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A Good Head and a Good Heart


Various events have conspired recently to strengthen my resolve to ensure that every woman and man about to become a parent has access to some really good education that’s timely, relevant and inspiring.

The first was reading the presentation made by the CEO of the Early Intervention Foundation, Carey Oppenheim, to the NSPCC conference, ‘How Safe Are Our Children?’ Carey noted that in countries where there is a relatively small gap between the rich and the poor, such as Denmark, children do better. Fewer babies die at birth and in the first year of life than in the UK and older children appear to be happier. This observation reminded me of a rather bitter conversation that I had with a midwife recently who told me that she had left the NHS because she had been summoned by her manager to explain why she was spending so much time talking to women in labour when her notes weren’t being properly completed. For this particular midwife, it was the blow that finally convinced her that she could not practise as a true midwife in the NHS, but only as an obstetric nurse/secretary. Yet this midwife – whom we quite definitely cannot afford to lose – worked in a very disadvantaged part of the country where most of her clients were poor women. Often, these are the very women who need the reassurance, the self-respect that comes from having a professional talk to them, rather than ‘at’ them, and spend time with them. This was a midwife who took an interest – not just in the fetal monitor – but in the wellbeing of the mother, in her life, her aspirations for motherhood. She was, in her way, lessening that considerable gap in our country between the service that the affluent can obtain and that which the poor can. She was also living the agenda outlined by Carey Oppenheim, namely that if we put more effort into the Very Early Years, then there will be less need for intervention spending later on.

And then I found myself at a conference in Dublin. I wasn’t there as a delegate because the topic of the conference was Duchenne Muscular Dystrophy (DMD) – not my field at all. I went because a close friend of my husband has three gorgeous little boys, all of whom have DMD, and all of whom will have very short lives. The suffering of the family and those close to them is unimaginable. Services are either non-existent or fragmented and disconnected. The boys’ mother, Paula, who has set up a Trust to galvanise the Irish Health Board into providing services for children with DMD and to support research into finding treatments and a cure for this appalling disease, spoke to launch the event. Her message was exactly the same as Carey Oppenheim’s, namely that we need, ‘a different way of working – one which is built around the wellbeing of children and families rather than separate departments, funding streams and working in silos’.

Paula also said that, ‘education is what changes the world’. She meant that if we can educate everyone – people, clinicians and health service managers - so that they are more aware of DMD, then services will start to come into being that address the needs of affected families, rather than simply addressing the clinical symptoms of the disease. And the same holds true for childbearing families. We need to look at families, and stop isolating mothers and their ‘fetus’ from the world in which they are going to bring up their children. And secondly, we need to educate women to ask for, to insist on the loving support they need to bring their babies into the world feeling strong and prepared for parenthood. The midwife who told me her story was doing just that – she was offering women who may not have known a great deal of respect and care in their lives – the total respectful attention that would transform their experience of becoming a mother.

At the DMD conference, Paula spoke of the importance of having ‘a good head and a good heart’. I think we’ve got the ‘good head’ bit out of all proportion. Yes, ‘the evidence’ (limited though it always is) and the paperwork are important, but if they trump ‘the heart’, the sensitive, responsive care that should be offered to all women, regardless of their socio-economic background, then we are on a losing wicket – all of us, every family.

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