Midwives and Social Media

Midwives are becoming more engaged with social media and electronic communications in both their professional and personal lives. Because there has been controversy with the use of social media by a few health professionals lately, I explore some of the pitfalls, precautions and powerful possibilities that social media offers to midwives in this post.

Social media and midwifery

Midwives love networking - whether sitting in the tea room, hanging out at the ‘desk’, having dinner out with colleagues or catching up at midwifery conferences, workshops and meetings. The buzz of midwives conversations and laughter is inevitable. The move to using social media as a way to stay in touch and keep connected has become easy for midwives.

What is social media?

The term ‘social media’ is an umbrella term which covers the multiple ways that technology is used for social interaction. Social media differs from traditional media, such as newspapers, television and radio; in that anyone using mobile and web based technologies can publish and receive information at any time. Real time interactive dialogue enables the co-creation of meaning and value of all aspects of social life - perfect for a socially-based profession such as midwifery.

Forms of social media

Mobile and web based technologies take many forms. The main forms used by midwives are: Email, Texting, Forums, Facebook, Twitter, LinkedIn, Blogs, Ning, Wikis, OneTrueMedia and YouTube. Wikipedia has an extensive categorized list of social media. There are links on the Wikipedia page to an explanatory note about each modality.  Google ‘social media’ and you will be amazed with what comes up for you to explore.

Uses of Social Media

Social media offers a means through which people can post their experiences as they go about their activities and enables their ‘followers’ and/or ‘friends’ to be updated instantaneously. You will be familiar with email and texting, so I won’t go into those tools in this article. Most of you will be familiar with Facebook too. Midwives who engage with social media tend to use Facebook as their social network platform, sharing their lives and their photos. Some midwives also use LinkedIn, a platform used by business owners and other professionals.  The microblogging site, Twitter, is popular with midwives too but most of them are from the USA.

Apart from social networking and updating friends on daily/hourly activities, social media is an excellent tool for raising awareness about issues, sharing information and organising events.  As recent world events have demonstrated one of social media’s most powerful roles is in mobilising community support for political and/or public interest issues. When the Gold Coast birth centre was threatened with closure in 2010, a massive campaign was launched on Facebook and Twitter to inform people that closure was imminent. The social media campaign culminated in a well publicised rally, traditional media became involved and the birth centre remains open.  Facebook and Twitter were used effectively as both official and unofficial sources of news and information during the Queensland floods at the beginning of 2011. The immediacy and success of that social media intervention dramatically increased the profile of social media for both government and the general public.

Ning is a useful social networking site for groups as it is password protected and requires moderation to enable access. You will find midwifery, birth and parent related communities on Ning. Another popular social media tool is blogging. Many midwives blog. The word ‘blog’ is the contraction of “Web log” and is a website which functions as an open online journal maintained by an individual. The blog owner, or an invited guest, writes regular commentaries about events, ideas and/or experiences. An example of a midwifery blog is Queensland’s Rachel Reed’s MidwifeThinking.

If you would like to find out more about the way that health professionals use social media, Sarah Stewart, the social media guru midwife has a blog article A discussion with health professionals about their use of social media with a video discussion on the use of social media. Sarah has initiated and coordinated the immensely successful and popular Virtual International Day of the Midwife, a virtual conference held over a 24 hour period on May 5^th. This year, 2011, marks the third year of that conference. Details can be found on Sarah’s blog.  Social media is making inroads into health care as health care facilities and doctors seek to improve patient doctor communication. Dr Kevin Pho, has a popular Medscape blog, KevinMD, He also discusses on YouTube Social Media to Traditional Media the way that social media helps to prepare doctors to talk with patients and the general public.

Traps for the unwary in using social media

Some of my greatest learning has been from sharing stories about birth with other midwives. Sitting in the tea room or going out to lunch and talking ‘shop’ is usually safe for discussing clinical issues and we are all aware of the need to ensure confidentiality in those forums. Those words we shared disappeared into thin air and only our memories recorded what we talked about. However, the online environment and communicating through social media permanently records our conversations. The fact that what we say and how we say it can be read by anyone forever in the online world means we as health professionals must be careful to project a professional persona in all our online communications. A rule of thumb for engaging in any social media is to ensure that you don’t write or say anything that you wouldn’t want to read on the front page of the national newspaper.

A recent study found that there were inappropriate physician comments on Twitter. The researchers in this study identified 3% of the posts that were unprofessional because the posts contained:

• Discriminatory statements;
• Potential violations of patient privacy;
• Profanity
• Sexually explicit material (Rettner, MyHealthNewsDaily/MSNBC, 2/17).

About 1% of posts included unsupported claims about a product or repeated promotions for certain health products. Ten of these tweets contradicted medical guidelines or knowledge (HealthDay, 2/17).

The results of that study are demonstrated further in a situation concerning the indiscriminate use of slang on twitter by several doctors. Anne Marie Cunningham, a GP lecturer from Cardiff, Wales wrote a professional and reflective blog post Social Media, Black Humour and Professionals about her experience when she sought to discuss privately what she thought was unprofessional language on social media with the doctors concerned.  Her post led to a very heated response from some, including an item on the Facebook page of The Medical Registrar in which Anne Marie was called a 'humourless old trout' amongst other things.  I've blogged about this situation which some wag labelled #hcsmgateuk (health care social media 'gate', referring to the watergate affair in the US). 

The Australian Medical Association, concerned that its members could find themselves in trouble through inappropriate behaviour on social networking sites, developed A guide to online professionalism for medical practitioners and medical students (available on their website). Even Liberal Party MPs now have a Liberal Party guide to social media, after several MPs were forced to resign for posting controversial tweets.

People do strange things, like calling in sick and then updating their status on Facebook talking about what they are doing for the day - neither wise nor honest.  Even parents complaining about childrens' messy rooms can sometimes find their words have fallout they couldn't imagine. Employers don’t take kindly to employees who bad mouth their workplace on social media sites either. Remember that the information and images you post on social networking sites are there forever.

An increasing trend is for employers to check prospective employee’s online information and take that information into their consideration of the applicant’s suitability for the position. Employers are looking at what their current employees are writing. I was told recently that someone employed at a university was advised to ‘defriend’ another person who posted a negative news item about the university on their Facebook page. Women in our care, and our colleagues, may also check us out on social networking sites.

As a summary of the perils that befall the unthinking, here is a list of “dont's” that have led to people being  fired because of their behaviour on social media.

Don’t post off-color remarks

Don’t post confidential details

Don’t badmouth your clients

Don’t disrespect your employer

Don’t post inappropriate photos

Don’t create animated videos of your co-workers

Don’t talk trash about your boss

Don’t play hooky - and then post about it

Netiquette and Social Media

So how do we engage in social media and stay safe?  While I’m sure the mistakes made in the examples above will not be made by any midwife, there are other pitfalls that need to be considered. We need an appreciation and understanding of the set of social conventions regarding online communication to ensure our communication will not offend others or land us in ‘hot water’. An important consideration is that there are no body language cues available for people to ‘read’ what we mean in online communication. The lack of body language cues means that humour can be misread or misinterpreted, especially what we may consider as merely ‘sarcasm’ and ‘wit’. We therefore have to ensure our message is clear and personable. Other important aspects of Netiquette are:

• Capital letters for whole words indicate shouting and is considered rude
• Keep emails short and put the important part of the message in the top sentence
• Make sure the email subject line is appropriate to the email topic
• Don’t expect or demand immediate responses when emails or texts are sent and don’t send another one immediately if there isn’t a quick reply
• If something private or urgent needs to be discussed, ring the person or direct message (DM) them. Don’t put it where everyone can see it
• Don’t conduct personal, private conversations on social media unless the site is locked and even then realise that the information, even DMs and emails can be subpoenaed by a court 
• Be courteous and polite
• Ensure the message is the message you send: reread before posting and ask yourself, how will this message be interpreted by the person who receives it? 
• Avoid the use of profanities
• Avoid any words or images that victimise, blaspheme or vilify
• Avoid any words or images that are racist, sexist  and  anti religious 
• Treat everyone and talk about everyone in positive terms, remember, what is written lasts forever   
• Don’t post and/or tag unflattering or compromising photos of friends. Be aware of your own photos and ensure the photos you are posting are professionally appropriate
• Be wary of who you ‘friend’ and your privacy settings; often you are required to take some action to ensure privacy
• Be aware that privacy settings are still vulnerable
• Ensure spelling and grammar are correct
• Remember that you are projecting your professional image whether you realise it or not
• If someone else makes a mistake, be kind. If you choose to correct them, do it privately and kindly       Be respectful of intellectual property

The USA’s Centre for Disease Control and Prevention produced an excellent Social Media Toolkit for health professionals you will find interesting and useful.

The rule of thumb bears repeating here. Don’t post anything you would not want to see on the front page of the national newspaper.

Remember, even with all those social networking rules, engaging in social media is fun and informative. The various forms of social media provide great tools for keeping in touch with family and friends. Social networking is a wonderful way to promote midwifery and you can make friends across the world in your areas of interest and expertise. Here's a link to a post Medical Students and Social Media: How to get involved that has some good tips for using social media to your advantage.  If you keep the ‘rule of thumb’ in mind, you will enjoy the sense of connection social networking brings and even feel free to develop a blog and tweet, secure in the knowledge that you are safe professionally and personally because you know the rules of engagement.

I look forward to seeing you online!

This article was first published in the Australian Midwifery News, a publication of the Australian College of Midwives newsletter in the Autumn edition, 2011.  I'm reproducing it here with permission and with some extra information added.

Hastie, C. 2011, 'Midwives and social media', Australian Midwifery News, Vol. 11, No. 1, Autumn 2011, pp.