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Midwifery - an ordinary, and extraordinary job

May 5, 2017

Today is International Midwives’ Day, and while the profession of midwifery may feel highly removed from most of us personally, in a way, it couldn’t be closer. For the vast majority of us, although we don’t remember it, we are literally guided into this world by their hands, and that’s pretty major.


In some ways, midwives have an everyday job; UNICEF estimates 353,000 babies are born around the world every 24 hours…. That’s a lot of deliveries. But on the other hand – despite how commonplace childbirth is – it is often described by those who witness it, work with it, or go through it as something quite extraordinary. There’s something about childbirth that captivates; you need only look at the success of UK TV show, One Born Every Minute, now in its fifth series, to appreciate that.


It’s one of those careers I am so curious about… what makes women decide to deliver babies for a job? Does it make having your own children a more or less daunting prospect? Does the wonder of childbirth wear off after it’s become something you witness and play a part in so often?


For any of you that have asked yourself similar questions, but never had the opportunity to actually put them to a midwife, I have spoken to two amazing women I know – one in New Zealand near the beginning of her career, and one in the UK with a few more years under her belt, currently completing PhD research in the field – to ask these questions and others.


Happy International Midwives Day to all the people in the profession out there! I think you’re all pretty incredible.


KYLIE – Based in Manchester

Q: What made you want to follow this career path? Was there a moment you knew you wanted to be a midwife?

A: I did a Chemistry degree at University and wasn’t really sure what to do after that. I had toyed with the idea of medical school but then I found out that I could do a midwifery degree without being a nurse; that was appealing as I’d never wanted to do nursing. As a child, I’d always been completely fascinated with pregnancy and birth, and once I ‘discovered’ midwifery I was obsessed! This was all in New Zealand (where I’m from) as well where women can choose their own midwife to care for them throughout pregnancy, birth and for 6 weeks afterwards. The autonomy and continuity that this type of care provides really appealed to me as well.


Q: What is the best part of your job?

A: Even after almost 20 years as a midwife the privilege of being with a woman at her most powerful, and sometimes most vulnerable, is almost indescribable. That moment of birth is completely wondrous and to be a part of that experience is definitely the best.


Q: What is the worst part? (Even if there aren’t any bad bits per se, is there any element which is particularly stressful?)

A: I’ve had lots of different roles as a midwife and the midwifery landscape has changed a lot recently. I think the worst part of the job is how stressful and busy it can be on a day-to-day level and wanting to provide the best care possible, which can sometimes be a huge challenge when you may have several women to care for.


Q: Do you think that being a midwife made the prospect of having your own children more or less daunting? And when you had them, was it difficult being on the other side?

A: Being a midwife definitely did prepare me for my own births, but it didn’t make them any easier! I was really looking forward to how my births were going to be as I’d seen so many others (mine were both very straightforward). I remember opening my eyes at one point during my first and thinking “I’ve been in this situation so many times before, but now it’s me in the middle of it!” People often ask if having your own children makes you a different or better midwife but I don’t think it does… you might just have a bit more experience in terms of the practicalities of caring for babies.


Q: What is the biggest challenge facing midwives in the UK?

A: A difficult question, as there are a number of challenges for midwives and the profession at the moment. I think a rising birth rate and a workforce that isn’t keeping pace is the biggest challenge. There are also a lot more women who are more complicated to care for than before; obesity is more of an issue, and there are more underlying medical and social complexities. But it’s also a very exciting time for midwifery nationally in the UK as different ways of providing more continuity for women is being discussed. 


Q: Would you ever or have you ever wanted to pursue another career path?

A: I don’t think so – I can’t really imagine wanting to do anything else. Maybe a top-flight chef but the hours are probably worse than midwifery!


Q: Can you tell me a little bit about the research you are currently undertaking?

A: I started a full-time PhD in September which has been both exciting and challenging. I am looking at monitoring the fetal heart in labour wirelessly. This type of equipment means that women who need their baby’s heart beat monitored continuously can be more mobile and go into a birth pool. I’m going to investigate whether women who have this type of monitoring feel more control and satisfaction, and whether there might be a difference in outcomes such as length of labour.


Q: I imagine every day in your job must be pretty special (bringing humans into the world, so cool!) but is there any day or moment that has been particularly memorable?

A: There are so many! I’ve been at an incredible home birth where afterwards everyone sat down to a gorgeous meal, I’ve been present at numerous very sad births where babies have passed away before being born, and I’ve been at plenty of emergencies where teams have worked together amazingly which makes you feel so proud to be part of something that makes a difference to people’s lives. In this profession no two days are the same!


Q: Any final thoughts you want to share on midwifery?

A: Midwifery is such a rewarding career despite some of the challenges, but that’s the same in many jobs. There are lots of different ways and areas to work in now too, so there is a lot of flexibility – community, hospital, teaching, and academia. I’m surrounded by inspiring women and colleagues every day and feel very proud to be a midwife.



GRACE - Based in New Zealand


Q: What made you want to follow this career path? Was there a moment that you knew you wanted to be a midwife?

A: I woke up on my 18th birthday to my mum running in my bedroom saying “Grace! Sarah (my cousin) is in labour!”. I had been waiting for this day since she rang me in tears from Australia saying she was pregnant and wanted to come back home… Within the month she was back. I walked beside her for her entire pregnancy, going to her appointments, meeting her midwife, seeing the scans, and the best moment of all, the labour and birth. I remember watching her baby entering this earth in the guiding hands of her amazing midwife… One moment Sarah was one, and in the same breath she was two. My heart could have exploded out of my chest right then and there. The light bulb went off in my head right at that moment. I wanted to be a midwife – I needed to be a midwife.


Q: What is the best part of your job?

A: The word ‘midwife’ literally translates to ‘with women’. And that is what I love the most; being with women and their families. Whether it be in the exciting times, the happy times, the hard times, the scary times or the heart-breaking times. I have the privilege to be that loving, supportive advocate for women at any point in their journey. I am there to rub their backs, I am there to wipe their tears, I am there to tie their hair up, I am there to gently hold their baby to the breast while the mother drifts off to sleep as she is so exhausted. I am there with them and for them, no matter what they need. The fresh baby cuddles are pretty awesome too!


Q: What is the worst part? (Even if there aren’t any bad bits per se, is there any element which is particularly stressful?)

A: There are so many elements to midwifery practice, and sometimes the sheer volume of my workload for the day gives me palpitations, but that is manageable. The emergencies are manageable too, as we are so well trained in how to deal with them. The worst part however, is easy to name; it’s when a baby passes away. As midwives, we are on the frontline looking after these women and families and we help them birth their beautiful stillborn babies into the world. We also look after them in the days following. Our hearts are heavy and ache in these situations, but we have to smile as we walk into the next room to help our other women, with their babies crying for food. More than once have I cried driving home from work thinking about what has happened during that day.


Q: Do you think that being a midwife makes the prospect of having your own children more or less daunting?

A: I am as clucky as they come! I think having inside knowledge of all the processes has made the prospect of having my own children only more exciting. I’m aiming for un-medicated home births when my time comes.


Q: What is the biggest challenge facing midwives in NZ?

A: As I write this, the New Zealand College of Midwives are in mediation with the government over pay equity. In the early 90’s midwives were given autonomy in maternity care in New Zealand, meaning they were able to be ‘Lead Maternity Carers’ (LMCs) for women, and follow them from pregnancy all the way through labour, birth and the postpartum period without a doctor needing to be involved unless medically necessary. After that, the pay rates for Midwife LMCs has not increased in line with the amount of critical primary healthcare they provide. As of today, the retention rate for midwives in New Zealand is only six years. I think the government has overlooked such a critical healthcare sector for a long time, and that means midwives burn out so early in their careers due to the high workloads, low pay, and increasing demands of this amazing job. Seen as ‘women’s work’ midwifery has been put on the back burner. We have a world class maternity system here, with world class health outcomes in maternity, and midwives need to be recognised and rewarded for our critical role in these outcomes.


Q: Where do you see yourself in the future; do you want to progress within the field, or do you see yourself ever pursing another career path?

A: I think I will always have my hand in midwifery. How long I will stay on the floor as a hospital midwife I am unsure, but midwifery is my calling and being with women and their babies gives me purpose. There will be many opportunities as I grow in my career and experience, so I will always be on the lookout for other ways I can use my knowledge to help the women and families of New Zealand


Q: I imagine every day in your job must be pretty special but is there any day or moment that has been particularly memorable?

A: I can’t share any specific details of some of the many amazing days I have had in my job and believe me, there have been so many. I will say though that where I work, there is quite a large Maori population; this means I often get to be present when a baby is born and the entire whānau (family) are singing a karakia to welcome the baby into the world. Those days are definitely memorable as the energy within the room is like nothing I can describe, and I feel very lucky to be there.


Q: Any final thoughts you want to share on midwifery?

A:  New Zealand has such a unique maternity system, unlike any other in the world. The women of New Zealand are so lucky to have access to this service, and as a woman myself I am so grateful that I live here and can have midwifery care when the time is needed. The research shows that midwifery care improves outcomes for mothers and babies. So next time you see your midwife – tell her how amazing she is!


Note: At her request I have used a pseudonym for Grace and anyone she mentioned.

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