My decision to become a midwife came from a deep-seated desire to care for others and a natural curiosity about pregnancy and birth. The idea of being the one to welcome new life into the world seemed idyllic and heartwarming.
Thirteen months after qualifying, I find myself in a position dreaded by most midwives. Notorious for its heavy workload and lack of staffing, the postnatal ward is my greatest challenge yet. It is mentally, emotionally and physically draining.
In the first few days of a new baby’s life, mothers will be encouraged to stay on the ward, to get them back on their feet and ready to go home, as well as providing a last opportunity to recognise any medical or social needs. It is an extremely special time for families and as a midwife it’s a great privilege to be a part of this. However, the role is not quite as it should be.
My day starts with a handover from the weary night staff. This involves getting a full run-down of each patient, what kind of birth they had, their medical history and what needs to be done for them that day. We split the workload between us, and as a young and relatively enthusiastic member of the team, I often get tasked with the most work.
Our ward is split into bays, with four beds in each. We are assigned two bays per midwife, totalling a maximum of eight women and eight babies. That’s 16 bodies under my care; 16 bodies to be responsible for if something goes wrong. As the day goes on there’s lots to be done: monitoring first dirty nappies, supporting four-hourly feeds (by breast or bottle), vaccinations, checking blood test results and neonatal reviews, preparing paperwork, administering medication, organising discharge meetings – the list goes on.
Each of these things often relies on someone else, be it a stressed neonatal doctor who is on call and covering the whole hospital, an obstetrician trying to stabilise a sick patient, or a busy pharmacist processing medication. Each patient is a different number on each of these waiting lists, and I have to keep track of them all. Simultaneously, you can be guaranteed that each bed that you “empty” has the name of another patient already assigned to it, waiting to arrive from the labour ward.
Often I feel like I work in a factory, not on a maternity ward. The sheer volume of mothers and babies we see means the only way to cater for them all is to keep them moving through the process as quickly as possible. If the labour ward gets full of postnatal patients, the antenatal ward gets full of women in labour and the whole place gets backed up. So, as the last link in the chain the pressure is on you to work fast and clear the beds.
I often don’t take a break so that I don’t fall behind, and the harder you work, the more work you are given. Sadly, this comes at the expense of patients. I can get to the end of a 12-hour day, and realise that I’ve only actually seen and spoken to some mothers once. I’ve been so busy, with my head buried in the daily toil of the ward, that I haven’t had a chance to get to know them and really be there for them. This is not what I signed up for. I wanted to help, to make the experience of birth a memorable one.
As well as pressure from colleagues, you have the added pressure from families, who want to go home as soon as possible and all feel they should be at the top of the priority list. Some get very angry that I’ve kept them waiting. I think this is the worst thing about my job. I hate feeling like I’m letting them down, that I don’t care about their needs or have forgotten about them. I try not to succumb to this pressure because if you rush, you run the risk of missing something important.
Each day my aim is to make sure that every single mother and baby that leaves the hospital has everything they need to feel safe and well supported. It may not seem like it at the time but this single day of waiting will be a mere drop in the ocean of the rest of their life with their child. Weeks from now it will no longer matter.
But if I forget something it could have long-term consequences. Not long ago someone didn’t give a mother an important antibody injection; she was sent home and refused to come back in to have it. Subsequently we had to send a midwife to her home to do it, leaving me and another midwife carrying the added weight of her workload. Had we not done this, her future pregnancies would have been at risk.
More often than not I feel lost in the system and struggling under the weight of a crumbling NHS. We keep begging for more staff but no one listens. The staff we do have are slowly abandoning ship. What I would do for another pair of hands so I could spend a bit more time helping a mother breastfeed for the first time or teach a new dad how to change a nappy. Most families are understanding and can see I’m doing my best.
I try to remain cheerful but have cried on many occasions because I can never please everyone. The time that I can spare I love to spend talking to the women and stealing the odd cuddle from a baby. The best part of my job is when you care for a woman who is clearly very anxious and scared, quite often after a traumatic birth, and after spending some time talking to her and supporting her, you manage to coax a smile.
The other day I was lucky enough to have an hour helping a woman express breast milk by hand for her premature baby. Afterwards she looked up at me and said: “I like you, I LOVE you! Thank you, this has made me so happy.” When someone says something like that you can’t help but beam with pride, to know that amid all the chaos you really have made a difference.