us this is the safest, most cost‐effective model, the community wants it, there’s clearly a demand, this should be really easy, right? Maybe someone’s just overlooked this and once they see the facts, this will be sorted in less than a year.’ It would take us a further three years and persistent determination for Better Births Illawarra to achieve one of our goals.
Through an opportunistic encounter with a midwife I was encouraged to speak up. This midwife said midwives often felt powerless to voice their concerns in the system. We sought other women’s voices who wanted to ‘direct their energy into something that they believe in’. An engaged and committed group of women gathered and it felt like women stepping up to protect and support other women –future mothers. Well prepared with the focus of significant change, we presented to the maternity executive decision‐makers. We called for an expansion of the MGP in line with community demand and a refurbishment of the birth suites. We were not talking about a colour scheme change. What we wanted was the use of the BUDset tool (Foureur et al. 2010) to audit the current space and to make scientific decisions on how it could be improved to facilitate normal birth.
Our group opportunistically connected and engaged with a midwifery PhD candidate who facilitated the collation of evidence, a midwifery academic to advise on birth unit redesign, and a journalism student who published an article in the local paper titled ‘Seven out of ten miss out’. This article would be the game changer, the turning point that opened doors for our group and gained us a seat at the table as advocates for health reform. A valuable position of influence but a complex one as well; we walked a tightrope trying to build a relationship (with staff) and have a voice, to be taken seriously and to be heard. Staff were not used to working with advocates; three years later we are still working out how to effectively collaborate.
The birth unit design was completed in July 2020 after funding was provided, and Better Births Illawarra remains at the table to provide the voice for birthing women.
Conclusion
All four authors have described a turning point with engagement in the methodology and philosophy of PD. We accidently or inadvertently fell upon PD when we were in search of answers to how we could improve the quality and safety of maternity care. We are now committed advocates of the process and believe in the crucial adoption of PD for supporting effective change. Our experiences were not limited by clinical discipline or professional position, by health service or boundaries of nations. This fact convinced us that with the right tools, contextual readiness, authentic willingness to engage in the process and seizing available opportunity, PD could be used in any setting and be effective for any change process regardless of the specifics of the change.
We were curious novices who had a desire to implement change that could embed evidence into practice that could make a measurable difference to maternity outcomes that could engage the intrinsic motivation of teams that would sustain improvements over time and would create a culture of continuous inquiry. We found this in PD, and we encourage you to explore this for yourself.
You may not yet be familiar with the methodology of PD. What you may have is recognition of opportunities for improvement in clinical practices, you may have some specific concerns with teamwork or organisational practices and don’t know what to do or where to go, or you may be curious about other ways of working or being. We encourage you to have the courage to explore PD as a way of transforming the here and now. PD has been the turning point in our transformation, and it could be for you; are you ready for the challenge?
‘We often set out to make a difference in the lives of others only to discover we have made a difference to our own’
(Ellie Braun‐Haley, Canadian author)
References
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