Exam challenges, personal circumstances, difficult colleagues or mentors, incidents...midwifery can be about as tough as life gets.
This post is on how to cope with midwifery knocks on the path to qualification and beyond and how to get back up. It's another piece of writing prompted by members of The Secret Community For Midwives In The Making.
Midwifery is about supporting the transition to motherhood and new life. This means it's a profession which comes with some of the most stressful and weighty (though amazing, privileged and enjoyable) situations.
The good news is that if you've hit a rough patch, you're not alone. Every midwife or other person I respect who I have got to know in any depth has faced catastrophic failure at some point.
It's just part of the life dance that we all do.
So considering midwifery knocks will happen to you at some point, you have to commit to being able to get through them in a constructive way*.
*NB: There are situations in which self-care needs to be your main consideration. If you are exhausted or burnt out, you need to see a personal tutor, supervisor or your GP to work out what the best plan is. For more information, see the Royal College of Midwives' 'Caring For You' Campaign.
For the times where things are tough but within the realms of normality, here are four strategies:
1. Make Turning Up Your Measure of Success
This sounds basic but it's been a profoundly important strategy for me.
Say you have a placement that you fear you may be failing, or you're struggling with a particular assignment or topic.
Or you have a challenge as a qualified midwife that's very difficult. For instance, in a certain staff midwife position, I used to hate early weekday shifts because I knew I'd have to balance memorising all the women on handover as well as trying to get elective caesarean patients admitted, cannulated, auscultated etc. It was a huge challenge for me and one I dreaded because if I failed at any of this (which happened regularly, knocking me back) my colleagues and the medical team would know as everyone was working together on the ward.
In this type of circumstance, I suggest you change the goal posts.
Don't aim for perfection.
Instead, make a mental shift so that turning up and authentically trying to be the best you can be is your measure of success.
No matter the outcome of a particular shift, lecture or assignment, you'll still be learning. Often you'll be absorbing far more than you realise. So turning up is often all you need to do to be successful in the end.
I used to wander round chanting 'I have no cherished outcome' in my head, over and over.
And of course, as soon as you decide that just having turned up makes it a successful day, you tend to relax and then everything goes better anyway.
2. Have a 'People List'
This is a suggestion from one of my favourite researchers, Brené Brown. She studies difficult topics like shame. She also looks at healthcare research and how professionals keep functioning at a high level, with compassion and empathy at the forefront of their care.
Brené Brown suggests that you have a small piece of paper you keep in your purse with no more than four names on it. These four names are of loved ones that you know judge you fairly, with knowledge of your personal values and capabilities.
She suggests these should be the only people whose opinions really matter to you because otherwise you'll be swamped by trying to please everyone.
When you hit failure in practice, placement or at University, you can pop to the loo or another quiet place and look at your list. I had no idea how effective this was until I tried it.
To para-quote Alan Bennett: seeing those names in a time of struggle was like having a hand come out of the piece of paper and take mine.
When you're being given criticism you're finding hard, you can think to yourself 'I don't need to take this to heart because this person is not on my list'.
This doesn't mean you don't take constructive criticism. It just means that when you're struggling with something that's knocked you, you're able to put it into perspective and realise the person criticising you doesn't know you well enough to comment on you personally.
3. Know Your Story About Struggle Will Inspire Others
Three of my hardest, face down midwifery knocks have been:
- Taking the lead from a professional when I should have known better and putting a client somewhat at risk. Nothing bad happened but it still scared the life out of me and all my colleagues and my supervisor knew about it, which was mortifying
- Failing an OSCE on breech birth
- Crying because I was so exhausted and being sent home early from a shift
I swear I was still well thought of (I think!) by my colleagues at this hospital and I have also:
- Worked in a different country, adapting quickly and smoothly
- Never missed a cannula in an emergency
- Co-ordinated an exceptionally busy shift on labour ward with several emergencies, despite being fairly junior
Every midwife has stories like these. We need to keep learning and obviously keep striving for the best care possible.
But when you are feeling small because you've made a mistake or you're taking a knock, know that in future your story is likely to be exactly what another student or midwife needs to hear.
4. Hug Your Failure To You
I know this sounds bizarre, but it's likely that you will learn from the times in life when you have to be courageous.
I believe that taking knocks is a good sign. If you're putting enough of yourself into life and your career, you will face failure and challenging circumstances.
The only people who don't fear failure, feel terrible when they've done something wrong, or feel silly and ashamed sometimes, are sociopaths.
You don't want to be a sociopath!
The fact you are capable of feeling so deeply shows how much you care. One of the most important skills for a healthcare professional is the ability to get back up again and keep an open heart despite knocks.
That's why one of the 6Cs is 'courage'.
Your failures are hugely important. Imagine taking them round with you in your placement backpack or pocket of your uniform. Those stories are hard won.
Getting through these knocks is helping make you into the experienced, emotionally capable and valued professional that the NHS so desperately needs.
Before I sign off I also want to say that I don't think knocks and failures ever go away, no matter how experienced you get.
Even students and midwives you think are coping well or are highly experienced will still take knocks. The only difference between these professionals and those with less experience is that the seasoned midwives know that feeling lost and down is to be expected sometimes. They have been into the dark before and know that they need to keep going regardless.
Everything is constantly changing. All things pass. Even if it feels like you're going through the same old struggle, every day, it's just a matter of time before this circumstance changes into something else.
I'm sending all my very best wishes to you.
Do you have a story to share on midwifery knocks that you think could be useful to someone else?
Or a strategy to help get you through hard times?
Let me know in a comment! x
p.s. I used the word 'tribe' in this post before. I know better now.
A class debate occurred on my access course – other aspiring midwifes on my course all stating that people who aren’t mothers (like myself) can’t be a midwife as they don’t know how it feels. What if this was said was about other healthcare professions? There would be no-one to look after anyone!
This is so brilliant Ellie and I found it incredibly comforting and also reassuring that everyone has those set-backs and you do get through them eventually! You’re simply fab, you inspired me and guided me before I even applied and still do while on my journey to becoming a midwife. Thank you! X
Thank you Ellie. I really needed to read that today, and it so happened that it stayed unread in my inbox till this exact moment, when I’ve been finding it difficult to be positive about the journey.
I’m a first year and having just had the Christmas break after a whirlwind very busy first 3 months, preparing to go back to placement and then lectures next week is seeming like a huge mountain – like I’m going back to a place where I struggle to catch my breath in a day. I’ve lived by the idea of finding the strength to just keep turning up so I feel encouraged that you’ve talked about it too.
You’ve done a fantastic job of making this post positive and I’m thankful that you’re out there, using your words to empower us no matter what stage we are at on our journey.
Xx Maria
Thanks so much for your comment Maria, I’m so glad it was helpful! Yes, people always want a big breakthrough moment don’t they but a lot of the important things in life just happen by turning up, day after day. Good luck! x
I will just say that I wish I had seen this when I left midwifery school in 2016. I was reeling from a divorce that was new, single mothering of 4, and the death of my mother, and I started clinical at that time. I had worked 3 years in classwork and was so incredibly happy to finally be at my goal — I had wanted to be a midwife for 20+ years. I was working full time nights an hour west of my home and doing 24 hour clinical shifts 2+ hours east of my house, and I was emotionally and physically exhausted in every way. I failed my first term of clinical. I just wasn’t ok. My preceptor was not supportive and, instead of talking to me about my experience, failed me. The school took that as an insurmountable rejection, and they dismissed me with the caveat that I could return in the future, maybe. I was heartbroken, ashamed, embarrassed, and lost — and still grieving and struggling in my other recent blows. I left midwifery and even labor and delivery at that time. I have not gone back.
I don’t know what I am going to do in the future, and if I’ll return to school to finish, or if I will pursue a different course of study. 2 years later, I am still in need of working through exactly what happened. I thank you for this, because even though it was too late to support me at that time, it’s still an open wound that this balm helped sooth . ?
Thank you so much for this Ellie, I feel like you wrote this just for me. I’m a third year student and have just finished my last community placement. I had a perpetually negative mentor who made me feel about an inch tall and like I should just give up. I can honestly say she has shown me precisely the kind of midwife I DON’T want to be, but her words have cut deep and really knocked my confidence. I feel like I second guess everything single thing I know/do now waiting to be told I’m wrong even though I’m now working with different people. But your words have helped me to gain some perspective and realise that I can get through this, there’s plenty I’m good at, there are lots of people who believe in me and love and support me, and that this experience, and the many other knocks I’ve had over the course of my training, will help to shape me into a midwife I can be proud of. Thank you so much x
It’s lovely to hear that Laura. Well, not lovely on the not great mentoring side of things but it sounds like you’ll be amazing – and you’ll help students going forward! x
Thanks Ellie,
Some great tips I’m unsure why I feel this way I can’t put my finger on anything in particular that’s happened to make me feel so emotional and drained x
Nearly three years of working very hard perhaps 🙂 If you need permission to be very kind to yourself, even if you feel nothing has triggered it, this is it <3
Thank you Ellie x
I think printing this article and having it in your pocket along with the names would help. This is such a good piece and a reminder that we will all have struggles and they come with the territory and are not a judgement on your ability.
As for the wording, maybe ‘midwifery knocks and developing resilience’ ??
Hmm, yes maybe! That’s a big compliment that you think this article will be helpful in practice! I just have something in me that likes ‘fight’ because it’s inspires action? But maybe inspires exhaustion too!