Tools for Change – Tactic and Strategy in Midwifery

By Ruth Weston

At a recent workshop on tactics and strategy for changing birth, we identified some super useful tools for change that I just had to share here!

1 Engage staff/people – learning together – message: ‘we are in this together’.

2. Going to / speaking to the person with the power.

3. Finding Champions for Change, these are individuals that others will respect and follow.

4.Believe in myself. Challenge the ‘impostor syndrome’ that we may have.

5. Being bold – having the cheek to ask for it. Doing it even though the outcome is unknown.

6. Dealing with rejection: don’t take it personally, try someone/somewhere else, be stubborn.

7. Make sure your rationale is clear. Make sure it means something to you and to the people you approach. E.G. What do you want? Why do you want it?

8. Finding people to join (you on) a statutory committee (lay members): Use Facebook and other social media, follow up contacts, remind them near the time, arrange to meet them to go in together. Mutual support works wonders!

9 JFDI – You have done the research, made your plans, worked out what resources you need. In the end you just have to Just F****** Do It!

I just want to add two quotes that I gathered from another international workshop. This first one is from young activists in Ireland:

“Take small steps both individually and collectively with unreasonable optimism to address the large and long term issues of poverty and exclusion which do not have to be inevitable.”

We can add in our own small and large issues there.

And from young activists in the Netherlands:

“There was a transformation in my thinking, not to be overwhelmed by all the worlds challenges and want to be able to solve them all, but to realise that focusing one’s energy into one specific area has the greatest impact.”


Edited by Emma Ashworth

Airedale NHS Trust – Leading the Way!

On almost the same day that Airedale NHS Trust, Yorkshire, announced that it is welcoming independent midwives onto their midwifery bank, a study into The Albany, one of the finest examples of midwifery caseloading in the UK, has yet again shown how the outcomes of caseloading and continuity are outstanding, for women, families, midwives and indeed the NHS. (Click for full Albany document)
Airedale NHS has joined a number of NHS Trusts who have recognised that independent midwives and NHS health professionals are a team who can work together to improve care for women, and to improve NHS services. They have welcomed independent midwives onto their bank contract system, ensuring that women who were left without their known and trusted midwife following the NMC’s decision can now obtain antenatal, labour and postnatal care from the midwife that they have chosen. This applies to existing and to new clients, and is not limited to the Airedale geographical area.
A Yorkshire independent midwife who is part of the new arrangement explained the workings of the IM’s holding bank contracts & what that means for them & the women.

‘Under these new arrangements we will use a bank contract from AGH [Airedale] when attending our clients in labour to ensure that we have indemnity insurance in place as required by the NMC for registration. This situation is fully discussed with our clients during the antenatal period. We use NICE as a starting point for our care discussion already and most guidance from AGH is the same. If there are any differences between NICE and AGH’s guidelines, we will discuss them. AGH understand that many women opting for IM care do so because they want care which is different to hospital/NICE guidelines, and they respect that. If women choose to have us care for them under AGH bank contract for birth (some may choose alternatives) we have to acknowledge their guidance, discuss this with the woman and document the choices then made. We will be being supported in this by Sarah at AGH who will complete the hospital ‘risk assessment’ process for us by offering women a phone or meeting consultation where their choices can be documented so correct procedures are being followed internally. Women remain completely able to make the choices they wish and we will support them fully in their decisions’.

In return, the local IMs will work with Airedale Trust on joint training projects, sharing knowledge and experience and improving the maternity care offered by all. The IMs will also act as back up to the Trust’s homebirth service, especially to support women with more complex needs for which specific IMs have extensive experience in the context of home birth.

NOT a solution to the IMUK/NMC Crisis
It is essential to understand that this does not resolve the fact that the NMC have refused to allow midwives using the IMUK’s indemnity solution, despite the NMC’s statement to IMUK that, “We (the NMC) are unable to advise you about the level of cover that you need. We consider that you are in the best position to determine, with your indemnity provider, what level of cover is appropriate for your practice”
While this offers independent midwives the ability to be able to work and support women and families, and while we are hugely grateful for the support and understanding of Airedale Trust, this is still not midwives being truly independent. The fight continues!
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