Respectful Care With a Sense of Momentum

The words "conference" and "passion" don't usually sit well together, but at the Dignity Conference at London's Royal College of Physicians last week, delegates were making a lot of passionate noises. Angry sounds of disapproval at tales of women deeply damaged during birth; enthusiastic bursts of applause at news of progress for midwives and mothers.
It was both cerebral -- How do we define "dignity" in law and human rights statutes? -- and also emotional. A huge hubbub during the breaks saw new friendships forged, old friends hugging. It was also a rare and potent combination of midwives and human rights lawyers, doulas and academics, brought together by the newly launched Birthrights Campaign in the UK, united in wanting better births for all women everywhere.

This connection of heart and head adds up to a passionate activism that spells change.
It was also a historic moment. For decades, maternal health activists have struggled to convey the outrage of women dying in childbirth (mostly in Africa and Asia) to those who live in countries where it rarely happens (like the UK). The story of maternal mortality has been a bleak one, and even though the numbers are down by half in the past decade, the women who mostly die have long been seen as strangers in strange lands. "Them," not "Us."

But now, through the lens of all women's right to dignity in childbirth, we are connected. A woman in the UK, hurt and depressed after a sudden forceps delivery, now feels common cause with the Asian or African woman who was neglected on the overcrowded maternity ward.
Birth is essentially the same wherever we live in the world, but the investment in it has been dramatically different, leading to the biggest health inequality on the planet. "Dignity" gives us a language to close the gap.

Meanwhile, the historical "us" helping "them" has been reversed. Leading midwives and other maternal health professionals in London are now adopting the White Ribbon Alliance Charter for Respectful Care that has been crafted by their counterparts in Lagos and Lahore.
Another uniting factor is that in countries all over the world, midwives are the agents of change, determined to root out abuses and to make sure that their profession has the status it deserves. One of the bursts of applause came when I told the conference how White Ribbon Alliance in Nepal had launched a sustained media campaign, including prime time TV, to make women aware of their rights in childbirth. This has culminated in the language of respectful care being included in a new Bill for safe motherhood which goes before Parliament in a few months' time.
Similarly, the Nigerian Health Minister has pledged that the Charter for Respectful Care will be applied to every level of the Nigerian health system, so why not here in the UK? Pioneering midwives at the Barking, Havering, Redbridge University Trust are already using the Charter and the White Ribbon film to train all their midwives in Respectful Care. The UK has always been a leader in midwifery, and so the ripples of change which have reached here will bounce back, re-energised.

It remains a scandal that childbirth is the leading cause of death for young women in many countries -- and that is fortunately a far cry from birth in the UK. But the concept of dignity, our universal rights to respect and care during childbirth, connect all mothers and midwives, wherever we live.