Ep 104 John Pendleton on Rethinking Midwifery: Gender, Power, And Care

Ep 104  (http://ibit.ly/Re5V) John Pendleton on Rethinking Midwifery: Gender, Power, And Care

@PhDMidwives #research #midwifery  #education #care #uninorthants_uon #genderinclusion #addressinginequities

research link - t.ly/UPDGX

A home birth at 2 a.m. changed everything. John Pendleton swapped the BBC’s long-form documentaries for the long arc of labour, finding the same core craft in both worlds: showing up, listening deeply, and holding space through life-changing moments. We trace his path from community midwife to senior lecturer, and how a planned PhD on third stage physiology morphed into a bracing inquiry about gender, power, and presence in the birth room.

We talk candidly about why people choose midwifery—and why many leave in years three to five. Younger cohorts are arriving straight from school while funding gaps, means-tested allowances, and a rising cost of living push placements and part-time work into the same week. Continuity-of-carer promises better outcomes but collides with childcare at 2 a.m. AI may streamline admin, but hands-on, relational care remains the human core. The hard question is practical: how do we build wraparound support so midwives can deliver the care families want without burning themselves out?

John opens the black box of his research: an interpretive phenomenological study asking what it’s like for men working as midwives. The answers live in details—where you stand, how you seek consent, when you offer a chaperone—and reveal how gender operates as power, not just identity. That lens widened into a hotly debated paper on gender-inclusive language and whether “midwife” still serves everyone we care for. The media firestorm missed the nuance, but the academic work stands: read to think, not to react. Along the way, we dig into decolonising midwifery education, teaching cultural humility, and why rigorous mentorship in physiological birth still matters.

If you care about safer, kinder maternity care—closing racial inequities, protecting informed consent, and keeping brilliant clinicians in the job—this conversation offers both realism and hope. Listen, reflect, and share it with a colleague. Then tell us: what one change would help you deliver better care tomorrow? Subscribe, leave a review, and join the conversation so more people can find these stories and shape the future of midwifery.

Transcript

SPEAKER_02 0:27

Thank you very much for joining me. As per usual, can you introduce yourself, please?

SPEAKER_00 0:33

Yes, so I'm John Pendleton, and uh yeah, I'm a senior lecturer in midwifery at the University of Northampton in the UK. Uh, been there for uh 11 years, and before that I was uh clinical midwife. Uh sort of a particular interest in home birth, really, but um yeah, I've done all of the different areas of midwifery.

SPEAKER_02 0:55

And you've had a really interesting pathway into midwifery. So how did you like you've it's not even a 180-degree pivot, like it's a parallel universe. How did you come to go become a midwife?

A Home Birth That Changed Everything

SPEAKER_00 1:11

Yeah, well, I think it seems really circuitous to other people, but to me it seems like it was quite an organic process. And so I before I was a midwife, I used to work for the BBC. I was the television producer director, and I made documentary programs, so long-form observational documentaries. And I would spend, you know, quite lengthy periods of time working with people, filming them, charting their journeys through transformational life events. Um so to me, there's a clear parallel with midwifery, if you like, really. Um, supporting people, encouraging them, empowering them to tell their stories. So that I think is the link. Um, but the reason that I left that behind was I did it for nine years and I'd really enjoyed it. But I had my first son and suddenly it just didn't work anymore because I was used to being traveling a lot and I couldn't really do that anymore. And it was just a perfect, I don't say storm, but yeah, they were offering voluntary redundancy. I'd sort of fallen out of love with it and I felt a bit passive, like I was always watching other people doing amazing things, and I wanted to be the person who was doing the amazing thing that other people would want to document, if you like. And I'd just been blown away by the midwife who had brought my son into the world because it was a home birth. Yeah. I won't say there was any, it was now that I know it was pretty textbook in a way. It wasn't, you know, whale music and dim lights or anything. It was, you know, it was a bit noisy, it was a bit messy, it was a bit scary at times, but you know, kind of normal. Yeah. Um, but just the way that this midwife came in at two o'clock in the morning, just was just a brilliant presence, managed everything, and just kept coming back every day just to check in. And um, it just sort of, yeah, it it ignited something in me. I mean, I have this theory that there are sort of two types of people who come into midwifery. There are ones who have come in because they have experienced uh midwifery and they want to either replicate the good care or try and ensure that they don't experience the bad care that they've experienced. Yes. Um then there are the sort of school leaders who are much more intellectual about it, like, oh, I just want a job where I can not baste at a desk and I'm you know I'm interested in healthcare and I'm much more pragmatic. So I was definitely performer.

SPEAKER_02 3:49

It's really interesting. One of the things I love in the first week of university and when the first the new crop come in is why do you want to become a midwife? And hearing the stories of the reasons why it's like, oh, I saw a birth when I was younger, or I've always wanted to be one, or I had this treatment, I want to make sure it's never happens again. It is, regardless of which pathway, it's very personal.

Why People Choose Midwifery

SPEAKER_00 4:14

For probably about 50%, I would say that's true. And maybe it's I don't know a difference between the UK and Australia. Don't know, but I think I've seen the change in the patterns of students coming through. We have a lot more straight from school rather than the mix of the older students and younger students. And the younger students, I don't, I a lot of them I think is is just a more of a practical decision. You know, it's a it's a secure job, it's a job for life. I mean, I think this is probably going to be something that will become more important as AI becomes more prominent. I I mean, I could be wrong, but I don't necessarily see AI taking over the role of the midwife, might take over some bits of it, but um and yeah, so those those kind of people who come to um maybe exercise some of their demons or to um ensure that they can keep the profession alive, but they don't seem to get the same opportunities anymore because of the funding issues here, which isn't which is a bit of a shame.

AI, Funding, And The Future Workforce

SPEAKER_02 5:21

It'd be really interesting, and this may just be kind of the whole you can't do causation and correlation, but it'd be really interesting to kind of look at people in about five years and see who's still in the system and what was their motivation for joining or becoming and and entering the profession, and then what was it that's caused them to leave? Because we know that three to five year is really critical, where we're having a big deficit of people who are going, I'm not putting up with this anymore. I can't, I can't continue with this. So I wonder if or whether that's just kind of like it's just a random thought, but it'd be interesting to have an explore.

SPEAKER_00 5:59

I think it would be good to do a sort of multi-country study and look at the you know, uh package that you get being a midwife and money and you know, benefits, etc., and whether that links with it. Because I also think that we don't pay enough attention within midwifery within the UK to how people can sustain a long-term career without um getting the financial reward that they need in order to be able to do it at some point. You know, I think classically people will go in. It will be quite a decent salary to start off with, but once you've got to start paying for childcare and all the rest of it, um, so three to five years in, maybe, once once um they're they're starting their own families, it becomes a real pinch point then of how is this going to work for me? And I think that's true of a lot of the semi-professions, you know, teaching, nursing, midwifery, um, maybe policing, etc., for women that um we haven't really given enough thought to that, particularly when we think about continuity of care, which is obviously something that is the direction of travel within the UK, but it's quite hard to implement at the moment. But you know, I often wonder I wouldn't have been able to do it if I had young children, because if someone phoned me up at two in the morning and said, you need to come to this labouring person, and I couldn't guarantee that I'd be home by seven o'clock to be able to, you know, take over the child care, whatever, the stress of that would have just broken me, I think. And yeah, I think it's it needs a bit more thought about how the whole wraparound care. How do we ensure that a largely female profession can deliver the care that you know service users want and midwives would like to give, but can't actually practically afford to deliver in many cases until their you know their families are grown up, actually. Um, but we've got a lot of younger midwives coming through rather than mature ones.

SPEAKER_02 8:06

Yeah, we we're kind of we're better at looking at the wraparound care for the people that we care about, but not ourselves.

Retention, Pay, And Care Continuity

SPEAKER_00 8:13

Exactly that. Yeah, exactly. And I think you need the two to be in synergy. Um, and maybe, and maybe we'll come onto this a bit, but because of the gendering of the profession, I think midwives are often not really allowed to put their needs or center their needs very often. Um, and I think that probably is going to be um a big issue for the profession in terms of recruitment and retention. It's just not that attractive anymore.

SPEAKER_02 8:41

No, and it is, yeah. Uh we've got, we've only just started this in July, I think, that there is a um an allowance that midwifery students, some nursing students, I think social work and maybe teaching, are getting for clinical placements. And we had to negotiate because nursing was easy, because they had their minimum is 800 hours for their course, so that was easy to extrapolate. Midwifery obviously is different, and then you've got your continuity of care on top of that. And so having to argue how does that fit into it? Has, but even now it's means tested and not everyone's getting it, and they're kind of working, they've got clinical hours, then they're doing part-time work as well as that, then they're trying to fit in caring hours. Um, and it's like, do you guys still have the birth tree for midwifery students, or was that stopped?

SPEAKER_00 9:33

Uh well, it was stopped, and then they brought it back in a limited fashion. So now they get£5,000 a year, which is, I believe, is not means tested. So um that is obviously significant, but it's not enough. It's just not enough.

SPEAKER_02 9:52

No. Not with cost of living and everything like that, because whilst that equates to about 10,000, just over$10,000 here with our exchange rate, if you're looking at the cost of services as well. And so when you bring in kind of accommodation when they're on leave, you kind of petrol cross childcare costs as you talk about, that disappears very, very easily.

SPEAKER_00 10:12

Yeah. Yes. And I think that was um brought in because they stopped the bursary on the base, well, I'm sure you you probably know all of this, don't you? But they stopped the bursary um because they realized that actually they could get people to study without having to pay for them. So let's just not pay them. Um and in a way they were right. You know, the students still kept coming until they haven't, you know, the numbers are decreasing quite significantly of people who are applying to study mid referee now. Um and yeah, it's not particularly my area of expertise, so I probably can't say too much about it, but I can I can see that trajectory is going to be something that needs to be corrected.

Balancing Care With Family Life

SPEAKER_02 10:56

Yeah, I think I saw a report that there was 21% less new registrations in the UK. Um, yeah, I think within the last 12 months or something like that. And plus, when you look at that, we actually we need more midwives to take over from the natural attrition that's happening with the baby boomers and the Gen Xs. Um, that we've already got a deficit, and then you've got healthcare services, I think, in both countries or in every country, that once somebody leaves, they just retweak. Oh no, no, no, we we only need this amount for staffing, so we're fully staffed and we're not going to re-employ anyone. Um, but anyway, let's kind of go on to nicer stuff. Let's go on to your midwifery education. So, where did you do it and what did you what do you remember of your initial course?

SPEAKER_00 11:42

Oh gosh, right. Um, what do I remember about it? Well, we were a relatively small cohort. I think there was maybe 25 of us or something like that. And what I really remember was the midwifery lecturers. You know, I was somewhat in awe of them. Um, I thought they were the font of all knowledge, and they were actually. Um, so I felt I was very privileged to have them teaching me. Um and I just felt really in safe hands with them and really inspired, and it was it was just a really positive experience for me personally. Um, there weren't that many of us, and we were really well looked after. And even I mean, you know, the NHS is the NHS, yeah, but I guess I was a mature student and my expectations were maybe a bit different from other people. So I I was quite had quite a positive experience. I had um the same midwife in the community support me as a mentor for three years.

SPEAKER_01 12:48

Oh lovely.

Training Memories And Mentorship

SPEAKER_00 12:49

That was just a joy, you know. Um I mean, the thing that makes me sad a bit for the students now is that I don't really remember having any obstetric emergencies in my training. Um I mean, which is is not great, I suppose, on one level, but I think it just reflects the fact that of the midwives I've worked with, um yeah, that we I had no problems getting my 40 birth. Yeah, everything was relatively calm, relatively low risk. Scary things did happen, of course, but everything was just managed really well. So the good thing was when I qualified, my training was so good that despite not having been exposed to many, if any, obstetric emergencies, when they happened to me, because of course they do, don't they? Um, I did know how to manage it. And I knew that I did, and um, and I did it, and it was all fine. And the most important thing is obviously to call for help, really. Absolutely.

SPEAKER_02 13:57

That and that early identification is key.

SPEAKER_00 14:00

Yeah, I just was really lucky. I thought I had a really good grounding in physiological birth and those sort of core midwifery skills. I had lots of opportunities to observe that and support that.

SPEAKER_02 14:16

Which is the foundation you need, and it's getting a bit harder to get with these days, the physiological birth, because there's a lot of inductions.

SPEAKER_00 14:25

And I think also the the midwives who were uh my mentors, as they were called then, you know, have been in the NHS for a long time, were incredibly experienced. You know, they had those sort of gold-plated pensions where they could retire at 55. So they were kind of in it for the long haul. There was that pot of gold at the end of it that was keeping them going. And um they were just incredibly safe hands, that's all I can say. You know, that they had been there a long time and knew how to uh how to deliver the support that I needed.

SPEAKER_02 14:57

Well, that's fabulous role modelling for you and your future kind of generations because we pass on what we see and what we practice, and not only the good but the bad as well. Where did you go after you finished your training when you qualified?

SPEAKER_00 15:11

Yeah, so I stayed in my local trust. So I mean, I've I've I've travelled and lived widely, but once my family came along, then that limited my mobility. So I trained at Northampton and I worked at Northampton and now I teach Northampton. Which uh yeah, is um it would be nice to have more uh diverse experience. But equally, again, I do feel incredibly lucky that Northampton has given me so much in terms of midwifery, so I owe it an awful lot. Yeah.

SPEAKER_02 15:46

But it's nice, nice having a home base where you know the services, you know the people, but then you still go visit because you've and we'll talk about this a little bit later, but you've got connections in Europe that you're representing for, so you've still got that outreach that you do anyway.

Staying Local, Thinking Global

SPEAKER_00 16:04

And I think you get that as an academic, is that you're you're part of a wider academic community. And so you're always talking and meeting and collaborating with people, which I guess you don't really get in clinical practice. So I do have some insight into how things are uh in other places. But it's interesting that tension that we talk about, because I was just reading Sarah Ahmed's new book actually. Um, and the worry is that if you stay somewhere for too long, that you learn the language of the institution, i.e., you become institutionalized, and then you're not able to um push back when you need to, um, because you've got too much to lose. And I wonder whether there's something equally important to be said for that longevity, that that sort of stable presence, that person who's there who is able to navigate and negotiate and support people coming through. And I guess that doesn't really get talked about quite so much. Um yeah.

SPEAKER_02 17:03

I think there's a nice balance when you've got the people who have been there for a long time, who've got the corporate knowledge, who know the history of what's been tried, what's worked, but are also open, and I think this is the key, to new blood coming in, new ideas coming in, who can still be the foundation and the the bedrock, but are not the ones that are completely blinking and go, this is the only way. You'll sit there and go, oh no, no, that's still oh, maybe we could do this. And I mean, I love conferences, and I've just come back from a middle-free education conference. And I love that concept of talking to listening to somebody else and going, oh, we could do that, or we could do this, or having that, but still having that stability. It's it's a very interesting kind of like seesaw sometimes.

Institutionalisation Versus Long-Term Presence

SPEAKER_00 17:51

Yeah, and I think also it's about what is your motivation. So, one of the reasons that I really loved community midwifery rather than I mean, I did actually, I spent a couple of years on the label, much to my surprise, and I did get a lot out of it, and I did really enjoy it, but my heart was always in the community, and I guess it's because you can remove yourself more from the politics and just focus on, you know, I'm here to support this person, and um can really focus on that. And that's what I feel in academia. Yes, of course, you have to um navigate the uh structures of you know the university you work in and you have to work with it. But my main focus would always be I guess my main focus is still on, you know, you know, the women and birthing people out there and making sure that the students that we are preparing have that same philosophy and are able to go out and meet their needs. So my I'm very much focused still on midwifery rather than than the university's needs. The two are obviously, you know, combined. I think that's what stops me from from becoming too institutionalized, if you like.

SPEAKER_02 19:00

But it is that that key, it's those stories that the students come back with and say, oh, this is what's happened at this birth that keeps you with that's the focus. Our focus is regardless of who we work for and work with, our focus as educators is to help kind of develop and facilitate the best quality midwifery care for the future of people who are going to focus on women, birthing people, their families, on the community and improve it. Yeah, agreed. It's a lovely kind of it's like the pebble in the lake. You just one person, you don't know how many people they'll affect, and that kind of goes on on the ripples in the future.

SPEAKER_00 19:39

Um Yeah. And that's what I say to the students, you know, the reason I'm still here, I'm still, you know, this is the longest I've ever held any job. I'm a bit of a magpie, you know, I can sort of see all shiny opportunity there, and I sort of move sideways an awful lot, um, which has been an incredible privilege, you know. I I I completely acknowledge that. But the reason I'm still in education is because I feel I can make the most difference to you know, service users through uh you know supporting students to go out and have you know that middle fruit philosophy.

SPEAKER_02 20:15

So you're working in community, you're working outside. How what exposure did you have to research them?

Education Philosophy And Purpose

SPEAKER_00 20:25

Oh, no exposure at all, at all. I mean, when I I mean I I say that. I I feel like in my job at the BBC, I was a researcher. I mean, I had the title of researcher at various points before I became an assistant producer. So I was doing research, it just wasn't really packaged the same way as it is in the university. You know, we were still bound by codes of ethics and um, you know, industry standards that we had to abide by. There were still moral decisions that you had to kind of navigate. There were still legal issues that you had to navigate. Um and yeah, so I was a storyteller, and that's what I still see in my research, is the thing that I love about it is how do I tell stories, either allow other people to tell their stories or you know, tell them on their behalf in a really um, you know, considered way. So I was doing it. It just looked different. And then I went into midwifery, so I was sort of having a bit of a break from it. I did very little research in my degree. I didn't actually get a degree, I did the diploma pathway as it was then, because I already had a first degree, and um, yeah, there were it was financially more advantageous for me to do the diploma at the time. So I didn't really do anything in my actual first degree. I then had to go on and top it up later on and do um a top up to the midwifery bachelor's and then the master's and then ultimately my PhD. But yeah, mid uh research wasn't a big thing for me within my early midwifery career at all.

SPEAKER_02 21:59

So, what got you interested in the master's pathway then?

SPEAKER_00 22:04

If I'm really honest, the only reason I did the master's was to get into education um because I was working as a community midwife and I loved it. But I could sort of feel that I needed to keep myself fresh and interested in order to be able to turn up every day and be the midwife that those people needed me to be, you know. Um, and I just didn't want to become bored, really, because then you're no use to anyone. True. And I was looking at the options that were available to me for the next step up, and the sort of middle management positions in the NHS just didn't look very attractive, if I'm really honest. There was sort of an awful lot of responsibility without any um agency.

SPEAKER_01 22:53

Yeah.

SPEAKER_00 22:55

Um and then I looked at education and I thought actually, that is, you know, I really love mentoring students. And back in you know, my early 20s when I finished my first degree, I had wanted to go on and and sort of have um an academic career, but I couldn't really afford it. And also I more wanted to go out and be in London and party and you know, be young and do all of those exciting things. As you do, yes, and not live in you know, a student um hovel for the next five, ten years. Eating kind of like noodles, yes. So it was just the timing was wrong then, and it seemed like a really exciting opportunity for me to keep myself right, keep myself interested, learn new things, support students in a different capacity, still learn about midwifery, and um yeah, I guess start to become an academic, which was a sort of novel idea to me at the time. Um, so that's why I did the master's. I did a master's in in education. I didn't enjoy it, if I'm really honest with you. I found it really tedious. I kind I don't uh yeah, the subject matter wasn't the thing that set me alight, but it was purely a means to an end and it worked.

SPEAKER_02 24:13

Like coursework or research?

Discovering Research And Story Methods

SPEAKER_00 24:16

Um so it was it was um, I did it part-time whilst I was in clinical practice and then finished it when I got into um academia and it was modular, but then there was a dissertation at the end of it, which was um was research. Trying to remember what it was, no, it was um focus group study of what was it? See, it didn't, it doesn't linger long.

SPEAKER_01 24:41

That's okay. That says a lot. That says a lot.

SPEAKER_02 24:47

So what was the break, or did you then go straight on to a PhD, or you had a bit of a break while you settled into academia and and kind of found your feet there?

SPEAKER_00 24:57

So I I went, I got into academia and I was a lecturer, and really I was just lecturing, lecturing, lecturing, you know, for a couple of years, didn't really do much else. Finishing off my master's, it took a long time. My father died in the middle of it, so that kind of put a bit of a delay on things and you know, had young children and just you know, life responsibilities. And also I've just, you know, I thought a PhD was something that clever people did, you know. I held it in very high regard from my days, you know, when I was uh first went to university. You know, in order to do a PhD, you had to have a first class degree, and they were very rarely funded, and it was just, you know, it was you know, not that many people went to university full stop at that time. So we widened participation much more since then. So there were less people who went, less people who got first, and less people who went on to do PhDs. And PhDs was really, you know, for those sort of super bright people who were going to become um, you know, sit in ivory towers and be the people I wanted to listen to, I guess. Um, and I just didn't see myself as that person. So I had no ambitions really to do a PhD for a long time.

SPEAKER_02 26:14

Yeah.

Masters As A Door To Teaching

SPEAKER_00 26:15

Because I just didn't think it was for me. Um and then eventually, but there were a couple of people who I guess saw something in me and would come up and say, Have you thought about doing a PhD? And that was enough, I guess, to sort of start that little flame going, oh, they think I might be able to do it. So maybe, maybe. And so it's just, and that grew and grew and grew until yeah, I committed to it.

SPEAKER_02 26:43

So did you already know the topic you wanted to do and know the supervisors and sort them out, or would you kind of work with the supervisors first and then develop your topic?

SPEAKER_00 26:56

So because I was already employed at the university, the funding arrangements were effectively if I do the PhD at the institution I was working at, then it would be funded by my employer. So that was, you know, so that was a no-brainer really for me, was that I would get to do it effectively for free. Um, so and and also interestingly, I had no idea what the processes were for PhD. So this notion of finding someone who's an expert in your field and applying to them to be nobody talked to me about that. I didn't understand it. So I stumbled, like most of my life, I guess. I sort of blundered my way through, trying to kind of do it John's way, um, thinking that everyone else had the memo, everyone else had been given the instructions apart from me, and I just had to uh, you know, just do something and hope it would work out, which it usually does. So, no, didn't know anything about the supervision process, didn't occur to me to find anyone. I just trusted that the university would provide me with the people I needed to support the work that I did. To be fair to them, actually, I had really fantastic supervisors. Um, I knew what I wanted to do, and I mean, I'll tell you the story. What I thought I wanted to do was around third stage of labor. I was really fascinated by how we all knew that physiological third stage labor for uncomplicated births was had so many advantages.

SPEAKER_01 28:28

Yeah.

Committing To A PhD

SPEAKER_00 28:28

Um and I also realized that almost no midwives facilitated physiological third stage. So I really wanted to try and understand what where why that wasn't happening. That was the PhD I wanted to do. And I was gonna go and create all of this knowledge that was going to be have a very practical application, and you know, that was going to be my little area of expertise. And every time people said, Oh, you know, what's what's your PhD going to be on? I'd say, Oh, it's gonna be about third stage of labor. And they said, Well, that's really interesting. What's it like being a male midwife? And that was it, you see. So, and literally that was the story of my, you know, my academic career. As no, it didn't really matter, whatever I was teaching, whoever I was talking to, I could be having any kind of conversation over a cup of tea. The same question kept coming up: what's it like being a male midwife? What's it like being a male midwife? And I was a bit like, well, I don't really know what it's like being a male midwife, I know what it's like being me. Yep. Um, and in the end, I just thought, well, I'll go and find out, shall I? And then when you ask me that question, I can give you the 80,000 words and say, here it is, go and have a read. So that was why I did the PhD I did. Partly. I'm being I'm being a little prestigious, but not entirely. I just thought, this is the only people will never be interested in anything else I have to say until we've had that conversation. And I don't really know what to say in response to it. So I and when I looked, there was nothing published, nothing had really been researched about it. I mean, apologies to anyone who's listening who had written about it. I mean, there there were um, yeah, but there I've done the literature review. I mean, at the time there really was very little, almost nothing, which seemed incredible. Congruous with the fascination that existed with the topic. And there was this perception that, oh, it's been done, it's been written about, but what has been written were very journalistic accounts of, you know, oh, a day in the life of a male midwife. I mean, I did one of them, you know, and other people have done them. And uh, yeah, quite sort of um yeah, objectifying pieces of of literature, which are well-intentioned. I'm not kind of dismissing them, but they weren't research and they didn't really explore some of the or any of the issues that really we needed to be talking about if we were going to go there.

SPEAKER_02 31:05

So, what did you find? So, how did you go about exploring that then?

Changing The PhD Question

What It’s Like For Men In Midwifery

SPEAKER_00 31:09

I mean, I was very uh naive, I suppose, going into it because I thought, like all of these conversations, that it was a very binary position, you know, being a male midwife supposed to being a female midwife. And it wasn't that long into my PhD where I we were talking about gender more expansively, you know, as a as a construct and that there were other ways of being which weren't just male or female. And I thought, oh my goodness, I've done I've done the I've asked the wrong question, you know. The conversation has moved on, you know, the things that we I'm an anachronism already because people are more interested in trans and non-binary midwives than they are about male midwives. So actually, what do we mean by male midwives? There was this whole post-structurist sort of deconstructive conversation which just blew my mind because I wasn't there yet. I was still at the start of the PhD journey, but was you know fascinating. Um, but what did so uh it was a very qualitative study, it was a very personal study. I think like many PhD researchers, there was an element of therapy involved in it. Oh yeah. You know, you're trying to trying to understand your own experiences through the experiences of other people as much. So um, but I did uh an IPA study, so interpretive phenomenological analysis. Yeah, yeah, which I loved. Um, and I interviewed I think it was 15 male midwives. I used that term. No, men, men who work as midwives, that was the term I used rather than male midwives. Um, and just literally just asked them, you know, tell me about your your story, what's it like, and try to kind of extrapolate some themes from that and then analyse them. Really looking at this tension between essentialism and social constructionism is what it really turned out to be. You know, is there an essence to being male or female, or is it something that is entirely sociological, constructed, you know, through speech and language? And um, because what I found when people were talking about the experiences is that they would sort of yo-yo between those two positions without consciously doing it. So they would say, Oh, well, there's you know, there's there's no difference between me and a female midwife, it's just a job, it's just what I do. Um, you know, a midwife is what they do, not who they are. And I'd be like, okay, that's interesting. And then they would say, um, oh, but obviously, you know, I wouldn't look after people who had, you know, experienced um sexual abuse, or I wouldn't look after people who had um, you know, maybe very conservative religious beliefs. And of course, that's completely understandable. So I would never want to make people uncomfortable. So, you know, that was fine. And I'm like, I completely agree, and I completely accept that, but that's actually something very different, isn't it, from just a job. Actually, it really matters who is the person doing that job and walking into that room to that person. So we can't necessarily just compartmentalize our gender or our sexuality or um our gender identity and say it doesn't matter when I go to work, I'm just you know, someone who is delivering a certain set of um skills and knowledge, you know, we bring our bodies into the room with us and people respond to those bodies. So, how do we account for that? And my feeling is that since men were introduced into midwifery in the UK around, you know, 1982, something like that, I'd have to look it up in my thesis in there. Um no one's ever talked about it because it's sort of sat in the kind of sat in the too difficult pile. If we talk about it, then we're gonna open up this Pandora's box of problems that we're gonna have to try and reconcile. And there probably isn't any way of easily reconciling all of these complex things because that's what gender is. It's it's a whole set of complex uh questions without answers, really. Um, but my argument is you you can't keep pretending that it doesn't do something when you have men in a profession, just in the same way as it is when you know women were first introduced into um, you know, male-dominated workforces. Actually, it's really interesting, and we should probably talk about it because we might get to somewhere a bit more interesting at the end of it.

SPEAKER_02 35:58

It would be it might it brings to mind some of the um the women that I know who've gone along the lines of um engineering and mechanics and have been very much like the and drivers who've been the only female um within that cohort and the the kind of the barriers that they've had to come across, but it's like the fee they feel like they've had to work twice as much to be seen to be as equally as good. Yeah. Do men, did you find men had that same kind of thought that they had to be worked harder to s to live up to the same standard?

Power, Presence, And Chaperones

SPEAKER_00 36:40

Well, I mean, it's interesting that you say that. I think the thing that is left out of the equation is power, really. So when we talk about, you know, uh women entering male-dominated professions, you know, women by and large um are minoritized as a as a group and therefore will have to um navigate those axes of power. That's really all gender is, it's an axis of power, isn't it? Um so men going into uh the uh a profession bring that power with them. And so for men going into nursing or midwifery, well, we talk about midwifery specifically, is how do you manage the power and the privilege that you walk into the room with and that people respond to? How do you navigate that? Um and again, it's about making that visible so that you can be more conscious of your behavior. Um, the men who um have succeeded in the profession, shall we say, as and they've managed to stay there, um, are people who probably don't know, they wouldn't put a label on it, but that is what they are doing. And so the conversations that um men talk to me about office, well, when I go into the room, I will position my body here to make the women feel safe. But you know, before we know I carry out any procedures, I would have these conversations with her, I would check in all the time, you know. So much more um uh negotiating um the position. And actually the the women, I'm saying women because the um the research, these the men exclusively identified themselves as cis men, and they talked exclusively about interactions with um cis gender service users. So um, but yeah, so that they were always um negotiating that, and and many female midwives do that, but not all of them.

SPEAKER_02 38:43

I was gonna say, that be standard behaviour.

SPEAKER_00 38:47

You would think, wouldn't you? But it's you know, it's really interesting. One of the things that I discovered really through this is that in the UK, the War College of Midwives has no guidelines on chaperoning at all. So chaperoning within mid-free is not um consistently a thing in the UK. Um, because the the idea was well, women could never um women caring for other women don't need a chaperone. It's a kind of um sort of unthinkable that they would really um cause harm. Yeah. And chaperone it in maybe obstetricians and gynecologies and the trust guidelines is that chaperone is offered regardless of the gender of the person performing the investigation or the gender of the person who's receiving it, it's largely to protect the person from accusations of you know um improper conduct or um or litigation further down the line. Whereas, and so that happens in nursing, but it doesn't seem to happen in in midwifery. Um and I think that probably tells you a lot about the relationship of trust that um develops between midwives and service users, but also maybe how some of that can get taken for granted or not negotiated um consistently. Whereas when your presence is not taken for granted at all by any stretch of the imagination, then you you will negotiate that very thoroughly.

SPEAKER_02 40:26

Yeah. And that kind of brings me on to the question I want to ask is what sticks in your mind about something that surprised you during your PhD process?

Surprises About Gender And Careers

SPEAKER_00 40:37

What surprised me? Um it's a really difficult one, isn't it? I mean, I think what probably surprised me was well, I I guess the first surprise was gender isn't just binary. And I didn't know that because, you know, I I've had trans friends, you know, I'm not I but it wasn't, I think it's become so ingrained in your kind of mind that it didn't occur to me to think of it in in any other terms than those that I had experienced in my career as a midwife, and how people had, you know, was it was it like being a male midwife? So it put me into that sort of um thought process. And actually, there are more trans and non-binary midwives than there are cisgender male midwives. So that surprised me as well. Um, and hopefully I'll be doing, you know, that would be the next iteration of my research is looking at that. Um I think maybe what surprised me was that there isn't a clear career pathway beyond the PhD, particularly for those who are doing more social science focused um studies. Maybe if you were more clinically orientated PhDs, there might be. So that's where I'm at now is is yes, I've done the PhD, yes, I'm incredibly proud of it, yes, nobody's ever going to read it, but that's okay. It is available, everyone, if you want to. Um what happens next? And and I don't know whether it's a uh a midwifery thing or whether it is more widespread than that, but you are kind of left kind of going, thank you very much, you've got your PhD, and just carry on teaching. Do you know what I mean? So you have to be really self-directed and self-motivated to try and seek out how to capitalise on that PhD. And maybe it's enough just to have done it. You know, that's okay, that sense of achievement and the the the evidence that you've collected or I've collected in this case is enough, and I could just stop here. Maybe the sensible bit would be to just stop here because I don't um anticipate earning lots of money through being an early career researcher.

SPEAKER_01 43:02

Yeah.

SPEAKER_00 43:03

But equally, I feel that there is there is more work to be done, and I have to find a way to do it, and that's what I'm really struggling with at the moment is how to kind of get it to the next stage. Um, so I don't know whether that's surprising, but it it's um it's what's happening now.

SPEAKER_02 43:24

Sadly, it's a universal thought as well for how to because the skills for my PhD are very transferable, and they're transferable in a lot of different areas, but the identification of a clear pathway is one of the things that is commonly lamented, especially for those who want to stay in clinical and don't want to go into tertiary, because a lot of people still think that if you the only way you can use a PhD is if you become a university lecturer. There's not enough jobs in university to everyone, but that's not true, and we can use it in anywhere, but we need that visibility of midwifery voice.

Pandemic Pressure And PhD Survival

SPEAKER_00 44:01

Yeah. But I also think, you know, there is a problem for what to do with a PhD when you are in um uh employed by university because midwifery is primarily um a teaching-led discipline. Yeah, the recent um uh many opportunities to do research when you were employed in higher education, believe it or not. So um I think it's the current financial climate. I'm not blaming my university or any other universities. It's the way that the universities will make money from you is through teaching. And at the at the moment, that's that it would be a luxury to spend money on you know, funding research for for people when they just don't have the money.

SPEAKER_02 44:50

While you were doing your studies, you were still your PhD, you were still working as well. How did you balance that with your work and with your family, with your kids, and how did you keep your sanity?

Publishing, Backlash, And Media Storms

SPEAKER_00 45:06

Well, it's interesting because a lot of my PhD took place over the pandemic. Okay, so it was a bit of a double-edged sword, really, because the workload in academia like tripled overnight. It did. So Jeff went absolutely crazy because we were having to uh all of these new emergency standards and um guidelines and processes were coming out from the NMC that were coming out from the university. You know, students couldn't go out into practice and then they could, and then they couldn't, and how do we keep them on track so that they're able to, you know, qualify, you know, because we knew that the the profession was desperate for desperate waiting for these uh midwives. So, you know, it was the hardest thing I've ever been through, you know, and I was, you know, literally kind of fizzing with stress and anxiety and you know, on the brink of tears many times, over which seemed to go on for at least 18 months, maybe, maybe even two years. I I mean, I I'm just it's all a blur, if I'm really honest with you. So you would think doing a PhD on top of that would be the straw that broke the camel's back. In fact, it was the thing that saved my sanity because it was the one thing that I could control that I didn't need anyone else to get involved in. Yeah, you know, it was just my it was my little kind of safe space where I could still manage it. I could still do all the data collection online, and actually people were sort of a little bit more uh literate with how to uh you know engage with technology and were um yeah, just sort of had, I would say they had the time, but you know, there wasn't a lot else to do outside of what like uh was still kind of happy to be interviewed, and um and I was very passionate about what I was doing. You know, I was reading a lot, I was you know thinking a lot, it it kind of helped, even though it increased the workload. From a practical point of view, for a couple of years I dropped my hours from working full-time to four days a week. So that massively helped. Um, and again, I know that's an incredibly privileged position to be in. Uh, I did have to go back up to full-time hours just because the cost of living crisis meant it wasn't sustainable, but I did manage to um get a contract that I do compressed hours. Yep. So I was doing full-time hours over four days a week. And that, you know, it's exhausting, but I just knew that having that one day a week where I didn't have to respond to emails that I couldn't be touched and that I could just sit in front of the computer. And some days, you know, I just didn't really do anything. You know, I would just sit and stare at it and just be so exhausted. And then other days, you know, things would flow, but you never really knew what was going to happen. But giving yourself the time and space just to kind of sit there and and allow it to come or not.

SPEAKER_02 48:08

And staying in that, in that mind zone, staying in that brain space is so important because you don't know when that inspiration, you don't know when those two neurons on the opposite side of your brain are suddenly going to make that connection that goes, that's what it is, and then kind of do that. So I think a lot of people find it walking their dogs.

SPEAKER_00 48:27

Yeah, walking the dogs, like sending myself voice notes whilst I was walking on my phone so that I could pick it up later. Had a notebook next because I was in the shower, was my offer my three commands, which is very frustrating because you can't do very much when you're in the shower. But I'd have a notebook kind of you know in the bedroom so I could scribble down things before they went. Often I'd look at them a week later and go, no, I have no idea what I was thinking of while I read this. Occasionally there was a bit of a nugget there which um landed. Yeah.

SPEAKER_02 48:59

Yeah. Okay, so how did you celebrate?

SPEAKER_00 49:05

Oh, how did I celebrate? Uh that's a good question. Um I went away, I went out with my family, and we, you know, um had a nice meal. And then probably about two or three months after the viber, I went away for a weekend with my partner to Liverpool, because that's sort of where my roots are, so my family's originally from, and had a weekend away, and yeah, so that was my celebration. I don't like um a lot of attention. I didn't go to my graduation. I don't like that sort of thing. I don't like people looking at me and having to kind of manage other people's time emotions. Um, so I was just really, I just thought, no, I'm gonna do something with the people that actually have supported me. No, I mean lots of people supported me, people at work supported me, but I think the people who, you know, invested in me emotionally, you know, who supported me financially, who gave me that space to, you know, lock myself away, who were, you know, doing the line share of the cooking and the cleaning and you know, all of that, even when they've got, you know, busy jobs and all the rest of it. Um, for me, it was, you know, those were the people I wanted to celebrate with because they were as much a part of my success, if you can call it that, as as I was, you know, you know, you can't really do these things on your own, I don't think.

SPEAKER_02 50:39

No, not successfully. It's very hard. So what have you done? Because you're involved, you've got you've had some really interesting publications um that have come out that have caught people's attention and certainly started conversations, which is what we need, because conversations are always good. Um, so what have you done since that has kind of led you into like some of the stuff that you're doing now?

Language, Inclusion, And Public Debate

SPEAKER_00 51:12

So I think one of the things that has been really beneficial to me in terms of giving me a life in research post-PHD is I published a couple of things early on from my PhD. So I haven't published my findings yet. I've got one under review at the moment and um a couple more that I need to get out there, but other opportunities have come up which have sort of got in the way slightly in a good way. Um, but a couple of the background chapters I published, and one of them caught the attention of uh Sally Pizarro, who you may or may not know. Um she actually studied at Northampton and worked at Northampton and then is now at Coventry University, and um yeah, had written on or researched around midwives and their knowledge around supporting trans and non-binary service users. I think that's right. Don't quote me on that, but I think that's the way it happened. And we just connected again because she read a background paper that I had um published and could see my interest in the area and reached out to me to write a little bit for a book she was doing, and then plugged me into this network of people who were writing um uh a paper around the use of gender inclusive language in midwifery, uh, which was um and so that has slightly taken over the Ph publishing the PhD because that that generated a lot of interest and a lot of opportunities, and was really the conversations that I think you know we need to be have or I need to be having, um, because of all the things that are happening in the world that are um creating disparities and and increasing marginalization for um trans and non-binary people, you know. So I have spent a lot of time in that space, and it has been very uncomfortable and I have had a lot of pushback. Um, I would like to say it's because people have been engaging with the academic arguments and ideas, but it it often isn't. It's you know, spats on social media, or I've had, I mean, Sally and I published um a paper in birth, I think it was. Yeah, was there?

SPEAKER_02 53:41

Yeah, March, both in March. The midwife and the perinatal practitioner.

Next Studies And New Grants

SPEAKER_00 53:46

Yeah. So it was um, it was, I mean, I knew it was going to be quite a challenging read for some people, and it was looking at, you know, is the idea of calling ourselves midwives still current in the 21st century, or does it do something? Is there another way of um you know rebranding ourselves actually? Yeah. Um and you know, for many people it's it's something that's just untouchable, and I understand that. But I thought, well, let's put the discussion out there and we'll see where it takes us. And if we end up at the same place, well, at least we'll know why we're doing it. And if we don't, then maybe we'll come up with something more emancipatory. And it's interesting when you look at um midwives in other countries. Obviously, I I I go every year to Europe and network and meet other midwives from across Europe who don't, you know, are not called midwives in their own languages, and you know, have no issue when we talk about it going, yes, of course, you know, you should change the word. Uh I'm not saying they represent everyone, but those are the conversations that I'm having. It doesn't create any great shock and all when we talk about it. Unfortunately, in the UK, the the headline made it into the uh popular press, and it went all across the press: the Daily Mail, the Telegraph, The Times, The Express, Mum's Net. I mean, like literally, it literally went viral, and people were then able to comment all over it and and wrote really um you know nasty and unpleasant things in their comment section. I can't remember how many thousands of comments we got.

SPEAKER_02 55:31

I must be when I saw it when it came out and then I saw it hit the guidelines, and I just wanted to, I just felt sorry for both of you because of what the response was, and was hoping that it knowing that it can get very nasty and very personal, even when you're talking about professionals. Um, but yeah, some of the responses were just it showed that they went to the headlines and not read the paper.

Culture, Politics, And Solidarity

SPEAKER_00 55:56

Well, and this is it, you know, because what um I have learned is the importance of using or me using my voice in the spaces where I feel I can articulate myself in the way that I want to. And for me, that's in academic writing. So that paper, I think it took almost two years to get published. You know, it was reviewed by three people, you know, it went through three lots of peer review. Each time with three people were having said it was really like every line, every sentence, every word was scrutinized and you know, argued, etc., before it actually got published. So I feel very comfortable with that. That has been a well thought through piece of paper. Whether people agree with um, you know, the ideas within it or not, the the academic arguments are well articulated and justified. But people don't want to read something uh which is going to require them to sit down for half an hour and and and think very often. People read to respond rather than read to think. Um, but in my mind, I could when it got very uncomfortable when all of this this sort of um you know rage was being played out on the social media spaces, however uncomfortable I felt, I thought, well, I know that the the paper stands up to scrutiny because I've already been through that process and I'm not going to engage with you know people who have only read headlines and have been poked and prodded into, you know, benting their spleen at me. I can always say, if you want to know what I can read the paper, because I've already argued and debated that paper with people who, you know, have engaged with it, and it's there for you to think about. So that was one lesson I learned about is you know, choose your space and and feel comfortable with that and don't get too upset when uh people say things who haven't engaged with the work that you have produced. It's not about you, it's about them, effectively. And it also and it also gave me, I guess, a slight taste of what people who you know are trans and non-binary have to live through every single day of their life. It was fine for me, you know. I could sit there for a couple of days and it would blow over. You know, there were a few moments where I was like, Well, this is a lot. I knew it passed and I could move on with my life. But for other people, this is what they're exposed to um relentlessly and constantly by by people who object to their very existence. And I guess that is why I continue to work in this space.

SPEAKER_02 58:40

So, what's next? What are you excited about that's coming up?

SPEAKER_00 58:43

Well, I really want to publish more of my PhD, so I'm waiting to see whether you know paper gets through this. It's been through one round of peer review, and I've sent it back and waiting for the next outcome. Uh, I've got a book chapter that I'm working on with um with another midwife, Dr. Claire Clues, for a textbook on decolonising midway free education, which I'm yeah, so that is um interesting. I've got a paper that I'm working on with Sally, which is coming out of the backlash that we experienced as a result of publishing that. So that will be really interesting. I probably can't say too much about it.

SPEAKER_02 59:23

No, that will be interesting to read.

SPEAKER_00 59:26

Um, but yeah, there's a there is uh a group of us working on that, and that will be, you know, hopefully ready to be submitted by the end of the year. But my experience is it can take a long time for it to get published, so we shall see. Um, and I've just put in a bid of a very small grant to do some work on looking at the experiences of trans and non-binary midwives, because we we have some evidence about the experiences of trans and non-binary service users. We have some evidence about cisgender midwives and their knowledge and experiences of working with the trans non-binary community. What we don't know is what it's like being trans and non-binary, having to work in a space which is very gendered, shall we say. So I'm excited to see whether that gets off the ground and where that will take me.

SPEAKER_02 1:00:17

Um it is a controversial area for too many people when it possibly shouldn't be a controversial area. Um, but it does depend on your I think a lot of it, as we know, if you've had personal exposure, it then makes it personal. It's not an abstract kind of discussion or an abstract confident uh concept. And the more personal it is, then the more you'll actually take the time maybe to understand it or to be open to conversations about change. Um, and we've got a lot happening in the world in different countries that are making that difficult.

Decolonising, Teaching, And Real Change

SPEAKER_00 1:00:54

Absolutely. Absolutely, yeah, and in very powerful countries, not not uh, I think sometimes when we look at processes of marginalization for uh, you know, on basis of gender or sexuality, we can sometimes bracket it off as oh, it's a country that we don't necessarily have a relationship with, and therefore, you know, we it's not going to impact that much on us. But when we look at what's happening in the United States, for example, for what's happening in Russia, for example, um, you know, Brazil, Hungary, etc.

SPEAKER_02 1:01:30

So many countries. Everyone, even the UK, even Australia, you get you talk to certain people and you've got the same issues, regardless of where you are.

SPEAKER_00 1:01:40

It's deeply uh worrying and distressing for everyone because what we know is that you know, once one group is um they come for one group, they will come for everyone, and everyone will um suffer as a consequence. So it's important to stand in solidarity.

SPEAKER_02 1:02:00

But there is positiveness. We are seeing more people. I think that when I see my students come through, a lot more of them are more comfortable with being open about their identity and about their way of interacting with the world, which I think is really nice, remembering kind of like when I was their age, it was still illegal to be anything but straight. And so you didn't talk about it. And in education, you never spoke about it if you're a teacher, because it was just so to see the fact that kind of like it's and I think the increasing growing of people identifying as pan, it's just kind of like it's the person, we don't worry about anything else. It's just the person, I think, is actually quite lovely and it's quite humanistic.

SPEAKER_00 1:02:50

I agree with you. Um, not everyone does, but I, you know, I'm obviously I'd grown up, you know, with section 28, you know, the age of consent was still uh 21. I think it was for gay men, there was no protection, no, no legal protection for employment. Um, it was still um a deeply stigmatizing place to be. The AIDS epidemic was raging. So within my lifetime, I've seen huge change, but I also know that it is a hard won and easily lost. Yes. Um, and that's something that we have to hold on to. But I agree with you. The the hope that I have is I teach about cultural humility as a module within my workspace. That never happened five years ago, so that's a huge change, you know. And we're not just talking about gender and sexuality, we're talking about race, we're talking about class, we're talking about, you know, um neurodiversity, ableism, etc. So, and students are really wanting to engage with this the more um they're already there a lot of the time.

SPEAKER_02 1:04:02

Yeah, but then they go into a system that's not, and that's where a lot of that frustration comes into it. So we've come a long way, we've got a long way to go, and we just have to keep them engaged and keep them with us as we move to that improving the system because we need them to be the change champions of the future. So that and we think about a lot of the issues that are international with obstetric violence, with disrespect, with informed consent being a joke in far too many places. It's there's so many little things that we can do, they can have a big impact.

SPEAKER_00 1:04:38

Absolutely. Yeah, and it's a bit it brings us full circle where you the reason I came into education is to try and um, you know, and it's not me imposing my views, I hope, uh, but it is me saying, here's the literature, have you thought about this? Go away and read about this, here's another way of thinking about things, have you looked at it through, you know, a feminist lens? You know, have uh how political are you? Does it matter? Does it bother you that you are going to, you know, be earning significantly less money than other people, you know, than men, for example, throughout your lifetime? Why, you know, why, why, why did you choose not to um why did Microsoft choose not to strike for uh greater pay when nurses did or when doctors did? Why do you think that might be? Do you think gender might have played a role on that? So it's not just, you know, I I worry a little bit that obviously my research profile seems to suggest that I'm in the classroom indoctrinating people into thinking a certain way. Uh but people will think and say that and have done. And my defense will always be if not, I'm giving people the tools to explore and come to their own opinions about you know complex issues. But if we don't put that in the curriculum, we know what happens. Look at the outcomes for you know black and brown women in the UK, you know, because we've never talked about race in midwifery in any meaningful way until relatively recently. So it's it's the same process that we're trying to expose, you know.

SPEAKER_02 1:06:10

Which is why decolonizing curriculum, decolonizing healthcare system is critical.

Closing Thanks

SPEAKER_00 1:06:16

It is critical as long as we are critical of the term decolonizing and don't let it become um a sort of you know, a word which stops us from having to do the difficult things, which is is slightly my worry sometimes. So again, we'll have those conversations in the classroom. I I know that students tell me, John, your lessons, they I go away and I've just got a headache because I'm having to kind of think really hard about things. I'm like, good, that's what you should be doing at university. Exactly. Otherwise, it would just be me telling you what to think and you writing it down, and that's what you'll go away and think, and that would be a terrifying prospect.

SPEAKER_02 1:06:51

You might as well just put everything online online and nobody turn up.

SPEAKER_00 1:06:55

Exactly. Yeah.

SPEAKER_02 1:06:57

Thank you so much for your time.

SPEAKER_00 1:07:00

Well, thank you, Liz. I I've enjoyed it very much.