The positive pants need to go back on

I don't imagine anyone sets out to become a midwife with intentions other than beneficence, non-maleficence, justice, equity. Whatever our motivations to be midwives, these values were surely fundamental when we began and must certainly be key to every shift we work, mustn't they? It's interesting to consider whether (and how quickly) these values are jeopardised when we're faced with someone bigger, bolder, seemingly more important than ourselves shouting the odds or calling the shots.

I finished a shift last week wondering where consideration for the women was when us midwives were being scolded for not moving women slickly to the ward. “Time efficiency” sacrificed individual care, threatened women's experience and perception of labour and birth, and put breastfeeding at risk. In addition, it put midwives under immense pressure to perform superhuman feats in order to achieve a quick turnaround of beds and rooms. Were we tempted to compromise our own standards of care and compassion because there was someone breathing down our neck to quite simply get a move on? I felt stressed and had a huge sense of failure and underachievement. Did I manage to stay true to my values?

In the past week or so I've finished my shifts feeling exhausted, unsatisfied, marginally traumatised, overwhelmingly useless. I've fought to get an epidural for a desperate woman, only to be told by her husband that it wasn't fair that the unfolding emergencies were taking priority over his wife. I supported the woman and her partner, apologised, explained the delay, apologised some more, chased the anaesthetist, offered alternative coping methods, documented, apologised again, and then had to justify why they were being pipped to the post again and again. When there is no alternative but to sit tight, it is gut-wrenching to have to explain to someone that pain relief is not a priority because there is a greater need in another room. The woman's partner heard “Your wife and baby are not important” and he retaliated accordingly. He was scared and frustrated, and my heart went out to him. He later apologised for getting angry and being rude, and he spent the rest of my shift trying to help me, despite my reassurances that all had been forgotten. I felt as though I had failed the woman. I didn't become a midwife to fail women, and I'd never felt less like a midwife than after that shift.

Yesterday I wondered what the hell I was doing. Why on earth was I a midwife? I'd never felt less inspired or enthusiastic, and it felt as though World Mental Health Day was a cruel day to have a crisis of confidence. I dragged my heels to my final appointment, a home visit to a woman I'd cared for several times before as a student midwife. Continuity at its best. I'd had a wobble earlier in the day, feeling as though I'd failed her. I thought we were banging our heads against a brick wall, trying to get her heard within an obstetric model of care. She'd been passed from pillar to post and was getting lost and disheartened. When I saw her yesterday, she looked as though a huge weight had been lifted from her shoulders. She looked relieved and happy, content. Someone had finally listened to her and she had a plan she was happy with. I was so pleased for her. Later in the conversation, she uttered the words “I told them that finally someone was listening to me like my midwife listens to me”. I gulped down the massive lump in my throat: she'd taken ownership of me, I was hers, and she felt as though I had listened to her. Maybe I hadn't failed her.

I listened in to her unborn baby, turning the volume up so that the whole family could hear the heartbeat. When I sat back to write my notes I looked around me and took stock. The woman and I were surrounded by her other children, two of whom I'd listened in to when she was pregnant with them, we were in a room full of noise and love. One of her youngest was helping me while skitting around, showing me how far she could jump. One of the older kids gave me a sticker to put on my name badge, and the tiny one was running a toy car down my arm. Moments like that are priceless. That's why I became a midwife, to be welcomed into someone else's family to share a snapshot of their lives, to provide a listening ear and to open doors so that women can access the care they need. That one visit to that one family restored my faith in my ability to do my job, my dedication, my strength of character and my passion for midwifery. It's time to put my positive pants back on (courtesy of @hellotreacle)!