When I started working as a midwife in 2001 our manager used to come round and make us tea. Not very often, but every few months.
‘I know you’ve been really busy today. Thank you so much.’ She used to say.
She didn’t use to roll up her sleeves and help for six hours, she just spent 15 minutes of her time making us each a cup of tea, which she delivered with a thank you. That was it. I remember that kindness to this day.
Kindness in midwifery doesn’t have to be difficult or time consuming. It looks like saying thank you for staying on late, thank you for changing a shift, thank you for working through your lunchbreak.
It looks like saying ‘I’m sorry you didn’t have a great day today.’ It looks like actually noticing your staff, your colleagues, as people.
Mostly that’s all any of us want, to be noticed. For the effort we are putting in, for the fact that we are human, that we have stuff going on outside of work sometimes and yes…unbelievable as it may seem!…that we sometimes make mistakes. A smile, a nod, a work of encouragement, praise if you did something well. And yes, supervision if you did something not so well. That’s kindness also, and it’s not a lot to ask really.
This kindness is also what the women in our care want and deserve. I have had the privilege recently of listening to a lot of women through my service ‘Healing Your Stories.’
Their stories are hauntingly similar. They weren’t SEEN. They weren’t acknowledged, they weren’t treated with respect, they weren’t heard. They were talked at, talked over, talked about.
Like the woman who in her panic and fright in early labour, forgot her notes.
No greeting, just ‘We can’t see you until someone brings your notes in for you’ she was told, a tone of judgement and exasperation as the midwife turned her back, leaving her alone in the corridor.
Or the woman, obviously strongly contracting, who was told,
‘I can’t let you onto labour ward unless you have a VE.’
I will let you imagine the tone. A woman who had had a previous traumatic birth, who was terrified and who had decided against all VEs.
As this woman said to me, ‘I was terrified. If this midwife didn’t have the authority to let me NOT have a VE, what else were they going to do to me in there that I wouldn’t be able to say ‘no’ to?
Were these midwives mean?
Of course not. They were just at the bottom of a system that has no time for its staff. They were just allowing their stress and busyness to talk for them.
They had just got into the habit of not really seeing who was in front of them, or how this person might be feeling.
They had forgotten how their words might come across, or rather how the ATTITUDE behind their words might come across. And they were scared that kindness would take more time than they had.
The truth is that kindness wouldn’t have taken them any longer.
The first midwife could have said ‘I’m really sorry, we’re not able to see you until we have your notes. Is there someone who could fetch them for you?’ Kind, non-judgmental, to the point.
She could have left at this point and the woman would have been OK. To be REALLY kind, she could have pointed this woman in the direction of where she could wait, how to get hold of someone if she needed them, smiled, even offered a drink. ANYTHING really to…yes, you guessed it, to be kind!
And I am reminded of another story here. Years ago we were walking in the Alps when a close friend had an accident. Nothing too serious, but we’re talking air ambulance, an operation, a hospital stay. No room of course on the helicopter, so I hitched a lift and arrived tired and dusty in A and E a couple of hours later, laden with all our baggage. A few hours later again, after form filling in a foreign language, organising a hotel and a lot of waiting around, I found myself on the ward, waiting for them to come back from theatre.
I was beginning to feel drained, the shock was beginning to kick in, tiredness was overwhelming. It was evening, towards the end of her shift, but the nurse saw it, she saw me. Not a sweaty tourist causing trouble, but a human being who was shattered.
‘Have you eaten?’ she said. In that one sentence, I knew that she saw me.
In fact in the mayhem I had completely forgotten. I was suddenly very, very hungry. She raided the patient’s suppers and brought a cup of tea, a yoghurt, an apple and a smile. That’s it. That’s all. Not even any words. She didn’t spend hours listening to my story or explaining every detail or rustling up a whole meal.
She did what she could in the time she had, and it was enough. More than enough. Five minutes of her time, and it makes me well up thinking about it now. Did that nurse receive flowers, chocolates, anything else we could find in the hospital shop? You bet she did! Why? Because she was kind!
Midwives don’t think they have time to care but it’s quicker than you think. She could have just said ‘I bet it’s been a long day.’ She would have seen me, and it would have been enough.
The second midwife could have said ‘I can see you’re really scared but it would really help us to make a proper plan of care if you consented to a VE.’ Ideally she would add ‘but of course it’s your choice.’
But I understand why midwives don’t. Having to explain to the Doctors, to the Coordinator why there was no proper assessment made, why once again it was YOUR woman who wanted something outside of the box.
Which brings me onto another point, rather an important one.
Consent. Consent is not a difficult concept to understand. We all learn it in midwifery school. And this is what the bullying, the humiliation, the lack of understanding we receive from the top, all the things that Ellie so wonderfully talks about, translates into.
Lack of consent at the bottom. A systematic overriding of womens’ rights. A culture of doing what needs to be done to conform to the system and avoid shame. Avoid standing out, avoid being ‘the difficult one.’
We are failing women by not upholding their rights, and then we shame them when they free birth.
This amongst other reasons is why I no longer work as a midwife. Was this an easy decision? NO. Was it the right decision? Yes. Because I cannot work within a system that treats its staff and its customers, its clients, its patients, whatever you want to call them, like this.
Kindness doesn’t take more time, it just takes a change in mindset. If we started treated staff and users with the same professional courtesy we would expect as a user at a hotel or a restaurant, even at a swimming pool, I honestly believe a lot of the problems in the NHS would be sorted. Without extra time, without extra funding.
Just through really seeing people, by really treating people from a place of kindness rather than from a place of stress and fear. Less sick time, less complaints, more praise, better moral, a better working environment, more job satisfaction, more being able to care as you first intended when you went into the profession. Imagine how much all of this would save the NHS in time and money?
Of course there are a lot of individual staff doing this. There are even whole units doing this. As well as the bad I also hear good stories, positive stories where people felt looked after, respected and nurtured. At the same time the system isn’t making it easy for these people, and I find that a shame.
But I’ve also realised something else since leaving midwifery. That its staff ARE the system. That yes, there is an ingrained culture, but that each individual contributes to that system through their own actions. That although it feels overwhelming, it wouldn’t take a LOT of people to start acting from kindness to change that system. If I’d been able to see this at the time, who knows, maybe I wouldn’t have left. But like I said, there were also other reasons.
This isn’t meant to be a lecture, it’s meant to maybe raise awareness of how the system fits together, and maybe give some of you hope that your daily acts of kindness really do and can make a difference.