By Ruth Weston
The Wigan ARM Study Day is fast becoming my Number One go-to event of the year for the quality of speakers, topics and discussion. This year was no exception, with a line-up of powerful and provocative speakers as well as some fantastic questions and input from the floor. Kicking off the day was superhero and RCM President Kathryn Gutteridge. Amongst many important messages her key message was ‘stronger together’. To build up the midwifery profession and face down the challenges we currently face we need to avoid fragmenting our community, to avoid splitting NHS from independent midwives, ARM from RCM, community from labour ward midwives and to work together for the good of the whole but also for each area of the profession.
Next up was Claire Mathews, Deputy Head of Midwifery (HOM) for NHS England who took us through her regular presentation on the implementation of Better Births across England. A highlight was the definitive short-term target of Delivering Continuity of Midwifery Care to 20% of women, the advice to trusts being to start with the low-hanging fruit – staff who are willing to have a go. In the questions, Deborah Hughes asked if NHS England would put a moratorium on the closure of midwife-led units whilst the strategy and implementation of Better Births (which includes the setting up of MLUs) was being agreed. Claire simply referred us back to the presentation without giving any further comment. This I found immensely infuriating and stood up to say so! We need more accountability for the recent MLU closures rather than avoiding the question and referring back to the plan!
To talk about the rest of the day would take too long but here are some more speakers:-
Jo Dagustun’s excellent presentation took us through the findings of her PhD looking at women’s experiences and perceptions of the birth system – and it is well worth looking out for her presentations on this subject. It was an illuminating and sometimes difficult listen. Talking to women about their experiences and what they wanted, Jo found that women were less concerned about continuity per se and more interested in being shown kindness. The lesson women were learning from their birth experiences was to shut up, shut down and choose the best way to protect their emotional and physical safety within what was felt to be an unfriendly environment, and for many women this meant taking the medical route for birth. Finally, with skill and sensitivity, Jo used a recent example of how some health service providers had handled a woman’s query about current practice on social media – to illustrate the relevance of her findings to midwifery practice right now. She asked, ‘But why is it so hard for providers to perceive issues first and foremost from the perspective of the woman and her family’s wellbeing?’
The amazing Soo Downe took the microphone and energised us with her enthusiasm and optimism, while overwhelming us with relevant data and research! The stand-out stats for me were how little difference induction of labour for postdates makes to outcomes for the baby. It leaves us reflecting on the impact of the iatrogenic effects on mothers of this policy. Another important point she made was that medical research is usually about solving problems: someone has a health problem – how can we solve it? This does not work well for physiological birth where our research is about enabling health and wellbeing rather than solving a medical issue.
There were some fantastic workshops on the new ‘not supervision’ system, on continuity of carer, on Airedale Hospital Trust’s system to enable independent midwives to carry on working (a win–win–WIN for parents, Trust and IMs!), to mention just a few. It was good to see One to One represented, Aquabirths and Margaret Jowitt with her Hi-Lo/Osborne birthing system, but most of all to see the fundraising stall for Haven – a new support group set up for midwives being disciplined or referred to the NMC. And as always the conversation and mutual support shared between us during the day was immensely warming and inspiring.
Finally Katherine Hales, ARM’s national coordinator, updated everyone on the campaign for better midwifery regulation, but in her own inimitable fashion also reminded us of who we are and where we are going. After doing some research I am now clear that what midwifery needs is its own professional body, like physiotherapists, rather than being combined with nursing. We were all pleased to have the RCM representative present stand up afterwards and show public support for the work being done here. As Kathryn Gutteridge said, ‘Working together we are stronger’.
Ruth Weston is an AIMS and ARM member, owner of Aquabirths, mother
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