12 Diane Ménage & Jenny Patterson

Diane is a prolific author and she's a part-time lecturer at the Montford University and she's also chair of the international research network for compassionate midwifrey. Jenny is previously an independent midwife and clinical midwife and she's now a lecturer at Edinburgh Napia University and she's got a particular interest in traumatic birth experiences and so hand you over to both of you to proceed. Thank you. Thank you Linda. Get this side. So yes, what led us to think about uh love in midwiffrey? Well, Diana and I both did PhDs around the same time as each other, although we didn't know each other. We met at a conference. We started chatting. We had lots in common in terms of midwifery, independent midway personal lives. Um, so we kept in touch. We shared our findings. We looked at our work and we started to realize that although we had looked at very very different topics, I'd been looking at birth trauma, traumatic experiences, Diane had been looking at women's experiences of compassionate care. So looking from very different perspectives, but discovered there was a lot of common ground. There was a lot of overlap in our findings and interestingly both of us independently in our own ways had begun to question whether love could be talked about whether it had a role and what it was and a few years later through a conversation Diane and I had Diane suggested let's let's write a book I said okay okay let's write a book what about and Diane said love and I said okay you're right we need to do this Because we know that from looking at the research and the work out there that love is very rarely explicitly spoken about in midwiffrey. It's spoken about in nursing a bit more but very rarely in midwiffrey and we wanted to know why. So we got together some really good a range of fantastic midwives and authors who've contributed to this book and it's it just feels like a wealth of wisdom and knowledge. Um, so let me give you a little overview of what we looked at. Well, first, you know, what do we mean by love? Um, we're going to talk a little about that through this this morning. Um, because, you know, it's not just falling in love or passionate love. What What do we mean when we're talking about it in the context of midwiffrey? Um, and why do we even need to talk about it? and particularly in the context of the humanization of of of childbirth. And so our whole part one of the book is exploring that giving up the foundation. Then in part two we wanted to look at in practice what does that mean? So we drew on the five Gary Chapman's five languages of love. Touch, actions, words, time, and gift. And straight away we thought these can very appropriately align with aspects of midwifery care. Um so there's there's sections on each of these with some very um experienced authors writing. And then we wanted to look at well let's look at the whole profession out with just our everyday practice. What does it mean in terms of ourselves as midwives engaging with our colleagues, midwiffery leadership, education of our students and all our new midwives and the profession as a whole. So we think that you know what we've got here thankfully to the the the great contributions from so many wonderful people is is a really good exploration of what we mean by love and what its role might be not just in the living out of midwiffery but hopefully in the transformation of midwifery across the world. >> Thanks Jenny. Um so yeah, Jenny was talking about the different parts of the book and part one is is what do we it includes this idea of what do we mean by love? Um the thing is people have lots of different ideas about what love is. Um and particularly in in western culture, it's often mainly associated with being in love, romantic love. Um, and that's well perhaps obviously, but that is not what we mean when we talk about love. We're talking about love in the ways that many different cultures and religions and people talk about love that it is to do with caring. If we care, then surely some of that care is grounded in a type of love. It's a value. We can see love as a value. And many people have written about this. It's a force for good. And I think when you look around the world and you look at all the things that are happening in the world, we need that force for good. We need that that humanization, that loving our our fellow humans to be able to live successfully together. It's a doing word. So that's important if we think of it as a verb, something we do rather than just something we feel. Uh perhaps thinking about loving rather than love and how we can practice lovingly. It's a meaningful connection and midwives are great at that. We have meaningful connections with the women and the families that we look after all the time. And what we are saying is that is coming from a place inside of you when you make a meaningful connection with a woman and a family that is coming from your loving practice. So love is very much part of being a human being and it's not something out there. It's something that's already within us. I think that's a a very important point and if you if you take some things away from when you leave this session today I think I want you to take that one uh there's some other things I'd I'd love you to take us but that one it's already within us and we what we need to do is um and what many of you I am sure do already is to find a way of connecting with that. Okay, thanks Jenny. Next slide. So, that's a little bit of background. Um, setting it in some context. And I'm like you to kind of just mle that one over and let that one just sit for a while. While you're doing that, I'd like you to think um when you hear the phrase love and midfree, what do you think of? What comes to mind? You've joined this session today for a reason. you saw it on the program and I don't know what you thought. Maybe you thought what's that all about or maybe you thought love and midwifree that doesn't sound like anything I've heard before. I don't know. I don't know what you thought and we would love to know. So just write a word or two, a sentence, just something in the chat. What do you think of when you hear the phrase love and midwifery? Going to give you a minute or two to do that. I'd love everybody to just write something. Just the first thing that comes into your head is fine. Um, okay. So, and it might not be it might be that this is a an alien concept to you in terms of linking it with midwifree. Um, and that's fine, too. Whatever comes to mind is good. So, Lena has said that great some great ones coming in. Now let me just go back to Linka. I thought that love and midwiffrey go beautifully together. Midwifrey is based on love. Thank you for that one. Linka number of people talking about oxytocin. So we we're quite good at talking about oxytocin, aren't we? The hormone oxytocin. And some people uh tend to call this um sort of the layer maybe is is love hormone. And so we know the part that oxytocin plays in um in in labor and birth and bonding and attachment and um delivery of the of the placenta and breastfeeding. We we we know about all that. Um, and that's a really important part of what we do. We're we're immersed in in love in a way all the time, aren't we? When Seline has said that the energy that is good for me, I think she's talking about that love is the energy that is good for me and for people with me. So, that's going back to this idea of of kind of an energy or a force for good. thinking deeper about women's life. So many great comments here. >> I I sorry go on. I noticed I noticed um somebody at the beginning BA wrote dedication and I think that's really interesting because there's something about that choosing to turn up day after day choosing to be present to people just giving your yourself to this role and to this life and there is a dedication and I think you're right I think that comes is motivated and driven by love. Wow, there's some so many fantastic comments here that we'd really love to um learn more about. Um so I I think it will be saved. Um Linda, I think the chat will be saved, won't it? So it may be that >> indeed. Yeah, >> that we can um >> Oh, Seline says, "Love is an intention, a source." Um intrinsic. It's intrinsic. >> Well, that's what that's what you were saying. It's already within us, isn't it? And people have spoken about compassion quite a lot there >> and compassion we find it much more comfortable perhaps to talk about compassion but you know what we're considering is is you know what motivates that compassion and and and our understanding and our belief from what we're learning and reading and hearing from others now is that love is what drives and motivates the compassion. Thank you for all these comments. I've loved your name. Before you can have love, you have to have respect. >> Yeah. Respect. >> Aum. >> And we talk about respectful care. And that's a big thing, isn't it? Because in many parts of the world, in many countries and in in all countries, in different ways, sometimes we don't have fully respectful care or respect for one another as colleagues and professionals. So you're you're great. >> Roslin, I'd love to talk to you. I'd absolutely love to talk to you um at some point. So maybe you might like to get in touch um because that is a really important point because respectful care is also very important and so is loving care and compassionate care. And it's the kind of the way these two come together that makes excellent care, isn't it? and and we've been um in in the uh international research network for compassionate midwifery we've been looking at how these two things overlap but how also they are different so I'm going to move on because otherwise we could spend way too long on this fascinating thank you for that so so just going back to this is not a tickbox approach this is not just another thing for you to do. We're always being given extra bits and pieces, documentation, uh now we've got to do this, now we've got to do that. It's not like that. A loving approach, the the most compelling reason to taking your love to work and demonstrating your love in your in your work in midfree um is it makes you feel better. And we know that back to oxytocin, we know that oxytocin gives us that fantastic feeling. Um so that is the most important reason for um practicing lovingly. It will make you feel better. And of course the knock-on effect of that will be is that your care will be amazing. It will it will help to guide your care and and the relationship you have with those that you care for. Practicing lovingly and taking your love to work, whichever way you want to um to talk about it, gives you more control. There's so much we don't have control over. Our workload sometimes is is out of our control. demands from competing um sources, demands from um perhaps from our managers, um demands from the people that we look after, demands from our colleagues, demands from our profession. Sometimes they they're all competing with each other. Um to act out of love gives you more control. As I've talked about, it will automatically improve the care you give, make the care that you give better. Uh, and I'm sure that's I'm not suggesting that any of you give care that isn't loving. So, I'm sure from your comments, what's happening is that you you are already doing that, but perhaps you've never had the chance to recognize that and talk about it before. So, your work as a midwife, it happens through these connections and these relationships. the relationship uh with the woman and the family are they're like the vehicle which is um it's the vehicle for high quality care and of course good connections with people um relationships with people um are often in the rest of life based on care and love. So why should it not be the same in midwiffery? Next slide. So what we found when we were um researching for the book was that midwives had different views. Some of them were quite shocked that we were talking about love, not many, but some. And they worried a little bit that it might be considered unprofessional. And we can talk about that later if you'd like us to that side of it. But lots of midwives told us that they did recognize the love in their work in many different ways. So I've got a few quotes here which uh not just in the run-up to the book um but but also following the book and more recently. I'm going to read some of them out. Practicing as a midwife most certainly involves the expression of love. Love is the reason many of us choose midwifrey in the first place and the reason why we continue despite the challenges the profession faces. The idea of talking openly about love in midifree resonates very deeply with me. Another one from Katie in the UK. Pregnancy and birth for me is a force that is beautiful, tragic, and unpredictable, and I simply love it. And the last one on this page, thank you so much for allowing me to remember my love for midwifery, passion, and calling for my vocation. Okay, Jenny's got a few more, I think. >> So, those ones were about um our love for our work and then some people have told us about the love within the role. So, love in midwiffrey is not an unprofessional indulgence. It is, I believe, at the very heart of what makes truly excellent care possible. And every midwife who has ever practiced this way deserves to have that vindicated. I bring love to every single workday, to every conversation, to every episode of care that I give. And in those moments during labor and birth, the love I feel expresses itself through very simple human gestures, stroking her hair, massaging her back, holding her hand, speaking quietly to reassure her. and sometimes she holds on to me in return. I thought that's a very beautiful expression of how we connect with somebody and building that relationship. So those are just some of the quotes that we've we have very many things that people have been telling us. Um those are a few I'd like to talk a little bit about in our workplace. Um for many of us and for many of you um perhaps at different times in different places workplaces are are can be very challenging and Diane has mentioned you know some of the pressures that exist in very high intense workplaces where there's large num you know big central units where there's loads of births happening a lot of pressure a lot of families coming through needing care Um, and sometimes the the culture and the environment can be challenging. We know this. It's written about a lot. There can be bullying. There can be undermining. There can be lots of things that happen that as humans we feel far from being loved. And it's very hard to to be within those places. So, so what you know what where does love speak to within this? And it's it's as Diane says, it's not another thing that we have to do and it's not another thing that we have to h that we have to put on, but what's within us? How can we connect with what's in us with that love that's in us? The love that brought us into midwifrey in the first place, which almost everybody tells us, the passion, the dedication, the desire to work in a way that makes a difference. And that's can be really squashed and really hard to maintain and keep alive in the culture. And one of the other parts that happens is in many places an us and them attitude. I in my life it was the community midwives compared to the hospital midwives or as an independent midwife, the independent midwives and the national health midwives, you know, um or the doctors and the midwives. There can be often a lot of tensions where we don't respect or collaborate well and we have this separation and this othering and and that really just hurts everybody in the process. So, you know, how can we how can love um address this? How can love make a difference here? And as Diane has also mentioned as well that connection. We've got a social connection. When we go into our workplaces, we are with other people. We have to engage with other people. Not just those we provide care for, but the people that we work with each day. The people that we share equipment with or we share moments with or we share documentation with um and we share the care and we collaborate. We have to connect. We have to be able to do this and love can sit right in the heart of that or it can be really squashed out. And here again we bring in the concept of that mutual respect and as as was mentioned earlier respect sits right at the heart of this. So these these are the the some of the challenges that we might be facing in our workplace. some of the realities of what we are all living with. Maybe not every day, but some days uh and often more. When I did my work on trauma, I discovered that trauma does not just happen to the people who are birthing in the families. Um but actually trauma for midwives and care providers is incredibly high. And sometimes it's from what we witness, but sometimes it's because we're in an environment where we really can't give the care that we know we want to give and that we know is optimal and that hurts us. So how can love how can love help us within this. So the first thing you know in in looking at this is we are all responsible for that workplace culture. each and every one of us. It's very easy to say, "Oh, it's because of that person that it's like this." But actually, what do we choose to be? How can we choose? How can we connect with that love within us and bring that in each day? How can we choose to practice lovingly? And it can be very challenging when we're feeling a lot of pressure. But sometimes it's just, you know, what we say, but how we say it, how we show up day in and day out. That's the dedication. We're coming each day and at the end of the day within this big picture, we can change nothing except ourselves. The only person we have control over is ourselves and how we choose to be. Now, that sounds to me very much like, oh, it's another thing we have to do and I'm tired and I'm exhausted and I'm hurt and I've, you know, been treated, you know, I feel I've been treated badly by people, but now I have to turn up and smile and be loving. That's hard. That's really hard. And it's not just about that because it is that but also within that it's how we connect with our colleagues the people we trust the people that we know are there to support us and say today I'm struggling today I want to be loving but because of this I'm finding it really hard maybe it's something in our own lives maybe it's something at work so then if one of our colleagues comes to us and is saying that we have the the opportunity to choose to be loving and supportive to that colleague. So we we have to work together. We have to choose. But it is just those little moments. Do I get involved in the conversation where I am bringing somebody down? I can choose not to do that. I can choose not to be negative about somebody. I can choose to say something positive to somebody who maybe doesn't hear it very often. Maybe the people that we find most challenging and who irritate us or we're scared of maybe saying to them that was great what you did today or here's a cup of tea or whatever the helpful thing is in your culture. We can take those choices and that is our loving approach. And when we do those small things then the human person in us and in the people we engage with can feel something different. they might turn around and go, "Oh, okay. That was nice. I felt that." And that will start to change. So, the way we treat each other matters totally in terms of our colleagues. I could spend too long on this. So, I'm going to move on and let Diane say something else now. Oh, sorry. Before that, a couple of quotes. Sorry, Diane. Um, and these are some of the quotes that people have told us about colleagues. It is the love I have felt from my colleagues that helped me through some of my darkest days. There is a wealth of love from awesome midwife friends. Gentleness and peace should be reflected in the interactions we have with our colleagues and students. Midwifery is the most loving sisterhood and I love how we carry each other every day and every night so we can transform and that's people's experiences of just being held and carried by each other. So, we've put the bunny here, the fluffy bunny, just to kind of make a really vital point. Love is not soft. Yes, within loving practice, there are times when a softness is it shows it shows love. It shows care. It shows understanding. It shows connection. There are times for that. Yes. But that is not what love is as a whole. Love is hard. And we've got a different image that we would like to show you really, which um is the book cover. And and that is of the a diamond. And a lot of people wondered why there was a diamond on the front of the book and why we've used it as a symbol for love. And it's because a diamond is one of the hardest and most resilient substances in the universe. And that is what we are likening love to. The other thing is this is a cut diamond with many many different faces, facets with light shining off it. And love is many things. We've talked about already. It's a choice. It's a it's a it's a doing thing. It's um it's an ethic. It's connection. It's so many things. It's compassion. Uh so, two big reasons. One, it's it's hard. It's resilient. Um but love is difficult. It's not an easy thing. And the other thing is that it's got all these faces that And of course, it's beautiful. So when we think about um love and the difficulty, the hardness of it, if you like, it's a difficult thing to do um every day, day in day out. Um we need it in so many different parts of the profession and each one has its own challenges. We need it in we need it in practice and I think that's probably the the the first thing people think of. Um but we need it in leadership. We need leaders who are leading lovingly. We need it in midwiffrey education so that we can from the very beginning of a midwife's journey. It it's there. It's embedded in it. We need it in research. Yeah. And and I noticed that there's quite a few researchers, midwife researchers um here today and uh I won't go into it now. there isn't time. But in the book, we talk about research as a form of love. And yes, we really do. You may not have thought of it that way before. Um, and research is is hard, too. Practice is hard. Leadership is hard. Education is all got its difficulties. It's all got its challenges. And yes, love can help us find a way through all of this. Um and we can bring it to enhance every aspect. Even midwifrey regulation um we want midwifree regulation to support loving practice and we don't know that it does at the moment. Um it supports relationship based care but falls short of talking about the details of that, the caring, the loving. So there's lots of aspects to it, lots of different facets. Next slide. So just some key messages we'd like you to take home from this session in that love is not just an emotion. It's not just a feeling. And that's not what we're talking about is gooey feelings. It's a fundamental human need. It's it's right there in human if we um for all humans in all parts of our lives. Love sits within everything that we need. It's a value as Diane has mentioned. It's a choice. And that choice, making that choice to practice lovingly, making that choice to turn up and be a loving person with a with a positive attitude and a compassionate attitude. And it's also a powerful force for good. It can transform. We actually believe it can totally transform midwifery care can transform lives. It can drive that real quality care. Diane was mentioning about research that motivation to make a difference to to follow through that action. One of the languages of love is act and action and research. And research is part of what's really driving the improvements in quality care so that we have the evidence to know what is best and it's meaningful for us. It it makes us feel better if we if we turn up lovingly as D has said lots as well. That is one of the things it's meaningful in in in our actions and in the difference that we can make to others. But it also contributes to a really sense of fulfilling work for job satisfaction as well. And that's why we do this. That's why a lot of us are here, isn't it? We came in with the love loving approach with really wanting to make a difference. And when we have the opportunity to work in a loving way, when we experience that loving connection with a woman and her family, or when we work in a really strong collaborative way with our colleagues, we go home with a real sense of that was a good day. We made a difference today. I feel inspired. I feel strengthened by today. Even when as somebody's in put in the chat if there's stuff going on at home, if we have family who are not well, children, we have things going on and we have to turn up and do this loving job again and try and bring it in. But when we do it and when we feel that love back to us from our colleagues, perhaps from the women and families, how fulfilling and amazing is that? That's what keeps us in this job, isn't it? That's that's what it's about. Um, so those are some of the key things that we we'd like you to to take away. We have a little task for you as well. So everything we've said so far. Okay. How does that work if nobody's talking about love? And and you've shown that you are you can easily talk about love if given the chance. When we've been around the country talking about this to student midwives and midwives, we've asked, "Have any of you had an opportunity to talk about the love in your work?" And nobody said they had. Everybody said, "No, I've never had a chance to talk about this in a professional way." Um, so we were at a university and students all said no. And so we asked the um the lecturers, "Have you ever had a chance?" Some of them had got, you know, many, many years experience as midwives and they said, "Oh, no, no, we not." And in the run-up to the book, I talked to individual midwives about this. And what was so moving was that some of them were actually moved to tears when I asked them about it and they told me no, they'd never they've always felt that there was this love for midwiffery and this this love within them when that they take to work and they have never had a chance to ever voice it or talk about it. So we have now got quite a few midwives who have told us about it mainly in the UK not totally but mainly and what we want to do is we want to record this we want to record this as part of mid midwiffery the part of the professional information that we that can be held about midwiffery um a a documented evidence that there is love in midwiffery and midwives want to talk about it and do talk about it and describe describe it. So we are putting together this collection which will be created and archived and it's a collection of different forms of evidence and um activities of a person or a group or an institution. Sorry that's sorry that's that's the definition of a of an archave. A collection of evidence of a group person person group or institution that have been accumulated and stored through an organic process. That's what we're aiming to do. Okay, that's what that's our next big project is that we want to put this together so that for forever I mean ever's a long time but for the for many years to come we will have this collection of mid midwives words on love in their work. I mean if we put together what people were saying about midwiffery at the moment if we look on social media etc reports investigations we would not get anything about love we would get some very dark stuff um in the media etc um about midwiffrey at the moment what we want to do is to balance that with the stories of love in midwifrey from midwives So could I have the next slide please Jenny? So we want to invite you to be part of this project and we invite you to share your thoughts and your stories of experiencing love in your work. This is not a research project. It's an archive. It's a record that we will curate. Um, so we're not going to do anything um special with it other than collect it and organize it and keep it safe. Um, so there's an email there you can contact us on. We've got the website that we would like to point you in the direction of. If you're on Instagram, you can connect with me at Diane Menage and message me. Send me a private me message or you can connect with me on LinkedIn and send me a message if you'd like to do it that way. So, there's various ways you can get in touch. Just let me know if you would like to get in touch and be part of this record of midwives words on love and share it if you would share it with other people. So I think we're we're we're just about to finish and I think we're going to open to questions but there's a couple of things come up in the chat that I just wanted to acknowledge. Um so Seline has said can too much happen and bring some fatigue and yes you know burnout, fatigue, exhaustion very much part of our role because we give and give and give. Um but that is very much where we need to look at love for ourself and take care of oursel and call on those colleagues who support us and to be able to say I need some help. I'm tired. I'm struggling. This is going on in my life. I've witnessed this event yesterday. Whatever it is that's, you know, hurting us because we are human beings. That is at the heart of everything that you Diane and I said and came across in both our research is we are human beings. We as the midwives, the families we care for, all our colleagues, we are not machines. We are not robots. We are people with lives, people with things that hurt us, people with illnesses, with fears, with bereiements and with things that we witness and that things that make us sad. We are human and we need to care for ourselves and we need to care for each other and love is right at the heart of that. So yes, things can be too much, but what can we do to support one another? Um there was one other thing I think um which was talking about selflove as well. So I just wanted to highlight that a bit. Thank you. So I think we're ready for questions. Do we have another slide? >> No, we don't need to do that other slide yet. Leave that one. >> Okay. So we have a questions slide now, but not really. >> So So um I've un I've allowed people to unmute and to show their video as well. So, Boopy is the first one to put up her hand. Boopy, would you like to ask your question? We've only got five minutes, by the way. So, >> okay. Thank you. Uh, so my questions are to Jenny and Deian. So, I want to find out your um context. So, where are you coming from? So if we were to ask about reflexivity, so what is re what really motivated you to do this uh project and where are you uh getting your philosophy of love from? Thank you. >> I shall I take shall I start with that and Jenny might want to add too. So for me uh I did a PhD. I was a midwife um and uh clinical midwife and I got the chance to do a PhD and I did this on compassionate midwiferey what women's experiences of compassionate midwifery what was it to the women uh what do they think it was what did it look like uh what difference did it make etc so um and at the end of that that was fantastic to be able to think about compassion for three years it was a great privilege Um and I continue to think about compassion and uh a chair of the international research network for compassionate midriffy. But at the end of it the question I had was okay I understand about compassion but why would anybody bother? What would make you what is the you know what is the driving force for being compassionate? And every way I looked at it, I was coming back to the same thing and the only word I had for that thing was love. So that was my motivation and um I wrote the first chapter in the book which is about what do we mean by love and so thank you very much for bringing that up um in terms of what was our sort of underlying theory and philosophy. I looked at lots of different things. I looked at love from a a a religious point of view. I looked at it from a sort of um humanistic point of view. I looked at it from psychological point of view, from a a sort of biohysical point of view, the hormones involved, etc. What what goes on there? Uh from a a philosoph um from philosophy point of view. Um so I looked at many many different aspects. Um so I hope that that goes some way to answering the question. Jenny, do you want to chip in? >> Uh well similarly I as I' said we we I did a PhD looking at women's experiences of trauma in childirth. Um and it was identifying within that in a sense what was missing the compassion was missing the respect and the compassion. So for me I came from a different perspective um and then started to look at well you know what what what's missing here what what's needed here and I started to question is you know where is the love in this and what role does love have and it was through Diane and I sharing over the years as we got to know each other and shared our work that we started to explore this together and then as Dian said we started to speak to others and it has grown from there. I hope that answers what you were saying there. >> Okay, >> thank you. >> Thank you. >> Would anybody else like to ask a question? Just unmute and ask away or make a comment. >> Good morning. >> Elsie, >> hello. Hi, D. >> Sneaking in there. Sorry, I was um I was up late last night listening to other um um talks. Okay, so I really appreciate this um move towards love being a part of our work and I am just thinking the inscription of midwiffrey as intangible cultural heritage is helping us to incorporate those indigenous midwives who work in this way. We're talking about the energy of spirituality, of love, and stuff like that that is so ingrained in who we are as midwives. And I'm just wondering whether Diana and Jenny think that the technological move towards um midwiffrey as a professional practice is what has driven out this love and caring approach. Certainly when I came into Midway Free all those years ago was it it it was it is what attracted me to the work and I've remained that way ever since despite the challenges. So I'm just wondering about the rise in technology and the move towards all the algorithms etc. you know what are your thoughts on that? >> Well yeah should I should I start Jenny or would you like to start? I don't mind Diane you can start. I have something to say so I'll join in after I think it's I think it's a really important point Elsie and thank you for joining and thank you for the question and it is that dilemma isn't it between yes technology has brought in a lot of benefits but there's also some consequences and there is a rub isn't there between um pathways guidelines uh particular formats and ways of doing things and individualized care. And that's one of the difficult things that midwives have to navigate all the time, don't they? Um, it's keeping hold of that person that's in the center of the care, that individual, that specialness, which I would say is the loving side of midwifrey, and providing the safest care that we can for probably a large population of women if we work in a in a in a in an area in most areas really. Um, so I I don't think there's any easy answer to that. It's it's there is a rub between those two things and certainly the professionalization of midwifery has been responsible for eradicating um the kind of caring love side um in the language. You know we we look back in old textbooks and and you you know well even new textbooks and you'll struggle to find it. And even yes we do talk about compassion but that's only about 15 years old that we didn't actually even talk about compassion in midferey um before that uh you were you were very very rarely find it in any documents or or textbooks. So yeah do you want to add Jenny? I'm just going to add that the the challenge that I find particularly with the technology and and everything is the the our attention is drawn to the equipment to the machines to finding the technology to documenting it all and that can mean that we take our attention away from the the woman in front of us. It can also take up a lot of time and so how do we find a a space within that that then that adds the pressures on obviously and the time pressure but when I'm working with students I am always trying to reinforce that individualized care and that even if we are working with the technology how can we still and we can still take the time to to look at the person to engage with the individual to still speak to our colleagues. We can work within it. it just it takes up a lot of time and attention and that's the ch that's the the tension that I find um and and that the focus is drawn from that professional point of view that we have to document we have to have used this equipment we have to have set it up we have to have collected everything from it and all our focus can very easily go towards just focusing on that technology and the computer or the CTG machine rather than the individual and it's it's trying to remember to keep our focus back to the individual and it is a challenge but that's sort of where I'm thinking. So I think the loving approach can be like how do we remind ourselves and give ourselves permission to engage with the person rather than the machine or alongside >> there's something that we often have a slide on but we haven't this time but I think it's worth mentioning here and that is that you you as a per a human being and you as a professional and you as an employee all those roles are important they're often conflicting with each each other and what we propose and this is difficult to do. We didn't say this is easy, but this is love. You know, it's hard. Um is what we would say is this is the right order. Human being first, professional second, employee third. So never let anybody dehumanize you in your work.