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.
If you’re a new or student midwife, please make use of The Secret Community For Midwives In The Making for support and advice. You can send in anonymous questions via team@midwifediaries.com.
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?
I’m currently a band 5 MW and really struggling. I can’t help but look for different career opportunities. I love looking after women but hate the pressures of the job.
I’ve just left midwifery due the controlling and often bullying nature of management. So many problems being caused by investigations not being handled well and the constant bombardment from a few who seem to rise through the ranks quickly and just as quickly forget what a clinical shift looks and feels like. I however was not a newly qualified midwife. But a senior clinical midwife burnt out from trying to show support to a team who were beaten down on a daily basis.
You are such a good Midwife and have made such a difference to women and their families. You cannot be replaced overnight! You have an enormous wealth of knowledge and experience and are highly skilled . We miss you dreadfully and I thank you for the support that you gave me on several occasions. God bless you xxxx
Band 6. Working for 9 years. Thank the Lord my contract is only 23 hrs. No way on this Earth could I do more. Every day we are begged to do extra hours as staffing is diabolical, but for fear of exhaustion, mistakes and litigation, I stay away. I also would never want to enter management or become a band 7. I fear that midwifery is dying. Leaving would only break the profession even more and there would be further reason to employ more MAPs and the profession would become semi-professional, as it is in Italy and other countries.
I lasted 7 months. That was after 16 years of being a competent, capable and HAPPY nurse. I left midwifery depressed, anxious and traumatised. I am so lucky I had another job to go back to and 2 months on I feel myself again.
Band 6, working full time for nearly 6 years now. I love the job, love being with women but the management doesn’t listen. They don’t look after the well being of the existing staff….. very sad… not sure how long I will go on for. It’s frustrating, heart breaking and very sad because we have so many amassing midwives who are being let down by the system….and women.
The ward I work on is currently manic, a 46 bedded ward, often with 6 midwives covering a day shift. We have 6-7 inductions a day, babies on numerous obs and mums with health issues, not to mention postnatal checks and discharges. But apparently we should be able to care for 8 patients per day and 14 overnight and we don’t count babies as they aren’t ‘patients’ even though often they have additional needs!!! HOW I ask. We maybe ‘looking after’ them but it certainly isn’t care! If I had 4 women then I could give care, we need more staff. That’s how I’d fix midwifery, more staff =happier midwives and patients!
Claire I have never understood how hospitals get away with not counting babies into the numbers of patients…often the babies require more care than the mums! They occupy a cot and are definitely ‘patients’…there is no other department in the hospital where they would not be counted!?! I think it’s just rediculous. Well done for keeping going. X
I was a final year student midwife and have had to take time out due to having a nervous breakdown, I felt so overwhelmed with very little support when I needed it! I am seriously considering if I even want to finish my degree for my registration because I was belittled and made to feel absolutely rubbish!
I feel like I gave it everything and it wasn’t enough, I literally have nothing left to give anymore! I’m now on medication because my anxiety got so bad and it’s affecting my everyday life now, I’m having to completely rebuild my confidence in my ability to do anything and even the thought of going back to the wards gives me panic attacks now! 🙁
Being a midwife was my dream but it’s turned into my nightmare and it’s devastating that I feel like that!
I’m a final year student too and so close to leaving the course. I still love midwifery but the demands are so daunting, I wonder how I’ll ever cope once qualified! Most shifts my mentor and I can’t get through the workload, how on earth can one person?! For now I’m carrying on but I don’t know how much more I can give. Sending love to you x
Band 7. I have been a midwife for over 20 years and a nurse before that. I have experienced staff shortages and other serious stresses over the years but this current cycle has me on my knees in despair. In the previous difficult times there has always been somewhere to turn, not all departments were so overwhelmed at once and you could always find and give perspective. Now there is no where to turn, labour ward is overwhelmed, community is spread gossamer thin and the management team are under so much pressure from the higher echelons of the trust that their capacity for caring and kindness has been almost completely drained away. Women are missing care and the care that is given is not of the quality that the midwives delivering it would wish it to be. For the first time i am looking outside the profession for job opportunities whilst trying to tell myself “surely this can’t get any worse”. I truly hope a radical shift comes soon, women and their babies need it and so does midwifery.
I am a former midwife who left due to lack of support at a difficult time in my life. The lack of care or understanding made worse by a catalogue of bad decisions and choices invoking a near breakdown and fear of going into work . I would never go back to the profession or indeed forgive those that contributed to my I’ll health as a result.
I struggled in my final year with the demands and attitudes of some mentors/Midwives.
I struggled as a newly qualified, changed trust. Began in my new trust & felt like I was supported. Trust changes happened, bigger caseload of women on postnatal ward.
Off work 6 months with anxiety and depression, medicated, ready to leave midwifery all together.
My next plan was to move abroad and work. I’ve been in Australia for 5 months and I have refound my love for midwifery. Staffing is good, supportive and attentive to needs of women and families, with the additional bonuses of being able to go to the toilet, drink, eat and have your breaks.
I hadn’t delivered a baby for 2 years as I was petrified to even go through the doors of delivery suite. Now I’m core birth suite staff, refound passion for intrapartum care and couldn’t be happier with my job.
As much as I love the NHS and all that it stands for, it makes me sad to say I’ll never go back to this type of working standard again.
I understand completely that not everyone is able to travel due to circumstances. But it’s been the best decision I have ever made.
I left an 18 year career in midwifery last year. The hours, the responsibility, the exhaustion was too much. One of my last homebirths was a huge pph while I was on my own as no second midwife was available. I managed it and the woman was safe but I couldn’t do it any longer. I’m much happier now I work in a bookshop eventhough I only earn minimum wage now.
Emily I’m so sorry to hear this. I don’t have any of the right words but I’m so glad you told us. Glad also you’ve found somewhere that works for you x
Band 6. When I qualified I moved to a different trust (slightly quieter than where I trained) best thing I ever did. I love the buzz of a busy ward and the business but some days it’s getting horrific with a unit that hasn’t got the capacity to handle the number of patients coming through the doors while providing quality care. Bed crisis after bed crisis. I see not so strong, less resilient midwives crumbling around us. When a trust begins offering resilience study days you can’t help but think they know exactly how the staff feel but management don’t want to face the sad truth that new midwives now are leaving as fast as they are coming into the profession.
It gets so busy some days Different departments seem to turn to a them and us culture with midwives who rotate regularly to all areas seemingly forgetting what it was like three weeks ago trying to clear beds on the ward while there are phone calls from all angles not just begging for beds but staff for delivery areas!
I finished my thirty plus year midwifery career five years ago. I was a hands on midwife working part time on a delivery suite in a large, busy hospital. I’d had a fantastic career and loved being a midwife until about two years before I left. I found the ceaseless workload with so few midwives to cope untenable. The disproportionate amount of paperwork, time spent on the computer, lack of breaks and the general atmosphere caused by low morale due to the overwhelming workload finally broke me. I’m one of the lucky few: I could afford to get out and take early retirement. I regularly see some former colleagues who assure me that it’s a whole lot worse now (I didn’t think that possible). Sadly, the whole set up, funding and management of our maternity service just isn’t fit for purpose.
I had my contract terminated after a new sick policy introduced, but 2 years on I am glad they did!! After 25 years as a midwife I wasn’t able to give the care women deserved, and I was starting to hate the job. Medication and counselling have helped but the NHS needs more bodies giving care. Not more managers or matrons.
I’ve been a midwife for 21 years and love being with women, but I’m another one that has been brooken by the system and am off sick with stress and anxiety. I’ve gone from being a gobby, assertive, proactive supporter of women’s rights to a blubbering mess that cries every time someone asks how I am. I miss my women but can’t look after them and their families when I’m in bits.
Third year student Midwife here. In my second year, I crumbled. Anxiety, depression and PTSD induced by horrendous shifts and the feeling of not being able to give women the care they deserved. I took a little time out and am seeking support from placement, uni and CBT. I’m slowly getting there but things need to change. My heart breaks for all the midwives and the conditions they are working under and I want so much more for the women we care for. As a result I’m looking into doing a masters in Policy straight from this degree because I refuse to leave something I love but equally I can’t bare to let things continue the way they are. I want to lobby for change.I want to make things better because midwives and women deserve it. If we don’t change things now, I worry the end of midwifery is near. I can’t bare to watch the midwives I admire so much crumble and fall ?
My contract was terminated due to my ill health, however it was Them that caused the ill health in the first place. So sad that midwives vomit by their cars prior to their shift, or dream of a car crash on the way to work, not too serious maybe a broken leg just to stay away from the wards. 2 colleagues took overdoses, when i was working as a midwife and i still can’t get my head around that. Scapegoating is rife. Now i’ve left my life is so much happier even though i continue to take strong antidepressants.
I left the profession after 18 years. Stress, shortage of staff, bullying, no support and a dangerous place to work. Dreaded going to work, felt sick & my stomach would be in knots. I’d never ever go back. I have returned to the nursing profession which I love. I’d never encourage anyone to go into the midwifery profession. It’s not a job people think it is. Life is too short to be unhappy. Be brave & make that change. More midwives are leaving now & who can blame them? Can’t be expected to work under those horrendous conditions.
Band 6. Qualified two years. Already had time off for ‘stress related symptoms’. I never suffered with anxiety prior to training other than when I stepped foot in an airport. I’m now medicated for it and also suffer with low mood and OCD. i’m ‘not the person I was’ according to my partner.
Admittedly I started my training with rose tinted glasses, two out of my three years of training were fantastic, my third year I had a lot of family losses, with no support and the wards became increasingly busy…this is nothing compared to how it is now.
Running a night shift on 6-7 midwives and a day on 8-10.
Full wards filled with high risk women and high risk babies. Large BMI’s, high risk inductions, cardiac problems, epileptics, preterm SROM and tightening, placenta previa. Babies on hypo pathways, reluctant feeders, babies on NG rude feeds, babies on IV antibiotics, reluctant breast feeders. Wards so full that labour ward backs up waiting for discharges some days.
Women do not receive the basic care they are entitled to and apologise when they need to ask you something because they can see just how busy you are. No breaks, no toilet breaks etc etc. Low moral. Poor staffing. Lack of understanding from management.
I want to provide the care women deserve, I want to know they’re safe when they step through our doors, I want to love the job I gave 5 years of my life to train to do but I am really unsure on how much longer I can keep this up.
Is my mental health and my home life second to wanting to care for women and their families?
I shouldn’t be made to make that decision, right?
But here I am, looking for jobs that I’d love and be able to keep the wage I’m used to living off of.
I’m close to broken and I don’t know where to turn. We need funding, we need staffing, we need new morals! The slate needs wiping and we need to start again.
I’m a band 6 midwife of 4 years. For the first time in my midwifery career, I’ve just had 4 weeks off sick due to suffering with severe anxiety and depression, which was a direct result of the current demands/conditions of the job- I can only describe it as complete burnout. This is the worst that I have felt in 4 years and think about leaving the profession every day; in order to improve my mental health and so that the job does not continue to have such an overwhelming negative impact on my life. The job is impossible at times and I constantly feel overworked and under valued.
I have been a Midwife for over 30 years and working as a clinical midwife is more difficult than ever before. We need to look at midwifery with fresh eyes to make things better. We are a national service yet documentation is often repetitive and differs from area to area, in our trust we then enter the same information on a computer. We have nice guidelines yet trusts don’t always follow them and statutory training within trusts should be the same nation wide. When errors occur blame is put on individuals instead of looking at the system that individuals are forced to work in. I just don’t understand why repetitive government don’t take a lead to sort us out, we need individuals from outside the nhs to communicate honesty with staff at the “coal face” otherwise the haemorrhage of midwives will continue. I feel many midwifery managers are powerless to affect real change.
My colleagues were too busy to ask why I had two weeks of sick. No one knows I was off on stress leave last month as I had started to self harm and it was getting out of control. No one knows that as I smile at them I’m thinking of ending it all. Everyone is too busy to notice I’ve lost 6kg in 2 months so I’m now back to being underweight. I get home and I’m too tired to go to Tesco, too tired to make my dinner and too emotionally drained to keep the smile on my face that has been plastered on there all day.
My GP has tried to persuade me to take antidepressants and attend counselling. The antidepressants made me too tired to think. The counselling would have to be done in work hours so I’d have to let even more mothers down as I wouldn’t be able to see as many at home.
I wish I could leave.
I always wonder if it’s like this everywhere in the country or is London the worst place to work as a midwife.
I went to an open day today as I’m looking at applying to do my post RN midwifery. I’ve been so excited as I’ve always wanted to be a midwife and I remember my careers adviser in sixth form saying to me, if you want to be a great midwife then you should do your nursing first. I don’t know if she knew how much she influenced my life as I went to study adult nursing and really enjoyed it and I have been doing it for the past 7 years working in an acute setting in a hospital. I work in a very stressful environment currently and I had no doubts that midwifery would be less stressful, however reading all of the above comments are a bit scary. I feel like I want to give each and every one of you a big hug.
Midwifery has always been at the back of my mind as something I really want to do, so I am going to have to go for it and be very wary of all the things you have all said. The whole NHS needs a big shake up and learn to care for their very hard working staff. Any tips and advice would be much appreciated. Sending you all lots of love xxx
My (admittedly pessimistic) top tip would be to stay with nursing. Or do midwifery in Australia or NZ. Even the smallest maternity units have the same pressures and midwives are in the awful position of being almost more responsible than doctors for any and all care given, childbirth litigation cases are valid for 25 years after the event, this fact hangs heavy over every single shift. I’ve been a midwife for 9 years now and sometimes wish I’d done nursing instead.
I am second year student midwife and I feel anxious at the pure fact of being rushed through all of my learning. The paperwork is ridiculous and is in constant confliction with the care I want to give women. Often having to rush though everything so we can move onto the next women in line. I am always being criticised for priorising care over paperwork. It’s manageable for low risk women, but as soon as a women is deemed high risk with complicated care needs… the personable approach is sidelined, and they do not get the care that they should get or that low risk women get. It will never happen but a dedicated MCA alongside a midwife for high risk complicated care would be beneficial. But we can’t get the staff numbers as it is 🙁
I’m a band 6 community midwife, qualified for 6 years. I’m crying reading the comments as I can relate to all of them. I’ve never felt so low, distressed and burnt out as I do right now. I’m on antidepressants and I’ve thought about ending it all on more than one occasion as I don’t see any way out. I work full time and have two children, I just about get by financially so can’t afford to drop any hours. I love my job when I am able to do it properly however our staffing at the moment is horrendous due to several of my team being on long term sick. I’ve thought about asking my GP to sign me off but I would feel too guilty for making things harder for my colleagues and the women and babies who need us. The workload just seems to get bigger and bigger and the amount of safeguarding and paperwork makes me feel like I’m drowning. I’m terrified that I’m going to miss something and end up in front of the NMC. I regularly work over my normal working hours just to get everything done. I hardly ever get a break or lunch and it’s not unusual for me to get home in the evening 2 hours late and realise I haven’t even had a sip of water since breakfast. Management don’t seem to care and never praise us or say thanks for working above and beyond but are quick to criticise or reprimand when you do something wrong (usually paperwork related). I feel so alone and fantasise about having an accident or illness so that I don’t have to go to work. How awful is that? I feel broken and a shell of the person I used to be. Someone asked me would I encourage my daughter to be a midwife and the thought of it filled me with dread. Not the way things are at the moment, no way.
This is so awful – please, please go and see your GP? I have a good friend who’s a homebirth midwife who’s been through something similar and the trust were able to give her better working hours for a while and it flagged up the problem more seriously. I am very concerned about you anonymous midwife, please don’t do this on your own, you deserve help x
Hello, I love your writing its so inspiring and honest ! Im a student midwife and it worries me to read articles like this as I sometimes wonder what I’m walking into, I love midwifery and am hoping for change!
The idea of utilising the Facebook forum is great, but one thing I find is that it is inundated with people asking about uni, this certainly has its place and I remember myself being in that position and needing advice However, it means that us midwives already at uni and placement become drowned out and unable to support each other? I find myself unfollowing as my news feed is constantly bleeping with notifications. this is only an observation but I wonder if a new group could be used for students currently studying?
Kind regards
Lisa Young
I have noticed this Lisa and it’s a really good idea. I’d fully support anyone starting one but I don’t have the bandwidth to moderate another right now. The self care for midwives Facebook group is great. Thanks so much for your kind praise 🙂
I left 2 and a half years ago after 20 yrs in the NHS first Auxillary, then qualified Nurse, then 12 years as a midwife.. I had stress in my personal life and stress in my job and it made me so ill I wanted to kill myself.. I remain on antidepressants but the pressure has lifted, I was continually made to feel inadequate and pressured into courses despite the fact that I was ill and not coping. I gradually cut my hours then left and feel so much happier, I work for a charity now nurturing caring and developing young people and help run our family Tearoom.. it is such a shame because I loved caring for women but the cuts,dangerous staff shortages and endless paperwork etc made it impossible to give the care the women deserved.
Band 6 Hospital based for 13 yrs when I became so disillusioned I was going to walk away, a community secondment came up and I thought I’d try that before leaving the profession as it was still the only job I wanted to do, i absolutely got my motivation and love of the job back but now after 10 yrs I’m on my knees, with nowhere else to go but leave. I cannot believe what they are asking of us….I’m both physically and mentally exhausted….dread every day, berate myself daily cos I haven’t the strength or motivation to do my job well, I’ve always been quite easy going but everything irritates me, my colleagues, students, even my women at times and that’s not me at all… this is destroying my personality bit by bit … and I feel trapped. I’m the main earner and can’t just walk away. . …I’ve always worked fulltime….I can’t afford to reduce my hrs but I’ve just had to for my mental and physical health. So will probably now have financial worries to top it off. And mostly all down to staffing levels…. In community were being pulled from pillar to post filling in shortages in the hosp as well as community, which pulls us away from our own job, adding more stress. The I.T and admin is just ridiculous…not only doing one or the other but both, duplicating so much. I’ve lost count of the wonderful skilled midwives we’ve lost over the last 2-3 yrs, and almost without exception they’ve gone before they wanted to because they just couldn’t take anymore. I don’t know where this yr will take me….but it’ll either be long term sick or out of the NHS altogether unless something changes….. I will not hold my breath 🙁 …..
I left the NHS earlier this year, following a couple of bouts of sick leave with depression and anxiety. It was a job I had dreamed of doing and I loved caring for women but it wore me down! Lack of support, bullying, little bitchy cliques, no breaks etc etc
I have moved into private sector providing abortion services for women, so I get to care for pregnant women and support them through what can be really distressing times. I can still be with woman! Currently this is my compromise, I can still be a midwife!
I did book some bank at the hospital and then couldn’t sleep with worry, no job is worth my mental health.
When I qualified I completed my preceptorship and moved to a quieter trust thinking things would improve … Far from it.
The management are bullies and belittle you if you don’t do as they say or you simply stand up for what you believe in and what is right. The people who are employed in positions to support you actually knock your confidence even more and tell you to leave midwifery!
I am not the problem and nor are any of other midwives on this post… The problem is the system and the way in which it is being run… But it is simply easier for them to blame the midwives on the frontline and crush us until we break. I never had any mental health …. Now I have bad anxiety which I am medicated for and depression. When things are becoming dangerously busy with not enough staff the band 7 midwives stay hidden in their offices, they don’t help. I worked hard for three years to get my pin and I just don’t want to lose it based on staffing issues creating severe danger… Wish I had of done nursing first and that gives you so many more employment opportunities but I didn’t so now have to think about leaving midwifery, wasting my degree and three years and taking a pay cut.
Why oh why are we being penalised for this? It makes me incredibly angry. I’ve gone from being a very passionate and bright eyed midwife to now being broken… And I fear it’s only going to get worse. People tell me just to suck it up and get used to it but after speaking to several colleagues who gave done this for over 30 years they have all said how this is the worst they have ever seen it… At least they can soon retire.
Feeling broken,crushed and just unworthy..