RESPECTFUL
RELATIONSHIPS
IN MATERNITY
SERVICES
Tall Poppy Maternity Consultancy
Workplace culture shapes everything – how staff feel, how teams function, and ultimately the care women and families receive.
Tall Poppy Maternity exists to support the creation of kind, safe and compassionate maternity and neonatal environments.
Drawing on extensive experience across practice, leadership and education, we work alongside individuals, teams and organisations to create meaningful, lasting change – from personal support to whole-system transformation.
When staff feel safe, valued and heard, women and neonates receive high-quality care.
And when cultures become inclusive, kind and innovative, confidence, joy, and humanity return to maternity and neonatal services.
Change is possible when we work together with courage and kindness — and that belief sits at the heart of everything we do.
Why ‘Tall Poppy’ Matters
I first spoke about the Tall Poppy Syndrome when I was inaugurated as president of the Royal College of Midwives in 2004; this provoked a strong reaction from many midwives present, who recognised themselves as tall poppies. I have used the symbolism of the tall poppy syndrome ever since. Originating in Australia, the term describes how individuals who stand out for their innovation, curiosity and drive to inspire change can become targets of envy or negativity. These ‘tall poppies’ are often the first to be cut down by their peers (just as tall poppies are the first to be cut down in the fields) through criticism and exclusion, simply because they dare to shine.
When Tall Poppy Syndrome becomes embedded, it stifles progress, with people holding back for fear of being singled out, resulting in a stagnant culture where change feels impossible. Over time, talented professionals stop supporting each other, and toxic behaviours like ostracism, horizontal violence and bullying become the norm.
For midwives, doctors and other healthcare professionals, this means meaningful change and cultural improvement become nearly impossible. It is important that we build workplaces where growth and innovation are celebrated, not punished. By supporting and encouraging each other, we can create positive, respectful environments—one where everyone is free to flourish.
From Recommendation to Implementation
Our vision is that maternity services in the UK and internationally ensure midwives, doctors, students, and all members of the workforce are respected, valued, and feel safe to raise concerns. We believe that kind, inclusive, psychologically safe cultures where disrespectful and bullying behaviours are challenged enable positive change to flourish.
Across the UK, hundreds of recommendations have been made over the last two decades following investigations into maternity services. Many highlight the need for cultural change, yet little progress has been made in some areas. At Tall Poppy Maternity, we specialise in bridging the gap between recommendation and reality.
Working in partnership with services, educators and leaders, together with listening to women and their families, we support the implementation of practical, sustainable actions that lead to cultural improvement across maternity and neonatal care.
Golden Threads of Change
Our mission is to provide guidance and give confidence on how to transform a respectful, compassionate culture from aspiration into daily practice through embedding ‘golden threads of change’ across maternity services, so that people are equipped to practice safely, courageously and respectfully to deliver high-quality, safe maternity care.
We will do this by advocating for zero‑tolerance to bullying and disrespectful behaviour; establishing a coaching mindset; values-based education; nurturing compassionate leadership at every level, and co‑designing models of midwifery care with service users that uphold dignity, equity, and kindness in every interaction.
The golden threads of change were identified as essential to achieving cultural change during the writing of our book ‘Respectful Relationships in the Maternity Service. A Guide to Achieving a Positive Maternity Culture’. These are:
- Psychological Safety
- Compassionate Leadership
- Values-Based Education
- Inclusion
- Model of Care
- Coaching Mindset
- Respectful Relationships
- Women’s Voices
Transforming change across maternity services
Tall Poppy Maternity Consultancy provides the following services:
Supporting Cultural Change in Maternity and Neonatal Services
Maternity services have been under scrutiny for at least two decades, with the most recent investigations detailing experiences of many families suffering profound consequences when care, culture, leadership and kindness are failing.
At Tall Poppy Maternity Consultancy, we believe it will not be possible to implement the recommendations of these reports until the culture within maternity units is kind, led by leaders who are courageous, respected and respectful.
If workplace culture is affecting staff wellbeing, team functioning or the quality of care provided to women and families in your workplace, and you need support to make changes. we can help.
Tall Poppy Maternity Consultancy works in partnership with services to provide any of the following:
- Presentations of how cultures originate and develop, what constitutes disrespectful behaviour, including recognising and addressing bullying behaviour and how incivility impacts staff, women and families.
- Workshops to identify if participants consider disrespectful behaviours occur in the areas they work in and self-reflection on their own behaviour
- Exercises and examples of how disrespectful behaviour can be challenged both as someone who is being targeted and as a bystander.
- Undertake an independent investigation to determine the extent of the cultural change required.
- In partnership with the service, agree bespoke action plans to resolve any identified issues.
(Where whole organisation culture change is required, we also signpost you to specialist partners, including a A Kind Life at www.akind.life)
Support for Individuals Working in Maternity and Neonatal Services
We offer confidential, compassionate support for individual maternity and neonatal staff. Our work is sensitive, person-centred and tailored to you. Support may include:
- Being truly listened to
- Emotional support
- Exploring possible resolution
- Developing an individual action plan
- Career planning
We offer a free initial consultation, discounted rates for students, and specific support for newly qualified midwives.
(We do not provide coaching but can signpost to trusted partners, including Coaches in Mind at www.coachesinmind.com )
Respectful Relationships in the Maternity Service
by Maggie O’Brien (Editor), Ellen Kitson-Reynolds (Editor)
- Offers guidance on how to solve poor professional behaviors and avoid their detrimental impacts in midwifery
- Provides advices to leaders to change the culture they are accountable for, to lead innovative positive services
- Prepares and supports students, who are crucial to the change that is required in clinical practice and at university.
This book inspires and acts as a resource for midwives, leaders, managers and students within maternity services who strongly desire to create positive cultures, whilst providing advice to individual professionals about available support.
About the team
Maggie O’brien
I’m Maggie, the author of “Respectful Relationships in Maternity Services’ and founder of Tall Poppy Maternity Consultancy.
I have a love of midwifery and a long‑standing dedication to creating kind, psychologically safe and inclusive cultures within maternity services for staff and the women and families they care for. My beliefs are shaped by decades of leading cultural change across maternity services and by representing midwives as a regional officer for the Royal College of Midwives.
I have held midwifery leadership roles including Director of Midwifery at Imperial College NHS Trust and Auckland District Health Board, where I led services through periods of cultural and organisational change. Working across two healthcare systems deepened my belief that respectful, inclusive workplace cultures are essential, both for staff wellbeing and for the quality and safety of care women and families receive.
My most recent role was as a Senior Teaching Fellow at the University of Southampton, supporting student midwives to develop confidence and professional identity within safe and nurturing learning environments. The importance of values- based education, where future midwives can thrive, remains close to my heart.
I was elected President of the Royal College of Midwives from 2004 to 2008 and was awarded an Honorary Fellowship of the RCM in 2009.
My belief that brave, compassionate leadership can restore trust, confidence and humanity to maternity services underpins everything I do through Tall Poppy Maternity; by working with Gill, in partnership with individuals, teams and organisations to achieve cultural change, making it possible to achieve meaningful, lasting change.
Gill Fisher
I’m Gill, and I bring a rare combination of strategic insight, qualitative research expertise and an unwavering commitment to improving patients and healthcare professionals experience. My career has focused on understanding what truly happens at the point of care, helping organisations move beyond data alone to uncover the human stories that drive meaningful and sustainable change.
My work spans patient experience, staff engagement, stakeholder consultation, data analysis and cultural change. I have a strong belief in giving patients, families and healthcare professionals the confidence to speak openly about their experiences.
I am particularly passionate about creating healthcare cultures where respectful relationships are not viewed as an aspiration but as the standard.
In my most recent role with University College London Hospitals NHS Foundation Trust, I successfully established community networks to engage with hard-to-reach patients. Whilst working for New Zealand’s Waitemata District Health Board, I worked to develop organisational values to drive positive cultural change.
Working alongside Maggie at Tall Poppy Maternity Consultancy, we have a shared belief that exceptional maternity services are built not only on clinical excellence, but on compassionate leadership, respectful relationships, psychological safety and cultures where every voice matters.
I complement Maggie’s nationally recognised leadership in maternity services by providing expertise in qualitative research, patient experience and organisational culture. Together we combine frontline credibility, evidence-based research and practical improvement expertise to work in partnership with maternity services to achieve safer, kinder and more compassionate environments for women, families and the professionals who care for them.
Make a change now
Contact us now for more information. Fill in the form below or email Maggie at maggie@tallpoppymaternity.co.uk or Gill at gill@tallpoppymaternity.co.uk
news and recommendations
‘A Cure for Culture – Nurturing a healthier workplace in rural maternity.‘
Maggie O’Brien speaking at the Australian Rural Maternity Association’s webinar
“Maggie’s gentle leadership empowers others to find positive workplace culture. A great mentor!”
Rural Generalist (Obstetrics) & Specialist GP, Founder of The Australian Rural Maternity Association (ARMA), 2024 ACRRM Registrar of the Year, Founder of Rural Obstetrics Down Under(RODU) & Midwives of Rural Aus(MoRA).