And so, the day has come. The one I was dreading. I am having to write a post on midwife motivation while not feeling very motivated myself!
In case you're not one of MidwifeDiaries' small but exclusive group of 70 subscribers (70? MADNESS! Where did you all come from?? Hello, it's very lovely you're here), and you haven't come across Midwife Motivation Mondays before, I'll explain. Monday is the day I post to inspire and motivate midwives (and midwives in the making). I generally take a topic that makes me remember why I'm so excited by midwifery and share it.
But I'm having a hard time with that today....
On shift, do you ever feel like there's just far too much to do? Do you ever get the feeling you're swimming upstream? But sometimes the current is so hard it feels like you're not getting anywhere at all, or perhaps you're even going backwards? And sometimes it just feels like it would be better to swim to the side, squidge your toes into the muddy bank of giving up, and go and find your towel of failure?
Yeah. It's been one of those weeks. But obviously, I'll keep going, I'll always try.
Maybe it's just because we're busy. Sometimes I really worry about myself and my colleagues and our stress levels. I worry about midwives' health.
20 minutes later, merlot in hand:
I went off and did what I usually do when I'm tired and cross and should be writing: I surfed YouTube. And I came across a fascinating lecture from Kelly McGonigal, health psychologist. She has very interesting research for anyone coping with stress, but in particular labouring women, and the midwives working with them.
This has reassured me on lots of levels. It directly credits midwifery philosophy, and also reassures me that we're not all essentially working ourselves into early graves. It's also perked me right up and made me appreciate midwifery again.
It's about oxytocin and stress, and how they work together. It turns out that being 'stressed' might not be as damaging to labouring women as we think, or even to ourselves.
Before you all call me crazy, let's go through the basics.
Oxytocin is the love hormone, the one the press refer to as the 'cuddle' hormone. It's secreted by the pituitary gland, makes us crave human contact, social situations, and contact/cuddles with close friends and family. It's released during sex, and it also regulates labour, childbirth and breastfeeding.
Most of us are also familiar with this kind of diagram, which shows oxytocin's role in natural labour:
And also this kind of diagram, which shows how stress can cause contractions to slow down and labour to be more painful:
As midwives, we are in danger of thinking oxytocin and stress can never work together.
But Kelly McGonigal argues that oxytocin is actually released as part of your stress response. Oxytocin is as much a part of your stress response as adrenaline.
We know this because of two major studies that we can draw conclusions from.
The first indicated through studies on rats that oxytocin has an anti-inflammatory response during stress. Kelly McGonigal and other scientists hypothesise that oxytocin is the body's inbuilt stress buster. It helps you blood vessels stay relaxed. Oxytocin even helps your heart cells regenerate if they've been damaged through stress.
The second study indicates that oxytocin induces social behaviors during stress. Essentially it prompts you to go and find social support. This support then creates more oxytocin, which further protects you against stress related disease.
The key fact Kelly McGonigal found was: although stress related diseases are a leading cause of death, stress itself doesn't seem to be the culprit. Whhaa?!
People who work with others during stressful situations, especially carers, are less affected by stress.
It's all about how we view and relate to the stress. If we genuinely care for and connect with people, and view stress as positive, it seems we are naturally protected against stressful situations.
This also has applications for thinking about labour. It seems if you feel anxious and worried, and unsupported, the damage to your body through stress goes up. Kelly McGonigal reports oxytocin makes your blood vessel walls relax, even if you're stressed. I would imagine this would provide better blood flow and oxygenation to any mother and baby going through labour.
There is not enough evidence to say for sure these findings can be directly applied to labour. But it is very reassuring to know recent findings about oxytocin tie into natural birth practices like keeping birth rooms quiet and calm, choosing birth companions with care, and avoiding lots of new people and scary experiences in labour.
I don't mean to underestimate the amount of stress we experience as midwives. It goes above and beyond the stress most 'normal' people experience. I also think sleep deprivation is an entirely different matter, and no amount of correct social support can replace being well rested. It's not realistic to expect to be motivated and happy to be at work every day, especially with the staffing and pay issues going on globally for midwives at the moment.
But it is realistic for a lot of us to look to our colleagues for support at work during stress. It's also realistic to enjoy to social contact that's an essential part of our job, and celebrate the fact that this enjoyment will do us a lot of good.
I wonder if this is why continuous midwifery care models consistently get better outcomes? Because we teach our women to handle stress and give them the social support they need, prompting better outcomes in labour with less interventions necessary.
Here is the lecture in full. It's really fascinating if you have a spare 15 minutes:
I'm now feeling a whole lot better about things, and I'll try and communicate this message to women who find it useful. I hope you found it as interesting as I did.
Perhaps it will help to remember next time you are in the onslaught of a frantic day, how you view the stress and what support you have can be your shield.
Personally I find tea, wine, and debriefing with people you love (and a bit of meditation, but that's a topic for another day) to be very helpful day to day!
Anyway, I'll see you next Monday, I hope you have a fabulous week with some great outcomes, you cope with everything thrown your way, and feel supported.
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