|1. The mother eavesdrops on a professional discussion.|
2. The anxious body language of the father who is left with responsibility during a spell of fetal bradycardia. Later he told how angry he felt at being left alone with his wife. The mother is not relating to him; grandmother provides essential support.
3. A mother who had had a previous stillbirth is left alone.
4. The professional communicates anxiety; a tired midwife, after midnight, is uncertain what she should do. No words pass; frequently information is given when monitoring is normal, but not when it is abnormal.
5. A mother using gas and oxygen for the first time is ignored by the midwife although having difficulties. The father tries to help her.
6. Unjustified written record keeping, every 10 minutes, taking the midwife away from the mother.
7. The record writing is done at the bedside, with a great improvement in communication between mother and midwife, eye to eye contact and questioning, and increased confidence.
8. Only when a mother says – worried by the monitor – It’s scaring me now, does she get attention. The midwife sits with her for only a minute, although it is known that mothers may, in these circumstances, believe that their babies are dying, although scared to express this.
9. It has taken a midwife an hour to familiarize herself with the paper work after a shift change. Their has been very little conversation between the parents or with the midwife, but as soon she sits with the mother the atmosphere is transformed; bedside manner is a phrase with real meaning.
10. A newly qualified midwife given a complex case is too stressed to notice that the mother is having to rub her own back; the mother is lying naked from the waist down and exposed. Where is respect for the mother’s dignity? Is good caring practice being neglected in the over-academic training of today’s practitioners?
11. 59 vaginal examinations were carried out in the 111 hours of observations. This midwife has not washed her hands; there is no trolley and zero communication. We see a power relationship in action, with the mother’s humiliation and loss of self esteem a likely result. A negative effect on parenting is not improbable. Routine procedures have to be carried out with sensitivity.
12. Grandmother is present during this vaginal examination, good communication and more hygienic technique result.
13. The father hides as his partner is prepared for epidural. Often too much is expected of fathers; they may not understand her needs, may themselves be frightened, and so cannot give support.
14. The father is left alone with a woman severely distressed by her pain.
15. A mother the centre of attention and well supported when a friend is with her, and the father has the confidence to be useful.