She emails me in the middle of the night because she’s going to give up.
When I see the email the next morning, I write back immediately with a few lines of support, letting her know I’ve seen it.
Midwives are suffering higher levels of depression and anxiety than the general population right now and I have visions of this midwife hurting herself because she feels no-one’s listening.
Later in the day I take the time to write something more carefully. I don’t know if I can help at all but I tell her I know the feeling, the circling and whirling, the onslaught of more tasks, more mothers and babies, unfeeling paperwork, desperate emergencies.
It seems to help a bit. I get an email back quite soon about the midwife going for a hike with her partner to get some headspace.
It’s nice she feels she can email me for support. I worry about the midwives who don’t talk about it all. I think they’re most at risk.
A month on from this email exchange, the WHELM study came out. You might have heard of it, the researchers assessed the emotional wellbeing of 2000 midwives using a survey. To quote the amazing Dr of Midwifery Sara Wickham:
'The findings were deeply concerning, indicating that midwives’ emotional wellbeing is compromised to such an extent that two thirds of those surveyed were considering leaving the profession.'
As I looked into things further, I found one statistic that said out of every 30 new midwives trained, 29 leave.
The profession of midwifery in the UK is profoundly, unnervingly in trouble.
I keep trying to come up with solutions but the sentences spin away, going no-where. The best midwifery minds are working on it so I don’t know what I can add. The politics needs changing. There are excellent blog posts here and here that I suggest you share so the public is aware.
But after talking to midwives and students this weekend, I have a small observation.
When you talk to a midwife who’s about to leave - often they're so depleted they’re like a battery who can no longer charge - you find it's never just the stress that causing the exhaustion.
Don’t get me wrong, we desperately need more midwives on the shop floor and when you can’t give good care it’s heartbreaking.
But the underlying factor under of all this, whenever I’ve talked to a midwife or student in crisis, is whether they feel they’re valued or not.
One of my best days as a midwife was, by most people’s standards, terrifying. There was a huge haemorrhage, one of numerous emergencies on the shift, and the midwives had to cope with it for twenty minutes before the consultant was free. I was two hours late off the shift and had so many loose ends I could have knitted a scarf. But we did it. We were an amazing team and I’m sure we saved the woman’s life.
I remember running down the corridor into the room and thinking ‘this is ridiculous’ because the emergency buzzer has gone yet again.
I caught the eye of my colleague and we were still running but we both laughed at the absurdity and the tension broke. I think we worked better as a team when we were in the room, because of this. It was the camaraderie that kept us going. Despite needing the loo, being thirsty and being so beyond hunger than we were floating.
On another occasion I tried to recreate this moment with a manager and she glared at me before going into the emergency. She clearly didn’t like the idea of emotional intimacy in that setting. Fair enough. But it also made me feel about three inches high.
Top the exhaustion, stress and the lack of quality care with a feeling of being an idiot for even trying and you have a set of circumstances that few can endure.
If the manager had turned to me and said ‘we can do this’ I would have walked into a burning building for her.
I keep thinking about the question Ina May Gaskin asked that time: ‘What if the first rule in maternity wards was: ‘be nice’?'
I absolutely know there is incredible management going on, I've witnessed it and been coached by these professionals (MLU in Peterborough I'm thinking of you in particular here). I think being a manager must be so hard and lonely at times. This is not about the grade. It's about being respectful to everyone no matter what.
Staffing is a huge issue that needs to be solved and workplace culture is linked to it; but I still think everyone can afford to be kind and this would make a start. There's an example of this going on here.
You also need non negotiable self care time and a mentor who’s ideally a good friend too who you can hang on to.
This is my current thinking on the WHELM study. Things will change - because they have to.
Now I'd love to hear from you.
1. How is life for you as a midwife right now? Can you leave a comment letting us know?
2. What would you do to fix the NHS?