How do we keep giving when there’s nothing left to give?

on 04 October 2021 Maternity Services Midwifery

As the RCM publishes the results of its member experience survey, a midwife working in England shares her story, which is reflected in every maternity service across the England, Wales, Scotland and Northern Ireland.

Midwifery is largely a celebration of new life, families starting and happy moments where we share joy with strangers we meet sometimes for a few months, sometimes for just a few minutes.

Those smiling, encouraging, kind, supporting, dedicated, knowledgeable maternity staff are at breaking point. Actually, the truth is they are past that, they are desperately struggling. They are struggling with a system that doesn’t allow us to do what we dreamed of doing for years, what we trained for, got into debt for, advocate passionately for, and sacrificed memories, time and relationships for.

It used to be an occasional, a once here and there talking point in the staff room, but it is now a gruelling daily occurrence. It’s every day, every shift, every week. We are pushed beyond safe limits, beyond capacity, beyond our roles.

Staffing is in a tragic state. Begging, borrowing and pleading for more staff, more help, more for tonight’s shift, cover for the weekend where we’re four short, where two just called in sick and only the newly qualified is rostered to cover the antenatal ward. Simply hiring more isn’t possible. There just is not more of us. We’re reducing the time we give to women, having to close facilities, reduce antenatal education, postnatal visits cut to a minimum and we’re having to send families on their way ASAP.

Some midwives are leaving their beloved role just a few years after starting, some signed off sick with stress, depression and anxiety. Some are leaving after years of service because they cannot stand to be a part of the NHS anymore, they are done with the constant dissatisfaction of just not being able to live up to the role of a midwife anymore. They have seen the system change so much over the years they cannot do what they signed up for, what they trained for what they are passionate for. They are drained and have no more to give.

Those who do make it through the training are drowning within days of starting. They are stressed, scared, anxious, exhausted, fearful of being alone in an environment where we’re forced to take on more and more and give more and more of ourselves, more than is safe to give.  “Can you see another patient? Can you assess this labouring lady that’s on her way in? Can you arrange an appointment for bed four with the scan department, her consultant and make sure she has weekly appointments for the rest of her pregnancy whilst triaging six other women, oh and get her an anaesthetic appointment too will you?” No is never an option, we can’t say “sorry I’m at capacity” or ask someone else to do, because there isn’t anyone else. We do and have to do more and more with less and less. Less staff, less support, less time, less mental capacity, less kindness and compassion because we are just burnt out. We can’t be ‘with woman’ and manage the rest of the demands put on us safely.

Stretched physically is one thing. You can rest your body eventually when home, but the mind does not have an easy off switch. The constant unrealistic expectations on maternity staff is damaging their mental health, it’s impacting on the wider service and it’s putting women, babies and families in danger.

Maternity staff are human. We can’t go on without getting a lunch break, a drink, a chance to go to the toilet in 12-plus hours, leaving late every day with the weight of the world on our shoulders. We can’t be expected to keep maternity services running and women safe, to keep apologising for delays and false promises when we don’t have the tools to do so. We are broken, the system is broken.

The Government needs to understand one simple point. Protecting and providing for maternity services in the NHS protects the whole country’s future. If we can nurture and care for pregnant women, we can protect the future of this country. We protect the next generation. Healthy, happy and supported mothers, babies and families is the ultimate goal for midwives and right now it’s not happening. The Government is failing all of us.