‘Students can help to give women back their ability to birth without fear as it is only when we remove fear will normal birth be restored as the true norm’.
– by Mary Sidebotham, Senior Lecturer (Midwifery), Griffith University, Australia.
The rate of intervention in childbirth has been steadily increasing on an international scale for the last two decades and there is a growing awareness that this presents us with a real public health challenge (NHS Institute for Innovation and Improvement, 2012)
There are a number of well-established frameworks and guidelines in place with the sole purpose of increasing the rate of normal birth (NHS Institute for Innovation and Improvement, 2012). Student midwives are often at the forefront of the evidence debate because of the assessments they are required to complete within their education programmes – but when questioned frequently report that they feel helpless and unable to ‘make a difference’ in practice. I would argue though that student midwives are in a prime position to support and promote normal birth and should seek out areas of positive practice in order to maintain their motivation, passion and determination to support choice and practice according to the evidence.
The student should not be afraid to lead by example wherever possible. In many cases it is the student not the supervising midwife who has an ongoing relationship with a woman because of the requirement for a student to follow women through their pregnancy journey. Those midwives who do not work in a caseload model do not always have the opportunity to build relationships over time with women, so do not have the opportunity to discuss birth options and follow them through into supporting the woman in labour. The student, however, often takes on this role and is able to support the woman, provide current evidence-based information and as a result contribute to a multidisciplinary culture within a community of practice (Li et al 2009) rather than operate within a traditional hierarchical model.
The student should be brave and be willing to change the unwelcoming environment – they are going into birthing environments with fresh eyes. The midwives become used to thinking the way they are. But if a student is brave enough to say ‘should we move the bed out of the way’ the whole dynamic and sense of purpose and space within a room can change.
Similarly, if the student remains in the room with the woman, supporting her throughout labour, resisting the temptation to watch a monitor from a desk and chat with friends, a positive change will take place. The student who gently closes the door that has been left open, knows when to touch and when to leave well alone, can begin to clear a sense of safety and well-being.
The student may be the one who respects the sound of silence and listens attentively to the woman’s birthing song rather than chats with friends and birth supporters, thus enabling an empowering and supportive environment for the woman.
The student who respectfully asks questions of other care professionals and shares her growing knowledge by offering to repeat the presentation she did for a university assignment to her colleagues in the practice environment begins to build collaborative relationships, again fostering a community of practice.
So can a student make a difference? Yes they can. It was the student coming behind me that inspired me to return to education (Sidebotham 1993), so in order to enable students to inspire us as they did me all those years ago, we need to provide the support they need to grow and develop and be part of the movement to reverse the trend. Students can help to give women back their ability to birth without fear as it is only when we remove fear will normal birth be restored as the true norm.
- Li LC, Grimshaw JM, Nielsen C (2009). Use of communities of practice in business and health care sectors: a systematic review. Implementation Science 4(1):27.
- NHS Institute for Innovation and Improvement (2012). Promoting normal birth – one of the high impact actions. http://www.institute.nhs.uk/building_capability/hia_supporting_info/promoting_normal_birth.html
- Sidebotham M (1993). Clinical expertise or academic degrees? British Journal of Midwifery 1(6):250-51.
Contributor: Mary Sidebotham, Senior Lecturer (Midwifery), Griffith University, Australia
Photo credit: Mary Sidebotham.