thru the pinard Podcast
a conversational podcast with @Academic_Liz with midwives & other birth professionals about their studies/ research & how it's changing our practice globally - email thruthepinard@gmail.com
thru the pinard Podcast
Ep 101 Deborah Davis on navigating hospitals, home births, and academic journeys
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Ep 101 (http://ibit.ly/Re5V) Deborah Davis on navigating hospitals, home births, and academic journeys
@PhDMidwives #research #midwifery #education @unicanberra #ACTHealth #homebirth #VIDM @world_midwives
research link - t.ly/mOzQh
Deborah Davis takes us on a captivating journey through her remarkable career evolution from cardiothoracic intensive care nurse to home birth midwife to academic leader. Her story reveals the profound shift in mindset required when moving from high-tech medical environments to relationship-based midwifery care.
Deborah speaks candidly about her early fascination with home birth, sparked during travels through Southeast Asia where she hearing stories of birth happening naturally in community settings. This perspective led her to pursue midwifery and then an apprenticeship in home birth practice, eventually practicing for 15 years across Australia and New Zealand. She describes the stark differences between these countries in how midwifery was positioned within the healthcare system, with New Zealand offering a more integrated approach where midwives were respected as autonomous practitioners.
The conversation delves into Deborah's academic awakening and her doctoral research examining how midwives promote and protect normal birth in hospital environments that "scream medical." Her findings revealed the complex strategies midwives develop to support physiological birth within institutional settings, and how even home birth practices are influenced by hospital policies. This research exemplifies how midwifery is inherently political, requiring constant advocacy at multiple levels.
We explore the challenges of balancing academia, clinical work and single parenthood, including Deborah's practical approach to completing her PhD over eight years by establishing a rigid evening study routine. Her reflections on maintaining wellbeing through community connections outside midwifery offer valuable insights for anyone balancing professional demands with personal life.
Deborah's current work focuses on improving care for women with gestational diabetes, inspired by one woman's powerful statement that "diabetes stole her pregnancy." This research aims to create models of care that maintain the woman at the center of her experience rather than reducing her to a medical diagnosis. As chair of the Scientific Program Committee for the upcoming International Confederation of Midwives conference, she's also helping shape global midwifery conversations.
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Thank you very much for joining me, as per usual. Can you introduce yourself, please?
Speaker 2:I can. So my name is Deborah Davis and I'm a professor of midwifery, and I'm a joint appointment with ACT Health and the University of Canberra.
Speaker 1:And we're going to get through your career. But, as I was kind of like doing my little bit of cyber stalking, stroke research one of the things you've worked across almost every single possible place that a midwife could work in your career, which is brilliant, and we've also got a shared kind of interest in another organisation that we've both kind of had some passion about, which is also Vidim, which is a virtual international day of the midwife, which I'm sure we'll get to as well. Yeah, let's start very, very beginning. How did you get into midwifery?
Speaker 2:I was, um, a nurse and I had never intended to be a midwife. So I know some people who just wanted to be midwives and, um, when I did my training, um, the only options were nursing. But I wanted to be a nurse. I was a nurse and enjoying nursing and I was working in cardiothoracic intensive care nice, um, yeah, high tech, you know, quite different, but enjoying it. But I gradually just got sick of being, you know, the ambulance at the bottom of the cliff. Basically, you know they'd already had, you know, years probably of heart disease and health problems. And here we were doing something pretty significant, you know, to kind of bring back some health and quality of life. So I really wanted to turn my attention to something that was more health oriented and probably more health promoting, and I saw midwifery as being, you know, a perfect avenue for that sort of thing. So, from, you know, high-tech ICU nursing over to midwifery Very different mindset.
Speaker 1:Absolutely yeah, and I was an ICU critical care nurse as well, so I understand that mindset.
Speaker 2:Funny, isn't it? Yeah, it was a complete shift. Complete shift basically because really, in ICU, um, you didn't have relationships because they were, um, you know they were, they were asleep and intubated and I wouldn't have known that you cared for them, so you know from from that to a really relationship based um. Engagement with the people you're working with is something really different.
Speaker 1:The only closeness that we had was with the long-term patients in like general ICU or neuro ICU in particular, where you develop that relationship with their family, yeah, and so that kind of that ability to make somebody feel comfortable at times of stress is a nicely transferable skill.
Speaker 2:Yeah, good point, really good point, that's right yeah.
Speaker 1:So where did you do your midwifery? I'm going to say training, because I'm still old school. It needs to be Well, it was Well it was.
Speaker 2:It was a hospital certificate. It was for my nursing, which was at Sutherland, and then it was St Margaret's in Sydney for my midwifery, and then it was St Margaret's in Sydney for my midwifery, and that was 88, 89. And of course it's no longer there anymore, which is a shame.
Speaker 1:But that's where I did it.
Speaker 2:And where did you work after that After that? So I was probably already quite interested in home birth before I started midwifery and that probably just comes from a sense of you know. I'd been travelling actually in Indonesia and Asia Southeast Asia, india, nepal for a long time before I worked in ICU and I kind of got to see that women were having babies all over the show you know, and hiking in Nepal, there was a wonderful family kind of lodge that we stayed in and there was someone with a very brand new baby there and I remember saying to her where did you have your baby?
Speaker 2:and she said, oh right, where you're sitting, actually, okay, I didn't know that could happen. I don't know how I thought it did happen. Um, so I'd already, I guess in my travels, started to formulate an idea that home and you know, for healthy women was a really, um, best place probably to have your babies. Um, so I went to midwifery thinking that home birth might be where I wanted to go, quite naively, because I think I remember saying that to the nun who interviewed me for a place as a student midwife and didn't realize that to say you're interested in home birth was almost to admit having two heads, which was fun, but anyway, they took me anyway, which was quite amazing.
Speaker 2:And so, yeah, so I had this one-year training and completely did not equip me in any way, shape or form to do the job of a midwife. Yeah, so after that I, well, I had a baby after that. And then I, we did what we called an apprenticeship, an informal kind of apprenticeship style arrangement, with a beautiful midwife, maxine Ross, in the Illawarra where I had moved south of Sydney. So I went straight into this gaining experience in home birth. So I didn't practice in hospital, I went really from my training to an apprentice midwife and then I began as a home birth midwife.
Speaker 1:And how long did you stay doing that?
Speaker 2:I did that probably all up 15 years.
Speaker 1:Nice.
Speaker 2:Australia and New Zealand. Yeah, it was part-time, you know, I had a child. I was a single parent after that, so it was fairly part-time, but I could manage it. I had a fantastic woman who I could call on to babysit and you know you, I would call on her at night very often three in the morning, two in the morning and say, can you come?
Speaker 2:and she'd just come and get into bed at my place, yeah, and take my daughter back to her place, you know, in the morning with her kids and they'd have breakfast to get them to school. So I mean I could never have done it without that or family support or something. But I did yes. So I did that for a long time and I moved to New Zealand and I continued with a part-time practice and I was also teaching in New Zealand.
Speaker 1:So why the move? What was attractive about New Zealand?
Speaker 2:Gosh, you know it was hard being a home birth midwife. No one liked you much. Some did. A lot of other midwives didn't like you. Certainly obstetricians didn't like you. It was very distressing to transfer because you know it wasn't a seamless experience. I don't know if it's any better anymore, but you know that they were horrible, horrible to me, they were horrible to the women, they were punitive to them sometimes. That was all pretty awful and I went to a conference in New Zealand and they had not long changed the law.
Speaker 2:Yeah, so you know, bachelor of Midwifery was the norm and Cas. Bachelor of midwifery was um the norm and um caseloading midwifery was the norm, the main model um and home birth was just another place that was easy for midwives to support women. Home hospital made no difference in some ways, um, and I just thought, oh, what a wonderful relief that would be to be in an environment where you know how you wanted to practice, was normal and respected, valued and um. And I also wanted to get into academia and um. So I looked for a position for teaching as well. So I was teaching and had some part-time practice when I went over there.
Speaker 1:What was the attraction for education and teaching?
Speaker 2:Yeah, I don't know. I think I just wanted a bit of a change, a bit more regular hours, a bit less on call, even though you know I still had some part-time practice. I would kind of gather that up over a few months. Yeah, do a bit of more intensive practice and then have periods where I wasn't. So I think it was the regular hours.
Speaker 2:Look, and I am a bit of a, I loved academia when I discovered it. You know I went to um academic study a bit later. As I said, I'm hospital trained in nursing and midwifery, so I was already registered when I went to academic work and started with a Bachelor of Nursing by distance, and I didn't know anything about journals, like. I just remember the excitement when I discovered that people wrote stuff. I had no idea, absolutely no idea. This was in my late 20s and I just thought it was so astounding and amazing and loved it and always have and still do so. I think that was the attraction for academia, that I could be doing that, more of that and contributing to my own writing, to that. You know, great kind of knowledge out there.
Speaker 1:Well, it was. I mean, I'm hospital nurse trained as well, so it was. This is the way you will do it. There was no argument. You just had to repeat it the same way. There was no justification. There was no rational. You just had to repeat it the same way. There was no justification, there was no rationales.
Speaker 2:Really it's whatever was in the textbook. Mine was Maggie Miles. You know I've still got it in there and it's all highlighted all the bits I had to learn and regurgitate for the exams or whatever. So that was. You know you're learning whatever they wrote in the book was what you did and you learnt.
Speaker 1:Yeah, yeah, but you know you're learning whatever they wrote in the book was what you did and you learned, yeah, yeah, but hopefully we've kind of advanced a little bit now as a, as a professor we certainly have, because, as a profession, evidence-based practice and involvement in research is throughout all of our standards and our ethics and our code of conduct, which is brilliant to see it certainly is, and I think australian midwives punch way above their weight in that area.
Speaker 2:You know we are just doing so much great research work, really shaping, you know, midwifery, I think, globally through our work.
Speaker 1:Well, we're still the only country, region and I'm going to include our cousins, the Kiwis in New Zealand in this that in 2020 that midwifery had its own research category and no other kind of country has been able to separate from nursing yet their midwifery. We have started the for a little country of whatever we are now 26, 27 million plus the 5 million I think that's in New Zealand.
Speaker 2:Yeah, we're doing, we're really pushing the boundaries and making them think you know the Trans-Tasman Midwifery Education Consortium was kind of central to making that change because we really really lobbied hard, we did a lot of submissions when they were suggesting making changes to that. So you know I think we were pretty core to in our agitation and in our feedback and lobbying to having that change made. And there wasn't always. You know, I had to keep that on the down low a bit in my university because it was related to the oh, is it the ERA? You know the funding and the categories and you know to kind of pull midwifery out was kind of detrimental in a way to that process.
Speaker 2:I don't know if that is how it has panned out, but there was certainly concern that the universities were better off lumping their publication and research work on broad-heading nursing, not skiving off midwifery. But you know I had such a it's often a tension actually between you know what the university might want for midwifery and what I want for midwifery and our profession wants for midwifery. So I'll always, pretty much always back that rather than you know someone else's view of what is good or necessary or needed.
Speaker 1:Oh look, and we're still fighting at times and have in the past that nursing and midwifery are not the same, still getting lumped together and it's like how can we still be having this fight?
Speaker 2:I know Us every day. It's probably for us. Yep, hey, let's probably.
Speaker 1:Yep and yes, there are countries that you still need to be a nurse and midwifery is like an added qualification and that is the process because of the requirements that that country has. Slowly, direct entry midwives or single registration midwives are becoming more popular. It's been around for over 20 years 25 years in Australia and longer than that in the UK. I think it was the end of the 80s, 1989, I think it started in the UK and when we look at the recognition that the World Health and the UN are putting to midwifery and midwifery-led care, that push is going through more and more. So I think the next 10 to 15 years we might see other countries kind of taking it on, but other countries have also got crippling healthcare systems as well, so they need to once again prioritise where their best money is served, and to have multiple skills to be able to use is where nursing and that dual qualification comes in.
Speaker 2:Yeah, look, I don't agree that it helps them financially or effectively. I mean there's so much need for midwives in the maternity space, you know. I mean I think there's. You know there's plenty of scope to have a separate profession. And look, I think it will change in Australia. I think it's just going to take time and I'm always really heartened when I see the news reports on different things that are happening. Now they say nurses and midwives. You know they never used to say that. So change is coming slowly. But you know, we still have to fight those fights. And that's actually what's tiring about being a midwife that you just can't get on and grow your profession and do your beautiful work and you know all the things you love to do. You've got to fight these little fights all the time, again and again and again. You know, which is quite exhausting, because I think midwifery is more than just a profession. You know, it's kind of a cause in a way. You've got to be an activist.
Speaker 1:Oh yes.
Speaker 2:You've got to be in the politics and I remember saying I don't want to be a political midwife. You just have had no choice.
Speaker 1:You have to tell my students on day one that you're going to be political. Midwifery is political. It's personal for personally, political for the woman and the birthing person in their choice. It's political for the midwife. It's political on a local level, on a national level, on an international level. So if you don't like politics, you're in the wrong profession.
Speaker 2:Absolutely, and that was the title of my thesis actually the politics of practice, because it just is yeah.
Speaker 1:So you got your kind of distance ed qualification. In the old days, everything was mailed to you. You did it, you mailed it back. Yeah, lots of photocopying.
Speaker 2:I think we probably killed a few forests. Hand wrote assignments, or type them up on your old typewriter and yep you send them back.
Speaker 1:Free internet, free kind of like all that. How did that then go teaching into academia? How did that lead into research master's, phd?
Speaker 2:um, I well, I did a bachelor of nursing and then I did a um master of nursing studies. They were the only degrees. I was a midwife by then, but that was the only degree I could do and that the master's um program was coursework but it had a research project, um, so I did a project which was kind of a deep dive into the midwife woman relationship in the context of home birth, which I really really enjoyed. Um, so that was my entree into research, um, and I and I think just my love of study, I just love how it extends you and makes you think differently, and the reading, and you know you're just not going to do that on your own. Necessarily you need something to kind of some framework. So probably a doctoral. You know, work was inevitable at some point and it wasn't long, I think between might might have probably was actually it's probably a couple of years between masters and me starting um doctoral studies did you already know what you wanted to do and who you wanted as your supervisors?
Speaker 1:or was that kind of like I want to do a PhD and I don't know what to do it. I don't know who to do work with yeah, it was that.
Speaker 2:And I I actually started in a professional doctorate which I thought would be good because it had different streams. You know, leadership, yeah, nationalism I can't remember what the other ones were and that was at uts, um, and I I'm not sure why I went there. I guess i'm'm a Sydneysider. I was in New Zealand by then, but you know I've been a Sydneysider.
Speaker 2:Leslie Barclay was my supervisor. I don't remember having choices, I don't know if she was the only one and it was a bit of the place to be. You know, caroline Homer was there quite junior as a. I'm not sure what exactly her role was, but she certainly didn't have the prominence she has now. Leslie Barclay certainly had the prominence she has now. So you know it was kind of a and they had started the ProfDoc. It was brand new. So it was kind of jumping into this new program. It was just for midwives, this new program. It was just for midwives. And you know my colleagues Karen Gilliland, all my peers in class, sally Pearman was doing it, sue Kruski, I think, pat and Nikki might- have been.
Speaker 1:That's my board, I know, oh, wow.
Speaker 2:Sue Kruski, sue Kruski I'm not sure if Sue Hildilde was part of it or not I remember Kruski, you know. You remember Kruski, I do. So it was a great, exciting, you know, new innovation and I started doing that and was kind of enjoying it, but then it was pressing me into units and streams that I found I didn't want to go and I actually moved out of it into a PhD and I didn't really know my topic. Home birth was inspiring me because that's what I had been for such a long time and in New Zealand it was really the first time that I was supporting women to birth in hospital because as a caseloading, as a private practising midwife, you could support them in hospital, support them at home. It was kind of same same. So you know I was quite fascinated by just.
Speaker 2:You know I'd been immersed as a home birth midwife and everything you know. I'd been immersed as a home birth midwife and everything you know was about natural birth and women were on board in Australia with the same kind of values and beliefs around that and my peers with other home birth midwives were. And then to kind of practice that and promote that in stand for and then hospitals and how do you do what we want to do in that kind of setting? That's really everything about. It screams medical from the way it looks, the way it's run, the hierarchy, the way it smells Exactly the way it smells.
Speaker 2:So I knew I wanted to do something in that space because I was personally experiencing, you know, kind of quite a jarring experience, suddenly now supporting women in hospital and wanting to know how other midwives were doing it in New Zealand. You know what was their experience of that. So it took a long time to hone that topic, how I was going to do it, exactly what I was going to do it. But you know I had some feel about what area I wanted to go into.
Speaker 1:So then, how did you go with? It was just who else, apart from Leslie, worked with you.
Speaker 2:Virginia Schmeid. I had Virginia Schmeid and actually partway through Leslie moved to Darwin and I could have followed Leslie to Darwin. But there was another academic at UTS who wasn't a midwife but I had gone down the murky, murky road of post-structural theory and Kim Walker, who's a nurse academic, was there and it made sense for me to go under his supervision in this. Once I'd kind of gone down this theoretical path because he was an absolute expert. So Leslie got me a long way and I'm ever thankful to her for supporting me because it took me ages to really hit on what I wanted and how I wanted to do it and she really just let me find my way and really supported me in that. And when I had started going down that path then actually Kim Walker was a really great supervisor for his specialty in that and Virginia Schmeed actually has a really good theoretical grounding in post-structural work as well. So she was my co-supervisor and it was kind of perfect for me.
Speaker 1:Did you find the difference in the questions asked from the midwifery supervisor and the non-midwifery supervisor helped you clarify and better articulate some points?
Speaker 2:Yeah, maybe. I think maybe the biggest difference was his pressing me to examine this from a post-structural issue, you know, perspective and unpack all my biases and, um, even natural birth, you know, had to completely let go of that as a dear, cherished, you know, part of my core. And because that's what post-structuralism makes you do, it makes you just examine things not as truths but as fabrications in some way that we use to different effect. So it was more him not being a midwife because I could bring that really more his pressing of me in terms of the theory and how I was using the theory and how I was unpacking my own kind of biases and deeply held beliefs which we have indeed so you were in full-time or part-time, while studying yeah, full-time.
Speaker 2:So that was you and you know what academic workloads are like, so that's hectic and it did take me a long time. Well, it was about eight years, I think, yeah, and I was a single mum and my daughter was probably seven or eight when I started and a teenager when I finished. So there was that. I did get a scholarship for one one of my years which allowed me just to work part-time and study full-time. So that progressed me at a really important stage, actually the year before I submitted. So I was doing the final analysis and writing up and I could do that full time and that was critical, probably in getting me there.
Speaker 1:Keeping your head in that groove and in that space is so important.
Speaker 2:It's so hard to do it in bits, you know, just coming to it in little chunks, you know a couple of chunks, you know a couple of hours here, a couple of hours there, like you've really got to. I found needed to deeply immerse in in that data and the analysis to to move it along. So that allowed me to do that.
Speaker 1:So how did you set up, what did you do to develop a routine for when you weren't having that scholarship time, that when you were struggling through all the stresses of academia and a full-time workload and parenting? How did you kind of then fit the PhD into that?
Speaker 2:yeah, so 7 30 was bedtime for my daughter um no negotiation, and she still remembers it to this day.
Speaker 2:So, and that was my study time, so we, you know, we bed and bath and eat and everything by then. So 7.30, I was sitting down to study and you know I might only go through to 10.30, but that's three hours a day and if I could steal hours on a weekend I would, but that wasn't always guaranteed. But you know, as she got older I found I could get some time on weekends, but otherwise it was that 7.30 to 10.30, Monday to Friday, that was what I did.
Speaker 1:How did you keep your sanity, because I'm sure that there were lots of times that you were going why the hell am I doing this? And the PhD struggle, which is a very independent struggle at times. How did you kind of deal with that kind of mental health side?
Speaker 2:I did maintain hobbies. So there was some things. I had a community. I was doing belly dancing at that stage oh, gloria, I know it was great fun. So I had a whole community of belly dancing buddies and you know we'd get together and dance and learn and have little concerts and things. So that was really important, having having a hobby and people outside of midwifery. But most of my other friends were midwives, as we tend to do. That were my colleagues and they were an enormous support and and not that they necessarily did anything practical, I mean they they did in a sense in allowing me to go full-time, you know, really dropping my hours back. I know that impacted on the team, but you know otherwise, it was just that they were there and they were fun and I enjoyed being with them and we had laughs at work and coffees and, you know, catch-ups and so I think just having friends that didn't have to do anything special, yeah, they were just there and part of my life and gave me joy and entertainment and I think that was absolutely critical.
Speaker 1:Yeah, Supporting the fact that you're doing this and understanding the importance to you.
Speaker 2:Yeah, and I don't even remember having big deep conversations about it necessarily, so it wasn't like you know I was bouncing off ideas. Maybe we did. It was a while ago now for me, but just their presence in my life, you know, as valued friends and colleagues, was enriching and helped. I guess, just in terms of the balance of everything that was helpful.
Speaker 1:So, looking back now onto your phd, what's something that surprised you, either about the journey or about your results?
Speaker 2:it. It maintained my interest and fascination for all those years. And still, when I went back and had a look, because I had to remember what I did so I could talk to you, and I almost got butterflies, I'm like, oh, this is such a great topic so it's still, you know, really interests me and fascinates me and I never would have thought that something could hold my interest in that way for such a long time. The way I approached it, I think, was really important the post-structural methodology, because it blew my mind in ways that I've never, I won't say recovered. I've recovered, but I don't think the same.
Speaker 1:But yeah, it does change your way of thinking.
Speaker 2:yes, it changed me and that's really what I'm so glad to have had. I didn't know I was going to do that because I had no idea about how I was going to approach it and what post-structural theory was. So you know, it changed me, it changed the way I think and that really surprised me. I think in terms of the findings I don't know if any concrete things were unexpected. You know it was kind of focusing on the discourses that shape midwifery, um, you know, the biomedical, the natural birth. One is there.
Speaker 2:There are professional kind of discourses especially in new zealand that was very strong at the time around partnership, um, neoliberal stuff, you know the consumerism, informed choice and women making, you know know, marketplace choices almost. So I mean, you know, I mean that's all interesting. But it also did send me down a bit of a look at the environment of the hospital and interpreting that from a discursive in a discursive way. So you know there's been more work on that since, but birth unit designs and what the birth unit says about birth and reading the architecture and design as text. So there were things that were really interesting and new places for me to go academically and new ways of thinking about them. So I think that's what surprised me most, what the impact it had on me personally as a scholar and a researcher.
Speaker 1:And what did you find from the participants?
Speaker 2:I found that. So I interviewed midwives. I interviewed 50 midwives in New Zealand who were caseload yeah, it was a lot all up and down the country and basically they had to do a whole lot of things to promote and protect normal birth in a hospital setting that they don't have to do anywhere else. You know layers and layers of strategies and things that they have to think about and struggle with, and you know things that they have to think about and struggle with and, um, you know, so it's, it's just such a lot of extra work um to promote, or, as best you can, a physiological process in that hospital setting.
Speaker 2:Um, that's mainly what they told me about, I mean. The other interesting thing was that even you know, if you're practicing as a home birth midwife I mean, you're really part of the you're impacted by the policies of obstetrics because they shape the medico-legal kind of expectations, don't they? So you know, even as much as we want to be and we are professionals and we draw on the best evidence there's still this very weighty impact on shaping what we do and how we do it, and it was things like home birth midwives routinely sweeping membranes because they're trying to avoid the hospital policy of um induction at 41 weeks or 40 weeks, whatever it was.
Speaker 2:So you know that policy wasn't there, they wouldn't be doing that practice yeah so you know, it was just, I guess, interesting to look at how those those biomedical kind of um frameworks were really impacting on their practice as midwives. So that's mainly what they told me about.
Speaker 1:So when you came back to Australia you were I'm not sure if my chronological is right here you then also came back to some joint positions in academia yes, I did and clinical. So you had then connection with Australian birthing places and rooms and delivery suites. Did you find similar things in Australia to what you'd found in New Zealand, or was it different?
Speaker 2:No, I think it's pretty much the same. I guess what's different is the normalising in New Zealand of privately practising midwives coming in and out of hospitals. I mean, that's, you know, that's normal in New Zealand and home birth is much more normal. So that still probably wasn't quite, probably still isn't quite normal here and I know we had very few opportunities for privately practicing midwives to be able to practice in hospital settings. But otherwise, you know it's um, it is pretty much the same. Hospitals are hospitals, um, there's the same kind of hierarchy. Probably there's a bit better collaboration between midwives and obstetricians in New Zealand because they do, I think when they are independent of employment, there's a different status afforded them and I think they are seen as more equal, um, in New Zealand. Um, but what I, what I was really scared about coming back to Australia was that I wouldn't find my tribe who cared so deeply about women and you know their possibilities for birth and you know being respected and supported. But I did. They're everywhere. Yeah, those midwives are everywhere but I did, they're everywhere.
Speaker 1:Yeah, those midwives are everywhere you studied. They're kind of some of the leaders of it now.
Speaker 2:Yes, they are, but they're in every hospital as well, you know, and they're in our graduates and they're practising everywhere. So, you know, they might not be the loudest voices and sometimes you might not think that they're the main. You know they might not be the loudest voices and sometimes they might not. You might not think that they're the the main. Uh, you know a big group, but, but there are plenty of them.
Speaker 1:So I was really, really heartened by that a lot of people that I've kind of anecdotal, talked into and seen on social media and other kind of places at conferences. I turned off about doing, in particular, doctoral studies because they want to stay clinical. So you had the good position of being both research and clinical and being able to encourage staff on venues to actually do research, to involve in it. What have you found? Some of the barriers, but also some of the enablers from midwives who are working in the system in the clinical side of it to appreciate that they're enhancing their own skills and then how they can use those skills back to enhance especially clinical care.
Speaker 2:Yeah, look, most of the clinical policies are written by midwives. You know they're the leaders of it. So I think you know we need to appreciate how influential we are in that and, you know, really hone our skills in research. I mean that's, you know, using research to write those policies. So I think we've got a really critical role there and I think clinicians are so well positioned to know, you know, avenues for improvement and see how policies and current practices impact on women. You know, I think many other clinicians sort of waltz in and waltz out, whereas midwives kind of follow through in that relationship and can see how things are impacting on women and families and also what opportunities there are for improvement. So you know they're opportunities but, given we're so well placed, we have such a critical role, our research will be different to others' research because we have a different lens, we have a different experience with families, but we have really limited opportunities.
Speaker 2:So I think that's the barrier. I mean, especially at the moment, everyone is needed on deck hands-on at the coalf, everyone is needed on deck hands on at the coalface, but there are so few positions that have any time built into it, you know, for doing any research. And I would love to see in our position descriptions and EBA going forward that you know, as you become kind of more senior, you have some time built in, you have some responsibilities for doing research or translating research into practice, because otherwise, yeah, it's just so very difficult to free up any time and I think we very rarely have any research positions at all full stop available. So where do you go when you've got those skills and you want to do more research? Most go to academia, don't they?
Speaker 1:because those opportunities. Some don't like it and don't want to stop them. And the irony is there is a system already set up in medicine that recognises it, that prioritises it, that is inclusive of of it. So it's not as if the venues and employers can say, well, no, it's like, but wait a minute. This is actually part of the process in medicine. Why can't it be part of our process? Because it's going to improve the care given. It's going to improve your outcomes. It's got like there are so many benefits from it, but all they see is yet not. We're not going to release you for one day a fortnight.
Speaker 2:There's really good, strong evidence that organizations that really do focus on research um are much better, more efficient, give better quality care, you know. I mean there are so many benefits to an organisation. Yeah, and, like you said, they do have got that system set up in the medical field, and that's similar also to credentialing midwives from private practice. We have got those systems. It's not like we need to invent the wheel, but for some reason, you know, it's okay for some but not okay for others. And that's again where I think we really need to lobby. As we're thinking about the future, the growth of our and development of our profession.
Speaker 1:They're the areas that we're really going to have to focus on and understanding what that, the scope of midwifery in general. But then how do you translate those skills? And understanding that those skills aren't are translatable.
Speaker 2:The phd skills, the research, the critical thinking, the the able to critique information, all of those skills are so transferable oh, they're so valuable to an organization, not just transferable, they are so valuable, and we do have a handful of nurses that I know of and, um, and we do have a handful of nurses that I know of, and the odd midwife who is PhD prepared in practice. But I don't necessarily think the organisations capitalise on that wonderful skill and knowledge that they have just because of the structures of working. Mostly it's coalface working, isn't it? And you know when you're on the floor, um, on your shift, you know you can't kind of get away to do any research, um, so you know there has to be other kinds of roles that these people occupy if they're going to do anything at all and I think that's something that in some american states that they're doing quite well with the dnp in kind of they've got the and obviously their system is very different with the certified nurse midwives and they're keep getting all the um initials mixed up.
Speaker 1:But there's a quite a few that I know that have got them, that are still working clinically but are able to use it and they're kind of the ones that are advancing and pushing things in their areas and doing that stuff which we I think we need to kind of take a leaf out of their book and kind of help them as well. We don't want anything else from the health care system at the moment, but do you want that?
Speaker 2:No, no, we'll be leaving this at it all.
Speaker 1:Oh, I know, it's just I kind of can't even imagine how they're keeping their sanity over there, and I'm sure some of them aren't. Before we get into what you're doing now, I want to ask how did you celebrate your PhD?
Speaker 2:I remember feeling very flat when I submitted and I expected to be over the moon. Um, so this, I don't know why uh, it was a funny feeling and I've heard others say that as well. Um, yeah, it was kind of. It was kind of weird. It was wasn't like I wanted to keep it in my life, I wanted to finish. So I was delighted. Um, I felt very flat and then, um, I think it was a family and friends celebration when the news you know when it was conferred, yeah, and that was before probably walking across the stage. So I had to come from New Zealand back to Australia to walk across the stage and it's lovely. You know, my old mum was so proud, and still is. You know she's always telling the neighbors about her doctor, professor good, so she should. So she's enormously proud. And and for my daughter to see that, you know, um, something came of of all that, um, that the overcommitted mum that she had for all those years and that, you know, just perseverance and and it did pay off.
Speaker 1:So I want to we mentioned earlier well, I mentioned earlier the link, mutual link, that we've got with the Vidim, so the Virtual International Day at the Midwife and you were there at the beginning with Sarah.
Speaker 2:I was yeah, so we were both at Otago Polytechnic in Dunedin yeah.
Speaker 1:So how did that? I know it was on Sarah's kitchen dining room table that it kind of started. But what was the kind of the genesis and the creation of Vidim? Because it's going this year we've just done the 17th year. It's a 24-hour virtual free online conference which is just chaotic behind the scenes but fabulous to kind of see so many people. But why did you start it?
Speaker 2:um, it was sarah's idea, um, and so we'd have to ask her, I guess, about that. But I think she'd been doing a bit of study and it was about technology and you know, the internet and facilitating things online, and new zealand was doing some of that in terms of education way before Australia, probably because of their geography, and you know how necessary it is to be able to do that. So she'd kind of been delving into that and came up with the idea of the conference and I guess why I jumped in was because I valued education. Why I jumped in was because a valued education, I understood that there were masses of people that couldn't attend conference, couldn't avail themselves easily of that, those opportunities. And then you know we have this technology, so why not put it to good use? And it's also always had quite a social imperative, I guess, to address some of those inequities and bring you know all those wonderful, brilliant researchers and innovators and speakers to a broader audience. Basically, in midwifery.
Speaker 1:One of the things that I like about it is that I think last year well, this year, sorry, I think we had 57 countries represented in attendees, because one of the questions we ask is where are you from? Which was just mind-boggling, and the presentations were from countries like talking about. One of the ones this year that just still stays in my brain was one of the girls were talking sorry, women, not girls was talking about how they have maintained midwifery education in Afghanistan after the Taliban shut the schools and how they're doing it from remote and doing it in line and then how they're trying to get the clinical placements and so stuff that, like us in a very privileged place, can't even contemplate. And then sharing all this and kind of going you know what? We're supporting you absolutely. Is there anything else?
Speaker 2:and having that online virtual community is just amazing, so thank you I think they get an enormous sense of support and you know a global community that are coming together and you know it's a feel-good event.
Speaker 2:And I remember one year there were a group of papua new guinean midwives and they did some deal with um uh, telstra or some provider to get access just under some kind of shelter, and midwives walked from the mountains for days to come to this central point where they had internet access, that they negotiated and they could participate and it was just the most phenomenal thing. Yeah, you end up with the most you know amazing respect for what these midwives endure to do their jobs and take advantage of some of these opportunities. So, yeah, so really, I always very, very much enjoy attending now as I'm not on the committee anymore, but it's so uplifting, you do an amazing job and it's so fantastic to see that it's grown and grown and grown. And my very first facilitation of a session I had one attendee, from Ireland actually, and it was very funny because I think I just bought it to tears and I remember her going. Oh well, look, I've got to go now border to tears and I remember her going oh well, look, I've got to go now.
Speaker 2:How much has grown with um.
Speaker 1:You know really well attended now with so many at each conference session well, last year I think we had um the most ever completely broke records. In one of the, the leaders in Peru midwifery spoke and spoke in Spanish and there was something like over 400 attendees, because they'd done a fabulous job of advertising it as well. And so we now we have sessions that are in Indonesian Spanish. We've had one in Italian, I think, and we had one in French this year. So we're kind of trying to allow those, and technology is actually helping us once again, because we do have the auto-translate. It doesn't always get it right, especially with some midwifery terms. It doesn't quite get there, but it does allow for people to still, because we look after a multicultural society. So having an understanding of what some of the experiences are from some of the countries that the women and pregnant people have that we're dealing with is really quite important too.
Speaker 2:Absolutely, and I think you know, with the global challenges that we're having, you know an online conference just really makes sense. So it's, you know, it's appealing to different sorts of audiences for different sorts of reasons and I think the appeal is amazingly strong. So long may it grow, continue and grow.
Speaker 1:And a really cool thing is that every single presentation is recorded and is put onto our YouTube channel of Virtual Midwives, in plural, so you can actually go back several years and look at the presentations from previous years and over the last few years. On the website you have also got the posters as well.
Speaker 2:So it's a nice record. I use them in my teaching regularly as a resource. There's often a topic that's just right, you know, for your teaching in the undergrad program or postgrad. So, yeah, great resource.
Speaker 1:I include it very much in my um global health topic, so it's perfect to sit there and go. Well, here's some of the issues and here's the conference. So what are you doing now? What are you kind of excited about for coming up research, or coming up activities or holidays, or anything.
Speaker 2:I have, uh, supervised some students and I've got one more that's using post-structural um theory though I haven't pursued it myself in any other work and I think it's because, once you know in the clinical setting, it's kind of I needed research that was a bit more, you know, evidence-based kind of stuff to really try and shape practice and examine what we're doing. So you know, it's kind of been a lot of research out of our own databases to say, look, here's your third and fourth degree tear. You know, what are we doing about this?
Speaker 1:How about we do?
Speaker 2:Yeah, that kind of stuff. And we looked at the characteristics of the women that were being induced. You know they were saying, oh yeah, but it's all. You know this group, but it wasn't. It was all the primate group and women who had no real reason to be induced. So it's been more a needs must kind of you know, more clinically focused work rather than the post-structural stuff, though I still love that and I have supervised a couple of theses who have used that approach. Ella Kurtz did a beautiful piece of work around parturescence. Oh, you need to interview her. It was amazing. I'll give you her contacts.
Speaker 1:Please do, yeah and Helene Anilak is doing an amazing job at the moment. Oh yes, I know her very well. I'm looking forward to doing hers next year.
Speaker 2:The artwork of women, which is so illuminating and fantastic. So you know that keeps stretching my brain. It's probably the hardest thesis to supervise but the most exciting. Yeah. And then my personal research is really more focusing at the moment on gestational diabetes. I mean, we just had a couple of big publications recently. We're looking at some guidelines and stuff yeah, I really think we can give better care to these women they're just really being slammed, you know, you know.
Speaker 2:Imagine already dealing with the demands of pregnancy and then someone hits you with diabetes and the only thing anyone's ever worried about is your blood sugar level and lapping you over the head because you're not doing well enough and it's going to have this impact and that impact. So I think we can do so much better there, and that's what we're building towards, really, um, models of care that support women with gestational diabetes uh, much better because as soon as you get the diagnosis, you're in the medical model and you become a medical diagnosis and not a person they hardly see a midwife and one woman.
Speaker 2:actually, one quote that really stands out is she said that diabetes stole her. Oh, how powerful is that. It was, and it stayed with me and I thought that's not right. That's a great title too. Yes, it is. Yeah, it'll come up somewhere again for me, so that's exciting. I mean, icm is the other big exciting thing.
Speaker 1:Yes, that's going to be one of my next things, to kind of, because that's coming up next year, next year, and you are the co-chair of the research committee.
Speaker 2:The chair. No, I'm not on the committee anymore. I'm the chair of the scientific program committee. Sorry, yep of the conference which is massive.
Speaker 1:So this is 3,000 plus midwives internationally.
Speaker 2:I think it's going to be a massive year because we had covert, then we had barley and a lot of europeans didn't want to travel um that far, um, so it's the first one back in europe. Yeah, and I think it's going to be massive I'm so excited for it.
Speaker 1:I loved barley. It was my first one. Oh, just, you walk in there. If you've got any kind of like lacking of confidence, of kind of being part of a midwifery profession or a midwifery sisterhood, even brotherhood, um, you walk into there and you just from the opening ceremony with all the flags, from meeting people that you may have been virtual with online, to just getting random hugs from people from different countries and suddenly being adopted and having chats about what's oh, it's just you walk out of there. So magic, it's just brilliant.
Speaker 2:It is, and I always think the opening ceremony is like the Midwifery Olympics. Yes, they all got their flags and their national dress, and it's so beautiful and you do feel like you're part of a really big uh community, don't you? It's?
Speaker 1:it's fantastic, so I think it's going to be very, very exciting next year there's just so much option to choose from because there's there's so many kind of amazing presentations and chats and workshops. The hardest thing I found was trying to pick exactly too many probably.
Speaker 2:But you know what? The sometimes the very best experience I've had is popping into something random. Yeah, and I remember couldn't get into one room I was keen on, it was full up and just popped into another one and it was the absolute best experience. It was so interesting. So I would encourage people to go to something random?
Speaker 1:I very much because I can't. My mobility is limited so I can't pop in and out of rooms. So I'll sit in a room for a session and I'll pick one thing that I'm interested in, but then I'll absorb everything else and go oh, that was, oh, that was really interesting and sit and chat, and I think from last year it was the Ukrainian midwife who just like there was not a dry eye in the room because Vera told us about her experience of being a midwife when Ukraine was invaded by Russia for those first 42 days and how they worked and prioritised and gave and helped women birth.
Speaker 1:was it 137 babies or something in that time, including twins and including triplets? That's right, that's.
Speaker 2:Daisy.
Speaker 1:And without knowing if her family was safe. And it was like her family knew she had to stay because and they were down in a bomb shelter. And it's like, yeah, once again the amazing. And the midwives in Haiti who kind of like talk about emotion, like being pulled, but midwives in Haiti are being kidnapped and killed and there's still midwives that are staying there to kind of look after the women. Yeah, it's yeah amazing.
Speaker 2:Yeah, it blows your mind um and yeah you, there's some incredible human beings out there, aren't there?
Speaker 1:midwives, incredible midwives, absolutely incredible things and in this time, in 12 months, you will be on the other side of it. Yes, that's right.
Speaker 2:Goodness me, it'll all be done.
Speaker 1:You'll have caught up with your sleep, hopefully by then, and be doing the debriefing and ready for the next kind of handing over, because it's every three years.
Speaker 2:Yes, that's right.
Speaker 1:Thank you so much for your time.
Speaker 2:It's been such fun having a chat with you and thinking about my journey. I haven't thought about it for a long time.
Speaker 1:Everyone's got a golden journey because everyone is it's all individual and there's nuggets, golden nuggets in every single one. So it's just it's fabulous to be able to spend the time and kind of ask questions that you don't normally get a chance to ask in professional settings.
Speaker 2:Well, thank you for giving me the opportunity and for doing this work. It's such a great project, thank you.