You may have read in the press recently about March with Midwives, a national effort to bring together midwives, birth workers, women and their families to show support for midwives and maternity services as a whole. The march took place on Sunday, the 21st and saw people marching in different cities throughout the UK, including Edinburgh. When I told some family about March with Midwives, they automatically assumed it was about money. Are you campaigning for a pay rise, they asked. No, is the simple answer. It is so much more than a pay rise. We are marching because 60% of midwives are considering leaving the profession in the next year. We are marching because one third of midwives display symptoms of PTSD. We are marching because 75% of midwives report skipping meals whilst on shift. We are marching because 96% of student midwives report mental health problems. We are marching for a service that is creaking at the seams. We are marching because giving birth in the UK, a high income country, is becoming unsafe.
The march was in solidarity for midwives who continue to turn up to work short staffed, unable to take breaks and unable to care properly for those they are looking after. But these midwives are mothers too. They have their babies in this creaking system. So too do their friends, sisters, cousins. When we aren’t at work and coping with the pressures of an understaffed, under-resourced workplace, we hear what our friends go through when giving birth. Midwives too busy to refill the water jug, unable to help our family members into the shower after giving birth, unable to provide vital support with feeding. These stories of poor care offend us both professionally and personally. We are well aware that the women we care for could be our sisters, friends, cousins. We are well aware that due to poor staffing levels, increased patient complexity and a rise in interventions, our care often falls short.
Midwifery is in crisis. Midwives are frustrated, sad and spent. Our skills are being lost. Our voices are being ignored. We work in environments of fear. Fear of making a mistake. Fear of saying the wrong thing. Fear of working in a system that can be coercive and controlling, of both midwives and women. We are not obstetric assistants. Or labour and delivery nurses. We trained to work autonomously. To be the guardians of normal birth. To witness, support and encourage women during the momentous period of pregnancy, birth and mothering.
Let me be clear, midwives should not be pursuing ‘normal birth’ above patient safety and the wellbeing of mothers and babies. We should not be encouraging toxic work environments or be pitting ourselves against our obstetrician friends. It is not them and us. But shouldn’t we have something to say about the epidemic levels of intervention within many of our maternity units? Rates of cesarean birth, instrumental deliveries, fourth degree tears, inductions, that are staggering. I don’t feel that midwives should be apologetic about our desire to see babies birthed through the vagina. A mode of birth we know to be best for the majority of mums and babies.
Ultimately, women should be in charge. Of their bodies and their births. As a close friend and obstetrician said recently, we spend way too long arguing between ourselves and not enough time asking what women want or how they feel about their births. And I agree. As midwives, it is our role to offer all options and choices. Not to coerce women into doing what we want them to do or think they should do. Midwifery is truly the most wonderful job in the world. But it is a complex profession rooted in so much more than just healthcare. A job where history, politics, medicine and feminism all collide. And it involves not just women and their babies but families, communities, societies and countries as a whole. Healthy, positive women who come away from their births feeling empowered and strong can have ripple down effects for whole generations. Women should not be coming away from their births traumatised, hurt, angry. The slow erosion of the midwifery profession and the crisis in maternity settings is not just a women’s issue. It is a public health issue on a national and global scale. Being able to offer safe, kind, dignified and women-centred care is fundamental to our role as midwives. Supporting women on this monumental journey is something that we must fight for, shout for, march for.
