A Labour of Love?

Lee Seekings-Norman

AIMS Journal 2005, Vol 17, No 3

Lee Seekings-Norman reports back on A Labour of Love? Emotion Work and Reproduction Conference on 15 /16 September 2005 at the University of Huddersfield.

This conference title attracted my attention immediately. It was a joint venture brought about by Ruth Deery (University of Huddersfield), Billie Hunter (University of Wales Swansea) and Mavis Kirkham (University of Sheffield).

With around 23 speakers and parallel sessions running throughout the day and half, I wasn't able to attend all of the papers. Of those I did hear, the space here doesn't allow me to comment on every one. Suffice to say that it was heartening to notice how each speaker's work complemented the others, dovetailing together to create a jigsaw picture which illuminated the depth of culturally embedded ways of being. Simply put, what's wrong with maternity services is that they operate within a culture of blame, fear and time-starved industrialisation. Did I say heartening? I don't take it back. This conference was addressing unreservedly the complexities of why maternity services aren't working in the best interests of anyone.

It takes courage and a lot of sweat to acknowledge and define problems which are rooted in relationships, emotions and communication. As Arlie Hochschild (who coined the phrase and defined the concept of 'emotional labour') said; as a scholar she puts a tool on the table (in this case the concept of 'emotional labour') and hopes that someone will come along and use it creatively. This conference and its collected works has expanded the toolkit and contributed to a creative process.

For as long as I've given any thought to childbirth I've been touched at a deep emotional level and I believe that many people are. Herein lies the crux of the matter. For the first time in 16 years of conscious thinking and feeling around birth matters, I was at a conference which was getting to the heart of why so many people are dissatisfied, damaged and distressed by their experience of childbirth, whether mothers or carers.

Speaker after speaker referred to their research which highlighted the emotional energy; the 'emotion work', which people (mothers, fathers, midwives, student midwives, researchers, nurses and others) necessarily and without choice put into their interaction with others around reproduction. That might sound obvious, but what was reiterated many times was that this emotion work is often in response to structures, protocols and policies which operate as a cold, mechanistic, industrial system of organisation and control, which is then imposed on all those involved in that system. The result is disconnection of people, breakdown of meaningful or rewarding relationships and birth crisis.

More tools on the table and some specific ways of using them came in the form of work presented by Jane Bloom (Group Analyst and Midwifery Lecturer). She has designed a Problem Based Learning module in which student midwives "share and explore their emotional responses as carers".

Kirsten Baker (Midwifery Lecturer) drew on her drama experience using 'forum theatre' in workshops with midwives and other health professionals to explore their feelings and how those feelings affect the care that they give.

Mavis Kirkham's paper looked at language and thinking in dualistic principles and how this creates the concept of 'otherness' and, sadly, then leads to oppression and bullying. Christine McCourt presented her study on caseload midwifery which unearthed similar themes and linked parallel concepts between midwives and pregnant women's experiences. Of particular interest was the finding that midwives in conventional services felt stressed and experienced little support, whereas the caseload midwives identified peer support as important and developed it quickly. This mirrored how the women cared for felt; undermined in conventional settings better informed and more in control with a caseload midwife whose own needs were being met. This fostered self confidence within them rather than dependency.

Arlie Hochschild's keynote talk followed a thread running from Charles Darwin's work on mammals and the origins of empathy, through the witchhunts and exclusion of women from healing, through to today. Currently midwives are "leading a moral and cultural struggle to win back a place for empathy", in part by recognising the "pharmacologising", "institutionalising", "bureaucratisation" and "commodification" of empathy. Fiona Dykes' keynote presentation drew on her study in hospital maternity wards. "The combination of temporal pressure, unpredictability and 'rapid turnover' of women made it almost impossible for midwives to establish relationships with them. They coped by gaining satisfaction from rapid processing of work and completion of procedures. Within this context women's needs for emotional and practical support were largely unmet. Unrelenting pressure on midwives' time is a source of oppression".

AIMS' Vice Chair Nadine Edwards was the first keynote speaker and drew on her PhD research into women's experience of planning homebirths (published this summer by Routledge as a book Birthing Autonomy, £16.99) and her current research into women's experiences as lay representatives on Maternity Service Liaison Committees. She talked about the impact each person's emotion work has on others. Reflecting Mavis Kirkham's work, it showed how the coping strategies midwives might employ for their own protection can seriously undermine the birthing woman with potentially long-term harm. Whilst both midwives and women can have mutually rewarding relationships with one another, "what's positive for women can be negative for midwives if they have to fend off the institution, and what is positive for midwives may be negative for women if they had to compromise on what they believed was best for their babies".

The final plenary session asked 'what next'? I have a feeling that there is more to come and a recognition that finding embodied ways of experiencing the power of empathy and providing opportunities for health professionals, students and teachers to experience this, will begin to supersede the current mass embodiment of fear. Fear which results in suppression and armouring of self which, in turn, limits caring relationships. I know one person who wrote something on her conference evaluation form along the lines of "it's a shame to tick boxes after a conference which was about getting rid of boxes". That says it all really.