In memory of Jo Cox

I have a confession: I took an online quiz. Look, it wasn’t one of those Facebook personality reveal-all-your-secrets-so-we-can-use-them-against-you type quizzes but, you know, anything that promises to categorise you into one of only seven types of people is could be a little reductive; participation is ill-advised. Even if you trust the quiz-master, which I guess I did.

The quiz was devised by More in Common, (https://www.moreincommon.org.uk/seven-segments/discover-your-segment/) the organisation set up in the wake of the MP Jo Cox’s heinous murder 10 years ago.  In her maidan speech in Parliament, she’d said “We are far more united and have far more in common than that which divides us.” I’m convinced she was right. We all want security, shelter, food, meaningful connections, basic creature comforts, and above all, fairness. Most of us would agree that democracy is a keeper. After that, it gets trickier as we struggle to agree on how to achieve these ends. But still, more in common, right?

Apparently, I would say that, being as I am, a Progressive Activist who, I learned, tends to overestimate the extent of support for progressive causes in Britain by a factor of two or three. Hmmm, so: naively optimistic? Not gonna lie, it’s not totally implausible…

Apparently, “groups with which Progressive Activists disagree are not necessarily informed by misinformation or prejudice. It is important [for us] to understand properly why people with opposing views hold the beliefs that they do and to try to empathise with their starting points.”

Now, if you’re like me (and I’ve just learned that you’re probably not) you may struggle to accept that your non-sympathisers are neither misinformed nor prejudiced. If you’re a Libran like me (look, everyone is unique and no-one can be neatly categorised, which is just as well otherwise how would we have more in common?) you’ll agree that it’s important to be empathetic and try to see their point of view.

The reason that this non-serious quiz got me thinking is that I recently went on a study day which might well have been devised for people like me. Over optimistic people who have teeny weeny issues understanding why others haven’t seen the light when it comes to, you know, sorting out the world’s problems…

The study day was teaching health professionals how to promote vaccine uptake among our patients. Loyal reader, you know how much I love a vaccine. I’m sure you can imagine how enthusiastically I big-up the recommended pregnancy vaccines. To be clear, and for the avoidance of all doubt, these are safe and effective,  they will protect the baby from horrid whooping cough and rubbish RSV. That isn’t up for debate. What we were being taught was methods of getting vaccine-hesitant people to consider getting their jabs. Because it turns out that just lecturing mothers-to-be about the virtues of vaccines is counterproductive. Who knew?!? To be fair, we all did, that’s kinda why we were on the course. We were all Progressive Activists, regarding vaccines, at least. All deeply committed to increasing uptake of these tried-and-tested immune-enhancing inoculations in the face of rising mistrust and bog-standard fear.

According to recent polls conducted in 2025 by More in Common, 80% of Britons believe the world is becoming
more dangerous, up around 10
points since 2020; 87% of Britons have either not very much trust in politicians or none at all; The political class – from councillors to MPs – is seen as self-serving and out of touch; and fewer than 1 in 5 would trust any of the main party leaders to watch their bag for them.
This lack of trust is intrinsically linked to a feeling of disrespect, with the most distrusting feeling that major
institutions – from the NHS to the judiciary– do not respect people ‘like them’

Distrust and fear.

Here’s a thing that you might not know: midwives know fear. It’s our nightly bedfellow. Our constant companion. We are steeped in it. We are terrified of harming you or your baby. And it can zap our common sense, accidentally turning us into guidelines-adherent-jobsworths who might come across as unsympathetic despite how much we care. And that’s basically what Progressive Activists are being warned against by the good people at More in Common. It doesn’t help that our patients are scared too. It helps even less that they don’t trust us. Why should they? Every time maternity comes up on the news, it’s bad news. But of course, it’s on us as professionals to foster trust and dispell the fear. I can’t lie: a bit of help from the press wouldn’t hurt, you know, reporting on the odd good news story. I mean, come on, maternity is frigging bursting with these because babies mostly get born alive and healthy. Apparently that’s not newsworthy. Oh, and a f*ckton of cash from the government wouldn’t go amiss. Still, when a frightened midwife is talking to a frightened mother, communication takes a hike. Goes AWOL.

Both Liberty and Demos (human rights think tanks) highlight the importance of engaging positively with people who are beyond their core support base even if this is uncomfortable. The Jitsuvax * course basically teaches us how to do this:  how to engage with vaccine-hesitant mothers in a manner that doesn’t further alienate them. It sounds obvious in theory, but Oh Em Gee, actually putting it into practice is not so simple. Like so much “good advice” it’s easier said than done.

So: we start by offering the recommended vaccines (so far so good) then gage the response, verbal and non-verbal (sure, we can do that) and if we sense total shut-down… we must fight our instinct to teach, to correct, to inform. Instead,  we should nod, find ways to relate to that person’s experience, maybe discover what we have in common, and find something pleasant to say.

Now I may be a Progressive Activist, but in my professional life, I’ve been quite good at getting people to trust me. I want to use words like nonjudgemental and empathetic but mostly, I just smile and I’m liberal with praise and compliments. Look, it’s easy until it isn’t, and I’m not the only midwife who’s had to dig deep at the end of a long day, to maintain a genuinely warm and welcoming smile, or find something positive to say about someone who is (unwittingly) driving you nuts.

When we fail to get that right, when we don’t meet them where they are, when we go in like battle axes with our unwanted (although potentially life-saving) advice, when we don’t earn our patient’s trust by laying strong foundations of respect and understanding, then we have to take some responsibility for the consequences. That’s hard to swallow. But if you’re going to be a Progressive Activist, you gotta do what it takes (within reason) to get people on board.  As an antenatal clinic midwife, when everything goes well, I might have as many as 6 appointments with a woman, so I can cultivate a trusting relationship over time, although first impressions are crucial. On the labour ward, I have less than 30 seconds to get a terrified, exhausted, suffering woman to trust me. Smiles and praise!

The mere fact that midwives can do this is testament to how awesome we are. It’s not even in the job description, although it should be.  That initial trust now has to be carefully nurtured. We know that. But we are sometimes the bearer of unwelcome news (could be that someone’s blood pressure has increased) and this can threaten to derail their plans for a waterbirth. Ignoring the problem won’t make it go away, and the whole point of antenatal care is to detect problems early so they can be resolved easily, while hopefully keeping the waterbirth as a safe option. You are much more likely to have your waterbirth if your blood pressure isn’t causing you to have a stroke. But thanks to our vastly improved care and vigilance, plus timely use of antihypertensives, full blown pre-eclampsia is almost unheard of now. And you feel fine. This is good. Except we may well recommend an induction sooner rather than later. And nobody wants that. Basically, we are victims of our own success. No-one knows eclampsia any more; no-one knows whooping cough, and every one feels fine… so why risk an induction or vaccines? Not gonna lie, I’m gonna need more training! Because it is hard. Hard to gently convince someone who is just fine, thanks very much, to accept an intervention that is unpleasant in the short-term but likely prevents the possibility of future pain. Someone in our group suggested showing a video of a baby with whooping cough in the antenatal waiting room, but apparently we can’t use fear as a compliance tool, even though they did it for years on cigarette packaging… It seems unfair because fear is constantly, unashamedly and successfully being harnessed by the antivaxxers. But we have to be better than that. Trust should never be built on fear. That’s just cheating because anyone can do that, which is why certain unscrupulous politicians do so well. Amplifying people’s fear and then providing a quasi-magical solution (which by total coincidence, makes you richer) is as cynical as it is despicable.

Fear and distrust in pregnancy is very normal and we expect it. We try so hard to help you deal with that fear in a constructive way, based on scientific evidence. But we simply don’t have all the answers. We know that and we’re upfront about it. We’d be lying if we promised you certainty, much as we’d love to. As a result we don’t alleviate your fear as much as you’d like. We are sorry about that. Unlike that women on Tiktok who seems to have it all completely sussed and will sell you her expensive, all-natural secrets, guaranteed to make you invincible. It’s hard to compete with her.

We’ll do our best though. We’ll meet you where you are and we’ll try to dispell your very understandable fears. We’ve known fear too, more than you know; we have that in common. We want you and your baby to have the best possible life. We have that in common too. We will hold your hand and we will look after you. We will make you feel seen and powerful. You are creating a whole new human and we respect that. If we get it right, your baby human could be tomorrow’s top rate tax-payer. We all want that!

*www.jitsuvaxtraining.com