Trust

To trust someone, we must have confidence in them. Between a woman and her midwife, this means confidence in each other's abilities. It also means confidence in each other's good intentions.

A woman needs to feel that you have the skills and experience to help her through this intense and sometimes frightening process of labour and birth. But she also needs to be sure that any advice or recommendations you offer are for her benefit, and the benefit of her baby - not to protect you, or for the convenience of your organization.

Equally, you have to be able to trust her capacity to give birth normally. Of course, if there is some reason why she cannot you need to explain this to her and plan an alternative course of action with her. But if you have lost confidence in the normal processes of birth, or feel under pressure to 'make things happen', your lack of confidence or urgency will communicate itself to her. She may then lose confidence in her own ability to give birth normally. This In turn may have the adverse effect in triggering 'a cascade of intervention'.

Beyond everything else, her willingness to trust you critically depends on you being there for her.

Handing over control

An important aspect of trust is being able to hand over control to another person when needed. None of us like giving up control, especially when we feel uncertainty, but true control can occur with the realisation that in some situations somebody else will make the right decision.

But...

A woman's need for control in labour ebbs and flows in an almost 'tidal' way according to how confident she feels. The physiological processes of labour are not under conscious control, and letting go of this control is different. It is about do go with the flow or do you swim against the tide. When she feels most attuned to the processes going on in her body, her willingness to give up the desire to be in control, and 'go with the flow', will be strongest. When she doesn't know what is happening to her, and her pain and anxiety seem overwhelming, she may rely on control being the only way to cope or feel 'safe'..

Trustworthy advice

You may not always agree with a woman's choices, but she does have the ultimate say. If it is important to challenge her decisions, you need to be seen by her as an absolutely trustworthy source of advice. If she thinks that you are withholding information or concealing something that might influence her decision, the trust between you will break down.

If you believe, and trust, the advice you are giving her, she will perceive it as 'trustworthy' (whether she agrees with it or not). But if you don't believe it, this will be communicated non-verbally through such things as your tone of voice, expressions and gestures.

Tips and tricks

Look at the people you trust – not only at work, but also generally in your life. How do they behave towards you? How do they speak to you? What makes you feel you can trust them? How can you put these things into practice with the women you work with?

Don't be afraid to state uncomfortable facts - be open and honest In your communication with her. If your body feels tense or you feel anxious, ask yourself why? Are you out of our depth, are you hiding something or are you uncomfortable with the situation or advice?

Respect her views, opinions and choices - learn to listen, and to hear (not the same thing!). Also watch her body language - does it accord with what she is saying, or does it seem to be saying something else? Can you accept the decisions she has made for herself? Do you feel a need to steer her choices towards your own experience or beliefs?

Trust

Handing over control

Trustworthy advice

Tips and tricks

Further reading