More misogynistic crappery from the madwives
An NHS BLOG DOCTOR emails to draw my attention to the recent outburst from Dr Denis Walsh. Dr Crippen has never heard of him, but apparantly he is an eminent professor in Nottingham. A professor of midwifery no less. A male midwife. Not many of them, and the few there are do not receive a warm welcome from the RCM. They are tolerated in the name of sexual equality, but that is as far as it goes. There ought to be a law regulating the use of the word "Dr" for people who work in a medical environment. "Dr" Walsh is not a doctor in the ordinary sense of the word. He is not a registered medical practitioner. He is a midwife with a PhD from the University of Accrington.
"Dr" Walsh has made a fool of himself. He claims he has been misquoted but he ought to know better than this:
The pain of childbirth may have benefits on which women who opt for painkilling epidurals miss out, a senior male midwife has said.
Dr Denis Walsh, associate professor in midwifery at Nottingham University, said pain was a "rite of passage" which often helped regulate childbirth. He said it helped strengthen a mother's bond with her baby, and prepared her for the responsibility of motherhood.
We are used to this sort of patronising guff from the madwives. NHS BLOG DOCTOR readers will recall that most midwives prefer women to suffer during labour
I wonder what "Dr" Walsh studied to get his PhD? Whatever it was, he should be aware that his customers are not happy:
And yet I still think the man is a twat.
What prepares women best for the first few months of parenthood- where bonding vies for equalpalce with sleeplessness, nappies and a whole new life- is being able to face that without having to also deal with severe PTSD, and the resultant possible post natal stress. It's not soemthing all women experience but is is what some poeple do (a browse through birth stories on here can make for enlightening reaidng if you've been as lucky with your births as I have been).
Absolutely women who want and are able to go without meds should be supported but taking the option away is mysogynistic crappery at its best. Would [Denis Walsh] have a vasectomy sans pain relief? Would he even have a headache without an aspirin FFS?
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I have to agree that Walsh has made a catastrophic error on this one.
In midwifery circles, Walsh is VERY well-known & by many midwives he is highly rated. I know 2 male midwives & I must say, they are not 'tolerated' by their colleagues (though I cannot speak for the RCM. The male midwives I know are caring practitioners, who are highly skilled and respected - gender doesn't appear to play a role in how we as fellow midwives view them.
There will always be some who disagree with male midwives, but perhaps these same people disagree with midwives like me, who have not (and, unfortunately cannot) had children.
I feel as midwives that we need to move away from the 'pain is good' attitude of the NCT movement. But we're damned no matter what we do. If we offer early pain relief, evidence shows that women have a MUCH increased chance of an instrumental birth, which of course carries the tag of an episiotomy, which features on EVERY birth plan i've ever read! "I do NOT want you to cut me" etc etc. So if we get them an epidural, when we know that they are in very early labour & that this is going to go on for many many more hours, we are putting women in that place where obstructed labour is almost a given, then they fail to progress, we go for trial, they have an epis, & oh dear, a section.
Did we fail because they had a cut, or did we fail because we didn't use our skills to help them cope better before we called in the anaethetist?
We are between a rock & a hard place. Women complained in the seventies that they wanted to have all births in hospital. They complained in the eighties that they didn't get enough epidurals, they complained in the nineties that they didn't get enough drug-free home births & now.... in 2009, they want MORE pain relief.
The NHS is desperately scrambling about to offer women the home births they said they wanted in Maternity Matters & Changing Childbirth, & for what?
Heartily concurr. What a twat ! He ought to be made to endure childbirth himself and then reflect on these views. As a man, if I had to do it; I have been present at the birth of two of my own, the human race would die out before I would. I well remember the words 'get this fucking thing out of me' and the prissy midwives response.
This guy is a mysogynistic fuckwit and is typical of the 'dumbed down' arsoles that people teaching hospitals and attain a status appropriate to thier to level of stupidity. I know his hospital and it is a bloody disgrace to even be called that. They spend my money paying halfwits like this to dictate policy and teach others the same crap he trots out whilst the edifice is crumbling around thier ears. They cannot even prevent heatstroke on wards due to lack of any cooling and have no intention of installing it. Thier new treatment centre is on its third service provider because the other two went bust and the level of patient care is so abysmal that they have to chain them to the beds to prevent escapes.
The place needs burning down with this guy as the 'wicker man'.
I don't buy the pain/bonding thing. In the worst cycles of dysmenorrhoea, I would vomit and pass out and I vividly remember the pain. Knowing that another human being put me through that would only cause me to resent them, thus slowing down the bonding process.
He does make a good point that with better midwifery care, more support, nicer environments etc, women could get by without so much pain relief. But could doesn't mean that women want to. It never sounds like it on internetland, but in real life, the 'natural birthers' are in the minority.
Epidurals have become a kind of norm for a lot of women. Sometimes women think, 'I just want to get rid of the pain, how fantastic'
God, what a terrible world we live in where available pain relief is the norm.
Oh, and at a very well known abortion provider, women having abortions with local anaesthetic get a topical gel (which does naff all and just serves as a lubricant to get the cervical dilators in). On vasectomy day, men get an injectable anaesthetic.
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"There ought to be a law regulating the use of the word "Dr" for people who work in a medical environment." I'd settle for a convention - to match the one where medics who lack a doctorate don't refer to themselves as "Dr" in a research environment.
"There ought to be a law regulating the use of the word "Dr" for people who work in a medical environment." I'd settle for a convention - to match the one where medics who lack a doctorate don't refer to themselves as "Dr" in a research environment.
*********
He is entitled to use the title "Professor" and the press should use this form of address to avoid any confusion!
Rather well covered at the Daily Mash -
http://www.thedailymash.co.uk/news/health/women-to-force-hat%11stand-into-anus-of-male-midwife-200907131899/
"We've set up the paddling pool, or 'hat-standing pool' so that he can see for himself exactly how much difference that will make."
Love it
i am a doctor of midwifery . i always tell the airline when i am travelling so that hopefully i will be upgraded into business class. of course i never go near any womans breast of fannys. No i became a professor because i am academic, i lecture, i write papers. methinks its the same in the medical profession? i mean the professor is the one in the lecture theater talking to the medical students. however it is the staff grade who can deliver a breach birth, on a plane flying from dubai to india.
I think the Daily Mash article says it all- hehehe :D
Neelu
I was reminded of the episode in Friends where Ross and Rachel are at the hospital, i think to visit her dad...
Ross: Hi, i'm Dr Geller.
Rachel: Ross! That means something here!
Whilst I agree with most of the stuff you write "Doc", I cannot possibly concur with your belief that only medical practitioners should be able to use the title "doctor".
In actual fact it should be the other way around.
Most medics do not have an MD or PhD. "Doctor" is simply a conventional honorary title. "Doctor" is an academic degree, not a profession.
If this confuses the public we should educate them.
Incidentally, I'm neither an MB nor PhD, so I have no axe to grind.
Doctor is both an academic degree and a profession.
People with a PhD are perfectly entitled to use the honorific "doctor", but the fact is that in the work place there is significant potential for confusion for patients. If someone comes up to you in hospital and introduces themselves as Dr X, your natural assumption unless informed otherwise is that they are a medic. Therefore I believe that non-medical PhDs should avoid the term when talking to patients.
They should legitimately describe themselves as doctor in the other aspects of their professional life, and do what they want in their private life.
And yes I am a medic with a PhD so can legitimately describe myself as doctor, but in fact I never use the term unless I am talking to a small minority of patients (usually of a certain age) who expect it, or occasionally on the phone where it is sometimes easier to establish who you are and what your role is.
But you can't help the feeling that one reason for the problem is that some (usually male) nurses and midwives do not feel that the status of their profession is as high as it should be and therefore want to mark themselves as superior to their fellows. Maybe if we (professionals and patients) accorded them more respect they wouldn't feel they needed to do it.
"[Walsh] is entitled to use the title "Professor" and the press should use this form of address to avoid any confusion!"
Well, in the UK both those statements are debatable. "Associate Professor" is actually Nottingham's new name for what used to be called in most Universities "Reader" - i.e. an academic grade above Senior Lecturer but BELOW full Professor.
I would say it was appropriate to say "Denis Walsh, who is an academic midwife with a PhD"
Misquoted or not, two schools of thought do exist with giving birth - as nature intended - 'working with the baby' and contractions or science based intervention numbing the mother's 'senses'. Money is not a factor in the first option, whereas profit making pharaceuticals are involved in epidurals. The latter may relieve pain, but not risks attached to a spinal injection.
Dr Walsh will, undoubtedly, raise the wrath of those focussed solely on profits epidurals yield, given their increased usage.
Without request or explanation, I was injected with pethadine in the final stages of giving birth to our second child - like a drunkard, I lost muscular control and could not physically work with the midwive's instructions - I was blamed for the tearing I suffered for not doing as I was told !
I refused pain control for my third birth experience.
fisting,
In the world of nursing and nursing academia, 'breach' is spelt 'breech'; the birth canal refered to as the 'vagina' - not 'fanny'.
according to a study of people are prone to bad these positions and strokes are much easier to be with chronic pain for life, the spine and head are the most sensitive areas for the sport, and there are many who will be prone to chronic back pain, so be careful and prevent, as in findrxonline show that chronic pain should be controlled normally by NARCOTICS opioids as vicodin must be very careful with these medicines.
The first problem with the kind of "natural good, pain relief nasty" positions loosely articulated by Anon Thurs 5.26 pm is, fairly obviously, that some women find the pain not bearable with gas'n'air. And for women who are induced, where the pain is worse, even Denis Walsh concedes that epidurals are "useful", if you track down the Powerpoint presentation of his lecture to the RCM (which gave rise to the story).
And the idea that doctors giving epidurals "serves Big Pharma profits", and that that is an real issue, is utter idiocy.
While Walsh arguably has a point about the ever-rising rate of C-Sections and epidurals, the remarks about "pain being good for bonding" were remarkably crass. And it bears saying that banging on about:
"It will hurt like nothing else ever, but PAIN IS GOOD and marks your being a REAL MOTHER"
(see any Sunday supplement near you)
- is fairly evidently going to be counterproductive in trying to persuade most women to take less pain relief. When Mrs Dr Aust was sticking in epidurals as an anaesthetics trainee one of the most common types of patient she met were women who had been scared witless by a "natural pain enthusiast" at some prenatal class. These women were clearly terrified of encountering the kind of midwife (one hopes apocryphal) who would snort in derision at the mere suggestion of pain relief. So they asked for an early epidural.
What is so difficult about saying:
"Having a baby is natural, but will hurt, as you doubtless know. If it gets to hurt more than you can tolerate, rest assured we can and will help you with the pain. Here is what we can do, including drugs and epidurals".
That kind of approach - which one hopes is what really happens when we can get past the daft rhetoric - is surely something Walsh and the more interventionist people can find some common ground on.
Declaration of potential conflicts of interest:
I am a man, like Denis Walsh, so I know what Mrs Dr Aust tells me, as she is the one wot had the sprogs. We had induction / epidural / assisted labour first time, natural delivery with gas'n'air second time. Both were fine since they produced healthy babies, which was rather the point.
Anon @ 10:38
I don't know where you get your research, but epidurals given appropriately (ie after the onset of active labour, usually around 4 cm dilation) have not been shown to cause dystocia.
If you are giving an episiotomy and THEN going for section, what in hell are you doing? The decision point for section is much earlier than the one for episiotomy and there is almost no reason why a patient with a competent provider should get both.
Anon @ 5:36
Pharma is making pots and pots of money off every epidural yes indeedy. What with them using morphine for epidurals (granted, epimorph is slightly more expensive than regular morphine) which is all of oh, pennies a dose. It would be nearly as expensive to use aspirin.
/sarcasm
"assisted labour" as in oxytocin drip, I mean - NOT assisted delivery with Ventouse or forceps
professor capgrass gave birth 4 days ago. he is now at home and needs to open his bowels for the first time since delivery. he is alone in the house. (well mother in law is down stairs with baby). No NO one is around now to mop his brow and offer gas and air or iced water to sip or encouraging words. Certainly there is no way anyone is going to come out and do an epidural. EVER tried to open your bowels when you are constipated post childbirth?(epidurals slow peristasis as do codiene tablets/pethidine and lack of excersize. further more no one wants to push much down there as things are pretty raw and apt to prolapse (and not just the womb). AGONY. No one tells you about this. No one. its like childbirth all over again, and no one offers to be your dowla. So dont worry: baby is bonded.
That's ok - I had 2 'normal abdominal' deliveries both booked as soon as I found out I was pregnant (the first time with twins). I thoroughly recommend this method as I am still 'honeymoon fresh' so to speak and I had no trouble bonding with my babies. I hate feral midwives (particulary male ones!) who presume to know what is best for the expectant mothers in their care. What a load of shite.
Fisting; classic... A nursing professor who can't spell or punctuate. Says it all really eh?
Mark UK, I think if you read what Dr C was saying, he had problems with the use of the title Doctor by non medics in a medical environment. Yes, it is an honorary title, but if nursing staff or paramedicals use the title it becomes very confusing for patients, no matter how well educated they are. It may also cause legal problems with informed consent.
I'm a medical student, and when seeing patients, there is a cohort that no matter how many times I tell them I'm not a doctor, they will call me doctor in their next sentence. Not ideal.
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Er..Im not a health care professional, I just gave birth 14 days ago.
I had so much gas and air that my voice changed and I started doing Gordon brown impressions as they were sewing me up
Basically, it fucken hurts, and pain relief is good.
It is medieval to suggest that it is otherwise .The main problem with epidurals is it slows things down and you can’t feel what’s happening. Like giving a speech after dental injections.
Staying upright gets labour going quicker (Gravity good) But if your legs have been jellified its not possible.
It’s very like at my old school when you broke the rules. You had a choice of the painfully drawn out 100 lines or the ten fast hard slaps. Most of my peers took the slaps, nasty but got it over with.
I had a back-to-back labour 14 days ago and I did cry out for a walking epi, it was at that point the midwife knew I was in transition and I gave birth shortly after. An epi would have prolonged the agony and caused a hell of a lot more damage than what I got away with.
I did my homework (Knew in advance that the babies head was size of a mekon and learnt about positioning, i.e. McRoberts position, knew what to do when the midwife call her college in to do it at one point)
I think it’s unfortunate that a man made these comments, I think Iv herd some even more ludicrous bollox from other women about the spiritual aspect of Birth. If you every wonder why your mothers a bit bonkers it can be accounted for by the pain during your birth your mother went through.
I do feel proud its something I and baby survived, lucky me for being born in the right country and not dieing under a bush somewhere.
I hate all the really hippy crap talked about birth and had no other thought of having my baby in anywhere other then hospital.
I also wanted it over and done with quickly, so only wanted other medical intervention if it was really necessary as, with a doctors best intention at heart, will unwittingly slow the process down.
I met the women how had my birth if I had of gone for epi at the hospital. She was back to back with a big baby too. She went for the epi, had extended labour and ended up with forceps. I came home with a small tear a day later, she’s probably still up there on the ward walking like she got a raw egg clutched between her buttox.
The most awesome part of my birth, as I opened my gas and air fogged eyes, with my legs up in stirrups, was my husband eating a chicken teekca sandwich as he watch my fanjo being sewn up, now that’s what I call a right of passage.
As an occasional obstetric epiduralist I recall listening to a lecture (Wellington, NZ) given by one of the two accredited nurse epiduralists in the UK---both based in Nottingham. Did Prof Walsh know he was being disloyal to the sisterhood??
On the "Dr" argument that's broken out.
I think it's in incredibly bad taste for a PhD (which I hold in Chemistry) to use the title Dr outside the research environment i.e. outside of work with the public.
Yes historically I have more claim to use the title "Dr" than Crippen does; but the assumption the public makes is that you're a medic and as such you run the risk of misrepresenting yourself. Use the suffix PhD if you must. (Obviously make exceptions when applying for credit or trying to get upgrades!)
We need to be much less precious about this. Especially as the world and his dog seem to be able to get a PhD in just about anything including apparently squeezing babies out which I believe used to happen before we had PhDs in it...
Dave PhD.
In a previous existence I came across a number of research proposals for PhD degrees from the University of Accrington - sorry Central Lancashire mostly in the health field. I would not have given a Masters degree to most of them. You will forgive me if I remain anonymous on this occasion.
I think it's in incredibly bad taste for a PhD (which I hold in Chemistry) to use the title Dr outside the research environment i.e. outside of work with the public.
********
It's also, by the same token, incredibly bad taste for a medically qualified doctor to use the academiv title "Professor" outside of the teaching and research environment of a University!
I doubt Denis Walsh would refer to himself as "Professor", see earlier comment, as the sniggering from UK academia and medicine would be deafening - there are full Professors of Midwifery in the UK, after all, and he isn't one.
While he certainly is entitled to call himself "Dr", it is good to avoid the title outside academia since mostly people do interpret it as "medical practitioner".
As a PhD type "Dr" myself, I have only ever called myself "Dr" outside the University in two settings: first, to get a rather less than sympathetic bank manager to be more understanding when I was a very junior and very impoverished academic; and second, in my "blog nom de guerre". And the latter is only because I picked the name in about two minutes several years ago, and I can't be bothered changing it.
Incidentally, based on my experience over several years at evening Spanish classes, where I regularly used to get quizzed about peoples' stiff shoulders, arthritic knees, or favourite herbal supplements, many of the public can't grasp the difference between a PhD and an MBChB doctor even when you tell them clearly "I am NOT a medical doctor".
Well, clearly if someone uses the title Dr in a medical environment then a lay person will presume they are a medical doctor.
In terms of childbirth you do tend to have better outcomes if you can avoid anything more extreme than gas and air but obviously a lot of women need a bit more because childbirth does tend to smart somewhat.
I think the whole "bonding" thing is very hard to quantify and am not sure how experiencing more pain would help the process?
I think that midwifes are fully within their rights to explain the benefits and problems of pain relief but should leave emotive terms such as bonding out of it.
These points to an interesting article in findrxonline where they talk about this subject it is necessary to inform the community.
It is ultimately the patient's responsibility to use narcotics responsibly.
A few years ago, narcotics were only prescribed after surgery, severe trauma, or for terminal cancer because of a concern over the possibility of addiction. Recently, they have been cautiously prescribed to treat moderate to severe non-malignant chronic pain in conjunction with other modalities such as physical therapy, cortisone and trigger point injections, muscle stretching, meditation, or aqua therapy. Unfortunately, the upsurge of narcotics as medical treatment also increased associated cases of abuse and addiction.
Derived from either opium (made from poppy plants) or similar synthetic compounds, narcotics not only block pain signals and reduce pain, but they affect other neurotransmitters, which can cause addiction. When taken for short periods, only minor side effects such as nausea, constipation, sedation and unclear thinking are noted.
However, when narcotics are taken for several weeks to months, these side effects can become more challenging: loss of effectiveness due to built-up tolerance, possible addiction, or overuse for a temporary "high," not for pain. Because of the potential for addiction, whether physical (anxiety, irritability, nausea, vomiting, abdominal cramps and insomnia) or psychological (compulsive use, craving the drug and needing it to "feel good," narcotics are considered controlled substances, which means that the FDA and DEA govern their distribution, prescription, and use and classify them into different schedules as per the Controlled Substances Act of 1970.
Really don't understand how pain is supposed to help 'bonding'. What is 'bonding' anyway? I was in so much pain throughout my (relatively short) labour that all I felt was horror, and when there were problems with the baby and they wanted to get her out quickly with ventouse or ceasarian if necessary, all I could think of was good - now they'll HAVE to give me the epidural I've been begging for in order to do a caesarian. I really didn't care about anything except ending the pain. Not entirely sure how feeling like that about your own baby is supposed to help you bond with it afterward. Except perhaps through guilt?
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Sorry but as a Clinical Biochemist with a PhD from Imperial, and in a profession where we have to pass exactly the same exams as the medics (FRCPath), how dare you suggest I should not be allowed to use the term "doctor"!!
I don't actually introduce myself to patients (or anyone!) as Doctor - I use my name - but if someone else introduces me as "Dr" or they notice my title somewhere, they are all perfectly able to understand when I say "I'm not a medical doctor, I have a PhD in biochemistry. My job is to help interpret your blood test results". People aren't stupid - they know that people get PhDs at university in all kinds of subjects. People like the idea of having very qualified staff looking after them.
Highly qualified non-medics are not brilliantly paid and have to work a hell of a lot harder to earn respect from medical doctors - especially when snide comments are made about the availability of PhDs.
""Dr" Walsh is not a doctor...He is a midwife with a PhD."
Sorry "doc", but if he has a Ph.D., then he is a doctor.
He may also be mistaken, a twat, or any other insult you care to throw, but he is, indubitably, a doctor.
I think that , unless he is pretending to be a medical "doctor" , he is quite entitled to use his title . Perhaps Dr Crippen is right , in that he should refrain from doing so when dealing with patients , to avoid confusion .
On a more irreverent note - why "midwives" and not "midpersons"?
Disgusting sexism which has no place in the brave , new Britain !
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Sorry Lab Rat, but using the term doctor in amedical environment will most definitly comfuse most members of the public. Maybe not your friends or social circle perhaps who I am sure are well aware of PhD education. But to the average Sun reader - I'm afraid they will instantly assume your medical training.
As for the FRCPath - sure. But the 5 years of medical school and at least 2, maybe 5, years of house jobs before sitting it learning core medicine and surgery like your medical collegues have done? If you refer to yourself as a doctor to patients in a medical environment without medical training you're setting yourself up for a fall.
And I sympathise with the +++ training and academic effort you put in for frankly crap wages by comparison to your medical colleagues. But patient safety and informed consent must come first.
Wow lots of sensible comments on here. I can't believe it.
As for people with PhDs - I have sympathy with your arguments, and you're technically correct. But a medical degree is pretty difficult to achieve - to get in, then complete over the 5-6 years it takes, without getting chucked out. It's an order of magnitude greater than an undergrad degree or a masters in most other subjects. In other countries medicine is a postgrad doctoral degree - the amount of learning is the same as the UK.
Any medical degree in the UK will have greater difficulty & achievement involved than this midwife's PhD.
So, "Dr" might be courtesy for medical doctors, but it's deserved courtesy, and a much more familiar usage for the lay public. I'd also draw your attention to the Membership & Fellowship of the Royal Colleges. Most doctors will have one of these, they are definitely harder to obtain than a PhD, with very high failure rates eg. 3/4 fail. In high level recruitment they are certainly regarded as doctorate equivalent.
BTW, the commenter further up should be much more proud of his/her FRCPath than their PhD! And I agree that NHS clinical scientists' salaries are unbelievably poor.
Haven't got my FRCPath quite yet but so far the PhD was waaaay harder...But I do accept they can vary in that respect!
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