thru the pinard Podcast
a conversational podcast with @Academic_Liz with midwives & other birth professionals about their studies/ research & how it's changing our practice globally - email thruthepinard@gmail.com
thru the pinard Podcast
Ep 77 Mo Tabib on Emotional Intelligence in Maternal Care
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Ep 77 (ibit.ly/Re5V) Mo Tabib on Emotional Intelligence in Maternal Care
@PhDMidwives #MidTwitter #research #midwifery @RobertGordonUni @RGUMidSoc @world_midwives @MidwivesRCM #phdlife #academiclife
Research link - ibit.ly/yBBrr
Imagine finding your life’s calling through a book in high school and embarking on a journey that takes you from the rural landscapes of Iran to lecturing at a prestigious university in Scotland. That's the incredible story of Mo Tabib, a midwifery lecturer at Roberts Gordon University. Inspired by a story about a midwife in rural Iran, Mo's passion led her through an extensive education at Tehran University and memorable experiences working in remote areas of Iran. Her narrative is a testament to the power of storytelling in midwifery, making a profound impact on her students and her own professional growth.
Transitioning to the UK, Mo faced numerous challenges, from adapting to team-based work to understanding different cultural practices. This transition highlighted the importance of evidence-based practice in midwifery, with real-world examples like optimal cord clamping underscoring the need for solid research. Mo's personal experiences with relaxation techniques, especially after a personal loss, inspired further academic pursuits, culminating in her PhD research focused on calmness techniques during cesarean sections.
Completing a PhD is no easy feat, and Mo's journey was filled with stress and the need for emotional balance. By developing a morning routine that included meditation, Mo found a way to stay present and make significant progress on her research. Her work on the emotional intelligence program for midwives in Aberdeen and Aberdeenshire shows promising results, aiming to support the mental and emotional well-being of midwives. This episode promises rich insights into the evolution of midwifery practices, the transformative power of storytelling, and the critical role of research in maternal care.
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Midwifery Journey and Research Experience
Speaker 1Thank you very much for joining me, as per usual. Can you introduce yourself, please?
Speaker 2Yes, of course my name is Mo Tabib. I'm a university midwifery lecturer actually at Roberts Gordon University in Scotland.
Speaker 1So how did you get into midwifery to begin with?
Speaker 2Oh, that's quite an old story, liz. Oh, that's quite an old story, liz. To be honest, it wasn't a very well-informed choice. I read a storybook and in one of the chapters was a story about a midwife who was working in remote, rural, deprived areas of Iran. I'm Iranian and I just found it fascinating and that was like when I was at high school and that was me deciding to become a midwife and work in rural and deprived areas.
Speaker 2Yeah, so it wasn't like I knew somebody who was a midwife or you know, it was, I think, maybe by accident, or we can call it fate.
Speaker 1So now looking back. Do you know whether that story was written by a midwife?
Speaker 2It was written by a midwife. I can't even remember the name of the book. It wasn't a famous book or anything, and it was in Persian, in Persian, but it was like a collection of people's stories, and that one chapter was about a midwife who attended a home birth in the middle of nowhere. It was really interesting.
Speaker 1It says a lot about the power of writing, though. If one person can write about one episode so well that it quite literally burnt itself into your memory and wrapped itself around your professional DNA, then that's powerful writing it is.
Speaker 2It is definitely Still yeah, when you asked me that question.
Speaker 1So, oh, that goes back many, many years ago so in a book that had so many other stories, that's the one that resonated with you. I love it. I think that's perfect. I think we underestimate the power of telling our own stories of what we have seen and we know. Midwifery is very handing down tales and talking and showing in that way that verbal history, that verbal art. But I think we now need to with publishing a lot easier these days. I think we need to remember that our stories can influence future generations.
Speaker 2They definitely do and I'm kind of. I think I have a habit of telling stories to my students and I can see how their faces, their facial expressions, actually, when I move from, like, talking about research and data to a story, the whole body language changes. They become so engaged and so interested and some of them, like now they have been qualified for some years and they see me and they actually ask me Mo remember that story you told us like seven, eight years ago? I say wow, so you remember that. I think stories tend to stay with us, Especially if we find them interesting and engaging.
Speaker 1Well, a lot of cultures, the verbal history is so old because that is still that tale that goes on, and a lot of responsibility comes to the or comes from the elders to tell those stories and keep them going. So why not midwifery? Absolutely, we've got lots of elders that are telling stories over the years that show some things have changed and some things don't change very true so where did you do your midwifery um education?
Speaker 2so I did it in um tehran university, so that's the capital city of iran and started at the age of 18 and, yeah, but very, very medicalized, I would say, very different from what we teach now, yep, and so, yeah, that was me. And then I finished and we had to do two years of kind of going actually to a place where the you know kind of the national health system would send us basically to, and I wanted to go to a deprived area and I did, or in a very, actually remote area. I was like 21, 22 and for a while, and most of actually my really good memories, good stories, come from that experience. And then, yeah, I got married and moved to another city and started sorry, should I continue? Yeah, yeah, go for it. Yeah, please do. And then I then worked as a community midwife for, again, national Health System of the country for a couple of years and then I started my own clinic.
Speaker 2I became a private midwife, independent midwife, for 11 years and I kind of was like a, you know, like a family midwife, so people would come and then the cousins would come, the mother-in-law would come, so I just knew everybody in the family. It was a city, a smaller city near Tehran, it wasn't the capital city. So I worked there for 11 years when I although I loved it, I really loved it, um, but I think it was just a repetition of this and another thing was like working in isolation. So, because I was an independent midwife kind of, I was not involved in teamwork et cetera. So that was when I decided to just go for a little bit of further education. So I started applying for universities. One of them was Sydney University, actually, and the other one was Aberdeen University.
Speaker 1One's close and one's a long way away.
Speaker 2And obviously Aberdeen University. They were more keen to get me, they responded early and I just decided, with my husband and two kids, to go for a year. I do my master's and come back.
Speaker 1and I'm still here that happens so many times, so many times so it's been 18 years 18 years, my goodness? Um, yes, one year. Let's see how it goes, kind of, and we never leave again. What?
Speaker 2did you do your master's on. So it was this. The project was based on my clinical experience. So what I did as an independent midwife back at home it was beyond me, beyond, let's say, pregnancy. So we also kind of um.
Speaker 2So the women who were not pregnant, basically they and many of them, are coming for lower abdominal pain, lower back pain. So midwife is like a or was at the time I was there and kind of like a screening, you know the problem and repairing where it was needed, and midwives also could prescribe some sort of antibiotics Not everything, but some antibiotics. So and usually the routine, let's say, treatment. I found out later, and actually that's the case across the world the routine treatment for unexplained lower abdominal pain. But we can't find any reason for it. There's no urinary infection, there's no schizoid scan, there's nothing actually physical, obvious, you know, as a reason for the pain. They usually are treated by antibiotics.
Speaker 2And back then a group of us independent midwives, we used another approach that was giving exercise, heat packs, avoiding some positions. You're looking at lifestyle of the, considering you know what can change to help with the lower abdominal pain and in our experience that was more effective. But that was all experiential, so that was more effective. And when I just talked about that to my supervisor who was a fantastic actually supervisor, dr Alice Kiger, with 26 PhD completions so I talked to her and she said, well, that's a good idea, let's do an RCT. Of course, the size was as small as it was just master. So we did that RCT. The data was collected by two midwives and one obstetrician, and RCT was kind of in line with my experience as well. Of course it wasn't a small size, but I thoroughly loved the whole process of research and yeah, and it was a good. So that was how I got into research, my first experience with research.
Speaker 1So, thinking back to that now and the whole process of jumping straight into something like an RCT, what surprised you about that process or what results surprised you that you found? Did it confirm that holistic care was better and more effective than antibiotic care?
Speaker 2Yes, yes, it did actually, it did, you know. But I then learned that, you know, you can't just jump into conclusion. Research, you know. And what was surprising? I think the process was surprising. I was, you know, at the time I'd been trained or, you know, had my education. We didn't learn much about research or evidence based practice, so it was just our textbooks, you know, know and our lectures.
Exploring Midwifery and Evidence-Based Practice
Speaker 2It wasn't that much of an evidence-based practice and that was kind of quite eye-opening for me that how you go through the process of research and actually nothing is certain at the end of the day. You know, even if you do a big RCT, still you can't say for sure, that's definitely the case, you know. Say for sure, that's definitely the case, you know. So I think that was. Yeah, that was quite eye-opening and a learning curve for me to learn to look at maybe life even a little bit more objectively, rather than be so fixated on my idea and pre-assumptions going and we're thinking we're going to find this and then going.
Speaker 1But wait a minute, that's not what we're finding yeah, yeah, yeah, definitely so.
Speaker 2Yeah, that was kind of the thought. And then I decided to, um, see what's midwifery like in the UK, let's see. So I had to do a course, uh, to be registered with the nursing, and I had to do like a short course, which I did at the time with Paisley University. It was a course just for me, to be honest. Oh nice, I know, I know it was so difficult. There was no such a course across Scotland and this lovely person lecturer in Paisley University, she just decided to help me, so she basically designed this course for me. I was attended some of the sessions with third-year students and doing the practical part in Aberdeen. They were really kind to accommodate me and yeah. So I managed to get registered with the NMC and started working as a midwife here, which was again really interesting and really different from what I'd seen back at home.
Speaker 1So how was it different?
Speaker 2Well, I think in one way was different, because I kind of used to work on my own, so I think you can have perhaps that much skills of like team working, how the teams work, how you align yourself with other people. So that was very enjoyable, I would say like a learning process. Well, babies are born, I guess, in the same way, better than you, yeah, but culture, culture was definitely different and I like it. You know. I like how midwives treated women.
Speaker 1Uh-huh.
Speaker 2At least in my context here, you know, and I learned a lot from colleagues. And yeah, again back to that evidence based practice. Of course not everybody practices based on evidence, but we have that principle that we should. And since I've done my master's, my little bit of research, let's say I kind of tried my best to be practical. I just kept kind of, I think, that learning process, you know, going back to research, going back to different articles, kind of questioning the practice. So, for example, one example I can give you.
Speaker 2So I just attended, actually I remember the very first round of the IDM, I remember, and then I heard something about optimal chord clamping there and I just something about optimal cord clamping there and I just read about it. And at the time in the NICE guidelines we didn't have such a thing. So when I started practicing that, I was questioned by my colleagues what are you doing so? Well, it's evidence-based and I'm happy to defend what I'm doing. But you know, after a few years that changed in the guidelines and now we have optimal code. So sometimes I say to a citizen the guidelines are great, but sometimes you know if you're actually actively following what's happening in the research world, in the world of midwifery research. It might be a few steps ahead of guidelines and, as long as you can defend, there is enough evidence to support what you do.
Speaker 1You know, um, that would have a positive impact on your practice and I think that leads to the importance of understanding what research means that yes, you can use the research out there, but if you've got a pilot study or a small feasibility study that only has 50 people in, then yeah, that looks interesting, but you can't change your practice on that. But if you've got a study that's got 50,000 participants in and you go, okay, so here's the weighting of it. This is where we can say but you've got to have that understanding of the importance of sample size, the importance of the credibility of evidence that a primary study is fabulous but a systematic review or a literature review that looks at multiple studies is going to give you more weight and therefore more credence in trying to change practice.
Speaker 2Yeah, yeah, and I think that's why it's so important for you know undergraduate midwifery students to understand research, be able to critically analyse research, you know, as you said, so that they can actually identify good research, robust research. You know, strong evidence versus. You know, if you've done, as you've said, a small pilot study, you can't use it against guidelines.
Speaker 1But it's going to start somewhere. And I mean it's getting harder and harder to publish, so there's greater demand and push to publish. Now there's so many more predatory journals out, but we also know that bad studies get published and so you still have to be able to critique it. Just because it's published, you can't kind of guarantee that it's going to be right for what you want to use it for.
Speaker 2Yeah, absolutely.
Speaker 1So where else did you work then? After that Did you stay? Obviously you stayed in Aberdeen to work in the NHS. Did you go community and go back to being a community midwife then, or did you stay within the healthcare system? Medical model.
Speaker 2Yeah, I stayed with the NHS working in different areas postnatal, antenatal, and then for a long time in the labour world obstetric-led unit, which is connected to a midwife-led unit actually. So I was kind of going between two, both obstetric-led unit and midwife-led unit, and I'm still actually a bank midwife and I did a shift a couple of days ago. So not very often, but every now and then I try to go and practice in labor board midwife unit. So, yes, that's when my experience, or observation, let's say, started, which was the foundation of my PhD, et cetera. And so what happened?
Speaker 2Basically, I, at a personal level, I became familiar with approaches I call them relaxation approaches, meditation, you know, hypnosis, et cetera. That was for personal use, mostly After I'd lost my sister to cancer. Oh yeah, that was kind of my way of getting myself back to normal life. Yeah, and, being a midwife at that time for nearly 20 years, I'd always known, you know, but we asked me to always say breathe, relax, et cetera. But that was it. I didn't go beyond that and I didn't see anybody else doing anything else. So, and that was kind of made me think, I said, you know, if I can bring my level of anxiety, fear, whatever so low. Using these practices can I help women so many women who come to labor world midwife, that you need be at a state of anxiety. Just bring the anxiety low. I saw that as a way of promoting a physiological process. When you calm down, the body is sort of, I would say, like flourishing, getting the optimal functioning of all the neurochemical processes et cetera. So that was just a thought, but I was really, to be honest, kind of a skeptical and maybe even fearful to use that because I hadn't seen anybody using that approach. I did some. I went for some hypnosis education myself, but what they taught us in those courses was how to run antenatal education. It wasn't anything about you know how to apply these skills as a midwife in labor world or midwife, you know people come actually already in labor.
Speaker 2So I had to think of a quick way of explaining physiology to women, the women who were having contractions, so that kind of. Then I could move them to a calm state, and my biggest students, my students, are very familiar with this. My way was asking them have you seen a labelling cat? And people would say usually, looking at me, is she okay? Asking this question, kind of getting a little bit of shock. They're just dotting this. And me, the wife was asking this silly question and I would say no, and I would continue to ask so why not? Why is that we don't see them? And some people said I don't know. Or some people said, well, yeah, they usually go and hide. And I was considering also, you know what, why they go and hide? Um, so getting to the point that I think my my was trying to grab their attention, but asking something unusual, and I would say, well, because they're trying to bring the adrenaline down. Yeah, adrenaline can actually paralyze our physiology if it's too much. And then I could see in their eyes something clicked. You know, something was clicking. And then I would ask okay, do you think you would be happy for me to help you to feel that lowering of adrenaline? Yeah, and in my experience, 99% of people would say yes. So that was the time.
Speaker 2Then I switched the light off, I just started, maybe sometimes just a breathing technique, using my non-verbal, let's say communication or paravarbal Paravarbal is a better word, communication kind of my voice, using pauses between the words or asking them. You know, if I ask you to be in a really lovely, calm, happy place, where would that be? So just kind of to tailor the place to what she wants rather than what I think is good for her. And some people said, well, my bedroom. I said, okay, can you just describe your bedroom for me? And they would say, yeah, the pink wall and the clock on the wall. So I would go with that and we kind of would work together to make the woman, and sometimes even the partner, be in that space.
Speaker 2Mm-hmm, and at least it was so revolutionary, I would say, for me, because I've been a midwife for 20, and I think it was so interesting to see how just something as simple as that could change the whole physiology of the woman. Most of them I wouldn't say all, but most of them wouldn't ask for pain relief, wouldn't ask for epidural anymore. That meant they could still mobilize and get aid from gravity. And the speed of labor was another thing. That was really, again, unexpected for me. I just tried to just take away fear what that meant. Apparently everything become faster. So anyway, sorry, that's my experience.
Speaker 2And then I thought at the time we had supervisor of mid-buzz I talked to I although I was a little bit, should I say anything? Shouldn't I say anything? And she was really encouraging. And at the time there was another colleague who was really good, actually very experienced. She'd been a yoga teacher for 20 years. She was teaching hypnobirthing. She was, you know, she had multiple, multiple, yeah, multiple um skills and they had assorted a class called relaxation class for women with severe fear of childhood who would come and ask for elective section with no clinical indication. So she assorted those classes and at the time that I kind of had experienced this, what I just shared with you, for maybe a couple of years. Then she was about to retire so I was asked if I would be happy to take over and I said yes, of course.
Speaker 2So I took over and everything started from there. We developed, we kept collecting data from women who came to the class and the classes went from like five people per month to 800 people per year. Oh, just word of mouth, yeah. So it became a three-hour class, structured based on self-efficacy theory, bringing all the excellent work of, you know, sudan, who did the ship trolleys, learning from basically people who were doing research on the topic, into the classes, plus, you know, experiences of women who were sharing with us after they gave birth and observations of the practitioners. So we kept collecting that. We have lots and lots of data, so it wasn't research, but maybe we can call it anecdotal data, but it was really strong and powerful and we could see different themes and that was what led me to wanting to do research on these classes, which I did.
PhD Research on Childbirth Experiences
Speaker 1And also it reinforces, I suppose, the Michel Odont and his kind of primitive and his beautiful description of, I think, in one of his first books is of the birth of Christ. And it stuck with me with the way he wrote it was that, yes, they got to the stable, that they finally got into the stable, that Mary probably was starting to have pains. Joseph didn't know what to do, so he went off to search for someone to help. So for the local midwife, and then Mary's in this warm stable with the animals that are doing their mooing and cowing and just making her feel it's safe, it's darkened, that she's feeling comfortable and that that whole natural process, that the adrenaline is now down, the oxytocin comes up, and that he kind of says that by the time joseph came back with a midwife, more than likely that the baby would have been born. But it is that whole environment of no fear, of relaxation and feeling of safety which is hard to get in a constantly engaged world.
Speaker 2Yeah, yeah, work of Grant Liddick-Rigg and then Michelle O'Donnell, sarah Broccoli. So all these people. When I look back, you know every one of these people have had an impact on what we all do I guess not just me. You know work of midwives and so, yes, it's. You know, for me at the beginning as a midwife, you know being so interested in natural bed and promoting physiology, kind of that was my primary aim, but obviously I learned more. You know that actually this is this could be used equally for women who have cesarean section, because if you can stay in a calm state during a process that could be really stressful, that would provide a very good foundation with bonding with your baby. You felt safe, you felt calm. So, yes, lots of learning, both through my observation and also through research, things that I had not thought of.
Speaker 1So but that's what research does. It makes us think the we read, the more we think.
Speaker 2Yes.
Speaker 1For the data for your PhD? Did you use what you had collected retrospectively or did you do a prospective research project?
Speaker 2No, we didn't use the old you know the data that we collected. Use the old, you know the data that we collected. So it was an exploratory, sequential, mixed method, which is a mouthful, and so that meant the first phase was a qualitative study. I interviewed 17 women and nine birth partners because we wanted to collect also the views of birth partners. And then, after analyzing that data and kind of finding the themes, the general themes, we built a survey, an online survey that included some really good, actually already validated questionnaires, such as peer of childbirth which model was state and trait anxiety, because these were the things that were coming up.
Speaker 2You know qualitative data, mental well-being, self-efficacy, childbirth self-efficacy and also some study-specific questions. So, yes, so the second phase then basically was kind of testing to see can we to some extent generalize what we found in our qualitative data to a bigger sample of women. So, with 91 women, we basically did the second study. So these women were a completely different group years later. So, yeah, that was kind of the methodology of this study, which was, yeah, I think I learned a lot.
Speaker 1Well, yep, you go from not knowing anything to become the expert in the field at the end of the PhD journey, which is scary but also good. What surprised you the most in doing your PhD?
Speaker 2What surprised me the most in your doing your PhD. What surprised me the most? Some of the findings actually, and one of them was that kind of, as I said at the beginning, was like focus on, you know. Because they also asked her did you use epidural, how did you cope with pain, etc. Etc. And pain, et cetera, et cetera. And then we found out, actually women who had an elective section. They had answered the question did you use the techniques you learned during childbirth? And they said yes.
Speaker 2And another thing that was really interesting. So we asked them in both phases of their study, how would you describe your experience of childbirth? And the level of satisfaction with childbirth was much higher than a general population. You know, with childbirth was much higher than a general population. You know, although my study didn't look at general probably, but you know data from other studies that would suggest something around 30 to 40 percent, if sometimes up to 30 to 40 percent of women would report having at least some aspects of their childbirth experience was negative. So it was unusually high. It was, I think, 91%, something around.
Speaker 2Yeah, and when then I zoomed actually into qualitative data, it felt these women had decided to have a positive experience. You know what I mean. So, for example, one of them maybe I would like to share this with you One of them was saying the midwife so that's in midwife lab unit, right, the midwife asked me to put, put my legs in the steps and I knew that wasn't right. She asked me to push. I didn't feel as to push and I knew that wasn't right. But you know what? That was good, because then when I had the forceps in theater, I had practiced that. So somehow they were trying to flip things that they didn't like around to make it positive. Yeah, that surprised me and my interpretation I'm not sure how accurate it is, but my interpretation is that I think they had learned how important it is to have a positive experience. So they try actively to even kind of turn negatives to positives. So that was really something I didn't expect. Yeah, it was interesting.
Speaker 1What was anything that surprised you in a negative way, that you thought didn't work, or, if you did it again, that you would do differently?
Speaker 2I think it was what that comes to my mind right now. It was this one woman who, because you know, know over years with you know of myself actually, from 2016, I handed over the classes to other colleagues, so it hasn't been me delivering the education, but we've just kept collecting surveys and feedback from women and 100% of the feedback was positive. So we were like I felt, like I'm so confident, and this one one woman came to the class and she had kind of a little bit of complaint to her community midwife, who referred her to the class. Why? Because in class, it was said, you know the way you feel in pregnancy can impact your baby.
Speaker 1Okay.
Speaker 2And the person who actually runs the class. She says you know, the positive feelings can have an impact, but I think she had translated that in a way that if you feel negatively and she had a close relative with like diagnosis of cancer, so throughout her pregnancy she'd been anxious yeah, so in her mind that meant she had hurt.
Speaker 2Which is understandable yeah, very understandable. But you know, I think I was oblivious to these things before learning this from this. So she said you know, yeah, the class made me feel worse, even because, yeah, that's what I'm thinking. And then then, so that was in the second phase of, as I didn't interview this woman, it was all information coming from the online survey.
Speaker 2So she was asked did you use any of the techniques you learn in class during pregnancy? And she said no, did you use any of this during your childbirth? And she said no, did you use any of this during your childbirth? And she said yes, and would you like to share with us? You know your childbirth experience? And I said yes, I used the techniques, and it wasn't good because I didn't realize I was in labor. So she used the techniques when it came to when her contractions started. So she goes to the hospital and the midwives look at her and say they don't look like ming in labor, let's take it to triage, not to labor ward or midwife latin. So they take her to triage and by the time they ask for a midwife to come and examine her, she's given birth. Oh, yeah, nobody being around, you know. So it was really a scary experience. So yes, that was again a surprise also. Maybe it could be negative.
Speaker 1We do rely as midwives, we do rely on that non-verbal communication, those signs of distress, to say yes or no to how far we think the woman's in active labour or if she's still kind of in the early stages. So if yeah, I mean if you do it really well, you might not show it, but if you don't really well you might not show it.
Speaker 2But if you don't know that you're in kind of labor and you've got so many other things that are distracting you, then it would make it difficult to do that kind of verbal physical assessment and that was a theme actually coming through because, in qualitative data, women most, most of these women well, a good proportion of them I should be careful with the use of the terms arrive in the hospital in active phase of labor.
Speaker 2Some of the primary parts of women arrive in the second stage of labor. So that was why we decided to actually look at that in the qualitative study as well, and 11% of women arrived in hospital in second stage, and I think 60-something person altogether were those who actually started spontaneous. You know, labor started spontaneously, with them came to hospital in established labor having a cervical dilatation of over four centimeters. So yeah, obviously we can't make a big claim, but I think it's worth further research. I would say it's well, you know, if, considering there are so many studies across the globe suggesting if women manage to stay at home during the earliest stages of labor, we have lower rate of interventions, we have lower rate of even maternal mortality, how much money we can save, as you know, when health systems etc. So that's how much money we can save, you know, in health systems, et cetera.
Speaker 1So that's, yeah, I would say, maybe it's work, further research to see. Actually, oh, absolutely, absolutely so. Were you doing your PhD full-time or part-time?
Speaker 2Part-time because I worked full-time.
Speaker 1So what were you working as, and where were you working while you were doing your PhD? I was a lecturer, ah, so when did you start getting into that?
Speaker 2It was 2012,. I started working at the university, so it's been 12 years now.
Speaker 1Yeah, so how did you balance your studies then with doing a full-time teaching load, and then, by this stage, I'm assuming that your children had got to be grown-ups, teenagers, teenagers. So their demand on your time would have been variable depending on what mood they were in. So how did you juggle your study time and your work time and your family responsibilities?
Speaker 2um, I think I was immersed in a study in a good way that actually had a positive impact on my family life as well, yeah, and so, yeah, I don't think the work of like work-life balance maybe applies to me in this case.
Success in PhD and Emotional Intelligence
Speaker 2Uh, they were both so kind of integrated, if you know what I mean. It was just, um, so, for example, I would go for a walk with my husband for one hour, and that one hour was my time to share my thoughts with him, and poor man was just listening, and but that meant he kind of had a good understanding and considering the topic. You know, I think the topic had an effect in our family life, even how, um, because the topic was about, I would say, learning about yourself, learning how to watch your own emotions and how to work with the emotions. That was what I was teaching women at the time. I, you know maybe obviously we didn't call it that, but mainly it was that how you work with your emotions, whether you're pregnant or you're giving birth, and that is applicable to any human being, I would say definitely for teenagers.
Speaker 2It'd be quite handy for them and so, and then I found myself actually applying whatever I was learning at the time into my teaching, bringing it into my session. So it wasn't a conflict between actually my research and my job and they were both contributing to each other. So that was it worked. It worked really well.
Speaker 2And I must admit, at the beginning, liz, I was, I was stressed. You know, at the beginning I was really stressed because perhaps I didn't have the necessary skills, I guess, and I was focused so much on deadlines and finishing, yeah, and that would freak me out. You know what if I don't finish, what, if you know? And that caused actually a really slow progress for me at the beginning. Yeah, but at some point I think it just kind of I came to a realization that I stopped thinking about end line. I mean, when people sometimes were suggesting to encourage me, you know, with intention, think about your graduation day. I didn't want to, I just thought I don't want to think about it. I just want to think about today, about it. I just want to think about today and what I can do.
Speaker 2Maybe I can read one paragraph of a you know paper of an hour less overwhelmed, yeah, yeah, and just you know what I can do today to get me a little bit closer to my final goal. But I don't want to look beyond that and I think when I am sorted, to kind of calm down a bit and be present which goes really well with the project be present in here and now. Things are sort of actually kind of unfolding, so I develop. I decided to develop a morning routine and maybe that's helpful for those who want to start a PhD or they're doing a PhD already. I read like several books that had no relevance to midwifery or to my project, such as, uh, seven habits of most people by Stephen Covey, and that was a game changer and I started kind of developing this routine.
Speaker 25 to 7 am was my time, not PhD time, not work time, and that was the time I did my meditation. I did some reading completely irrelevant to the routine, and, to be honest, I've heard these things. They say it's 20% of what you do that brings 80% of the results. Yes, yes, and I think definitely that was the case because the things I was reading with no intention to relate to my PhD, all of a sudden they become like eye-opening, oh my God. And this is so relevant. Actually, maybe I can go and like explore this topic a little bit more so, and then from there, I think the studies seemed to progress really well and everything just came together. Naturally. It was a positive, a really positive experience, and I think my supervisory team also made a difference, made a. You know, I was really lucky to have those people as my supervisors.
Speaker 1Were they the same ones that you did your Masters with no, no, so different people? Did you choose them or were they allocated to you?
Speaker 2One of them. Well, she was the one who had encouraged me to actually develop this survey, so she had worked together, so she was the one who also had encouraged me to do my phd. And, and should I name her? Or? Yes, yeah, absolutely so, it's professor ter Humphrey. She actually is in Australia University of South Australia. She's an executive at university.
Speaker 1Oh, she's down the road from.
Speaker 2me as well, and they work together as a team to support me and we are still working together. We're still, you know, doing research, writing, you know like, applying for funding, writing applications together. So, yes, it's still, and I'm hoping I still will work for them for a long period of time.
Speaker 1It is. Once you get that nice relationship and you've come through it, then it's easy to keep on producing afterwards. So, whilst you didn't think about your graduation, while you were doing it, what did you do to celebrate when you did graduate?
Speaker 2Oh, it was such a lovely day. It was a sunny, beautiful day in Edinburgh, because that's where I did my PhD. I did it with the Napier University in Edinburgh and my daughter, who lives in Amsterdam, she flew all the way to celebrate it. It was my son, my daughter, my husband. We ate out, we celebrated and after that it was like a little holiday with my husband. So, yes, it was such an unforgettable day, I would say.
Speaker 1Was the holiday, just somewhere special, that you were looking forward to it was in Turkey actually.
Speaker 2So, yeah, it was lovely, a beautiful yeah place.
Speaker 1I like sea okay, so you've done your PhD. Now you're still teaching and integrating what you've learnt. So where did you go after you finished? What kind of like directions you already talked about? You're still doing research in that area and you're talking now. Some of your research now involves emotional intelligence. That's correct yes. So how did you get into that from what you were doing, Because I can see a clear linkage. But was it a linkage through that or was it another opportunity?
Enhancing Midwives' Emotional Intelligence Program
Speaker 2So basically, when we were having those classes at the beginning, way back before I started my PhD, I also was asked to help with the training of other people. So I worked with nearly 100 midwives to help them to integrate these skills in their practice and, as I mentioned before, I have brought that into my teaching so we had specific sessions on the topic for our students. So with a few hundreds of student midwives as well, and again learning from their experiences because I wanted to see actually would they experience what I had personally experienced in my practice or not. So I learned a lot and I think I kept collecting again anecdotal data for my own learning. And when I finished the PhD and we had the results, then the NHS health board in the area asked us to considering the results of this study, asked us to make sure this class was available across all community teams in Aberdeen and Aberdeenshire was available across all community teams in Aberdeen and Aberdeenshire. So that was the time.
Speaker 2This time was like a proper you know with the allocator, because previously it was like on my annual leave, even mid-week. Sometimes they were given the time back, sometimes they were not, it was just their passion coming to the sessions, but this time they were properly like, supported by their employer. We were also in the same position. We had like proper like planning and we brought all the learning from work with all those student midwives and midwives into this emotional intelligence program. So this emotional intelligence programs basically is amalgamating the concepts of emotional intelligence with relaxation techniques. So it's very relevant. It's you know.
Speaker 2So, these midwives. The aim was for these midwives to actually to enhance their mental well-being, their emotional well-being, enhance their job satisfaction and also enable them to integrate these skills into their day-to-day practice when they have a difficult conversation with a woman, when they're looking after a woman with the needle phobia, somebody in labor who's afraid, you know, somebody with a traumatic experience. So they could bring all of this into their day-to-day, basically responsibilities of a midwife. And it was a four-month course, we ran it for two cohorts and, as a result, now the classes are available across all community midwifery teams and, yeah, that's how everything kind of was related to everything.
Speaker 1But that's what you want to see. You want to see something that you've worked with, something that you've done by using the evidence to support it, and then it being recognised for what it is doing and the change that it is making, and then support it and going yep, this is good enough, because we know that the stress levels are ridiculous. We know that midwives are leaving internationally. We know we need to keep them in there. We need that whilst we're trying to change the system. There's small things we can do to build up their resilience. But it's not just midwives, it's also women and people who are pregnant and their expectations of what's happening in the system. So every little bit helps in that kind of context to change the experience from hopefully negative to more positive.
Speaker 2Yeah, and that's where we did actually this time we did a research study. So this time it wasn't anecdotal data, we did a qualitative study. So, using focus groups, an external researcher interviewed these midwives and we also did a survey study. But, considering the number was not big we had 14, and we measured mental well-being, self-efficacy. What else did we measure? Uh, anxiety, um, and they also ask like questions such as you know, do you think that that has had that impact on your job satisfaction, on your relationship, etc. And so the results, again, are promising, but obviously we need further research, a larger size research, to see. And it was obviously then it had some limitations, such as being carried out on only one health board, all midwives being community midwives, so they had some limitation and some strengths as well. So, such as, for example, we had a a wide range of age range. We had people in their 20s to 60s, from one year of experience to 30 years of experience. So, yeah, there were, I guess, like, yeah, strengths and limitations for this study, but yeah, it was.
Speaker 2It seems to be promising because it seems when midwives that's my learning out of it when midwives actually use their skills well, you know, in this case we're talking about this because they learn in emotional intelligence program for women and when they see the results for women, it has an impact on their well-being. So that's what they were telling us. You know I use it and then this happened and that made me feel really good about my job. You know the power I have as a midwife I can get something really negative and turn it around to a positive for a woman, and that was something that kept them actually going, because how often we go to do these trainings we learn something, we enjoy the program and then life takes over and we forget about it. But it seems from this smallest study that you know they didn't forget because they kept using it and they kept seeing the results and it was like a yeah, they called it a ripple effect. So anyway, I don't want to give you a headache about that. No, no, no.
Speaker 1I was just thinking that if anyone wants to hear more about your AI, in particular emotional intelligence work, work, that they're going to have a fabulous opportunity that you're doing a presentation, with the virtual international day of the midwives conference coming up very shortly, and for those hearing of listening to this podcast after may 5th of 2024, then you can go to the youtube Virtual Midwives YouTube channel and all of the presentations will be recorded there, so it doesn't matter when they can go back and find your name.
Speaker 2The study has been published also in Women and Birth Journal just in March Okay cool, and there's details of the program, you know, which is kind of out with the capacity of our podcast. So if people want to know what actually the program content was, et cetera, or see the results for themselves, there is a research article published in yeah Women and Birth Journal in March 2024.
Speaker 1Yeah Women and Birth Journal in March 2024. Which I will put the link to your ResearchGate page there and that is on there as well. Doing is never enough if being neglected, so they'll be able to have the link there for that. So I'll put that on to the thing as well. So where to now? What's kind of what's next?
Speaker 2so the next is that, uh, v. Well then, I see, v is just my supervisors, and I hope I still work together.
Speaker 2They're not my supervisors anymore no, they're now your colleagues and partners, partners we're seeking for um funding opportunities to carry out like further research, maybe larger sizes, such multiple uh centered research, and also another thing that we are planning to do is for students, actually undergraduate. You know we want to see actually if this is a part of student midwives education. Does that make a difference and what kind of difference does that make? So we're planning for a mixed method study and a student's experience first and, if we get the opportunity, maybe people who can collaborate with us are interested. We can also. We would love to also kind of do further research on midwives experiences to see, yeah, if that the findings are generalizable to other people. So that's where we are at. And um, yeah, we're also perhaps it's worth mentioning uh with a colleague. We've started kind of uh offering also private kind of um, but we're thinking about it. We haven't started. We're thinking about having some emotional intelligence program.
Speaker 1Why not?
Speaker 2Absolutely yeah. So that's kind of an idea at this stage. Sometimes it could be a little bit difficult and challenging, a little bit slow with these big organisations. You know, working with this organisation, considering they have so many, you know, challenges right now.
Speaker 1But if people are interested in it, then they can always contact you to chat more about yeah absolutely yeah, if anybody is.
Speaker 2you know they work with health. You know plan is to work with health boards, trusts as well as universities. But yes, if people are interested, we can start a conversation Excellent.
Speaker 1Thank you so much for joining me.
Speaker 2Thank you so much for having me, liz. It's been lovely to have this conversation. Yeah, I thoroughly enjoyed it actually.