Maternity Experience

MatExp and Hugo’s Legacy

A significant part of Hugo’s legacy includes improving experiences of maternity services for women who have a traumatic birth, and/or whose baby is cared for in a neonatal unit. My particular focus is on making sure language, communication and information is clear and effective at this time, which can be bewildering and upsetting for mums (and dads).

Twitter is a fantastic networking resource, and for the past few months I have been tweeting with a group of health care professionals (HCPs), NHS change agent folk, and other women who, like me, are passionate about helping improve other women’s experience of maternity services.

I was delighted to meet Flo, Gill, Kath, and Carolyn after tweeting for so long. Being able to talk in sentences longer than 140 characters was refreshing! My good friend Michaela was also at the event, and it was lovely to catch up with her.

There are a series of #MatExp events, which seek to get service users and HCPs together to discuss experiences. I went to an event at Queen’s Hospital in Romford, which is part of Barking, Havering and Redbridge University Hospitals NHS Trust.

It is an impressive hospital: the reception airy is airy and colourful. Someone was even playing a grand piano.

The attendees for the event included trust staff from a range of professions and grades, as well as service users. We were sat on round tables: when I introduced myself, I was amazed that someone on my table said they followed me on Twitter. Hugo’s story is getting around!

A comment in the opening speeches about “pregnancy not being an illness” raised my hackles. Yes, for the vast majority of women pregnancy and birth is a natural, wonderful life event. But for some women, pregnancy and birth can be a source of great trauma. Indeed, pregnancy can make a minority of women very ill indeed, as I can attest.

The speech was full of aspiration and positivity, which is understandable in the context of the hospital seeking to become one of the country’s highest-performing maternity services (a few years ago they ranked amongst the worst). However, speakers do need to be mindful of the range of women who are likely to be in the audience. Pregnancy and birth does not always go to plan – there are times when it is unavoidable, it is no one’s fault, and women like me do appreciate this being acknowledged. That’s my soap box moment – it is a point of sensitivity.

Each table played the Whose Shoes game. The game is simple – you roll the dice, move your shoe around the board, and discuss the scenario related to the colour shoe you land on. The scenarios involve getting in the shoes of a mum, or a range of HCPs.

The Whose Shoes Game in action.

My table’s scenarios generated some interesting discussion. For example, we talked about perception around labouring women being ‘not allowed’ to do certain things. The HCPs said they never knowingly say women are ‘not allowed’ to do anything, which is interesting in terms of perception.

In any healthcare setting, a patient may feel disempowered, and feel like they have to do what they are told. Think of transactional analysis: even if the HCP and patient might have an adult/adult relationship in a social setting, a healthcare environment can transform that relationship to a parent/child relationship.

Think about how parents tend to talk to children. The children are given parameters, boundaries, and if they disobey they may find themselves at the receiving end of a wagging finger or sharp tongue. That’s not fun as a child, and even less so as an adult. It’s a key example for HCPs to consider language – what they say, and how they say it.

Of course, as the table discussed, there are some situations where women are told they shouldn’t do things, and for good reason – for example, directly before or after a Caesarean section. In any such situation, the table agreed, it is vital for the HCP to explain the reasons, as well as any suitable alternative options and what they might mean. The HCP can use active listening (paraphrasing what the woman has said) to check their understanding. That doesn’t take long, costs nothing, and has the benefit of helping the woman (or any patient) feel like an equal partner in decisions about their care.

Equality was the subject of another scenario. The scenario related to the needs of minority ethnic women, but sparked a wider discussion about equity of care. The consensus was that women should not be treated equally. That might sound counter-intuitive, but think about it for a moment: every human being is an individual, with their own individual hopes, dreams, fears and needs. In a maternity setting, you and the woman in the bay next to you might be there for the same reason, but because you are each unique individuals your needs are unlikely to be the same.

For example, I was treated differently in some ways to the other mums when I was in the post-natal ward after giving birth to Hugo. I was grateful for the private side room, meaning I avoided being in a bay with mums who had their babies with them. However, the staff didn’t consider all my needs as a new mum whose baby was being cared for in the neonatal unit: I was left waiting for too long to see the doctor on their rounds, for instance, which meant I missed precious time with my seriously-ill baby.

The event concluded with the key points from each table’s discussions included on a giant piece of paper by a graphic facilitator. You can see some of the points in the photo below. Appropriate care for women like me who have had a traumatic birth and/or whose baby is in a neonatal unit is a focus for me and I would have liked to have seen more on that. However, if there is an overall focus on doing everything possible to meet individual women’s needs, as well as other points of feedback, then this will hopefully improve as part of that.

There was then a challenge to decide what the hospital’s maternity services wanted to be known for. I was relieved the suggestion of ‘a positive birth experience for every woman’ wasn’t accepted, because they would be setting themselves up to fail and more importantly, setting women who don’t have a positive experience (for whatever reason) to feel like they have failed. “Having pride in our delivery of care with excellence” was the chosen slogan. While positive, I am on the fence about it (it is pretty standard) but to be fair it was chosen quickly by mass of people who were at the end of a long day.

 

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A is for Action; B is for Bold; C is for Crazy! The #MatExp ABC has been a bit … D for Dynamic!!

Have you been following the #MatExp journey?
Have you been following the #MatExp ABC?

It has been so exciting and so so full on that I haven’t had time to write a blog about it – and I don’t think anybody else has either! But it has been absolutely compelling, with people waking up early each day to post words that reflect key issues around improving the maternity experience of women, sharing good practice examples, building our inclusive community – and having a lot of fun!

I made a visual story book at the weekend using Steller. I should be able to embed it here but can’t get the code to work so here is the link. It was inspired by a walk in the woods on Saturday and has been very popular. It is published today in the Stellerverse…! (No idea what that means except that I guess people like it!)

I cannot possibly do justice to what has been happening in our #MatExp ABC.

There is something about ideas that my #MatExp ‘partner in crime’ Florence Wilcock has which mean that they ‘go a bit viral’ and turn into something way beyond our wildest expectations.

A very small pilotI should have been warned. The very first phone call I had with Florence resulted in us starting a collaboration that has turned into #MatExp. Florence wrote neatly in her ‘little black book of serious ideas’ that she envisaged just ‘a very small pilot’.

Six months on now, we have run 5 Whose Shoes? workshops across London in partnership with the London Strategic Clinical Network and NHS England, and a Train the Facilitator session attended by people from most of the London hospitals and much further afield.

We are now starting to plan equivalent sessions with creative people who ‘get’ the process and are sufficiently open and transparent to embrace it, in other parts of the country. There is a particularly exciting workshop in Guernsey at the end of next month.

So when Florence got that glint in her eye and said she had been thinking about a #MatExp alphabet – one letter a day; Florence leading with one or two words and people invited to join the conversation… I should have had some idea of what was coming!

We have had contributions from so many people. A deluge of tweets every day, and fantastic learning in terms of things that really matter to women, shared with passion and love – or sometimes out of pure frustration.

I have compiled a cross-section of tweets into a Storify, trying to bring in something from all of the main contributors but it has not been easy – please let me know if I have missed you!

The Storify is just a flavour – for the full story, look on the #MatExp hashtag.

#MatExp is a very small pilot. We know that because Florence wrote it in her book so it is evidence-based. So that makes it true… Hmm.

Conversely we struggle to record everything we are actually doing – because we are too busy doing it. #irony

So click on the link to the Storify to feel the passion, the energy and the camaraderie of our shared purpose in #MatExp – and then join in! 

Z may be the last letter of the alphabet but it is only the beginning of the
#MatExp campaign 😉


With special thanks to my friend Ken Howard, who happens to live with younger onset dementia and breaks  every stereotype in the book,  who very kindly designed a logo for us. No meetings, no prolonged agonies, no massive expense (thinking British Airways here)… just a simple request and a quick ‘JFDI’ response, with three different versions. And everyone loves it. Thank you Ken!

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