Memories of a Midwife ..
I cannot recall why I was to drawn to a midwifery career as my only experience was my placement in my nurse training and that brought only fear. Fear of the process of childbirth and especially fear of the midwives who only appeared to just tolerate student nurses but as soon as I started my training, I knew I wanted to be nowhere else.
I started my training in 1985 at the midwifery school in Hull maternity Hospital. The course was 18months, no university degree course then and everyone had to be a registered nurse to be accepted. The training was centred around classroom learning and 12-week placements. We only had 2 main textbooks for reference, Myles and Mayes Midwifery. Our lectures were given by our onsite midwifery tutors and the obstetric consultants including one who smoked his pipe throughout his lectures.
"I rode around on my bike, in my navy coat and hat. Yes, just like in Call the Midwife"
We had practice logbooks to complete for antenatal, postnatal examinations and births ,2 written exams and a viva to pass in order to qualify and be registered as a midwife. The course was exciting and intense but the care in the hospital was very Consultant led so I loved my placement with the community midwife the best. With her supervision I was given my own case load of women but as I could not drive then or afford a car I rode around on my bike in my navy coat and hat. Yes, just like in Call the Midwife. Luckily Hull is pretty flat so I never had the hills of Leeds to conquer.
I qualified in September 1986 and started working at the hospital. We were given no preceptorship period and I felt pretty green so it was a difficult transition period, I just felt I was gaining ground when my husband got a job in Leeds so I followed him and started work at Leeds General Infirmary in May 1987 where I stayed until my retirement in May 2022. I remember my interview well as it was essentially a chat with a senior midwife. She was from Hull and as soon as she discovered that’s where I had trained that was good enough for her. I was in.
LGI felt huge compared to Hull and I was given very little time to settle in. I was put in charge of the antenatal ward on nights after only one week where I felt rather unprepared and overwhelmed. One night I called the on-call doctor but was more than surprised when the senior midwife on delivery suite rang me to demand to know why I had disturbed her doctor. I quickly learnt I must ring her first to justify my need before she would wake them to come to the ward, I could not quite believe it. Many practices have definitely changed for the better.
"Certain practices were still routine such as the giving of enemas and perineal shaves for women in early labour .. practices now are driven by providing individualised and evidence based care"
Midwifery care was still very consultant led at that time. All women came to the hospital for their booking appointment and there was regularly 70-80 women attending clinics every day. All women had a full physical examination at first visit, and most had a vaginal examination to date the pregnancy as no routine dating scans were performed. Partners rarely attended for appointments but if they did they were often asked to leave during these examinations and most surprisingly everyone did!
Women with hypertension, pre-eclampsia or placenta praevia where often admitted for weeks of bedrest until researched showed it had little value in improving outcomes and was terrible for the wellbeing of the women and their families. The opening of an Antenatal Day Unit in the mid nineties meant women could have enhanced care, increased monitoring and still stay safe at home with their families. It saved the hospitals money this way also, so a win win situation for everyone. I spent the last 20 years of my career working in the day unit and fetal medicine unit where I was very happy.
(Above example of a Low Risk "home from home" room today).
Women stayed in the hospital much longer following the birth of their babies ,often 3-5 days for a first time mum and 5-7 days after an operative delivery. Visiting was restricted to 2 hours in the afternoon and 2 in the evening even for partners so the women developed close bonds with each other and with all the staff on the ward. The ward had enrolled nurses, nursery nurses and maternity support workers as well as the midwives to care for the women and babies. Other practitioners visited the ward such as a physio who taught postnatal exercises , a GP who discussed and prescribed contraceptives and a Registrar who would register the babies and save a visit to the townhall. On discharge the women and their newborns were escorted by a staff member to the front door of the hospital. I always enjoyed doing this as it felt a fitting way to send them off to start their new family life.
Delivery suite was very much the domain of some very experienced and strong senior midwives. Junior midwives had to earn their trust and respect which was not always easy but I loved it. Certain practices were still routine such as perineal shaving and enemas in early labour but my memory feels these things changed quite quickly much to the midwives and especially the women’s relief!
Many small satellite midwifery led units were closed in the eighties so the LGI decided to open a low risk midwifery led unit on delivery suite called the Home from Home unit which is now the Lotus suite. I was lucky enough to be invited to join the team and I jumped at the chance. We encountered some resistance and strange looks because we offered women the opportunity to be fully mobile in labour, to labour but not deliver then in water, and to even birth on the floor if they wished. It's funny now to think how radical we felt at the time, but the women naturally gave very positive responses.
"I believe women want to be cared for by midwives who have excellent training, up to date knowledge, have a caring nature and most important of all by someone who is kind. I do not think this will ever change"
There have been so many changes during my practice and all driven by the need to give individualised care which is evidenced based. Women and their partners now feel heard and much more involved in the decision making regarding their needs.
I had 36 wonderful years as a midwife even though I was often physically and emotionally exhausted. I look back with fondness at all my amazing colleagues and I am especially thankful to the women and families who invited me to share in such a special time of their lives.
Written by Trish (Retired and very much loved and missed midwife).