The First Letter

Fountain pen writing on lined paper.

TRIGGER WARNING- Before reading this post please ensure you feel ready. It contains a real life experience of life as a midwife. It describes bullying, poor clinical care and belittling of women, along with other distressing stories. 

This is one of the first letters I received from a midwife. It is powerful, real and upsetting. These are the kind of things that happen in maternity care, they are simply not talked about and that’s why I’m using this platform to get the conversation going. I am giving midwives the opportunity to share their stories, to speak up and to use their voices to change the maternity care system. It has to change for the sake of newborn babies, mothers and the staff that work within it. It is broken and it needs to be fixed, so let’s start speaking about it and let’s fuel the change that we all so desperately need.

 This is all part of ‘The Voice of a Midwife’ Campaign, you can find out more about it and how to get involved here.

“So….how it all started. Growing up I had lots of really positive messages about childbirth from my mum and my nan. My nan gave birth to twins AT HOME…..9 HOURS APART. Can you imagine that ever being “allowed” nowadays? Any way, they were fine (of course they were) and one of them is my mum! My nan always spoke really positively about her births. And, similarly, my mum spoke really positively about my brothers’ birth and then mine. She always said it was “hard work” but that is was not something to be afraid of type of thing. And EVERY…SINGLE….YEAR my mum tells me my birth story in the run up to my birth – “OOOH…. I was just starting with tightenings round about now…so I carried on making dinner” etc etc.

I didn’t realise until recently but this is probably why I became a midwife. I can’t honestly think of any other influences. I trained to be a midwife when I was 18-21. (18!!!). Getting on the course was so competitive and I was enormously proud of myself when I got a place.

I enjoyed my training but there were definitely some “warning signs” about what life post-qualification would be like. Bossy mentors/criticism from some – but placements were short (about 6weeks) and I didn’t feel they were a true account as “the end was always in sight”.

When I qualified, there was a real scarcity of jobs. We all applied for 1 job from our cohort (there were 9 of us)…..and….because I was pretty quiet….It was pretty obvious that some of the others felt I didn’t have a chance! But guess who got the job….little old quiet me!!!! I really went for it in the interview and did not hold back on what an amazing midwife I would be. At least 3 of my fellow students barely spoke to me at our graduation when it was known that I got the job.

A few weeks before I started working at the hospital, I got my uniform. Sounding like a total sad bastard….I tried my uniform on most nights at home in the mirror. My mum even took pictures of me in it!!! And I would daydream about being a qualified midwife. I felt an ENORMOUS sense of pride at my achievement (I got a first class honors degree and the ONLY JOB going) and at being a midwife. I was very nervous about starting but mostly I felt proud.

On my first day, I was introduced to the staff (some of them did know me as a student) and I got a BIG WARNING SIGN that this wasn’t going to go well. At the nurses station, I saw the shift leader drop a needle on the floor. She picked it up and continued to inject it in the bag of fluids saying “well…it’s not going in anyone’s arm”. I remember thinking “but it’s going in someone’s VEIN”). There were at least 6 other people who saw this. And nobody said anything as far as I’m aware (I also, a few weeks later, saw the same midwife pick up and then immediately hang up the labour ward phone saying “I don’t have time for this. They’ll ring back if it’s important”. Obviously, I should have reported this. But I was shocked and totally speechless. And again, not the only one to witness this).

I honestly and truly don’t know how the bullying started. I remember that I was NEVER put on duty at the same time as my preceptor. We raised this and eventually things improved but not much.

I can’t pinpoint a particular event, but I know it started incredibly slowly and built up. I didn’t fully realise what was happening until much later down the line – though I think I had an instinct much earlier that things weren’t right and tried to brush this aside.

What I do remember actually, is within my first week on labour ward….I was ALWAYS given the extremely complicated patients. There were women in spontaneous/straightforward labour, whom I thought as a newly qualified midwife I would be given….but on my first day I was given a woman who had been pushing for over 4 hours. She was on the bed (obvs) and when I felt her abdomen she had a very full bladder. Once she’d urinated….voila! baby was born 2 mins later! Anyway, because of the LOOOOONG pushing time…..she acquired pressure sores and I had to write a statement to protect my practice. I remember thinking this was really unfair. Yes, I was the midwife there for the birth but the pressure sore had (probably) developed way before I came on duty. I’m pretty sure this was one of my first days on Labour Ward actually.

I also, very early on, was given an ICU patient on labour ward. I am not nurse trained (direct entry midwife) and felt this was way above my competencies. I asked if I could have a different patient or co-work this one, but was told “No. You are a qualifed midwife”. I felt foolish and incompetent.

What happened next becomes a blur (thank goodness) but I knew very early on I was not well liked. I was a very safe midwife, and quite nervous – I know that. But I honestly and truly expected to be nurtured and supported in my new (and extremely responsible) role. I was often criticised for asking for advice/a second opinion “too often”. I was very often told “it’s up to you. YOU are the midwife now”. And because I knew people were criticising me for asking for help, it became harder and harder to do so. And I would often feel very alone and afraid caring for some very complicated cases.

I had been qualified 6 months when I was “put in charge” of Antenatal Ward. There was only me on duty and a midwife less experienced than me. We had a lady miscarrying in the SANDS Room (NB SANDS is a charity that works with anyone affected by the bereavement of a baby) and a ward full of early labourers and complicated antenatal cases. I felt extremely frightened. It was terrifying the level of responsibility that was pushed upon me. But I was made to feel that it was me that there was something wrong with, that I wasn’t confident or competent enough (oh the irony….i wasn’t competent enough….so we’ll put you in charge of the ward. I can only see the ridiculousness of it now).

Some specific things I remember was a shift leader coming into the labour room one time when my lady was pushing. The shift leader shouted at me “HURRY HER UP. WE HAVE NO BEDS”. And I just remember apologising to the couple and thinking to myself “what can I possibly do to hurry her up….this is ridiculous”.

I saw a “trial of forceps” (NB this means a doctor attempting to assist a baby’s birth with forceps, with a view to opting for a c-section if the forceps are unsuccessful) in theatre once and because the woman had an epidural in it seemed the doctor felt he could be as rough as he wanted. He inserted his arm into her vagina….his whole hand and up to his mid-arm….and then he applied the forceps. He was pulling so hard the theatre bed was swinging from side to side (I’m now crying as I write this by the way) and I was utterly terrified. I honestly thought the baby’s head would come away from its body (I’m sorry to those reading this) and I wondered at the time if this could actually happen. But he was pulling so hard. His face was screwed up and the bed was SWINGING. The couple never said anything….presumably because she couldn’t feel anything. And the other staff said nothing. The baby was born and the doctor was patted on the back. And I felt so confused. How was that to be applauded? I remember that day as if it was yesterday.

One really random thing I remember which I think will “set the scene” for the environment where I was working was that one member of staff would laugh at my “skinny arms”. I was told so manytimes (this is so random!) to start doing weights as I “wasn’t strong enough to pull babies out”. PULL BABIES OUT. What the actual….??

I used to ABSOLUTELY HATE induction of labour. If I was given an induction patient I would go to the toilet to throw up before I went in to see her – knowing full well how it would likely end. I could not understand what we were doing. The hormone drip would go up….and as you know….it’s very potent stuff. The contractions would start quickly and every 30 minutes we would DOUBLE the syntocinon drip. I have had ladies screaming in pain and begging me not to turn the drip up. I honestly would just be frozen with fear. I could not and would not put the woman through any more distress but also knew I would be well and truly humiliated by the shift leader for not continuing the induction process. I know some people say if you turn it up “they contractions even out more” but it just felt so wrong. I always used to ask “why are we doing this? I don’t get it”. But no one could ever answer me and I was told that I would “toughen up” with time.

We were encouraged to artificially rupture most women’s waters to speed them up and free the bed for the next patient. I was actually pretty crap at breaking waters and usually always had to ask someone else to do it. I’m wondering now if actually I just emotionally couldn’t do it as I didn’t agree with it.

I was once looking after a woman having a very late (therapeutic) miscarriage. The baby had anencephaly so baby was not compatible with life. I cared for her all morning and was pretty happy with the care I was giving considering I had not done this before. When the afternoon shift came on….a midwife who was extremely vocal and dismissive of others offered to takeover immediately (there was a 1.5 hour crossover) and I was so relieved. It was emotionally exhausting caring for this woman. I was suspicious though of the midwife’s motives- she had never wanted to help me before and I knew she talked about me to other members of staff.  But I was mostly relieved – yes…take her. I needed to eat. The woman needed a BP measurement, and a new bag of fluids. The midwife offered to takeover immediately so PHEW. A few days later however, I was summoned to the Head of Midwifery’s office. The midwife had gone to the head “concerned” about my practice. She had told the head that I had asked her to take the blood pressure measurement and change the fluids as I didn’t know how to do it. The head of midwifery told me my competencies would need to be checked and I was given a little booklet to record my activities and get them signed off by my colleagues.

I felt humiliated.

So…every day, I had to take my little book in and show the shift leader what I needed to do and get them to sign me off at the end of the day. It was so unbelievably fucked up (sorry for the swears but I’m angry now)….that I was still being given students to supervise/teach….yet my competencies were being assessed. Obviously now I can see that they weren’t that concerned but at the time I felt ashamed.

Wow….ashamed. That’s a big horrible word.

I took my little booklet to the Head of Midwifery every so often. She refused to move me to a Band 6 pay whilst my competencies were being assessed (you’re supposed to progress at 6 months qualified if I remember rightly) but I never got to. Never. I always stayed at band 5 pay. I remember thinking it was unfair. But mostly I felt ashamed and humiliated. I wasn’t good enough. Wasn’t clever enough. Wasn’t tough enough. I didn’t deserve Band 6 pay. I questioned her a few times – “you’re giving me students – you must think I’m competent” and she literally laughed in my face. And said “having a student doesn’t prove anything”. I never mentioned this again.

Things then just went out of control. And I would be caring for women in lovely amazing labour (I learnt to shut the door and not come out to avoid criticism) but was accused of “avoiding getting more patients” and this was reported too. I would be caring for a woman in established labour and my shift leader would tell me to scrub for theatre for a totally different patient. There were other midwives available but it had to be me according to them. My booklet needed signing so I had to leave my patient and see to another. I felt this was unfair and unjust on my patient and myself and questioned this but was told not to be “awkward”. I was reported to the Head of Midwifery after this for being arrogant. Me!!! Arrogant. That is beyond funny.

Most days I would end up in the Sluice Room crying. We had so many “near miss” incidents – it honestly was a pure miracle that we hadn’t killed anyone by this point. I’m not being dramatic. Some of the things that I saw were terrifying but somehow we swerved a major incident every shift.

One time we had a power cut in theatre and then the back up generators failed. The theatre was in pitch black and the woman was mid caesarean.  She started screaming and screaming and we performed that caesarean by torch light. I know that is not any of the teams fault but I’m just setting the scene of what it was like.

I always had to scrub in threatre (to meet my competencies) and then recover the woman afterwards (if you’re not a midwife reading this….this isn’t unusual but isn’t the norm generally. You usually do one or the other). But I was constantly told – “you need to learn. You need your competencies signing off” and I often felt it was an excuse.

I finally handed my notice in after 2 years. I was covered in cystic acne by this point and had lost nearly two stone in weight. I cried and vomited every morning before work, and had diarrhoea every single day. I stopped going out and buying nice clothes or other nice things. I didn’t see the point any more.

When I handed my notice in, the Head of Midwifery was surprised. My closing statement was “the disparity between my love of my work and my experiences at work has ultimately led to my resignation”. Her response was “why do all the best midwives leave?” I was utterly speechless. Literally – nothing came out of my mouth. If I could turn back the clock I would have said “are you actually being serious?” but I had run out of words.

I was actually pretty well liked amongst the doctors on the Unit and got quite a few of them to write in my competency booklet what they thought of me. I handed it proudly to the Head of Midwifery. But I received no feedback.

I remember once there was also a woman in labour doing what she referred to a “camel walking” to help open her pelvis. Oh….the staff were in fits of giggles over this – that she felt she could “beat the system” was how it seemed. The woman’s midwife kept coming out the room and doing impressions of her whilst everyone laughed. They mocked “that she’d be in theatre within “x” amount of hours”….and of course, she was. I’m pretty sure we caused that C-section. I am embarrassed to say that by this point I joined in with the giggling. It was much easier by this point to join in than question other people’s practice. And I was not happy with the person that I was becoming.

After I’d handed my notice in (but no one else knew), on one particular shift I had a student with me and my lady was about to have a ventouse birth. The shift leader (the main ring leader) came in as I was trying to connect the suction cup to the machine. My hands were SHAKING like mad by her presence. I couldn’t connect the machine through fear and pressure. She bent down and whispered in my ear “you are ridiculous”. I started crying in the room and had to use everything I had not to burst out crying and run. The shift leader connected the machine, and the ventouse birth went ahead. Afterwards, I vaguely told my student what was happening and asked her not to repeat anything she saw from here on in. I went out into the corridor and shouted at the shift leader “to get in the drug cupboard room” (it was a small and pretty private room) and I said to her “WHAT HAVE YOU GOT AGAINST ME?! DON’T YOU DARE SPEAK TO ME LIKE THAT EVER AGAIN”. She had literally nothing to say. She looked a bit shocked and scared actually and was totally speechless. I truly wish I had spoken up like this much sooner but was too frightened to until I had “nothing to lose” (I’d handed my notice in).

I never told any other member of staff that I was leaving. I felt excluded and alone. On my last shift a few people asked “when are you back in?” and I said “I’m not. I quit 6 weeks ago. You won’t see me again”. Everyone was like “oh my god, you cant quit!!! We’ll miss you” and I was like wtaf. A few midwives came up to me and said “you HAVE to tell management what it’s like here. Now you’re leaving, speak up for us”. And I said no.

Someone went out and bought me a cake. And I half heartedly said goodbye to everyone. And then I left.

And I was F R E E.

And it felt so good. I still carried guilt, shame and humiliation with me. But I was free.

I did a few other jobs and after a couple of years went on to be a health visitor. I was really frightened actually – I was really and genuinely worried that the same would happen again, but my personality and approach was very well received and I did really well in my health visiting career.

I had mostly forgotten a lot of this and got on with my life, until it came to us trying for our own baby.

I was truly terrified of giving birth and so put pregnancy off for many many years. I actually needed fertility treatment and my first thought when I realised I was pregnant was that “I had to give birth”. I cried constantly during my pregnancy – my husband couldn’t understand it. Yes – it might hurt a bit but he couldn’t grasp why my fears were so huge.

When we went on our hospital tour – this was my first time going in a labour room for over a decade. It was a different hospital but as soon as I walked down the corridor and into the labour room, all those unpleasant emotions came back. I started crying with fear about my birth and thankfully a really lovely member of staff (a healthcare assistant) sat me down and talked to me.

I then decided to teach myself hypnobirthing. It all started making perfect sense. The unnecessary intervention. The cascade of intervention. It clicked. There was never anything wrong with my practice – I wasn’t unsafe or incompetent – I just didn’t believe in many of the hospital polices and what we were inficting upon women – so couldn’t go through with a lot of it. When I queried these things as a midwife, it was never considered that “my way” was right -that there was another way of doing things. It was that I was incompentent because I wouldn’t “do what we’ve always done” (does this make sense?)

After lots of thinking and teaching myself hypnobirthing, I realised that I was not afraid of birth. Yes,..nervous. But my fears were of the maternity system. I was terrified that I would be on the bed (this is mostly what I’d seen and what we were encouraged to do) screaming in agony. That the staff would be wanting to break my waters/put a synto drip up/give me an episiotomy and I would be pleading with my husband not to let them but that he would be saying “it’s for the best….the staff are recommending it”. I got so much confidence from hypnobirthing. I developed some kind of super strength and was adamant nothing and no one would touch my body or my baby. I didn’t realise this at the time (I didn’t do it intentionally but looking back may be I did)… I waited until I was pushing until I went to hospital. I waited until the very end and arrived at hospital, gave birth 15-20mins later and left within 2 hours. I wanted minimal contact with midwives out of fear.

During my labour, I never did any breathing techniques…I just breathed! I never did any visualisations. I never got in the bath. I had no gas and air. I just stayed at home and avoided the hospital. And I had a bloody great birth!!! It was painful (probably should have done the breathing etc) but this was not the most important part for me. It was the confidence. The assertion. The right to say no that empowered me.

I have no idea whether any of this makes sense or if it’s helpful or in the right order. But this is my story. How I remember it. There were some fabulous midwives who I adored who I would not have stayed at that hospital for so ,long had it not been for them. But they were outnumbered.”

Want to help to be a part of the change? Want to get involved? Want to prevent this from happening ever again? Here’s how-

  • Share this story with friends in real life and on social media, the more people that read these stories, the better.
  • If you’re a midwife reading this and you’d like to share your story- please either email it to me at chloe@doitlikeamother.co.uk or mail it to Mrs C Mulholland, Do It Like A Mother, 869 London Road, Essex, SS0 9SZ. 
  • If you’re a parent and you want to share your story- hop over to Make Birth Better and share it there. 
  • If you work in maternity services in any capacity, use this story to form conversations with colleagues and managers. Discuss it and examine whether any of this behaviour is occurring in your unit. Is this acceptable?

I really do believe that by sharing our stories and speaking up about the truth, we can really make an impact and change maternity services to work for both midwives and the families that we serve. We really can make birth better.

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