Disenchanted Midwife
Off we go again. For 3 years now my colleague and I have been facilitating the Active Birth classes at our unit. Why? Well a section rate of 26% is not something that any obstetric unit should aspire to and so thoughts turned to how had other units managed to reduce their rates. It turned out it was the simple things that made the difference, the bed not being in the middle of the room, labouring women being encouraged to mobilise, women and partners being shown simple techniques that could assist the womens body in making room for the birth of the baby and, of course, a reduction in epidural rates. Our contribution, commencing the classes. They are very popular, we tried to get other midwives involved, but met brick walls, mainly to do with staff shortages. We enjoyed taking the sessions, the feedback was good, we felt we might be making a difference. As finances were non-existant we provided the birthing balls, devised and had the leaflets printed, paid for, and went on courses, would come in on days off and during annual leave. Today colleague phoned me to say that a sheet of paper had been put in our trays telling us that from January the classes were to stop and thanking us for our input. Full stop, end of story.
It feels like my enjoyment of my job is being eroded bit by bit. The elements of it that gave me fulfilment are being whittled away. I no longer feel that the care we provide to Mothers, at home, following the birth is adequate. Antenatally the number of times we see pregnant women has been cut, what we are supposed to do at these appointments has been modified, we are not encouraged to listen in to the baby, baby's movements are enough! To ensure that we are adhering to these new guidelines our manager will be observing one of our clinics. If someone personally requests that I care for them antenatally I am questioned, if they want me to care for them in labour, well, that seems to be the most terrifying request ever.
This is why I want to become an independent midwife, not to take on the cases where homebirths have been refused as the baby is breech, or there are twins, or some other serious reason why a homebirth is inadvisable but so that I can provide women with the care I know they want, and deserve. I'm not considering offering homebirths, what I want to do is provide an antenatal and postnatal care package. Classes provided to suit the individuals need, antenatal appointments when they are convenient to the women and flexible enough to allow the answering of questions without watching the clock. Sometimes though I start to feel so dejected about everything that I lose motivation, I feel as if I am wading through treacle, all I feel like doing is jacking the whole thing in.
I'm a small cog, a tooth really, in a huge wheel. Anything I do makes so little difference that I might as well give up. Sometimes it feels that whatever you do will be shouted down. A salutary lesson was this amazing response to a nurses blog. Stick your head above the parapet if you dare, your fellow professionals will rip you to pieces
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emily / Website (7.11.06 21:29) That is ridiculous the active birthing classes are being stopped. For those who can't afford the NCT classes, that workshop sounded great. Sometimes for a new mum, the labour room is daunting. You don't know what you are allowed to do and what you can touch and move about. Having those active classes helps them gain confidence about all that. What a crying shame. |
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midwifemuse / Website (7.11.06 21:55) Emily - Certainly the women, and their partners loved them. They all complete a feedback form after the birth, and the responses are always positive. It's finances, again. |
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Oink (8.11.06 13:15) I'm sure that if you do go independent your patients will welcome your support. |
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mumof4 / Website (8.11.06 19:22) It must feel like such a slap in the face. I think the admin people/suits see their job as finances and nothing more. The people everyday aspect of the job is lost on them. They are on autopilot for cutting costs - pretty much as they would be if they worked say, in a sock factory. Perhaps they are comparing it to situations overseas.....here there is no such thing as postpartum care at the home (unless you pay for very exspensive maternity nurses) and you are required to take baby in to be weighed etc at pediatricians. Any problems with mum and you trot off to the OBGYN/midwife. It probably seems far from ideal - I know compared to my friends who had the UK system I very much felt out on a limb. But I see it as a cost cutting measure down the line over there. I don't think your conscience is going to allow you to stay with the NHS much longer and it is THEIR LOSS. You really need to consider the independent route but I can completely understand your reluctance to on the grounds of paperwork, insurance etc. You can only do so much vs the system - sorry it must be such a frustrating time for you 
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midwifemuse / Website (8.11.06 19:30) Mumof4 - You have it in a nutshell! Thank you. Oink - Why should people have to pay for it though? This is our future we are playing with here. I just get so wound-up, as you have probably guessed! |
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Julie (10.11.06 12:45) I just wanted to encourage you to keep up the good fight. A midwife and now close friend has changed my life and others by helping us learn that our births are key to our identities as women. She has changed my life and I'm sure you're doing the same for your patients. Hang in there! -- Julie in Texas |