With the lack of midwives in hospitals, is it time we questioned why such a gender divide exists in some obstetric professions?
“You don’t need to have suffered a heart attack to operate on a heart,” Juan Soria says sturdily. Juan has used this analogy plenty of times throughout his career as a midwife to some of his less understanding colleagues and patients. And despite the fairly recent progress, there are plenty of hardships that come with being a midwife and it seems being a male is still one of them.
The gender divide in midwifery remains the greatest of any of the obstetric professions and has largely grown from outdated social stereotypes. Just over 40 years ago men weren’t allowed to train as midwives but public discontent from wannabe midwives began to grow. A group of male nurses joined forces with the Royal College of Midwives (RCM) and began to campaign for men to be allowed to train as midwives and the government bowed to the pressure. In 1977 the government allowed men to train in two separate experimental training programmes for the first time. By 1983 the Sex Discrimination (Midwives) Order meant men were able to train as midwives on equal terms with women. Despite the progress that was being made, the order remained a radical one for a time when midwifery was still typically associated with women.
Although there are more men in the profession today than there was in the 1980s, the Nursing and Midwifery Council’s (NMC) 2018 statistics show that male midwives make up just 0.3% of the profession. Last year the government announced it would train more than 3000 midwives by 2021, but if current trends are anything to go by the large majority of these midwives will still be women. The gap isn’t as big in other medical professions that were formerly given the label of being female dominated, so why do the stereotypes with male midwives still exist today?
Juan has been working as a midwife for 10 years and he believes society places restrictions on men when it comes to careers in midwifery and nursing. “Even today men are unfortunately not expected to work in jobs that women would usually do,” Juan says.
Throughout his time as a midwife, some patients have refused Juan’s help when they find out he is the midwife that will deliver their baby. “It is important to never take it personally and to respect their wishes,” he says.
“At first it was difficult understanding why women would make these kinds of decisions and a lot of the time it was their partners who felt uncomfortable with the idea of a male midwife,” Juan says.
Some women remain reluctant to accept the idea of a male midwife although with reassurance from Juan they soon get to grips with the idea of a male midwife. And he believes that gaining a rapport with the women is the key to ensuring they remain happy with their labour. “It is perhaps one of the most important moments of their life so you just want them to be comfortable with everything that is going on,” Juan says.
And Juan believes that despite the refusal of some women, he has thoroughly enjoyed his time working as a midwife, saying: “The lasting relationships and the impact you have on the lives of families make it all worthwhile.”
Juan is now at the stage of his career where he has the ability to inspire the next generation of student midwives. He has been teaching midwifery for just over a year and aims to encourage everyone to get involved in midwifery and nursing regardless of gender.
In a survey recently carried out by CTRL, 42% of women said they would prefer to have a female midwife. The survey was primarily sent out to parents who have children attending Ilford Lane Under 5’s Playgroup and the results also showed that 77% of parents believe that people have the right to refuse the treatment of a male midwife should they feel uncomfortable.
However, this was not the case for manager of the playgroup Lindita Filipi who experienced the care of a male midwife during the birth of her second child. Linda detailed the birth of her first child as being a “difficult and stressful experience” and didn’t think to question the male midwife when he was assigned to take care of her the second time.
“At the time I was in so much pain I didn’t care who was helping me with my labour,” Linda says. “I just saw him as someone doing their job rather than a male midwife. The hospital was so busy; I was just happy to have someone that could help whenever I needed.” Linda says that although she was treated wonderfully throughout her labour, her family were still shocked that she encountered a male midwife.
“We were happy with the treatment but my family members had always had female midwives so it was a different experience for them when they came to the hospital,” she says.
Despite the large gap between male and female midwives, the gender ratio is smaller for nurses. The NMC’s latest statistics show that 11.4% and this figure has barely changed since a decade ago where the number stood at 11.5%.
And for Ihtisham Ahmed the road to becoming a nurse wasn’t so easy. Ihtisham comes from a traditional Pakistani background and he was petrified to tell his extended family about his career aspirations. “In our culture if you’re not a doctor, you won’t be accepted by the more old-fashioned members of the family,” he says.
However, Ihtisham didn’t always plan to be a nurse. He had no idea what he wanted to pursue until realised later on in his life that nursing was a viable career opportunity.
“I just always wanted to help people and in a lot of ways a nurse’s care is as essential to patients as the doctor,” he says. That’s what he always tells his family members despite knowing that they would never appreciate the work he does. Being the subject of jokes at family gatherings is something Ihtisham has gradually grown accustomed to, despite his frustration at their lack of understanding.
Ihtisham himself has been refused by a number of female patients throughout his time as a nurse. He works at Newham University Hospital who he says are often understaffed. And while Ihtisham accepts the decision gracefully and tries to find another nurse to care for female patients, sometimes this isn’t possible. “We need more staff, whether that’s men or women,” he says.
In 2017, the government removed NHS bursaries for nursing and midwifery students which hardly encourages men to take up nursing and midwifery. Instead these students are offered the same student loans as other students which means men are more inclined to take job roles that society deem masculine. Although, the largely positive experiences of Juan and Ihtisham should encourage others to consider their career options.
With the government outlining their intention to increase the amount of midwives and more men like Juan speaking out about the profession, a surge in more male midwives showing up in hospitals across the UK isn’t inconceivable.
And Juan thinks the government needs to be doing more to encourage men to take up the profession and believes people are more understanding today than they ever have been. “Being a midwife brings a unique challenge even though we’re outnumbered by women… it is still surprising to see so few men working as midwives,” Juan says.
“We need more people to understand how gratifying a job it is. What men don’t realise is that most of the time we’re actually treated better as midwives by other workers and patients because we bring something different and we’re unique to the job.”
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