The creators of MIDIRS need a very large pat on the back for realising something that took other professions much longer to realise; the mid-1980s was about to see an explosion in computer technology and the future was in information: who controlled it, who had access to it, and who could use it effectively.
It was a time when most midwives in the United Kingdom had become relegated to fragmented providers of very medicalised care. Having been lead providers of care in their own right, by the early eighties most midwives were working within a single ward setting in a hospital as obstetric assistants to the medical team. In order for midwives to be able to reverse this trend and take their place as all-round lead providers of modern maternity care, they needed to have easy access to, and good understanding of, all the new research information that was slowly beginning to appear. There was also a strong belief that armed with good research information, midwives would be able to challenge many of the medicalised practices that were becoming more and more routine.
Information, information, information. It’s hard to remember back then as so much has changed in such a relatively short space of time. Remember, this was a time when there were very few journals and most midwives only received the RCM journal Midwives, which often went in the bin with its plastic wrapper still unopened. Most midwives didn’t know what a randomised controlled trial or a systematic review was, let alone be able to discuss it or present it in a multidisciplinary forum, and midwifery research was in its infancy. Most midwifery was still being taught from Myles or Mayes textbooks; the internet did not yet exist and library catalogues were becoming computerised but limited in what they could do. Midwifery education itself was in the process of moving from being hospital-based to being part of the new universities, a move which was to have huge implications for access to libraries and information, both positive and negative. Midwives were soon going to be studying for university-based diplomas and degrees. Something was needed that would help midwives keep up to date and abreast of all the changes that were about to occur. Midwifery was ahead of the game, and MIDIRS was to be the answer.
The beginning of MIDIRS
MIDIRS began life in 1985 as the information working party of the Association of Radical Midwives (ARM — which had been formed some seven years earlier). One of the founders of ARM was a visionary American midwife called Marianne Scruggs. She was a key member of this working party, and was an inspiring entrepreneur — very much a ‘doer’. It was coming towards the end of the time of the Greater London Council led by the maverick Ken Livingstone, and they had money to virtually give away. Marianne applied for some money from the GLC to take this information working party and set it up as an organisation in its own right, with its own funding, management structure and identity. The application was successful and, in 1986, the Midwives Information and Resource Service, known as MIDIRS, was born.
Initially there were three of us employed: Marianne Scruggs was the Director, Sue Hawkins was the Information Officer and I was appointed as the Administration Officer.
We were supported by a Management Committee from ARM which included Caroline Flint, who became the first Chair of the Executive Committee when it was formed a year or so later. Our rather small, tatty and initially empty basement office was in Camden, London. Tatty it may have been, but I remember there being a great sense of excitement and possibility.
Sue Hawkins, our librarian, was incredible and deserves all our thanks. You know when you start a filing system at home, and you always end up needing a category called ‘other’ that seems to get bigger and bigger, and all the ones you started with which seemed so clever and right remain almost empty? Sue spent the early weeks devising the initial MIDIRS classification system, which has stood the test of time and is still very much in use 21 years later. This is no mean feat and is a clear example of her analytical and careful mind which led the information and enquiry service for over ten years.
Slowly, month by month, the MIDIRS library filled up. We had to decide which journals to subscribe to, boxes were labelled, shelves were put up. Leaflets were produced to promote the new service and the now famous ‘MIDIRS pink’ colour was chosen. The first subscriptions came rolling in. Shortly afterwards we were joined by Jilly Rosser as our Midwifery Officer, and we three became four. Many of you will remember at that time Jilly’s hearing at the then UKCC, her striking off the professional register and subsequent reinstatement by the High Court (elizabeth). All of us involved in MIDIRS were pleased to support her through the turmoil and to celebrate with her on her reinstatement.
People found the name very hard to get used to! We used to get all sorts of pronunciations on the telephone — MIDRAS, MIDRIFF, MIDAS — and we were often having to explain what it stood for.
The information packs
The intention of subscribing to MIDIRS was that you would know that you had not missed out on anything major that had appeared in a key midwifery or obstetric journal over the past four months. The MIDIRS team scanned all the journals every month and put in short abstracts and commentaries of all the key research articles which were designed to be read quickly by busy midwives. It was a genuine digest of current midwifery and obstetric information. There were also articles on how to read and understand research to enable midwives to develop their own critical skills.
We outgrew our basement office and were lucky enough to find what was to be almost the opposite: bright airy offices on the eighth floor of the nurses’ home of Westminster Hospital, with a view of Big Ben if you strained your neck, and an outside sun terrace! This was all very well when the lift was working… but we all got fit on the days when it decided to go on strike! As the subscription base grew and MIDIRS started to expand, we took on other members of staff: secretarial help, and an information assistant. Sue Hawkins set up a volunteer librarian scheme whereby student librarians from North America and Canada came to do their elective placements with us.
In 1988, with the money from the GLC now gone, we took the big decision to accept Pampers sponsorship for one year. This was not a decision taken lightly but turned out to be a shrewd move. The money enabled MIDIRS to move from being a funded charity to being a non-profit making but financially viable organisation in its own right. MIDIRS has been proud throughout its history never to take money in any shape or form from baby milk companies and has maintained a rigorous advertising policy throughout its existence.
In 1989 we had the option to move out of London to new premises in Bristol, initially to work alongside the Institute of Child Health there. This seemed an ideal opportunity to escape high London rents and suited the workers who all were happy to move and get out of the London ‘rat-race’. Marianne had by this time left to adopt twin girls and move back to America! I was off to start my training as a midwife in Dorset. There seemed no real reason why MIDIRS needed to be London-based; and so a successful move took MIDIRS to St Michael’s Hill in Bristol and then 10 years ago to Elmdale Road where it still is today.
The subscription base grew and grew until MIDIRS became one of the most successful journals in maternity care, a position it still holds today. The information service developed from handling simple individual enquiries to the complex and detailed service of searches now on offer. The MIDIRS On-line Service database now has over 140,000 references, the information team scan around 550 international English language journals and there is a range of 475 standard searches that are subject to continual updating. The Informed Choice Initiative has taken information out to women and other professionals too. MIDIRS grew and developed; new staff joined as others left. Like any organisation it changed as it grew: an inevitable process. Now it has a staff of 17 permanent staff and is a thriving, internationally renowned organisation which I am proud to have been part of.
The early days all seem a far cry from the glossy, multi-coloured and professional MIDIRS that we know and perhaps take for granted today. In this day and age of websites, internet searching and computer downloads, it is hard to imagine a group of tired women walking repeatedly around a table picking up one photocopied page after another to pack into folders by hand!
MIDIRS is a truly inspiring tale of what can be achieved if you have a vision and, most importantly of all, stick to it. As the saying goes, “from little acorns….”. From an initial idea by a group of radical midwives, MIDIRS has become the state-of-the-art information service for maternity services in the world and is the envy of many professions. It is constantly developing its services, not afraid of change and keeps up with advances in information technology. I believe it has played a key role in supporting women and midwives in a myriad of ways, from choices in birth and research awareness to policy development and education.
What does the midwifery profession need now? What ideas do you have today that could be supporting and leading the profession in 21 years’ time?
Anderson T. MIDIRS Midwifery Digest, vol 16, no 2, June 2006, pp 279-281.
Original article written by Tricia Anderson, midwifery lecturer.
© MIDIRS 2006.