Anna Brown - Better Births

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I am delighted to welcome you to this essential text: Better Births: The Midwife ‘with Woman’ . I know the passion and dedication shown by the Lead Author and Editor, Dr Anna M. Brown as I have been fortunate to work with her for many (nearly 20) years! Many of the other authors are also colleagues and practice partners which gives me a real sense of pride in the enthusiasm shown by the clinicians who I work alongside.

The introductory chapter sets the scene clearly for the focus of the book, detailing the stories from Midwives on being ‘with women.’ The importance of sharing our experiences is paramount in supporting the learning and reflection of our colleagues, students and the generation of professionals. Indeed, the voice of women also comes through clearly; thank you to all those who have shared their personal experiences of pregnancy and birth, your courage and honesty will support learning for the profession.

I would personally like to thank the contributors of this book as I know it will form a valuable resource for all who access it. I look forward to seeing our Surrey students ‘thumbing’ through it, knowing that it is being opened more widely across the next generation of this vibrant group of professionals.

Professor Melaine CowardHead of School, School of Health Sciences, University of Surrey Interim Executive Dean, Faculty of Health and Medical Sciences

Anna M. Brown, Kath Lawton, Lauren Brown; Victoria Walker, Lucy Jane, Paruit Cass (midwives); and Emily and Victoria (women)

This exploration of the ‘with woman’ concept stems from a need to understand the perceptions of women and midwives of its meaning. It is hoped that a broader understanding of the concept will encourage midwives to work towards engagement with women to fulfil the true meaning of the concept. Hunter (2002) suggests that the ‘with woman’ concept involves emotional, physical, spiritual and psychological events or phenomenon and its meaning fluctuates according to process, behaviour or environment towards the purpose that its serves (Rodgers 1989; Higgins et al. 2017).

Higgins et al. (2017, p. 30) identified that many concepts in healthcare can have different meaning to individual professions and likewise to the patients themselves, ‘ shaped by the relationship between the patient and the provider and the environment in which healthcare delivery takes place ’. In bringing together a mutual understanding, by midwife and woman, it will improve the process and outcomes or consequences of the concept. In addition, a brief historic review will place the ‘with woman’ concept in its context.

Contemporary British midwifery education often includes a consideration of the historical context of midwifery, and as such many midwives will be aware that the term ‘midwife’ derives from Anglo‐Saxon, meaning ‘with woman’. This terminology itself identifies the role of the midwife, and the importance it puts on the person whom the midwife attends. However, it is acknowledged that the voice of this woman has historically been unheard (Evenden 2000), as has the voice of the midwife (Harley 1993). This lack of voice generally stems from a lack of strong historic evidence, resulting in the historic misrepresentation of midwives (McIntosh 2012; Marland 1993; Harley 1990). Oral histories such as Leap and Hunter (1993) and collected letters such as Llewelyn Davies (1915) do give us an insight into the more recent past, but to go further back presents challenges. What evidence we do have, in terms of parish registers (Allison 2016) or material from early midwives' licenses (Evenden 2000; Harley 1990), does not directly inform us about the relationship between midwife and woman.