All the posts Ellie's written since 2012.

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Is 37 weeks a full term pregnancy?

Is 37 weeks a full term pregnancy?

I run a big midwifery Facebook group and one of the questions coming up a lot recently is:

‘Is 37 weeks pregnant actually term?’

Follow up questions include:

Is a Mum allowed to use a birth centre if she’s exactly 37 weeks pregnant? What about if she’s one day before that?

Does a baby at 36+6 need extra observations and heel prick blood glucose levels doing? What about if the heel pricks stresses them out and interferes with breastfeeding? Could we just pretend they’re 37 weeks since it’s so close?

How important is this concept of 'term' anyway?

I can easily get stuck on this kind of question. This is my typical thought process:

1. SAFETY! Safety first, I have a responsibility to offer the safest care I can, and who am I to question guidelines, I’m just one fairly junior midwife

2. Lots of excellent midwives I know are fans of cut off points, so there must be good evidence for this

3. But when I look up the evidence or read researcher’s blogs words like ‘low quality’ and ‘weak’ start to pop up...are we making decisions based on culture again?

4. Conversations about due dates, induction of labour, and whether babies born at 37 weeks are more at risk are HARD!

I bet you’ve come across similar problems?

You might know about Dr Sara Wickham, I have a burning desire to lock myself in my room and binge read her blog fairly often. She’s a researcher and independent midwife.

She and other researchers have a lot to say on the topic of due dates and the concept of being 'term'.

For instance, the 280 days of pregnancy we use to estimate the ideal length of pregnancy appears to come from something called Naegele’s rule, which we started using in the 1800s. There’s not much new evidence to back it up.

(Naegele was a German Obstetrician or a ‘dirty old man who names things after himself’ to quote one of my old midwifery lecturers, smashing the patriarchy one physiology lecture at a time...).

Only 4% of babies will arrive on their due date. Also, there’s evidence to suggest that dating scans are only as accurate as last period dates. They're not as precise as we sometimes like to think.

Also, what about genetics, ethnicity and even nutrition? Wouldn’t it be weird if these things had no impact on a woman’s ideal length of pregnancy?

All in all, due dates are questionable.

The other thing is, we’re not really sure what starts labour. It’s a synchronised swim of hormones and physiology. It's not a factory process which notices a finished baby and then ships it at the correct date.

How do we know if a woman’s gone into labour for the correct physiological reasons or if something else has started it? We don’t often have clear answers. One baby could be completely ready at 37 weeks and another might be displaying breathing problems associated with prematurity.

We also don’t know why! Is it because women have varying length pregnancies or because we have due dates wrong?!

What we come back to is:

What even is a full term pregnancy?

I’ve come across some evidence from the American College of Obstetricians and Gynaecologists which suggests that the idea of ‘term’ simply looks at the evidence on how babies get on when they’re born. On average, at 40 weeks, babies have least respiratory and other problems, though anything from 37-40 weeks looks pretty good too.

But newer evidence suggests babies born between 39-41 weeks do ever so slightly better. This means in the USA, 37-38 weeks is now considered ‘early term’.

But these studies aren’t perfect, the concept of a due date is just our best educated guess.

So is 37 weeks actually term?

If we going to go along with the concept of a term pregnancy, most  guidelines, including those from the UK, say yes. America has recently renamed 37-38 weeks ‘early term’.

But as with all these things, it’s a line in the sand based on all available evidence.

Mother Nature didn’t leave us with a rule book saying ‘pregnancies will end between 37 and 42 weeks and if this doesn’t happen medical science will need to intervene’. It’s all just on a scale.

Having good observational midwifery skills and knowing the things that babies need like breastfeeding, skin to skin, rooming in with Mum, etc., are all good ways of supporting a baby who may or may not be a little early.

I’ll be making it my mission to to get to know every Mum and baby as an individual (as far as possible in busy practice!), as this is the best way of picking up on issues.

Now I’d love to hear from you:

Have you had experience with babies born around 37 weeks? Any stories you can share to teach us?

Is questioning the evidence and not having absolute answers about due dates outside your comfort zone? If so, what’s one action you can take to better communicate evidence to women?

Hope you found this as interesting to read as I did to write!

All my best, Ellie xx

p.s. Comments welcome, please put in as much detail as possible. You never know, what you add might prompt the breakthrough that another student or midwife needs to support a woman 🙂

April 11, 2019 5

Being a Transgender Midwife; Caring for Transgender Clients; and the Language of Motherhood, with Midwife Nathan Welch

Being a Transgender Midwife; Caring for Transgender Clients; and the Language of Motherhood, with Midwife Nathan Welch

Since this post was put together in 2018, Nathan's YouTube channel, TransMidwife, has really taken off.

Nathan does a ton of free support as an LGBTQ+ advocate in midwifery and elsewhere, if you'd like to support him see his brand new KoFi page here.



'The empowerment of childbearing women can co-exist with supportive care for trans people.'


At the beginning of January 2018, I thought about all the inspirational birth world people I’m in contact with.

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January 23, 2019 5

“Tell me, what is it you plan to do with your one wild and precious life?”

“Tell me, what is it you plan to do with your one wild and precious life?”

I got to talk to a lovely trans male midwife this week. He’s called Nathan and I’ll try and get his whole blog post up soon.

The most important thing I learnt from Nathan was this:

He and every other trans sibling he’s asked believe that motherhood and womanhood are what midwifery are made of.

I don’t know if you’ve heard but there are some debates that ‘woman’ and ‘mother’ are too gendered and shouldn’t be automatically used in midwifery?

Nathan believes that all midwives and other healthcare professionals should be aware that you can’t tell someone’s gender by looking at them, and be open to asking questions about pronouns, especially if there are cues like more androgynous clothing.

But motherhood is too important a word to take out of childbearing. It's just we need to ask people what they need from us with sensitivity.

Nathan stance on this argument goes with my gut, but I’d love to hear your thoughts.

There’s a fantastic blog from Shawn Walker (RM, PhD) here that covers the concept: Can “mothering” be gender-neutral?

In other news, I’ll be going to Mary Cronk’s funeral tomorrow. I didn’t know Mary but I think she’s extraordinary. The daughter of a unionist, she campaigned for women’s rights in maternity care, became a breech birth expert and was amazing at handling complex politics.

You can see more about Mary and some important fundraising in her honour here.

If you have a few seconds this week please think of her and her family. Also the fundraising is for the Association of Radical Midwives, if you can add anything, she'd so appreciate this.

It’s a strange coincidence that as I was putting this blog together I found out another Mary, one of my favourite poets, Mary Oliver has died today. I'm quoting her in the title of this blog:

“Tell me, what is it you plan to do with your one wild and precious life?”

May we be as brave, clever and funny as both Marys, and as open and wise as Nathan.

Much Love,

Ellie x

January 17, 2019 0

Christmas Midwifery

Christmas Midwifery

Thank you if you're working Christmas. We're all impressed and comforted by the people who keep caring for us. There's sacrifice involved and we don't underestimate it.

Some students and midwives shared their thoughts on Christmas time with me and I thought you might want to see. I asked them how they coped and this is what they said (picnic in the lounge anyone? 😉 )

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December 25, 2018 0

The One Time In Midwifery I Want You Not To Empathise (Read: ‘Free Yourself From Workplace Bullying’)

The One Time In Midwifery I Want You Not To Empathise (Read: ‘Free Yourself From Workplace Bullying’)

I suggest you rethink that care plan,” said the co-ordinator to me, quietly, but in front of a group of doctors.

Nothing so wrong with that. But in the context of daily puts downs, blank stares and a lack of humour or respect, it forms a pattern of bullying.

To summarise Aryanne Oade, author of ‘Free Yourself From Workplace Bullying’, bullying is made up of:

  • Personal attacks which you find emotionally or professionally harmful
  • Deliberate attempts to undermine you
  • Deliberate attempts to remove power from you, especially when the bully keeps the power for themselves

At first, it can present as the staff member testing to see if you react.

If you wobble at an nonconstructive piece of criticism - ‘that’s a mistake that I’ve never seen on this ward – ever’ - it can then progress to more frequent attacks.

But even though I've read all the books and have experienced bullying a few times, it's still really hard for me to react well. 

When I face bullying behaviour, I experience mental and emotional confusion. I don’t want to think badly of anyone so my first instinct is to think I've misunderstood or I'm overreacting.

The co-ordinator I'm writing about was particularly bewildering because I’d seen her been kind to women in her care. She had amazing clinical skills as a midwife.

And yet she was horrible to me.

I assumed it was my fault, that I wasn’t up to scratch, that perhaps I was annoying. That I should be able to show her what bringing me down in front of the doctors was doing to my confidence.

Surely if I could get into her head and heart I could convince her to be kind?

With the greatest respect, this is the one situation in midwifery where I want you not to empathise.

Empathy is not going to work with someone who has chosen to use aggression in the workforce. This co-ordinator had chosen to remove my power so it's unlikely she had any interest in emotionally supporting me. I believe she already felt entitled and like she belonged at that hospital, and experienced little to no self-doubt. Me reaching out to her and explaining how I felt was unimportant to her.

This all sounds awful but the upside is, knowing how things can be will help you develop coping skills.

As a midwife you need many social skills in your toolbox. You don’t always have to be upfront and honest about your vulnerabilities with every team member and hope that they will have your best interests at heart. Sometimes clearly stating your boundaries and showing you’re not going to be bullied is the best thing you can do for the women and your workforce.

If you’re in a bullying situation, I would strongly suggest you get Aryanne Oade’s book.

You have no idea how much power you have in small moments.

Taking on someone older and more experienced can be done if you’re clever about it, stand up for yourself and remain calm.

Looking back, I had many opportunities to put things right. Once I lost my marbles and was using an obstetric wheel to work out a woman was term + 1 (doh!) and once I forgot to label something in the fridge. On both of these occasions I acquiesced to bullying behaviour because I felt I deserved to be ‘told off’.

But I was learning. I could respond carefully and accurately at times. I wasn’t letting my professional power be taken away nearly as much.

There’s a sense of personal accomplishment and breakthrough to be had. The ability to set professional boundaries is an essential part of midwifery.

A couple of years later I saw the co-ordinator out having coffee. By this point she’d retired. It would make a better story to say that she was like Meryl Streep in the Devil Wears Prada, swinging a handbag and an expression of disgust under her sunglasses but she was out with a group of women and a toddler, sweetly laughing, drinking tea and ordering scones.

Thinking that holding a grudge wasn’t my style, I actually went and said Hi.

She looked a bit surprised but greeted me politely. Then she praised my midwifery skills and I thanked her and left.

I honestly don’t know whether she felt guilty, had no idea she’d been bullying me or simply wanted to keep things peaceful in front of friends.

It reminded me that she was just a person after all.

But save the empathy for the women and your colleagues that value it. They’ll get more out your kindness than a bully would get from five years of you trying to scale their walls.

This all sounds very severe - but the flip side is, if you show strength to someone with bullying characteristics, in a way that's the most empathetic thing you could do. You're not stooping to their level but you are showing you understand the dynamic going on. If I'd have been a push over, I never would have had the strength to approach the co-ordinator when she'd retired. Who knows, perhaps she appreciated me standing up for myself in the long run.

Have you read Aryanne's book? Have you got strategies to deal with such situations and people?

Let me know in the comments below. And if you're in a workplace bullying situation right now, I'm sending you strength and support.

Ellie x

*(details have been changed to preserve anonymity)

November 7, 2018 1

11 Responses

  1. Hi I’m 12 and hope to become a midwife when I am older do you have any tips or know anything I could work on now towards it??

    • Hi Katie, thanks for you comment, wow you’re very focused at such a young age! I would come and subscribe to midwifediaries.com for free blog posts on midwifery which are up to date, I have fun with them too so they’re good to read! Volunteering with people is always a good thing to do to develop your transferrable skills, could you get involved via your school with any caring volunteer positions? I’d also start to read everything you can get your hands on midwifery wise, and perhaps come over to the Secret Community for Midwives in the Making on Facebook for an idea of what midwives talk about x

  2. I love your blog and am currently reading your book. Unfortunately, I am from the US so the educational path and such is much different than what you describe in the UK. Do you know of any American midwife blogs? I’ve tried searching online but most are very, very established in their careers and the things they write about are so far off from where I am in my journey to be a midwife.

    • Hi Alicia,

      Great question! I don’t know many American midwife blogs sadly, though MidwifeThinking is a great Australian one, and SaraWickham.com is one of my favourite UK ones. Please do let me know if you find any good American midwife blogs, I’m always on the lookout! x

  3. Hi Ellie,
    I just wanted to share a bit of the furore that is occurring in the Queensland state of Australia. Obstetricians are moaning about the poor outcomes etc etc of midwifery led care. http://www.couriermail.com.au/news/queensland/ama-queensland-seeks-urgent-change-to-way-maternal-services-delivered-in-queensland/news-story/5fa372d6478e4cdbba9de7977df224e1
    I thought we were passed all this but apparently not.

  4. Pille

    Hi Ellie,
    I’m a first year student midwife, and would eventually like to work as a midwife on First Nations reserves in Canada. Do you have any contacts who have trained as a midwife in the uk and moved over to Canada? Or do you yourself have any idea how the transfer would work?

    • Rachel Wild

      Hi Ellie – if you particularly want to work for First Nations’ families I would first contact some of the Aboriginal health organisations or governance bodies to scope out how they would see a midwife from the UK working out. Perhaps you have First Nations/ Aboriginal heritage yourself, but if not you’d need to consider the implications of working as a outsider in communities that have a history of colonialism harming their existing birth cultures. e.g. http://www.naho.ca/midwifery/ also your immigration and work visa would be through the Canadian government but perhaps you could also ask permission of First Nation government for the area you’d like to practice in?

  5. Miroslava

    Hi Ellie, i am a second year student of midwifery in Slovakia.
    I would like to ask you, what’s your posture for needs of women who are in puerperium ? What is your opinion for lactation and sports activities in postpartal period?

    Thanks, for answer 🙂

  6. Alysia

    Hello, I have always been interested in midwifery at young age. At the moment, I am a Senior in high school and I am writing a paper on a career that I am interested in. I am required to have an interview with a midwife for research for my pages.Would you mind if I interviewed you for the role?

  7. Keeley

    I’d LOVE LOVE LOVE to win a free month of your personal statement school! I’m a 33(nearly!) year young working Mum of 2, retaking 2 of my GCSE’s, training to become a breastfeeding peer supporter, and trying to save as much as I can for 3 years without a wage and shed loads of student debt, with a mortgage! I’ve got your book which I LOVE! But I am still struggling on how to even get started!!! And what experience I have that’s relevant enough to be worthy of going on my statement to stand out! I’ll be applying in Sept 19, to hopefully get a place in Sept 2020, so this would be amazing!!! Pretty pretty pretty please!!!! ??????

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