This blog post regarding the theme around the maternity services on RTE Liveline this week was sent to the MAI from a Midwife who wishes to remain anonymous. We suspect many midwives around the country are feeling similarly listening to the radio this week.
I am in such pain following the Liveline coverage of women’s’ experiences of care in Irish maternity services this past week. It is never anything short of horrifying to me that women and their families are being so profoundly hurt by experiences that ought to be, at a bare minimum, infused with dignity, respect, safety and care. I have an ache in the centre of my chest over it.
I am doubly pained because I am a midwife in the Irish maternity services and it’s feels like someone is repeatedly punching me in the chest right where that ache is, when they say that I should admit that I am part of the problem or that my pain doesn’t count.
Everyday I go to work and I put my body and my heart on the line, hoping that I can make at least one woman’s experience positive, easier, more meaningful.
Everyday I go to work and I put my body and my heart on the line, hoping that I can make at least one woman’s experience positive, easier, more meaningful. However, I work in the postnatal ward, which is often referred to as the ‘Cinderella service’ of maternity services as it is most often underfunded, underresourced, understaffed, overlooked and oversubscribed. There are often days/nights where I am the midwife in charge of the shift and therefore all junior staff, responsible for teaching a student midwife and for absolutely every task they undertake, and also responsible for the care of up to 12 women and their babies myself. That can mean I am looking after 24 or more patients myself. That’s 12 sets of maternal vital signs and postnatal checks, 12 or more daily newborn checks (plus full sets of vitals signs for those that need it), some days up to 7 discharge checks and information sharing, then the inevitable 7 admissions. At least half of those women will need help with breast or bottle feeding and concentrated time to be shown how to change a nappy, wind a baby, soothe a baby. Most of those women will have pain at some stage and to address this I do at least four hourly medication rounds, and four hourly vital signs for those mothers and babies that need them. That doesn’t even account for the women or babies who may not be stable and who may require me to escalate care and intervene for high fevers, high blood pressures, low oxygen levels, low blood sugars etc. And it’s still doesn’t account for those episodes where a woman will haemorrhage, a baby will stop breathing and so much more. I have to do this all in 12 hours.
Some days I cannot split myself in enough ways to attend to everything the way I should, and I hate myself for that. But I hate the system more.
I’m not trying to excuse away any woman’s experience. Never. I never would and I think it’s been so important to have those stories finally aired on mainstream media. I hope so desperately that the conversation doesn’t end there and that the liveline show is the beginning of real and meaningful change.
I just wanted someone to hear that I am in pain too. The system is ravaging me too. Ravaging me of the time and opportunity to practice midwifery in a way that is true to its inherent philosophy and values, and in a way that represents me personally. Some days I cannot split myself in enough ways to attend to everything the way I should, and I hate myself for that. But I hate the system more.
I go home and cry that I let you down, and that I have been let down by the way the service is stacked against me being able to execute care to the best of my ability.
I don’t think there is a month in the last 2 and a half years that I haven’t come home at least once and fallen into my husband’s arms and cried at the end of a day, over my inability to provide good care because I have been so overstretched. I cannot promise that I haven’t spoken shortly to women, or seemed in a rush, or not had the time to get back to someone in an appropriate timeframe – if I tried to claim that, I would simply be lying. But if I have been rushing, or late with that painkiller or forgotten that you asked me for a bottle, I can also promise you that I didn’t mean it and I am always sorry and always disappointed in myself. I go home and cry that I let you down, and that I have been let down by the way the service is stacked against me being able to execute care to the best of my ability.
It’s hard to fight the system. And despite my best efforts, sometimes the people in power come crushing down on top of me and I feel that I have to tow the hospital line in order to survive the day at work. This doesn’t mean I didn’t listen to you, or want the best for you or know that you deserve better. It means that sometimes I fail at challenging the system under threat of discipline.
You might be reading this thinking – why on earth would I ever continue to work in an environment where I cannot perform to the best of my abilities and risk being complicit in the traumatisation of women and their families? Some days I ask myself that too, but most days I really believe that I can make the difference from the inside out by challenging from within as much as I can.
Know that I am part of the system only to try and dismantle it. Please see that in my eyes, I’m trying my very very best and I simply cannot get it right or perfect all of the time because I am a human being too, but I will keep trying.
I hope that this is taken for what it is. A statement of solidarity from a midwife to all those brave women who shared their stories in the past week. Know that I am in pain too. Know that I see the problems too. Know that I’m trying to fight and I want to carry both of us through it. Know that I am part of the system only to try and dismantle it. Please see that in my eyes, I’m trying my very very best and I simply cannot get it right or perfect all of the time because I am a human being too, but I will keep trying.
-Anonymous Irish Midwife