Ep 60 (ibit.ly/Re5V) Mary Steen on creating the Feme pad for perineal trauma, the cost of domestic violence and removing shame and creating a positive research culture
@PhDMidwives #MidTwitter #research #midwifery @MidwivesACM @world_midwives #asgoodasanyonebutbetterthannoone
paper link- t.ly/3GHlH
TRIGGER warning for some UK midwives
Mary Steen, a seasoned midwife whose stories and experiences offer a window into the riveting world of midwifery. From the bustling wards of Leeds to the tranquil ambience of Wakefield, Mary's journey is not just a personal narrative but a chronicle of the evolution of midwifery itself.
Ever heard of Feme Pad? It's an innovation that started as a personal need and developed into an NHS-backed project aimed at post-birth healing for women. The creation of the Feme Pad is just one testament to Mary's dedication to women's health. But her journey didn't stop there. Juggling her PhD with other responsibilities, Mary faced surprises and challenges in her research that paved the way to new discoveries and insights. And Mary's influence extends beyond the UK. Her work in midwifery research has had a global impact, especially in Africa where a World Bank grant has helped midwives across the continent.
Do you know someone who should tell their story?
email me - thruthepodcast@gmail.com
The aim is for this to be a fortnightly podcast with extra episodes thrown in
This podcast can be found on various socials as @thruthepinardd and our website -https://thruthepinardpodcast.buzzsprout.com/ or ibit.ly/Re5V
Ep 60 (ibit.ly/Re5V) Mary Steen on creating the Feme pad for perineal trauma, the cost of domestic violence and removing shame and creating a positive research culture
@PhDMidwives #MidTwitter #research #midwifery @MidwivesACM @world_midwives #asgoodasanyonebutbetterthannoone
paper link- t.ly/3GHlH
TRIGGER warning for some UK midwives
Mary Steen, a seasoned midwife whose stories and experiences offer a window into the riveting world of midwifery. From the bustling wards of Leeds to the tranquil ambience of Wakefield, Mary's journey is not just a personal narrative but a chronicle of the evolution of midwifery itself.
Ever heard of Feme Pad? It's an innovation that started as a personal need and developed into an NHS-backed project aimed at post-birth healing for women. The creation of the Feme Pad is just one testament to Mary's dedication to women's health. But her journey didn't stop there. Juggling her PhD with other responsibilities, Mary faced surprises and challenges in her research that paved the way to new discoveries and insights. And Mary's influence extends beyond the UK. Her work in midwifery research has had a global impact, especially in Africa where a World Bank grant has helped midwives across the continent.
Do you know someone who should tell their story?
email me - thruthepodcast@gmail.com
The aim is for this to be a fortnightly podcast with extra episodes thrown in
This podcast can be found on various socials as @thruthepinardd and our website -https://thruthepinardpodcast.buzzsprout.com/ or ibit.ly/Re5V
And welcome to Through the Pinard, your conversational podcast talking to midwives around the world about the research they are doing to improve midwifery practice. This research can range from small quality improvement programs and projects to those starting partway through or just finishing their postgraduate studies, and to those that have been there, done that and got the t-shirt. So settle back and enjoy the conversation and remember you can continue the conversation on Twitter after you finish listening. Thank you very much for joining us today. We're coming live from well, we'll be recorded by the time this kind of goes on but from the ICM in one of the dining halls. So you'll have a bit of background information and background sound that we don't normally have. But, as per usual, can you introduce yourself please? Yeah, I'm.
Speaker 2:Mary Steen, I'm a professor of midwifery. I'm now at Norfolkbury University in the UK, but I was previously in Adelaide as the professor of midwifery at UniSA and before that at Chester. So yeah, that's me.
Speaker 1:Covered a few.
Speaker 2:you've covered a few grounds Covered a few miles Covered a few places, haven't I?
Speaker 1:So let's go right back to the beginning then. So how did you get into midwifery?
Speaker 2:Well, obviously I've gone through the old because I've just turned 60, so obviously I did my nurse general nurse training first day. So I was a registered general nurse. I was always interested in midwifery but to be honest I would have considered sick children's nursing. It was going to be one or the other but the pathway seemed to take me when you applied for midwifery. So I followed the pathway and I applied to a few because I'm obviously from West Yorkshire. So obviously there you're quite young still, just in your early 20s, after you've done your nursing and I did a little bit of nursing.
Speaker 2:I was always interested in wound care and pain relief and trauma, which I've actually brought into midwifery and a lot of my research. So there was some transferable sort of ideas and some skills there and I'd applied to St James's. There was the Leeds Teaching Hospitals, nhs Trust or those Wakefield many gates or Sheffield what was doable at that time, because you didn't go far from home. Then Wakefield came up early and you'd laugh. It was September the 8th, the start date. Well, that's our lady's birthday. Well, I come from a very kind of Irish Catholic family so I thought that's a good omen. So I do that. So I actually chose Wakefield and I knew that I would get home birth experiences, whereas in Leeds it was still quite medicalised, because we're talking the mid 80s when I did my midwifery and I thought no, I want to go to Wakefield where I'll be able to really support women with a social model of care and to do really experienced home births and learn how suturing was. So it was a choice to follow that pathway.
Speaker 1:So how long did you stay within that area, and doing that after you finished your education training?
Speaker 2:Yeah, I did. Well, I did the 18 months education and training and then I actually got a job back in Leeds and that was fascinating and I worked at both sides of Leeds Leeds Teaching Hospitals and NHS Trust and then I went to St James's in Leeds and it was quite an eye opener because they were very medicalised. I mean, in Wakefield they didn't even have hyped, you know, entinox, it was just cylinders, lots of home births and it was good to a point. But then if a woman really needed something, they only had a 2% epidural rate. They had to go to Pindafields, which was the general hospital. So there was advantages and disadvantages from it, whereas when I went to the LGI, oh my god, I was eye opener. It was quite. This is the room for the obstetricians, this is the room for the midwives. They were like, oh, okay.
Speaker 1:They were separated completely oh absolutely.
Speaker 2:And I said to them at the time could I wear my brown shoes? Because I didn't have a lot of money. I just had a student nurse, a student midwife and I had a baby in arms myself and they said, oh, yeah. And then when I got there I got towed off. No, you need the black shoes. You know, it was quite. Oh, this is interesting. All women were flat on their backs. They were still like as if it were in theatre, in the rooms with, like the stainless steel fire there, and they had a little wedging and I was horrified because midwives would break their waters and they would say you can confirm, mary? And then they would have some of the hair from the baby's head, you know, and I was like in the cockpit, yeah, oh wow.
Speaker 2:I was like, no, that's not what I've been taught. No, we had like a little amniotone. If we did have to break women's waters, it was a little. It was like a false nail that went on your finger and you would thread in and it was really and it just popped. It was so gentle, whereas here they were, you know, it was just so. But it was good experience because I could see how not to do it and medical and medicalised. And then they were interested in doing the sort of digital and the labour ward kind of system, which was obviously different when you go everywhere. And I remember saying, oh yeah, is that for? You know Elizabeth, you know our queen? They went no, ellen Road. Oh no, which is the football? Oh, fair enough.
Speaker 1:Oh OK.
Speaker 2:Yeah, so that was quite interesting. And then obviously you wrote it to Antoninical Post-Natal Wars, the Cleigs, and they actually quite liked more that because there was a cult and a culture on that labour ward and you were careful how to manage the microcultures really and the environment. But it was quite good that I'd done that. And then it got to the stage where I was struggling with my little one and like child-minding her all. But I wanted more set hours and interestingly enough I'd read a lot of work about Jimmy Walker's work, a professor, and he was doing all the work with the Antoninical daycare and Peter Buchman was the obstetrician at St James's. So I thought I'm going to apply.
Speaker 2:A job came up, they were opening an Antoninical day unit and I thought I like that and I'd read all of the work on Gene Proud's work and I was into like the scans and you know, for a sense of preview and I thought, oh, I'll apply just on the off chance. It's a job share and then I can maybe make my hours up casual, you know, on the bank and that would fit in with obviously having a little boy Matching the balance, balance. So I decided anyway I got it and then, funny enough, the head of midwifery at the LGI said well, we can give you nights now, because you know I was going to go to do nights, and I went no, I've actually got this job and I'm quite interested in it and we can do, and it was a way to do research and that got me into research as well, because they were exploring the benefits of the Antoninical day unit.
Speaker 2:That's good, instead of admitting women to the Antoninical ward, that we could actually give them the care in an Antoninical day unit. And they were looking at different ways to book a woman. And it was Richard Lillford he was another really good researcher and Simon Turrell and I used to do scans with him and it was a nice and it was nice hours, if you like, when you've got a little one. But I'd do the odd shift on Labour ward or you know, or there, and even at helping out on my own GPs. He said I need to practice nurse and I thought I could do a few hours for you because you could.
Speaker 2:You know you were dual trained and that got me to do all the smears and things which you didn't do as a midwife, which when you look at the US and everything they do, well, it's even with the scope of practice, yes, it's in the scope of practice, yeah. So I actually got via that route that I could build all those scopes up to do all the smears and vaccinations and things, so that fit in, so that for a while. And then obviously you have a few more children.
Speaker 2:So then it did become nights and days and Labour ward and you know all around, it's always that balance, isn't it, between with really young children and being a midwife and it was, and I always wanted to be a community midwife and I was fascinated in research and my first baby was a Keelan Fawcett and I remember it was like I couldn't sit down and nobody really kept. Oh, for goodness sake, you know, you've only had a baby, mare, I could not sit down, but you must breastfeed. I thought. I mean, I can hear you, and it were black silk sutures then. So I remember that they had to come out and I thought, oh, it's so.
Speaker 2:And then I remember one and I've got, as you know, I've got a sense of humour, liz. And they said, well, you can sit on the frozen pack of peas, mare. And I went, oh, the bird's eye. I said I'd only sit on bird's eye, even though I'm in agony, you know, and I didn't even look down there, you know, after, without stitches. And then I remember and he was born on the 25th of January and he was the 30th of January, so that sutures had to come out on the fifth day. And I thought, oh, my God, how horrible is this, you know when you.
Speaker 1:This is my birthday. Hope I'll have taken it out.
Speaker 2:Yeah. And then I thought surely there's something. And then I got, and then me, usman was a keen footballer and he was a scouser and he injured his knee and he had this cold compress on and I thought, my God, there's got there for his knee after football and I can't sit down with these stitches. And then, and that's the idea, oh, do I come specifically design something for you, me, you know why haven't we got summer? And when I said you know, they've told me to sit on a frozen pack of peas and we've given them the saltwater sashes, frozen. Oh, that's a rock hard. A rock hard. Is it doing more harm than good because you do it for a couple of days? But then you thought, my God, the corn is sticking here, it's rock hard, it's wet. So you think, why bother, wouldn't you? Yeah, so I thought why haven't we got summer? Specifically, isn't that for women?
Speaker 2:So I started exploring and I went to and I asked one of the obstetricians and Jimmy Walker did help me, actually, because he could see that. He said you've got real potential to. You're quite, you know, and I could do statistics as well, I was quite bright that way and he said I said I've got this idea and Matt and Griffith Jones, the other obstetrician that I worked closely with, and he said, well, go explore. So I went to Johnson and Johnson 3M and they were like, is there a need? Because it's women, all right there. And then one project manager, I kid you not, he said to me because they were always it's always monitoring how much we were making. What's it, you know? And he said, well, actually we could, because we make a large size for horses.
Speaker 1:So horses get better treatment than what women do.
Speaker 2:A larger size for horses. That's very nice for our horses after you've been horse racing and they've got injuries. But I need someone specifically designed for women. So you've got sports injuries and it's mostly the men, wasn't it in the rugby and football? And you've got large for horses but nothing for women. No, oh, marvellous.
Speaker 2:Anyway, one of the guys, because in who we know in Leeds and everything it's like the Irish community and it seemed me trying and trying and getting knocked back and he went I'll have a goat making them for you. And he was really, you know, because he's quite innovative and he created jobs and he made the machines that could make what we call the FEMPAD, the cooling gel pad. And I did an initial trial in 1992, 93. And I got told that midwives don't do randomized control trials and I said, well, we do now.
Speaker 2:Oh, and that was at St James's in Leeds and I went and got some funding, which they were really in my head in midwifery. We went to London with me. She was so proud, so we were starting to do it and the midwives were obviously very challenging because they did, you know, research. But I kind of did a small study 27, 28 and 29 was in the first study and I had to do ice pack, the new treatment, my FEMPAD, an epiform, because epiform was being used at the time, the anti-inflammatory which we didn't ported from because that originally was designed for rectal pain and hemorrhoids but we did use it for, like after a PZ, optimism pains. I don't know why, but I had to do that because it was a standard regime.
Speaker 1:Yes.
Speaker 2:Well, really it'd have been easy to just do two groups but no three. But it's good because I learned all the different sort of statistics and things and with that evidence and I had to obviously work. So I never give up. And time was passing by. I went for an NHS executive research fellowship and it was Jimmy Walker that supported me, the obstetrician, and he said no, I think you could do it, mary, you've got the evidence. You know. You've done like a feasibility study.
Speaker 1:Yeah, yeah, yeah.
Speaker 2:You've done a small study, a pilot, but let's do a. You know you could do a larger randomized control trial now. And I went you really think I could and he said you could do it. You're PhD, you're clever, you've got your BSC honours, you've got like first, you could do it, it's really and so he really supported me. So you know, that is excellent, isn't it? It worked. Anyway, I went and I had to be interviewed and everything, and I think I'd get it.
Speaker 2:And I was on the first midwinter to get an NHS executive research fellowship, which now is the NIHR.
Speaker 1:Yeah, so I was, you know which is critical for midwice funding for PhDs in the UK.
Speaker 2:And then I said, and they would have given me it full time, but I didn't want to. I said I still wanted to do some research. Yeah, because it passed passed and I'd been given a community midwifery post. So I said, well, if I job share and Verina Wallace had come and she could do like the consultant midwifery, but I could do research, but we could share a caseload, because I wasn't ready to give up and it wasn't till I don't know, I think it might be.
Speaker 2:Mary Renfrew said you can't be at the moment, the way the system is, a research practitioner, but that's what I wanted to be. And she said you know and you do a lot of education as well, mary, you can do two out of the three, but trying to do all three you're not. You're going to have to make a decision, but you could do the ripple effect because you're good at you know and teaching and you've got on and in that five years and then when I did the big study, it got all working. She said really how you've managed to. You know, swayed, if you like, she's got really good persuasive skills.
Speaker 2:I said well, yeah, effective community skills. We've all been really quite. They've been there years and do research to actually change that culture, to have a positive culture, research culture and to do a randomized control trial. And then the obstetricians were quite shocked that this young midwife, staffed midwife with these three children, were doing this research and a randomized control trial. And then she got the funding. That time I know we never practically lived on a label because you have to do, and then they were saying, oh, you're going to pick an envelope. Mary A, r B, I said oh, no, no, no.
Speaker 2:I said I'm going to do a computer generated list of numbers in block size of six and they were like formal, proper, like real, yeah, wow, yeah, you know where she, where she come from. And I said how does she know that I didn't. I knew a really nice man that could help me, the IT manager who set up Lebedale.
Speaker 1:That's what it is.
Speaker 2:And I said Mike Kelly, I love him to bits. And I went Michael, could you help me please? What would you like, Mary? I know it's like explaining. I want it randomized and I've got this trial and it's yeah, okay, yeah, yeah, I could do that lab del, that I can set that up for you, and all it costs a nice cup of tea.
Speaker 1:See, that's the best thing about Barter System and people that you know that you go to the skills they're willing to help because it's what they do and they enjoy doing it yeah.
Speaker 2:And they try and to help me. And then I got the guys that would collect all the data, the IT, and do that, and because I was trying to learn all about statistics and how to do it and it was SPSS6 then oh, go. Version 6. Yeah, so we're like what on 26 or something like that. Because I'd have a go myself and try that they were willing to help me.
Speaker 1:Yeah.
Speaker 2:Because I was interested, you know, but obviously I'm not the expert in that area they are, so they really kind of help me. Then you change the culture and I remember the first, when it first started and I had my questionnaires there to be. You know, when it come up on Abdel, you know if it'd be ice pack or epiphobe and I got all bathing. And the second big trial we didn't have to do epiphobe but they didn't want the no treatment group.
Speaker 1:So it was called bathing, so it was called bathing Well everybody hot and cold therapy bathing.
Speaker 2:So that was, that was fine to get around that with ethics. And I was, I remember being on days next day on the postnatal ward doing a shift on ward three and I thought, oh, is anybody? Has anybody recruited? You know, I was really nervous. And then there was five that had come through onto the postnatal ward that had been rammed to my students today. So I was really so that started me off. You know, with the, with the research and on community, and it was so nice and the women were saying, but the midwives were, they were terrorists, they were like, honestly, they were like at the cooling gel pattern, I had so many and I had three in a box because I wanted them so they could take them home with them and reuse them, because paying them to stop at the hospital no, exactly not 48 hours.
Speaker 2:I've demonstrated that for the first seven days they used them and pain was worse on a night. I got all that evidence from the first study. And then I go on and I just look these femme pads. At the labor ward desk there was a sister, louis, with it on the red. I've got a migraine, so she was using me cooling gel pads.
Speaker 1:So they admitted that they worked, but not for what you wanted them to work for.
Speaker 2:So versatile. And then there were around the wrist Somebody had burnt the hand on the kettle I just thought, oh my God. And then the other one was squeezing it like a squeeze ball, because it's like a gel gel, because she was doing all the work while they were doing that and I said I've only got so many, you know, and the women have to go on with them and reuse them. And then when they, when it took the trial, because they were learning about intention to treat, and they were saying but all the women need to do that. It's a randomized control trial. The randomized to either the ice pack or be so.
Speaker 1:education the staff is critical.
Speaker 2:And then I say and then a couple of the young ones didn't understand us. So we can't randomize them. They've got to have informed choice. They've got to understand, Haven't they what? You know what it is that they, that they. It may be that they don't get the femme pad, you know. So you have to explain that to them. And then this little Asian woman was saying oh yeah, I've got the Mary pad, Because the dissociating me with the pad, oh my gosh.
Speaker 1:Okay, they could have named it the Mary pad. Well, I know they've got Kylie sheets.
Speaker 2:Yeah, yeah, that's true, so that was quite good. And then just analyzing the data and with that fellowship and doing the PhD, and it was kind of and Jimmy Walker just took me under his wing to so that's all.
Speaker 1:Had it with your supervisors because it was something that developed. Did they just jump on board to help supervise you?
Speaker 2:Yeah, there was. Um, there was a bit of trouble. There was one supervisor at the university that was trying to claim it as his work, unfortunately, so that year, um, but Jimmy Walker and Mattingvish Joseph, two obstetricians from the trust, were behind me. Yeah, because he was thinking, because I, I, I, I got it patented and they supported me. But the service supervisor was trying to go down a different path and get it patented and that. So there was a bit of trouble. But the actual trust, I was their midwife, they supported me. Good, against the university, they said you can't do this, it's the midwives work. Yeah, so I was, even though there was, you know, some somebody that tried to take credit for it.
Speaker 1:So you saw the benefit of it.
Speaker 2:Oh, yes, yeah, yeah, because there would have been a, and it wasn't about that Cause I said I'd never made any money from it. The money that ever came from the FEMP had went into another project about meeting the needs of abused women. Yeah, you wouldn't get funding for that, no, and I would work. And I had started working for a charity called Stop Start Treating of A Midwife and I could use it like for there. And it was. I had a really good head of midwifery, miss Cooper. She looked after me first. That was when I got my first order, and then it was on Geddes, yeah, and they would find it. And then, cause they knew I wanted to do research but there was no pathway or no role, specific role for a midwife. She would find me a little pocket, some money to do little projects, oh nice, and that. And still I could do the clinical, yeah, and then doing the PhD. So it kind of all went and with the children and that's how I developed sort of to become a midwifery researcher. So what?
Speaker 1:actually got you into research in the first place? Were you interested as a student, like, or what was it? So what kind of got your attention about research?
Speaker 2:Just when I just saw winning. I was on the postnatal ward when they were really bad with her and Neil Trauma and couldn't sit down and they were being ignored and it was like we'll just give you the ice pack and it was kind of downplayed and I thought 85% of women have stitches or some sort of trauma. This is quite big. You know, we've put all this effort into breastfeeding. She can't sit down comfortably. How do you expect her to breastfeed? Let's step back here a minute. And why are we got so much specifically designed for women?
Speaker 2:And I had a flashback and I remembered like I was that woman only a few years ago and this woman's crying here in pain and we're not addressing it. You know, we should have never allowed that to happen. We should be in there saying how can we help you, how can we alleviate your pain? So that's what got me into research that I thought we can do something better here. But for me to do it I'm going to have to demonstrate evidence and I'd obviously we'd gone back because, remember, we were registered general nurses, registered midwives, so they were doing the CAT scheme that you could then get credit to get your level two and level three, because they didn't know how to put you forward with credits when you're doing vives, you're midwife to go get your BSc honours degree and then I liked the research and obviously the research modules and that got me into yeah, I want to do research.
Speaker 1:So, when you think back to your PhD now and with the data collection, what's something that sticks in your memory, that surprised you about the process of doing your PhD?
Speaker 2:I think the length of time that it takes, because it's not Especially part time. Yeah, part time, it's not overnight and how you fit it in with all your other sort of commitments and how did you fit it in?
Speaker 1:So, apart from kind of bits and pieces here, did you have set study times when the kids were in school or kids were at sleep? How did you kind of juggle all that?
Speaker 2:Obviously at weekends, evenings or a day off, and it took you a good half a day to get back into what you were, where you had left off, hadn't it really, and how to pull it together. So you have to have sort of that perseverance. And it's interesting because when we developed the FEMPAD and I did focus group with women and asked them about different sort of plastic coverings and they wanted a nice soft one and I thought they'd want it covered up, not clear, you know. So I assumed wrongly because there was a lovely like a blue, lovely like plastic covering and they were quite a diverse group because I was obviously in Leeds and we've got a very diverse background and in Beeston area, so it was all there.
Speaker 2:So I had black Afo-Caribou ones in my first group, asian women, you know. So it was well attended and they went uh-uh, honey, we want to see what we're getting. I went oh, okay, okay.
Speaker 1:So this is the most intimate place you can be, really, isn't it?
Speaker 2:So we had the clear. So that was quite nice to do the tribe and even looking at the data. And when it's your own data, you look at data when you're doing your degree and it's like boring, isn't it? But when it's yours, you want it, you're fascinated. And, interestingly enough, when we developed it and I got the add um, martin Griffith Jones and Jimmy Walker helped me. They had labs and things, because it's a big centre at St James's in Leeds to do research and go over to the lab and because when I first did it, we made our own gel pads and then I got my colleague, my friend, to make them, you know, and he set up a company, flory Femme, and it created jobs for women Fabulous, from nine to three, so it's social enterprise, actually in a poor area of Leeds. So that was an added bonus that obviously I didn't expect. So the women were making it for the women. So it was really really nice, just a nice little give back.
Speaker 2:And then this was by chance, so I didn't think about it. Well, of course, if women have got perineal trauma, a high proportion of them will have hemorrhoids. You know as well, and I really didn't consider that I should have done it, because epiphone were for rectal pain. Anyway, when we made the gel pads, for some reason they were an inch longer than I'd measured the perineum.
Speaker 2:You know, everything has to be, just like a sanitary towel and the shape. And I'd ask women and they were an inch longer. So I'm like, but they're an inch longer. Anyway, as it happened, 25% of the women had hemorrhoids and they wrote about how it was so helpful for hemorrhoids. So the obstetricians everybody were having a joke, as we do.
Speaker 1:We do a humour in obstetrics and we're like Mary, that inch did matter, yeah the size does count, so that was by chance, as I was doing the research, you look at so many things that happen serendipitously. That happen because somebody opened a door somewhere and none of it's planned or it's a byproduct of something else, and you sit there and go well, that didn't work, penicillin being the great thing. That was purely an accident and he left something open when he kind of went away and came back and kind of went oh my god, that's killed that. So you don't know what's meant to be and what's not.
Speaker 2:And I did publish as I went along because Jimmy Walker said so. He really pushed us. So when I put my thesis in I had all the and conference presentations, all the different stages from the development work, the focus group works, the pilot, all the reviews, everything to do with perennial trauma. And they used to call me Mary Perineum Steen. It is Mary Patricia, actually it is Mary Pean. I was like, oh, I'll take it as a compliment. And then that led me on.
Speaker 2:And then Anne Deddy said to her because she knows that I work like she says I've got a job for you. We've got a big project with Leap, leeds Interagency Project for Women and Violence. I know you're very into that area because you're a community midwife social model care Do you want to? I want you to put a programme together to educate all the midwives in Leeds. Wow, and she backed me and that's what I did.
Speaker 2:So how long were you in that job for? She just likes to con me Because you know, because still do me 0.5 for my case load, because I loved, you know, I think, 16 years as a community midwife. So I was happy, like doing projects but still having you know, sharing job, sharing a case load. And yeah, I educated 360 midwives in Leeds and that's when we merged, because it was St James's and the LGI and then we became Leeds Teaching Hospitals NHS Trust. So it was actually a good way to merge the midwives Absolutely, because when I started the workshops, when I put it together and piloted them, obviously the LGI midwives would sit at one side and the St James's midwives would sit at the other side and I'd actually worked at both.
Speaker 2:So I knew both of it.
Speaker 1:Thanks to Trini.
Speaker 2:So then I ended up having to name them and mix and match them and then they integrated. So that was quite nice and it was really quite an eye opener because you know meeting the needs of abused women, because we were trying to problem solve and it's not our problem to solve, we're there to guide. So they did need the education and training.
Speaker 1:Very much so we always want to go in and solve problems. But it's here are the resources. When you're ready, here are the steps you can take. This is the people you can contact to, and I think we've taken what seven times for a woman to leave in a brastic relationship because of the sortment of different reasons where the kids pet kind of like finances, loss of contact with outside family members, all of those kind of like abusive.
Speaker 2:It was really fascinating and we did when you and it was English National Board, then before the UKCC, and so we had to write that up, that we've done the work. And then other areas came in and we even helped to educate and train in the armed forces and there were some in German SAFA, some of the midwives there, so it really did take off to help sort of help with me. But then it was then we were discovering that a lot of midwives oh, yes, themselves and so we had to obviously set up a support group. And I remember one community midwife and she'd worked with me for years and she was just about to retire and she was to say when we were at home births, oh you get yourself off, mary, you know you need to go on to your young ones.
Speaker 2:And I clicked that she didn't want to go home, she was always at work. And then she moved, got a little flat and she had quite an estranged, got a relationship with the two daughters because obviously they've got a different perspective and they blamed her. Really she never left her abusive partner so hard and when she couldn't, it couldn't even like the gas stove, you know, with the pilot light, and so obviously the girls would help it because there's still a daughters. But she just said she had one profound statement. She went I'm lonely but I'm safe.
Speaker 1:Yeah, yeah.
Speaker 2:And it's just so, so interesting, isn't it?
Speaker 1:But when you look at midwifery and it is dominantly female. It is what's represented in community that we care for. The women is going to be represented by women. It is going to be represented within the workforce itself, because we are the community and that is. Some people don't have that hassle, that don't have the ability to separate those two or do a very good job of hiding.
Speaker 2:Yeah, and that is interesting because I will mention Angedis, who really supported me and obviously she was involved in training Mary Renfrew. She was a really good head of midwifery from Dundee and she worked with Jimmy Walker and Jimmy Drive to very powerful obstetricians One was from Glasgow, one from Edinburgh. It was really interesting and she got me to do that project and educate all the midwives and leads. And we are there and then years later I'd gone and then I become a reader because she supported when I got my PhD. Then that opens the doors.
Speaker 1:So for those that aren't in the UK, a reader is actually a lecturer and educator.
Speaker 2:Associate professor. Associate professor.
Speaker 1:You read at Oxford and Cambridge and universities, whereas you teach at other places.
Speaker 2:So you are a reader, so you are an associate professor you are at that level at University of Chester and I was doing some work and I had gone over to the States to do something and come back and then I got some news from Marina Wallace, my friend, and she said have you heard about Angedis? I thought, oh, because she just retired. Is she ill? She went no, she says her husband has killed her.
Speaker 1:So hence her interest came from somewhere.
Speaker 2:that and I just thought, wow, she got me as the home as she says, I was a little champion to educate all the midwives to help women in Leeds and she was in that powerful position and she was managing what was going on behind closed doors and she had moved back up to Dundee and charged with culpable homicide and I couldn't believe that that was the outcome. I was just hoping that it wasn't too traumatic for her. So it really affected us all to say that she could help all those other women, Ultimately Herself.
Speaker 1:Yeah. Yeah, I was going to ask you about celebrating your PhD, but I felt like that's kind of like a complete taking away from the.
Speaker 2:Oh, no, she was so proud of me and when I went to the funeral we all went up to Dundee and he was never mentioned at the funeral. She had a one daughter, angela. She saw your other midwives and I brought her back from Africa, her mother and baby. She was so proud of you and she said you will get there, mary. Yeah, you know, and that's who she said to me and I mentioned it in my workshop today.
Speaker 2:She says remember one thing, mary you were as good as anyone, but better than no one, and with that you will be a calm, caring, kind, you know, confident midwife. And I never forgotten that Beautiful sentiment and it was like yeah, that's what you do. Yeah, you know, really. So she's always and when I do training, everything, she's always at the back of me. I can feel her. I just felt how sad that we and I used to see her aerobics and different things and she did all the child protection, so that was her way of coping and she'd watch me. And yet all that was going on. Afterwards you reflect dirtier and you think there was some?
Speaker 2:signs wasn't there.
Speaker 1:Yeah, but unless people want help, you can't. You can't, you can only just show the resources. Yeah.
Speaker 2:I mean she was apparently leaving him and she had a Scottish 50 pound note hidden and he would be pressed and tried to cover it up and he ended up in Kerstes, which is like Rampton. But yeah, so that was.
Speaker 1:And quite often unfortunately that's a trigger when someone does leave. Yeah, that that's the trigger and we know that if there's any physical abuse, we know that strangulation. If they have got to the stage of strangulation that they have got a much higher chance then of actually carrying through. Yeah, and you look at I mean I hear in here in Australia we're still a one woman a week approximately in the 21st century yeah, it's like, well, I don't get. Yeah, I don't get. Understand that, you know, let's go back to something nicer. I did celebrate your PhD.
Speaker 2:I think it was just a relief to get it. And then, when you go, my children went with me because I was divorced by then. So I think sometimes it is hard to manage PhD work, own life, everything. Children so it does actually met, play a part in your relationships as well. So I've celebrated with I like the kids. They were really proud, you know, because it was women's experiences of periodotroman that you'd actually created it and that was basically this company that were making it for women in a socially deprived area of Leeds. So it was an added bonus. So and then so we kind of just celebrated. I just celebrated it like that. But my dad celebrated with me.
Speaker 2:He got me a private number plate from my car. It was really quite reasonable, but it was my name, m4ruy Marui. So the fall looked like an A oh, quite nice, wasn't it? Because I got obviously come from a family where my dad was hard working, you know man, and my mum was housewife and then, as I called them, you know, I called in those days or did part-time jobs. So I kind of thought, where did we get her from? Yeah, you know, really.
Speaker 1:So you've now gone into the education, you're now into Chester as a reader, as a reader from there. So then, how has the experience of doing a PhD and the knowledge that you got from that PhD, how has that then kind of like shaped the next kind of part of your career?
Speaker 2:Well, because I was obviously the knowledge of research because most of the people I work with are educators, aren't they? I would obviously take the dissertation module. All the students, the undergraduates, look for funding which I did and was quite successful to do research and obviously I could do statistics and then I was quite quantitative then. So all going to be, won't I if I'd done trials? And then you have to learn about different methodology. And just before I got the reader's post, there was a surcomment for the Royal College of Midwives and UCLanit with a joint appointment. So I thought, well, I'll do that to gain some experience. And then I could learn. And at UCLanit I learned more about qualitative research, supported by Sue Down, and then she had a whole team Dennis Walsh were there. It was really, it was really good. So I'd learned that. So that kind of tech, tech in me, on a path to become a mixed methods research, because I had the quantitative background. But then I had to develop the qualitative which was in a good which is definitely Sue's kind of like yeah, parallel.
Speaker 2:And then when I've got that experience and I was the first research fellow for the Royal College of Midwives, so then that gave me a lot of open doors and going to Portugal I just saw Victor Vizier, he's here from Portugal, he's Vitor Virelia, and I ended up doing work at, you know, for the Royal College of Midwives, I think.
Speaker 1:the next I think I saw a slide this morning the 2026, the next ICM's in Portugal.
Speaker 2:Yeah, lisbon, and he's just given me a key ring. So I've gone to Portugal. So I don't work for the Royal College of Midwives. I'm supported by Francis Dester, who used to be the former president of the ICM here, and Kali Darius, and because I was on council and I had to step down because I become the research fellow, I didn't want any conflict of interest. So I ended up doing master classes for the Royal College of Midwives. Obviously I'm doing work with UCLan and got a lot of opportunities.
Speaker 2:And then as I developed that like I was ready like Sue Down says, you're ready to, you're ready to, you know to go and develop further. And that's when I took the Readers' Post of Jester and, funny enough, the Dean had worked for me in Leeds it's a small world and he's from a mental health background, mike Thomas and we just wrote. We ended up writing mental health cost, lifespan and that got me. I always got into the mental health because of social model care and being a community midwife, ended up doing a lot more sort of education around mental health and then a mix really with the different sort of research that you could actually do and then developed maternity assist with Oracle because I was a supervisor and then I went back and did after your PhD. I realised that teaching is a different set of skills. So I did my postgraduate diploma in health education, health professional education, so you learn the teaching. So they're like saying you've got quite a few strings to your bone, mary, so you could. You know you can either do research in the workshops or you can do the clinical. So I've got a wide variation and I was interested in obviously being a community midwife for years. I know the antenatal care pathways from Nice Guidelines or anything.
Speaker 2:And Liverpool worked to do their own, like Google and it's biggest Liverpool. So I worked with Duncan Fisher and I've done a lot of work with fathers and we've been get. We saw down. She said look at the how we engage with fathers and we've done a big. I've got funding and we lead Ryados in Manchester. So it's kind of along that spread that you kind of go, don't you? From Leeds to Manchester, to Liverpool, to UCLan. You know that it's there and we've done a lot of work there and a big, a big pioneer for sort of involving fathers. Duncan Fisher and he got his OBE for that work come to me and said what can we do and work.
Speaker 1:And then, oh nice, coming to you now, so they should.
Speaker 2:And then developed maternity assist and it's anyone with Google and we got. We ended up getting quite a bit of funding, but from different trust funds, and I love Liverpool. They had a kitty. We would want that in. Liverpool and they've got some funding from that, so we ended up getting about 125.
Speaker 2:Oh nice, which was quite a lot of money. Yeah, that was in like 2011, 2012, when I was doing that work and we set it up the whole pathway and what you would do is they they could register for maternity assist, they could nominate a partner. So if they didn't have a partner, it could be their, their mother, and it was quite I know a lot did in Liverpool, or one young girl. She would come out of care, she nominated a friend. That's fine Because they're all getting information, so it's a really good way that you could do all the public health role of a midwife. So that was a really successful and still using it maternity assist. They did that.
Speaker 2:And then you get people coming to you to help to supervise for PhDs and I watched what other people were doing and obviously learning and I got one particularly from Nigeria, Faith Diogro, and she said and it was perennial trauma and over in Nigeria and she would do supervise me and she'd done a masters at Nottingham and they actually recommended me at James Marshall and I think Dennis Walsh would at Nottingham at time. They said the best person to supervise you is Mary Stee. It's perennial trauma. You're going to go to Mary Stee and she emailed me and I went and I just put yes.
Speaker 2:She always remembers that and she came and she's successful and did a PhD with me and then went back and did work and that's how I ended up in Nigeria helping her and that's gone from strength to strength and she's the first nurse midwife to get a PhD in Nigeria.
Speaker 2:Oh, definitely to have her information, so I can chat to her Definitely, and then I got the job obviously I was going to get. Then Australia came up, so it was slight few miles extra, but they all followed me. And when she said and she presented in other languages where my prof goes, I go Yep, you know, because obviously from the reader I was only a reader less than a year and they I applied for the professor and I met the criteria and the new you know we put the funding as well, so the publications the funding and the supervision.
Speaker 2:And then getting the supervision.
Speaker 2:So I had all I'm Patons, yeah, said, all peas yeah, and.
Speaker 2:And now we got worked and they've got an African excellence centre and the first time they put nurses and midwives because they're both Austrian, I'm going to say in Nigeria because she's a Port Harcourt University and I've gone over and presented and really helped her because they were against it and she introduced birth balls and all things which are reasonable to the women and like not to, you know, be doing the appease the op-mes unless absolutely necessary. And the World Bank, the involvement itself, and I got Carol Gresh who was the I wish you would think it was the head of school, but then they came the provost at Uni, esa to Batme and we put in for a World Bank grant and obviously Port Harcourt University, the PI, but where the core research has struck educators, and we got it six million and I was like wow, and now we've got a professional doctorate for midwives at Port Harcourt University and I run it with safety or room and we have a masters and the masters have to be midwifery and child health. It has to meet population needs Absolutely.
Speaker 1:Absolutely.
Speaker 2:So absolutely, but the doctorate. But because COVID hit, she's got a load of midwives from all the different African countries that I've actually enrolled because you can do Zoom, yeah, and just before I came here last week I was doing confirmation. So candidature, we've all. And I've got a midwife from Uganda that I supervise and we're doing that. So it's, it's going to spread because that's going to be all the leaders going to the different countries.
Speaker 1:We've, so we've traditionally we've had that there's been in a lot of the countries that have not had the infrastructure to be able to do postgraduate studies, so they've had to physically move to other countries to do the postgraduate studies.
Speaker 2:Like safety are coming to the masters at Nottingham, and then she come and do the PNG.
Speaker 1:Papua New Guinea, Kenya, Ghana, we, I like so many people. Do you see one of the advantages of COVID now being research without borders that we can do a whole PhD supervision session online?
Speaker 2:I just did on Tuesday and I watched all the confirmations that candidates, all the students, whether we're over two days I just had mine were on.
Speaker 2:So I said I could do one day and I obviously have to watch my own PhD candidate, but you can't, you know, I can take notes and, like you know, she's doing quite well and it's interesting because they're very clinical, because a lot of the doctors are there and obstetrician led and they want obviously trials, clinical trials. They're not understanding that you can do qualitative research, yeah, obvious methods. So there was going to be a transition, you know for that. But they've come from all different countries so I was allocated a midwife from Uganda.
Speaker 2:Eve but the and that's nice that it's opened the borders, but they've actually got the centre in Port Harcourt in Nigeria but they're getting free. You know, and you love it when they come and they go hello my sister, hello my African sister, hello my. And then she'll tell the story and when we do, I do sessions online for the you know the talk part of the doctorate to show them how to do a type of different literature review and the prisma. You know all the skills, maybe an integrative review with Remington and Toronto and Remington, and they love it because they learn it. And then she'll say, but they'll start and they're like, oh, my sisters, there's no. You know that we are no different. Yeah, and so it is nice that it has opened.
Speaker 2:But COVID actually she was focusing on, obviously, nigeria, but it actually expanded to all the other African countries because of COVID and they have enrolled and they're able to study for, like this professional doctorate that's got the funding at the centre and from the World Bank because it was all public health and toxicity, because they have a lot of issues over in Nigeria there, but they brought the nursing in midwifery and they've got. And then, just if I were to come here she just is the first full professor of midwifery in Nigeria. So how that?
Speaker 1:ripple effects, absolutely, absolutely, and that is going to be we've talked about here at the ICM. We had at the opening plenary session. We had young leaders and a fantastic talk by a young leader in ETA and about that we need their leaders of the future and they're going to be the young ones, because all of us oldies are kind of like at the other end of our careers.
Speaker 2:We've got a succession plan haven't we?
Speaker 1:But you see the energy coming from them and you sit there and go and I get emotional about it. We do have a future. We have an amazing, powerful, energetic future and we look at that with the way that midwifery research is growing. Like the ICM has been around a hundred years, we look at this as the decade, and when I was talking to Franka, this is a decade of midwifery research. So if we use this decade of the twenties, we get to 2030 and will you look back at the amazing amount of research we've done in midwifery? We are going to be a voice that has to be listened to, because we do have that spread and it's a global spread now of research being generated that is going to change individual countries, individual cities, but it is. We're going to get there, because they can't argue against the evidence.
Speaker 2:It's exciting to try, though oh like to try.
Speaker 2:Confirmation bias you know we have to say and to be honest, we're human beings and we will look for evidence that supports our views. I mean, so we have to accept that. But then we have to try and step back and say, no, hang on here, let's look at all. Let's not truly pick, basically. But I think it's exciting that that ripple effect that is coming through in the different countries, because I've done a lot of work with midwives in Brazil and I have a PhD students there and obviously a child nurse as well, because it was a far off thing, doing a lot of work with eating disorders and atlas, because it's the same methodology, you know, maybe different target populations.
Speaker 2:And then that one of the midwives from Brazil has come to work with me in UK as an assistant professor. You know, obviously there's always issues around visas and getting through, but you get through barriers and hurdles, don't you? And then now I see myself as the mentor because I have a lot of PhD students that are really coming on and there's a lot that are international English is not their first language, yeah, and they're amazing and they're Mithra Jovana Mad, suika Offman. I got that, you know, when I was in Australia and Suika followed me as well because she'd got in touch with me at Chester and then she came to Australia to do a PhD with me.
Speaker 1:But that's it, the relationship, the relationship that you have with a PhD professor or supervisor, If you're especially doing it part time. It is a relationship and sometimes it can be more intense than a marriage, because your ups and downs your vulnerable. You need to be able to have trust in that person because they're going to see you.
Speaker 1:And you become. You go from this kind of like the supervisor has all the knowledge and then you slowly kind of increase your knowledge to ultimately you should be the kind of the one who is the most knowledgeable about that one area. But that is. It's a very intense relationship. So you, to have that good relationship, you will follow them anywhere because you don't want to have to break someone else in you. You don't want to have to kind of start from scratch again. You don't know what you're going to get. It's a major kind of investment in your life and future.
Speaker 2:But yeah, it's, it's easy to see how people follow you and how you see how they progress, and with hers I mean the old published because it's a prospective PhD. Mithra did the you know the four, that was fine. Suika did six, six papers, and the last one I said you don't need it, you've got enough for your PhD, which would not. No, no, no profile. I want to do it. How to integrate quantitative and qualitative and she's wrote that yet and give the midwifery like projects as an example, and it's got the most views.
Speaker 2:Yeah, oh yeah, because it's new methodology. No, you don't with the matrix, and I was like so in the end, your students teaches you, yep? And I went oh, I didn't know this. This is good, this is oh well. Yeah, let's you know. All right, we'll learn together, suika, and now she wants us to go over back to Egypt and teach mixed methods, which we might do, but she's in the Samre, oh good, and we're doing work and she's done JBI training and Mithra got a job at University of Adelaide just for now. So I've tried to help them start off, kickstart their career.
Speaker 2:And then I have Monica Diaz and Belinda Lovell finishing theirs, and then Naomi Simpson and then I was supporting Lois as a core for for Kathy Stoddley but Belinda's. I wanted to do work. I was doing health and family-sales relationships because my background was stopping all the domestic violence or anything and I'd always been interested in really vulnerable women and I wanted to work in the women's prison in Adelaide and I knew I wouldn't get the funding because they're you know, they're a forgotten kind of group of women. But I thought if you get a PhD scholarship, that's the way to do it isn't it?
Speaker 2:And we did, and then Belinda, we got it and it's been really one of the most challenging projects we've ever done because obviously of fear and the Department of Criminal Services are much more risk averse than the health, oh my goodness. But we got around it and it took us quite a long time to get ethics and to get the approval and then obviously sort of publication funding, putting the whole program together, doing the focus groups and then COVID it, but with the women, and nobody had ever, ever asked them and they were out projects that they were out in the community.
Speaker 2:Well, they were a special. It needs a bespoke program.
Speaker 1:Did you have a look up with Laura and the Pips in the UK? Laura Abbott, laura Abbott? No, so she's. She does. She's involved with prison populations as well and maternity services and with that, and I think it's Pips, so PIPPS. I can't remember what it stands for now, something to do with prison service, but she's kind of that sort of target area as well.
Speaker 2:But mothers matter, so it's just, you know. And actually we couldn't end up interviewing the pregnant women and there was nine at the time and we didn't have a mother and baby unit. But they've got one now. Get back in Adelaide, haven't they? And but we did. Aboriginal women, migrant women, a separate focus group, so the main focus group, because 32% are Aboriginal women, 29% are migrant women and the rest have obviously maybe learning difficulties or socially deprived.
Speaker 1:And unfortunately, adelaide has got one of the few mothers and babies units where the babies do not get to return with them from birth. Yeah, they get taken away straight away, which is another complete issue that's being worked on.
Speaker 2:Yeah, well, they are working on it, joe Pips is because they didn't even have a mother and baby unit, whereas they have now in the health centre. Working with SA Prison Health Service, we've just had. We've got. We've got level two to go in. And you see, because I've done a little bit of work in the prison in Hodgesfield just helping with the stop when I was working because obviously there is vulnerable families.
Speaker 2:So that has been a real journey and we've just had it accepted. The Aboriginal paper we did a separate one for the Aboriginal women's needs and that's took a long time to get published because obviously you've got a. You know it's quite controversial, isn't it? Yeah? And then the next one the first one she's got there, so that was being a really good project. Monica Dias from the Pony Oil Trauma has got quite a bit of money and I put an online program for Pony Oil Trauma. Oh good, I've got category four and you get $98,000 for that project and you think we're where it is. So you can do midwifery like research it doesn't have to be obstetric like.
Speaker 1:And that kind of really goes back to what Mary said to you in the beginning of your career of being a research practitioner. It is slowly, we don't have enough opportunities now, but we're starting to open up that pathway. So you don't have to be a researcher and you don't have to be an educator, you can actually still be a research practitioner.
Speaker 2:And the NIHR in the UK. I've got to do that. They're trying to sorry, they're trying to create that. It's slow progress but it's the start.
Speaker 1:We have to start somewhere.
Speaker 2:And Monica's doing all the work with the FGM in Australia and that led from Pony Oil Trauma and then the continents. Julie took her the after effects. She came to me because she was actually at University Adelaide, but I don't know if the supervisor had gone. And I thought well, she's a midwife, I'm going to help her. I don't see boundaries of University of Adelaide.
Speaker 1:Oh, God, no, no.
Speaker 2:And there, if a midwife comes to me and wants help. So I became a supervisor, Exactly. And they'll say well, what's your outcome? Well, is it more publications?
Speaker 1:You, know English, do you? And helping women.
Speaker 2:Yeah, and then we did the bladder scanner. We got the Commonwealth Industry Grants and we tested the bladder scanner as well and that was really good. We got two bikes at the chair, we got two industry Commonwealth and worked with Psygnostics. So we work with us industry partners to do the bladder scanner because we knew a lot of research and how it worked in general nursing but not in midwifery and not in maternity and, funny enough, it was OK postnatally but antinatally it's completely different.
Speaker 2:Completely different. Yeah, though we're getting the liker, the baby's head, mixed up. There was a technique of how to scan and they had to change the algal nevins. We had to go back and say, look, it'll work. Yeah, I'm sorry, we piloted it and it's like. And then when they did do that, it did work and we did interrateria reliability and then we got the interrateria reliability Because they did the scan within a couple of minutes of each other, so the volumes were very, very Like a mask, or yeah.
Speaker 2:It's very similar. So you think all that work. So we quite good at bringing sort of technology in and stem as well as the care of vulnerable women. So it's a wide range. I've just got funding. Now I've gone a physiotherapist up at Northumbria University soon as I come back and they're working with astronauts and she's a physiotherapist but astronauts. And they've got this machine called Fred Sasso. I mean Fred, I think in Frederick Google what's?
Speaker 1:the word.
Speaker 2:Yeah, yeah, and she's. No, it stands for functional re-adaptive exercise device. So, okay, fred, anyway, they use it. It's like a cross trainer and they use it for costability and back backs. Anyway, when she had her baby herself, she had trouble with stress incontinence, which a high portion of women do. So her and then her other colleagues of her physio had similar problem. Anyway, just experiment, it's not just you, isn't it? Just on the off. Again, another thing on off chance, With the off chance, and it worked. And I said well, of course, if it works for backs and costability, it's going to work for the pelvic floor.
Speaker 1:Absolutely.
Speaker 2:Because Mary's ears are like oh, and it's always like bladders or perineums or you know. All right, mary's interested. Anyway, we looked at them. She says do you think it would work with postnatal women? I says I think it would, but we'll have to do a feasibility study. So anyway, we've wrote a protocol like that. She's gone to one of the physiotherapy awarding boards and we've just got 30,000 sterling to do a feasibility study.
Speaker 2:So I can see that going then to for an NIHR, a big grant if we show the evidence. But it's nice how it looked from another area and it was astronauts it's coming to. So you know, sometimes you don't have to read and then vent the wheel oh that could. Maybe that could work for us in our area.
Speaker 1:And he just needs someone who's got that lateral mind, yeah, or someone who tries something and kind of go oh, and then kind of talks to somebody else and you go oh that would work really well.
Speaker 2:And she's just doing a review and she's horrified. She's married and she's going to prog and poke and whatever how you like. Ask women and find out about stressing content. She's do you know what they do to women, mary? So I said, oh, go and tell me. I think I know, but go on, she's what. Do you put them like in the Lefotome position and ask them to cough and watch them? Would they do that to a man, mary? Mm-hmm. And I went yeah, no, they wouldn't. We've got scams, we've got other ways of doing it, ways and no dimensions, dignity, nope. And I went actually you've got a point there, kirsty. So I said right, you've got all the ways that you're going to do. So she's looking at the literature now. Excellent To see we could do that better in guidelines.
Speaker 1:I can always do things better. That's the easy thing you can always do it better.
Speaker 2:Yeah, we can always do better, can't we? So it's always like there's always loads of projects. My mum said you're not happy if you haven't got a project. I thought that's true.
Speaker 1:But I mean you look at all of the projects that you've done. It's all about improving the women experience. Yeah, it's all about, or care for the women.
Speaker 2:It's all women's sense.
Speaker 1:Yeah.
Speaker 2:Care, whether they're vulnerable or whether they've got a physical injury from the, you know, the perennial trauma to relief, and it's the relief, pain or anxiety or some sort of discomfort, stress and concerns. And there's a lot of taboo subjects there, mm-hmm. But to the woman, you know, that's a lot of shame, and it's all the quality of care.
Speaker 1:Shame shame is that big word and I think that was something that I was listening to somebody mention that Benai Brown did a big research on shame kind of about a decade ago and found that that was the feeling of shame was the biggest indicator of women not engaging. And especially when you think about any to do with the issues that we don't talk about, as you said, the taboo issues that we don't talk about. We don't talk about sex. We don't talk about if, kind of after women, so many people have stress, incontinence, they will have incontinence, and yet they won't talk. They would rather actually just wear pads and actually go and admit to someone and talk to someone about it. Because we don't talk about it and how's that linked to mental health.
Speaker 2:Exactly I remember our shadow minister, norman Lam. I really liked him and he said the parity of esteem, that mental health should have equal weighting to physical health. And it doesn't. And I think, and I said here, he's still doing a lot around mental health. Many of us will. Yeah, because you can't separate. Why do we try and deal with physical health over here, mental health over there? They're entwined Exactly. You can't if one calls the other or vice versa. Do you know what I mean? And that's why I'm doing a lot of work.
Speaker 2:And when I was in Australia I'm never, I'm always thrive on learning. So I did the Australian Psychology Society there in direct counseling, and I don't, I don't counseling back in the UK. I've got a certificate. And then I did the clinical hypnosis. You know, with the clinical hypnosis, australia, self Australian society, because it's tools and it goes on.
Speaker 2:And then I went and I thought finally, before that I went up to the Nantan Institute and did their postgraduate diploma in mental health. Because they said to me, would you want a master's? And I said, well, no, I didn't, because what I did was the. They were going to introduce the higher level practitioner in the UK and then they didn't.
Speaker 2:When the UK's CC came in and they asked me to do a whole program, put a big portfolio together and go through what we call the city and gills to demonstrate that you're such a high level and are a community practitioner that you are rewarded. And we were all more to the masters in city and gills Institute because we demonstrate the evidence, and the police do that, and the fire, the fire service, because you're you're at that level. But how do they? How, how do they your impact and your level of knowledge? How do you translate that into sort of a recognized pathway and a qualification? And it was the city and gills Institute that they have done with that and we were doing that and I think, there were 17 midwives that will put forward and we have to demonstrate the evidence that we've let all those.
Speaker 2:And then it was, and it was a lot of work. So would that be a big, a big like a portfolio?
Speaker 1:So would that be equivalent to the endorsed that we have in Australia, or would that be kind of? That's more to do with disqualification and recognition as opposed to scope of practice.
Speaker 2:Yeah, this work you are to demonstrate your skills, your competencies, if you like, in different areas. You have to meet a lot of criteria, which were, and a lot of it came from, even in house all the.
Speaker 2:NHS, cpd and everything that. Then you got the masters masters, it's a masters qualification through the city and girls Institute and the and the UK CEC were doing that, but then they decided not to so when they've done all the pilot and all this work. But there were only a small cohort then the you know it's just going to cost effective, and then it all changed regulation and then became the NMC.
Speaker 1:And they had their own rulings as well. So if you've got somebody and one of the questions that I kind of well, one of the comments I hear quite often is when I kind of talk because I'll talk about PhDs and postgraduate studies to anyone at any time because I think they're so important to enhance what we're doing, improve what we're doing but if you've got somebody who comes up to you and says look, I'm not smart enough to do a PhD, how do you?
Speaker 2:respond to them I'd say it's not the most educated student that I want to supervise, I want the most motivated, because she will A lot of. It's great, true, great. It's perseverance. And what do you mean? Define to me? You're not smart enough. Do you know me? I believe you, you can. Like we've got all the international students that English in their first language have all succeeded and got there. And then I say, look where you were and now look where you are and it's, you know, and it's come. Sometimes it is when you're doing your PhD. It's hard, but we always do before you kick straight away, like you do in education, you'll kiss, you kick, you kiss.
Speaker 1:That's great, it's definitely enough and done.
Speaker 2:That's great, but really need to work on that. However, if you do that, you'll come out and get that and that'll be brilliant.
Speaker 1:And in those down times it's just the sandwich effect, isn't it? It is. But and those kick times is when the supervisors that's what their role is but also celebrating each little milestone and actually kind of not waiting to the end and kind of going I've got this far or I've done this and I think the PhD by publications is a fantastic way to do it, because when they get their first publication, that might be the literature review or the research protocol, because you know we're publishing the protocols as well.
Speaker 2:It's amazing.
Speaker 1:Because they're out there. Wow factor, isn't it? It's getting harder, like the publications, when you look at the whole and then you're like with the payment, exactly it's getting. My concern is that it's going to break eventually. The system has to break because it can't keep going the way it's going. But how much is that going to influence people trying to do by publication in the future? I think the next 10 years are going to be the breaker point for the system. It's always hard, isn't it?
Speaker 2:Yeah, I know, I said at the workshop here and when I first wrote and I wanted to help over mid-wise, because they said they didn't understand Because it's like a new language, isn't it Research language? And I'll give you a laugh, when I went to learning when I was at St James, it was evidence-based medicine, it wasn't evidence-based practice there. Yeah, Remember where David Sackett and I'd get myself there as a mid-person. I wanted to learn and I could go to these in-house sessions because we had the R&D info at St James as in leads and obviously it was very medical and I'm probably the only midwife there. And then this medical director who was doing the research kept saying for EBM, ebm, ebm and he was got an EBA here. Well, that was sending me off on a different track. On it, I'm a midwife. So he says Mary, you're looking very confused and he means evidence-based medicine. Every time he says EBM to me.
Speaker 2:I was thinking, I'm thinking baby, I'm a breast-feeding person. I've gone down on a different tangent and I said to him well, every time you say EBM, it means express breast milk to me, and I'm thinking this woman's got problems with it. And he went oh my God, midwives again. And I said well, an acronym to you might mean some differently, so you have to explain what it is.
Speaker 2:And obviously when you write, always put the acronym in first yes, and the skills for writing and the craft. And when we're writing and all my former PhD students are doing projects with me or we can pull in on helping each other and they all go, yeah, but will you write the discussion, mary? Yeah, and sometimes I've been pinched somewhere from the background, you know, because it's like it's a craft you know. And then you should always have your strengths and limitations, never just the limitations. What's the strengths?
Speaker 1:Yes, and you've got. There is a formula that is you kind of sit there, dot point at all, and then you kind of craft it out.
Speaker 2:So it kind of works and it's that belief, you know, and if it don't work, all right, we didn't get that like, try another door then, and the door's going to open. Yeah.
Speaker 1:Absolutely.
Speaker 2:And it's like oh, and the math used to get distraught when they got rejected for it. I said, oh, it's part and part of the course, let's see another one and then corrections. Right, let's start with the table. Yeah, let's do the review response. We agree with some, but not of us. If it's out of scope of the paper, you just have to say that, yeah, but some of it is really helpful, absolutely. So don't take it personally.
Speaker 2:So learning and actually I didn't think of it from that perspective. So that's actually improved your paper. But yes, it's a game, because sometimes some of them can feel threatened because it's their area of expertise.
Speaker 1:So you have to learn how to do it and you haven't been included or they haven't been cited. And then some are just pedanting and some are just mean and some of them have a very bad day and shouldn't be reviewing anyway. Thank you very much. Kind of like for kind of sitting in a hotel or a convention center kind of dining room table. Hopefully the sounds kind of come out really cool. But I really appreciate your time and kind of being able to grab it while we're here.
Speaker 2:And there is a thing I have to do that I have avoided was the handbook of Midwifery Research, because I wrote that book in nice, simple terms so midwives would understand what research is. But I've got to do the second edition. Anyway, I've asked if I can bring over midwives on to help me, because I just don't have the time and I just think I've got to have a life. I can't be doing this every other weekend. So sustainability. So if you want to be involved.
Speaker 2:Oh, hell, yeah, absolutely I need a need of a midwives to help me write the chapters and I'm putting in a new chapter on mixed methods, but obviously I've got to update. But I showed that we could do any type of research, action, research, phenomenology, whether it's a randomized control trial, that we will be capable.
Speaker 1:So here you go. This will probably go out in the next couple of weeks after the ICM, because I'm going to upload it when it's at home, because the internet's a little bit better. So if you're interested, you'll actually be able to tag into Mary's details. So drop her a line and start the conversation, because you never know where it could take you by having the store open. Thank you for joining us today. You'll find all the links on Twitter, instagram and on the podcast website. If you are a midwife and you would like to share your research, your postgraduate studies or even the quality improvement projects you are doing now, then email me at throughthepinardcom, send me a tweet or send me a DM.