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

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Art work: “I am here for you” – Amanda Greavette http://amandagreavette.com

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.” 

About MidwifeThinking

Midwife and Academic
This entry was posted in guest post, midwifery practice, opinion and thoughts and tagged , . Bookmark the permalink.

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

  1. Louisa says:

    Wow, what a powerful piece!
    Can I suggest that this student may consider having this published in the college journal, so that all midwives can see and be reminded of this very important message?
    Thank you for sharing with us.

    • Kim says:

      What a great suggestion!

      • Gail Johnson says:

        This article needs to be shared more , Canada is in a big mess with exactly this situation , the csection rate I climbing every year and midwives are becoming medwives
        Could you send me this article to share with midwives in Canada via email , please
        Midwife.international@ Gmail.com
        I am not computer savvy to do it myself
        Gail Johnson
        Midwifewithoutborders.com

  2. I just Love this article and I identify with her words and passion! Thank you Rachel xox

    Kind regards, Olivia Wu

    >

  3. Cathy says:

    Thank you so much for writing this and posting this. I am a student midwife in the United States and my apprenticeship took place in an out of hospital birth center run by midwives. I really relate to the experience of what it is to be a midwifery student. Now that I am finished with my apprenticeship, I am left without anyone to hold my hand and help me on my new midwife path. No one has asked what my plans are, no one has offered to help me or given me a suggestion where to start. This also applies to the 3 year school I am working to finish. I am expected to learn to help women in a myriad of ways, for instance -what are the parameters of the welfare system (which, while studying, I found out that I was eligible for!), what are my resources for counseling and so on. It struck me that not one person has extended this information to me. I pay a lot for my education (and recently found out my midwifery school is not eligible for an education tax credit) and I get an online program with three years of work set out in front of me. All of the work and scheduling thereof is up to me, there are no teachers or groups helping me get through. I feel tired and beat up and broke. I feel unseen and unappreciated. My school gets my cash. My apprenticeship gets my free labor (and a free cleaning lady to boot). Right now its hard for me to see the light (I am hoping there is one) at the end of the long, dark, tunnel.

  4. I agree wholeheartedly…. I was one of those students. Thankfully my passion has not left me! I am an independent midwife. I love what I do, I love women with a love I cannot explain or understand. There is nothing I want to do more than what I am doing now. I could not have expressed what you have written in a better way. Every midwife and mother to be must read this. We need to take birth back.

  5. Michaela says:

    Yes, yes, so perfectly articulated. I stand with and for the women who are mothers and student midwives and feel the same yearning for compassionate role models and powerful advocates. May we all dig into the power that we hold within to realise a new future for Midwifery care! Thanks for sharing Rachel.

  6. Emma says:

    What a brilliant article. It spoke to my core. As a newly graduated midwife myself, I wholeheartedly agree with this paper. Well done!!
    I feel I am constantly battling the system, trying to stay true to what it means to be a midwife. A great reminder that we as women need to come together and change this horrendous situation. I worry about my daughter and what the landscape will look like when she’s ready to have a baby.
    Thank you for sharing!!

  7. susanne says:

    Thank you for this article- it is all the same in germany!!
    I am a midwife since 1995 and I left hospital after 13 hard years of disempowerment to be then a homebirth-midwife for some years, seeing and feeling the power of birth at home. Unfortunately this time ended, but I am with women still in all times around pregnancy and after birth.
    I will give this link to german student-midwives to encourage them to hold on, not giving up to become powerful midwives.
    Thank you Rachel for your wonderful website!

  8. Julie Watson says:

    How true! This student has seen and has said it like it is. So often midwives are shut down and feel powerless to advocate for women and give up the fight. I hope this student retains her passion and becomes a gamechanger.

  9. Kerrie Adams says:

    It’s time ‘we’ midwives change the the stuck record that we are. Nothing has changed since I trained in 2005 in the UK. We are part of the problem for women. This student is right for the most part we are a poor example of what we should be. I have been a student facilitator, a manager, worked in MGP you name it I have been that system midwife and across the board and it’s disgraceful. There is a lack of self care, self love amongst us and we don’t give to the women what they deserve. A piece of our best selves.

  10. I feel very sad that the attitude to students – the next generation of midwives, is no different to what I experienced, 37 yrs ago when was a student. I arrived to the UK at the tender age of 18yrs to start my general training. The plan in my head was to eventually do medicine. The plan changed as soon as I did my 6 wks placement in maternity. I knew I wanted to be a midwife.
    I shudder when I think of the number of times I went back to my room, cried my eyes out after a awful shift and nearly walked away from midwifery.
    Thanks to a one midwife who was just amazing to women students and the world – that’s how I saw her, kind to every one. I promised my self that I was going to be the kind of midwife, colleague and person she was. I didn’t quite keep to the promises I made to my self. I did bail out after 2 yrs of sitting at a desk and turned to independent midwifery.
    It is hard to be in a system as described by students, women and other midwives.
    Hoping for lots more midwives like my mentor to keep midwifery what it means – with woman.

  11. BabJj says:

    So true. I admire all student Midwives who question and support the woman, reminding me all the time that the most important person in the birthing room is the woman, then her team. Being a student is not ‘just a qualification’ or tick the boxes.
    It’s sad to say in ‘baby making’ palaces with 24/7 inductions done all throughout the day and night there are very few Midwives speaking up to say enough is enough! The Midwives have become desensitised, the students witness the poorly informed, the poorly prepared clients and then are asked to participate in the ‘learning process’ often traumatic births! Shameful.
    I will walk beside you, the student, guide you and share with you how things could be done differently. However the midwife is almost invisible in decisions like being ‘known’ to the woman, asking the woman what she knows of induction and why it has been suggested.
    These palaces need to be shut down and birth returned to local communities where questions can be asked safely and informed consent being the standard. Students need to be supported, guided and respected. Excellence for all.

  12. Megan Butler says:

    I feel for students. I was one 5 years ago and was a mature age student. Even as a grown woman with children I felt intimidated with some certain midwives ( not always the older midwives either). I was often in tears in Birth unit or Antenatal clinic. The unsupportive midwives didn’t care. I loved and still love being a midwife. I work as a community midwife and encourage my clients to ask for a student midwife as they are empathetic, energetic and love being with woman. Student Midwives are great.

  13. Céline Lemay says:

    the medicalization of birth is one thing but the medicalization of midwifery is another….This is not our paradigm but we still are acting like an oppressed group… this student is making advocacy for women AND at the same time for a strong profession. I cannot help but think that without a serious and rigourous deconstruction of EBM, exposing its limits, women will be AGAIN considered as an “object” of care. If midwives are just “applying” recommendations they will contribute to that and will deviate from their fundamental paradigm. The dominance of EBM will then be only a way of “manufacturing consent”…..There is a real need to name the elephant in the room……

  14. Deborah Walsh says:

    Yes it’s true . If we stand together we are very powerful!
    Stop the petty games and one upmanship

  15. Beth says:

    This resonates loudly with me too. I wrote a poem for my final semester of study, and it mirrors these thoughts. When will we stand up for ‘our’ women?

  16. hypnokerrott895 says:

    I’m not a midwife or midwifery student but I understand and weep for all of the above. She said so much and I hope that many more people will read this, listen .. and act.

  17. Salli says:

    Beautifully said

  18. Kirsty Doyle says:

    I totally agree! I’m now a midwife but my road was a rocky one due to my student days. Unsupported and bullied is how I felt at times. The uni did it’s best and I got thru but why did this have to happen?! Why dont we stick together, as women, after all isnt that why we became midwives in the first place? Not to ridicule, cause pain and suffering but to encourage, support, be advocates! Very often I saw fellow student midwives upset, dismayed and ready to give up like myself.
    As a mentor myself now, i encourage support teach and show my students the beauty of midwifery and all because I remember how it felt to be a student. We should never forget what it’s like in someone else’s shoes, whether it’s our friend, client, colleague or student!

  19. I so much miss being side-by-side with Wonderful Women, Student and Graduate Midwives. To fulfill my ageing missing link I have decided to move to strengthening Women by sharing knowledge that provides powerful planning to encourage a stronger Woman who faces the hospital machine of disempowerment and disrespect. I’m doing so, I dearly want to engage the new generation midwives with the aim of strong Women empower strong Midwives. Now into day 3 of a 5 day Challenge and will continue so that Women take charge of their transition through pregnancy, labour, birth, Breastfeeding and beyond. Women are supported in developing in pregnancy and continuing to develop their own “My Gentle Birth and Breastfeeding Plan”. Those providing services for the Women who develop and present their plan will be expected to sign the document to engage in the fact that they have read and recognise what the Woman is aiming for. Of course without doubt recognising their may be unplanned events that will need appropriate review. Legal consent and Women’s Rights are included. My experience, collective knowledge and the wisdom gained over decades drives me to make this part of my professional journey a reflection of the respect I have for Women and my much loved Profession.

  20. Harriet Price says:

    Wow. Just wow. Very powerful and important message!
    Exactly what I felt as a student, now I’m starting my journey as a qualified midwife, I never want to make any students feel the way I did during my training.
    I want to help them empower women, and fully commit to their training in the most positive ways!

  21. Alina says:

    Having been a midwife for so many years … We were not taught what students are taught today.. I had to unlearn and teach myself proper midwifery but it is such a hassle to practice this in liability led obstetric units.
    Students and new midwives are so amazing…they are the future…but they are bullied by the system and by us into disregading the women and everything they dreamed about remains just that. I have had the privilege to mentor student midwives but when they end studies they are witnessing exactly what this student has described and as new midwives cannot fight the establishment…and end up frustrated.
    Sorry to say…but not all senior midwives have realised that midwifery should be a lot different than it was “back then” . Okay… experience is important…but come on..the days of lithotomy… perineum pulling…and “uninformed consent” are long gone.
    There is a saying in the Talmud ..”I have learnt a lot from my teachers….but mostly from my students”

  22. Debbie says:

    When I graduated from Nursing School in 1989, I was thrilled that I got a position in L&D in a small hospital with 4 LDR’s, 1 OR, and 19 PP/GYN beds. My mentor trained me to be at the bedside during labor. When my husband and I moved to another state, I naturally began working in a teaching hospital and everything I learned in my first hospital was WRONG! My manager said I spent too much time with my patients! Working there was too clinical. Birth did not seem like a natural process anymore.

    Years later, I took a travel nursing job at a small hospital that used midwives. I was overjoyed and thought I could really learn from them. I was shocked to see that they were treated as MD’s, and acted like MD’s…(wake me when she’s ready to deliver). I decided then, that I no longer wanted to pursue Nurse Midwifery.

  23. Z M says:

    This is a beautiful article and resonates with me so much as a student midwife. I really hope this medicalised culture in childbirth changes and women receive the care they deserve.

  24. Nichola says:

    So true, we need to enable students and new midwives speak up and to maintain the passion that drove them into the profession, always feel inspired and revitalized by their desire to learn new things with a open mind that some of us loose over the years.

  25. Denise Hynd says:

    Women and midwives need to relearn that their physiology DOES work however they live the reverse and yet they do not question why! For the hormones of labour to work, women need to feel confident and able to trust in their instincts and be in an environment which supports the flow of these hormones to be with those who know them,. and how to support these hormonal flows! If this were the case in Australian hospitals then our intervention rates would not be increasing as they have been for the last 40 years! If the Australian cricket team lost so much there would a national out cry, money allocated to fix it but there is not even a public debate about the rising traumatic birth outcomes! All current midwives need to raise these questions both privately and publicly!

  26. Val Clarke - Duke says:

    For the majority of my thirty year Midwifery career, I fervently believed the ONLY chance we have of changing the widely practised culture of Medicalised Birth lies with our Student Midwives and the Mothers, who are deprived of Informed Choice..It is for that reason I wrote my book Instinctive Birthing by Val Clarke…Many Midwives feel totally frustrated by not being able to practice Midwifery.

  27. This is so powerful. This is a human right issue. I will hope for change while actively pursuing and kind of awareness about the strength of birth!

  28. Liz says:

    I implore the student who wrote this to please publish this where every she can. It does need to be published in the ACM magazine but on every social media outlet.
    There are alot of posts here from midwives who were treated the same way when they were students and this is very sad that times have not changed.
    I am an educator at a hospital and I totally understand and I hear what my students are going through. What you learn at University unfortunately does not transpire in the clinical setting. We are becoming more and more medically led and DR’s are becoming more risk averse. It is a very sad state of affairs.
    As students you do have a voice!! You can educate the women as to where to get evidence based information so that they can make informed decisions. You are the ones who have more relevant information because you are more informed. You have that passion and do not let anyone dampen it, because WE NEED THAT PASSION!!!.
    Midwives.. we need to nuture and harvest our students! THEY ARE THE FUTURE. We have an ageing midwifery population and these new midwives need to empowered, encouraged and nutured so that they can make positive changes.

  29. This is beautiful. Thank You.

  30. Pam Randles says:

    I am a midwife working outside the NHS. I did my training in a large hospital and stayed to work there, I strived every day to give my women autonomy, but it didn’t always work out. I moved to a smaller hospital, that was worse! Now I am truly a midwife. I love my job, I see only physiological birth at home, where the woman is in control and I facilitate her wishes. I have had students come to me at the end of their training and have taught them true midwifery when all they’ve known is obstetric nursing. Come and work with me for a while. You can stay in my house for free (if you don’t mind cats and the snores of my husband!). I will show you that midwives do exist. I will encourage you to develop your own practice. Get in touch, we will sort something out. Don’t lose sight of why you became a midwife in the first place.

  31. Nina says:

    Thank you so much to the student who wrote this and Rachel for publishing it. It would be great to see it published widely. The point is that midwifery is at its core a feminist profession that must seek to support women in their innate power. My student experience 7 years ago was similar but I was and still am very fortunate to have some wonderful midwife mentors. I have recently resigned from the hospital. Myself, my colleagues and the women and babies under our care were regularly crying by the end of many crazy shifts filled with confusion, disappointment, exhaustion, and fear. I couldn’t bare to have such a passion for my work and be so unable to actually be a midwife with woman. So now I am in private practice doing home birth and I LOVE it! I drive around the country side, visiting beautiful families in their home. I witness and support the true power of women at every birth I attend. These wonderful women are my teachers and I am finally allowed to love them, show simple human kindnesses, and am not rushing off to the next task. I hope one day that I can share this awesome way of working with student midwives.

  32. Jane says:

    You , darling midwife of the future have brought tears to my eyes with your observed reality of a majority of births and the continual lack of power women have. I have seen your experiences too Let your passion and voice be heard because it will be ,even if it is only small initially Remind yourself that with your compassion and support many women,other midwives and doctors will hear you and learn from you and be grateful they did

  33. lozz33 says:

    As a freshly graduated midwife, I can see myself perfectly through this article! I even wrote something very similar, however not as articulate, on my blog (fummery.wordpress.com). We need to start shouting!

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