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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. Edited by Sheena Byrom & Soo Downe, with contributions by Hana Ruth Abel, Maria Helena Bastos, Dean Beaumont, Dianne Bowser, Anna Byrom, Sheena Byrom, Penny Campling, Michael Clift, Hannah Dahlen, Raymond de Vries, Soo Downe, Ngai Fen Cheung, Julie Frohlich, Kathryn Guttridge, Jennifer Hall, Shelagh Heneghan, Milli Hill, Billie Hunter, Mavis Kirkham, Mande Limbu, Amali Lokugamage, Kerstin Uvnas Moberg, Mercedes Perez-Botella, Gill Phillips, Elizabeth Prochaska, Progress Theatre Group, Rineke Schram, Anna Ternovszky, Lucie Warren and Robin Youngson.

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2015 | paperback | 256pp | 198x127mm
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Midwives and Mothers Working Together

Downs Side Up on 6th May 2015

Roar is an incredible book. It mixes the perspectives of Mothers, midwives and other healthcare professionals in an honest and collaborative way. It is a must read for anyone involved in maternity care. I have shed tears and nodded along as I have read, and I am proud to see the focus firmly on humanity and compassion, understanding and support in this book. <br />The chapter I found most heart-wrenchingly beautiful was When silence roars: Finley's stillbirth which proves the powers of compassion and honesty during times of grief.


Maddie McMahon on 16th Apr 2015

I want every commissioner and CQC inspector to read this book. Every Health Minister, every NHS manager. Heads of midwifery, consultants, registrars, midwives, health care assistants, read this book too! I want doulas and mothers to read it as well. THIS is where we can find common ground and work towards admitting our mistakes and making birth better, kinder, healthier and more fun, for parents and staff.

Dense but readable!

Karen Hall on 7th Apr 2015

The first impression I had of The Roar Behind The Silence was that it is so densely packed: 50 chapters contributed by midwives, researchers, parents, obstetricians, doulas, antenatal teachers and one eloquent anaesthetist, covering such a huge range of thought: many different perspectives on why kindness, compassion and respect matter in maternity care.<br /><br />Surely this ought to be a no-brainer. The implication that kindness, compassion and respect matter is right there in the word Òcare,Ó but itÕs very clear from some of these stories that in our risk-averse culture, mothers are sometimes dehumanised in the baby production system. This is ground that has been covered by many authors, but Roar comes at a time when compassionate care is right in the headlines, a time when it is really important to agree on what this means, and how to make it happen.<br /><br />The book is divided into three main sections. First, stories and persepctives from maternity care, including Mel ScottÕs harrowing stillbirth story, and obstetrician Alison BarrettÕs understanding of where the midwife stands from the consultantÕs perspective. Next, principles and theories underpinning current practice and possible new ways of working. And finally Making it happen: solutions from around the world Ð both in terms of global experience, and different approaches to practice. This last section is probably the most useful and informative, setting the bar much higher than a healthy baby as the only valued outcome.<br /><br />Most of the chapters are short and the book could be read in an ad hoc way; however I found most of the contributions compelling, and read it straight through, making a few notes. I was struck by the prevalence of social media in many of the chapters, as a way to share experience and compassion with colleagues and other interested parties; though it might also be worth acknowledging the downside of potential for kneejerk reactions in such a public space.<br /><br />I particularly enjoyed the two contributions from anaesthetist Robin Youngson, who perfectly summarises the impact of relationships Ð good and bad Ð and the importance of kindness in all aspects of care. Which should, as I said, be a no-brainer.

The Roar Behind the Silence

Denis Walsh on 30th Mar 2015

This latest book by Sheena Byrom and Soo Downe is one of the best books I have read on maternity care in the past 10 years. It will inspire and encourage in equal measure. A 'must read' for midwives and women.

Everyone in maternity care should read this book

Frances Hodgson on 16th Mar 2015

This is a very timely book which says things which have needed saying for a long time. It is insightful and inspiring to read, and also wonderfully practical - I have changed areas of my practice already based on what I have read here. I now want to buy extra copies to leave around our unit in strategic places - this book is not just for midwives but should be read by obstetricians, anaesthetists, HCAs and anyone else working in maternity care.