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THE ROAR BEHIND
THE SILENCE:
why kindness, compassion and
respect matter in maternity care
Sheena Byrom and Soo Downe
An idea…..
A story
What’s happening in
maternity care?
National
Only half of the women we surveyed had the birt
h they
wanted. The majority felt that their childbirth experie
nces
affected their self-image and relationships with their
baby and their partner.
A significant proportion of these
women believed that the effect was negative.
September 2013 1,100 women
Photo: Birthrights birthrights.co.uk
5,500 women
International
Disrespect and abuse in institutional
maternity care (Bowserand Hill 2010)
= diminished compassion?
Solutions:
Macro and Micro
Macro
Dignity in maternity: the power
of human rights to improve
care for childbearing women
Elizabeth Prochaska
Human Rights
‘The principle of human dignity demands that every person is
treated as an end in herself, and not as a means to an end. It
provides a basis for respectful maternity care and treats women
as capable of making their own autonomous decisions about
birth’
‘A human rights approach to healthcare promotes positive and
respectful relationships between women and their caregivers, and
can guard against harm in childbirth’ Elizabeth Prochaska 2014
White Ribbon Alliance
Respectful Care Charter
Routine unnecessary
intervention in birth
-an ethical issue
Openness
#MatExp
#BirthJustHappened
https://www.youtube.com/watch?v=sI4inBAcHs
M
Micro
• Courage
• Role Modeling
• Language
• Openness
• Guidelines are GUIDElines
• Partnerships and collaboration
Courage for Compassion
Dr Tracey Cooper
Photo: Claire Riding & Lynda Drummond
Role Modeling
Delivery Big baby
Only 3cms....
Labour wardPain relief
Birth SuiteWorking with pain
Patient
Birth Fantastic!
You are 3 cms!
Refused
Woman
Healthy
baby
Declined
Partnerships
Guidelines
What do NICE say?
Olivia Armshaw
Mel Scott
Action points
Milli Hill
Anna Ternovsky
Robin Youngson
I came across a spectacularly compassionate midwife once (actually she
was a student) whose actions transformed a very traumatic experience
and for that I have always been immensely grateful so if this in some tiny
way pays back Sharon’s kindness then that would be wonderful.
My first baby was born by c-section under a general anaesthetic after a
cascade of fear-based interventions culminating in an incompetent
registrar panicking. Afterwards I had a whole host of hospital staff
visiting, because a GA section was a rare event, and most of them
strutted in with an ‘isn’t modern medicine marvellous, all-that-matters-is-
a-healthy-baby’ spiel that really p***d me off. Sharon was the ONLY one
who came in, said ‘well, that didn’t go so well did it’, held my hand and
told me about those precious first few minutes of my daughter’s life that
we’d missed. Even my husband wasn’t in the room when she was born
and hearing about how she looked and sounded and what happened to
her made an incalculable difference.
Helen Bilton
The small things
= diminished compassion?
There are only two feelings: Love
and fear. There are only two
languages: Love and fear. There are
only two activities: Love and fear.
There are only two motives, two
procedures, two frameworks, two
results. Love and fear.
Building virtuous cycles
Prof Soo Downe
Michael Leunig's prayers from A Common
Prayer
We can differentiate between the fear
that is real and protects us, and the
fear that is manufactured and
strangles us.
Manufactured fear reflects how we see
women and birth. (Dahlen 2010)
#Roar
A story
Thank you

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The Roar Behind the Silence May 2015

  • 1. THE ROAR BEHIND THE SILENCE: why kindness, compassion and respect matter in maternity care Sheena Byrom and Soo Downe
  • 6. Only half of the women we surveyed had the birt h they wanted. The majority felt that their childbirth experie nces affected their self-image and relationships with their baby and their partner. A significant proportion of these women believed that the effect was negative. September 2013 1,100 women Photo: Birthrights birthrights.co.uk
  • 8.
  • 10. Disrespect and abuse in institutional maternity care (Bowserand Hill 2010)
  • 13. Macro
  • 14. Dignity in maternity: the power of human rights to improve care for childbearing women Elizabeth Prochaska
  • 15. Human Rights ‘The principle of human dignity demands that every person is treated as an end in herself, and not as a means to an end. It provides a basis for respectful maternity care and treats women as capable of making their own autonomous decisions about birth’ ‘A human rights approach to healthcare promotes positive and respectful relationships between women and their caregivers, and can guard against harm in childbirth’ Elizabeth Prochaska 2014
  • 17.
  • 18. Routine unnecessary intervention in birth -an ethical issue
  • 22. Micro • Courage • Role Modeling • Language • Openness • Guidelines are GUIDElines • Partnerships and collaboration
  • 23. Courage for Compassion Dr Tracey Cooper
  • 24. Photo: Claire Riding & Lynda Drummond Role Modeling
  • 25.
  • 26. Delivery Big baby Only 3cms.... Labour wardPain relief Birth SuiteWorking with pain Patient Birth Fantastic! You are 3 cms! Refused Woman Healthy baby Declined
  • 31. I came across a spectacularly compassionate midwife once (actually she was a student) whose actions transformed a very traumatic experience and for that I have always been immensely grateful so if this in some tiny way pays back Sharon’s kindness then that would be wonderful. My first baby was born by c-section under a general anaesthetic after a cascade of fear-based interventions culminating in an incompetent registrar panicking. Afterwards I had a whole host of hospital staff visiting, because a GA section was a rare event, and most of them strutted in with an ‘isn’t modern medicine marvellous, all-that-matters-is- a-healthy-baby’ spiel that really p***d me off. Sharon was the ONLY one who came in, said ‘well, that didn’t go so well did it’, held my hand and told me about those precious first few minutes of my daughter’s life that we’d missed. Even my husband wasn’t in the room when she was born and hearing about how she looked and sounded and what happened to her made an incalculable difference. Helen Bilton The small things
  • 33. There are only two feelings: Love and fear. There are only two languages: Love and fear. There are only two activities: Love and fear. There are only two motives, two procedures, two frameworks, two results. Love and fear. Building virtuous cycles Prof Soo Downe Michael Leunig's prayers from A Common Prayer
  • 34. We can differentiate between the fear that is real and protects us, and the fear that is manufactured and strangles us. Manufactured fear reflects how we see women and birth. (Dahlen 2010)
  • 35. #Roar

Notas do Editor

  1. A little about our conversations…my sessions, Gill’s research v Positive stories of courage and compassion….
  2. Tell the story of doctor in ED, then ask delegates to pause…
  3. Increasing intervention rates Dissatisfaction Disrespect and abuse Kirkup
  4. Fear endemic both women and families and maternity care workers Increased buraucracy and risk management leads to more fear, potential for more mistakes. What is safety?
  5. Social Movement
  6. Activist
  7. Respectful relationships
  8. Fear endemic both women and families and maternity care workers Increased buraucracy and risk management leads to more fear, potential for more mistakes. What is safety?
  9. Arguably, it is fear that drives current pathological ways of doing birth. Fear of things going wrong, fear of being sued, fear of not being competent in the new technologies. Could it be that a turn towards love as the basis of maternity care may change the high rates of intervention for women and children, while still keeping them clinically safe?
  10. Capacity not catastrophe
  11. Tell the story of doctor in ED, then ask delegates to pause…