I was recently asked to write a ‘Day in the Life’ to be part of a feature on maternity people in a journal. I wrote two versions, one an actual day (our April MSLC meeting day), and the other this more reflective piece. I thought that explaining ‘how I got started with this, and what happened then’ might be more helpful than ‘what I do now’. The editor chose the hour-by-hour day. So I am posting this here now as a companion piece to my blog about the NHS Constitution: for maternity commissioners – to explain a little about what volunteer service user MSLC members ‘do’, other than attending formal meetings.
Also acknowledging my many service user rep colleagues for the hours and hours of unpaid time you commit to the work. Those who tell their own stories; those who stay and facilitate the involvement of others. The time listening to women and families; the planning and prep time; the writing up; the meetings; the reading things that make your head hurt (research, policy) because if we join in knowing more of that stuff, maybe we can be more effective – maybe we’ll be heard. Because it takes many working together to see something like the whole picture, and to say clearly, together, that no one of us has the right to speak for all women, or to tell women in general ‘what to think, what to do.’ (6 May 2016)
I used to be a quiet, rather academic property lawyer, my days spent among papers, sorting out complex legal problems. I didn’t especially enjoy telephoning people, except other lawyers. Talking my way into things without an invitation was not me. Calling my local community centre and asking to visit a mother and baby group to listen to the mothers’ views about their maternity care, was a bigger deal than you might think. Off protocol. No rules, no formal roles, no idea how things would go.
And so it was with some anxiety that I first left my toddler and my baby with a friend for a couple of hours and, sitting on the floor of the community centre on a brightly-coloured mat, among baby toys, began to teach myself about public engagement and involvement. It worked! Women are keen to share their stories if someone will listen quietly and without judgment, especially if they think that they can ‘make a difference’ to other women’s experiences.
Along with praise for staff kindness, the common theme that emerged from those first conversations was women’s concerns about the cleanliness of postnatal ward bathrooms. I typed up their words and took the report to the multidisciplinary NHS ‘MSLC’ group of which I was a service user member. The Head of Midwifery duly had discussions with the cleaning contractor. I called the community group facilitator to ask her to tell the group that sharing their experiences had made a difference.
This was the start, back in 2005.
By 2014, I was serving on a different MSLC, having moved house, and wanting to stay involved. I was also a Lay Member on the soon-to-be-published NICE Intrapartum Care guideline CG190, devoting one day each week to maternity work. My typical maternity day began early, contacting community groups by phone and Facebook, to arrange listening sessions to be facilitated by me or one of my team of volunteers (I was chair of the MSLC).
Then out mid-morning to meet with women, always moved and always noticing the diversity of views. Two recurring themes: how busy and overstretched maternity services are – and how much good communication and kindness matter. Carefully rolling up the flip-chart sheet afterwards, the paper covered with sticky-notes on which the women or I have written their words. Home for a quick sandwich and more emails.
In the afternoon, a NICE editorial conference by phone, working on the information for the public with the NICE editor, my lay colleague, midwives and doctors. Much lively discussion; everyone keen to empower women to make evidence-informed decisions about their care.
Dinner with the family (“Babies, Mum, always babies!”) and then a cup of coffee and my laptop to turn those sticky-notes into a tidy report. Quick email to a midwife friend asking questions about a research paper I’m reading. Bed.
Twitter has added something new to my work; a maternity policy report read over breakfast and tweeted as @BerksMaternity to #MatExp contacts – women, midwives, researchers, doctors, doulas, families, and birth people of all kinds – is a usual start to the day. What I like about Twitter is the sharing of ideas – keeping up with research, and news about projects and good practice – and the networking. Links made on Twitter mean even more effective networking at real-time-and-space events like #MUNet16, the official launch of the Midwifery Unit Network, where I was proud to represent the steering group of UKmidSS – a study system set up to conduct research that matters to women, collecting information about care in midwifery-led birth settings like Alongside Midwifery Units.
So what do ‘MSLC service user reps’ do? What is a ‘lay advocate’? A ‘maternity lay representative’? ‘Why do you do this work?’ Many answers. Service user reps are diverse, and we have different backgrounds, views, ideas. We network regionally and nationally. We’re talking every day. We are networked with our healthcare professional and commissioner MSLC colleagues.
Woman-centred, individualised, maternity care. Evidence-based services, with real choices, and respect for women’s decisions. We’re part of making it happen, because these things are important (see case studies) for all women using maternity services.