Exhaustion in midwifery is a problem of monumental proportions right now. The long hours, paperwork and being plugged into the job mentally 24/7 because of the responsibility, are among the hardest challenges.
While I couldn't even pretend to have the answers to sort the issue out, and I wouldn't dream of telling you what to do, I do have a few ideas on how you might go about treating yourself mentally when you are fatigued.
As a midwife or student midwife, you are phenomenal, but you are just a person.
Midwifery demands that you burn your multidimensional candle at all ends and this can make you feel like you're doing a rubbish job even when you're amazing, or you're doing amazing work in a near impossible situation.
What are you supposed to do when you feel like that?
Well first, please know you’re not alone. I often have emails from midwives in this situation. Close friends of mine who are wonderful clinicians are feeling like they're unravelling.
I'm devastated by the statistic that 1/20 midwives are experiencing Post Traumatic Stress Disorder (PTSD) symptoms, according to Midwives, the Royal College of Midwives' journal.
If you are having PTSD symptoms like nightmares, flashbacks, wanting to avoid people or places associated with trauma, intense emotions around a certain event like guilt or shame, or detachment, you need to see your GP. The Royal College of Midwives suggest counselling is not what you need - trauma support is effective and more likely to help.
If you are exhausted and don't think you have PTSD, I would prioritise sleep, good food and exercise above all else. If my inbox correspondence is anything to go by, some students and midwives seem to have not got the memo giving them permission to care for themselves as a priority!!
When you've recovered from a set of shifts, it can be helpful and affirming to think about the reasons you went into midwifery in the first place.
Do you make a difference to each woman?
Have you got particular skills, knowledge or emotional intelligence which benefits midwifery?
Do you love supporting birth, and can’t think of a better way of spending your energy?
The odds are, once you identify this, you’ll remember how rewarding and unlike any other job midwifery is.
It might be you’re feeling heavy and slow, and like even making a cup of tea is an effort. (I can remember getting into the shower and having to reapply shampoo as the first time I put it on I couldn't find the energy to rub it in.)
If this is the case, I hope you'll recognise how important you are.
This is the hard part – but if you can manage it, it’ll pay off big time.
I'd love for you to be able to take a whole 48 hours off.
No midwifery related activities, no studying, no jobs. I’m talking major duvet and DVD day as soon as you can. Slob around. Have a bath. Paint your toenails and go to sleep early.
If you have the energy, do something fun like get out of town and go for a long country walk. Or take your kids somewhere outside you know they’ll be occupied all day.
I know this might sound impossible – but taking 48 hours off will pay for itself in productivity later. In our society, we almost measure our worth by how tired we are. So this self care can feel like a very 'wrong' thing to do.
There may be times in your life when this simply isn't possible.
But I believe the work you do is so important that this kind of recovery is necessary and normal.
In the long term, evidence shows there are three major things you can do to protect your mental health:
It may sound hard, but try and work in at least a bit of exercise every day. For me, physical fitness is important but it's really just a side effect of the mental health benefits that exercise gives you.
It’s for your mind. I used to cycle to work and back every day, which was perfect because you can’t hear or answer your phone when you’re riding and you can decompress.
- Can you have a 20-minute walk in the evening before nightshift?
- Can you do one of these 8-minute yoga videos?
- Are you an active mum with kids you run around after, so you’ve actually got this bit covered? (the amount of exercise you get if you have a toddler is not to be underestimated.)
2. Enjoy Good Food
This can be very hard to achieve on shift. I used to take little packs of fruit and nuts I could nibble on, and a really nice water bottle. Orange juice cartons are also really quick to drink and nutritious when you need a sugar hit that’s healthy.
Treats can be an amazing way of looking after yourself, so a nice dessert can be a great way of relaxing.
But snacking on biscuits and Quality Street at work can often just be a way of numbing your exhaustion. It might be unavoidable some days but treats work much better if they are on the rare occasion.
Often chain eating six biscuits just makes you feel rougher at the end of a shift, and there's no comfort to be found by doing it.
At home tins of fish are nutritious and can be combined with frozen veg. A high-quality bread such as wholemeal sourdough ready cut up in the freezer can mean you always have a tasty and healthy meal on stand by.
Eating in this way will give you more energy in the long term than having ready meals.
Leftovers and slow cooker meals are also something my colleagues and friends swear by (I have to admit to being less organised than them).
3. Midwifery Mindfulness
They teach this 'live in the moment' stuff to military personnel (the suggestions used to annoy the hell out of me until I started using them).
Midwifery some days is not so different from being on active service 😉
Even on the most desperate of days, thirty seconds here and there of clearing your mind can make the difference between being incredibly tired, or triumphant.
Square breathing, as seen in the image here, is something I adore and use in difficult situations.
What you do is BREATHE in for four (one elephant, two elephant, three elephant, four elephant), HOLD for four (one elephant, two elephant, three elephant, four elephant), BREATHE out for four (one elephant, two elephant, three elephant, four elephant), HOLD for four (one elephant, two elephant, three elephant, four elephant). Then repeat for as long as you want or until you feel calm.
I used to find this kind of thing so patronising but these days it works for me. Feel free to use or ignore as you think is best for you 🙂
I think it's important to end this post by stating that all these things can help, but there's nothing wrong with you or your approach if you're still finding everything tough.
You are enough. In fact, you are amazing.
I'd love to know how you cope with midwifery exhaustion as a student or midwife.
Leave me a comment below, it might be exactly what someone needs to hear!
(Post updated 29/11/2016)