By Rebecca Mar Young
Following on from my last post on the 11th Normal Labour and Birth Conference 2016, I wanted to share some important information that stayed with me and had a lasting impact.
Margaret McCormick, a midwife educator from Melbourne who is currently undertaking a PhD, talked about women’s perception of safety during labour and birth.
Research says if women don’t feel safe during birth and labour then outcomes aren’t good. What does safety actually mean to mums? What influences their perceptions of safety? And what does it mean to organisations (like hospitals) and how they operationalise safety?
In her integrative review of this, Margaret looked at 4994 articles written between 2005–2015 on this issue and they extended over 17 different countries. Of all of those articles, only 11 provided a definition of safety and only four articles defined safety from the woman’s perspective.
When looking at those four articles, it was apparent that clear communication was central for women and it was critical that they had a sense of autonomy and control when it came to their safety.
For organisations, the attitude to safety was more about avoiding injuries, reducing harm and managing risk – adopting a “safety culture”. It was more related to physical safety and there was an absence of women’s voices in their definitions.
Emotional, psychological, spiritual and cultural aspects that are important to women were not mentioned at the organisational level.
Listening to this make me think ah ha – so this is where the problems come in. The feelings and needs of mums don’t match what the organisations are offering. Organisations have a vested interest in protecting their reputation and ensuring their policies are legally sound. But where is the investment in the women in their care?
It seems that in large organised groups, people actively go about distancing themselves from real people and their feelings and emotions as perhaps a coping mechanism because of many different reasons. Some of these may include the fact that they aren’t necessarily with the one client from the start to the end of their time at the hospital. The client’s experience at the hospital is often split between many different providers and so they can only get to know them so well.
Margaret’s perspectives were eye-opening and point to a need for a dramatic shift in attitudes to safety in birth and labour. This is why we are passionate about supporting midwives, researchers and birth educators. Spreading this message is incredibly important.
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