Episode 60: Supporting Women to Birth Well and Addressing Freebirthing with Elsie Gayle

August 19, 2020 Avni Trivedi

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In this episode we talked about:

Elsie became interested in birth whilst undertaking her nursing training. The first birth she saw was a forceps birth. She still says that to this day, she doesn’t know what made her yearn to work in midwifery!
Elsie worked in the UK, including John Radcliffe hospital in Oxford, on the South Coast, Bristol and Birmingham. She moved to Jamaica and then Botswana with her husband for a short while.
She has experience in different settings such as high-tech hospitals as well as offering continuity of care in the community and supporting home births.
Elsie has supported many different types of women from different backgrounds and cultures, with different needs and values.
Developing a trusting relationship with a woman and her family with mutual respect
Elsie shared a story (with permission) of a woman with previous birth trauma, who wasn’t allowed to have her partner with her
Managing a pandemic
“The voice of women is not always heard or respected”
From the midwife’s perspective: the continuity of carer model helps to develop a relationship and ensures that important things are not missed and people aren’t ‘lost in the system’. Gaining experience in how to manage conditions.
Continuity of the carer from the woman’s perspective: learning to trust her body and her midwife and focus on taking care of her needs
Fewer losses and trauma are possible with continuity of care
The things that people say, but also the things that people don’t say
The Albany Model in an economically deprived area of South London was a gold-standard of midwifery care. It was set up by a group of Independent Midwives and offered woman-centred care with continuity of care. The set-up had to close, despite having exemplary outcomes.
“Freebirthing is when a woman chooses to birth without medical support or interventions”
BBA - babies born before arrival (of the midwife)
Elsie became an independent midwife in 2007
Some women have ‘stepped out of the system’ to birth because they haven’t been well-treated, or don’t wish to return to the system where they experienced trauma. For some women, freebirth is a consideration because they don’t feel that birth is a ‘hospital event’
Freebirth is lawful, but there aren’t statistics on how and why women are choosing to birth outside the system
Freebirthing and the potential link with human trafficking
Some women get reported to social services or the police when freebirthing
Issues of safeguarding e.g. neglect or addiction
Some women who choose to freebirth live a life of autonomy and independence
Supporting women rather than ‘telling’ them what to do it
CNST - ‘Clinical Negligence Schemes for Trusts’
“If midwives are allowed to slow down, have less clients, take time to build a relationship, and remember to put a woman at the top”
“Helping women to remember how important they are in the equation....irrespective about the type of birth, they must be a part of decision-making.”
Normalising pregnancy and birth and avoiding language that cause tension and stress
The trauma of not being heard
Elsie’s experience of raising concerns about patient safety, which led to losing her job, an employment tribunal process and other legal processes. She has undergone the ‘Whistleblowing support scheme’ to support whistleblowers to regain employment in the NHS. https://improvement.nhs.uk/resources/whistleblowers-support-scheme/
Women of African descent have the worst outcomes
“Leadership is more important than management, particularly within professions. Good leaders are able to negotiate, support, and surmount any problems”
Elsie is a Patient lead for ‘Hapier’, and organisation for public and patient involvement at a national level https://www.hapia2013.org/september-2017.html
The feminine way of working with the body v the ‘masculine’ way of thinking
Midwives such as Mary Cronk spoke about these issues
Intergenerational work to ensure that knowledge is embedded