If the Road You Travel Stays All Uphill: Autoethnographic perspectives of a midwifery lecturer and supervisor of midwives.

McHugh, Nessa

Abstract

I am a midwife with over twenty years of midwifery experience. I currently work as a lecturer in midwifery at Edinburgh Napier University and also as a supervisor of midwives in the National Health Service (NHS). I have worked as an employed midwife in the NHS and as an independent midwife attending women at homebirths. My main areas of interest are feminism and childbirth. I am interested in how critically exploring my own professional experiences enables me to move between the boundaries of academia and midwifery practice, in ways that can creatively enhance my current role as an educator, helping to spark understanding of and deep reflection on the political context of modern midwifery and childbirth. My movement between these spheres of midwifery practice resonates with Kreb’s (1999) concept of the edge walker. Using an autoethnographic framework I aim to explore the contradictions of midwifery supervision whilst supporting both midwives and women in ever increasing clinically complex and risk orientated environments.

Midwifery is one of the most regulated of the UK (United Kingdom) professional groups, and a feminist perspective of childbirth practices formulates understanding of the social and political embodiment of power and control. Through the control of the bodies of birthing women, and by wielding potentially punitive control over those whose working lives are immersed in birth work, childbirth has become an increasingly fraught experience.

Supervision of midwifery within the UK is a statutory role specific to the profession of midwifery (Nursing and Midwifery Council (NMC) 2006). Statutory supervision serves to protect women by ensuring safe midwifery practice. It also aims to support midwives in providing women centred care (NMC 2010).

Mayes (2002) states that midwifery supervision originated in the Midwives Acts (1902 in England and Wales, 1915 in Scotland and 1918 in Northern Ireland). The roots of midwifery supervision are deeply buried in the early struggle for professional recognition and control (Stapleton, Duerden and Kirkham 2000). The early supervisors of midwives were known as lady inspectors and did not need to be midwives themselves. The key role of these early supervisors was mainly surveillance of uneducated and working class midwives (Stapleton, Duerden and Kirkham 2000). In this context supervision served to support the establishment of a midwifery profession that would be increasingly middle class and educated. The consequence of this role was that when coupled with the political dynamics of professional recognition, midwives were subjected to an extra layer of regulation and scrutiny which has been persistently perceived as controlling and punitive (Heagerty 1996).

Current Situation- Modern midwifery supervision has the potential to move away from the restrictions of the past and provide a unique level of support for both women and midwives (McHugh, Edwards and Leap 2013) - something that could be very valuable in the current climate of medicalised and risk focussed birth which increasingly limits both the birth choices of women and the sphere of practice of midwives. Women are increasingly wary of service provision and midwives are increasingly anxious about being reported to their regulatory body (the NMC). Many midwives experience an ongoing struggle between providing choice and support for women whilst managing policies, protocols and risks (Kirkham, Davies and Edwards 2012). This leaves the modern supervisor of midwives with the dual role of providing both support and carrying out practice investigations. Using autoethnography to explore ways of using supervision as a key element of relational midwifery practice presents a challenge to both the educator and the clinician.

Citation

McHugh, N. (2014). If the Road You Travel Stays All Uphill: Autoethnographic perspectives of a midwifery lecturer and supervisor of midwives. Manuscript submitted for publication

• Conference Name: The third annual “Doing Autoethnography” conference
• Conference Location: San Angelo State University, Texas, US
• Start Date: Feb 27, 2014
• End Date: Mar 1, 2014
• Publication Date: 2014
• Deposit Date: Apr 23, 2015
• Peer Reviewed: Not Peer Reviewed
• Keywords: Autoethnographic; midwifery; homebirth; childbirth
• Public URL: http://researchrepository.napier.ac.uk/id/eprint/7840