Erg. Alarm. Disentangle self from warmth.
Clothes. Coffee. Toast. Still sleeeeepy.
Onto bike. Cycling up first of many hills. Awake now!
This was my routine to get to every morning shift.
I got called crazy, but cycling is a double espresso for me, even when suffering from midwifery sleep deprivation. And I'm someone who doesn't cope well with little sleep - I'm an 8-hour girl at the best of times.
I get the odd aspiring applicant emailing a question something like:
‘I need a lot of sleep, is it still possible for me to become a midwife?'
It's such a good question. I won't sugar coat things - you need to think really hard about it.
But, there are tactics to help you cope with unsocial hours.
In this post, I'll talk about midwifery sleep deprivation truths, and 4 tactics I found helpful.
1. Have a Sleep Strategy
Getting enough sleep when on shifts is tough. Your sleep needs are golden.
Many midwives on 8 hours shifts patterns power nap - not at work (pfft, if only), but to top up on sleep overall. Napping also helps you enjoy downtime between shifts.
The honest truth?
Originally I felt weird about napping during the day….but I felt much better when I read Olympic cyclists sleep 9-10 hours a night, and get an extra 45 minute nap after lunch (pure lazy! 😉 I hear they don't do any housework either to conserve energy).
Arguably, midwives have a more important job than Olympians.
You might not be pushing as hard physically, but you're definitely on your feet and engaged for more hours.
If you’re on 12-hour shifts (aka 'long days'), napping is a lot less possible. I'm not a fan of 12 hours shifts, but in theory at least you only work 3 days a week, so get more days off to rest.
I do know one lead midwife who, on long days, sleeps through her break (if she gets one) and inhales her sandwich in the last few minutes. Obviously this is hard to achieve, but having a sleep strategy so you can take advantage of ideal circumstances is helpful.
Other ideas:
Exercise - to help you sleep/keep you more awake when working. Cycle commuting was a good way for me to fit exercise into my routine. Some like exercising in front of the TV, of an eve, with an exercise bike or treadmill.
Routine - My post 12-hour shift routine involved getting in, showering and drying my hair, reheating food, and eating it in bed in front of the TV (dishes done in the morning before work). The routine helped me get the most out of the downtime.
2. Realistic Expectations
The NHS is swamped, and in most other countries midwifery is extremely challenging.
Midwifery sleep deprivation will happen sometimes, no matter what you try.
I found just accepting this was very helpful – some days I was ''coming in strong'' and others I was knackered and knew this was part of the ups and downs.
It’s important NOT to beat yourself up for being tired.
You may find even when you’ve had 8 hours sleep, you’re still feeling knackered, and this is OK – understand what an amazing thing you’re achieving by getting to work at all, with the job you do.
Most people would need counselling to cope with the kind of emotional and physical demands midwives deal with. If your body's a bit sleepy, forgive it.
3. Pills and Potions
I make no secret of the fact tea and coffee were my best friends as a midwife. If you're a caffeine person, there's evidence to suggest this is helpful especially for nights (study).
For insomnia, many swear by melatonin, a hormone you can get in tablet form. It's what your body uses to signal to your brain that it’s time to go to sleep.
I also love electrolytes tablets in my water bottle, which are calorie free and keep you hydrated.
Having a water bottle with you is an extremely good idea – I know some trusts don’t let you, but I would strongly advise you to fight for the right, if you have the energy.* It'll help you avoid the night shift headaches, too.
I found chewing gum very helpful on those occasions that my body was screaming out for sweet carbohydrates at the midwife’s station – ultimately chocolate caramels at 3am just made me feel rubbish in the end.
4. Future Career Plans
If you still struggle with midwifery sleep deprivation - don't feel disempowered. There are other types of midwifery which might be a better fit for you.
Part Time - Full-time shift work always = more hours than normal full-time work. Most midwives in the UK work part time.
Community Midwifery - usually within normal hours (still the old midwifery mix of very rewarding and very demanding). You'll generally get some oncall, but it’s more likely you’ll be able to sleep at reasonable times.
Specialist Midwives - often work 9-5, there are lots of different types, from diabetes to teenage pregnancy.
Independent Midwifery - You'd be on call for demanding hours – but you won’t have routine nightshifts, which means your pattern will be more day orientated.
Plus, you get to know your clients and many midwives find it incredibly rewarding.
Virginia Howes wrote a great book on her life as an IM (I'm waiting for the day 'IM' automatically means 'Independent Midwife' and not 'Intra Muscular', haha). She says it's easier time wise for her and her family.
Being a fabulous midwife is absolutely achievable if you’re a big sleeper – you just have to think through carefully if you’re willing to give that much of your time to planning and recovery.
If you have kids: Some of these tips don’t work well when you have little people. All I can suggest is taking sleep needs seriously and getting help from friends and family - and hats off to you. Some of my friends are amazing midwife mothers and I'm in awe of them.
To all the midwives and students balancing sleep with shifts....thank you for the sacrifices you make.
I’d love it if one day we were paid a lot more for rotating shifts (as they impact so much on health), given many breaks to sleep during nights (as research suggests we should be)…..and brought strong coffee on silver platters in ‘world’s best midwife’ mugs.
But until then…I would so love to hear from you:
1. Do any of these tactics resonate with you? Is there something you can implement now which is easy and will help?
2. Any other tacticts I’ve left out?
3. Do you have children as an aspiring, student or qualified midwife? What are your tips and tricks for coping with shiftwork?
As always, thanks so much for reading. If you enjoyed this post, consider subscribing to MidwifeDiaries. You’ll get new posts and an email once in a blue moon when I’ve got something really exciting to share. If there’s a midwife you know who’d find the post useful, please consider sharing it.
All the best to you and yours,
Ellie xxx
* It’s a statutory duty for you to have access to drinking water. Midwifery is an emergency profession, so some of these laws don’t apply all the time BUT if you're not allowed water bottles, you have a good chance of resolving this by contacting the RCM.
They can then contact your trust and ask them to reconsider. If this fails, they will then ask you to register a complaint with ACAS, who are employment specialists.
You can call ACAS for free here: 0300 123 1100/1150 open between Mon-Fri; 8am-8pm, Sat; 9am-1pm.
This is, in my opinion, something definitely worth fighting for, but it would have to be a complaint in your name – and I know how hard it is to keep your head above water. If you’re brave enough to do this, you’d be a credit to the profession in my opinion.
I had a six month old baby i was still breastfeeding when i began the course, and a four year old that had never slept through the night, this actually was a good thing as it meant i could survive and function on two to four hours unbroken sleep when on shifts. However writing essays made it a real struggle as by the time they were in bed i was exhausted and my brain generally stopped working at around 2 pm. solution, getting up at six, drinking a literal pint of extra strong coffee and sitting somehwere the kids couldnt find me, meant i could write huge chunks in the hour before breakfast. I have also found that when working night shifts I tend to keep my meals and meal times the same. So when I get home in the morning I will eat cereal/toast and have a cup of decaf tea, then bed, i wake up at lunch and have a light meal and then back to bed untill around 3-4 o clock then i get up pick up the kids and have a carb heavy meal with them ie pasta before going to work the following night. as a result i very rarely eat on a night shift and dont usually get hit by exhaustion untill around 6.30 am. I find this makes the switch back to day shifts far easier as well.
My best sleep strategy now that my kids are old enough to be in school: When I lose a night of sleep due to a birth, I always clear the following day and sleep sleep sleep. A full day of day-sleeping plus the following night of sleep, has me recovered enough to do it again if need be. Before I implemented this, it would take me three days to recover from one night sleep lost. It’s worth it to reschedule that day of office visits.
Do you know the rationale behind not being allowed a water bottle? That seems, quite frankly, absurd.
I love the idea of electrolyte tablets in them.
I swear by my blackout blinds/curtains – I don’t use them when I’m on days, or at uni, for for nights they’re my safety net.
I like to have a little bag with my on nights, with things like lipbalm, face wipes and a new pair of socks which can make all the difference in making you feel more human at 2am.
As Jess, I also don’t really eat on nights, I find that a)I’m not hungry and b)It helps put me back to the land of the living. The one thing I would say though is that I have a proper meal at breakfast time so that if I do fall asleep properly I’m not woken at lunchtime by hunger pangs.
I think it’s because some trusts see it as ‘unprofessional’. Makes me crazy! Thanks for the tips…nothing like that new sock feeling 🙂
I started ted midwifery school right after my 23rd birthday with a 3 year old and a 1 year old. I got pregnant a couple months later. I had my baby in my 2nd year of school. I kept on trucking. Baby wearing to school and the births where mom was comfortable with me bringing my infant. After 6 weeks pp I went to 10 births in 3 weeks. I am now about to graduate in December. Luckily my husband is an amazingly helpful strong daddy. Most of the time he is basically playing single father. I find many of these tips useful. I also think essential oils have helped me. Things like lavender to help calm and sleep. Others like peppermint or citrus to boost me. Sucking on cinnamon mints for those long dark silent drives home. Green tea and a B complex. There are many options to try just have to figure out what works for you =)
I’ve only done a few night shifts so far. A wise midwife I was working with gave me some great advice that really helped when I had 4 nights in a row: when you go to bed after breakfast, if you wake before you wanted to, stay in bed. Don’t get up to cook or do the washing or whatever. You wouldn’t do that if you woke in the middle of the night so don’t do it when you need to sleep during the day. The other things I found helped (in the absence of blackout curtains) were eyeshades (those things you get in airplanes) and earplugs. They really helped me to stay asleep longer during the day.
But hey, caseload continuity midwifery beats shiftwork any day!
I read this article before on Friday then did a night shift Saturday, I’ve been doing nights for a year and 7 months as a maternity care assistant, and I’m not a big fan of them. (I used to sometimes skip meals then eat over night and try not to sleep the next day if I was only doing one night) Since following these tips I feel like I have unlocked a magic formula, I have never felt better, thankyou so much!
That’s great to hear! Hope things continue to be manageable, and even enjoyable! 🙂
I’ve been a midwife for 4 years now and most of that time I have done permanent night shifts. I found the transition from day shifts to night shifts and vice versa, unbearable. The worst, doing a night shift and then a 13 hour day the following day! I knew that my trust wouldn’t allow me to only do day shifts, so I opted for permanent nights. And it has made a huge difference to my wellbeing! I always nap if I get a break, even if it’s a 20 minute power nap. I love some of the ideas above and definitely will be implementing them! Thank you for sharing.
Thanks for your comment Nickoli! Great to hear you’ve found a system that works for you in terms of nights! Are you on labour ward?
I’m now in Oz so no 12hrs shifts anymore – thank goodness! I also work perm nights 2115pm-0645. My body struggled to do the changeover from nights to days. Nights also mean my kids can do sports after school. When I get in i wave the kids off in the morning and sleep while they go to school. If I wake early (Normally between 2nd and 3rd night) I grab a cuppa and go back to bed, sometimes having a doze. I then normally have a power nap between 7pm and 8pm. Always sleep on my breaks, drink tea and water on shifts. I am a crisp monster on nights though!