Katie Moriarty says modern day midwifes are in a key role to help a family and to be an advocate for their needs.

Editor’s Note: The opinions expressed in this blog post are solely those of the author.

Spoiler Alert: This post discusses events in Call the Midwife Season 6 Episode 5

“Bringing up children is not simple.
From the moment the midwife cuts the cord the mother’s task is to nurture and cherish, to shelter and protect. Even as she does so - she must teach the child to leave her.
Train it to let go of her hand. at first to walk unaided and then to walk away.
But there is a cord that nothing can sever …. the invisible bond that ties the mother to her infant, which endures when the child is a child no more.”

This episode brought up issues of advocacy and I really felt that the Nonnatus House midwives, nurses and nuns really met the challenges that they were faced with. Fred and Ivy took on the best interests for Reggie as he struggled with a disability. Trixie built trust and really went above and beyond for Crystal as she dealt with her dental issues. And Sister Monica Joan summed up the feelings that we often have when we truly need to be an advocate after seeing Sister Mary Cynthia by stating …” we must muster our cohorts- we must instruct our troops. An innocent is in danger and one of our own is in a mire of torment.”

As a Modern Day Midwife I truly find myself being an advocate on a daily basis! Each woman or family has their own specific needs and often they need assistance navigating this health care environment. Advocacy is defined as one that pleads the cause of another; one that defends or maintains a cause or proposal, or; one that supports or promotes the interest of another (Merriam-Webster, online dictionary). At the root of being a good advocate is having the desire to help! Many people can be an advocate—a friend, a family member, a healthcare provider, a case manager—and there is a newer term that we often hear which is a patient navigator. As a midwife, we are in a key role to help a family and to be an advocate for their needs and desires and to help optimize their health and their outcomes.

Some skill sets that have been thought to be helpful as you try to advocate for another can be some of the following: It is helpful to be able to research a topic area to find quality evidence. Having a critical eye as you read the evidence base to see both the strengths and limitations and how it will fit for that specific situation. Then you need to really kick in with your problem solving skills. You often have to be creative and think how you will navigate the many issues and options. At times you will need to think outside the box. You need to think of each option along with their pros and cons. You need to have the person that will be impacted sharing in the decision making process.

The most successful times are when everyone works as a team—an interdisciplinary team. There has to be open communication and trust within that team. If you feel resistance—you must be persistent and at time really pull on your patience level!! You must be unafraid and persevere –but if you have empathy for that person and their issue then you must carry on.

The issues of ‘vulnerable populations’ still abound! However, look at the victories within this episode. Reggie and Crystal had amazing advocates and it felt like a true success story for both. However, Sister Mary Cynthia—we will need to see how this unfolds. I found it heart breaking; however, I know that her “family” of friends and colleagues will use their love and their amazing advocacy skills. Somehow I feel like Reggie—and just want to ask ‘where will the little hand be when her problem will be solved’. As I know time is of the essence.

“And so we let go of the hands but not their hearts — the need to be needed but not the need to love. And, however much it hurts — there is joy within that moment … because of the unseen cord that binds us and which will never break.”

Katie Moriarty, PhD, CNM, CAFCI, FACNM, RN is a professor on faculty at Frontier Nursing University and a Certified Nurse-Midwife with WSUPG CNM Service at Hutzel Women’s Hospital in Detroit, Michigan. Katie serves on the Board of Directors for the American College of Nurse-Midwives as the Region IV Representative. Previously she was the Associate Director of the Nurse-Midwifery Education Program at the University of Michigan.
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