Today started as many of my days do, with me going straight into a meeting, no time to grab a drink or check my emails.
The meeting was discussing how we improve services for women accessing early pregnancy and gynaecology. How does that relate to their human rights? Well, ensuring women are cared for in an area that’s private and appropriately staffed with skilled nurses and medical staff means women that are suffering a miscarriage or early complications in pregnancy are appropriately cared for and supported.
Midwives working in a hospital setting often don’t have any dealings with women below 20 weeks so it’s important I make sure that the way these women are cared for compliments the midwifery care they receive and promotes the ethos of women-centred care. If the care we give is based on the needs and wishes of individual women then we are will be meeting their human rights.
‘Trust is the building block of a human rights relationship’
Walking around the maternity unit I meet one of our new consultant midwives who talks to me about a women she has been caring for. This woman is very keen to have a vaginal birth but is being discouraged by some of the medical staff who have concerns about her risks. Midwives and obstetricians have an obligation to talk to woman about any risk factors they may have. Unfortunately, every doctor this woman has met has felt the need to reiterate this woman’s risks factors.
As she clearly states “ I know the risks, I’ve been told them, I’ve researched them, I just want the best chance to have a good birth experience”. The skill to being a woman-centred midwife or doctor is to speak to women on an equal footing. To remove the power dynamic that is so often present in the relationship between health professionals and those they care for is one of the fundamental steps in building a trusting relationship. Trust is, I feel, one of the building blocks of a human rights based relationship with those we care for.
‘I see many, many happy faces of women’
My afternoon is spent trying to support the managers in staffing the unit safely, rewriting a job advert for midwives focussing on attracting candidates that believe in women-centred care. I then respond to a complaint from a woman who feels she wasn’t listened to when she was in pain, didn’t have her wishes respected or her beliefs.
All of the above makes my day sound pretty depressing but actually its full of positive stuff. I see midwives and doctors supporting women, being kind, communicating well and appropriately. I see staff members supporting each other with guidance and tips on how to manage particular situations and I see many, many happy faces of women, their partners and their families who have recently met the latest arrival to their family.
‘Kindness, respect, honesty and fundamental belief in a women’s right to choice’
So, what makes a “human rights focused midwife’? Kindness, compassion, consideration, respect, honesty and a fundamental belief in a woman’s right to choice.
You know what’s interesting? You could take out “human rights focused” because these are all the qualities that make a great midwife. Having spent 22 years working in maternity services the overwhelming majority of midwives I have met have all those qualities.
Unfortunately, sometimes the services they work in or the culture of the organisation in which they are employed doesn’t support them in demonstrating all these qualities. Fear of litigation, of not following guidelines, or of being labeled a “maverick” midwife by supporting choices women make that might not be the norm make some midwives act towards women in a way that they don’t feel comfortable with. This makes some midwives move on, some leave the profession all together and some give in, becoming part of the culture.
My words of wisdom? Be brave, be strong, be a midwife.
Simon is a trustee of Birthrights, a charity committed to improving women’s experience of childbirth by promoting respect for human rights.
Want to see more of our #WorldHealthDay coverage?
- See our piece on five times human rights laws have protected health
- Read why human rights are fundamental to end of life care