MaltaToday, 30 Jan 2008 | Birth of a new health policy
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NEWS | Wednesday, 30 January 2008

Birth of a new health policy

If a big job needs to be done, the best person to do it is someone who has big ambitions. This is certainly true of Dr Katie Birch, who went from selling insurance in the UK to mentoring the government of Malta and ultimately changing the country’s national childbirth policy.
After experiencing an accident at the age of 15, Katie, originally from the UK, was unsure of whether she would be able to fulfil her dream to work in psychology and health, so she began working for an insurance company instead. She was fortunate enough to come across an important stepping stone in her career at the age of 17.
“In those days nursing was an option but my arm caused me problems, she recalls. “I have a great respect for the Royal Victoria Infirmary in Newcastle because they took me on when no one else would. So I started my path as a nurse. I was specialised in casualty and operating theatre work. It was fascinating work and I learnt a lot.”
By the time she was 19, Katie had seen more of life than most of us would want to. It was a daunting experience and Katie decided she wanted to see the lives of people from a broader perspective than just after having been in an accident or somehow hurting themselves.
“I chose to go into mother health and did midwifery and then I went to what was then ‘college’. I got a Health Visitor Certificate and became a health visitor. This is when I first studied psychology, anthropology and sociology as part of my studies.”
Malta does not have health visitors, which are like General Practitioners in that they are registered to practice and each one is given an area and a caseload. He or she is responsible for monitoring the health of the families within that area. So, for example, if a woman is pregnant, a health visitor makes sure she goes for check-ups to ensure everything is going well. They generally work in conjunction with a GP practice.
Between the age of 22 and 27, Katie had her three children and took time out of work to spend more time with them whilst doing voluntary work in the evenings.
She says, “I never understood why the local vicar and a psychiatrist asked me to do this, but I set up a voluntary Telephone Samaritans in Newcastle, which was a suicide watch, at the age of 24. My husband stopped me from continuing the job because I was pregnant, and one time I went to check on someone who was knifing himself. My husband didn’t think it was appropriate for a pregnant woman to do this kind of thing.”
Her curiosity into what causes families to react differently to the same contexts prompted her to apply for a job as a lecturer in health education for nursery nurses. It was the ideal job for her at the time, but things took a turn for the worse when she got very sick.
“I knew I was not well and could not continue with the lectures. I was exhausted but needed to make some money. This is when I saw an advert in the newspaper to sell cosmetics and I eventually built up a huge business with about 500 people working for me. It was incredible.”
She discovered later after collapsing outside an office in Leeds that something was wrong.
“I had cancer. I had to undergo a serious operation which resulted in selling the business and a complete change in lifestyle. It was one hell of a shock but fortunately they got it all. With three kids you begin to wonder about what you are doing. I realised I was doing too much and that I was no super woman. It was a massive rethink.”
Recovering from the traumatic experience allowed Katie to go back into the health field and became a Health Promoter. In the meantime, she adopted Deb.
“My daughters kept bringing her round to the house, and due to her circumstances, we negotiated and I eventually adopted her, so I had four daughters and it was really lovely. The teenage years were interesting with the four of them and very emotional too. Teenagers come up with issues about life for which there are no answers.”
Ask her what her greatest achievement in life is and she will tell you that just being able to grow up with her children and grandchildren makes her unbelievably proud.
Excitedly she says, “I became a grandmother at the age of 42 when my eldest had a daughter. Now I’m a buznanna! I think it is the affirmation of life because my children are having children who are having children. They’re having the courage to produce children where most do not want to bring children into this world.”
Katie admits to being an incredibly curious person with a strong will to learn. She wanted to explore family development as a result of having children and wanted to look at how families cope with pregnancy as a whole. She set up a research project on the antenatal area to discover if allowing people chosen by the mother to be present during birth apart from medical care would make a difference.
She explains, “I wanted to see how the woman could have not just the medical care but also the emotional care. There was a large pharmaceutical company used to offer research awards to fund research projects and I was awarded this opportunity.
“I was able to study 300 families and managed to change the Health Service’s method of how birthing took place because I discovered that when the mother had the people she wanted with her during childbirth, the baby was born healthier. It resulted in the babies having less illness and the mother experiencing less post-natal depression.”
Although pleased with the success of her research and the result, Katie did something which she will never do again when conducting a study. She made use of a control group.
A control group is used in experiments, whereby a group of test subjects is left unexposed to some procedures for comparative reasons, in order to validate the results of a test.
Cringing, she says, “It was terrible. The babies born within the control group resulted in being less healthy than the others and ethically I will never do that again, although ultimately it proved beneficial because the policies were changed within the health service. Although I was pleased with the success in the result, I was disappointed by the ethics of research. I’ll never do it again.”
She obtained a Phd at the age of 50 some years later and celebrated by climbing the Himalayan Mountains with a group of friends.
“We climbed 16,000 feet and went on trails which had never been explored before. It was fantastic. Being in Malta, I definitely don’t climb anymore” she laughs and adds, “I am so grateful to my granddaughter for choosing Malta as her getaway otherwise I may never have discovered this sunny niche.”

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