Midwifery Without Fear

I had the privilege of chairing the ARM national conference on Friday last ( 23rd Nov 2012), and what a conference!  Not what we had planned but every bit as good.  Today just a few of the random notes from the day in between checking what was coming next and making sure the coffee was hot for the break!

Mavis Kirkham openned the conference:

Fear has come as

Medicine has strayed from its sphere supporting abnormal births and treating pathologies into caring for healthy women.

there is such a complex concept of risk that medicine now has access to healthy women

False dichotomies such as:  home and hospital, breast or bottle, medical or midwfery-led.  When the reality is that most people would or could or wish to fall somewhere between the two extremes.  False dichotomies are a bad habit picked up from medicine – we need to reclaim the big grey area in between.


there is a fear of not coping but more potent ba fear of being perceived as not coping – both midwves and women feel it.

Research showed midwives coming back to work were more worried about looking like they were competent than being competent

Record keeping rather than being about good care is about covering your back.

When something goes wrong it is always someone’s fault it ahs to be.


the choice rhetoric is belied by the fact that the local nhs chooses whats on the menu to choose from and controls the funding that resources it – and there isn’t another restaurant in town – indeed after Oct 2013 there will be no choice as far as midwifery care is concerned.  this is not real choice.

Fear means we educate women in making the right choice for us. Egs of Midwives being told off for letting their women make such choices

It is about an NHS that works on an outmoded Industrial model which is about process rather than relationship

efficiency rather than good care

that is about standardization rather than personalisation of care.

Eg Triarge was desinged for battle zones to see decide who would be left to die and who would be treated or transferred etc.

We now have telephone triage where a stranger decides over the phone whether youa re far enough on to come into hospital.  This does not make people feel cared for and produces fear in women.

Fear is produced in this system and it produces alot of pretending and wasting of resources

Fear of missing something, not fitting in, that phrase used by midwves about their colleagues and women about the midwives “I don’t like to ask”.

My comment:Is ‘Intentional rounding being introduced in local hospitals, therefore a system response to a relationship problem?


What women need is not fear but

a sense of being safe

warmth comfort and privacy

minimal mental stimulation

the company of people they trust

carers who listen

In our hospital system this is not what women get.