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Standing up for Ireland’s maternity services

In its first week, the Twitter hashtag #wearedelivering inspired 1,500 tweets and created more than one million impressions.

In June, six months after it was first launched, it was associated with more than 2,500 tweets and over 35,000 impressions every day.

The innovative hashtag aims to highlight the positive ongoing work in Irish maternity services and has been used by numerous health professionals in maternity and gynaecology services, patients and patient advocate groups.

The hashtag itself, #wearedelivering, was designed as a clever pun in reference to the delivery of services, research and notable development in obstetrics and gynaecology — it was not designed in reference to the delivery of babies, Dr Keelin O’Donoghue, Consultant Obstetrician at Cork University Maternity Hospital (CUMH), explained.

By highlighting the positive aspects of maternity and gynaecology care, the hashtag aims to balance the current topical debate that many perceive to be negatively biased against Irish maternity services.

The hashtag was used for the first time following a number of negative media stories on healthcare professionals and the healthcare system, as well as maternity services.

“We felt there was an increasingly unbalanced portrayal of obstetrics and gynaecology as a specialty in the media and that concerned a particular group of us, all of whom are active clinicians working in various aspects of obs and gynae [sic], all with a variety of other jobs; not just working as clinicians, some of us working as academics or with leadership or national roles,” Dr O’Donoghue noted.

“Sure, we acknowledge it’s a specialty that has had its challenges, but it does deliver excellence over many metrics. And some of that, we felt, was getting lost in the negative reporting.

“I contacted some friends and said ‘could we start counteracting this, could we use a clever hashtag to display the range of work we do?’” she recalled.

“The following day there was, we felt, quite an inflammatory piece in The Irish Times. The title of that was, ‘Ireland’s maternity services: An ongoing horror story’. It was that day the hashtag was used; that was the final act that told us we needed to stand up and do something.”

On December 15 2016, a letter signed by more than 20 female doctors and professors working in obstetrics and gynaecology was published in The Irish Times in response to the ‘horror story’ piece. The hashtag campaign started that week.

“The aim of the hashtag was to advocate for and highlight all the positive aspects of maternity and gynaecology services, showing that we’re working hard and everyone is trying to do their best, but also showing the breadth of activities we all do,” Dr O’Donoghue outlined.

“We tried to turn something negative into something positive in terms of that letter and it certainly felt like a turning point at the time for all of us and it created a nice bit of unity among everybody.”

Led by a group of eight doctors and professors working in obstetrics and gynaecology, (Dr Aoife Mullally, Dr Cliona Murphy, Dr Jennifer Donnelly, Dr Keelin O’Donoghue, Prof Louise Kenny, Prof Mary Higgins, Dr Maeve Eogan and Dr Noirin Russell), the hashtag campaign was immediately taken up by Twitter users in Ireland, America, Canada, Australia and the UK.

The engagement has led to the formation of an online community that engages with trainees and highlights research presented at meetings and courses being attended.

Good-news stories are highlighted from maternity hospitals around the country and service users and the public can also engage.

“The hashtag is still being used and is being taken up by far more people than we would have ever anticipated. If you look at it over the last week, not only are there obstetricians and gynaecologists, you have pharmacists, medical scientists, lab managers, patients, the RCPI, healthcare societies, chaplains, universities… midwives, nurses, patient advocate groups and bereavement midwives.

“People generally use the hashtag hooking it on to something relevant about the maternity services — not that we’re trying to ignore things that go wrong and they’re certainly being shared as well,” Dr O’Donoghue commented.

Balance

The hashtag has inadvertently turned into a support network for healthcare workers within maternity services.

The group behind the hashtag felt that constant negative reporting was creating a public perception that things go wrong all the time within Irish maternity services, which potentially creates fear in the population and in turn was creating a sense of helplessness, futility and lack of motivation among healthcare staff within services.

“At times it’s a very difficult specialty to work in because there has been a lot of very adverse media coverage. Stories like that really affect you day-to-day. It’s difficult to go into work when you know your patients have been reading the papers and been reading reviews and the bad-news stories,” said Dr Aoife Mullally, Obstetrician and Gynaecologist at the Coombe Women and Infants University Hospital, Dublin.

According to Dr O’Donoghue, the hashtag has helped to create camaraderie in the services and lift the morale of staff who have been affected by negative media reporting.

The team behind the hashtag has engaged with other social media campaigns such as #Ilooklikeasurgeon, #NYerORcoverchallenge, #morewomen and #IrishMatExp.

The positive engagement has led to the team, and its contacts, beginning to disseminate their newest research from international meetings, such as the British Maternal and Foetal Medical Society (BMFMS), Irish Network of Medical Educators (INMED) and Royal College of Obstetricians and Gynaecologists (RCOG) World Congress.

The hashtag also seeks to represent clinical staff on social media; advocate for services that are standard in other countries, such as a routine anomaly scans for all pregnant women; collect data for analysis; and engage with education programmes.

Members of the campaign team have featured on national blog sites, such as Humans of Maternity and the INFANT Centre blog, as well as the international British Medical Journal (BMJ) Opinions, with one member of the group now a finalist for an Irish healthcare award. 

The hashtag also helped lead to the development of GOWN, a new Gynaecology and Obstetrics Women’s Network (see panel), and recently won an award for best use of social media in healthcare.

Positive feedback

Feedback to the campaign has been largely positive, particularly among healthcare staff working in maternity services.

“Some of our doctors in training have said to us, ‘It just turns things around’; ‘it makes the speciality look more positive’; ‘I feel happier to be working in this specialty’. It has been very difficult having so much negative reporting and so many things said about healthcare staff and doctors, and actually, it turned things around,” Dr O’Donoghue revealed.

And for the eight women who began the campaign, it has led to them becoming active advocates for the specialty in political and media circles, campaigning for increased resources for maternity services.

The team has made submissions to the Oireachtas Women’s Caucus and has directly advocated to TDs regarding the lack of routine anomaly scans in a number of maternity units and excessive gynaecology waiting lists.

A wide variety of articles and opinion editorials have been written and published, particularly calling for universal access to foetal anomaly scans for all pregnant women, while Dr Murphy was recently interviewed on television and radio regarding the hospital beds crisis and its relationship to elective surgery.

 “It’s a very small and simple thing but for those of us who started it off, it empowered us to speak and hold forth, and as a result, I think it encouraged the eight of us to be a little bit more present,” Dr O’Donoghue concluded.

New peer support women’s medical network established

A new, exclusively female medical network, believed to be one of the first of its kind in medicine in Ireland, has been established by Irish obstetricians and gynaecologists.

GOWN Ireland, the Gynaecology and Obstetrics Women’s Network, was set up last year with the aim of providing a peer support network for women working in the specialty.

An executive committee made up of seven members has been established and the group plans to hold its next meeting in April 2018.

Speaking to the Medical Independent (MI), Dr Aoife Mullally, an Executive Committee member of GOWN, said the network grew on Twitter following a campaign by obstetricians and gynaecologists using the hashtag #wearedelivering.

“We started off tweeting about our day-to-day work and what we did. We got lots of patient engagement and engagement from midwives and other specialties. The main thing we got out of it was a huge amount of peer-to-peer support.

“We then thought, ‘wouldn’t it be fantastic if we could make the notion of peer-to-peer support a wider concept and involve all other women in the specialty’? That’s how the concept of a women’s network in the specialty came about.”

According to Dr Mullally, there are now 71 female consultant obstetricians and gynaecologists in permanent and locum posts in Ireland, putting women in the majority in the speciality in terms of consultants.

“But the voices of the profession have been overwhelmingly male over the last couple of years. We felt that it was important we try to support each other in getting into positions where we could represent the specialty at the highest level,” Dr Mullally added.

The network is open to all women working in the specialty and can be contacted on Twitter on @GownIreland. A website is currently in development.

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