Today’s post is a guest submission written by Ruth Pay, birth and postnatal doula in Kent and South London. Thank you so much for your words, Ruth – your thoughts on gratitude and how it is accepted are so interesting and I’m sure many of us will be able to identify with them!
When I am leaving a birth (or if someone else leaves first) I make a point of thanking the others in the room. Sometimes I don’t thank them because it would feel disingenuous to do so. But, when I do say “thank you”, I mean it. I tell them the reasons they made an impact, made us smile, made us feel safe and cared for. The intention is to leave them feeling valued and motivated to continue doing the good things; to make sure they know that their efforts, skills and energy are worth it. It is so worth it.
So many times when I do this people respond in a similar way that never fails to surprise me a little; with variations of “oh no, midwives get a bad reputation, but we are alright really”. Sometimes there is a more bite in their voice; shock or anger, exasperation. This has stuck with me and made me want to delve into it a little; I think there are just so many possible psychological layers there. These were the ones I could think of, can you add any others?
~ Standard (female) dismissive attitude to positive feedback (negative attribution)?
~ Defensiveness of being judged whether positively or not?
~ Irritation that I expected the care to be bad and have been pleasantly surprised?
~ Belief that I am basing my reaction on hearsay and not first-hand experience?
~ Aligning themselves with All Midwives, some of whom are certainly not practicing in the same way as them?
~ Complete or willing ignorance of the terrible things that go on inside birth rooms all around them at their trust and others?
As a closed-door profession, where colleagues may only see snippets of work, might it be that families receive quite varied care across a team of midwives who believe they are working in unison with the group? I can imagine it is so challenging to maintain personal ambitions of individualised care for women when you are facing pressure from so many different angles. From my perspective, somewhere between outside and inside, it seems that the workplace culture might have a swaying effect on the mindset of midwives. I know for sure that an insidious bullying underbelly in a previous workplace left me shattered, and I was not ever responsible for anyone’s life, let alone multiple people every day.
We generally think about continuity of care from the perspective of the families receiving care. How could it work in favour of a midwife who was balancing between ticking boxes for her management, maintaining her own mental and physical health by being a helpful, unassuming voice in her team (and therefore not being singled out or left without as much support as others) and giving sensitive, clinically sound, but sometimes policy challenging care to families she has been working with over 9 months? I’d certainly be much more likely to work harder for someone I knew well, rather than someone I met that day. As a doula I regularly get out of bed at 1, 2, 3am and I don’t ever resent it for the families I’ve bonded with, but I cannot imagine being happily on call for strangers.
I also want to entertain the possibility that my praise is out of place or patronising. Why on earth would a midwife of years of clinical skill and responsibility for the lives in the room listen to my words about the soft skills that I value? If I knew that my colleagues were not working to my expectations of quality, but I didn’t want to rock the boat, perhaps I wouldn’t be agreeing with a doula (we are a mistrusted and misunderstood breed in the main! Trying to change that view, of course).
My interest in this whole topic comes from a desire to take the work of the kind, compassionate and clinically skilled midwives and put it into the hands of the midwives who have left families in their care, and me, shell shocked. Commenting on the NMC Register Report from March this year, Andrea Sutcliffe, Chief Executive and Registrar at the NMC, said: “our survey fires yet another warning shot – that the pressures nurses and midwives face are real and must be taken seriously if we are to properly attract, support and retain the workforce that we need now, and for the future.” How do we safeguard families from poor care and really celebrate those who shine? I’m going to keep doing my tiny bit and going out of my way to thank and explain the difference made by people I work with – even if it takes them by surprise. I hope that they think on it later and absorb the good intention.