The ward is crazy today. I’m in charge of three women all giving birth at the same time, and I don’t know how I’m going to keep all the plates spinning. There are 44 mothers in the unit – not to mention the babies – and just six midwives to look after them, so it’s not only me who is going flat out. We all are.
By the time I get in the car to drive home I’m exhausted – just like most days. Except that this isn’t any old day. It’s my first shift back after four months off with work-related stress and depression – and it’s as if I’ve never been away.
Don’t get me wrong, it’s wonderful to be back among my much-loved colleagues, the families and all the babies again. It’s always an absolute privilege to be present at the beginning of a new life, and I never lose sight of that.
The best part of my job without doubt is the high of seeing a mother’s face when she first sets eyes on her child – that euphoric moment when they meet each other for the first time after nine months of such intense closeness. It brings tears to my eyes, and I never tire of it.
There is a highly unsatisfactory practice of delaying induced labour by 24 or even 48 hours when we're understaffed, says the secret midwife. We usually start the women on slow-release hormones for 24 hours before breaking their waters and allowing labour to begin. But these days it is possible that the ward will have to close during those 24 hours because of under-staffing
But I’d been promised a ‘phased return’ to work by the hospital’s management, and this has been the complete opposite. It isn’t just throwing me in at the deep end – this is like being towed out to sea and dumped in the middle of the ocean. Perhaps tomorrow will be better, I tell myself. But it isn’t.
‘Are you all right? Do you need anything?’ I hastily call to one new mother as I rush from pillar to post. ‘I’m fine. Don’t worry about me,’ she replies. She smiles, clearly besotted with her newborn. Thankfully she has lots of help from her partner and mother, but that doesn’t stop me feeling guilty that I’m not looking after her properly.
There is no time for a nice, relaxed conversation. No chance to change her bed linen, admire her baby or show her how to do her first feed. And, sadly, that’s how things are for midwives in 2020.
It’s not just the aftercare that we’re unable to provide. In the months since I’ve been back at work I’ve noticed some worrying new developments creeping in – things that wouldn’t have happened even a year ago.
Understaffing means hospital staff have to stop everything we’re doing for these poor women (file image) until the unit opens again, usually 12 hours later
One of these is the highly unsatisfactory practice of delaying induced labour by 24 or even 48 hours when we’re understaffed.
At our hospital we carry out about four inductions a day, usually for clinical reasons such as diabetes, or if the mother-to-be has gone two weeks beyond her due date.
We usually start the women on slow-release hormones for 24 hours before breaking their waters and allowing labour to begin. But these days it is possible that the ward will have to close during those 24 hours because of under-staffing. This not only means the woman can’t go home, but she can’t start her labour either. We have to stop everything we’re doing for these poor women until the unit opens again, usually 12 hours later. So they remain on our noisy, busy ward, having contractions, getting no sleep and becoming more exhausted by the hour. It’s an awful situation for the mother and the baby. It used to be a rarity, but in the past year it’s become a regular occurrence.
Understandably, people get very upset but there’s nothing I can do to change things. It’s stressful for everyone – especially for families who are watching those they love in pain, when everyone just wants the baby out as quickly and as safely as possible. After all, isn’t that what we’re supposed to be there for?
I’d really struggled with the idea of going off sick in the first place. It’s not something you do lightly at the hospital where I work, because there is a big chance that if you’re away too often, you will lose your job.
In the autumn of 2018, just before I was signed off with stress, I’d been suffering with a cold that left me feeling like hell warmed up. There is a strict sickness protocol at our hospital trust. If you take more than two days off within six months, you are summoned for a ‘capability meeting’ with your line manager and HR staff to assess whether you are actually capable of working any longer.
Sickness and infections are rife in hospitals so it is only natural to allow them to have a sick day. We all understand that the sickness protocol is designed to stop staff (pictured) from taking unnecessary days off. But it prevents them taking necessary days off
In other words, if you are properly ill, then your job is at risk. As a result, staff are terrified of taking time off sick. I’d had two days off in the August of that year with a chest infection, so if I went off sick now, I would potentially face the sack. I dragged myself out of bed, threw on my uniform and drove to work.
Halfway through that morning, while I was in the middle of delivering a baby, I felt my nose begin to stream. ‘Alison,’ I whispered to my student midwife, ‘will you please wipe my nose? I don’t want this baby to be covered in germs the moment she arrives in this world.’
It was farcical, really, watching my colleague rushing off to the bathroom for some loo roll so that she could do the honours. Not exactly part of her job description.
And anyway, we shouldn’t be breathing our bugs over new mothers and tiny babies, some of whom aren’t in the best of health.
We all understand that the sickness protocol is designed to stop people from taking unnecessary days off. But it prevents them taking necessary days off, too. We’re working in a hospital, for goodness sake, where sickness, bugs and infections are rife.
It’s only natural that we will occasionally fall ill. And being punished for that undoubtedly contributes to the stress epidemic engulfing our hospital wards. I am convinced there would be less depression if people weren’t so worried about taking one or two days off sick for genuine reasons.
All of us on our unit know highly qualified