Episode 188 A Chat with Frances, Consultant midwife

In this episode I talk with my wonderful collelague consultant midwife Frances Rivers about what the role looks like on the ground and why it matters for women, midwives, and obstetricians. We dig into evidence, inequality, and personalised care, and how respectful conversations can keep trust even when choices sit outside recommendations. 
• what a consultant midwife does and why the role was created 
• the four pillars: clinical expertise, leadership, research, education 
• how women can access consultant midwife support through their midwife 
• disparities in place of birth by ethnicity and why awareness matters 
• the evidence for midwife-led units, home birth and birth centres 
• why birth centre rates are falling and what leadership can change 
• working with healthy tension between midwifery and obstetrics 
• personalised care when national guidance and evidence do not align 
• freebirth, disengagement from care and the difference between information and coercion 
• communication that starts with yes, continuity of care and being heard 

Want to know more?

The role of the consultant midwife

https://rcm.org.uk/wp-content/uploads/2026/03/JGC2520-CM-Role-publication-v6-DIGITAL-1.pdf

Frances's research into ethnicity and place of birth

https://link.springer.com/article/10.1186/s12884-024-06977-z

A recent article by Frances and others about midwifery unit useage

https://www.all4maternity.com/racialised-womens-use-of-midwifery-units-barriers-and-facilitators/

https://birthrights.org.uk/

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Thank you all for listening,  My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
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Its easy to explore my back catalogue of episodes, I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
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My bea...

Transcript

Welcome To The Obspod

Florence 0:00

Hello, my name's Florence. Welcome to the Obspod. I'm an NHS obstetrician, hoping to share some thoughts and experiences about my working life. Perhaps you enjoy Cool the Midwife, maybe birth fascinates you, or you're simply curious about what exactly an obstetrician is. You might be pregnant and preparing for birth. Perhaps you work in maternity and want to know what makes your obstetric colleagues tick, or you want some fresh ideas and inspiration. Whichever of these is the case, and for that matter anyone else that's interested, the obspod is for you.

Meeting Consultant Midwife Frances Rivers

Florence 0:55

On today's episode, I am welcoming Frances Rivers, Consultant Midwife, who I work with at my own trust and who I do a joint clinic with. And I'm embarrassed to say that despite having a fantastic working relationship, it had not popped into my head to have her on the podcast, which is really terrible, until somebody said to me, Why haven't you done a joint one with Frances? So it seemed like a splendid idea. So here we are, Francis.

Frances 1:30

Here we are. Well, thank you for inviting me.

Florence 1:33

Do you want to introduce yourself, say a little bit about yourself?

Frances 1:39

Yes. So as you said, I'm a consultant midwife at Kingston in South West London, and I've been working there for on and off for almost 10 years now, and actually trained there as a midwife, and then I went off and worked at other trusts and then came back. I actually started out uh on a different career pathway. So I I started out in life as a TV journalist and did that for about 10 years, so very different from midwifery, and that was in my 20s, and then had children, and that sort of steered me away from uh the world of um travel and TV news and down a different pathway, and I ended up um in the midwifery and birthing world and have been there ever since. So, yeah, now um my day-to-day role is as a consultant midwife. I'm the only one at our trust where we have about almost 5,000 births a year, and so it's a big job for one person.

Florence 2:49

I guess a consultant midwife I think of as a relatively new role. So, certainly, when I started in my career in the 90s, there wasn't such a thing, or if there was, I didn't know about it. So, what what is the

The Four Pillars Of The Role

Florence 3:09

role of a consultant midwife if for people that aren't familiar with that?

Frances 3:14

You're right that they are relatively new. So I think um the first consultant midwives came into being around sort of 2000, turn of the century, with the idea that often what could happen is that as midwives progress through their career and become more experienced, that they'd end up in managerial roles, sort of behind the scenes running a unit, but actually no longer involved in caring for women in any way and using their clinical skills, um, which is quite different from senior doctors like yourself. You know, as a consultant obstetrician, obviously most of your time is still spent on the shop floor clinically. The consultant midwife is slightly different, I would say, and I think you know, when I speak to my colleagues who are fellow consultant midwives, we all approach the role slightly differently, and I quite like the fact that there isn't a kind of set, if you like, you know, you must do it this way or that way, and that you've got quite a lot of freedom in how you interpret the role, but there are supposedly these four pillars of the role, um, so that's uh sort of clinical expertise, um, and that might be that you have a specific um expertise um which might have come about through a specialist role that you've done. So, for instance, there are consultant midwives who have come up through the public health route or through providing specialist mental health services to women, and then there are others that will have more traditional kind of expertise in providing intrapartum care. So, I guess my own clinical expertise is around supporting physiological birth, that's my real passion, particularly home birth and midwife-led care. But also a lot of what I do is around supporting women's choices, and that involves meeting women regularly to support choices, particularly when they don't align with what we're recommending. And when I say we, I mean we, the maternity unit, doctors, midwives. I'm sure we'll talk about that more. So that's one pillar. Then you've got the professional leadership. So that's about uh being a bit of a figurehead, a sort of champion for midwives, whether that's within your own trust or externally, you know, appearing on things like this podcast or going to conferences, um, and being a voice for midwives. And within the trust uh where you work, certainly how I see it, it's about being a voice in the room where decisions are made, whether that's about guidelines or the direction that we're going in, changes to clinical pathways, um, and being that voice for midwives and for women as well, and always thinking about what the woman's experience of whatever it is that we're proposing is going to be, what impact it will make on her, um, and that and I'm that voice, I always think. And then there's the third pillar is about research. So I am absolutely passionate about evidence and our use of evidence in practice. Um, so research is obviously how we develop that evidence, and I've been involved in um research projects myself, doing my own research, and then in much bigger pieces of research that others are leading on. And then the fourth pillar is education, so that's about training and being involved in the training of midwives. So I regularly teach, for instance, I was teaching yesterday our midwives about um how we can support what I call personalized care. Again, that's around supporting women's choices and making sure that those women are heard and have a voice and have those choices supported. So it's a lot.

Florence 7:22

I was just thinking that.

Frances 7:27

Well, and I think to be honest, you can't. So you have to pick and choose, and this is what I've learned over the years doing the job, and you can't be everything to everybody. And sometimes I do feel like this that you're just constantly running from one thing to the next without ever pausing, and you have to just decide what your priorities are, and they will be different at different times. Um, and sometimes it is really important to just be there for that. You know, for instance, recently I've attended quite a few home births which have been quite complex, and it's been important for me to be there, and then at other times I'll take more of a step back, and actually I'm focusing on making improvements to a particular pathway, for instance, um, really trying to improve women's experience of induction of labour at the moment at our trust. So, yeah, it's just about just picking what your focus is and trying to do that as as well as you can. And of course, you're always working with a team, you're not on your own.

Florence 8:29

Yes. I hadn't thought about it in that respect of being able to be a more senior midwife, but also being clinical, because I always found that really baffling when I was doing medical management, that I would still be going to the lay board and doing my sessions and then stepping away and doing the management of the service, whereas my contemporary, you know, head of midwifery was just doing the management of the service. So I hadn't thought about the consultant midwife in that that way. Is that why you decided you'd like to be a consultant midwife to retain that clinical practice?

Frances 9:15

I think so. For me, if I if I don't see women regularly, then it it sort of lose, you know, I would lose the passion for it, I think. And and and I get the most out of it by just meeting women every day and hearing what they have to say and hearing what their experiences are and also what they're hoping for, and trying to make that happen for them. So having worked briefly as a matron myself, I would just like to give a big shout out to all matrons across the country because it is a really unforgiving, challenging role, but so important. I'm making sure that there are enough midwives, enough support workers, enough nurses on the shift to keep everybody safe. And a lot of it is behind the scenes, and you know, it's absolutely essential for the safe running of the maternity unit, but it's not what kind of drives me to get out of bed in the morning. So it wasn't a job that I wanted to continue doing for very long, but I'm really glad that I did it for a brief time because I learnt a lot doing it, and um you know, it's it's just important to understand, you know, that operational side of things. But for me, I still want to have that connection with the women um and to be able to, you know, go to a home birth and watch a baby be born in a into a pool and and all of that, I you know, I would hate to miss out on that.

How Women Access Consultant Midwives

Florence 10:39

Yes, yes. So you mentioned that you spend a lot of time seeing women. So do all UK maternity units have a consultant midwife? And if they do, how do women access or get to see a consultant midwife?

Frances 11:01

Not all maternity units have a consultant midwife. There isn't a sort of legal obligation, if you like, to have one. And I have to confess, I don't know the current number of consultant midwives across the country. But if a woman wants to contact a consultant midwife, she just speaks to her community midwife, her clinic midwife about how she might do that. I think one of the roles that we have as consultant midwives is to make ourselves as accessible as possible. And I'm not necessarily suggesting that women should be referring themselves directly to us, but I do think it's really important that women know that we exist and what we're there for, and that we're there for everybody. Because I think one of the issues that we have at the moment is that we have women who know that they have a voice and that they can make choices, um, and that's great. Um, but there are also many women who don't know that they have a voice and that they can, you know, decline aspects of care or make choices about where they give birth or how they give birth or when they give birth, and you know, you don't know what you don't know. So if people don't tell you that, then they're never going to end up um seeing me in my clinic. So it is really important, I think, that we make sure that midwives know that our doors are open to everybody, and there's there's ongoing work, I think, to do around that. And you know, a lot of my the research that I did, which looked at place of birth and ethnicity, um, did show that there were significant disparities between, you know, white women and for instance Asian or black women and where they chose to give birth or where they ended up giving birth. And I think a lot of that potentially has to do with um whether women are aware of their options. So definitely work to do there, and that's something that I and and my colleagues in the consultant midwife sort of world need to address.

Florence 13:13

Yeah, I think so. Reading your research and realizing that disparity really, I don't know, it really brought it home to me. You know, there's lots of talk in maternity about inequality or inequity, and to kind of see the lack of knowledge, awareness, even thinking about home birth or water birth or birth centre birth for certain sections of our population is really stark. And I think the way we run the referrals into your clinic and um our joint clinic is is really good. So we have a referral form that any midwife can fill up and refer people to come and see Frances, which Frances will go through and decide which ones she sees and which ones might be better seen jointly. But it was very gratifying to me when you looked at the numbers of people coming to our clinic that it did actually match our background population, that we have got the same sorts of percentages of black and brown women coming to our joint clinic as we have in our population overall.

Frances 14:44

You're right. I mean, there you know, I I think the midwives that we work with in our trust know that that service exists, but I don't think we should pretend that there isn't still disparity there. And you know, it's about trying to understand the causes behind that, you know, and they're multifactorial. Certainly, when I did my research, um, so I looked at the last 10 years of data at our trust and looked at and sort of accounted for things like uh was it that women from other um ethnic groups had um comorbidities, for instance, that might prevent them from accessing different places of birth, um, or was

Place Of Birth Evidence And Inequality

Frances 15:35

it something else? And and you know, I interviewed a very small number of South Asian women to ask them about how they'd made their decisions about place of birth. Um, and it was so interesting hearing them talk about their decision making, um, and a lot of it is down to just a sort of cultural assumption that I don't think is unique to South Asian women, I think it's actually quite prevalent in most societies that hospital is the safest place to give birth, and not just hospital, but on a labor with doctors, and I think that is a view that many, probably the majority of women, hold. So um, when that is the kind of prevalent view, then it takes quite a lot, I think, to change that mindset. And it's really interesting to talk to people who have come to a different decision about well, what was it that changed your mind? Often it wasn't actually a midwife that changed their mind, it was more likely to be a friend, a sister who would say, Oh, I gave birth in a birth center, it was amazing, you should give it a go. Um, or they'd, you know, been on social media and seen some, I don't know, Instagram account where a woman had said, Oh, my water birth was fabulous, and and this woman had thought, Oh, I've never thought about that. So there are so many influences, aren't there? And we're just a small part of that. But I do think we have a duty, and when I we as midwives and obstetricians too, to not be afraid to give women evidence about the benefits because I think sometimes, particularly midwives, are a bit reluctant to um say, well, you might benefit more from this going to this place than going to that place. You know, I'm talking about really widespread evidence that's been around for a long time now, um, that says healthy women with uncomplicated pregnancies are much more likely to have a straightforward vaginal birth if they go into spontaneous labour and choose to go to a birth centre than if they choose to go to a labour ward. I'm not saying that that is right for all women, but even to just be given that information is really powerful. So, again, it's going back to my role as a consultant midwife, I think, is to try and empower the midwives to not be afraid of sharing that evidence, to know the evidence in the first place, and then to actually make sure that women are all are aware of it, um, because then they can make an informed decision.

Florence 18:22

Yeah, I do find it a bit weird because we talk a lot about evidence-based medicine or evidence-based practice, but it's like we pick and choose the evidence. So and it's kind of but we're not we shouldn't be shouting out some of the birthplace evidence, you know, you're much less likely to have a cesarean, you're much less likely to tear, you're much less likely to need assistance if you start in a birth centre or or home. But we're we're not giving people that evidence, or if we are, I don't know, it's not kind of sinking into the collective consciousness.

Frances 19:13

Well, and also, so that evidence is there. So there's overwhelming evidence for that particular population, and actually for some women, even with some additional risk factors, you know, there's good evidence emerging around older women or um women with high BMIs or um women who have gestational diabetes that's well controlled, that those women also have really good outcomes if they give birth in a midwife-led setting. But despite all that evidence, like you say, for some reason, birth centres, midwife-led units, the birth rate in those is declining. And again, so I think my role is to really question that, to shout about that, and to say, what are we doing about it? So here I am saying, what are we doing about it? Because, you know, 10 years ago, births in birth centres were, you know, in double did uh double-digit sort of 12-14%, and they've more than halved now. So, like you said, if we were following the evidence, they should be on the increase, not on the decrease. So, what's going wrong there?

Florence 20:24

Yes. I think that's something. So you and I went to a conference together and they presented that evidence about the reduction in midwifery-led unit birth. I was really shocked actually, and I think it's important to say for people listening that that doesn't result in an improvement in outcomes. You know, it's not that oh, by moving births from a midwifery-led unit to a hospital, they're safer for the baby or the mother. In fact, you could say they could be less safe because of more intervention potentially. So it is a really, I think, a big worry that decline. I agree.

Frances 21:19

But I do think that when you have the right leadership in place, and I'm not talking about me personally necessarily, but I do think at our trust we have a culture there which does support midwife-led care. So you can buck the trend, uh, and we do buck the trend at our unit. We do have a birth rate in our midwife led unit of around 14% a month and a home birth rate of sort of two to three percent a month, so that both those are well, well above the national average. And why is that? Because we've got a senior leadership team of midwives and obstetricians who Value it and who see that it is important. And we've also got women who want it and who make their voices heard. So for those units that are struggling, I do think it is about looking at is there support from your leadership for it? And I do think that's what partly the role of the consultant midwife is for. Like I said before, to be the voice in the room that says, hang on a minute, this is really important. This is what the evidence says. This is what women want. You know, there's that phrase, isn't there? If you build it, they will come. If you close midwife lead units, then of course your rate is going to plummet. If it's always closed, then women can't give birth there. But if you keep them open and you

Why Birth Centre Rates Are Falling

Frances 22:45

staff them and you make them a priority and you clearly show that they are a priority to your staff and to your women, then they will come.

Florence 22:54

They will come, yeah. And and I think I think the obstetric voice is really important alongside that. As you know, you know, I think quite a lot about what's the obstetric role when midwifery care is so beneficial. How do you support it, but in the background, so that when things deviate from physiology, then you're there and you can make sensible decisions when intervention is required, but you're supporting that midwifery care, but a step back, if sort of mean.

Frances 23:40

Absolutely, there's got to be that mutual respect, hasn't there? And I think there absolutely is, you know, where we work, you know, I I really value my obstetric colleagues, and you know, you you you can't exist without each other. So I think there's so much in the media at the moment, isn't there? And there has been in these successive inquiries about um a sort of them and us between midwives and obstetricians, um, and I just don't see it personally where I work, so I don't know what you think, Florence, but um I do value the idea of a kind of healthy tension, I think is what I would call it, because we do come from different perspectives and our training is different, but I think that's a benefit, not a a risk, because I, you know, you don't want everyone in an organization all having exactly the same viewpoints and all just going yes, yes, yes, all the time. It's really important to have sort of healthy debate and healthy challenge and respectful challenge.

Florence 24:49

Yeah, I think I think you're right. I I agree with you that you need that diversity of opinion and different perspectives, and that's how you evolve, isn't it? So, you know, you you can discuss things, and you know, you might shift your opinion because of something I've said, and vice versa. I might slightly think, oh, I hadn't thought about this in the way Francis is describing. So I think you're absolutely right. You you're richer definitely for those different opinions, and you'll hopefully come out in a better place.

Frances 25:28

Definitely. I mean, and and I've had consultant obstetrians come to me and actually challenge me, you know, almost in reverse, saying, Why are you worried about this woman coming to the birth centre? Actually, I think it would be a really good place for her to be. Or, you know, and I will do the same thing. I will say to a consultant obstetrian, why do you think this woman, I don't know, for instance, needs continuous electronic fetal monitoring in labour? What is it that you're really concerned about, or how concerned are you? Because, you know, so often it isn't black and white, is it? Yes. And so much of what we're dealing with, uh, and particularly what I see, you know, I I normally I'm seeing women where there are several complexities, or there isn't good evidence um for their particular risk factors, and so there isn't a sort of definite right or wrong answer as to, well, we definitely think you should give birth by this point, or we definitely think you shouldn't have a vaginal birth, or you definitely shouldn't give birth in a birth centre, or whatever it is.

Personalised Care When Guidance Conflicts

Florence 26:39

Yeah, I agree. And I so sort of moving on to personalized care, which you mentioned earlier, you're kind of doing some training and teaching for wider midwifery staff. We do a lot of personalized care together. Do you think that's on the increase?

Frances 27:01

Oh, without a doubt. I mean, when I first started as a midwife, I don't think I'd even heard. I mean, I call it personalised care, which is a bit of a mouthful, but a lot of people talk about out of guidance, and I don't think I'd ever heard of that phrase until I was quite a long way into my career. And I'm sure there were always women who were making decisions that didn't align with recommendations, but I think it's just become more and more prominent, uh, and and more and more women are aware perhaps of their rights, of their human rights in terms of what they can say yes or no to. And I do think that's really important. Um, and perhaps the whole nature of you know, it I guess traditionally the medical profession was seen as this profession where what you said was what went, you know, this paternalistic sort of idea, um, and that has changed hugely, hasn't it? I'm sure you've seen that in your career, but probably over the last sort of 20, 30 years, really shifted. Um, and I do think that's for the better, but it does also um create lots of tensions and uncertainties, and it's sort of trying to navigate those. I do think we're in a climate now, so I I really welcome the fact that women, many women, feel able to voice what they want, but it can be challenging when sometimes women are making choices that it's really difficult for us to support safely, or we may think that, and you know, we could debate definitions of safety, but you know, in things like women declining so many aspects of care that we worry that they are putting themselves in a position where they may um ultimately compromise the safety of their own health or or that of their babies, and that's their choice to make, but that can be really challenging to navigate. And I think in the climate that we're in now where more and more women are talking about trauma in their birth experiences, that unfortunately is leading to more women sort of disengaging from care and wanting to either, I think what we see both of us, isn't it? More and more women either going down a route of saying, I'm just too scared to have a vaginal birth, and I want to have a planned Caesarean that I can completely control, or I don't want your care at all, and I'm gonna go and sort of do it by myself, or with very minimal midwifery or or obstetric input.

Florence 29:50

Yeah, I think I find it really difficult. I mean, the personalized care, some of the conversations are great. Some of the conversations can be almost embarrassing because you're having to go, well, the national guidance recommends blah de blah. So, for example, continuous CTG might be a case in point. National guidance is that you are recommended to have continuous CTG, but actually the evidence is that it doesn't make any difference. So I've got to, as a health professional, tell you something that actually doesn't have a good base of evidence. Um, so I find that quite complicated. And I mean, you you know we're very honest in our clinic, and we just say that to women. This is the national guidance, but um, but there are some things that I end up feeling really concerned that a woman hasn't heard or hasn't maybe understood the degree of concern I have about some of the choices she's making. And you're right, it's absolutely her body, she's autonomous, she makes that decision. But it can be a very uncomfortable place as a professional, can't it?

Frances 31:26

It can, and I think you know, it's finding that balance. So I yeah, totally fundamentally believe in a woman's right to choose what happens to her body. Um, and I think you know, we all do, but it's trying to balance that with, like you say, that discomfort, and uh, you know, and a woman might say, Well, I don't care about your discomfort, I'm gonna do what I'm gonna do. But as a as a healthcare professional, um, and just as a human being as well, it can be really um, you can feel very vulnerable because you, although you're not responsible for someone's decisions, and I always say that to midwives, you are not responsible for their decisions, you're just responsible for sharing what evidence there is. And like you said, sometimes the evidence is poor and we should be honest about that. But just you know, we do have that responsibility, we're not responsible for their decisions, but that doesn't mean that as human beings, we're not affected by those decisions, and particularly, you know, if you know, sometimes, unfortunately and devastatingly, um, the consequences of their decisions can mean that the worst possible outcome happens, and and for the family, that's that's absolutely catastrophic, but it also really hits the healthcare professional, and that's something that we have to live with, you know, as healthcare professionals anyway, isn't it? It's something we deal with.

Florence 32:54

Yes, yeah, absolutely.

Freebirth Fears Trust And Avoiding Coercion

Florence 32:58

I know also sort of as an extension of that, there is quite an increase of free birth, and I know you hear a bit about that on the consultant midwife network. And so I suppose what we're trying to do is try and meet women, so like you say, they're not feeling they can't have those conversations with us and and try and keep them at least receiving some care. But it's it's challenging because I know you do some teaching for birthrights, the charity and about human rights in childbirth, and I know they've just done a report on coercion, so it's quite a tricky one to navigate, isn't it? What's good information versus what's coercion?

Frances 33:57

Absolutely, and I think every time I speak to a woman, counsel a woman, I'm always thinking about the language that I use, how I'm phrasing things, am I listening? Because, you know, so many of these reports that have come out in the last decade, you know, Ochenden, Morcambay, all of those women have said time and time again, I didn't feel heard. And so that's always at the forefront of my mind. Am I listening? I think you were talking about in terms of free birth, you know, we feel as healthcare professionals that we want to provide care. That's why we've gone into this profession, because we think that women need and deserve good care and that we can provide that. So when women are making choices that don't align with our recommendations, really what we try want to try and do is to keep them engaged because we fundamentally believe that they will benefit from our care. Um, and if you've got women that are starting to disengage, I think it's about trying to keep their trust. And I think one of the ways that you can do that, and I sometimes say to midwives, is start by saying yes, don't start by saying no. So, and that's something that uh birthrights the charity talk about too. So if someone is saying, for instance, and I've had um this very case, you know, a woman who was uh expecting twins and wanted to have a home birth. Now, of course, that's not what we normally recommend, but if you start by saying no, then you've instantly sort of alienated them, and you may end up losing their trust. Whereas if you say yes and and then continue the conversation, you're much more likely to keep them on side, and it's just about continuing that relationship. You know, there's so much evidence, isn't there, around continuity of care, and it's it's so obvious when you are practicing it because you meet a woman for the first time and you're kind of sussing each other out a bit, aren't you? Um and she's sort of listening to what you have to say and you're listening to her, but you're never going to solve it all in one conversation necessarily, especially if it's quite complex. So if you can keep her on side, if you like, and meet her again and build that trust, then over time you're you're much more likely, I think, to come to some kind of compromise. Um, and again, it's not about trying to coerce people, but it is just about trying to provide the care that you feel is safest, that they feel is safest, and somehow meet in the middle.

Florence 36:48

Yeah, I think that's very true. And I and kind of back to what you said about listening and really hearing what women are saying. I think one of the things I love best about the joint clinic we do is I mean, some of the women have amazing outcomes, fantastic. But actually, the thing that's really important to me is the women that come and say, I feel I've been heard, I've been respected, and you know, my feelings have been acknowledged, and it may be ultimately that they have a different pregnancy or birth from what they perhaps was on their maybe wish list, but they feel properly they've been thought about and listened to. I think there's value in the conversations, I suppose, is what I'm saying.

Frances 37:51

Definitely there's value in the conversations, just giving them that space and that time, like you say, so that they do feel that you've heard their story, you've understood, you know, if especially if they've had previous trauma, um, that we've taken the time to listen to that, and then made some kind of plan with them. And I think you're absolutely right, it doesn't always work out the w the way that they have hoped, but generally, if they feel like they've been treated with respect all the way through, then that doesn't matter.

Florence 38:31

Yeah. What's your zesty bit, Francis,

Every Woman Has A Voice

Florence 38:37

from from that conversation?

Frances 38:41

So my zesty bit would be to remember that all women, no matter where they come from, what their background is, what their medical history is, that they have choices about how they give birth, where they give birth, when they give birth. And if they don't know that, then we as midwives and doctors have a duty to let them know that they have a voice, to amplify that voice, um, particularly for women you know who perhaps um don't speak English as a first language, are less well educated. You know, it's about remembering that all women have a right to make choices and to be heard. And if they're struggling to get that voice heard, then please remember that the consultant midwife is here to help you. So seek us out.

Florence 39:34

Thank you, Francis, for giving up your time to make this episode possible and giving everyone a real insight into what a consultant midwife is and does. I very much hope you found this episode of the Obspod interesting. If you have, it'd be fantastic if you could subscribe, rate, and review on whatever platform you find your podcasts, as well as recommending the Obspod to anyone you think might find it interesting. There's also tons of episodes to explore in my back catalogue from clinical topics, my career and journey as an obstetrician, and life in the NHS more generally. I'd like to assure women I care for that I take confidentiality very seriously and take great care not to use any patient identifiable information unless I have expressly asked the permission of the person involved on that rare occasion when it's been absolutely necessary. If you found this episode interesting and want to explore the subject a little more deeply, don't forget to take a look at the programme notes where I've attached some links. If you want to get in touch or to suggest topics for future episodes, you can find me at the Obspod on an Instagram and you can email me at the Obspod at gmail.com. And finally, it's very important to me to keep the Obspod free and accessible to as many people as possible. But it does cost me a very small amount to keep it going and keep it live on the internet. So if you've enjoyed my episodes and by chance you do have a tiny bit to spare, you can now contribute to keep the podcast going and keep it free via my link to buy me a coffee. Don't feel under any obligation. But if you'd like to contribute, you now can. Thank you for listening.