By Caroline Flint

Love is all you need, all you need is love says the song and I am beginning to think that a bit of it is what we need in midwifery today.

Midwives have grumbled (justifiably) at the takeover by obstetricians of childbirth, at the takeover by the computer giants such as Sony and Hewlett Packard who have made inestimable fortunes with electronic fetal monitors and ultrasound scanning equipment, while midwives have earned small salaries and worked long hours and actually `done the work'. But now it is time to take stock.

Last year was a shameful year for midwives, not only because of the farce of the clinical grading review, but another more deep seated sore which was exposed, the torrent of accusation and blame which gripped our profession. With Jilly Rosscr up before the Professional Conduct Committee, Caroline Flint up before the Investigating Committee, nearly all the independent midwives being questioned, supervised, investigated no midwife who spoke out, no midwife who tried to be strong for women, felt safe.

Supervisors of midwives came under attack from the criticism levelled against them during the Rosser Case. The workings of the Professional Conduct Committee came under attack for the way it interpreted its own rules and conducted its business. As Juno looked down from Olympus at the goings on in the world of midwifery she began to realize that what she was seeing was the tip of a very large iceberg, the blaming and accusation was actually rising up from the very bottom until it permeated all the way through this great and old profession.

An extraordinary psychology has evolved within the childbirth services - that is, that death is unwarranted and it has to be someone's fault. If a baby dies a perinatal meeting is called and everyone looks round on the person who can have the blame pinned on them - everyone who was off duty on the day in question heaves a sigh of relief, everyone who didn't deal with that woman feels justified and exonerated despite the fact that they were probably caring for the woman in the next room in a very similar way. As a result of a baby dying labour ward policies may be changed within an instant, something that has always been acceptable and unchallenged is now verboten and must never be done again. Our practice needs to be based on research and knowledge, not on overemotional reactions. Everyone grieves when a baby dies, everyone is heart-broken when a mother dies, it is a terrible thing to happen and part of grief is to try and pin the blame on somebody or something, to ensure that life is controllable and to pretend to ourselves that if we always behave in a `perfect' way we ourselves will be immortal.

Death is part of life, in the same way that laughing is, and being born and giving birth are. It is the feelings of panic and fear which permeate many labour wards which make the blaming and accusation a natural sequel. Often I identify the panic and fear as being fear of mortality itself; the flip side of this coin needs to be exposed in order to help the tension and accusing to flow away, the flip side of the coin is loving and cherishing.

Midwives need consciously to begin to love and support each other, and to consciously love and support obstetricians, in the same way that for every midwives have loved and supported women.

With love and cherishing of each other, we shall be able to stop blaming each other, just imagine the dreaded words `Come to my office I want to talk to you about your conduct of Mrs Jones' delivery' -just imagine how much better that midwife would feel if with her she had eight other midwives who came along because they loved her and because they wanted to learn with her a better way of caring for the Mrs Joneses of this world.

Have you ever wondered how Jilly Rosser managed to survive her dreadful ordeal? It was love, love from mothers and love from other midwives and doctors who saw and recognized a midwife who cared about women and who was a woman of great integrity herself - love, it's all we need.

September 1989