From MIDWIFERY MATTERS, Issue No.115, Winter 2007
Anonymous
The thing about waiting is that it's ten times more difficult when you don't know how long it's going to last. Whether it's waiting for labour to start, waiting for labour to stop, waiting for cracked nipples to heal or, as in my case, waiting for a midwifery job. It's the not knowing when (or if) it will all be OK, that makes waiting such hard work.
I qualified as a midwife back in March 2007; as I write we're now in October and I still haven't once worked as a midwife. When it first occurred to me to train, six years ago, I knew it wouldn't be easy. I knew I would be torn between different philosophies, I knew the nights would be long, that I would have to deal with other peoples' pain, secretions and excretions. But I would have been truly shocked it I had been told that I would be left on the heap with all the other qualified midwives, scrabbling around for jobs, desperately trying to make ends meet.
It just doesn't make sense to think that the taxpayer has paid for my training (they said it costs £40,000 to train a midwife, but realistically it must be much higher than this) and now the NHS doesn't want me. I am a valuable resource, available for work in a big city where the local hospital has 6,000 births a year, in a country with a rising birth rate. Midwives are leaving the profession in their droves due to long-term stress, and fear of criticism of their work. The EU Working Times Directive means shorter hours for SHOs (junior doctors) while midwives take on many of the tasks once performed by them, like cannulation. Heck, I know our local labour ward is understaffed because as a student I was 'used' as a midwife, taking on sole care of women whose labours were complicated by the likes of epidural analgesia and syntocinon augmentation. This did not happen because it had been discussed with my mentor outside the door (there was no mentor outside the door); it happened because there was no midwife available to look after these women. Still, that same hospital has not yet found it within its budget actually to pay me for such services. Difficult to square with the recent Government reports promising women choice and continuity, isn't it?
I have been disheartened to find that some of my peers have given up on the idea of actually practising as midwives. It's just too dangerous, too thankless a task, and the job market is too difficult to enter, to make it worthwhile. Others had never for a moment intended to practise in this country, but take their skills abroad, where they are actually appreciated by employers. I sometimes read statistics on midwives leaving the profession, and wonder if there are similar records of number of students who qualify, but never work here as midwives. What a waste.
It's not as if I have a lot of choice about where I can work. Centralisation of services means there is only one big hospital nearby. There are no little freestanding birth centres I can apply to. I have a family, a husband with a job, children in school, and can't easily up sticks and relocate to London. Nor is it simple to travel long distances to and from work within a 12.5 hour shift pattern.
As a student I had always considered independent midwifery as a longer-term option, if NHS employment became intolerable. However, the on-call commitment required is not an option for me for until my children are a little older and more able to look after themselves. That is, if independent midwifery still exists then.
Sometimes, when I'm in a particularly self-destructive frame of mind, I recall the one job interview I did attend, to join the local 'nurse bank'. I thoroughly enjoyed this interview and came out of it buzzing. It was therefore a bombshell to read the letter telling me that my application had been unsuccessful. I later learned that I had failed on interview, without my references having been read, because the interviewers felt that I would not follow guidelines at work. This was despite me specifically telling them that I would - provided that the guidelines coincided with the wishes of the women. Clearly, my proviso had been enough to warn them of my radical leanings. Or perhaps it was the fact that my 'statement in support' spoke about 'births' rather than 'deliveries', or perhaps it was my admission on the application form that I am self-employed as a breastfeeding counsellor with the NCT. Let's face it, they could probably smell the remnants of flap-jacks consumed at the ARM meeting I attended six months previously. (The mentor acting as my referee was gobsmacked to hear I was unsuccessful, as she is responsible for hiring midwives from the bank, and knows that they are not always available.) So because of the prejudices of two people (who I don't think were even midwives themselves), I have not had the chance to do even a palpation for seven months.
There have been some benefits to my enforced unemployment. I have had time to be with my son while he makes the transition to high school, and have reminded the family what home-made soup tastes like. I spent a wedding anniversary with my husband (wow!), although we were too poor to go out. I have even hoovered the house. My NCT work keeps me in touch with pregnant and postnatal women, and helping women breastfeed gives me some sense of purpose and professionalism in my life. But even this, I fear, may reduce my chances of getting the job as I may come across in some way as too, well, too 'NCT'.
I wrote the above paragraphs two weeks ago, in the knowledge that another job interview was approaching. I had hoped to finish with a positive flourish, that I had finally found a job and all was well. Alas, no. I have apparently again failed on interview. My first task is to find out why, my next is to pick up the pieces and feel positive again about midwifery and positive about working for the NHS. Wish me luck.
Midwife Anonymous
Department of Health (2007). - Maternity Matters: Choice, access and continuity of care in a safe service.
Shribman S (2007). - Making it Better for Mother and Baby: Clinical case for change, Department of Health.
This article was originally published in Midwifery Matters ISSUE 115 Winter 2007, p 14
AH updated 15 June 2001