soeaking out – @JennyTheM©️

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Talking with strangers and unconscious bias in the NHS Maternity System

October 29, 2019October 29, 2019 Follow @JennyTheM

This blog is dedicated to Sandra Bland with love to her family #SayHerName ❤️

I have just finished reading the book “Talking to Strangers” by Malcolm Gladwell

The book is a critique of how we approach others through our body language speech, demeanour plus the various cues that we interpret or misinterpret according to our own life experiences, culture, colour , upbringing, religion or non religion , education , training ,inner feelings at that time and individual roles plus many other factors too numerous to list . One particular woman who in the book was Sandra Bland a black woman who was forced to change lanes on a highway because a police car was approaching with speed – the officer totally misinterpreted Sandra’s distress at being pulled over – he wasn’t kind with his words or approach and this led to Sandra being wrongfully arrested and she died in her cell three days later the verdict was suicide . When you listen to the recording of the officers first interaction with Sandra you can sense the irritation and suspicion in his voice as well as the tone he uses. He doesn’t see that Sandra may have vulnerabilities and that she is trying to calm herself by lighting a cigarette .

As a midwife I have witnessed disparity of care towards women depending on their social status, background, colour, culture and ethnicity- something I have challenged throughout my career . These experiences have often placed me in some difficult situations with colleagues. On one occasion I refused to allow someone from finance dept into the woman’s labour room . This years (2019) RCM International Day of the Midwife campaign was around Midwives as defenders and I wrote a blog about my interpretation of this . We must approach women placidly and an excerpt quote from the poem Desiderata by Max Ehrmann © 1927 illustrates this rather well.

“GO PLACIDLY amid the noise and the haste, and remember what peace there may be in silence.

As far as possible, without surrender, be on good terms with all persons“

Unconscious bias is something we all have – This animation by Professor Uta Frith of The Royal Society explains unconscious bias in a concise way . It’s the 21st Century – time for all NHS staff to be educated, assessed and held to account around the subject of unconscious bias plus to question their own personal identity around this issue .

Here is a photograph of part of the philosophy of the Royal Society panel members – a philosophy for the NHS .

Whilst writing this blog I also came across this refreshing blog post for By ‪@SuzRankin‬ CEO of Ashford and St Peters NHS Foundation Trust, Chertsey , Surrey .

If you are a midwife I want you to start to question the way you speak to women and families that you meet and whether you treat each woman or person exactly the same despite their background , culture , colour, sexual orientation and education. Make an attempt to hear yourself as the woman hears you – be patient and thoughtful with your words and actions . Watch how other midwives speak about the women they care for (at the bedside and in the office ) and monitor one another for unconscious bias .

Did you see someone give the woman everyone recognised from a TV programme better care than the woman who arrived unannounced from the local homeless shelter ?

Please question everything you see and if you talk about it more when reviewing cases of different women you might see a pattern start to occur – that’s what you need to change. Does your incident reporting system include statistics on race , sexual orientation, religion and ethnicity? If not how can such incidents be thoroughly evaluated ?

How do you talk to the women you meet as strangers ? When you show patience, kindness, compassion and understanding you are building on the relationship and helping the woman to feel safe . This behaviour has an effect on the woman’s oxytocin response as her adrenaline and cortisol will be reduced as well as her own fears . You are putting her at ease – becoming a friend . If on the other hand you are brusque , rushed , impatient and critical you will put the woman on edge and increase her fear , pain and cortisol which will inhibit oxytocin production.

Are you pre judging a woman when she phones up the hospital for advice ? Does that judgment impact on the way you interact with the woman ? Do you feel calm or under pressure? Are you more or less patient with her in comparison to someone else you’ve recently cared for ? Are you imparting information and evidence of equal quality or do you feel a change in your own demeanour which may make the woman feel uncomfortable without realising?

Reflect on a situation when you didn’t feel listened to – that may have been a complaint to a store or a the way an employee at a restaurant/ service / shop spoke to you – do you recall how you were made to feel or how you reacted?

Black and Asian women have a higher risk of dying in pregnancy as the November 2018 MBRRACE-UK triennial report shows and as midwives we must question why this is happening as well as campaigning for this tragic disparity to end .

I will leave you with a quote by Paul Coelho

Raising perceptions of midwifery ©️

November 17, 2018 Follow @JennyTheM

This is a current drive in the NHS so I’ve decided it’s time for me to blog about it .

We are often told as midwives that it’s not about working harder but working smarter .

I’d like to try and find out if there is data collected about individual Trusts . The data would perhaps identify times when staffing was low , what the risks were to the women and the pattern of incident reports on those occasions . I also suggest that all maternity units have a duty of care to their staff to maintain accurate , exact records on how women are allocated to midwives, midwives individual workloads and time spent on NHS computers for work and personal use – this should be reviewed on a monthly basis and as part of FOI be available to the public . Do NHS Trusts that are using their own full time maternity staff to supplement staff absence and sickness assess the wellbeing of those staff? Is there a collaboration with occupational health , organisational development and Human Resources departments to review whether or not satisfactory and timely breaks were given. When this is quantified does it identify a distinct association with lack of breaks , working unpaid overtime , poor culture and is there a correlation with staff sickness and absence ?

it’s time now to look at the bigger picture and collect data on these topics as well as birth statistics , outcomes , morbidly and mortality .

Thank you for reading

Yours in midwifery love

Jenny ❤️

Antenatal education, Babies, Being a mum, Birth, Children, Compassion, Hospital, Human rights, Labour , birth, Labour and birth, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, Postnatal care, Respect, Skin to skin contact, soeaking out, Student Midwives, Women's rights, Young mothers, Young women, zero separation

Newborn babies – photographed without their parents – my bugbear

October 19, 2018December 2, 2018 Follow @JennyTheM

Everyone who knows me knows that I promote , research and present about SkinToSkin contact . I know exactly why it matters to mothers , fathers and babies .

Just recently I’ve noticed an advert for an upcoming ITV series “Delivering Babies ” in which Emma Willis stars as a auxiliary nurse assisting on a maternity unit – the profile photo shows a picture of Emma holding someone else’s baby without any of the parents in the photograph – this is what prompted me to write this blog .

One particular bugbear I have is seeing a baby on a photograph with a health care professional without the mother or father being included in the picture .

I have discussed this with many future and new parents and explained that they are the guardians of the newborn – protecting it from unnecessary exposure to anything . At most schools there is a social media policy which prevents the posting of children on social media sites . However the same rules don’t seem to apply for newborn babies.

I see many programmes about pregnancy, labour , birth and the postnatal on TV which I choose to critique. Some I have given up watching through exasperation that the baby is not seem as a child of someone .

I have had heated debates with maternity managers , future midwives , midwives , maternity support workers about why a baby should not be photographed without any of its parents . I ask them this question “if you had a baby would you want it’s photo to be on someone else’s social media account , mobile phone or perhaps even framed on a sideboard in someone else’s home that’s not even related to you ?”

Just google “Midwife” and numerous photos will pop up of midwives holding someone else’s baby . There’s even one from Call The Midwife – time to rethink why these photos exist and consider the human rights of the newborn ?

Below are two collages I made following a google search – who are these babies and were the parents asked for full consent and counselled thoroughly about the fact that their babies would appear on internet searches ?

My other concern is WHO takes the photo ? If it’s on the parents phone and given to the midwife as a gift does that make it ok . What is consent ? Eg “could I have consent to use this photograph of me holding your baby to post on social media / put into a frame at home , look back on and wonder who that baby belonged to in 20 years time ” OR “could I have a photo of you as a family with me in the background which I will treasure and treat with respect , I will not post it on social media and it will remain a midwifery memory for me of meeting you ?”

In taking photos we must consider

Is it necessary ?

Please leave your comments below

Yours in midwifery love

@JennyTheM