Wednesday, June 27, 2012

Birthzillas, wars and midwives

I have had many midwives say to me over the last few months that they don't want to engage with social media...that's it's a waste of time....and that it is irrelevant to their roles as midwives. I believe they are wrong. And it's the "Birthzilla" post that brought it home to me.

Online wars
If there's one thing I have noticed on the Internet, it is that there are many vocal opinions about childbirth. Nothing gets the blood heated (or nasty bullying) like an article on birth - the more extreme it is, the more comments it attracts. This is becoming particularly noticeable in the Australian media. Laureen Hudson, a social media expert, has talked about "war"...and that's what it feels like at times.

One recent example of these "online wars" is the post  "Birthzillas: when it’s all about the birth, not the baby", written by Mia Freedman, a few days ago. In this post, Mia talks about birth plans and the danger of focusing on the experience of birth,  to the detriment of the baby.

This post garnered over 1,150 comments (which is a huge number for a blog post) with a diverse range of opinions. What has struck me is two things. Firstly, the amount of unsubstantiated, mis-information that is spread about. For example, Rita says "Homebirth has a 3x greater risk of fetal demise…how can anyone say they’re thinking of the baby when they choose it?" This is a very scary statement with no reference, no context, and is certainly is not my understanding of the research around home birth.

The second thing that is apparent is the passion displayed by commentators, and in some cases, darn right rudeness and nastiness. One commentator, who identified herself as a senior student midwife wrote,

"This article is a prime example of pure stupidity and ignorance. I am nearly registered as a midwife, and I can tell you that just because you have had a couple of babies, does not make you an expert in the safety or the science of birth...... Read the evidence and get your opinions off such a public forum! People are too ignorant and unaware to be exposed to this kind of crap – it only adds to the problem!"

The problem with this sort of comment is that it can incite further nastiness, and does not contribute constructively to discussion. And I am concerned about how it reflects on the midwifery profession.

I think it is important for midwives to get involved with discussions such as this, to provide evidence-based research to counteract the erroneous information that is propagated in some areas. But there are a couple of tricks to engaging in these discussions.

1. Know your evidence
Make it your aim to provide evidence-based information in a way that can be understood by the average mum, and link to that information, so mothers can check it out for themselves.

2. Do not engage in an emotional way
You must remember that everyone is entitled to their opinion. And also be mindful some writers like to be deliberately provocative to increase readership and comments (don't we all!). The aim of the game is to educate people, not get into flame wars. Here is Tara Moss's response to the Birthzilla article: In defence of birth plans. Tara resists the temptation to be rude, derogatory or patronising, but rather writes a reasoned, balanced response - a lesson for us all to remember.

3. Remember you are representing your profession
I'll be the first to admit that I have got caught up in flame wars. And however much you disagree with a writer, you must remember that you represent the profession as a whole. If you're in doubt about the topic of the discussion and the evidence you can contribute, my advice would be not to engage at all. Or at the very least, wait 24 hours before you comment, or run it by someone else before you post.

Do you comment in online discussions? What tips would you pass on about how to do it safely and professionally? Have you ever got yourself into "trouble" online? What did you do about it?

Image: 'untitled'


Carolyn Hastie said...

Sarah, you are so right. I agree 100% that we as health professionals and midwives can do a lot of good by commenting online, in particular in providing a professional reflection/insight/aspect on some topics that may be a useful lens to add for women and their families. I'm cautious though about commenting on some forums as they are deliberately provocative and deliberately designed to influence people in particular and to my mind, unhelpful ways. Good conversation piece, thanks for starting it! kind regards, Carolyn

On Thompson said...

True, cattle producers learnt that with the Live Export debacle last year. Activists use the social media very well & you have to fight fire with fire & be proactive. There is a facebook page called "ask an aussie farmer" where the public can as questions of primary producers, why not something similar? You have to really police it & the admins have to be on the ball to keep things in line & make sure everyone plays nice.

Tina Ziegenfusz said...

I am not a midwife. I'm an experienced doula and I work closely with women in the childbearing year.

I engage a great deal through social media, commenting on issues I feel strongly about and trying to provide a counterbalance to some of the more hysterical views that seem to find legs in what passes for "objective media" .

Women of childbearing age (say 25-40) are strong users of social media and utilise the internet in every single aspect of our lives. I'm in my late 30's - and I can't even tell you the last time I looked in the Yellow Pages (I don't even have one) or picked up a newspaper, or phoned a professional without checking them out online first. The internet is where I go for everything and most people in my age group are no different. I feel strongly that if midwives want to connect with women in this age group - women who are in their childbearing phase of life - social media and blog comments are an incredibly effective way to reach them, particularly when they're at home with a new baby. It is often the jumping off point for finding information, finding support, and finding resources. Anyone who thinks that women will still pick up a telephone, or get in the car and do leg work as a first resort to find support or information now needs to reassess their approach. Online interaction in midwifery is far from irrelevant. It's essential.

Anonymous said...

I totally agree. I was upset by the MF blog & some of the comments but I really try to keep an open mind and learn from opinions I disagree with. I did engage in debate on a particular aspect with a couple of the commenters & whilst it got a bit emotional in parts by the end I think we'd calmed down & understood each other better. Reacting with hostility only creates more hostility, it is in our interests to stay rational and try to understand where the other is coming from.

I'm a homebirther who is considering studying midwifery, my prime motivation is wanting to provide non-judgmental support to women regardless of how "ignorant" or enlightened they are. My sister in law is having her first baby & she is completely confused by the different messages she gets from the midwives at the hospital she attends - one said "do not give us a birth plan, we will not read it" another asked her why she hadn't done a birth plan yet, and then proceeded, when my SIL asked about pain relief options, to say that there was no way she would be able to get an epidural as it was against the hospital's policy & that if she wasn't going to do as she was told she should stay at home & do it herself.

starpath said...

The contributors to this discussion have given good reasons why the pursuit of online knowledge transfer is worthwhile.
The properly used participatory online environment is a relatively new, and stimulating environment that is already useful to many health professionals, administrators and researchers. Ways to exploit digital channels for knowledge transfer, decision support, communication and psychosocial support already exist. Let the process continue in the best possible way, with no ‘flaming’, ‘scaremongering’, ‘warring’ or ‘cyberbullying’. Reasoned discussion is called for. (Is this too idealistic?) Then perhaps more midwives will follow the lead of those who already make a valuable contribution online. By participating in existing virtual communities, women have indicated they are willing participants and pregnant women commonly seek knowledge online.
(PhD candidate in Health Information Science)

Sarah Stewart said...

On: I don't know much about the Australian cattle campaign...I'll have to go and have a look. Midwives could easily run a "ask the midwife" FB page, but as you say...resources would have to be put into it...and you do have to be careful about what you say...that it is fully backed up with evidence etc.

Anonymous: What a shame that there is no consistency at your SIL's hospital. This is one of the most effective arguments for a "continuity of midwife" scheme.

@starpath Sometimes it is easier said than done. I can name you one person at least who makes it her job to hound and bully midwives online. And the vitriol that you read around midwives and birth can be darn right scary at times....I can understand why that would put midwives off engaging online.

starpath said...

Yes, I have read some of the unhelpful vitriolic comments leveled by women at midwives. It is an unhelpful approach but hopefully it does not stifle reasoned discussion. It is fantastic to see @LesleyPageRCM joining the conversation on Twitter.
More collaboration, more conversation: bring it on.
There are many midwives already online doing a great job with their openness and sharing. Fantastic.

starpath said...

I can't believe it! 1391 comments on the Birthzilla story you wrote about Sarah. As you say, emotions run high and there are many categories of response, some reasoned, many emotive. It is difficult for some people to have a balanced perspective and respect differences of opinion.