Stress and the student midwife
Heavy workloads, demanding placements, financial problems… training to be a midwife isn’t all fun and games. So how can students recognise the signs of stress and ensure it doesn’t become overwhelming? Ramona Rodder offers some advice.
Being a student midwife should be an enjoyable and challenging experience, where students meet new people with the same interest, study the subject we are passionate about and develop a career we love. Unfortunately, this is not always the case and it can become a very stressful experience. I have seen quite a few students take a year off or stop the course completely as they could not cope with the constraints of the course. The academic and practical workload can be daunting at times. This is distressing to observe and can be demoralising for the remaining students, who are staying on the course and trying to make the best of it. Luckily, quite a few return to midwifery and continue or restart their training.
Stress affects every individual differently and everybody will cope with it differently. In addition, midwives might handle stress differently to students. For this reason I want to raise this issue among the student midwife community to show ways to prevent the loss of all these valuable future midwives, who are so badly needed for future maternity services.
Stress is basically the way we react, physically and emotionally, to change. It activates our ‘fight or flight’ response controlled by the autonomic nervous system and is accompanied by lots of adrenaline and noradrenaline. There are two different types of stress, which are positive stress and negative stress. Positive stress can help us to stay focused, give us a rush of energy, motivate us and provide a challenge. Situations that trigger this could be assignments, practical assessments or starting a new placement. This is good stress and usually disappears quickly after the event. The one to worry about is negative stress, examples would be bullying at work or no continuity with mentors in placement.
Another vital factor that influences how we perceive and cope with stress is confidence and self-esteem. According to Seaward (2006), the higher our confidence and self-esteem, the better we cope with stress. Confidence and self-esteem can be increased by achievements; for example, if a student receives positive feedback, passed assessments or assignments, these can increase their confidence and reduce stress levels. Fortunately, I had some good mentors and teachers who supported and motivated me. Student midwives can experience stress due to the academic or placement workload, mentor issues or a distressing experience in placement. But social factors might also impact on how well a student midwife can cope with demands of the course, for example childcare issues, illness or problems within the family. However, peer support can be really helpful and I certainly made some really good friends at university as well as at the hospital I worked for. Lastly, and one of the biggest issues I observed, students often have financial difficulties, and a lot of students have an additional part-time job alongside their full-time course. A new worry for midwifery students is the prospect of not getting a job at the end of their course, as the NHS is undergoing so many changes. Many students feel that they face an uncertain future.
Universities try to prepare students for the demands of the course and to address foreseeable problems prior to the course. But sometimes students do not take it that seriously, or convince themselves that they will manage somehow. I was most definitely one of them. It turned out to be not as easy as this. I can only advise students to look out for signs of negative stress, get support on how to handle it and to ask for help as soon as they realise they are struggling. Stress can make you tense, anxious, angry, depressed, withdrawn, tired or aggressive. It can also cause ill health in the form of tense muscles, hypertension, digestive system symptoms or headaches. These are only a few examples of the effects of stress. If any symptoms are observed, it is vital to get support.
Support is usually provided by the university, where students can talk to their teachers or personal mentors, but also their fellow students. Some universities provide a counselling service for student support. On placement, there is the possibility to talk to your mentor, supervisor of midwives or a steward from the RCM. Other support can come from family and friends. I would also suggest that students should think about a technique to cope with or prevent negative stress. This could be a relaxation technique such as yoga or meditation. Regular exercise helps as it improves general health. Other options would be recreational exercise or socialising with friends and family. A very important and vital part in beating stress is time management. Good time management makes much easier to focus on the task ahead, but also to prioritise. Ways to improve time management skills include keeping a diary, setting goals and keeping to-do lists.
Overall I hope this article will show students how to prevent stress or ways how to deal with it and reassure them that it is experienced by a lot of us. Midwives are badly needed and it is a real shame to lose students due to stress. We as student midwives need to support each other during our training and look out for each other while we work towards our goal of becoming a qualified midwife and joining this amazing profession.
Brewer KC. (1997) Managing Stress. National Press Publications Inc: Aldershot.
Seaward BL. (2006) Managing Stress. Jones and Bartlett Publishers: London.