'We're going to get the doctor to give you a hand'
'Baby doesn't like when you do that'
'Its best if baby comes out sooner'
How often are we told that one of the key roles of the midwife is communication, and yet how often are we experiencing old outdated phrases from medical staff and colleagues, repeated merely in learnt behaviour, to women and families?
As a first year student I found it difficult to find my 'voice' when caring for mothers and families, often repeating what I had heard from other midwives and medical staff - often patronising and unclear.
We are constantly taught that to communicate well we should avoid technical and medical jargon, but I question whether this is really helping mothers in regaining the control they often desire during childbirth.
After developing my Midwifery style three years I have become more focused on creating a positive birth environment including keeping women informed during the journey. This is more commonly experienced when caring for women in labour ward, and interventions are required.
Often I find myself using my advocating role to explain procedures and medical staff plans to the woman and her birth partner.
This has developed from my experiences of really being 'with-woman' and experiencing the look that they often get when procedures or intervention are discussed and they physically glance to myself as the midwife, not for guidance but more for explanation.
Many times I have found myself looking at the woman and partner explaining 'this means the doctor is suggesting a forceps delivery' when they are faced with the comment 'we will give baby a hand to be delivered'. The consent is often ignored and I find myself being the one to put the control back into the woman's hands by explaining why this is suggested and if she wishes for this to happen. Often this takes a matter of seconds but is often followed by a thank you or understanding nod which relaxes the woman and removes some negative energy surrounding the impending intervention.
Language can build trust, which is key in providing women centred care and I find talking with the women I am caring for, discussing their wishes and wants for birth, along sometimes with discussions surrounding potential interventions (for example, the potential need for neonatal resuscitation if meconium is present in liquor) creates a bond, and can promote calm well informed birthing experience.
Many families I have cared for state they 'didn't know what was going on' in previous traumatic deliveries and as this is my area of interest I always ensure I spent time discussing their worries or concerns and answering any small or large question they have. Even non verbal body language such as a smile during a contraction, a nod of the head when they reach for the gas and air. I believe good communication can prevent birth trauma occurring again.
I will constantly be reminded of this from an experience at the beginning of this year where continuity meant I had spent two days caring for a woman undergoing induction of labour. Our communications surrounded the reasoning for this (reduced fetal movements), her concerns, her previous births meant that when her membranes ruptured in the induction ward and she felt the spontaneous urge to push, merely eye contact allowed her to calm and be transferred to a labour room. Each contraction she made direct eye contact with me, a direct form of non verbal communication, a show of trust built on a developing relationship.
Afterwards she stated she looked at me because if I was calm she knew everything was going to be okay.
