• The Fit Midwife


Respect is a strange concept really. It means different things to different people. And holds more weight in certain cultures, in certain countries. In healthcare, especially here, the hierarchy of practitioners demands respect. Demands it for themselves. Heaven forbid you treat people because that is your vocation. Since when did the practitioners treating the clients/patients become more worthy of respect than those they are treating? Is it becoming a tree falling in the woods kind of situation? If I treat someone and something great happens but no one sees it or hears about it, did I even really do anything? It is baffling….

They say respect is a two way street. Such a common phrase right? I find myself walking these streets alone whilst people insist their respect is there but fail to demonstrate it through their actions. Whilst we can apply this to our personal life, that is not my intention here! I find it professionally every day. Where I am now, my career choice, it does not earn me the respect of other medical professionals. It more often than not, earns their contempt. Why? Because I respect women on a different level. I have a way of doing things, as do certain other colleagues (Midwives and Doctors alike). And this way ensures that our women and their families feel heard, cared for, respected. It is how I was raised, as a tiny student midwife all those years ago. But I have to mention, I am lucky to have some excellent Doctors in my corner in this country who trust me and respect me implicitly and vice versa. Without them, I’d have been back in England 12 months ago.

Some people assume respect is their god given right due to their professional title. Yet these are often the people who fail to demonstrate respect to others in their care. I’m not talking specifically about respecting beliefs, cultures, personal circumstances, as important and necessary as that it. Here I talk about respecting women’s pregnant, birthing bodies, their right to privacy, their right to decline anything they feel uncomfortable with. Being trained in obstetrics and midwifery does not give you the right to do anything to another woman without permission or respect. I talk about respect in such a basic form as from one human being to another.

This is something I have been thinking a lot about. After my birth trauma blog post yielded a considerable amount of feedback, which I will share in due course. I wanted to come up with something easy. A resource for professionals, something to prompt them to think about what they are about to do and to remind them to respect the woman in front of them, her body, her rights. Something to remind us all of the fundamentals we are taught but so quickly can forget in clinical practice. And for women, to use as a tool to ensure they are treated in the best possible way to maintain and grow a good relationship with their midwife/nurse/doctor. I have been told multiple times this is fruitless, that no one will listen. All I actually want to do is staple this to many practitioners foreheads butI don’t think i’d do well in a UAE prison. So I am hoping one person reads it. And they think about their practice. Or one woman reads it and finds her voice, to speak up if something is making her uncomfortable.

I’m keeping it really simple. And I am channeling my inner Aretha Franklin to help remember this:

R - Reason (why do you want to do this procedure, examination)

E - Empower (provide all information to empower an informed choice)

S - Safeguard (Protect your woman’s dignity, confidentiality, her body rights)

P - Patience (Be kind and gentle, follow your woman's lead)

E - Empathise (Be mindful of any wishes, fears, concerns, previous experiences)

C - Consent (Signed or verbal - Never touch a woman without her consent)

T - Talk it out (Discuss all findings with your woman and always always always DOCUMENT in your notes)

Whilst I understand there are some emergency situations that require action to be taken within minutes, there is no reason these principles cannot be followed. I have found a umbilical cord prolapsed and still managed within seconds to explain what has happened and how I need to push the baby’s head off the cord whilst we rush to theatre to deliver. Delivery of information and respect of a woman is everything in this profession. I try as much as I can to encourage others to imagine it is themselves in this position, their sisters, daughters, friends. Perspective is needed. If you read some of the responses I received to my birth trauma post, you would cry. Fruitless as it may be, I won’t stop trying to make this experience better for all women. Not just those in my care!

Nikki xx

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