I was born and raised in the Middle Eastern country of Yemen. My mother was an English midwife and my father, who was Australian, taught Arabic, set up clinics, cleaned and bandaged camel bites, pulled teeth and even assisted in sewing up the odd shark attack victim. But, he was neither doctor, nurse nor dentist.
Determined to be different
My father and mother’s love for each other and the Yemeni people was beyond any love I have ever experienced. It was their love and acceptance of those sometimes unlovable and unacceptable that taught me to have an open and generous heart and despite the odds to never give up. It was, however, my experience of watching the way women are treated and their lack of worth in a society that made me determined to fight for the rights of women alongside their health needs.
As I have grown older I have realised these rights are integrated to wellbeing and one of the biggest battle we face in the world today. Human rights in childbirth have become my burning passion.
Many years later, when I was given the honour of delivering a keynote address at the 2005 International Congress of Midwives in Sydney. I related my first fifteen years of experience of my life in Yemen.
I spent those years watching and learning the reality that is a woman’s life in a country where women had no rights, no voice and no status.
I watched my friends get married as girls.
I watched them give birth to stillborn babies after days of labour and then saw the terrible impact those labours had on their bodies afterwards.
I watched girls being dismissed and boys revered.
I watched girls slave at home and in the fields while their brothers were educated.
I watched girls sold into marriage like cattle and boys taught to rule their sisters, mothers and wives.
And I saw all this with such rage, for in my father’s eyes I was his adored first born. I had all the opportunities awarded to my four brothers, if not more. I had choices, education, respect, love and power [1].
Catching babies
When I was 5 days shy of my 12th birthday, a girl on the brink of womanhood, in a world on the brink of a major paradigm shift (1970’s), I was part of a birth that changed my destiny forever.
I was with my best friend Amal when I experienced the birth that changed my life forever. Fatima, Amal’s sister-in-law who was married to Amal’s oldest brother, was pregnant and agreed to let me come attend the birth when the time came.
At 16 years of age Fatima was pregnant with her third child in three years. She had two daughters both born a year apart and there was great hope this baby would be a boy. As a result of three years of pregnancy in a row Fatima was very anaemic and needed to have iron injections regularly.
When I approached her husband to drive her to the clinic for injections (as he possessed the only car in the family), he refused, justifying that petrol is too expensive and she can walk.
And so walk we did.
At 11 years of age, we accompanied Fatima, who was now heavily pregnant and had shockingly low hemoglobin, to get her iron injections, each carrying a child. We did it once or twice before she refused to go back. No wonder she refused and no women die during pregnancy and childbirth if they are not seen to be more valuable than some petrol!
On the first of July 1977 Fatima went into labour.
Amal woke me up.
In the top room of their house, we, alongside the local midwife, bought a beautiful little girl into the world. Fatima took one look at the child and turned her head.
“Take it away” she said, “its another girl”.
Her value as woman and wife was tied to the ability to produce sons not daughters.
I remember holding that newborn baby as the dawn began to pierce the black of night and the first thin warble of the minarets began to break up the quiet of the coming day and I knew this was my calling.
They named her Hannah after me. I understood so clearly then as a young girl, on the brink of womanhood, that midwifery was a way to change the world and women’s rights was the key.
Becoming a midwife
My desire to become a midwife was strong and I went to the United Kingdom after undertaking my nursing training in Australia to train as a midwife.
I grew up on stories of midwifery in the East End of London. It was probably one of the main reasons I became a midwife and went to the UK to undertake my midwifery training. My mum was a midwife in the East End of London in the 1950’s. When the TV series Call the Midwife came out my mum had already died and I felt very sad not to be able to share it with her. My mum’s best friend Fiona Haines (my youngest, oldest friend I call her) was able to share it with me recently when I was in the UK in 2014.
We went on a pilgrimage together to All Saints and found the real Nonnatus house they lived and worked in over 22 years ago. I have written about this in the article Call the Real Midwives. In fact, it was Jennifer Worth herself (she was Jennifer Lee then), author of the book Call the Midwife, that opened the door to my mum and Fiona when they went there to train as midwives in 1959.
Apparently Jennifer looked down her nose over a pair of glasses and said “I will let the sister superior know you are here.”
“I was terrified,” says Fiona, “I thought, ‘What on earth have I got myself into?’ ”
Apparently my mum was doing a good job faking calmness, a characteristic that came to define her.
My years of being a midwife and watching the amazing power of women, the transition into motherhood and sharing the laugher and tears has been rewarding beyond belief.
When I returned to Australia in 1991, I embarked on a twenty-year career in busy public hospitals and found that while I loved my job..
I did not love the way women were often treated and the way they often became victims of a fragmented and highly medicalised system. While I became one of those ‘expert midwives’ I found that slowly little pieces of my soul felt like they were withering and dying.
Finally I found the fear had crept in and I began to think of everything that could go wrong before I thought about what could go right.
I found often unwittingly I was an instrument of the system rather than in partnership with women. Having said this, I have worked with some incredible midwives during my career who managed to carve a path of love and trust through a system that is often an enemy to these fundamental requirements for birth.
Thank goodness for these amazing midwives.
The long road home
In the last five years, I moved from a clinical role into an academic role and became Professor of Midwifery at the University of Western Sydney. The questioning nature I developed during my childhood appropriately channeled me into research.
In this role, I research and teach and mange higher degree research students. This has helped me to work for change to maternity care on a macro rather than a micro level.
In November 2012 I was named in the Sydney Morning Herald’s list of 100 “people who change our city for the better” and named as one of the leading “science and knowledge thinkers” for 2012 due to my research and public profile.
A nice award for someone who was once a young girl in the deserts of Arabia asking questions about the effect of honey on burns…
Working with the media has also been a key strategy I have engaged in. I am the national media spokesperson for the Australian College of Midwives and work hard to get midwives into the public domain and on the radar of consumers, helping to overcome the invisibility of our profession. The Australian College of Midwives has fought a strong and proud battle in making the recent reforms in maternity come true and I was so honoured to be a part of that moment in history on November 1st 2010 when midwives gained access to Medicare.
However, amidst the excitement and full life I lead, I have missed women and babies and have realised that I have to be a part of this historical time midwives have entered into.
Jane Palmer, Robyn Dempsey, Melanie Jackson (three wonderful midwives) and I formed a group practice together called Midwives@Sydney and Beyond. Later Emma Fitzpatrick and Janine O’Brien joined us and we became six.
We became Eligible midwives, undertook a prescribing course to finally get endorsed with the Nurses and Midwives Board of Australia. This means the women we care for can get Medicare rebates for a large proportion of the care we provide and we can prescribe commonly used medications. We continue to work through the quagmire of collaborative arrangements, Medicare red tape and clinical privileging but are getting there. Hopefully soon we will be able offer women the option of birth in hospital with a private midwife.
A day in my life is never the same as the next or the previous day and that is how I like it. I feel finally that I have come home. Love and trust once again fill my working life and bring reality into my research teaching and political life.
I watch the amazing power of women when they know their midwives and believe in themselves. I see how birth can be and I am simply addicted! The greatest role of a midwife I now know is to keep fear at bay and respect women…
Going back to my first birth at home again, after many years, was amazing. As I drove through the dark empty streets I wound roll down the window and began to chant my mantra:
‘Trust in birth and respect it also.”
In the early hours of the morning a beautiful little girl was born into water and her Middle Eastern parent’s arms. I was reminded of the first home birth I was at nearly four decades previously when still a young girl. There was peace, love and power there. I thought later at how safe it all felt.
I realized, with wicked joy, that I had violated several hospital protocols and policies, but- at no time was the care unsafe. The woman took a while to birth her placenta.
In a hospital, a drip and manual removal may have been her reality but her uterus was well contracted and we waited. The baby crawled its way up to the breast and we did not touch it for hours.
In a hospital, would we have had time to sit and watch and wait? The baby was on the small side and a bit cold.
In hospital, we would have warmed it up under the radiant heater and probably done a blood sugar test but at home we bundled them into bed and kept the breastfeeding and skin to skin happening…
In the early hours of the morning, as the dawn began to pierce the black of night and the garbage trucks rumbled past the empty streets, the baby’s father surfed the internet to find out the exact time dawn would break and putt his prayer rug on the floor, he faced west and prayed.
There was of course no call to prayer from the minarets like there was at the first home birth I attended at just eleven years of age, but I knew that while it had taken almost four decades, and was a long and at times convoluted journey, I had finally come home.
- Dahlen, H., Midwifery at the edge of history. Women and Birth, 2006. 19(1): p. 3-10.
**A version of this story has also been published in the book Aussie Midwives (2016)**
**The full story of Hannah’s mother can be found here**
Don’t miss to see Hannah speak at the Human Rights in Childbirth Conference in Mumbai, India.
Sign this petition to make it mandatory that Indian hospitals declare their c-section rates!
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