Most of us are such well behaved, people pleasing suck-ups. At least in the context of attending appointments with health professionals. By and large, we show up on time (despite knowing we’re likely to be kept waiting), we come prepared with relevant documentation, we’re polite, apologetic even (despite having been kept waiting), we readily divulge enormous amounts of deeply personal information – often to someone we’ve never met – trusting that it won’t become the subject of idle gossip and intrigue, we submit unquestioningly to intimate physical examination, we somehow maintain faith that the system’s purpose and ours interconnect, we pay for it (private, public, we pay for it all in some way), and then, often, we head back out to reception and book in to do it all again another day.
And it is by no means dreadful to be a well behaved, people pleasing suck-up. It keeps the system ticking along nicely. Not just the smaller system of, say, a fairly large public hospital, but the larger system too, of general social interaction. It would be utterly exhausting to spend every day in conflict, constantly shoring up our defences against personal scrutiny, fiercely guarding our intimate information from prying eyes and ears. And from inside my particular system, it is useful and expedient when people behave themselves. We midwives get to tick all our boxes. Statistics line up neatly. Clinics run a little closer to time. We feel liked and appreciated. The women feel like they get all their answers right (because somehow being quizzed about your personal life can seem just like a test that you could well fail). The computer system doesn’t implode. Everyone goes home happy.
Well, kind of. For the midwife who sees the system as an unwieldy, impersonal production line, all this nicey-niceness, pleaseandthankyou, I’m so normal and uncomplicated, I’ll just agree to float along the mainstream, just tell me what to do, can leave you a bit cold. For us contrary beings, we like the slightly less expedient. We like the women who question, who educate themselves, who pick and choose which interventions they will accept or decline. We like the women who see us for the service-providers we really can be and use us in kind. We love the women who stand up and take responsibility for themselves and their babies. But it’s easy to love these women. Because on the whole, these women are still people pleasing suck-ups. They’re just very good at being politely assertive. They’re working pretty damn hard to anticipate how we want them to behave and what they’ll have to do get what they need from us. It’s an absurd paradox that the best educated pregnant women spend the most time justifying their decisions.
And then there is the small group of women who manage to be simultaneously the hardest and easiest to love. They are the least expedient, the least well behaved. Pleasing you is the last item on their agenda. In fact, you seem to have pissed them off before you’ve even met. I met one of these women this week. From the look she gave me when I called her name, coming to her first antenatal clinic visit was about as much fun as sticking pins in her eyes. And I didn’t even pronounce her name the wrong way. Some excerpts from our conversation:
Woman, arms crossed hard, slumped in her chair, glaring – What do you want from me?
Me, quickly revising usual chit chat in head – Urhh, really I like to approach this more as ‘what do you want from me?’
* * *
So, this wasn’t a planned pregnancy. How do you feel about being pregnant?
(still glaring) Happy. Obviously. Or I wouldn’t be here. Jeez, what are you? Stupid?
* * *
Nuh, never been sick. My family don’t get sick.
Have you ever had any surgery?
Yes. I’m not telling you what though.
That’s fine. You don’t have to tell me. I only want to know if the surgery would affect your pregnancy, labour or birth. Do you think it could?
I don’t want to talk about it.
* * *
And they were the high points of our forty minutes together. Yes, it was unpleasant. Yes, it made my job harder. Yes, it’s irritating knowing that the very patchy history entered on the unforgiving computer system will no doubt come back to bite me in managerial form. Yes, I hope that, at some point, the pregnancy-relevant bits of her history will come out so we can care for her and her baby safely. No, it didn’t leave me with the warm glow of trust and rapport. But at the end of that day I didn’t care about any of this. Because it’s not so odd really, is it? It’s not so odd to be cautious about revealing yourself to a strange midwife that you probably won’t see again. It’s not so odd to be cautious about what’s expected of you. It’s not so odd to be distrustful of the impersonal system, with its jargon and machines that go ping and its one-size-fits-all approach to care. Kind of seems reasonable, if you ask me.