This is an account of an education experience where the traditional boundaries of separation between the external social versus the internal psychological, are called into question. The students and myself, the author, became both the audience and the players when over a 6-month education period we connected with, shared, articulated and rehearsed certain psychological and social aspects of our clinical work. Using a group analytic perspective, emerging themes of separation, hope, despair, searching, loss and survival are explored in this article as they were articulated and worked on in a group.

Midwives are required to form relationships with their clients that are therapeutic and supportive, based on trust, respect and the appropriate use of power (NMC, 2002). This article points to the interpersonal tensions and opportunities students face in their relationships and explores management of the boundaries between therapy and education when emotions are stirred up in clinicians in response to their work. The education group has enormous potential, providing a stage for exploring the tensions and opportunities that women face. Problem-based learning can be used in midwifery education to examine these issues.

Anti-war feeling is perhaps as old as warfare itself. There are, for example, ancient Chinese and Persian poems that are powerful expressions of pacifism. The pacifist phenomenon is thus nothing new, and it is indeed understandable that as a reaction against the undoubted horrors of war there should be some in every age who would be inclined to reject it entirely. Others would seek only that when war is waged it is justifiable and as limited in its ill-effects as possible. For still others, however, war and conquest is an end in itself, the glory and heroism of victory and battle holding out the promise of an inspiring vision. These three positions are, of course, overdrawn. Nevertheless, it is the tensions between these three types of perspective, including here the complexities of intermediate and overlapping positions, that determine the background and provide the dynamic for confrontation between pacifism and the military

Research indicates that when mothers become depressed or disturbed the majority do not seek help from any source and only 25% of them consult a professional (McIntosh, 1993). When psychological problems are identified, there is widespread confusion about appropriate referral to the variety of psychological therapies available. Current demand for psychological services outstrips supply, with a shortage of trained practitioners and long waiting lists for both clinical psychology and psychotherapy. Added to this, there are fears that staff offer therapies for which they do not have adequate training or supervision (Department of Health, 1996). There is also a general lack of information available nationally and locally about the psychological needs and treatment of women during the reproductive years, with a resulting lack of benchmarks against which services could be audited. This paper draws attention to the unidentified and unmet psychoanalytical psychotherapy treatment needs of women during the reproductive years, and further NHS developments that would support midwives professionally to appropriately keep the mother in midwifery care while also continuing to improve perinatal mental health care.