Reflections on RCM conference 2018- Less is more
“a disturbing silence at the heart of the conference”
Meeting new midwives, as well as old colleagues and friends, is always a pleasure and a tonic. It was great for us to see so many midwives enjoying the chance to reconnect and to feel the excitement emanating from newly qualified and student midwives embarking on their midwifery journeys. But this optimism and enthusiasm will drain away if we miss opportunities like this annual conference to harness the collective strength of the midwifery profession to tackle the longstanding and endemic problems in midwifery.
A strong and united RCM is the vehicle with the brief and the capacity to support and strengthen midwifery for the benefit of midwives and women. Although there was talk in the opening ceremony about breaking down hierarchies with integrated multidisciplinary team working, the RCM hierarchy itself was paraded via the glitz and glamour of this carefully choreographed opening event. The relatively unmarked departure of two high-profile, long-serving RCM officers, the recent, silent, unexpected departure of another, and the RCM President’s absence from the stage where she might have been expected to have been asked to welcome midwives and give her insights into her first year in office, left us wondering about unity within the RCM itself.
One of the invigorating aspects of any professional conference is the opportunity to debate and discuss issues of the day. We felt that the use of a new app, through which all questions were routed, took away the immediacy of this. It was suggested that delegates might feel less intimidated by using this tool but we would argue that it would be beneficial for midwives to use this safe space to challenge, comment, share experiences and engage in healthy debate. Speaking need not be the prerogative of those identified as part of the ‘elite’ or the ‘leaders’ but of each and every RCM member: passion for midwifery and its very survival as an autonomous profession depends on this. Bodies like the RCM have a responsibility to encourage and enable midwives to stand up and be counted, to challenge poor practice or bullying in their workplaces and to tackle the wider issues that impact on midwives’ and womens’ lives.
The fringe session with research midwives, Denis Walsh, Alison Corr and Helen Spiby was one of the most enjoyable, although the press of people felt claustrophobic and momentarily, concerning. The venue was full, with standing room only, indicating the importance of the presentations, which the speakers skilfully managed to deliver coherently in slots of just 12 minutes. There was barely time for questions, via the app, and certainly no time for debate and discussion. It was clear that the issues, birth centre closures (Walsh), tensions between
midwives (Corr) and an increasing incidence of PTSD among midwives (Spiby) resonated with the audience. In the current climate, curtailing speakers’ time on such crucial matters could feel like a carefully orchestrated attempt to dampen down issues of concern. When key issues are raised only on the fringes it leaves a disturbing silence at the heart of the conference. Urging midwives in the opening ceremony to hug each other and ‘be positive’ will do nothing to tackle the deep rooted and on-going gap between the reality of maternity services today and the rhetoric. It feels as though midwives are being lulled and dulled by the rhetoric of passion and positivity that leaves no room for analysis of our profession here and now, through discussion and debate. One newly qualified midwife commented afterwards, ‘dissenting voices are being discouraged in favour of a view which suggests that relentless positivity is the only way.’
Midwives and women need a strong RCM that represents and supports midwives who struggle with the daily challenges they face. We need to understand why so many midwives are suffering from PTSD and leaving the profession. Interventions like the programme of support identified in the POPPY study https://www.sciencedirect.com/science/article/pii/S0260691718306919?dgcid=rss_sd_all, while very welcome, will only go some way towards dealing with midwife retention This is because although midwives work is inherently challenging, it is compounded by the impossible conditions identified in our last blogs (https://www.birthpracticeandpolitics.org) and here (https://www.all4maternity.com/i-am-a-midwife-and-i-am-broken/). These are not isolated accounts, but the tip of the iceberg. We need a language with which to discuss these painful realities and a professional body that represents midwives and champions midwifery.