Lynn Walcott
ARM appended this article to our response to Modernising Regulation. Lynn´s story seemed to state so clearly what was wrong with midwifery in the NHS and what can be done to change things that we thought it would paint a far better picture of the mountain to be climbed than all the research in the world. Appending Lynn's story was the nearest we could get to talking to the faceless people who are working on our responses.
WITHIN TWO YEARS of qualifying as a midwife, I had reached my lowest ebb. My health was suffering, and I was utterly disillusioned by what I was seeing on a daily basis within the hospital system.
I had entered midwifery in my 30s, having birthed three children, comparatively easily. It was very much a calling. I felt that I had sailed through my training and had high hopes for the future.
Changing Childbirth (DoH, 1993) was published, and more and more caseload practices were successfully running. Perhaps I was too idealistic; I did not think so. I had been through the system myself, and knew what a difference individual care made to women's experiences and so concentrated on my own practice, happy in the knowledge that I could make a difference.
So what happened?
Having trained in the 1990s, I knew and valued evidence to inform my practice, and frequently gave clinical evidence to back my decisions, when I was challenged by doctors, senior midwives and management. But on a daily basis, constantly justifying why you haven't done an admission trace, why you haven't performed an ARM, why ‘your trial of scar' (awful term) is in the pool, the list is endless, eventually wears you down.
The ‘crunch' came after a run of experiences where I felt powerless to act on women's behalf, including; topping up an epidural (heavily) on a woman fully dilated with twins for over four hours as, ‘theatre was busy'.
I now knew that the system had won – I was justifying my decisions by saying to myself ‘if that was how it was done by everyone around me, so it's OK'. This realisation was too much to bear, and an extended period off work ensued. I completely understand now why midwives are leaving the profession.
I had heard a wonderful expression I heard at a Midwifery Today conference: "I could not not be a midwife" and this describes exactly how I feel. So what was the answer for me? What saved me?
As fate would have it, an opportunity to spend a secondment an independent midwifery birth centre was looming. Of course I had to be interviewed along with other hopefuls, obviously just as fed up with the NHS as I was! But I strongly felt that I would be successful, even though I had to convince the midwives there that a round trip of 110 miles a day would not be too much, I really needed this.
And so it was, that a couple of months later, I began my, I believe, life saving foray into the world of independent midwifery. In just three and a half months, I was rejuvenated, positive and enjoying being a midwife again thanks to the incredible support and mentorship of some incredible midwives.
For the first time in ages, I was truly working as a midwife. Sometimes away from home for days, working intensively but with fantastic support from midwives and, dare I say it, wonderful chefs and other essential people who ensured that women and their families actually enjoyed the time around birth.
I had been asked at interview what I expected to get out of the experience. I recall saying that I wished to finally learn some 'real midwifery skills', not the extended roles seen as an advantage in the hospital setting such as epidural top-ups, scrubbing for sections etc, but skills I would need in homebirths, for instance.
This was realised many times over, even in such a short space of time. I learnt about support, nutrition and a hundred other things, but most of all, I was reminded of what I once knew to be true, that women can birth their own babies, safely, without intervention in most cases, simply by giving the right environment and encouragement.
I knew these things deep down, but had been prevented from practising accordingly, so that in the end, I began to doubt them, and I had started to believe in the obstetric views constantly faced with in the hospital environment.
Now I had a new confidence, a new lease of life but was I ready and able to go back to the NHS? Yes, but I couldn't stay on the wards, I had to get out into community, something I had striven for constantly before, unsuccessfully, but once again, fate lent a hand and the perfect job just appeared. A community post within one of the few cottage hospital midwifery units left open became available and it was only 12 miles from home!
A year later, I am happier and healthier, and although I would love to work independently, I relish being able to offer women midwifery care and not obstetric care within the NHS. In a unit that has less than 100 births a year, I have managed to catch more babies than when I worked on delivery suite!
So, to everyone out there unhappy at work, don't give up, women need midwives like us, your turning point could be just around the corner.
LW updated February 4, 2005