No Woman’s Land: a student midwife’s call (guest post)

Art work: “I am here for you” – Amanda Greavette

I received the following from an Australian midwifery student who has agreed for me to publish the post anonymously.  Whilst it can be confronting, it is so important to listen to midwifery students with open ears and hearts. They see maternity care through fresh eyes. As midwives we need to nurture students and role model woman-centred care and strong advocacy. If we lose our midwifery students, we lose our next generation of midwives. – Rachel

This piece is not an evidence based article. There is no science or rationale, no Cochrane review, to be found in these words. Just honest thoughts on the student midwifery experience, an individual narrative and nothing more. Yet, I must believe that these thoughts stand for something. They mean something and are worth sharing. In the hope that one student midwife feels a little less alone or one midwife reflects on their practice with women and how they support students.

As student midwives, we begin bright eyed and bushy tailed, with a passion for natural birth, for normal birth. We believe in the innate abilities of women, the knowing that she knows her body, her baby. That the woman is the expert and we trust in the seeming simplicity of this. Our university education aims to facilitate this passion, underpinned with feminist theory, enabling critical thinking, the use of evidence and the ability to learn how to apply clinical skill with heart and soul. Then, at some point, the on-the-ground practice begins. We set foot into the hospital. Here we fall into the deep chasm between theory and practice and experience the raw and visceral realities of the midwifery culture which exists at present. Where we thought we would be supporting women and the spectacular physiology of birth, we find the technocratic perspectives in full force. At every turn, in every space, be it antenatal, birth suite or postnatal, we view women being actively disempowered, intervened with and unsupported. Every damn day.

The excuses are rampant – women are unhealthier today, women don’t want natural births, women don’t know or don’t care and yes, perhaps it may be called naive to step into this world thinking it was all to be experiences of babies being breathed out into warm water and then snuggled up into the loving arms of their new parents. But let’s stop blaming the women and take a hard look at maternity culture right now. To be explicit, student midwives are constantly bearing witness to the atrocities of birth in some hospitals today – poor information sharing, cultural practices rather than evidence based, disrespectful communication, women being held down in labour, being told off, lied to, having care providers do all manner of procedures without true informed consent at different points in the process such as stretch and sweeps, vaginal examinations, episiotomies, the instigation of inductions without application of the research and the cascade of intervention which ensues…the list is too huge and exhaustive to mention. The crushing reality is that physiological birth is so far from the norm that it is somewhat unbelievable. The medicalisation of birth has hit an all-time high. Yet student midwives are called naïve. To have thought that the professional codes of conduct and the international definition of the midwife would be upheld and that amazingly, women would be treated with basic kindness and respect.

This is not about pushing a natural birth agenda. This is a human rights issue.

I have not yet become desensitised to what I see every time I walk into the hospital, to be with woman, with birth and that is a very challenging space to be in. The emotional work of being with women is immense and what we see and come to embody is that birth is now a battle ground, leaving bruised, battered and traumatised women in its wake, with many midwives the witness or the handmaids of the hospital birth machine.

As a student midwife, I thought that midwives love women and would be their advocates. That they would stand with women and acknowledge and support their inherent power. And yes, I cannot possibly speak for all midwives but my personal experience is that majority midwives are not speaking up for women and they are not speaking up for themselves. We understand that the paradigm is powerful and that you are overworked, run off your feet; you are burning out. Yet we can’t learn midwifery and the art of being with-woman if we don’t see it from you. We need to see your kindness, bravery and compassion with women, for yourself and with us. We need to see you standing up for women and bucking the dominate culture. We need to see you not playing nice anymore. No longer playing the good girl.

Students can be clumsy and time consuming in our learning but ultimately we want to be you, we want to be midwives. We look to you to show us the way, to show us midwifery but most often we are bullied, unsupported, gossiped about, made to feel insignificant or downright hazed. Too often student midwives are voiceless, dwelling in the liminal space between woman and practitioner- we exist in no woman’s land, a nebulous other-world where we are not the layperson nor the practitioner.

It is my solemn plea that you remember that student midwives are also women and please be with us too. Please remember why you got into midwifery in the first place and remember you were once like us.

Midwives, we see you and we know that you are powerful, and can be the instruments of profound change for women right now. Simply by rising up together, joining as one and saying,

“No more, I will not participate in these practices, in this culture, a second longer!” For if enough midwives do this then it would change.

Stand with and for women. All women. For in the end, we are all women and we are powerful together beyond measure.

In the words of Lucy Pearce:

“We do not need to wait for permission before we open our mouths. We do not need to wait for others to make space for us, we can take it. We do not need to read from others’ scripts or style ourselves in weak comparison. We do not need to look to another’s authority because we have our own. Down in our cores. We have waited so long for permission to know that it was our time, our turn on stage. That time is now. Our voices are being heard into being. They are needed.”