Mediation in Professional Birth Work

Introduction

Mediation is about finding a way to positive communication. Reaching an agreement is secondary to building positive communication.

Language is the key. The mediator's body language and verbal language
need to be honest authentic and empathetic. This is achieved not by
faking it until we make it, (although that might be a way of beginning), but by self awareness. When the mediator is aware of their thoughts emotions and reactions they can process this safely and facilitate others to express themselves.

Open Reflective Questioning

Open questions are useful to find ways to greater understanding. Questions such as: who how where why when what and then, gently questioning the answer, will open up momentum. New ideas, new problems and new opportunities come with this momentum. Conflict can be a situation that is stuck in unresolved and often unheard grievances. Momentum can help move forward through greater understanding. Listening and being listened to will often produce momentum and provide some stuck patterns and negativity to release. Venting negative feelings may be a useful therapeutic tool if the parties agree and it is conducted with a feeling of safety.

Safe 

Feeling safe is key to engaging with those in disagreement. Therefore the mediator can use a variety of options and techniques including: empathetic language, shuttling between the parties, preparing them for mediation before starting the joint session and creating an environment that the parties feel safe with. For midwives who think about the oxytocin response in labouring women they can adapt this attitude towards those in conflict. Providing a quiet nurturing attitude and environment may mean finding a quiet space. Imagine a noisy busy birthing suite with staff and families and buzzers and a conflict situation. Then imagine inviting the parties to a calm quiet room, taking some time to settle with hot drinks and shared common humanity. Even beginning this process is a form of mediation by sharing decisions on where people feel comfortable to sit and what they would like to drink can engender an environment conducive to effective mediation. We can aim to reduce the fight and flight mechanism by asking the people involved what they would like. Then exploring their answers to check we are on track with providing what they would like.

Omnipartial

Omnipartial means to be on all sides. This is a refreshingly honest
approach to take. Many expect a mediator to declare their neutrality as
being impartial yet omnipartial is more honest and effective. Both parties
will be told that the mediator will be on both sides and supporting them all
to find the best way forward.

Open Reflective Questioning

Key questions are simply:

• How are you?
• What would you like?
• What would it take for you to agree… to xyz?
• What if….(then suggest a scenario)?

Using gentle reflective open questioning can help parties see their issues in a new light or from another viewpoint. This is similar to Professional Supervision or Counselling that is person-centered and led by the supervisee/person. It is more effective to realise their own solutions than to be told them by others as the solutions need to be theirs to be effective.

Testing the veracity of the answers is key to mediation. It could be easy to say something that does not stand up to scrutiny. It is the mediators role to test the information given. Without challenging the person, more
focused on ‘how would that work in reality’ type of questioning.

Future-Proof

One aim of mediation is to future proof the agreement. This means that
parties may be encouraged to find that any future disagreements can be resolved themselves earlier through their improved communication. This increases independence and reduces co-dependence on the mediator or others.

The ultimate aim of an agreement is already closer when there is
agreement to mediate. When one person says they will not agree
something we find out what they will agree and build momentum. For
example, asking a colleague to leave the cord unclamped at the birth to
allow the baby to benefit from receiving their placental blood volume,
could be met with a direct ‘No’. So asking would they agree to one minute which may be more achievable then once that agreement is made asking what would it take to increase this to two or three minutes and then this may lead to waiting for white. Once there is some momentum of some agreement this can be built upon. It is as if once resistance begins to be reduced it can be let go either completely or at least with increasing quantities. Imagine a dam opening up and the rest of the dam disintegrating to allow the new positive flow.

We are the Technique

There are many books and teachings about mediation yet it may come down to this simple statement

‘we are the technique’. 

There can be learning and reading around mediation as a subject yet really it is simply being mindful of self and others with calmness and respect to listen to and engage in conflict. The fear of not engaging may be less than the fear of not engaging and allowing conflict to continue. Similarly, the cost of not engaging may be greater than the cost of mediation.

Binding agreements

Mediation is a creative process that focuses on a win win solution yet in
reality needs both parties to compromise to get some of they want rather than nothing. This involves the mediator showing them there are worse alternatives to a negotiated agreement. They can aim for the best and are reminded of reality. It possible to find that the issues can be reframed and both parties actually feel they have won without compromise. This involves reviewing the conflict objectively and creatively to see if there are other options not yet considered. Then bringing these to the negotiations it is possible to be creative. Any agreement that declares it is binding will be enforced by a court if required. It is up to the parties to decide if they would like an agreement to be binding or not.

Professional Birth Workers as Mediators 

Professional birth workers (PBW) are natural communicators. They are good at listening verbally and non-verbally including with their hands. PBWs are familiar with high emotion, fear and pain. They are reflective practitioners and people. These skills set them up to navigate through conflict into agreement. Developing reflective questioning, listening and the ability to stop a party from dominating a conversation are some of the skills that will bring lasting agreements and or improved communication and build effective relationships.