March on the NMC: What Bornstroppy said

The NMC is not fit for purpose when it does not understand the profession it is regulating and does not work with the people it is supposed to be protecting.

This was the message Ruth gave at the demonstration outside the NMC headquarters on the 5th May 2017.  Led by Caroline Flint on International Day of the Midwife, mothers and midwves partners and children from all over the country came to protest at the actions and attitude of the NMC. A small delgation of mothers and midwves also met with NMC’s CEO, Jackie Smith and two members of her team.

It  was Ruth’s, first open air speech with a megaphone so here is what she would have said if she had not been up a ladder shouting over the traffic!

Her speech was captured on video here.

Our vision is for families in Britain to be happy, healthy, strong and stable.  We need a midwifery profession to be there to nurture, enable and empower mothers and their families to be just that.

In the words of Margaret Jowitt former editor of Midwifery Matters :

“Women need a strong midwifery profession with autonomous midwives backed up by a governance system NOT paid for, or supplied by, the Trust for which they work. Midwives keep birth safe. Midwives treat women as individuals. Midwives respect women’s right to choose.”

And so we want a regulator that understands this.  We want a regulator who nurtures, empowers and supports midwives so they can nurture, empower and support mothers.

Midwives keep birth safe and a midwifery regulator is there to keep midwives safe and midwives respected.

We therefore need a midwifery regulator that has an open and transparent culture, which is accountable both to the mothers and their families it serves and also the midwifery profession it regulates .  Do we have this? NO! Do we want it? YES!

We need a regulator that is supportive rather than punitive, a regulator that does not run on fear but on mutual professional respect, a regulator who midwives can ring up for advice and guidance without fear of retribution.   Do we have this? NO! Do we want it? YES!

We want a regulator that rather than increasing litigation by its activity reduces it!  And we don’t want a regulator who just bans attendance at the births of family and friends to try and get itself out of a tight spot. We want a regulator that acts reflectively and with sensitivity for best practice and compassion.  Do we have this? NO!  Do we want it? YES!

And we want a regulator that knows what a midwife is for goodness’ sake!  We want a regulator that knows the difference between employment and self employment in the profession! That understands and discourses with midwives from all branches of the profession – Do we have this ?NO!  Do we want it? YES!

I am a mother.  A mother of five children, and where I had good quality continuity of carer I remember the names of my midwives – they are etched on my heart.  Thank you Ann Devanney, Thank you Madge Boyle.  Thank you Michelle Irving.  Independent Midwife Michelle Irving was my midwife for Child number 5 because the NHS care I was being offered was no longer safe and my complaint had been ignored and refuted.  Independent Midwifery was a choice for safety and it cost 20% of our income and it took 2 years to pay it off – but we decided that a good, safe birth is priceless.

The NMC knows the cost of everything but the value of nothing. It speaks the language of legal regulation and public protection but does not speak to or listen to the mothers who know the real cost of their policies and the real value of a safe and compassionate midwife!

The NMC is not fit for purpose when it does not understand the profession it is regulating and does not work with the people it is supposed to be protecting.

NMC reform yourself, or we, the mothers and grandmothers of this nation, will TAKE YOU DOWN!

And we WILL take you down, Jackie Smith, if you do not start talking with us and listening to us. Julia Cumberlege talked to parents all over the country as part of her Maternity Review – the NMC should be doing this as part of their engagement and accountability programme.  It is courtesy to the public you say you protect.

So my call to you here today as mothers and midwives of this generation is to set about making the regulator we need and deserve for the benefit of the midwives and mothers to come.  It will take work and cunning and more work and political wheeling and dealing and a hell of a lot of campaigning but it can be done and we can do it.  That all mothers are supported through the maternal pathway is our vision, that the centre of our practice is nurture and good evidence is a value, but  OUR BIG HAIRY AUDACIOUS GOAL is to have a fit for purpose regulatory body for midwives.  And if you won’t do it, NMC, we shall do it ourselves.  Because we, the public, want to be protected and to be protected we need a strong, autonomous, respected midwifery profession.

Follow me – Bornstroppy – on my blog.  Join the #savethemidwife campaign on FB.  Write to your MP AGAIN!  And tell your family, friends and neighbours, your sisters, cousins, children, tell your colleagues at work, the people in the supermarket queue, the people you meet on the train tonight.  This is about our babies, our bodies, our births!  It is about our profession, our good practice, our future autonomy. We do not ask for it because it is a nice thing – we demand it because it is our human right to be respected and nurtured to birth safely how we choose.  And a strong respected well supported compassionate midwifery profession is required to deliver this.

#SavetheMidwife!

#NMCNotFitforPurpose!

The Big Hairy Audacious Goal: New Midwifery Regulation

What a fantastic day we had at the Wigan ARM Study day (18th March 2017) on midwifery regulation. Here, as requested is my speech. 

We want to set up a new Regulatory Body for Midwifery based on strong values: beginning with the wellbeing of the mother and her family.  We want all mothers to feel supported throughout their maternal pathway and we believe that good quality evidence is at the centre of midwifery practice- for this is what public protection most properly means for maternity.

So my call to you at the end of this day as mothers and midwives of this generation is to set about making this happen for the benefit of the midwives and mothers to come.  It will take work and cunning and more work and political wheeling and dealing and a hell of alot of campaigning but it can be done and we can do it.  And this is what is called a BIG HAIRY AUDACIOUS GOAL.

A BIG HAIRY AUDACIOUS GOAL is based on vision but is not itself a vision – vision is about values such as the stuff I have just said.  A Big Hairy Audacious goal is what you want and what you are determine to achieve.  That all mothers are supported through the maternal pathway is our vision, that the centre of our practice is nurture and good evidence is a value, but  OUR BIG HAIRY AUDACIOUS GOAL – to achieve this vision and these values – is to set up a new Regulatory Council for Midwives.

It is AUDACIOUS: it makes one raise ones eyebrow, it makes others sit up and think, it may keep some of us awake at night wondering how the hell we are going to do it.  It is audacious but it is a concrete outcome and it is achievable so it is a goal.  And it is BIG and HAIRY because ALL Audacious Goals have to be Big and Hairy.  It is more fun that way.

And fun is a big part of this BHAG.  Because it is not much fun being a midwife with a regulatory body that does not have a practicing midwife on it, has a one day a week midwifery advisor to the CEO and does not know the difference between a private midwife and an independent one. It is not fun to lose your practise because your regulatory body can’t be bothered to go through your insurance policy in detail. Fragmentary factory care is not fun!  Coming off a 12 hour shift feeling like you have given your all but not met the needs of the women you have cared for is not fun.  It is not fun to find that supervision, the independent professional support for midwives and mothers has now been seceded in England to the employers – where we are already seeing conflicts of interest come into play.  It is not much fun if you have ever had the misfortune to be hauled infront of the NMC to be tried ( because that is what it is) by judges who do not know or understand your profession – or anything much about maternity.  It is not fun to pay more in regulatory fees than other better paid professions. It is not fun to watch what you hold precious in your profession de-valued so much that it is abolished as has happened with the midwifery code.  It is not right – that is for sure – but it takes all the FUN out of being a midwife.

So our BIG HAIRY AUDACIOUS GOAL is about putting the fun back into our profession.  And so I do suggest that whatever we do whilst achieving this goal, that we ensure that we have FUN whilst achieving it.  Some activists in the Netherlands recently spoke of working with ‘unrealistic optimism’ for the eradication of poverty and injustice.  And that is the attitude we must now have.  In the face of all challenges and setbacks we must work diligently with unrealistic optimism, because that is why we have a BIG HAIRY AUDACIOUS GOAL.

OK so how do we go about achieving our BIG HAIRY AUDACIOUS GOAL? That would be a 2 day course I think so some pointers.  We need a strategy and it needs to be simple and clear.  And then from it we have tasks – things we have to do to take the strategy forward.  A group of us have started working on a strategy and it is simple there are 3 initial key lines (more will emerge and other will fall back).

ONE

We need a research  group – These are our scouts who will find out, what happened last time, what has gone wrong now (digging into papers and minutes), what examples and models are there out there which we could use or partner with etc.  Lots of reading homework for those so inclined. Could do with a lawyer or two as well.  Also some formal meetings and networking work too – they may need to be different people as visiting people is not just about information it is about politics – its not just information we seek but a bond and a political position. We want to get all our ducks in a row all our evidence in place all our arguments formulated, the key people nobbled,before we go in there with our formal proposals

TWO

We need our campaign group to become a movement.  Currently it is small it can be ignored, laughed at and derided – this is currently the outward attitude of the NMC and the Government to the Save Independent Midwifery Campaign and this move against the NMC that has come out of it.  That is fine – they are behaving just as expected.  What we need to do now is make it so big, have so many stake holders in it that it cannot be ignored – this is when we will find the real opposition in and outside midwifery because this is when the fight really begins.

How do we build a movement?  By talking and educating everyone. So we set up meetings, we speak at meetings, we set up study days and conferences. We set up websites, and FB groups blogs and memes (notice the plural – let every flower bloom is my view).  We have meetings with our MPs and our counterparts in other professions.  We talk to consumer groups and parents.  We just talk to everyone who will listen – all the time.  I talk to drunk men coming home on the train from a foot ball match for God’s sake!  Never pass up an opportunity. Yes you become a regulatory bore but make it fun – it is BIG and HAIRY after all – unlike the guy on the train I might add.

Remember Caroline Flint talking about the vow to tell someone everyday about being a midwife and having a homebirth?  Well this is it!  That is how you make a campaign group into a movement – when everyone in the campaign starts telling someone anyone, who crosses their path that they want midwifery to be regulated by midwives and mums, and why. And we have social media which means you don’t even have to go out of your front door to do it.

THREE

The technical organiser in me says we will need to constitute a proper organisation at some point – just because this is going to be too big for any small group to hold.  Also we need buy in, leadership and input from a wide cross section of people.  An organisation will keep things relatively orderly when and where it matters which is when we approach funders, ministers, professional bodies and so on and so forth.  Don’t get me wrong the nature of movements is that there will be a happy and at times unhappy chaos.  But at the steely core there has to be a strong structure that can hold things together.  This will take a bit of time and effort but is not hard to do, but running this organisation will take over the lives of the people involved as the ARM has taken over the lives of some of the people involved and as Aquabirths took over my life.  But the group who do this will be making a difference and contributing a big chunk to the BIG HAIRY AUDACIOUS GOAL.

MAKING IT HAPPEN

Now the next level down from the big strategy above is the detail – and I certainly aint boring you with that at this time of day!  Join the campaign group choose which bit of the strategy you want to go for and linking in with others get on with it is what I say. Except for one thing: One detail you could all help the campaign with TODAY, is to write a letter of support for a new regulatory body for midwifery.  We need letters of support – hundreds of them – so we must start now.  With you.  Like at school, I need you to write a short letter stating your support for new regulation for midwifery and why.  It does not have to be long – two paragraphs will do – one saying what you want and the other saying why.  Sign off with your role and position – eg Midwife and mother, Big cheese midwife, professor midwife with big hat, Baroness Nobody and mother etc etc  you get the idea anyway.  We can bank these and collect many more for when we need to demonstrate that there is a seriously big mandate for change.  Email to me for now: ruth@aquabirths.co.uk or message me:  ruth Aquabirths Weston – my colleagues who support me selling pools will go mad as they wade through  all the emails.  But hey  – the price of success.

Yes and the price of Success.  This BHAG/Project cannot and must not rest on the shoulders of one person or even of a small few.  And this is a warning to my lovely ARM colleagues here and also to myself.  This is a massive project – it could take years if the movement stays small and we get no money.  So we have to build structures into our movement that ensure that as one falls there is another to take her place.  Not because we are all going to drop off the peg but because we are all ordinary folk here – we have jobs, we have children, we have aging parents we have life in all its fullness.  We will all need to deal with stuff other than Midwifery Regulation and so to box clever we need to ensure that the whole thing rolls on without one particular person having to be there.

This is so important to the achievement of this goal and why constitution of an organisation is part of the initial strategy.  One suffragette who was also a mother and a mill worker said – ‘We fight with one hand tied behind our back because seldom has a cause been won between dinner and tea!’  The suffrage movement – and it became a movement with several organisations within it – was forced to organise in this way to achieve its BHAG.  And these are the women on whose shoulders we stand today.

If you need to learn some lessons on changing constitutions then go and read up on the suffrage movement, we have all their barriers: a profession dominated by another professions, a patriarchal culture still in existence within and outside maternity, our room for manoeuvre limited by our place in society and the expectations and decisions of others.  Do not underestimate the subtle and pernicious ways this affects us and our opponents in the achievement of our goal.  I am not saying this to get you down but to be realistic.  For instance one of the points made at our formative meeting was that midwives are so overworked and crushed by their working conditions they won’t want to know or do anything.  Yep that is so true – and has been true for other movements for change like suffrage – but it is a challenge to be overcome not an eternal barrier – so we must seek out fun ways to meet that challenge in our colleagues. In Peace and Justice circles it is called ‘empowerment’..

And just like this job isn’t just for one person or one group of people, so we cannot do everything at once and won’t achieve everything at once – so we must be focussed.  As a group and as individuals we must recognise what we can do now – choose our priorities and do those few things we can do, the next step will enable us to do more, and so will more people, but ultimately it is choosing our priorities doing what we can do and not worrying about what we cannot.  Really and truly this is how big changes happen.

Remember the cycling team success for the Olympics? – they decided their focus was to be fixing the small things that got in the way of achieving their BHAG and in fixing the small things by degrees they arrived at their BHAG and gold medals.

I remember learning my lesson as a University chaplain many years ago.  My senior colleague told me – there is so much work to be done here, you can only see 10% of it, and of that you can only do 2%.  You have to learn to live with this fact and not try to do everything but do your 2% well.  And he was right – do what you can well and don’t worry about the rest.  This still enabled me to run a national campaign on student poverty, it still enabled me to set up and facilitate a student housing group, that achieved a cross professions task group with council and university reps that ultimately set in place policies that are still in place today keeping students safe.  And I bailed out half way through to have a baby and then was made redundant. But I had facilitated the change from a campaign group to a movement and it did not need me anymore to make the change actually happen.

I despair when people give up on the small thing they could do because it won’t change anything – because I know and so do other change-makers that it is doing the small things everyday that changes EVERYTHING.  If everyone here does the small things they can do – I am telling you we will be well on our way.

SUMMARY

Okay, so my time is up and we need to recap to remember.  What is a new regulatory body for midwifery?  A BIG HAIRY AUDACIOUS GOAL – it is big and hairy because it is fun, and it is big and audacious because it is a mighty challenge but it is a GOAL because it is achievable.  And we can and will achieve it.

We achieve it by having fun and having a strategy.  Our strategy is simple 123. 1 Build a movement – and the key action today is to tell everyone and any one – and all of us can do this, 2. Do our homework and get all our ducks in a row before heading down the M6 to march on Westminster, 3 make sure we have an organisational structure that will keep order and ensure no one person or persons becomes critical to the achievement of our GOAL

We know that we are human that we are women with LIFE and responsibilities but we know that other women before us have faced the challenge of change-making in the midst of life and faced greater discrimination that we do.  So we will be focussed and do what we can well, we will be focussed boxing clever with our priorities, we will be patient because this could take a long time, but we will be confident that change can happen – because this is our  BHAG and we are working stolidly to achieve it.

And today’s actions by this group are: 1. to write a letter of support for this big hairy audacious goal, 2. to make a personal vow to tell someone each day about this by whatever social means, and 3. to think about setting up a public or private meeting and inviting one or two of us to talk about it so we can grow our campaign through the maternity communities of our land.

No big deal then!  Small steps and Big Hairy Audacious Goal – I am looking forward to the fun – and I hope you are too!