Better Births. Anna Brown

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      Library of Congress Cataloging‐in‐Publication Data Names: Brown, Anna (Anna Maria), editor. Title: Better births : the midwife ‘with woman’ / edited by Anna M. Brown. Description: Hoboken, NJ : Wiley‐Blackwell, 2021. | Includes bibliographical references and index. Identifiers: LCCN 2020051701 (print) | LCCN 2020051702 (ebook) | ISBN 9781119628743 (paperback) | ISBN 9781119628804 (adobe pdf) | ISBN 9781119628842 (epub) Subjects: MESH: Nurse Midwives | Midwifery | Nurse‐Patient Relations Classification: LCC RG525 (print) | LCC RG525 (ebook) | NLM WY 157 | DDC 618.2–dc23 LC record available at https://lccn.loc.gov/2020051701 LC ebook record available at https://lccn.loc.gov/2020051702

      Cover Design: Wiley

      Cover Illustration: © Harriet Lee‐Merrion

       This book is dedicated to my family, my colleagues and friends who have supported me during its creation. I especially wish to thank all the women and midwives who have sent me their stories. Their contribution to this work is pivotal and I hope the content will inspire future generations of midwives, as well as those currently in the profession. A midwifery colleague wrote these lovely words below. When I read them, they resonated with me and the true essence and spirit of this book: Holding Space By kind permission of Emily Clark

       What does it mean to hold space For the pregnant/ birthing person And the new parent?

      To be a hundred percent present Emotionally, physically and mentally.

      To walk their journey with them Without judgement or opinion.

      To understand by opening Your heart to them.

      To give them space to feel Their feelings and just be.

      To be ‘with woman’. Finally, I wish to remember my parents Myriam and Paul who sadly are no longer with us, but who have always wholeheartedly supported my endeavours.

       Anna M. Brown

      Preface

      I have been a midwife for 35 years. Throughout this time, I have witnessed the impact and implications of childbirth. However, more recent events have encouraged me to examine childbirth experiences which have involved close family members. Heartfelt comments have ranged from desperate pleas such as ‘nobody tells you the reality of becoming a mother … I feel overwhelmed’ to ‘I feel abandoned’. Such observations have urged me to explore the concept of what it means to women and midwives to be ‘with woman’. In addition, new standards for the profession were published in November 2019, one of which requires midwives to be able to provide and promote continuity of care and carer. This is not a new phenomenon but seen through the concept of being ‘with woman’ would provide a safer and more effective delivery of maternity care.

      ‘With woman’ is an old term in the English language from which the word ‘midwife’ is derived. The meaning and concept of being ‘with woman’ may be interpreted as providing care and support in a physical, psychological, emotional and spiritual sense. Hunter (2002, p. 650), explored this concept to focus on the ‘presence and support by a caregiver as desired by the labouring woman’. Early on, nurse‐midwife core competencies in America emphasised the importance of human presence with the childbearing woman as a therapeutic and professional philosophy (ACNM 1979). More recently, Bradfield et al.'s (2018a) integrative review of the literature explored the ‘with woman’ phenomena to present an understanding and perspective of this concept. The authors suggest that being ‘with woman’ is an evolutionary construct, which is dynamic and continues to develop, and is fundamental to midwifery practices and professional philosophy.

An integrative review of the literature pertaining to midwives being ‘with woman’ (Bradfield et al. 2018a) suggests that this concept is a developing, integrative construct that is dynamic and ever evolving. Its philosophy underpins midwifery practice to identify and guide it in context, making it contemporary and creating spaces for innovation and further research, enhancing an ever‐growing body of knowledge. ‘With woman’ requires building mutually trusting relationships between the woman, her partner and the midwife and the complexities and challenges that this entails. It needs to take into consideration the expectations and decisions of women in partnership with the midwife. This relationship ‘with woman’ ought to be empowering for both woman and midwife, but sadly women's stories are a disappointing testament to a lack of control in what should be a safe and happy life‐changing event.

      The purpose of this textbook is to provide an arena of enquiry and debate for those interested in the concept of being ‘with woman’ in the childbearing context. Recent publications from the Royal College of Midwives (RCM) on Better Births (NHS England 2016a), followed by the implementation of research (NHS England 2017), explored what women want from the childbearing experience. This National Maternity Review (NHS England 2016b) set out a five‐year plan to ensure that NHS maternity services in England are safer and more personal and that women's expectations of the childbearing experience is as close as is reasonably possible. The Better Births vision is to ensure that women are able to build a trusting relationship with their named midwife based on mutual trust and respect in line with the woman's decisions and fulfilling a true philosophy of being ‘with woman’. This can only be achieved through a personal relationship of continuity of carer over the childbearing. Such a relationship has been found to have positive effects on women's birthing experience and safer outcomes for mothers and neonates (Hunter 2009; Dahlberg and Aune 2013; Sandall 2014; Rayment‐Jones et al. 2015).

      A national Maternity Transformation Programme (NHS England 2016b) has been created to achieve the Better Births (NHS England 2016a) vision through its implementation and establish transformed maternity services. This is to be achieved by providing consistency of care throughout the antenatal, intrapartum and postnatal periods by a known midwife or obstetrician. The named midwife would take responsibility for coordinated care throughout the