26 Ways to Change Birth Globally
by Sara Wickham, RM

© 2000 Midwifery Today, Inc. All Rights Reserved.

[Editor's Note: This article originally appeared in Midwifery Today Issue 53 (Spring 2000), page 28.]

This action list of small things all midwives can do to change societal attitudes toward birth and to promote midwifery and the midwifery model was derived from some research I carried out a few years ago. All the suggestions are either free or very low cost, and none will take too much time or effort. Some things on the list won't be new ideas to you, but they might act as a gentle reminder that simple, everyday things might have a positive impact on the way our society sees birth and midwifery. No. 26 wasn't on my original list but was a suggestion that Judy Edmunds offered and is something she does herself. Thanks, Judy!

If you are interested in why they work, here is a brief lowdown of some of the main factors involved:

• The more people are exposed to hearing about midwifery and gentle birth, the more it will become a norm for them.
• Attitudes are formed in childhood; therefore, we need to ensure that children are exposed to these ideas at an early stage.
• Experience is an important part in attitude change—if you can encourage people to experience something for themselves, it is much more powerful than telling them about it.
• People are more likely to listen to those who appear to understand and sympathise with the other side of the argument. Appearing to be unbiased means you will appear more credible than if you come across as feeling very passionate about your cause (even though the majority of us do feel this way).
• Talking to people who support birthing women (partners, grandparents) is just as important as talking to women themselves, because these are the people who influence women's decisions.
• Reflecting on past decisions and their outcomes helps us think more logically about why a situation might have happened and discourages us from making (possibly incorrect) assumptions.

Action List

1. Get a bumper sticker that supports midwifery and gentle birth.
2. Wear a T-shirt that does the same!
3. Talk to everybody you meet about what you do and why you do it.
4. Be able to cite the evidence for midwifery care, homebirth and so on.
5. Offer women free/low-cost experiences of midwifery services (free tours, short talks or pregnancy testing). This can enable women to meet midwives for themselves or bring potential clients into a birth center to see what they could be experiencing.
6. Talk to people in an unbiased way.
7. Talk to children/school audiences.
8. Offer workshops/talks to the public.
9. Breastfeed in public.
10. Offer to go on local TV/radio.
11. Write short articles for local newspapers.
12. Write to TV shows that misrepresent birth.
13. Create and distribute information leaflets about midwifery/gentle birth.
14. Target partners and grandparents as well as women themselves.
15. Arrange to have your births listed in the local papers—offer photos on special occasions (e.g., first baby of the new year).
16. Enable women to reflect on their experiences.
17. Encourage others to reflect on their practice.
18. Encourage people to visit your place of work.
19. Develop a team of birth change agents in your area, to work together and support each other.
20. Ensure that women you know understand the enormity of the decisions they need to make.
21. Seek opportunities to speak to teenage girls.
22. Be able to lend books/videos.
23. Know your enemy and practice his argument!
24. Foster a dialogue with women's groups.
25. Ask everybody you midwife to tell a friend about their experience of midwifery and about their birth.
26. Sponsor a couple of miles of highway—in return for clearing up the rubbish, you can have the name of your practice or group displayed for all to see!

Sara Wickham, MA, BA (Hons), RM, is a direct-entry midwife who has practised in both the United Kingdom and the United States. She is currently a lecturer in midwifery at Anglia Polytechnic University, England, and is the UK country contact and a contributing editor for Midwifery Today. She can be reached at withwomanuk@yahoo.co.uk

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