Midwifery: bridging culture and practice
International Confederation of Midwives
June 9, 2014Thursday, June 5th: The last day of the 30th ICM Triennial Congress started with a truly interesting session titled ‘promotion of midwifery as a career’. Chaired by Ingela Wiklund (ICM Board Member) and conducted in partnership with the White Ribbon Alliance (WRA), it was an interactive workshop focused on an exploration of what it means to be a midwife around the world today, examining the stereotypes in different countries and identifying strategic ways of challenging them.
Nester Moyo, ICM Senior Midwifery Advisor, started the session by saying that midwifery has been described as an aging profession. Unfortunately, there are not many young people striving for a career in midwifery, due to the negative image portrayed about midwives.
Brigid McConville (WRA) introduced a short film called ‘Mythbusting Midwives – The Downside’. Midwives around the world shared some words that they heard people using to describe them and their work. A midwife from Malawi shared her experience saying that ‘what I feel is that midwives have a bad reputation’, they are often called ‘bossy, dismissive, unskilled, uneducated, old fashioned, strict, without compassion’. Voices from the audience shared: ‘The bad image presented by the media is due to the fact that midwives support pain and labour, therefore are sometimes perceived as bossy and unkind’. A male midwife from Malawi shared that the majority of people in his country consider midwifery as the lowest level on a professional scale. The second part of the movie, called ‘The Upside’, presented the good things people say about midwives and included: ‘caring, helpful, gentle, emphatic, loving, listening, understanding, strong, warm, indispensable, compassionate, humane, supportive, sensitive to unspoken needs, magical, passionate about their work, knowledgeable, calm, extraordinary’.
Many countries face low enrolment in midwifery education programs, for example Tanzania has seen a 90% decrease in student intake compared to a decade ago. Reasons include the status of midwives, negative perception of midwives’ role, poor pay, and working conditions. Nester Moyo said the issue lays in our society’s perceptions about midwifery, ‘the power gradient that midwives create between them and the women they serve’, said Nester. ‘Society sees midwives as those people who don’t want to work with anyone else, don’t listen and don’t understand’. Secondly, Nester said that the entry qualifications for midwifery education are not competitive, they are often called ‘academic leftovers’. The third theme that came through was the education process itself, because of the perception of student midwives. ‘We are not producing confident individuals, we need to change the ways we address, interact, and treat young midwives’, added Nester. The fourth point Nester made were the conditions of service; ‘the economic level of a country does not necessarily reflect the conditions midwives work in’. Nester also stated that midwives don’t have a uniform image around the world, therefore people ‘don’t want to join this feeling of vagueness’.
Frances Ganges, ICM Chief Executive, shared her experience in the US and said that on several occasions people asked her ‘are you really a midwife? They still have those?’ She added that midwives in the US only attend 10% of births. When she worked as a nurse, one would be sent to a postpartum unit as a punishment as it was believed that didn’t require skills. Mary Chuwe, WRA Tanzania, shared the example of a campaign that was carried out to promote midwifery in her country, called ‘Be in Science – Choose Midwifery’. Before the campaign, ‘midwifery was seen as a last resort, not the ‘career of choice’, said Mary. By establishing youth clubs in schools and encouraging students to take science classes, the campaign promoted a very high awareness of midwifery and as a result – more students enrolled in midwifery programs. Read The Full Article