I thought by now, after 12 years of hanging around in hospitals, that I might be feeling a little bit bilingual, atuned somehow to the language and culture. Yet I still feel like a visitor to another world. Like I’ve been dumped, unceremonially, on an alien planet and told to get on with attempting to understand the local lingo. In the hope of eventually cracking the code, I’m going to ask for some help publicly. Here are my top 10 things I hear being said by Maternity Services Workers that I don’t understand. Please, if you can translate, I’d be eternally grateful.
- “You are high risk”. Higher than what? The 10% of women who are actually considered boring and normal? Do all of us have to be treated the same just because you’ve put us in a pigeon hole? What risk is high risk? Why do you only have two ways to catagorize pregnant women? Excuse me for my confusion, but why are two situations with exactly the same risk factors presented so differently – one as an appropriate choice and the other as an unacceptable risk?
- “It’s safer to have your baby in hospital where you can monitor you. Go home, you’re not in labour.” Yikes, help! I’m having contractions that feel big and scary. You tell me this is the safe place to be but I’m not allowed in? Is there a secret password? What am I doing wrong? What will happen to me outside the safety of the hospital?
- “It’s your choice, of course, but to do as I say is safer”. Erm…if it’s dangerous, I don’t understand why you say I have a choice? Do you think I’d choose to endanger my baby? Are you loco? In my world, women make safe and appropriate choices for their babies given enough information, time and space. And yes, in labour too. It is possible.
- “It’s my registration on the line”. Really? For respecting patient choice? For not coercing a woman into following the guidelines or the Consultant’s instructions? On my planet that would earn you a commendation. Don’t your own professional organisations teach you that the patient’s choice takes precedence over guidelines?
- “I can’t know where you are in labour unless I do an internal exam every 4 hours”. Why do you need to know? If mother and baby are happy, eventually a baby will come out. Or not. Then perhaps your fingers might tell you something useful. Or am I missing something?
- “I have to….” No. No you don’t have to. Honestly, I’m trying to understand, but any system that forces you to do something against the patient’s will is broken. Broken, I say.
- “Your baby needs formula”. Oh? That’s odd. On my planet, there are lots of books and videos and well trained and experienced specialists in infant feeding who know that with a little time and knowledge, the vast majority of babies can easily be fed mother’s own milk. Why do so many of your mothers need formula?
- “Do it like this…do it like that…no, like this…no, like that”. Is conflicting advice some sort of rite of passage on your planet? Do we get an extra prize for birthing and feeding a baby despite being told different things by a never ending stream of people, all wearing different uniforms who don’t introduce themselves clearly so we have no idea who you are? It’s like some bizarre, Kafkaesque game show in which the rules are secret.
- “Homebirth is dangerous. Homebirth is a drain on resources. Homebirth is selfish. Have a homebirth. It is safe, and cheap and leads to better outcomes for mother and baby”. Help, my head is spinning! This game show is very unsettling! How do I choose?
- “We know we cut too many women open, induce too many, intervene too often. We know we need to bring these rates down for the health of our mothers and babies. We even know how to go about doing it”. Yet you don’t act? On my planet this would be seen as willful negilgence or extreme laziness. Or perhaps there is too much to be lost, by too many to turn the ship around now?
I’m adding one more – this time a translation from my language to yours. This is about how we talk to mothers – the ‘soft skills’. It seems whenever I try to talk about them with your species I am met with blank stares. Here’s a definition of Soft Skills:
personal attributes that enable someone to interact effectively and harmoniously with other people
It means that good old-fashioned bedside manner your species used to judge each other by. It means having emotional intelligence. It means being able to actively listen to a mother so that you can understand her desires and motivations. So that you can help her find her own answers. So that she can make fully informed decisions. These ‘soft skills’ compliment and enhance your ‘hard skills’ of clinical knowledge and judgement. Social and emotional intelligence, people skills, counselling skills, a person-centred approach, emotional literacy and personal reflection…whatever you want to call them, on my planet we say:
Soft skills get little respect but will make or break your career — Peggy Klaus
It’s time to start learning each other’s languages and having a conversation. There’s a mountain to climb, but we can do it.
PS. I know some Health Professionals who I LOVE, LOVE, LOVE. They are gentle, and kind and explain things fully without putting more weight on the choice they consider to be the ‘right’ one. This post is by no means addressed to all inhabitants of planet NHS. I also believe in being a positive force for change rather than a moaning old minny.
But I really, really needed to say this stuff.