I was born at home in 1954, number four of six children and my mum’s midwife was called Constance Blackshaw. The reason I know her name is because I have a very special book – The Daily Missal – printed in 1927 and with a handwritten message in the front from Constance:
May 1955: Given to Ronald Francis, to whom Uncle Will was schoolmaster, and to his daughter Rosemary, at whose birth I was nurse. Constance Blackshaw
Her previous family connection with my father is an illustration of how midwives used to be familiar faces within local communities - linked to the families they cared for in a myriad of ways…. ‘Call the Midwife’ wasn’t just a series on television, it was the lived reality of every community.
The other fact I know about Constance is that, after I was born - in the back bedroom of our home in Derbyshire - my mother had a bath and had her hair washed and dried by her – something mum told me about years later and which was clearly a very special and intimate moment between them.
Fast forward to 2015 and the chances of knowing your midwife – who you meet at the beginning of your pregnancy; who you call when you go into labour; and who then looks after you and your new baby for the next few weeks – are vanishingly small. The image of your midwife washing your hair or gifting a precious book to your baby is a hard one to conjure up.
The question is, does it matter? Over the years, we have lost sight of the positive difference that having a relationship with a midwife you know and trust can make, for both women and midwives (another post for another time!) We have come to accept that having a steady stream of strangers caring for you - however kind and competent they are - is the norm. It hardly needs to be pointed out that knowing the midwife/s caring for you though pregnancy, birth and early motherhood makes a difference to the experience. But this needs a little more clarification…
The experience of having a baby and becoming a mother isn’t just an ‘episode of care’ which can simply be rated as ‘positive or negative’ in a hospital feedback form or a maternity services survey. Answering the question ‘Were you happy with your care’ cannot capture the value of knowing your midwife. Very few women giving birth for the first time have any idea what to expect and will probably be very apprehensive about ‘the experience’.
But forming a relationship with a midwife and working to establish (or even negotiate) trust, gives a woman the best chance to properly prepare for the experience of birth and ultimately motherhood. In an equal partnership with her midwife, she will grow in confidence and knowledge as a woman actively ‘experiencing’ childbirth, rather than as a passive recipient of the fragmented and often disjointed care she may otherwise receive.
Personally, for me - carrying within my heart the knowledge of that intimacy between Constance and my mother at my birth - the answer to the question is an emphatic YES - knowing your midwife does matter. That is why I chose to have the same midwife care for me when birthing my own children and why, as a midwife myself, I have chosen the same path: The relationship I have with the women I care for is at the core of my midwifery practice and the ultimate goal of providing this model to all women who choose it, is the reason Neighbourhood Midwives exists ….
NHS England has set up a national maternity review, which is currently exploring these questions and considering what the maternity services of the future should look like. If you have an opinion then they need to hear it…. you can register with them at: [email protected] and have your say.
(Rosemary) Annie Francis
www.neighbourhoodmidwives.org.uk