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Male midwives: trendy or unpopular

1 midwife, 1 nurse and husband

It has never mattered if my GP was male or female neither does it matter if I am treated by a male nurse or female one; however I would have a slight unease if my midwife was a man. The uneasiness is not due to the gender but the emotional and intimate journey I may have to go through with him, is it unusual?. I am also intrigued by the differences in people’s perception of men that deliver. Let us start from the beginning; Midwifery has been traditionally seen as the care of pregnant ‘women’ by ”women”. It also means assisting in the birth of a baby, the expression ‘together with’ or ‘with woman’ in turn refers to a midwife.  Midwifes or male midwives, the former being normally addressed to refer to men in countries such as Canada. Without looking too deep in to its historical meaning and the matrix of the terminology, it is clear the trend is shifting. The fact is we now have around 93 practising male midwives within the UK; Is this reflective of where our society is heading?  Well I think so; cultural barriers are coming down, though at a slower pace, female roles are being undertaken by males and vice versa. As more men practice midwifery, the challenges faced by pregnant women and couples is down to choice, its’ the behaviour, culture and psychology, I would personally say. It is the whole emotional baggage that comes with a man having to take you through the 9 months, bearing in mind he is the community midwife, then the delivering and the process there after. And then I wonder what the difference is if I have to face the Obstetrician and Gynaecologist a male dominated proffession, perhaps it is the lengthy time and journey spent with a midwife. So what is the real issue here? Could it be the gender or maybe our own discomfort? Male midwives are still rejected or looked upon with surprise. It is easy to think that as long as one has the skills and attributes, has a caring nature and is competent it hardly matters if they are male or female. But we then tend to carry baggage of ‘social norms’ and ideology influenced by history and culture with regards to gender roles.

It appears some women prefer female midwives, all sorts of reasons I gathered included ‘comfort’, ‘women understanding what they are going through much better than men’, ‘needing someone who would mother them’. On the other hand we had women that did not mind having a male midwife, for them it was a wonderful experience and were no different to female midwives. In one instance it was the woman’s 4th child and had previously had bad experiences until she had a male midwife. One interesting comment I quote ‘My husband felt he would have benefited from a male midwife when I had my children. He felt that he missed out and didn’t fully understand all of what was happening. He thinks that a male midwife would possibly be able to explain the whole thing to him in a language he understood and that female midwives take certain knowledge for granted during labour’. “Association of Radical midwives, 2011”. It is true through a number of experience that a few female midwives lack the empathy and desire of being ‘with woman’.

It is all these different views and experiences that may change people’s perspective on gender and midwifery roles. As women campaigned for equal rights, so should it be for men that want to train and practice as midwives; surely this is a professional career that stands its ground with merit, academic and practice knowledge as well as a passion for it. I am beginning to warm up to the idea that gender should not determine good practice and service delivery.

It is interesting that prior to the mid 1970s, it was thought that male midwives would be unpopular with pregnant women; research demonstrated that female midwives did not like the idea of men invading their roles (Journal of advanced nursing, 1991). I want to believe that attitudes are changing in this 21st century. It is still certain that two different sexes experience emotion in a completely different manner, could it be that these differences man and women experience determines suitability for certain jobs and perhaps gender impacts on emotional understanding and psychological response. However, modern psychological researches indicate that men and women possess different skills related to the sending and receiving of emotion. In general, women are more emotionally expressive (Miller, 1976), where as men conceal or control their emotional displays (Buck, Miller, & Caul, 1974). In addition, women talk more about emotional aspects of their experiences than men, hence parent-daughter dads placed emotional experiences in a more interpersonal context than did parent-son-dads. These findings may well have an impact on men’s response, behaviour and approach as a midwife and therefore some women use this as a base to their choices and would still prefer to be attended to by a female midwife. Despite this, it is clear men are as competent and have a passion, and exert great interpersonal skills, so we should embrace more male midwives and not be products of socialization or culture but still give expectant mothers and couples choice.

What can I say; I have come to the end of this and personally feel I would welcome a male midwife, as for the ‘uneasiness’ I will cross that bridge when I get there….


Its’ all about you

Health as a term has acquired a broad spectrum of definitions and meaning. As individuals, ‘being healthy’ can mean happiness every day, disease free or simple things like getting up everyday to be able to take care of you and others. To some people, it is about drinking 1 litre of water, 5 fruit and vegetables plus exercises a day. One survey described the many meanings of what health meant to individuals. We live in the 21st century where we have acquired a range of conditions particularly chronic ones, Medicine and medical procedures have improved over the years, and have had a long term impact on different conditions and the life expectancy. It is all about you and taking the driving sit to better health regardless of the ailments we suffer from.

Person centred thinking and planning is the art of having a positive outlook on life; the planning is about writing down in words, pictures or visual graphics where you are now and what you want to achieve? What is working in your life and what isn’t? What makes you happy or sad? What makes a good day and what makes a bad one? It is knowing the things that are important to you, now and in the future . As you begin to answer these questions, it is vital to think about changing negative (bad days, sadness, what s’ not working) into positives.  It is very much focused on the individual and these tools eventually help to map out your life and therefore managing our lives and health much better. The most important part of this process is ‘YOU’…more like taking action to live your life fully and letting the medical professionals  deal with your ailments.

Applying a different number of person centred tools is the beginning of de cluttering your life. It then becomes clear what or who is important to and for you and makes it easier to recognise simple long term goals. For instance the feeling of happiness, being healthy and able to do things, inner peace, greater knowledge and exploring opportunities you have never thought of doing.

Devising your own solutions to meet your everyday needs, setting goals and outcomes and then making sure those outcomes are met realistically…Simplicity is what I call it…try not to set farfetched goals that are not realistic to meet. Remember it is about what ‘you’ want, need and how, when ‘you’ will achieve. Having said this, personalization has to show a comprehensive positive outlook on life and using person centered tools to deal with the condition that you have.

It is a valuable habit to have an optimistic view of your life, you have received enough bad news now look at the good things about you. Personally, that is what being healthy is all about  and this definitely fits in to personalisation as I am taking control of my life.


Are we at risk with maternity services?

The ongoing proposed closure of birth centres around the country is an outcry, from both health professionals and communities. We have become aware that areas such as Dover, the East. and Coastal regions and parts of Derbyshire have fallen victim to the postcode lottery of health services provision whilst in Cambridge progress continues for a world first class maternity services, mainly through campaign and donations and the public’s charitable help. I wonder if this is a sign and times to come for this gesture to be rolled out nationally.

Pregnancy specifically is a very critical and tender phase for mother and the child as well as fathers. Repercussion of ignoring the health during this critical phase can be seen in mother as well as child in the form of various disorders, some being irreversible ones and even perinatal mortality.

Like many other issues going on, I have chosen to raise this issue with friends and colleagues who have or are going to experience pregnancy and childbirth at some point. Certainly, for first timers it is overwhelming, well at least I was. Amazingly, despite living in the same region we all seem to have experienced very different services. Other than the feeling of joy about our pregnancy; I commend the midwife, all the other health professionals that were involved and the maternity services provided. The end result: A healthy newborn, overjoyed parents and enough education to deal with the next one. It was comforting to know I would be getting my weekly visits from the midwife and never needed to worry.  Not many have the same experience, and what I had concluded from all the chatting was, fear for another pregnancy and birth process, looking to go private and some wanting a different birth experience in a hospital not local to them. These feelings have been brought on as a result of shortage of staff; lack of time to share valuable information and basic education, particularly first time mothers; understaffed hospitals with poor services. In one case, she had had a caesarean (not out of choice) when the baby was born, she was left to it, a remembrance of the many times she buzzed, with no response.

courtesy of Treetops Photgrapgy

Learning from hospital incidents is important for patient safety; at the same time ensuring expectant mothers are given a choice about their birthing options, as long as health professional deem it safe. There are a number of initiatives that seek to reduce incidents, that impact on patient safety in which case lessons should be learnt. I have come to learn that hospitals in relatively poor areas have a population with more social health problems therefore increasing the perinatal mortality rate to 30% within the UK. Research shows that, two thirds of the mortality rate results directly from differences in medical and health care. So this could mean neonatal death and unnecessary complications can be prevented by improving medical and health care in failing areas.

The perinatal mortality rate is indicative of perinatal and neonatal care, as well as living standards, maternal health, medical intervention and care. There is an awareness of the risk factors through research and lessons learnt from hospital incidents. A combination of factors seem to increase the risk of poor maternal health, “Patient UK” 2009 quotes that maternal health; social class; age of mother( below 20 or over 40); region of maternal residence and marital status (where still babies  born outside marriage) are all possible risk factors.

To choose between campaigning for better services for the NHS with the help of public donations or privatising maternal services, I am certain I will be lifting that placard high enough and marching the streets. In some cases I must say it is either sheer luck or a consistently good service or maybe bad timing and a continuous lack of standards. If all women are to have one-to-one midwifery care through labour, and in some cases, urgent assistance from other members of the maternity care team such as obstetricians, anaesthetists and neonatologists. Then a review in funding maternity services and resources needs to be considered. Pregnancy and childbirth should be safer for mother and baby, should not be determined by region, ethnicity, health condition or even social factors, at least not in the UK. Strengthening partnership working has been the order of the day for some time; hence all these factors presented should be addressed. It is imperative that there should be systems and funding in place for people to do their jobs effectively.

If there is a chance that routine visits from the midwife are to be affected due to staff shortages or merely not enough trained community midwifes, then why not educate first time mothers and fathers to make them aware of the most vital issues to watch out for.

This will definitely not just affect mothers and new borns’, but we may find ourselves at the bottom of the Europe league tables in terms of providing and sustaining good standards of maternal services. People talk about accessing better health and care; accessing is the easy part, its’ the fully funded, equipped and resourceful services that need to be available.


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