I became a direct entry student midwife in 1978. It was a time when the Peel report stated that all babies should be born in hospital; when the medical ethos stated that all first-time mothers should have episiotomies and that one episiotomy was an indication for another -- necessarily in implying a 100% episiotomy rate; when the use of induction for the social convenience medical staff was the subject of BBC documentaries. The Association of Radical Midwives had been formed by a number of students in 1976. All these issues were well reported on the Guardian women's page and the feminist magazine Spare Rib. My reasons for becoming a midwife were very complex but they were made in this political context. I believed, and believe, that childbirth is a feminist issue.
I became a member of ARM soon after becoming a student. There were regular meetings with AIMS and the NCT at the NCT headquarters in Bayswater where we students soon learnt there was a group of community midwives including Janet Jennings, Juliet Wilmot, Caroline Flint and Mary Cronk. These midwives were notable because they had been trained at a time when district midwives came under the jurisdiction of the local authority, not the health service, and they therefore had much more autonomy and were used to taking clinical responsibility. They had been trained and practised at a time when home birth was the norm. They had encountered conditions of dire poverty, undiagnosed twins and breech births. Coping with all this was considered within the midwife's remit. These midwives considered these recent developments to be bad for women and midwives. They were bad for women because they reduced choice and bad for midwives because they eroded clinical autonomy. They unthinkingly prioritised the medical and the medical was not necessarily the right physical or theoretical context in which to have babies. These midwives, with their assumptions, criticism and experiences were certainly an example to me.
Midwives have traditionally interpreted instructions to suit what they considered the best interests of the mother in a somewhat covert fashion. When there are policy time limits on the length of second stage we soon learnt that it was best not to define its onset. And the famous historical example in the Book of Exodus in the Bible shows midwives being very economical with the truth when Pharaoh wanted to know why the Jewish babies were not being killed according to his instructions (those Hebrew women just deliver too quickly...) One fellow student of mine used to drop the episiotomy scissors on the floor. I was never brave enough to do anything so obvious and just used to delay until I could honestly say that I thought it was too late. But Mary was utterly courageous and assertive. She explained that she was not going to perform episiotomies unless she considered them clinically necessary and told the consultant obstetrician that he could report her to the Central Midwives' Board if he wished, offering to give him the address. Of course he did not do so.
Throughout her career Mary has used all her clinical skills. She must be the world's authority on how to safely facilitate vaginal breech birth. She has shared her expertise, especially in the 'Day at the Breech' workshops. When she was awarded the MBE the Queen asked her how midwifery had changed and Mary replied that it was kinder. I fear greatly that NHS midwifery is under threat: I fear that the NHS is under threat. But insofar as the profession of true midwifery still exists, both in the NHS and independently, Mary as a practitioner, teacher and member of ARM deserves much of the credit.
I remember travelling down with Mary on the train from Liverpool to London after a conference on Supervision organised by ARM. At one point she fixed me with her gaze and I remember thinking 'this woman is wise. She really understands the non-verbal.' And midwives need to understand the non-verbal because when women are in labour they are on a level other than the rational. This is not a skill which can be learnt from books but only from experience. Mary's experience will be desperately missed. Is there anyone with the energy and skill who can transcribe Mary's experience and create a book?
With love, Meg Taylor