Welcome to midwifery
Hands down the best piece of advice I've ever been given (apart from the much ignored “sleep when the babies sleep”) was this:
Treat your midwifery degree as a three year job interview
Read into that what you will, but it goes beyond the obvious list of arrive on time, be ready and willing to work hard, adopt a sunny disposition and can do attitude, iron your uniform, polish your shoes, brush your hair, get rid of your gum, put on your name badge, make tea, introduce yourself, be courteous, look interested, help out.
When you're a student you have moments of feeling so utterly insignificant that you forget you're not invisible. The reality is that you are very visible. People talk. Women you care for, other students, midwives, mentors, lecturers, managers, word gets round about who students are. Favourable and, occasionally, unfavourable observations are made. People get to know your name. Even during your training, you start to build a network of other students, midwives, mentors, tutors, who pick you up and set you back on the right path. On the days you feel like bashing your head against a brick wall, when the essays are piled up and you're having to negotiate stacks of library books and journal articles balanced precariously around your house, you need to have started building networks.
You need people to inspire you and teach you. Books are my most treasured possessions and, while the pages will come alive and draw you in, rile you up and spit you out the other side, having living breathing midwives by your side each and every shift is priceless. You need to be receptive to this opportunity. The midwives on the front line now are just as awe-inspiring as Sheila Kitzinger, Ina May Gaskin, Sheena Byrom and the multitude of other incredible midwives who have written books that are legendary in midwifery circles and beyond. You need to know where to look for the trail blazers in your own corner of midwifery too and recognise the tiny moments of wonder each day. Community midwives who manage jam-packed antenatal clinics are just as skilled as those who work on busy labour wards. Don't dismiss anyone, you can learn from everyone you meet in one way or another.
At the end of three years, you will be having final placements signed off, references written, introductions and recommendations made. What will be said about you? Stubborn, bossy, closed-minded, unforgiving, superior, adversarial. Choose what impression you wish to make. I remember a very busy labour ward shift during my third year. My mentor and I were given more women to care for than was ideal in terms of workload. The women were all well cared for, but my fluid intake was probably worryingly low that day. When the consultant knocked on the door, she asked if I was ready to present the three women. I had a moment of panic, “Oh God, I'm a third year, I should know this”. I looked her in the eye, greeted her, smiled, apologised and explained that we were caring for three postnatal women and a fourth woman who had birthed her baby quickly and unexpectedly half an hour previously, which is where my mentor was. I said I was unable to give her a comprehensive handover for each woman, but that I had done all observations, which were stable, all blood results were within normal limits, and all women were well. The consultant looked me in the eye and I anticipated a dressing down. She nodded, smiled, told me she appreciated my honesty and said “well done”. My point? Don't try to blag it. Be honest, always, about what you don't know (and drink enough water).
Never assume you know everything. You can't possibly know everything. Even when you think you know all there is to know about a subject, you're wrong. Midwifery is like the sky: always evolving, ever-changing, moving, shifting. Just when you think you have it sussed, something changes: evidence, guidelines, protocols. Even seemingly concrete things present different challenges. Women are individual, each one as unique as the next, some will gladly consent to just about anything that anyone with a job in healthcare suggests or recommends. “You want to take my blood, give my baby vitamin K, stab my leg with a dose of Syntocinon to deliver my placenta, check my perineum? Go for it! I don't even know where my perineum is, but check it. You're a midwife, I trust you.”
Other women will question or decline something seemingly routine. Booking bloods, CO monitoring, healthy living referrals, vaginal examinations, fetal monitoring. These are things we risk taking for granted as they form part of our spiel that we assume women will happily comply with. All hail the women who question us, because that provides the opportunity for further discussion and fully-informed decision-making. You will be questioned, and sometimes you won't know the answers. There's no shame in not knowing, because you will find out and get back to them. At the end of your training, not only are you being given an academic qualification, you are also being given licence to practise as a midwife. It's not just saying that you are safe to work under the supervision of other midwives on the wards. At the end of your training, the midwives signing you off are affirming that you are safe and competent to run your own antenatal clinic, go out on your own to do postnatal visits, attend a homebirth. They're declaring that you know how to risk assess each and every woman you meet, and refer them to whoever is appropriate. You won't be alone, but you might be.
You've got three years to work out who you might be and who you might want to become. You might qualify and set your sights high, your career aspirations might be consultant midwife or labour ward coordinator or birth centre lead or community team leader or independent midwife. You might 'just' (and I use that word with my tongue firmly in my cheek, because what is wrong with wanting to be a cracking midwife?) want to be a damn good midwife who loves their job and does their very best.
Your training is going to shine a spotlight onto all sorts of things about yourself that have stayed buried or that you may not like. Terminations, miscarriages, stillborn babies, messy marriages, fear of abandonment, difficult pregnancies, infertility, postnatal depression, PTSD, anxiety, eating disorders, rape, abuse, bereavement. Whatever you've had go on in your life, midwifery will dig it up and throw it in your face. You will work in some of the most rewarding, challenging and soul-destroying situations you might ever have come into contact with. Training will open old wounds, make you new friends, broaden your horizons, stretch you to your limits, teach you how to learn. If you let it, midwifery will lay you bare and it will give you something that is hard to define. You won't be able to accurately convey to anyone outside of this dysfunctional midwifery family how it feels to place a newborn on its mum's skin for the very first time. They may see you ricochet off the walls or hear the excitement in your voice, but they won't get it completely.You will laugh and cry and shout and rage, you will debrief with friends, colleagues, mentors, lecturers, life gurus. You will evolve from student to midwife, and those relationships you've forged will be the ones that carry you through some of the darker days. These people will share your successes and applaud your 40th birth. You will renegotiate relationships and cherish the friendships that have lasted. You will qualify and you will cry with laughter at memories you share with a once mentor who is now a life long friend.
You've got three years to get involved. Join the midwifery society, create one, go to study days, organise your own, #getyourtweeton, understand that we're #InItTogether. Make a network of contacts who share your vision, talk to those who inspire you, embrace those who challenge you. Ask questions, submit papers, put your hand up, go to conferences, open your mind and learn. What else are you going to do that sets you aside? Go above and beyond to hunt out new experiences because the bare minimum isn't enough. What sets you apart, what will get you the job?
You have three years to learn, refine skills, learn some more. Never stop learning, never stop asking. Be thirsty for knowledge. Realise that you will all get the experiences you need. By the time you graduate, you will all have fulfilled the requirements set out before all of us. Births, antenatal and postnatal checks, the list seems endless. You will all get the numbers, so be generous with others. Know that you don't need to trample anyone to get to where you want to be. There is no competition, just community. We are vociferous in our support of women we care for, extend that same care and compassion to fellow students and colleagues. Advocate for each other. You will see what kind of community this is, you will see that midwives are courageous, hard-working, loving, and so many other adjectives that I could write you a list longer than my arm. If you take the time to ask and listen, you will realise that most midwives have tales of heartache and woe that they hide carefully behind their work smiles. Those smiles are genuine, but they belie a history, sadness, sorrow, loss, tears. Midwives, quite simply, are awe-inspiring.
You are in for an exquisite ride, embrace it. You will walk side by side with some phenomenal women, you are no better than them, no worse, just different. You will advocate, support, challenge, change, learn and grow. You will also fall, but you will have built a tribe ready and willing to catch you, sometimes before you even fall. You will qualify stronger, more resilient, more self-aware. Don't ever forget that you're beginning a career with some of the most jaw-droppingly incredible women you could ever wish to meet.
Welcome to midwifery, don't forget to enjoy it.
