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Can I wear my heart on my sleeve?

02 June 2014
Volume 22 · Issue 6

Abstract

Student midwife Paulina Sporek discusses the emotional work in midwifery practice

I had anticipated that I would cry when I witnessed my first birth. But I did not, my reaction was rather reserved. In fact, I felt more emotional watching ‘One born every minute’. So much for ‘the miracle of life’, I thought. Since then, I have been privileged to share a very special birthing experience. At that point everything changed. There was a certain quality present at the birth that reminded me that one of the most uplifting experiences of childbearing is forming a relationship with the woman and her family. I am aware that I have felt different since that birth. I felt connected at a human level where I didn't with my first three births.

Hunter and Deery (2009) recognise that much of midwifery involves emotional work. Finding myself ‘choked up’ and shedding a tear at birth was unexpected yet acceptable. I didn't want anyone to see me getting upset, as being emotional contravened the rational professional demeanour I was aiming to present. For a long time, I tried to suppress my emotions in order to maintain a professional image, this approach can be characterised as an affective neutrality (Parsons, 1951). Even though this model fits more with a ‘with institution’ ideology (Hunter, 2004), I was adopting an approach of ‘affective awareness’, described by Copp (1998: 304) as ‘the professional with a heart’. I realised that I needed to share myself with the woman as much as I ask her to share her moment with me. I learned therefore, that instead of hiding my emotions and dealing with them on my own, it is not only acceptable to display them but it is better to express than suppress them (Fineman, 2000), without loosing my credibility as a student midwife.

Being unable to deal with emotions can result in midwives ‘doing to’ and ‘checking woman’ rather offering her holistic, woman-centred care (Kirkham, 2009). This concept has been proven in a small qualitative research of Davies and Atkinson (1991) on the early experiences of student midwives and their initial encounters, in which they inspected all data types collected—interview transcripts, student diaries, group discussion and observational notes. I was not surprised with their findings that identify ‘doing the obs’ as one of the main coping strategies. In fact, in my experience, my first impulse was to ‘do things’—measure blood pressure alongside with other baseline observations. The underlying rationale is ‘that is how we have always done it’ (Bluff and Cluett, 2006: 17). Kennedy (2000) in her insightful study of US midwives has certainly showed the other way, which refers to as ‘doing nothing well’. The concept of ‘the less we do, the more we give’ (Leap, 2010: 18) illustrates that point very well.

It was not just my relationship with the woman that created emotions, it can also be other people we work with, in my case my mentor (Hunter, 2004). Smith (1992) concluded that students learn the rules in relation to emotional display through trial and error, mainly by observing the behaviour of other midwives and by interacting with them. I have been fortunate to have had a good role model in my mentor who was practicing ‘slow midwifery’ (Browne and Chandra, 2009) by allowing for the power of ‘presence’ to manifest. The midwifery I experienced that day was one of passion for the role and love for the woman. It was all about woman, being there for her and giving her the information to enable her to make informed decisions.

As Chödrön (2002: 18) says, ‘If your everyday practice is open to all your emotions, to all the people you meet, to all the situations you encounter, without closing down, trusting that you can do that—then that will take you are far as you can go’. With this in mind, I truly believe that emotional care is at the heart of supportive midwifery practice and is an element of a therapeutic midwife–mother relationship based on woman's confidence, control and trust. I will always hold close to me that showing emotions is not a sign of weakness and femininity, but a sign of holistic and woman-centred care. I will therefore do my best to stay truthful to my feelings and take extra time and effort to provide emotional care to women on their journey to motherhood.