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Roar Behind the Silence

Why kindness, compassion and respect matter in maternity care
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For many years there has been growing concern about the culture of fear that is penetrating maternity services throughout the world, and that the fear felt by maternity care workers is directly and indirectly being transferred to the women and families they serve. The consequences of fear includes increased risk of defensive practice, where the woman and her family become potential enemies to those providing her care. In addition, the prevailing risk management and tick box culture in maternity services encourages maternity workers to give priority to the records instead of the childbearing woman. These factors contribute to the dissatisfaction felt by those using and providing maternity services, and the apparent lack of kindness and respect. There is however increasing evidence that kindness, compassion and mutual respect improves efficiency, effectiveness, experience and staff morale within healthcare settings.

The Roar Behind the Silence provides information, inspiration and practical suggestions to support maternity care workers, policy makers, and maternity care funders across the world in their quest to deliver sensitive, compassionate and high quality maternity services. The book highlights examples of good practice, and practical tools for making change happen, using evidence and stories where appropriate.

Sheena Byrom has been a midwife since the 1970s, working in hospitals, birth centres and homes, and later becoming a consultant midwife and head of midwifery. She writes and lectures regularly on midwifery topics, chairs the Royal College of Midwives campaign for normal birth, and is a trustee of the Iolanthe Midwifery Trust and a patron of StudentMidwife.net Professor Soo Downe has worked as a clinical midwife for 15 years. Her research focus is the nature of, and cultures around, normal birth. She introduced the concepts of salutogenesis and complexity into midwifery in her edited book on normal childbirth in 2004. She is a member of the steering group for the recent Lancet Series on Midwifery, and of the WHO Technical Working Group on antenatal guidelines.

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