidence based practice? Glynis started me on my academic studies and when I start to fall into bad habits, I think of Glynis and the vital importance of questioning my practice and why I do things.

Lesley Page: total midwifery caseload practice
Lesley Page is a very well known midwifery researcher and writer. My midwifery claim to fame is that I have had a curry in Manchester with Lesley before a conference a few years ago. She has written a very influential midwifery textbook called 'The New Midwifery: Science and Sensitivity in Practice'. But the reason I cite Lesley as an inspiration is because of the work she did investigating caseload midwifery back in the early 1990s. The result of this work was an editied book called 'Effective Group Practice in Midwifery: Working with Women'.

At the time I read Lesley's book I was working in a hospital rotating around the wards, staying on a ward several months at a time. I enjoyed my work and loved working with women. But it felt quite unsatisfactory. I only knew the women for a short time and the whole process felt very disjointed. I wanted more from my job as a midwife. Once I read Lesley's work and the experiences of the midwives and women in her research, I knew that I wanted to work in a way that allowed me to provide continuity of midwifery care to women throughout their birthing experience, not just for a few days in hospital.

I campaigned with others for caseload midwifery in the area where I worked but it never came to being. And then we moved to New Zealand. It was when I landed in Gisborne I realized the whole maternity system in New Zealand is based on caseload midwifery and I started my job as an LMC. It was thanks to Lesley that I knew how I wanted to practice as a midwife and have been committed to caseload midwifery ever since.

Sheila Hunt: communication and research
Professor Sheila Hunt is also a midwifery academic who truly inspired me as a result of her book 'The social meaning of midwifery' which she wrote in 1994. This book was the result of ethnographic research that Sheila carried out watching midwives interact with women when they were in labour. Some of the results were distressing because it showed that midwives can be thoughtless and denigrating in the way they interact with women, which can be devastating to the women and their families.

There was nothing in this book that was rocket science, but it did make me sit up and reflect on how I am with women and how I communicate with them and my midwifery colleagues. This was definitely an important part of the development of my midwifery philosophy in which I feel it is vital to work in a respectful relationship with women.

This was also one of the first pieces of qualitative midwifery research that I had read and it opened my eyes to the potential of research in midwifery practice - I could see the relevance and application of research. And I think that it was this book that hooked me into research
compared to the dry, statistical randomized-controlled trials that I usually tried to wade through, and it started my interest in being a researcher.

Image: Some of my colleagues who inspire me on a daily basis

What will the students say?
I am really looking to our lunch and can't wait to hear about the midwives who inspire our students.

If you are a midwife, what would be your answer to this question? And if you are not a midwife, who inspires you?

24 comments:

Anonymous said...

great post!

Sarah Stewart said...

Thank you for that, anonymous. I thought it was very long and boring but it has been in my head for years and I am really glad to have documented it at last.

Anonymous said...

found it really interesting - hope more of these stories emerge at our lunch!

Anonymous said...

Sarah, I think this is a fantastic way to celebrate the International Day. When you have received other suggestions for inspiring midwives please send a summary to me at the ICM journal. It would be wonderful to publish a selection of the names, hopefully from worldwide backgrounds.

Elizabeth (e.duff@internationalmidwives.org)

Sarah Stewart said...

Elizabeth: a great idea. I'll be happy to do that. Sarah

Anonymous said...

Hi Fellow midwives
The midwife who inspires me is a unsung heroine
Judith Kurutac
In the 1980s when everyone else seemed to be into technology as a young student midwife at St Marys Hospital Manchester, I observed patience wisdom courage and intuition in one inspirational midwife and decided I wanted to be like her
The highlight of my career to date was when i worked in partnership with Judith in the late 1990s when we shared a caseload I can honestly say, that is when i really learned how to be a midwife.
She is a champion for women and will always be my champion
Thank you Judith

Mary Sidebotham

Sarah Stewart said...

That's fantastic , Mary. Thank you very much for leading the way. This is making me quite teary (which is very strange for me because usually I'm hard as nails). I must try to contact the midwives I was talking about and thank them personally.

Traci Hudson said...

What a nice way to publicly thank people who have helped along the way, my people are:
Kathie Grimes: When I was a student Kathie taught me to respect and protect normality but to be able to efficiently deal with any emergencies. From Kathie I learnt about accountability, autonomy, professionalism and midwifery
Irene Walton: Irene encouraged me to undertake my MSc and subsequently become a lecturer. She had faith in my abilities - I owe her a lot. From Irene I learnt about critical thinking and investment in people
Barbara Ellison: Barbara was my ward manager when I first qualified. She was a true leader, quietly asserting her authority and dealing with situations with compassion and gentleness. From Barbara I learnt the values of leadership and management

Sarah Stewart said...

Hi Traci, thank you very much for your contribution. Are you able to say what part of the world you're from - would I be right in guessing the UK? Cheers

Traci Hudson said...

Hi Sarah

Yes I can do that; I am now a lecturer at Liverpool John Moores University (previously worked at Bolton, Halton and Chester - all different guises)

Sarah Stewart said...

Thank you for that, Traci. Great to hear from you. Its good to get a feel for where people are from, especially as this will end up in the ICM journal.

sj said...

Hi Sarah,
This a wonderful way to let people know about the midwives who are inspirational. I am a student midwife in my first year and have been fortunate to meet some VERY inspiring midwives. I have met a number of midwives although 3 are at the top of my list and i fel that they really need a mention because i feel that without their encouragement, support and influences that i have received in my short time i would have not (nearly) survived my 1st year.
The 1st midwife is Julie Sanderson. Julie has been a practicing midwife for many years but still manages to make women feel special and cared for on a personal level. Her practice includes being a bereverment midwife and the women she has had cared for over the years think very highly of her and many women who have had a berevement and been cared for by julie contact her again if they become pregnant to share their joy and happiness. In my short time of knowing julie she has taught me more than i need in my first year and has prepared me for my 2nd yr of training. I am very fortunate to have worked alongside julie, and know that if i ever need any advise or encouragment she is there. Julie will always be an inspiration to me and i hope to be just like her one day. Her knowledge and experiences are totally priceless and this makes her a very special midwife.
The 2nd is Una Goodall, she is one of my lecturers and has taught me that normality can happen it just needs knowledge and encouragement.She is very inspirational and helps to question practice on a daily basis, which is vital if new midwives are to change the future.
The 3rd midwife which i need to mention is Joanne Battensby. Joanne is a practicing midwife and totally holistic without even realising it. Joanne builds a rappore with women the moment she meets them. Joanne practices holistic midwifery the way the university teaches us and this is inspirational when working in a medical environment. These 3 midwives are just a few who have inspired me but i know that they have been my rock in my 1st year of training.

Sarah Stewart said...

Thanks for dropping by Sarahjane. It is lovely to hear from a student. Your comment gives us an insight into what is important for a student-thank you.

Sarah Stewart said...

Cynthia Flynn, who is a midwife and educator at the College of Nursing, Seattle University, finds the midwives she met in Sri Lanka following the tsunami in 2005 to be her inspiration. You can find out about her trip by visiting her web site: http://www.columbiabirthcenter.com

Cynthia's travel log is here: http://www.mytripjournal.com/TsunamiFlynn1-05
and the password is 'Cynthia'.

Thank you, Cynthia.

Sarah Stewart said...

Pamela Hines-Powell is a midwife in Oregan. The midwives she finds inspiring are Sara Wickham (yes, so do I!), Gloria Lemay and Lisa Barrett.

For those of you who have not heard of Lisa, she has a very exciting homebirth blog.

Lee Kolbert said...

Sarah,
15 years ago, I gave birth to a stillborn girl. She was born at 39 weeks and weigh 7 lbs 14 oz. She was beautiful. The birth went very, very fast and the doctor did not make it in time. There was a midwife in the hospital who not only delivered my little girl, but held my hand through the whole ordeal, before and after. She was a blessing, and I never even got her name. At the time, I had my son, Jordan, and since had my son, Josh. When I remember my daughter, Samantha, I also remember that wonderful woman who gave me her heart and touched mine. Thank you for helping to inspire such a noble field. ~Lee

Sarah Stewart said...

Thank you so much for sharing a story that no doubt brings you some sadness, Lee. You know, sometimes I get so caught up in 'me' that I forget what midwifery is all about - making a difference to women. Thank you for reminding me.

Sarah Stewart said...

Hi Sarah

What a great idea!

The midwife who has most inspired me (though it has been difficult to
choose) is Nicky Leap. I have known Nicky for about 27 years. We first met at an Association of Radical Midwives meeting back in about 1980-1, when Nicky was still a student midwife.
Over the years we have worked together as independent midwives, giving each other back-up with our caseloads, and then as co-researchers and co-authors of the oral history, The Midwife's Tale. We have now both
moved into academic life, and I continue to be impressed by Nicky's
optimism, creativity, fresh 'take' on issues and unstinting commitment
to putting women first. She continues to challenge my thinking and stimulate my 'midwifery imagination'. She is also great fun to be with - a brilliant sense of humour and fun. (I'm sure I can find a story here if you'd like one!)

Nicky is one of midwifery's great pioneers - whether it was setting up
the now famed Albany practice in SE London or developing direct entry
midwifery education in Sydney or researching how best midwives can
support women through the pain of childbirth. However, Nicky remains
very much 'of the people' - I guess her most endearing quality is that
she doesn't realise how special she is.

Finally and most importantly, I myself have benefited hugely from
Nicky's approach to midwifery and childbirth, as Nicky was my own
midwife at the home births of my two sons. I have had first hand
experience of her knowledge, artistry and skill, and in particular have benefited from her maxim: "the less we do the more we give".
All the best
Billie

Billie Hunter
Swansea

Anonymous said...

Hi Sarah, what a great idea! I would like to highlight the huge impact that homebirth midwives (and women) have had on me personally and on the profession of midwifery. When midwifery was at its lowest ebb with fragmented models of institutionalised care dominating and even the title midwife (in New Zealand) on the brink of being obliterated, homebirth midwives kept the fire of midwifery alight. They have shown us (and continue to remind us) how to be “with women” providing continuity of care and also they have shown us the power of believing in women’s ability to birth. They have done this and continue to do this in contexts that are often unsupportive and hostile.
I have also been inspired (on many levels) by Professor Nicky Leap. I know that she works tirelessly for midwifery but it is the way that she goes about her work that I find so inspiring. In all her working relationships I see that she is working to listen and understand other’s perspectives, to give them time and support, to create opportunities for them, to empower and to build their confidence. When we think about midwifery, these are exactly the things that we are trying to achieve for the women in our care. Wouldn’t the world be a better place if we could all bring these values to all our relationships!
Deborah Davis

Anonymous said...

well after trying to limit myself to just one inspirational midwife - I have to admit defeat - there really are too many - midwives are as inspiring as the women they work with - so its no wonder this is such a challenge. I believe all midwives imspire someone on a regular day to day basis.
That said - there are some worthy of particular mention - Jackie Pearse was one of my lecturers who was also studying law at the time and went on to be our legal advisor. Jackie was always so articulate and reasoned - she had a big midwifery heart and a strong sense of social justice and generosity. When she talked about women and mothers the respect she held for them was clear. She was a positive role model who midwifed many through the fear of litigation that came with increased autonomy - reminding us that the womens right to question our practices was a fundamental right and one we had all fought for. Great perspective.
From practice I have to acknowledge all midwives in NZ who strive to work in partnership with women and foster the womens role and active participation in pregnancy, birth and beyond - but particularly my practice whanau - Marie, Estelle, Nicky and Karen.All these women have open hearts, broad minds, wisdom, passion and dedication to women and their families, to the community, to normal birth and the power of women to achieve their maximum potential. They also provided me with a happy practice home, a lot of laughs and endless support and encouragement.
Nicky Leap - just says it all so well every time. Sara Wickham - I love the way she asks the questions that show us how little is actually known. Nadine Edwards - for her contribution in making sense of it all in the technocratic context we find ourselves in.
rae

Anonymous said...

Hi Sarah

Many caring midwives have inspired me over the years but three in particular stand out. The first an unsung heroine Bridget Fernon, a community midwife from wakefield UK who was caring for women who's mothers she had also cared for when they were born. I had the priveledge of attending several homebirths with her as a student midwife and she showed me how to become a calm caring confident midwife.
The second Ann Geddes who was my former HOM and supervisor in Leeds UK encouraged and motivated me for over a decade to study and undertake midwifery-led research whilst continuing to have a caseload, she found funding when there wasn't any funding!
The third Soo Downe who has mentored and nurtured me over the last few years to become a well rounded midwife + researcher and to always stay focused on woman-centredness.
Mary Steen

Sarah Stewart said...

This Midwife is most certainly Dr Mary Steen. Mary is currently supervising me whilst I undertake my dissertation for the Masters in Midwifery Studies. Mary is friendly, approachable and supportive. Her sheer enthusiasm is enough to inspire me. I believe there are too many academics who are out of touch with so many aspects of clinical practice, and these are the people who are involved with the education of midwives and midwifery students, on a daily basis. Its so refreshing to know a midwife, who is at the forefront of midwifery on a clinical level, who as a result of determination and self motivation, has somehow managed to build a perfect bridge between practice and midwifery research. I don't know of anyone else who provides such a perfect link. Mary shares her knowledge in whatever way she can, whether this, for example, be with work colleagues, through publications in journals, books, or speaking at conferences or lectures worldwide The passion and drive Mary has for midwifery is admirable, and she is a voice for all midwives who will strive to promote and achieve excellence, which is what women, families and midwives deserve.

Katrina Rigby
Midwife
Preston, England

Anonymous said...

the midwife that has helped/inspired me is Jackie Moulla another of the Albany midwives who is now the head of community at QEH woolwich, she has made me believe that I am a good midwife and she has been there for me when my belief in myself has been at its lowest, thank you Jackie xxx

Sarah Stewart said...

To everyone who has contributed to this discussion, thank you all very much. In the next few days, I will collate all the posts into an article for the ICM.

In the meantime, please feel free to keep adding names and stories.