137. Reclaiming Midwifery a modern day battle cry
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[00:00:00] Mel: Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD. And each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey.
[00:00:22] Mel: Today, Professor Hannah Darland is in the house and girl, does she have a Something to say about our power to reclaim midwifery. She, like many of us are on a, on a mission to make midwifery woman focused again. Midwifery got away from us as a society and Hannah has a unique bird's eye view of the landscape and was to tell us about it.
[00:00:44] Mel: So we're talking about, um, where have we come from? Where are we now? And where are we going as midwives? What's your kind of, where do you want to take it?
[00:00:57] Hannah: You know, I, I've always believed it's really important to stop, to think about where we've come from. What are the lessons we've learned? What did we do wrong?
[00:01:10] Hannah: What did we do right? Have we forgotten the lessons we learned from what we did right and what we did wrong? And are we repeating some of those behaviors? today. I also think we can often get really down and depressed when we look at now and we think, why is this, why is it still so bad? Why is nothing ever changing?
[00:01:30] Hannah: Why are we here? We're going backwards. I hear a lot of this coming from midwives and I always do a stop and then I try to take my back, myself back, my 35 year midwifery career and then back to my mother's era. And we've come a huge way. But I also see us repeating some of the mistakes of the past. And I'm also so excited about where we're heading.
[00:01:53] Hannah: And I just feel like the whole world is there going, here's the little gift that you've been fighting for your entire life. And my biggest concern is we're going to stuff it up. And we can't afford to do that for women. We can't afford to do that for midwifery. You can't afford to do it for our daughters and for our granddaughters and for the future of humanity.
[00:02:14] Hannah: So for me, it's about wisdom. It's about taking a breath. It's about reflection. It's about. Being really kind of taking those lessons, taking those instructions, not being bogged down by them because we can do things better and we can't do things differently, but don't lose hope. And how do we take ourselves the next step without blowing it up?
[00:02:36] Mel: Yes. And I think we also have to acknowledge that we, we have, I think we're coming out of a historical lull in midwifery history. And now we're clawing our way up out of the lull. Are you feeling like we could potentially self sabotage this progress, internally sabotage this progress somehow, and that the challenge to us is not actually external?
[00:03:05] Hannah: Yeah. So look, I've seen lots of points along the way where in retrospect, I think we could have been. And when you talk about the lala, I see it as a sort of being out on this wide open ocean where you have waves and you have troughs and midwifery has gone through a series of waves and troughs and waves and troughs, and the thing about being on the top of the wave is the world can look great.
[00:03:28] Hannah: You're really excited. The thing about being down on the bottom of the trough is sometimes you lose perspective that. The top of the wave is coming. So midwifery is full of that. And when I look in my own, I guess, relatively short career in the scope of women having babies in this planet, you know, there's been 35 years since I became.
[00:03:52] Hannah: A midwife though probably a lot longer. 'cause you know, I grew up in Yemen and I used to help my mom catch babies over there, much younger. But in that 35 years, I've seen a lot of waves and a lot of troughs and, and for me, the most, I guess, stunning wave happened when, uh, 2008, nine, and then 10 happened, where that wonderful collection and collaboration of incredible consumers.
[00:04:21] Hannah: And I want to name them first because we wouldn't be here without those women and their partners and their families that supported us. Amazing midwives who just fought and fought and fought and finally, and stood on shoulders of great people who also fought, but may not have got where we are now, a political point in history where we had a government.
[00:04:45] Hannah: That listened to us and a movement in the world towards really starting to listen to women's issues on top of this avalanche of evidence that many of us have been a part of showing that midwifery is important. So it was that great crescendo that occurred and we got Medicare, as you know. We got insurance of, of sorts, we got huge recognition, we started to get admissions to hospital, you know, lots of, lots of great things were happening and we should have been ready for the backlash.
[00:05:18] Hannah: We should have been ready for those who are going to try and, and take you back as always happens in any revolution. And everyone was exhausted. And so what I saw at that time that occurred in, in that, Like period and on was a little bit of us kind of falling apart. So you had consumers that I think were utterly exhausted and were sometimes at odds with each other and at odds with the midwives, you had midwives that were also at odds because midwives who wanted the pure, we need everything.
[00:05:50] Hannah: And we won't agree to something. You had the negotiated midwives and I was a negotiated midwife. I was like, put the foot in the door. And then we'll reef it open at a later point. And you had the midwives who frankly didn't know what the hell was going on. And you know, I, I did see things kind of fall apart a little bit, but out of the fallen issues always came new energy and, and new energy.
[00:06:14] Hannah: new thoughts and the ongoing fight to get insurance for home birth, the ongoing fight to get home birth recognized in Medicare, the ongoing fight to open up the doors of hospitals, the ongoing fight to get rid of the collaborative arrangement, which was a horrendous, Restriction on midwives and women that continued for another exhausting 15 years.
[00:06:37] Hannah: And here we are now, 15 years later in 2025, still fighting that fight, still feeling quite exhausted and now getting obviously. Insurance becoming a potential reality for home birth. Medicare items becoming absolutely a reality for home birth. Admitting rights now starting to expand. The collaborative arrangement has, has been dropped, and I see that a lot of these opportunities are coming right now, and I'm starting to see people start to fall apart again.
[00:07:07] Hannah: My concern is. Fabulous, fabulous women. We've got to hold it together, got to get on the same page. Doesn't mean we always have to agree, but let's have those public conversations about what we agree on and let's have private conversations about what we don't, but if you make a tiny little issue, the thing that will stop you talking to someone.
[00:07:31] Hannah: You're kind of blowing the whole potential up. So that's some of the things that keep me up at night now when I see history repeated and I've probably been around too long and that's, I get worried. Yes, well let's take it
[00:07:46] Mel: back because, because there's a massive global context around midwifery. So in, there's so many little mini ecosystems.
[00:07:54] Mel: For midwives, you know, here in Australia, we've got all these little ways that you can be a midwife and all the political issues and globally, there's different issues. But if we go right back to the beginning of time, , when we started all having babies, there was always the midwife. And certainly, you know, you and I know the stories, a histor, you know, all around the world.
[00:08:19] Mel: There's stories of the early midwives and what they did. You know, there's these beautiful, I love the biblical stories of midwives because they were so terribly rebellious against big authorities, uh, in the interest of being with women.
[00:08:33] Hannah: named in the Bible, which was quite a rare thing for women, unless they were particularly special.
[00:08:40] Mel: And really all through history, the naming and, um, proclaiming of women's, you know, activities was really not a thing. And so the fact that, yeah, these midwives were named in this historical text, uh, is significant. And so it feels like. And you know, I've heard you say the, the, the two oldest professions, uh, prostitution and midwifery for women.
[00:09:04] Mel: So midwives have always been a part of birth and actually as well, you know, we had a podcast episode about, uh, the indigenous history of midwives and how significant they were in indigenous and Aboriginal communities here in Australia, where the, The First Nations community sort of chose these midwives and those midwives nurtured other people to become midwives and it's almost like this calling that you would be a midwife.
[00:09:35] Mel: And the community valued midwifery and they invited, and this is kind of a global thing, is that women have traditionally invited midwives into their birth spaces. So it's, it's always been a thing. But for you You know, we have global definitions of midwives, but what are midwives? What is their role supposed to be?
[00:09:56] Mel: In pregnancy, birth and postpartum.
[00:09:59] Hannah: Well, what, what I love is that the name says it all, which is with a woman, which is exactly what midwife means, mid being with and wife, the old fashioned English word for woman. So that's what we are meant to be with woman. Now, when you unpack midwife a little bit more, what does that mean?
[00:10:18] Hannah: What does that mean? That means that being with woman is, yes, you are following what a woman wants. You're supporting what a woman wants, but the woman's wanting you in her space because you've also got these very special skills and experience and equipment. Let's face it. We've got some nice fancy things that can make, make life a lot safer.
[00:10:36] Hannah: You have this knowledge, you have this. So, in many ways, I've kind of, you know, seen midwives as, as, you know, the ultimate, um, Sherpas on that journey that women have to do it alone, but they can do it with a companion, but they still have to pick their legs up and they have to walk that journey. If you then take midwifery from that ancient, Description you just gave what is now overlaid on midwifery, which is a good thing and can be a problematic thing is the standards of education.
[00:11:10] Hannah: It is the codes of conduct and practice. It is the fact that we are now registered health professionals with obligations and legal requirements. And why I say a good and a bad thing is I would never go back because the good thing about that is it does hold us to account for the safety of the public.
[00:11:28] Hannah: It also makes sure that we have. Midwives are all educated to a similar level. It also makes sure we have the skills and the knowledge to be able to step in and deal with issues, recognize, transfer, consult, and refer. So they're all critical things. The negative thing is that's often used as a big stick to control women because you legally can't control women in this country because of the laws, but you can't control midwives.
[00:11:53] Hannah: So we're at that point that we have to make where we are now work again for women. Without midwives being thrown under the bus, what I'm currently seeing that worries me a bit, and Mel, this takes us back to kind of the work you did also for your PhD when you were with me as well, is I'm seeing midwives get punished if they follow what a woman wants, if they Uh, a woman makes an informed decision and perhaps, um, says no thank you very much to what might be considered best practice.
[00:12:26] Hannah: And then midwives get thrown under the bus, they get reported, they get, you know, disciplined, they get publicly scrutinized, and then they get fired. Brightened and cautious. And they either leave providing that kind of care or they become more and more conservative. And on the other side, then you've got the system that is constantly damaging women, increasingly doing so emotionally and psychologically and spiritually and culturally, and I would say now physically as well, and you've got.
[00:12:56] Hannah: That being women, the women are between a rock and a hard place. So you've got this awful situation where women are now going. I've got midwives who are, who are scared and midwives who are getting penalized and midwives who are leaving, I can't access or they're trying to pressure me. And now you've opened up this whole world of, you know, free birth and birth workers and, and, um, you know, there's, there's many, many different names for it.
[00:13:22] Hannah: So that concerns me and I don't think we have the system right. And we have to have a system that protects. Does regulate midwifery, but does it in a way that the end goal of regulation should always be protecting the public, the safety of the public. What I don't think we're doing now in the way we do it is protecting the safety of the public.
[00:13:43] Mel: There's this. We're in a situation now where if midwives act completely with women, we're scrutinized by our regulatory bodies in the system. If we have any allegiance to our regulatory requirements or to the current system, then we become discriminated against. not the victims of, but scrutinized by women.
[00:14:08] Mel: So it is a no win situation for midwives. There's this pressurized system where if we don't act according to how somebody else thinks we should act, then our practice and our decisions are open for public scrutiny. I mean, I, I really understand both perspectives. I'm with you on the appreciation for what regulation does for midwifery because we can feel confident that we're part of a profession that has a minimum standard, that theoretically our training and registration should maintain a standard that women can expect from their midwives.
[00:14:51] Mel: But then we are potentially acting less autonomously as midwives, then we become, yeah, under the scrutiny of women. And so there's this weird moment where, you know, regulation happened and professionalization happened as kind of simultaneously with the medicalization of childbirth. And so a lot of women see the regulation of midwives as all part of this systematic process of trying to take ownership of and control birth.
[00:15:22] Mel: And so it's, but midwives are also internally battling against this medicalized system, desperately wanting to be with women, but also knowing that in this time in history, we exist under regulation. And so I understand the mistrust that some women have towards midwives, because we are existing in a difficult historical point.
[00:15:48] Mel: Through no fault of our own, we, I can't control that. Um, I had to get educated through university and that I have to register as a midwife, you know, if I want to be a midwife, I have to exist in that reality and I can do my very best to be with woman, but there are always going to be elements that I can't give of myself because.
[00:16:10] Mel: We are a regulated profession. So it's this really tedious point where we will constantly be under scrutiny. It doesn't matter what we do. Somebody will scrutinize our behavior, but that's also a potentially a good thing because we're consciously and like always cautious about what we do, but that's a massive mental game for a midwife to be constantly battling with.
[00:16:37] Mel: Am I being with women in this situation? Am I submitting to this medicalized system that I don't really want to be a part of, but that I am, and I have to be, you know, what are people going to think? Am I operating out of fear? Am I operating out of skill? Am I using my intuition? Am I using the research?
[00:16:53] Mel: Am I listening to the woman? You know, it's this such internal turmoil that we're in as midwives at the moment. And I don't think it's just Australian midwives. I feel like this is a global situation. Where the autonomy and skill of midwives is not upheld and respected by a lot of our regulation bodies.
[00:17:11] Mel: And so now we don't know, we don't know what to do.
[00:17:15] Hannah: Yes. A couple of things on that that you've just raised. In some ways that's where midwives are sometimes placed, having to choose between women and their registration. But it is a very false picture because actually if you look at regulations. If you look at the midwifery consultation referral guidelines, if you look at literally every, uh, legal policy document, fundamentally embedded in all of that.
[00:17:42] Hannah: Is the right to choose the right to make an informed choice, the right to decline in the midwifery consultation and for our guidelines. And there was this whole eruption and everyone was saying, we're not going to have the guidelines. Those guidelines are excellent, but everybody forgot this very important point at the back of them is the appendix a, which says, If a woman has made an informed decision and you have told her what you think, according to the evidence would be the best recommendation, then you complete this document and she gets to follow her choice through.
[00:18:16] Hannah: So everything is on the side of midwives to support women. Doesn't mean no out on easy straight that it is actually easy because one of the greatest and most scary places for a midwife to be is to receive that letter from APRA. Have that public criticism to be hauled in front of a coroner's court, to be outed in the media.
[00:18:42] Hannah: But I just want to kind of really reiterate to midwives, you find me one document that is the documents which we practice by and abide by that doesn't totally support us to follow what women want.
[00:18:57] Mel: I absolutely agree with you. I think that on paper, and especially for private midwives in Australia, on paper, we have a lot of freedom and autonomy.
[00:19:07] Mel: There's no doubt about that. I don't feel particularly restricted in my practice by the ACM guidelines or by APRA, because I do think APRA, on paper, supports Us informing women and, and us being autonomous practitioners. I think what doesn't, and the majority of midwives in Australia are working in public and private hospital systems.
[00:19:32] Mel: Very, there's very few boutique kind of woman centered, you know, fundamentally woman centered and women and midwife led services. And the big issue is that there's this, uh, registration standard and guidelines, which are written from a woman centered in a way that allows midwives to have autonomy and evidence based and evidence based evidence based.
[00:19:58] Mel: The issue is, is that when you come in as an employee, Into an institution and a service that there's this other layer of policy and guidelines and sort of contractual agreements that when you work in our facility, you'll work in the way that our facility works. And there's this whole workplace culture, this unspoken workplace culture.
[00:20:19] Mel: Sometimes it's not written down, but there's this cultural expectation that you'll toe the line and do things the way that we do them here at hospital. And I've got midwifery friends and colleagues who. Have been constantly sort of disciplined and reprimanded by their workplaces for not following policy because the midwives are trying to give women, women centered care, and then women are declining certain things.
[00:20:46] Mel: And then the midwife comes under scrutiny because she's not working or he's not working to the policy. So while I do agree with you that a lot of the things that are written down. Particularly for autonomous midwives, particularly private midwives who are more autonomous and aren't heavily supervised.
[00:21:04] Mel: I just think there's this really pervasive workplace culture that still prevents midwives from working the way that our documents tell us we can work.
[00:21:16] Hannah: I absolutely agree with you. We have coercive cultures and anyone within an institution, the fundamental Results and almost purpose of an institution is to work on an industrial model, which is to normalize, to keep things the same, to pump women in, pump women out, to do that efficiently, to try and save costs, to try and minimize their own risk and criticism.
[00:21:41] Hannah: What does that all tell you? It all tells you that our systems are set up about the system, not women. And that's the fundamental thing that I think we've got wrong. But I've found in every point in my life when I've raised my quavering little voice, and I remember once doing this in a huge government meeting when literally the decision was made to shut down every maternity unit that had under 2000 births and only have large units.
[00:22:09] Hannah: And I could see all these very sage doctors all agreeing with each other. It'd be so much safer, so much better. And I remember this one doctor saying, Oh, my wife, you know, she's had six babies. She totally agrees with me. And I raised my quavering little voice and I said, where is your evidence? And the whole room went deathly silence and the chair of the committee said, actually, that's a very good point.
[00:22:32] Hannah: What is the evidence? And of course the evidence didn't support this and it never went through. Cause imagine what decimation that would have had to rural remote Australia, like it's unthinkably stupid. So at every point in my career where I've raised my quavering voice, let me tell you, heart pounding, quite nervous, still do still feel the heart pounding, I've realized.
[00:22:54] Hannah: That the fear I have of the ramifications of doing that. Never ever eventuate that actually raising that quavering voice makes that quavering voice stronger and starts to get action. I think midwives have been very silenced. We're silenced in the hierarchy. We're silenced as a, often a dominantly female part of society.
[00:23:18] Hannah: And yet when we raise our quavering voice, we're an enormously powerful voice. So I agree with you, Mel, I have absolutely, it's horrendous walking into those organizations, but I urge midwives to do it for the sake of women.
[00:23:36] Mel: Yes, it, it's just so exhausting is, do you know what I mean? At this point in history, a lot of midwives want to be midwives.
[00:23:47] Mel: You want to work with women and help them through their pregnancies and their birth and be with them postpartum. In their postpartum without being restricted by time or rules. Then we realize actually. The easy part of midwifery is doing that is being with women. And the hard part of midwifery is that we are fighting against this cultural situation around birth at the moment, that, that has stopped valuing birth that doesn't know how to treat women properly in labor and birth and through their pregnancies.
[00:24:17] Mel: And so we exist in a political situation, in a cultural situation, in a medical situation, we, we constantly fighting to try and. And defend physiological birth and prevent unnecessary interventions. Like our job is so much bigger than checking a baby's heartbeat and holding someone's hand. That's not, you know, midwifery is not that anymore where it used to be.
[00:24:42] Mel: We didn't have to think about this political context. My concern is, is that where we are at the moment and you, you touched on it. Is that people are so tired of this fight. Yeah. And the longevity for midwifery midwives in their career is getting so short cause we're so morally distressed by what. We're seeing what we've been asked to do, the culture in our birth units, what women have been exposed to.
[00:25:10] Mel: What's the remedy for this midwifery exhaustion and distress because, like, how long can
[00:25:14] we
[00:25:15] Hannah: keep going? Well, again, I'll come back to raising the quavering voice. Because I think one of the most awful things about feeling marginalized and not listened to is not having your voice listened to. And the moment you do raise that quavering voice and somebody starts to listen to you and then they start to think, Oh, actually that person's got common sense.
[00:25:35] Hannah: Then they start to pull you into more meetings and then you start to rise up the ladder and hey, before you know it, you're the director of nursing and midwifery and guess what? You can change the world. Not totally because again, they deal with their issues. So I go back to that, but I, I did a keynote address at the ICM conference in, in 2023, and I put up 10 reasons why we are not there yet.
[00:25:58] Hannah: And I just want to read those out to you because these are my takes. And once we know that, then we know what the monster is that we have to deal with it. So the number one reason is midwifery is predominantly a female profession and it's embedded in a patriarchal medicalized business structure. So if you look at that, you go, well, that's the reality.
[00:26:18] Hannah: How do we take midwifery out of that patriarchal medicalized structure? That's one solution, which is private midwifery. Second solution is how do we make changes to that patriarchal medicalized structure so that once you know that you've got two targets, number two, midwives are hampered from providing relationship based care.
[00:26:38] Hannah: There is nothing more powerful than the trust built between a midwife and a woman to shape birth, to shape the satisfaction and the power in midwives, to change outcomes and to turn revolutionary consumers into God help you when they land in front of you in your Parliament House. So, relationship based care is, it's that secret weapon.
[00:27:03] Hannah: that actually unlocks everything because it gives voice to women. The third thing is that belief is stronger than evidence, especially in our post truth world. So while we may say we're evidence based, I think we are still prehistoric. We are still making effigies to invisible gods and we're dancing around fires in the plains of the Sahara.
[00:27:26] Hannah: We still fundamentally are motivated by what we do based on our beliefs and our fears. So we have to really start to address those beliefs and, and, and those fears. And we have to start to really question the stuff that is happening in our systems that is not evidence based. The fourth one is belief is informed by what we experience.
[00:27:51] Hannah: And birth is traumatic for many women today. And midwives are seen to be part of that system. And midwives also traumatized. So we've got this kind of cycle of trauma that women think that's how birth should be. Midwives think that's how birth should be. Midwives are burning out. They're creating more trauma.
[00:28:09] Hannah: Women are becoming more traumatized. And before you know it, you're almost in this little world that. Nobody can see out of. So again, I come back to relationship based care. When you can transform birth experiences, women go, Hello, my life doesn't have to be like this. It can be better. My fifth one is fear has consumed maternity and it is a very limited view of safety we embrace.
[00:28:33] Hannah: So when we talk about safety, we're always talking about the death and damage of a baby. Let's face it. That's what we're talking about. But safety is also about cultural, emotional, psychological, spiritual safety. It's not just about physical safety. And we've got to keep the health system accountable to what makes us truly human.
[00:28:53] Hannah: My sixth one is midwifery doesn't make money, but it saves it. So we do not buy the big machines that go pin, but we save so much money and money is power. So midwives have got to be very clever in articulating how they are contributing to the fiscal benefit of the world. We save money. We are the green solution to healthcare in the maternity system.
[00:29:19] Hannah: My seventh one is midwifery is dominated by medicine and nursing and we have to break the shackles. Now, this is not saying we shouldn't collaborate. This is not saying many of our wonderful nursing colleagues have walked alongside us. I'm married to a nurse. This is nothing against them, but the domination of midwifery and the kind of trying to keep midwives in their place so they don't think they're special or different or break away.
[00:29:44] Hannah: And for medicine's perspective, so they kind of do what we say and do all of our hard work. That's got to stop. And if we could take away that domination and have midwives regulated with a chief midwife, With midwifery at every level, midwifery in the hospital, regulating midwives, all the way down, we need to have that happening.
[00:30:06] Hannah: My eighth one is that everyone's focused on the immediate outcomes. and not on long term health and well being. And we're about to have a paper published next week, probably, which is called the Birth Patterns Paper, which is following through all the women who have given birth in New South Wales for 16 years.
[00:30:23] Hannah: What happens when you have a vaginal birth for number one, with number two and number three? What happens when you have a cesarean for number one, with number two and number three? What happens when you have a forceps? And what happens when you have that baby in a private and a public hospital? Let me tell you the, we are so focused on this birth that we're not thinking about the fact that in this birth I'm creating the next three or four births and what is the lifetime effect and then what is the health impact of that on the mother throughout her reproductive life course.
[00:30:53] Hannah: Number nine is that mum, women, midwives and women and mothering are not valued in many countries. And so how do we do that? And I think we've done an enormous job. What I've seen in my career since I came back to Australia in 1991, always called the nurse, nobody knew what a midwife was, people used to pronounce it strangely, people had no idea what it was nowadays, everybody knows what a midwife is, so we have to raise the value of women generally.
[00:31:22] Hannah: Midwives and, and what mothering and parenting is. And my final point while we're not there yet is the midwives and consumers need to unite, work together and truly value each other's contributions. And that's where I think we can lose the whole course. Now, by unite, I don't mean agree all the time.
[00:31:44] Hannah: Absolutely. It's not a consumer's job to agree with us. It's not a midwife's job to necessarily agree. It's not that not either of our job, but how do we unite around the issues that we agree on and how do we publicly fight them together and then deal privately with the areas where there may be some disagreement where I see real danger is when it comes out into the public.
[00:32:09] Hannah: And all of those who are desperate for us not to succeed just rub their hands together and sit back and they just watch the implosion. So those are my 10 reasons for why we are not there yet. But in each of those reasons are the solutions of where we can, what we need to do to get there. So I haven't started because they're all easy to be dealt with.
[00:32:30] Hannah: We just got to strategically start tackling them.
[00:32:33] Mel: Well, and I agree with you in a sense, I think a lot of the problems that we have could be fixed very quickly, and I used to think we couldn't fix them quickly, but then I saw what a united response can do, for example, during COVID. When things changed overnight and you could change the whole way a hospital system or a maternity care system operated.
[00:32:58] Mel: Everyone rallied, everyone followed, you know, there was security guards, there was checkpoints, there was new processes, every, you know, there was communication, there was this global response that, and all of a sudden everything changed. And so I actually think once you're motivated, absolutely. There could be a massive change and if overnight we started trusting women and midwives to work together for each other's good, then this could turn around very, very quickly.
[00:33:30] Mel: It, it's not like it can't be done. I think we've got solutions. We know midwifery and autonomous care and giving women choice is where the evidence is at. And I was thinking of two points when you were talking. You know, a lot of people don't understand why it would be important to separate midwifery away from nursing and medicine.
[00:33:52] Mel: And it's a, it's a fundamentally a philosophical reason in a sense that doctors and nurses are trained and supposed to look after sick people. So they only are normally presented with people who, who need medical care. And in today's society, we think pregnancy and birth are a medical situation, but they're not, they're actually just.
[00:34:15] Mel: This is what our body's designed to do. It's like saying every woman who has a period is, is currently in a pathological state. It's not, it's just, it's what our bodies do. They grow and they have babies and, and a job of a midwife is to, to nurture and supervise that life stage and assist where needed.
[00:34:34] Mel: And so they're two fundamentally different professions. The reason they were bundled together is that people think of. Childbirth and pregnancy and postpartum as a medical event. So they're like, Oh, nursing and being a doctor is a medical thing. Let's put them in there. So that's why we advocating for that.
[00:34:54] Mel: We're not saying that nurses and doctors are less, we're saying this is a completely different profession. We don't need to be affiliated with a medical profession, but we work with them, absolutely. Uh, that's, that's, that's great. We compliment each other. So that's the first thing. If anyone's going, why would that be important?
[00:35:14] Mel: I often take the example of I've just had
[00:35:17] Hannah: orthopedic surgery, right? Fabulous, um, orthopod, who tend to me go see the physios. They're wonderful. When I would see the, see him, he'd say, what did the physios say? No issue with orthopedic surgeons, not totally respecting using recommending and seeing that physios have skills they do not have.
[00:35:38] Hannah: What is the issue between obstetricians and midwives or nurses and midwives? Well, particularly between obstetricians and midwives, I'll tell you what the issue is. We are competing over the same clients. And the more popular midwifery becomes and the more women seek midwives out, the less they spend huge amounts of money paying for obstetric care.
[00:36:03] Hannah: Also, the more midwifery does its job well, the less obstetricians need to do cesareans and epidurals and, and, and forceps and all the other things where they make a massive living, but not just make a living. They also have incredible respect and power and control. So the big. Difficulty we've got of de enmeshing ourselves is learning to say, these are my skills, those are your skills, and we can make each other's lives better.
[00:36:32] Hannah: But the other big problem we've got in this country that doesn't exist in countries like, um, Scandinavia and the UK, for example, is that we have a fiscal competition. Because of our private public model. So those are two big things we've got to work on where we do not create a poor life for obstetricians, but they can still go on and provide that service.
[00:36:55] Hannah: But we also are able to facilitate women's choice and midwifery growth. And this is one of the reasons that I'm a great advocate of bundle payment where, like in New Zealand, a woman has a package of payments. She can choose whoever she goes to, and she can use that payment to whoever she goes to.
[00:37:13] Hannah: Because we got to take the sting of money out of it and that'll really work strongly towards taking the sting of power out of it. Well, this is where it started though. This
[00:37:25] Mel: is how obstetrics took hold is that they could see that, that women paid midwives to care for them through this stage of their lives.
[00:37:36] Mel: And they thought, Oh, hang on a second. We could get in on that. Uh, and originally the obstetric takeover was about taking a piece of the pie of what women paid towards their care when they were pregnant and giving birth. And certainly the rise of the GP obstetricians that wanted to capture women from the beginning of their lives and take them through in their family practice and their family ongoing.
[00:38:03] Mel: And so it's just, it's all rooted in this original, um. Growth of obstetrics, they just haven't let go of that historical past, you know, obstetricians do an incredibly difficult job. They do. Where they are presented, ideally, their whole job is to manage the complexities that can occur with pregnancy, birth and afterwards.
[00:38:30] Mel: If they're doing their job correctly, they're always working in acuity circumstance where the women have risk factors. Where their medical training and medicine and tools can be of benefit to the, sometimes the complexity that can be, be part of being pregnant and giving birth. And so I think in order to honor the fact that they're working in that really stressful, high acuity, sometimes fast paced, very high executive decision making, um, world.
[00:39:04] Mel: They need to be compensated appropriately for the amount of impact that has on their lives and their health and their families. So I'm not against obstetricians being paid well for their skill. I think the big issue is that obstetricians now are trying to claim care over low risk women who don't need their services, but also de skilling at the same time.
[00:39:30] Mel: So there's a huge, uh, collection of obstetricians who don't or won't do breech births, vaginal breech births, for example, cause they either don't have the skill, they're not confident or they're frightened. Uh, there's a growing number who won't or don't do forceps, uh, manual rotation, all these skills.
[00:39:50] Mel: that could potentially prevent women from needing caesarean sections. And it's like the profession is collectively deciding to de skill and favour caesarean sections. So, so a
[00:40:04] Hannah: couple of things. In addition to the way we fund care, which I think creates more of these problems, and we need to, to disaggregate that as a political motivation.
[00:40:15] Hannah: The other big issue we've got is insurance and medical indemnity. So again, I think we need to go to a no fault compensation system. We have now got an NDIS system set up that supports people with disabilities. That doesn't mean that you're not going to prosecute people who have been negligent. But the second thing that I would raise about Obstetrics and I have got some wonderful obstetric colleagues and I love obstetricians and I agree with you.
[00:40:39] Hannah: I think they have a very tough world where they walk in sometimes in the midst of drama and have to do the hard stuff. It's really tough stuff when you've got the relationship, when you've got the care, Client and they come in and they're the big bad guy, but they're doing what they're trying to do. So let's not demonize obstetricians.
[00:40:59] Hannah: But one of the terms I often hear my colleagues use is we do not want to be the ambulance at the bottom of the cliff. And I love analyzing that term because first of all, what they're saying is basically we're pushing people over and they're having to deal with the damage that we caught. But you go to a paramedic and you say to a paramedic, what's your job?
[00:41:20] Hannah: Well, their job is to go when the acute situation happens to rectify, to stabilize and transfer. They don't say to us, We should be involved back here in preventative health. We should be there talking to people about not drinking. We should be there to, we should, that's where we should be. No, no, they recognize their job is to be the ambulance at the bottom of the cliff.
[00:41:41] Hannah: So how do we have the conversations with obstetricians to say you are highly valued for this really important thing you do? But you also need to trust that when we come to you, we haven't pushed women over the cliff. We have done our absolute best to get the best outcome. And now we need your skill.
[00:42:00] Hannah: This is not a detractor. This is not a failure. This is how a safe maternity system should look. And I think we've got to have these reconstructed conversations and we've got to have a reconstructed fiscal and insurance system that stops us from being so polarized and against each other because women suffer when we are not working together.
[00:42:23] Mel: Well, and this is the issue with the hierarchical system is when you work in a hospital, often there's like over, there's obstetric oversight into these maternity units. And so you've got this ridiculous situation where the, the obstetrician who's there, For the day makes a point of introducing themselves, for example, to every woman who's in the unit.
[00:42:47] Mel: Hi, I'm the obstetrician here today. I just wanted to show you my face and introduce myself in case you should need me. I don't think there's ever been a person who's been in an emergency situation that's thought it would be really nice if I knew the name and face of the, the paramedic who would come to my rescue in that scenario.
[00:43:10] Mel: I mean, it's just, it's a complete overstepping. Of
[00:43:15] Hannah: the, their role for male, let's take it even a step further. You've got to meet everybody working in theater in case you end up there, including the AIN, including the needs, just including the person on the recess trolley, you've got to meet them all just in case you end up there.
[00:43:30] Hannah: We're never going to have a system that does that. And not about seeing that person's face. It's about a relationship of trust and respect so that when that midwife says, Dr. Sanchin Satch, I need you to come in here. She's already said to this woman, he's a fan, or she's a fantastic doctor. And then the relationship between those two say to the woman, I can trust that doctor because my midwife respects him and her or her.
[00:43:56] Hannah: And This person respects my midwife. It's all we need for women to go, it's safe here.
[00:44:03] Mel: Yeah, and I think there's a lot of oversight and checking and supervising of midwives work because of what you said. And we don't want to hear the input of an obstetrician into the work of midwives where it's not needed.
[00:44:16] Mel: But man, when it's needed, I do not want to be the emergency care provider. I mean, I am at home often, you know, if there's an emergency, I am it, I'm the person, me and my colleague, and we're waiting for an ambulance or we're, we're waiting to transfer. It doesn't happen very often, but when it does, that's the scenario I'm in.
[00:44:33] Mel: Obstetricians are sort of like, we want to be involved in every birth. Okay. And midwife is like, no, no, we, we're involved in every birth. You only need to be involved in some births. So there's this just misunderstanding or lack of respect for what a midwife can do and what we're capable of doing.
[00:44:52] Hannah: There's two things going on there, Mel.
[00:44:53] Hannah: I think one is that you and I know having both worked in private practice, the incredible rush that comes from having women. Who you get to know, who you're part of their journey, the love almost, I would call it, that develops between a mother and a midwife, it's, it's intoxicating. So I can see how they look at that and go, a little bit of adoration for me too, please.
[00:45:17] Hannah: I totally, I totally understand that. So, I think we have to work on a way of boosting that part up. I, I think that's really, really important. But I also think with obstetricians, it's about us, it's about, what I always found with obstetricians is at first when they first met me, they really was like, who's this?
[00:45:40] Hannah: You know? And then after a while they got to trust me and they would, and I remember this one obstetrician I worked with and he used to be one of these people that came into every room and I just stopped him at the door and I said, Can I help you? And he said, well, I'm doing my round. I go, well, we're fine in here and you, Oh, okay.
[00:45:56] Hannah: And he backed out and he was a lovely obstetrician, but no one had said to him, we're fine in here. We don't need you. The next day I heard them coming and doing the rounds. I got ready near the door and he put his hand on the door and he went, Oh, Hannah's in there. That's no problem. We'll just keep going.
[00:46:08] Hannah: So. We need to be brave and we need to also show the best of our skills. So our obstetric colleagues realize that working with us actually makes life better, but they're less busy, more joyful. And we need to share a little bit in the adoration. We need to make sure that they do feel loved and appreciated rather than the big, bad bully.
[00:46:33] Hannah: And nobody wants to, nobody ever came to our professions to be doing an awful job to women. Very few, well, it might be one or two psychopaths.
[00:46:40] Mel: But
[00:46:41] Hannah: generally, none of us did, but the system is what often mutates the way we practice and makes that problematic. So we have to fix the system, but we also have to have those conversations.
[00:46:53] Mel: Yeah. Well, I mean, they've been raised in that culture, just like us as midwives have been raised in the culture of, you know. of where we are now. So, I mean, I hope that didn't sound too pooh poohy of obstetricians, but I do think there's this issue of the hierarchy currently has obstetrics as the overseer and supervisor of midwifery work, and that's not the idea.
[00:47:15] Mel: It's supposed to be more collegial than that. You mentioned in your 10 points of how we get 10 things of how we can get where we are going, but Where are we going? What are we aiming for?
[00:47:29] Hannah: We're going for a glorious future and the reason why I think so much is coming our way is because there are these large external forces that have never been part of midwifery per se, but are coming along to help us.
[00:47:44] Hannah: So we've been fighting this battle here, but behind us have been this whole movement towards sustainable health care, this whole movement towards primary health care, towards making sure we do not use medicine and intervention when it's not needed so that it is also fiscally responsive. And then alongside all of these things that are all what midwifery is.
[00:48:12] Hannah: the loudest woman's voice in history. It is the Me Too movement of birth. I mean, the birth trauma inquiry recently in New South Wales, um, government that we had was absolutely, I called the Me Too movement of birth. We've had the Me Too movement as a response to some of the patriarchy that we've seen around the world.
[00:48:31] Hannah: We are. Saying, no, we are outing lots of abuses of women. We are recognizing the importance of women's choice. And then behind all of that to help us and part of what Midwifes have been doing is this incredible scientific body of evidence that's telling us midwifery is not only the short term solution.
[00:48:52] Hannah: It's got long term implications. And so I can't think of another profession sitting in history at the moment that isn't in line with all of the zeitgeist, if you want to use that term, the zeitgeist that is going on. We're absolutely on target. So where are we heading? I wanna see a world where we have midwives able to function in many different worlds.
[00:49:17] Hannah: I wanna see midwives in parliament as we company do see midwives. I wanna see midwives in policy makers. I wanna see them heading hospitals. I wanna see them working in private practice. I wanna see doors open so they can come into practice. And I wanna see women birthing wherever they want to birth and with whoever they want to birth.
[00:49:34] Hannah: And however. They want to birth and having that supported to the best of our ability. We're sitting there with that possible world opening. If we address the, why are we not there yet? And we truly look behind us. At this incredible force around sustainability, fiscal responsibility, and the whole movement in medicine now of too much medicine and needing evidence base.
[00:50:00] Hannah: We've got it made. We've, we've got every document. I mean, when I look back over the last 10 years of, of international and national government, uh, documents from the WHO intrapartum care to the WHO statement on midwives to the serial midwifery to, you know, too much, too soon, uh, you know, We've had paper after paper after paper after paper saying midwifery is the answer.
[00:50:26] Hannah: But with all of that behind us, why do we feel so down? So for me, the final, final solution to that is you've got to be brave. You've got to be brave and you've got to raise the quavering voice and you've got to say, what about the evidence? And you've got to say, can I just discuss something, please?
[00:50:47] Hannah: That's the final chink because if midwives hang their heads, no one's going to look around for someone else to fight our battles. They're not. Number two, we have to recognize the incredible power of consumers. Absolutely phenomenal to work alongside them. Sometimes they make us uncomfortable. Good.
[00:51:07] Hannah: Whatever changed in the world without a bit of discomfort, but let's work together respectfully, strategically, and in a progressive format. And then we've, we've got the world made.
[00:51:19] Mel: So what we're trying to do, you know, midwifery existed. There was a systematic takeover, a patriarchal systematic takeover of midwifery.
[00:51:31] Mel: And the side effect is that women have suffered. Under the hands of this new birth regime. And so midwives, uh, just reclaiming our original role. I'm not asking for anything new. We're not asking for more autonomy, like power over more of the birth space. We just want the original role that we had, and we want to give care to women that they want.
[00:52:01] Mel: That's the idea is
[00:52:03] Hannah: reclaiming our heritage, the advantages of science. And knowledge and also political backing. Now, what midwives never had in the past was they were not politically organized. They were not educated. They had no voice in the hierarchical situations where doctors came from the upper echelons and midwives were really working class.
[00:52:27] Hannah: So what we've got now we've never had before in history. So we're just reclaiming our heritage, but with all these advantages that have never been there before in history.
[00:52:36] Mel: The reason they were able to just strategically take over is that the patriarchy silenced women. And yes, they use that authoritative power to in, in that takeover.
[00:52:49] Mel: But now we've kind of caught up, you know, it's the, the 300 or 200 year lag we've caught up and gone, Oh, those are the strategies you used to squash this whole thing in the first place. Well, we've gathered ourselves, we got educated, we got some rights within society. We've got our voice Um, we've reclaimed our space in the world as women and so now we'd like to raise our hand again and say well we also need to now reverse all of the patriarchal takeover of birth and we want to reclaim our role as midwives and midwives aren't, we're not fighting for ourselves because Midwifery is fun.
[00:53:27] Mel: Yes, it's our job, but we fundamentally wanna serve women. All we're asking for is to be able to fully serve women as midwives and not have midwifery governed by some other external body. We want women to govern what midwives do for them, and we've gotta also realize that this idea of evidence-based medicine is actually a really new idea as well.
[00:53:52] Mel: It's only really, I mean, 40 or 50 years. old that people go, well, what does the evidence say? So we're also pioneering this new way of caring for people is saying, actually, we've got evidence that shows us this is a good thing, uh, or, or not a good thing. So we can leverage the evidence in our favor. And fortunately it is in favor of midwifery.
[00:54:16] Mel: It's, it's not like we've got no leg to stand on. So basically Hannah, Midwives need to be brave, speak up with their voices that we have now as women in society. We actually also have, we can add so many other voices. Yes, the consumer groups, but women themselves, even if they're not linked into these organized consumer groups have got so much power.
[00:54:44] Mel: If you write a letter to a hospital about your care, boy, did they take it. Hopefully, usually, seriously, if it's coming from a woman, there's a lot of power that consumers have, except also that it's unfair that they should have to fight for themselves in this way. Um, when they're, when women are also trying to parent their babies, this is a really vulnerable time.
[00:55:09] Mel: So partly, I think it's about. Having adequate levels of self care for you as a midwife, but also we've got the women have to be cared for if we're going to be able to fight and I think that's where other women come in and this is what you're talking about with not in fighting against each other because it takes what little energy we have after.
[00:55:31] Mel: Caring for ourselves and caring for our families. If there's infighting, that's expensive on our time.
[00:55:38] Hannah: Exhausting. And it makes people go, I've had enough. I'm not going to be part of this anymore. I
[00:55:47] Mel: know there's been times, it could be as simple as a very rude message on Instagram, or an upsetting email where somebody's called you a name, or somebody's, you know, I recently put up a post and got called all kinds of horrible things.
[00:56:05] Mel: And then when you're lying there in bed What am I doing? If everybody hates me, why am I still doing this? And then you get these beautiful messages from people going, keep going, we love you. And you can see how one drains your energy and takes your time and emotion and how one props you up. I actually think this is a really simple thing.
[00:56:29] Mel: If you're listening to something that you really love, if you're hearing this podcast, or if you see something great that Hannah's done or that I've done or whoever you're, you know, you want to support has done the power of sending a quick message of, Hey sister, I am with you. I'm here in the background.
[00:56:46] Mel: Keep going. You're doing amazing work. Oh my gosh. It's a breath of fresh air. It actually injects energy. You think, great, I'm going to go write that podcast
[00:56:55] Hannah: episode, or I'm going to go write that paper, but, but it's even more complex than that, Mel, I completely, a hundred percent agree with you. We are constructed as humans to be skewed to the negative.
[00:57:09] Hannah: That's how come we became the successful human race that we have today. Because we walked out of the cave entrance and we scanned the long grass for the saber toothed tiger. So we worried about bad things happening to us that actually made us survive. So our whole psyche skewed to the negative. It takes about three positive things to overcome one negative.
[00:57:32] Hannah: Now you just think of the world today. You think about what's on the news every now, you think about the crap that goes on sometimes in social media, where everybody attacks everyone in a nameless fashion, that means that the whole of society's psyche is being pulled lower and lower and lower. So. I have two pieces of advice when it comes to social media.
[00:57:52] Hannah: I'd be dead and buried and gone a long time ago if I hadn't learned about the mute button and the delete button and the turn your back on them like a naughty dog and just ignore them. The moment you give people like this any feel, they're going to turn you off. You end up in an escalating system of I'm right.
[00:58:10] Hannah: I'm right. I'm right. I'm right. And it's going to never end well. So you've got to learn to be dignified. Got to learn to hold your head up high. And you got to say, did I do what was right? Have I got evidence behind me? Is there anything that I think that I should be apologizing for? Okay. If the answer is no, keep going, keep going, going.
[00:58:29] Hannah: So that's number one, do that. And number two, Remember, you're not the only person in this world, it's not all on your shoulders, but it is your responsibility to build around you like minded people, bring them into your gravitational pull. Remember, leadership isn't just about that person, leadership's about followers.
[00:58:50] Mel: There is
[00:58:50] Hannah: no leader without a follower. So who can you bring into the gravitational pull and how can you make them stronger? And I want to give you one example. Once I was a midwifery consultant in a big LHD and I remember the midwife coming back from lunch and said, Hannah, you should have been there.
[00:59:07] Hannah: This mother got thrown out of the cafe for breastfeeding her baby. And do you know what my response was? Not, Oh my God, I should have been there because only Hannah Darling can sort this stuff out. But it was, what did you do about it? What did you do about it? And if people look at leaders as being the only one who can do things, first of all, we're going to get old.
[00:59:31] Hannah: We're going to go, we're going to die and it'll all fall down. You've got to do it yourself. You've got to be brave and you've got to bring like minded people with you. And imagine if overnight, every midwife became brave. And advocated for women and for best practice. Imagine we could change the system overnight.
[00:59:49] Mel: How do, how do we, so this is my last question. How do we become brave? When we're tired, repressed. infighting, um, trying to parent, trying to stay healthy, trying not to get in trouble, trying to serve women, trying to keep our jobs. What are the strategies for preventing burnout so we can keep going? Be energized for this fight.
[01:00:21] Hannah: Yeah. So sometimes it's a simple people say to me, how do you keep going after all these years? Well, sometimes I don't keep going. Sometimes I turn all my social media off and I disappear for a week and I curl up on a lounge with a good book and I put my family around me and I swim and I walk and I listen to music.
[01:00:39] Hannah: And I find my strength again and I keep on going. So I think we've got to look after ourselves. We've got to remember that this movement is only one part of our life. It can't be everything, or we will, we will fall apart. I think. We've just got to raise the quavering voice and what we'll find when we do that, because that day in that meeting, when I said, where is your evidence, a whole bunch of other really scared people all went, yeah, yeah, yeah, yeah.
[01:01:05] Hannah: And it turned everything around. We've also got to measure progress, not in days, but in decades. Tough because we think we're so important. But remember, we've got an incredibly long history here. And if I look back 35 years, I can absolutely see how much progress we've made in 35 years. Again, we're going to see a whole lot about this.
[01:01:24] Hannah: But if I look back one year, sometimes I go, I think we've just gone backwards because the statistics are worse and women are more unhappy and we've had a birth trauma inquiry. And so we've also got to have that. That really wise perspective. And I guess my last piece of advice is do not get tangled down in the war.
[01:01:44] Hannah: Become past part of the peace treaty. And don't engage, don't engage, don't feel, don't respond. Come back with something positive, change the subject, change the, the, the discourse and say, how about we discuss this? Because that's something that we can agree on because we've got to take the negativity, the spiral of negativity people get trapped in away.
[01:02:10] Hannah: So be kind to yourself, switch off, be brave. Bring people with you and engage in the peace treaty, not the war. Yes.
[01:02:20] Mel: And can, I mean, yeah, as a fellow kind of passionate person who is committed to not giving up on this and you asked to be brave all the time, I think the things that give me strength are having like minded people in your corner so that when something happens, you know, I've got friends who might see something unfolding in my life.
[01:02:42] Mel: And they go on the front foot and they'll send you this message. It could be nothing. It could be like, I'm seeing what's happening, babe. And I just need you to know, I've got your back, you know, what do you need? And you go, Oh, that's right. That's right. So you could either be that person for people. And just be the positive input.
[01:03:01] Mel: But for me, it's that self care of, of having actually really clear boundaries and actually not tolerating poor treatment. So,
[01:03:09] Hannah: um, I don't know. I mean, you know, we've got some fantastic, you know, activists, um, out there and I remember somebody once putting on social media, this picture of all these bisons in the circle around a baby and it had one simple caption not enter under it.
[01:03:28] Hannah: and it was the phalanx of badassery. Yes. And basically, when, when shit goes down, we need to get around people. And we need to say, come on, that's, this isn't what we are. This isn't right. Let's find a way to sort this out. We can't pile in and we can't be silent. And that's a really difficult thing to do.
[01:03:50] Hannah: But anyone who comes to me and says, who's being attacked or I see being attacked, I always say to them, That's what the mute and the block button is and get off social media and give it a break because let me tell you it's very true, even though maybe we don't say that anymore today, but you know, today's newspaper is tomorrow's fishwrapper, as we used to say, something else that'll be angry about tomorrow, something else that'll be the end of the world tomorrow, give them a, give it a break, get out of the situation, diffuse it, come back in because it's sometimes the best way to do it.
[01:04:25] Hannah: So remember, hurt people hurt. Yes. And there are so many hurt women and midwives. And unfortunately, what often happens is our response to hurt is to hurt. And it gets us nowhere. So how do hurt people heal so that they become strong and powerful and stop hurting and are more resilient when they do get hurt?
[01:04:49] Hannah: And that's the kind of cycle we've got to get out. You, you talked before about how so many midwives are burnt out, so many midwives who are not listened to, et cetera. So we've got to try and start to heal that hurt or we're going to just continue to replay that hurt and enact that hurt and make Mm hmm.
[01:05:07] Mel: All right. So let's bring it in. So basically Midwives have come from being with women throughout history as the carers in their pregnancy, birth and postpartum. There was this period in history where that got hijacked and muddled and medicalised and over pathologised and midwives have been repressed through that journey.
[01:05:30] Mel: And now we're in a unique point in history. Where all of the stars, uh, all of the, the ingredients to rediscover the history of midwifery and our role in birth and our, in the care of women. There's everything colliding in this new, uh, culture and around birth that is allowing us to reclaim our original role.
[01:05:55] Mel: And it's, if I understand it correctly. The only thing that's going to hold us back from that now is how we interact with ourselves and each other. And if we don't work together on it and be kind and uplifting to each other, we could subconsciously sabotage the progress that we're at the cusp of. And set back our collective goal and where we want to go.
[01:06:21] Mel: Would that be, that'd be the summary, right? We are here. We actually are in a point where not as far as we think we are from this potential birth and utopia where midwives and women are working peacefully together for the best possible outcomes and where women have autonomy and midwives feel free to provide care that serves women.
[01:06:44] Mel: We're not that far from it. Yeah. For so many reasons, uh, we just need to,
[01:06:52] Hannah: we need to take a chill pill, Mel. We've always been here. We'll always be here till time closes. That is an absolute definite. So why are we all getting so freaked out and why are we attacking each other? Let's get together and let's take this baby home.
[01:07:12] Mel: Yes, I pledge my allegiance to that cause and I want to say there's a few things if you're out there as a midwife and thinking, how can I get behind this? Just see what's around you, who's doing amazing work around you, get behind them. Or if you're doing something amazing and transformative, rally people around you.
[01:07:35] Mel: Um, there are little pockets where you can find inspiration. So Hannah's a speaker at the Convergence of Rebellious Midwives that's happening this year and every year in August. Uh, we've got, I've got the Assembly of Rebellious Midwives, which is like an online version of the Convergence. You know, where we are gathering together, we're gathering our strengths.
[01:07:56] Mel: We're learning how to have a voice and be brave, but I think together and united is the message here. You don't have to do it alone. There are people who can support and love you and together we'll just bring it home, take it over the line.
[01:08:14] Hannah: Yeah, and join the Australian College of Midwives, find your local sub branch, get politically active, write to your local member if you're a consumer, join a consumer group that relates to you that's in your area, write to your local member, you're so powerful, don't sit back and feel helpless.
[01:08:31] Hannah: I think
[01:08:32] Mel: everyone has something they could do that. So, yes, I think having respectful conversations, if, because, you know, you mentioned it before, we don't have to all agree, but we do all have to be respectful. To each other, and if you're disrespectful, I think you, you will not go as far in your efforts to create change because you'll be burning bridges and making enemies.
[01:08:54] Mel: But we can respectfully disagree and try and get people to understand our point of view in a respectful way without personally attacking someone. I think that's how we work together. It's important. We can work with people that we don't agree with, so long as we can work respectfully.
[01:09:11] Hannah: And every human can find common ground.
[01:09:14] Hannah: But when you find common ground, you see the humanity of somebody. And once you see the humanity of someone, it's very hard for you to be horrible to them. Yes, I
[01:09:21] Mel: agree. Fantastic, Hannah. This has been an amazing conversation and I hope energizing for people who are out there feeling exhausted without hope that we're ever going to be in a situation where women and midwives, uh, you know, have autonomy and respect in this part of their lives and careers.
[01:09:43] Mel: It's a marathon, not a sprint. So get ready. Yeah. Oh, yeah. I mean, I'm still in it for another 30 years. I reckon I've got another 30 years. I'll
[01:09:52] Hannah: hear you one from the rocking chair, Mel. I know you
[01:09:55] Mel: will. I'll be getting text messages from Hannah with auto correct problems in it. All right. That has been this week's episode of the Great Birth Rebellion podcast, and we'll see you in the next episode.
[01:10:06] Mel: To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com And to support the work of this podcast, wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.Com. Follow me Mel @Melaniethemidwife on socials and the show @thegreatbirthrebellion, all the details are in the show notes.
