The resilience ride

Recently I was having a discussion with a medical professional that has recently become a parent for the second time. “There’s a lot of midwives with ‘out there’ opinions. And let’s face it - It is a medical event”.

Whoa. No it’s not. It’s a normal event that sometimes becomes a medical event. I pointed out that they only see the abnormal or the panicked events in their job. They don’t see the ten other births that happened in birth centres and at home with no interventions at all.

And those ‘out there’ opinions suit a lot of women. They research and find the midwife that’s right for them. They should have that choice.

Anyway that was my comeback. I wish I had been quicker and more eloquent. I’m better with writing!

Do you view birth as a medical event? Is death? Are they just an in breath and an out breath? We’ve been doing both since the beginning of time. that’s what I should have said. Something to think about anyway.

Then for the sake of friendship we mutually changed the subject. It’s a bit like a vaccine discussion right now 🤣.

But it made me so sad. What hope is there for our fantastic continuity of care midwifery model when we are all getting beaten down and leaving? When this is what some of our colleagues think?

In my rural area a year ago there were 7 midwives, by the middle of this year there will be 2.

This is not just due to the mandate, it’s the fact that if one of a partnership leaves the profession the other one can’t sustain always being on call. It’s lack of appreciation - the governments reclassification of a clients rural zoning for our travel payments caused a drop (yes a large DROP!) in our income. For years we have been fighting for an improvement in our pay - just to get what an on call plumber gets would be nice. Not that I’m dissing plumbers, but they don’t have a massive student loan and two lives in their hands. Although they do deal with bodily fluids I guess 🤣. Then when the promised changes to our payment were finally released in November we discovered we had a pay decrease, not a raise. It’s been swept under the carpet with the pandemic - which is of course next level importance - but it was the final kick in the teeth for a lot of midwives.

We just lost hope. So, so many of us are leaving. Paid less and working more! So who will become the caretakers of normal birth? What will it mean for all those women unable to find a midwife?

A lot of my rural clients struggle to get transport to my pregnancy clinic as it is, sometimes if I am out their way doing a postnatal visit I will swing by just so the stress is off us both.so I know they have been seen. Now with no midwife these women will be expected to drive an hour further to get antenatal care through the already stretched hospital. Not only will this be turning a normal life event medical just by walking through the doors, a lot just won’t get any antenatal care, they don’t have the transport or funds or maybe the time to take a whole day off work. They will just turn up in labour - so their birth will immediately be deemed high risk and treated as such.

They won’t get postnatal care in their homes. No one to help them establish breastfeeding, to notice if they aren’t coping, to monitor their babies. Well child nurses like Plunket who take over from midwives at six weeks are already doing minimal home visits since the onset of covid, they won’t pick up the slack.

So we end up with the Australian model. Care at a hospital with a midwife on shift, no doubt she’s awesome 😉 but it will be someone you haven’t met before. The care will become generic not individualised.

There isn’t time for that personalised stuff.

You would have to meet all the criteria and tick all the correct boxes in order to ‘try’ for a normal birth. The midwife you get in labour you most likely will not have met before. She’s not going to know if your behaviour in labour is just your personality type or if something is actually wrong. So to be on the safe side she’s going to assume that you need help or that maybe you can’t do it. There will be more caesareans.

I’ve talked often about how a woman sometimes has to reach the point where she feels she can’t do it before she can have a baby. Its that rite of passage. This period of time is often the busiest and most difficult emotionally for a midwife too, getting a client through that, to make her believe she can do it is much harder if you’ve never met before and formed that trust.

I don’t know what’s going to happen. I’m guessing here. But it’s not looking good, I’m scared for our daughters.

Anyway enough of all that, one birth that was definitely a medical event - a beautiful one - was a caesarean I went to recently. After two previous long labours that had resulted in emergency caesareans the woman had opted to go straight to surgery this time. So it was completely different. We knew the exact time this baby was to arrive, she was well rested and mentally ready. We had worked through her decision to not vaginally birth with lots of discussion and a few tears and lots of laughter of course. But you know what, it doesn’t matter how a baby comes out. The moment that I handed her baby to her was the same. That look, that love.

Even I bloody cried. I must be going soft. I had to quickly bend down and pick something up 😉.

So I write this from bed on a long awaited weekend off. I’m finding the lack of a partner from the mandate really hard and this time off call was needed. What I didn’t count on was that I would have to also fight for my family to attend! Trying to get away as a whole family without the offer of Bali or somewhere exotic has proven difficult. Neither kid really wants to hang with us, we are no longer cool. The camper and a tent just doesn’t cut it and there are parties and pig hunting they are missing! I get that this is a right of passage for all parents of teenagers but adjusting to being uncool is tricky 🤣.

We haven’t been away together for over a year. And the idea is if on holiday we won’t yell at them and they will fall in like with us again.

But we are not off to a good start. On arrival last night the son went straight to bed with a hangover. This morning the daughter left with our car to play sport, hopefully she comes back. Hubby who was going to be joining us a day late got the runs so had to call in sick to work last night. So he came with us and appeared on the mend. But then spent all last night pooing and spewing.

I put my earplugs in.

It’s going ace 🤣