tell me a story
lorna davies
This article was originally published in
The Practising Midwife, July/August 2004.
Republished with permission.
When my son was only two or three years of age, my husband created a fictional character who paid daily visits prior to bedtime. The character called Jomu, was a boy from Hawaii who experienced exciting adventures with his friends and families. Jomu was an influential figure in the life of my son and he still makes the occasional visit even though Joe is now well into his ninth year. The benefits of storytelling for children, such as those mentioned above, are well documented.(Marshall 1990, Gussin Paley 1991) I believe that the stories have provided Joe with a multitude of life skills and attributes; have helped him to develop listening skills and taught him the rewards of concentration: have given him a structure for his daydreams and fantasies and have provided an opportunity for him to contribute his thoughts and ideas which may have helped him to establish self worth and esteem. In short, Jomu has helped my little boy to make sense of his world and I would even go as far as to say that the stories helped Joe to create values and beliefs that he may carry into adulthood.
The benefits for adults are also well recognised and storytelling is being used by a wide range of professions from family therapists (Woodward 2003) to Professors in business schools. (Simmons 2002) The determined effort to reduce all knowledge to analytic proposal so prevalent in contemporary culture, is now seriously challenged. (Denning 2000) The internet is awash with sites related to storytelling and there is a plethora of courses available at all levels from basic technique to study at postgraduate level.
Stories can be used for many different purposes. They may be used to instill a sense of integration, understanding, and pride in family and culture. The telling of stories can foster healing, offer new perspectives on one's own place in the world, and demonstrate a willingness to appreciate and celebrate the cultures of others. Stories put us in context and connect individual bits of information to the bigger picture, increasing our understanding of the details and the vision. By sharing and creating a common experience in storytelling we are able to interpret events beyond our immediate experience (Baker & Green 1998) Storytelling even boasts worth epistemoligically when valued as a way of knowing.
Storytelling is currently gaining greater respect within the fields of medicine and allied health professions. We now know that words may have profound recuperative effects, promote healing, and create a more nurturing environment for people to deal with the trials of pain, suffering, and grief. The Arts in Health Council website (http://www.nnah.org.uk/) lists the projects where storytellers are invited into health care establishment to participate in therapeutic activities with patients.
In midwifery, authors such as Kirkham (in Kirkham and Perkins 1997) and McHugh (2002) have acknowledged the value of storytelling for women in the childbearing period of their lives. They emphasise the importance of recognising the value of stories in enabling the women to make meaning of the profound experience of birth and new parenthood for use in areas such as debriefing. England (1998) stresses the significance of using storytelling in the antenatal period as part of the preparation for becoming a mother.
Traditionally, storytelling was the way in which women were prepared for the birth experience and were able to make sense of the experience from the reflections of those who had been there already. Equally ,midwifery was learned by apprenticeship, the knowledge and skills required were passed down from generation to generation. Her skills were largely acquired from the stories that she was told. (Sharp et al 1999) Perhaps we need to look back to the arts of our foremothers and take heed.
The value of storytelling should certainly not be reserved for the women that midwives serve. Midwives themselves benefit from the inclusion of storytelling, in its many guises within midwifery education and practice. Kirkham (1997) believes that our life experience is only rendered meaningful and coherent if it is created from stories. For example, reflective practice is the theoretical embodiment of storytelling and its benefits for practice are manifold. And as Judy Edmunds, an American midwife eloquently states:-
“Storytelling is right up there with love and support as far as seeming trivial but actually being hugely important. We are the torchbearers of truth, the weavers of courageous empowering visions to set before the women and families we serve. Our stories must be told often, until they become more compelling and convincing than the horrible 'you are weak and defective, prone to failure, need our technology, and might as well give up and give in now' myths people hear all around them.”
Although we may be tentatively reaching out to reclaim the art and value of storytelling, in practice we all too sadly recognise that the reality of poor staffing levels and a ritualised approach to care frequently results in a story never told, or made meaningful.
There are potential time bombs ticking away in midwifery practice. These days a midwife is expected to be self-aware (Hammett in Kirkham & Perkins 1997). Burnard (2002) believes that self awareness is bound up with other relationships and therefore it cannot be forced upon the individual but must be sought by her. If the midwife needs to understand the needs of women she first has to understand her own needs and her own agenda. Midwives as women need to debrief, or defuse as much as the women that they support during this period.
Some years ago when I applied to the National Childbirth Trust to become an antenatal teacher, I was invited to the home of the local tutor, for what I imagined was going to be an interview. I was surprised when she asked me to talk about my own birth experiences. I was even more surprised how cathartic it was to talk about some aspects of the experiences which I realised I had locked away for some time.
Within the NCT philosophy, it is considered to be unreasonable to expect you to cope with other peoples 'baggage', when you have not unpacked your own. However, in midwifery, at least in my own experience, we do not actively encourage this practice. Isn't this something we should be introducing into our selection processes? Even if the applicant has not given birth herself, her values and beliefs around birth have been formulated from a wide range of sources and will irrefutably influence the sort of midwife that she will come to be.
We recently introduced a 'hearts and minds' element to our induction programme at the University where I am employed. In one of the sessions, the group are asked to produce a life steps chart where they map their own life's journey highlighting what events and incidents link with their decision to become a midwife. It is a powerful exercise that leaves me evermore aware as I listen to their stories, of the importance of the decision for many of the women and the sacrifices that they have made to achieve that goal. At the end of the day, there is a much greater sense of unity and cohesion within the group, which I am convinced, albeit anecdotally, leads to greater tolerance and respect.
When I spoke to my husband about the exercise, he could not really grasp the relevance of such an event, which led me to reflect on whether there was a gender related issue.
Feminists have long recognised that women's experience is different (Weiner 1994). Traditional epistemology has tended to exclude women, by placing a boundary on knowledge, defining it through the means used to identify it, that is objective, empirical and scientific.
As a midwife teacher I observe women students draw upon a wide range of evidence, including anecdotal experience, homespun philosophy and intuition. Much of the subject matter discussed relates to the personal experiences from their own areas of practice as midwives.
Feminist educational theorists include personal experience as a basis for the production of
knowledge, embracing the private sphere as a legitimate area of investigation. (Kirby & McKenna 1989). Bell hooks (1994) states that feminist pedagogy includes a goal of justice for all humans and allows students to be empowered through the recognition and validation of their own personal experience, and by encouraging them to draw on their personal experiences while learning about theory. Story telling produces a vehicle for validating personal experience.
Pinkola Estes, (1993) in her book “Women who run with the Wolves”, suggests that women
have always used storytelling circles in order to create a space of their own and to develop a
voice. Circles offer an opportunity to discuss freely and in detail the issues that are most
important to them. Such gatherings may also offer warm encouragement to develop ideas
and aspirations. Perhaps this is something that we need to take on board in regard to how we
organise the learning environment. Our move into higher education has led in my experience
to a more patriarchal approach to structure and practice. Large student group numbers
militate against using group structured interactive activities.
By adopting the ancient tradition of storytelling (Hughes 2000) and gathering in circles, we can create a safe and permissive environment which is women focussed and serves as a positive role model that our students can take into practice to use in for example parent education.
At my university in spite of large group numbers, I believe that we still manage to achieve this to some degree, by employing an adaptation of Problem Based Learning (IBL)
Problem-based learning (PBL) is a facilitative educational method that challenges students to "learn to learn," working cooperatively in groups to seek solutions to real world problems. It transfers control of the learning process from the teacher to the student. The students formulate and pursue their own learning objectives and select those learning resources which are best suited to their current information needs. Teachers contribute to PBL by providing suggestions. In problem-based learning, the traditional teacher and student roles change. The students assume increasing responsibility for their learning, giving them more motivation and more feelings of accomplishment, setting the pattern for them to become successful life-long learners. Teachers do not prescribe or dominate. The classical model consists of six to ten students who need to resolve a phenomenon or a set of events that require explanation (Sadlo 1994) There is a strong emphasis on the use of group dynamics to facilitate motivation and the elaboration of an issue and values the personal contribution of the student.
PBL (or as we term it, Inquiry Based Learning IBL) thereby promotes the sharing of stories, from the personal and professional lives of the participants.
I also attempt to incorporate storytelling in other modules that I lead in creative and resourceful ways. For example I have utilised the methods advocated by Pam England in Birthing from Within (1998) Pam teaches antenatal educators the value of using birth art in parent education. Birth art encourages the group to explore their own ideas on what birth is about and to begin to identify their own personal philosophies and to share birth stories. I have used this approach with very experienced midwives and sometimes with profound effects.
Every picture tells a story and the use of images of birth is a valuable tool in promoting discussion and the formulation of ideas. My own particular favourite way of achieving this is to use a slide presentation of birth accomplishment accompanied by appropriate music.
On occasions I have asked each student to bring a birth story, either their own birth (i.e. as told by their mother) the birth of one of their own children or a birth from their practice experience that has a particular significance for them. They then tell their stories and share their feelings with the group. Clearly this exercise requires a nurturing environment in which the students feel safe to share intimate parts of their life's experience, and will only work with small groups. The students start to link their own stories with their approach to practice. This activity never ceases to amaze me inasmuch as many of the woman have never asked their mothers for their own birth story. Yet when given 'permission' the mothers frequently come up with the most detailed accounts of their birthing experiences, twenty, thirty even forty years ago. For me, this activity hammers home the message that the birthing experience has a profound impact on the life of women. Robinson (1998) says that:-
“Letters about birth were different. They had an immediacy and clarity of expression which made them leap off the page. Even if the writer was poorly educated, descriptions of labour and birth were incredibly vivid. Women had intensity of recall for birth experiences which was different from other memories”
The birth-story telling also gives participants a sense of who they are in the greater scheme of things, and this takes on particular significance for women if used in parent education sessions. We all need a sense of where we belong in the universe. The link with our past is said to take on greater significance in pregnancy. (Hall 2000)
In conclusion, by virtue of their role, midwives have the potential to share this incredibly important time in the lives of women and their families. By sharing some of the time on this journey into parenthood, the midwife may gain right of entry into the previously undisclosed world of the woman, and as a result, share her hopes, fears, anxieties, dreams and expectations during the period of contact. The use of story telling may provide a vehicle to facilitate the establishment of a trusting and mutually respectful relationship that allows both partners to gain and grow from the experience.
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