“I will keep trying” – A Midwife Responds

“Know that I am part of the system only to try and dismantle it.”

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

9 thoughts on ““I will keep trying” – A Midwife Responds

  1. Thank you so much for speaking out here, and using your voice. So so many midwives feel like you, you are not alone. Thank you for all you do from day to day, I am sure you are making a difference. I want you to know I am with you, and I will support you by speaking out too. Sending love to you – take care of yourself, you are the most important person..Sheena xx

  2. There are so many incredible midwives, but the system you work in, is repeatedly setting you up for failure. You’re not getting the support you deserve, the pay you deserve, you’re not receiving training on how to adequately and efficiently aid breastfeeding mothers. You’re so often over ruled by doctors who barely look at charts when dealing with a new patient you’ve been helping for hours. You’re expected to single handedly take cake of 5, 10 or more women on shifts that are woefully understaffed.
    We are angry at the system. We are angry at the government who repeatedly take, take, take. We are angry at defensive medical practices. We are angry at the number of women routinely ignored, not taken seriously, not listened to. We are angry at the handful of midwives who just don’t care anymore or who have had to learn to not care in order to protect their own sanity.
    In a system where the Euro is the top consideration by those who set your standards, guidelines, targets and work practices, both you as a decent midwife, and I as a mum, will always come last.

  3. Bless you Lovely. No one deserves to have the love of their job beaten out of them by the very system they have to make work. Particularly when so many lives and families can be so effected so quickly and fundamentaly.
    Bless you and all the brilliant midwives out there hanging on by their heart strings.
    There must be some senior politician who can steer changes to a system that is slowly grinding away at its own foundations!

  4. you must remember that even though you are part of a dysfunctional and questionable system,you work from intention,other people will feel that and you will positively stand out and impact upon an experience,I have been a patient and birthed 4 children the midwives and health practitioners who work from their true intentions and heart helped me through and I would say their very presence positively supported me and increased my tolerance for pain,they did small things and conveyed their compassion and care which is easier to feel than any words.Take heart you are acting with a real vocation and that has more meaning for your patients and families than you may ever know. Maternity services need people like you.

  5. Thank you for your honesty . It is important that you know many midwives feel like this the systems they work in fail them and unfortunately they then fail some women. In a well funded, safely staffed utopia , midwives would be able to deliver the Better Births agendas. Women would all have personalised one to one care tailored to their individual needs.
    Stay strong, keep fighting the fight. Women need compassionate , caring midwives like you

  6. Having recently had a child in the Rotunda all I can say is the midwives in the postnatal wards are angels, they are so understaffed and overworked yet they still manage to be so caring and compassionate to the mothers and babies they are looking after. I have nothing but the utmost respect for midwives, yes women in Ireland are being let down by the health system but midwives are going above and beyond for the women in their care daily and nightly. We need to stand with the nurses and midwives who are doing an amazing job despite the horrific conditions and terms of their profession, the women of Ireland deserve better care and the midwives deserve better working conditions. Thank you to the wonderful midwives who looked after me and my son so well despite the system they are working within, you are amazing, and deserve to be recognized for the level of care and commitment you show your patients on a daily basis.

  7. Thank you for sharing your heartache over these many ‘wrongs’. It is important to speak out and important to have your voice heard. You WILL have made a difference to individual mothers’ experiences and yet you know it’s not good enough. You can see the bigger picture despite being tired out by your endeavours. It’s not you that isn’t good enough and you shouldn’t be expected to go ‘above and beyond’. Postnatal services and the women and babies using them deserve to be properly supported. Don’t underestimate yourself and keep talking, we support you. Jilly x

  8. This is EXACTLY how I feel but have never been able to articulate it as clearly as this piece does. The pressure that comes from all angles including the crazy pressure I put on myself is devastating. I want so desperately to make a positive impact on women, their experiences and their families but our society and governing bodies just don’t place enough value on this “right of passage” for families, women & babies. Unfortunately this translates to poor funding, poor staffing and all of the problems we are seeing across the world. It’s crushing.

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