Encore: An accidental midwife and the business of everyday miracles

This podcast contains audio advertising. To hear it without ads, head to the ABC Listen app now. Thanks for holding. I'm Julian Moro from the ABC's You Consumer Podcast, The People vs. Your call is important to us and so is hearing about your consumer gripes. So if you've been short-changed, ripped off or just left on hold for an eternity, send your tip-offs to [email protected] or please hold for episodes of The People vs. coming soon to ABC Listen. ABC Listen, podcasts, radio, news, music and more. Before I had kids of my own, I always imagined that the obstetrician would be the consumer expert at childbirth and that a midwife would be a kind of stand-in. Well, that was completely wrong, wasn't it? When I brought my wife into the hospital, I was amazed at the team of midwives as they took her into their care and moved about with a calm efficiency. They were like an order of pre-stesses with all this secret information about bringing life into the world. Lisa Pabidi never particularly wanted to be a midwife. She never thought she'd be cut out for it. In fact, the whole business of childbirth completely freaked her out. But once Lisa successfully delivered a baby on her own, she was exhilarated and hooked. And Lisa's delivered babies in big city hospitals and some of the most remote parts of Australia in extraordinary conditions. And Lisa still shed tears of joy. Every birth she's present for. Hi, Lisa. Hi, Richard. How are you? I'm so wanted to talk to a midwife on this program. I don't know why it's taken me so long. I just want to ask you first to all about that experience from your side of the thing when the parents to be come into the hospital with a baby about to give birth. We tend to arrive in this state of really high excitement, obviously. Are you feeling any of that excitement too as a midwife when the parents to be come up to you? Oh, definitely. If mum and dad are smiling, it's good. If mum and dad aren't smiling, you know, it's time to pull out the gloves and get down to business. But yes, she can feel that excitement. It seems like midwives just seem to gather up the mother to be. What do you say to her? How do you assess what to say to the mother as she first comes into your care? Looking at facial expressions, and as I said, if she's smiling, it's just general chat and get a feel for where she is in her labour. If she's smiling, you know, you've got a bit of time. You can get a bit of history there. It's hard to explain, actually. What does every woman need to know when they arrive? What do they want to hear from you? That everything's going to be okay. That we're there to help them. And baby's going to be fine. Dad's another thing that really amused me is, I think, you know, egotistical dads are just a little shocked about how invisible we are. The midwives make my wife feel like the most important creature in the world. She certainly wasn't at moments. And it's just like, I had to reduce myself to the midwives because I was just part of the. You're almost an appendage, aren't you? Just hanging on there. We're just surplus to requirements in this process as dads aren't we? We're just lucky to be there, isn't that right? Well, look, the midwives really appreciate the dads. They really do because you just. Really? Yeah, definitely. You're just. No, no, no. You distract the woman from what she's going through. You talk through the contractions. You encourage her to keep going that, yes, she can do this. She can climb this mountain and it is going to end and you're going to have a beautiful baby at the end of it. Dad's is so important. And you take a lot of the work away from us midwives. So, it's a lot more relaxing for us. It's team. It really is a team effort. Well, it's lovely to hear you say that, Lisa, but I sort of kind of cotton down when I was doing prenatal classes. Yeah, you can give your partner a lovely massage, but I'm pretty sure that's just to get us away from the business end where all the real work is being done. Oh, no. Look, I really. I always appreciate dads. I really do. And you do become a team. It's the three of you in there, very much birthing this baby. A healthy birth is not guaranteed. That's just the truth of it. I wonder if some people parents to be approached the whole process like a consumer. It's like, well, I did everything right. I bought the iPad. I expected to work. Do you see that often, Lisa? Definitely. Everyone expects if they've read the books, they've read the text book, they're going to do it as it happens in order in the book. And sometimes it just doesn't go like that. And you can do everything you can to have a healthy baby and sometimes it just doesn't happen. No. So is there a sense sometimes when that doesn't happen that my rights have been violated or something like that? Does that happen at times? Very much. maybe not violated, but very much I've failed. Oh. The women feel I've failed. Why? Why did this happen? What did I do wrong? What could have I done better? Childbirth is heroic. What women do is heroic in those moments. It's extraordinary. Have you. I've heard stories about this. I just wanted to know if this is urban myth or true. Have you ever seen women try to walk out and love it? Oh, definitely. Oh, definitely. Oh, definitely. Transition. There's a period, you know, just before the pushing starts and oh, every woman, every woman, that's it. I've had enough. I'm going home. And of course the dads, they already packed the bags and go as well, but that was ours ago. But no, definitely, every woman gets that point when she says, "I cannot do this. I'm going home. I'm sick of it. I'm bored with it. No, I don't want to do this." And it's all your fault as she points to the dad and the corner, yes. I've heard stories where the mother-to-be goes, "You bastard. It actually clocks." Oh, yes. There's some words spoken. There's some harsh words spoken. Dads have to have thick skins. Really thick skins, yeah. But look, nearly every woman wants to go home at some point. Yeah, my wife said something interesting and I went, "But it's okay, love. It's just transition." And I relaxed. My wife was completely heroic throughout this process. And when our first child arrived, I thought, "I should bought my eyes out." And I was kind of shocked. I didn't think I'd cry like that since I was a little boy. Is that common for dads to cry? Nearly all of them cry. It doesn't matter, you know, the biggest, strongest, mussely, brawniest men will break down in tears. Oh, definitely. I still do. I still do. I squawk louder than the babies. I'm sure the tears flow. Look, it's very emotional. It's new life. It's hearing the baby cry. There's nothing like that. The first cry. There's nothing like that in the world to hear that. It's just beautiful. There's that kind of really moment of expectation when you go to proper labor, the secondary stage, is that what it is? Yeah, the second stage. The second stage, which is what takes about an hour more or less some time to learn about. Oh, my God. There's a new person that's about to enter the room. A new human being is about to enter the room. This expectation you have, this child you're going to have, you know, you're going to meet this child for the first time. That heightened expectation is so powerful. I suppose what I love, there's so much I love about midwifery. I can't put my finger on anything in particular. But one thing is actually when you're the midwife and you're actually birthing that baby, to think you are the first person to touch this little baby. And you really are the first person this little baby sees. I hope you got your lipstick on. It's an enormous privilege to be there at that moment for that couple, but for that baby as well. It's just a really beautiful experience. You've delivered babies in extreme conditions. It's fair to say in regional Australia. For a while you worked on Thursday Island and Torres Strait. How much did you love the place when you went there? I always love the Torres. It's just something unique about it. It's very beautiful place to live. Very tropical. And it's very laid back. Very laid back. Everything runs on island time. Forget your watch, forget the clock. And the people are really beautiful, really friendly, accommodating and relaxed. What's the hospital there like? It's lovely. Actually, it's a very nice little hospital. It's only about 20 beds to the main part of the hospital and the turn to units about six beds and two little birthing rooms and a little nursery. At what stage would Torres Strait Islander women come in to actually give birth? When they live on the other islands, we like them to be on Thursday Island, which is the main island with the hospital by about 36 weeks. If anything happens, they go into labor beforehand. They've only got to walk across the road to the hospital. But there are a few that leave it to the very last minute because they want to stay on their home islands with their families for as long as possible. And it's the culture of giving birth kind of different there than it is in the rest of Australia? I find it's more relaxed there and it's more, it really is women's business and it's the women of the family all get involved with the woman that's birthing. So it is. It's a lot more relaxed, a lot more natural. Are you writing in one of your essays that women are unusually silent while they're able to give birth in Torres Strait? They are. They're just very calm. They just have this inner strength that you don't see in Caucasian women. I suppose from an early age, there's always babies around them. There's always pregnant women around them. There's always women giving birth around them. So for them, it's just a very natural thing. And they are just so calm. And the first you know that you're about to have a baby, as the midwife, you're about to have this baby, is they get this little bit of sweat on their lip and you think, oh my gosh, get the gloves, get the gloves. That's when you know. That is when you know. So it is. It's just a very calm. Tell me about the most insanely tricky delivery you were part of while you were up there. I would say it was delivering a baby in a dinghy. That was certainly probably the trickiest. How did you get the call for that? Well, it was it was late in the afternoon early evening and we got a call from one of the outer islands to say that there was a woman in labour and she was coming across in a dinghy. So and it was Friday Island. So it was the island just behind Thursday Island. And so I grabbed the delivery bundle, grabbed the watermelon, grabbed the wheelchair and went down to back beach, which is just behind the hospital to wait for the dinghy to come in. And when the dinghy came closer, I had a little chat to her, asked her how she was feeling, she was smiling, everything was OK, but there was just a little bit of sweat on that lip that I could see and she was sort of moving a bit funny as she was sitting there in the dinghy and I thought, OK, then. So before I asked her to get out of the dinghy, I asked, could I just have a little look under the moon, which is the Torres Strait Island dress that they wear and I had a little peek and there was hair there and it wasn't pubic hair and I thought, we're going to have a baby and we're going to have one right now. So in the dinghy, so there was nothing much we could do, you don't want to move a lady at that, that pointing time, so we just everything just progressed quite naturally and how much natural light was there? No, there was there was next to no natural light at that point, we had a torch and that was the wardsman's duty to hold the torch, but of course he didn't want to look, that was women's business. So the torch was going, he wasn't looking and the torch was going in all different directions. So it really was just birthed by Braille, I suppose. So you couldn't hold it? Oh, no, of course you can't hold the torch. No, I was going in to get that baby. So yes, it was birthed by Braille, it was just put the little hands out and just have a little feel and just guide that little baby out. Just in darkness. In darkness, it had been moonlight, but basically darkness, yes. Lisa, aren't they crock-infested waters up there? Yes, we did have a resident crock that used to swim around, but at that point in time I wasn't really thinking of that, so I was knee-deep, yeah knee-deep and water, beside the dinghy. All right, and the baby came out just fine. Oh, yes, she was beautiful. Now you grew up on the sunshine coast in Queensland, and what led you to start nursing to begin with Lisa? Well, my great career aspirations, Richard, when I finished year 12, was to be beach bum actually, was to work on my dad, but it was some of the girls that I went to school with who decided they were going to do nursing, so it sounded like a good idea at the time. So I joined the queue to start nursing, so that's how I got into it. It wasn't something that I thought I would ever do, and I'm certainly not someone who is very good with blood and things like that. Not very good with blood. Not very good with blood, no, I can't watch a birth on video. No, and I can't watch an operation on TV. It makes me sick, but I can be a scrub nurse in theatre, assisting the surgeon, and I can deliver a baby, but I can only do it if I'm concentrating and I've got a job to do. I can't watch someone else do it. I can't be there. I'm dreadful as the second midwife in the room, absolutely dreadful, because I feel every bit of discomfort. I would say that the woman's feeling and I don't like the side of blood, so I'm best at the head end if I'm the second midwife and I'm there just for the baby. And then it's fine if you're a participant? If I'm not looking at what's happening down there, that is fine. But when you wear a midwife, you have to look at what's happening there. I have to look, and because I don't know what it is, but if I'm concentrating, I think I've got a job to do, and you just get in there and you do it. And I don't think of anything else. I've just got this little bit of tunnel vision. What's that about? Do you think? I don't know. I don't know. Nonetheless, you must have known you were squeamish about blood when you went into the room. I did, I did, I did. So as I said, it was just I was just calling my girlfriends, yeah. So from nursing, you would have to study in a nurse's college or something like that. Is that image of the kind of the strict nurses' college with Matron saying lights out in the end and all that? Very, very much 30 years ago, when I trained, it was. Not so much now, but oh yes, I lived in the nurses' quarters at St Andrews, War Memorial Hospital on Wickham Terrace, and Matron Lemon lived on the floor. The first year's all lived on top, the little ones, and then Matron Lemon on the middle floor, and then the senior nurses on the bottom floor. And it's very much Matron Lemon kept an eye on us. What kind of things would you get into trouble for? Oh, lots of things, staying up too late. I do believe there was the odd mile that ventured into the nurses' quarters that shouldn't have. Yeah, you're only human, Lisa. Well, what was it mean? Well, look, Richard wasn't me, my dad listening wasn't me. And of course, you're making sure, very strict with our dress code back then, we had to wear our caps, we had to. The uniforms had to be start, we had to wear stockings, and the shoes had to be polished, all of those sorts of things. What was the reason given for why you had to wear pantyhose all the time as a nurse? Well, as a 17-year-old, it certainly shocked me, but it was because a pubic fallout, apparently. So a pubic hair fallout, I'll never forget that Matron Lemon on my very first day told us that's why we wear stockings. The day after you graduated from your nursing course, your brother went missing. How were you told about that, Lisa? I received a phone call from my uncle just to say that my brother had gone missing on the beach, and being a flippant teenager myself, I just thought he had gone to McDonald's and they would find him in a few hours. He'd met a girl going to McDonald's, so that's how I found out. Was he a lifesaver? He was. He was a nipper, actually. At Alexandria Surf Life Saving Club on the Sunshine Coast, and he was a nipper. Was there a great concern that he'd disappeared in the surf at that point? Yes, or definitely, definitely. It was very rough the day he went missing, and there were mainly just the young boys on the beach that day, and they were training for an upcoming surf carnival. When were all the senior lifesavers staff on that day? It coincidentally was Grant Kenny and Lisa Curry's wedding day, and of course that was their good-grand Kenny's Surf Life Saving Club, so they sort of were detained at the wedding, or they were attending the wedding. And what happened to your brother Paul while he was out in the surf? Apparently it was quite rough, and all of the boys said he got knocked off at times from the waves. They were training on their surf skis, and apparently he got knocked off three times in the third time. He didn't resurface, so he must have been knocked unconscious. So with him missing, did the family go looking for him then? Well, we were actually advised to stay away from the beach, because they were assuming that it would be a body that they would be recovering, but my brother-in-law did join the search for my brother. How long did it take to find him? Three days. And how were you told that he'd been found? From my memory, the police came to the door. We were all at home that morning, and they came and they presented his watch that he had been wearing. So that was how we sort of found out. How long did you stay by your parents after this? For over a year, I felt, I sort of had to grow up overnight, so I stayed for about a year. Just keeping an eye on Mum and Dad, because as you can imagine, you've got children Richard, so it's a huge loss. And they say, you know, stress levels is probably the most stressful thing that you go through as a parent to lose a child. Did friends know what to say to you after this? No, no, because it was a very isolating time for myself, but also for my family, because we didn't know anyone who this had happened to before. And how do you talk to someone or say, you're sorry that it's happened? No, it was a very isolating time for the whole family. Yeah, we often reach for something good to find at the end. There's nothing good about this though. There's nothing good at this, you know, it's just terrible. No. Do you think people stay away for that reason? I think it is, and they don't know what to say, and they're very uncomfortable and they don't want to upset you. So is that way you wanted to go bush after this and work in the country for a while? I think just to get away, yeah, and just to start living life, because you really do, you feel like the world is still continuing out there, but you've stopped. And it was to go back out and just to start living life like a normal teenager. But different was it working in a country hospital, once you went out west to Buck Holden in Queensland? Very different. There was no water, there was no waves, there was no sand, there was no beach. And it was just a very tiny, they're very tiny, tight-knit communities. So you get to know the people in the town really well, and the staff really well, and the patients. And really, the majority of the patients that make up the hospital elderly people who are really there, it becomes almost like a nursing home, so you become very attached to the patients, because they're long-termists. Having said that, being a bit squeamish around blood, when you have an accident in the country, you have a proper accident. That is exactly it, that is exactly it. Pharmal is a foot in a combine harvester or something, and how did you go with all that? Well, I don't know what it is with me Richard, but if I have to concentrate on something, I'm fine. But look, if I have to stand back and watch and just hand something, that's it. I mean, I'm on the floor. Now, you were a nurse, but you weren't a midwife. What did you think about midwifery in those days? Oh, look, well, my first real experience was when I was working at Bush and you'd have to go down and give a hand in the labour ward when the babies were born. It was like, "Oh, you know, this is messy business. This is messy business." I thought, "I'm not going anywhere near that. No, definitely not for me. Too scary. It was really scary." Because, you know, it's a huge responsibility to deliver a baby. Oh, yes, absolutely. And so, did you have the foot? Wow, there's one thing I'm never going to do. It's like that. Oh, never. Richard, never, ever, ever in a million years was I going to do that no way. So Lisa, what changed your mind? What made you want to study midwifery? Well, Richard, I could say that, you know, it was just my love, you know, my love of maternal and, you know, all the rest of it, but no, it was a boy. It was, yeah, it was a boy. It's always a boy, isn't it? But no, I met this fellow and Pete. And he got transferred to Sydney. And it was at a time when there was just a glut of registered nurses. And I could not get a position in Sydney as a registered nurse. So the only thing that I could do, I saw an ad for student midwifery. And they were trialling the very first university course, midwifery course at the University of Western Sydney. And I thought, oh, yeah, you get paid, you go. You work three days in the hospital being trained as midwife. You get paid and you go to university two days a week. Yes, I'll do that. So that's how it all happened. So you really are the accidental midwife there? Oh, yeah, I look very accidental, very accidental. Like, I didn't look, I loved little children, little babies. But the actual birthing, no, I was never going there. Child health maybe, but no. So in order to stay in Sydney, then you took this course. What was your approach to your first day? In the birthing suite when you walked in there? Oh, that was Chia Terra, absolute Chia Terra. But we'd spent a month at the university prior to actually going into the hospital. And I was told, the third week, we all got our rosters and where we were going to be located for our first practice. And of course, they hand them all out and lo and behold, I got birthing suite. And my whole month was going to be birthing suite. And I was just like, oh, no. This can't be happening. They could have left that till the very end and I could have got at least nine months living in Sydney. But no, I got birthing suite. And the other girls were just laughing and laughing. Because we'd been watching them. The births on videos for three weeks in the school of nursing. And I had to leave the room every time. So I'm never going to get through this. You're going to have to pack your bags now. And I said, no, I'm going to do this. I am going to do this. How are you going to do this? I don't know. But I'm going to do this. So walking in there my first day was just-- I don't think I slept the night before. And just walking in the little knees and knocking and sweating and stuttering and couldn't even say my name. And look, it was huge. I think there was about eight labor wards. There was people everywhere. It was the really old school labor wards. Black shiny, vinyl floor, the smell of disinfectant, screams, noises everywhere. And I thought, oh gosh, what am I going to do? How am I going to get through this? But there was a senior student midwife there who I had met briefly at uni. And I saw her and I thought, oh, thank gosh. So she sort of took me under her wing. But it was one of the senior midwives who could tell that I was so scared. And because I was a country girl, she took me under her wing as well. And that's what got me through. And Turner, I'll never forget her name. Wow, what you describing says like a phobic reaction to this? Oh, look it was. It was. It was so scary. It really was. It was dread. It was fear. It was everything. What were your first days like it in the peon hospital in Penrith? I loved it. Yeah, I loved it. You loved it. Yeah, look, I loved the fear of being in labor ward was dreadful. But I loved being there. It was a totally different experience than nursing in Queensland, I suppose you could say. With everyone expecting you to fail, everyone kind of knowing. Because I don't think you did that feeling did you about your squirmishness around? No, no. Was there a bit of, oh, I'll show you? Definitely, because everyone was, you know, there was almost like bets going. How long are you going to last? It was like, oh, I'll show you. I will do this. I will do this. So that's why you were determined to carry on this course then to prove something to yourself and to other people? Yeah, I think it was. I, I didn't, I had got myself into this situation. I was going to get myself out of this situation. I wasn't going to fail. I think that was it. So what happened to the first time you saw a baby and a placenta emerge from a mother's womb? Well, I don't think I actually saw the baby being born because the eyes were squinted shut and the knees were crossed and on the rest of it. And I'm sure I was looking in the corner, but it was the placenta that got me rich. And I'd never seen a real placenta before. Well, you've seen the placenta now. You've seen two. And I hope you had a darn good look at them. They're very interesting. But anyway, the first time I saw a placenta, that was it I'd held it together and the placenta was delivered and it was like, oh my gosh, and that was it. That was it. I had to grab the bowl. I had to grab the bowl and I've omitted. And I've never been so embarrassed in all of my life. Oh, look, that was embarrassing. It was like, give me the bowl. And it was like, oh, the placenta was supposed to go in that bowl. Lisa, it was like, dig deep in your find one. Yes, it's in there, I'm sure. And it was the mother. The new mother noticing anything you've just going on in the background. Oh, yes, they certainly all looked. Yeah, they certainly all looked. Yeah. And of course, seeing your midwife said to me, you know, after it all called, it had all sort of calmed down. We were in the pan room, we were cleaning up and everything. She said, did you have a big night last night? And I said, no. I've had a big day, though. And yet you stuck at it. You stuck at it. Yeah, I had-- look, once I've got over that fear, loved to-- and the thing is, if I'm a midwife, the best part of midwifery is actually the both-ing process for me now. I absolutely love it. I still have this fear. There is this fear. It's the responsibility to have a healthy mum and a healthy mum at the end of it. Inevitably, yes, a midwife. Lisa, you attend or experience a stillborn birth. Do you remember the first one you attended? Yes, I do, Richard, and I suppose you never forget it, ever. But it was a young lady who I had had a lot to do with an leader to the birth. She was a single mother, and she had a lot of pregnancy complications. So she spent quite a bit of time in hospital, and I've looked after her on the anti-natal ward, and I've got to know her quite well. And then, of course, she went into labor when I was doing my final rotation of labor ward at the end of my midwifery training. It was my second last week. And everything was progressing well, and then the baby started to become a bit distressed. So after an obstetric review, they decided to probably best let's go for an emergency section, cesarean section. And are you monitoring the fetal heartbeat? Oh, definitely, yeah. And that's what alerted us to all things aren't going as planned. Well, it was distressed, or.? It was, yeah, it was getting quite distressed and Baba done a little poo. And so we knew things weren't that good. It was a very, look, all babies are precious. All of them are. But I just felt, for this girl, this was very precious for her, just her background, and how she got, you know, come to this point of having this baby. So we decided to go for an emergency cesarean, and it was on a weekend, and it was on the night shift. And of course, you only have skeleton staff in the operating theaters overnight. And there was another emergency had come in a drunken fellow, had fallen over, and broken his arm, so it needed to be plated and pinned. So that meant that we had to wait for the operating theater to be available for us, and there was a bit of a delay. And her and I were in the corridor. She was on the hospital bed, and I was continuing to monitor the baby's heartbeat. And we were talking to her at the hospital. Oh, talking to her the whole way through, because I had got to know her quite well, and trying to reassure her. And of course, the last thing that she asked me as we wheeled into theater was, is my baby going to be OK? And of course, I said, your baby is going to be just fine. Your baby is going to be just fine. And. You couldn't have known that, I couldn't. I couldn't have known that, but I was just your way of reassuring the woman. Which was more important in that moment. I know this is a hard thing. I don't know what I'd say in that moment, but. It is so hard, Richard, because you know, you know, from the signs that you're seeing that this baby is in a bit of trouble. But because I hadn't experienced a stool warm before, I hadn't been in that situation. Look, I'd been to a lot of emergency cesareans. And yes, we'd had bubs with, you know, poor fetal hearts, and they'd done poos and everything. And the baby's delivered, and it's pink, and it's squawking, and all the rest and everything's fine. So I just assumed it would be like that. But of course, when they did the cesarean, and the baby was born, when a baby is healthy, it's blue when you see a baby that's born, it's blue, and then it pinks up. It's like, yeah, this is fantastic. This is what it's all about. But of course, when a baby is not good, it is born white, and it just doesn't get any better. So of course, they lifted this little baby out, and he was white. And he was floppy, and there was no signs of life, and it was like, oh my gosh. So it was my first full neonatal resuscitation, and it was very, it was quite traumatic, and we did try resusciting for about 45 minutes, and 45 minutes, and there was just no response at all from the baby, and because it was an emergency cesarean, the mother had a general anesthetic. So at least that was one thing. She wasn't aware of this resuscitation going on, but it was very difficult to then, when she woke up, to actually have to tell her that, no, her baby was not okay. And to, and look, I felt very dreadful because I felt, I had let her down because I had said your baby's going to be okay. - I think I'm kind of alerted to this, the new practice about, you know, 10, 15 years ago, it used to be, of course, a stillborn child would be just taken away, and I think Lord would be said, these days it's more common, I understand, for a stillborn child to be swaddled and presented to the family so they can grieve. I remember when I first saw this, I thought that was gullish and weird and horrible, but now I can absolutely see the sense in it and the importance of that moment, so everyone can have a awful cry over it. What do you think about that process? - I think it's definitely necessary. Definitely, they need to see the baby, they need to spend time with the baby. And they need, I mean, it was part of their lives for nine months, really, from the moment you know you're pregnant. You know, you consider this to be a person, and it is a person, so I think it is very important for them to meet this little person that they've carried for nine months, and then to say goodbye to this little person, and to have memories, memories with this little person. - Given that there's this beautiful sense of pride, feel as a bit more faithful. If you've helped deliver a healthy baby, does it go the opposite way when the baby arrives still born? Do you feel like you've, I don't know, let someone down? - In this situation, I did feel like I had let her down. I think I've had still born since then. And it's just you feel so sad, you feel for them. You really feel for them, because you put yourself in their situation and how would you feel? And it is so sad, it's supposed to be such a happy time. And it's just a devastating time. So you can't help but get drawn into their grief. Since then, I have always said, we are going to do everything we possibly can to make sure your little baby's okay. - So did you have a cry after that? - I did, not immediately, because I mean, I think I was more shocked than anything. And you know, I had to bath the baby, I had to dress the baby, swaddled the baby. And it wasn't until, it was about three hours later, and of course, I had to go back to Labor Ward and finish the shift and it was about six o'clock in the morning at this stage. And another couple walked through the doors, though in this quite established labour. And the senior midwife on with me said to me, do you want to take care of this lady? And I sort of umdened and one of the other midwives said, you have to get back on the bike. You have to get back on the bike, just do it. So I sort of, you know, being the student midwife, I'll do what I'm told. So I did, I went in and I, I cared for this woman and it was her fourth baby. And so she actually was progressing quite quickly. And she did, I did birth that baby before I went home. - Did that erase some of the, some of it? Or is that the way, I don't know if that's the way we're looking at it, but that stabilised you. - A little bit, that's when I cried. That is when I actually did cry because it was a very, even though it was a very quick birth, it was a very large baby. It was a very difficult delivery. I had to really manipulate to get that little baby out. And a little bit of shoulder dystocia, the shoulders were getting stuck. So I started to panic at that point. Oh my gosh, oh my gosh, it's going to happen again. And the senior midwife guided me through it. And of course, once we got that baby out and the baby was given to mum and I was waiting to deliver the placenta. And just to keep conversation, because you know, the adrenaline was really pumping and my little knees were knocking. And all these things were going through my mind. And my first question to the parents were, oh my gosh, it's a little boy, congratulations. And have you got a name for him? And they said the name. And it was the name, it was the same name of the baby that I had just, it was helped deliver, that was still born Dylan. And as soon as I said the name Dylan, that was it, then I, you know, the tears flowed and you just stopped, it was quite embarrassing actually. And of course, the parents are looking at me and the senior midwives looking at me. And the first thing that came into my mind popped out of my mouth and that was I always cry at the birth of a placenta. So that's sort of, I know, I know. I'm good with one line of sound, I know. So yeah, so that's how it's sort of beautiful. Well, that's exactly right. I don't need the cry, I vomit. So that sort of did, that sort of stable like, that sort of, you know, the baby was born, it was okay. It was a tough birth, and maybe it was a good thing that it was a tough birth because I could do it. Were you close to throwing in the towel? Oh, definitely. Like I went home, you know, 7.30 in the morning. And, you know, when I've just had a night like that, you know, how do you go to, go to sleep? So I don't think I got any sleep at all. And I had to come back to night duty the next night and I walked in and I was just an absolute mess. And yeah, the first thing I said was, I just can't do this, this is not for me. Not for me at all, I'm out of here. You know, I'm packing my little nap sack, I'm going home. And once again, it was Anne Turner who talked me out about it was like, you know, you have got this far. You are one week away from finishing. Do not, do not throw it in. You will regret it for the rest of your life. So they dragged me through that last week and I got through it. But, oh, oh, look, if it wasn't for the support of the senior midwives around me, I would have walked away easily. You went out to Calculli in W.A. for a while. Is that when you were able to finally really get past your fear? Oh, definitely because the reason I went to Calculli was I had a really good graduate midwifery program. So I went there to sort of get my confidence and you were in labor ward on your own. Like they only had, I think it was four labor wards and there'd be one midwife in the labor ward. And when the baby was due to be born and you could see there was a little bit of head on view there, you rang the buzzer in a second ward and midwife had come from the ward. So it was Sink or Swim. And I remember the first few weeks of it, oh my gosh. Oh my gosh, oh my gosh, I can't do that. I'm not doing labor wood all now. I'll have the nursery. And I just, I had to do it. So throw me in the deep end and it was Sink or Swim and I bobbed up and I swam just. Once you finished your graduate program, you went up to Darwin for a while too. Do you ever get the pleasure of seeing a baby you've delivered into the world after a difficult birth, for example, and then see that baby growing up? Yeah, there was, there was an experience in Darwin actually where I delivered a little premy baby, David. I'll never forget his name, David. He was 32 weeks and he was a little Indigenous baby who had come across from Milling Inby, one of the remote Aboriginal communities, tiny, scrawny little thing he was, but he was just the most placid, gorgeous little baby. And it was at a time where I was doing a lot of night duty. So I always seemed to have David. His mother, Jacqueline, was still in hospital. She was a lovely, very, very gentle, real lady, but at night she used to like to palm David often 'cause I just loved David. I'd delivered him at 32 weeks and then sort of I was watching him grow up. So I'd spent eight weeks with him before he went home to North East Arnhem Land to Milling Inby, his community. And then about eight years later, I went to North East Arnhem Land. I was working as the women's health educator based in Gove and Lumberholder had to go out to one of the communities to do the women's health checks and into the clinic at Milling Inby walks Jacqueline. And we both recognized each other at the same time. And my first question to her was, oh, Jacqueline, how are you? And the second question was, how is a little David? Well, she brought little David, went home, got little David and little David was not little David anymore. You know, he's about eight years old. And from this scrawny little prem Aboriginal baby, he'd actually grown into quite a tall plump boy and a little bit of football. Right, a proper lad. There must be a lovely feeling knowing there are kind of upright people walking around the community that you've brought into the world, that people that dotted all around the place that you've been bringing. Look, I would love to see some of them. I mean, all of them, actually, just to see what they're brought into. Lisa, tell me about the little girl that you nursed, that newborn little girl that was you nursed through, her withdrawal from drugs while you're at training at an appearance. That's one of the sad things, is when you birth these beautiful little babies and they've already born with a drug addiction because mum has been on drugs or she's been on the methadone program or something. But when I did my neonatal stint in my midwifery training, I did eight solid weeks of it. So we had this little girl who had been born drug addicted. So it was our role. She was a healthy little thing, good size and on the rest of it, but she had to go through the withdrawal. So we had her for the whole eight weeks. I was there in the clinic in like, have you ever heard a baby withdrawing from drugs? It is a cry that just goes right through to your bone. They are just in agony. They really are in agony. And so this little girl, she used to scream and scream and scream and you just want to put her ear plugs in and it could be so frustrating. But over that eight weeks, you could see she was getting better and more settled and it got to the point where she was settled. She'd gone through the withdrawals. She was feeding well, settling well all the rest of it. And she was taken home by Mum and Dad. Mum and Dad, both addicts themselves. Both Ivy drug users. So off she went home with Mum and Dad. You see that happen quite often. You just think, "I wonder what will ever happen. You know, what your life will be like and on the rest of it." Anyway, it was my last rotation in Burst Suite, actually. It was before the stillborn incident. But someone came down from Accent Emergency and said they'd been a little baby. I think she was three months old at that point in time. Had been brought in dead on arrival to Accent Emergency and she'd been overdosed on methadone. She'd been overdosed. She'd the baby had been overdosed. And that was quite sad because she had been. The reason they came to Burst Suite to tell us was because she had been born at that hospital. So, and I recognised her name, as soon as they said her name. And that was pretty traumatic, because. How did she receive. How did she receive? I have no idea. I have no idea. Is it possible they fed her methadone to come? Yeah, I would say that probably would be why it happened. So. But that was just so upsetting because I had had this little baby for eight weeks and you'd grown this little baby and you'd withdrawn this little baby. And it is very stressful to withdraw a baby from drugs. And to see it go home and you wonder, "Tee, I wonder what'll ever happen." You know, what your life will be like. Like, you've started. It's been such a tough start. You've been born addicted to drugs. We've withdrawn you. We're sending you home healthy. You know, what's the rest of your life going to be like? Have you sort of starting behind the eight-ball and in that situation. Have you seen things go the other way? Where a baby goes out, you know, or a baby arrives at the world in awkward circumstances that things don't turn out quite so bad? Um, I suppose another incident when I was training was, I looked after a young girl who was a single mother and she was adopting her baby out. So she gave birth, she was quite unwell so she spent a lot of time in hospital in the lead. up to it. Was she quite young? She was quite young and she had a chronic illness and that was one of the reasons she was adopting the baby out. She didn't think she would be able to cope with her illness and she came from a very good family, very settled family and they were very supportive of her and she gave birth to the baby and she stayed in hospital with the baby for three days and then the baby was placed in the nursery waiting to be fostered out and she went home and it was when the baby bonus had just been introduced and a lot of people would she got the baby bonus being the birth mother and a lot of young people you would think would spend the money on themselves but no she actually came back about two or three days later and she bought all these things to go with the baby to its new home. Oh like what baby clothes? Your baby clothes and toys and books and things like that which was really lovely but the reason I think this is a good story is that you have a month cooling off period when you put a baby up for adoption and she actually came back and she decided she would keep the baby so I thought that that was a lovely I thought that was lovely I really did. I think there's all these you don't really know what you go what's going to happen I suppose do that's the thing there's there's a kind of a it's a real throw of the dice isn't it sometimes women experience postnatal depression and how do you help a woman through that as a midwife is that do you have a role there? Well we don't see it because really with postnatal depression you don't really start to pick it up yes you know everyone goes through the day day three blues but you really don't see postnatal depression develop until after that it's only when you see the puperial psychosis which is the really acute severe postnatal depression where where women can actually kill their babies you do see that that that happens very early but it's very very rare if you look out for the you train to look out or definitely definitely we watch for the way the mother is attaching with the with the child and just her mood and things like that is something we do watch for now Lisa you're involved in the business of cord blood banking can you just explain a bit about what that is? Oh look essentially after babies born their you know parents have the choice whether they what they do with that cord blood they can do nothing with the cord blood or they can actually store the cord blood privately for their families use or they can also donate it and if they donated it can go anywhere those the cord blood can be sent anywhere in the world where someone needs stem cell therapies. Why is it valuable? It's because of the stem cells in the the actual cord blood. Like these are prototypical cells that can become cells. Yeah they can develop into to any sort of organ of the body it just depends how they're manipulated but I suppose the the beauty like stem cells you can get from your bone marrow you're probably aware of that people have bone marrow transmits all the time but the the really important thing with the cord blood stem cells is they're still so immature that you don't need to have an absolutely perfect identical match for them to be transfused into somebody else so say your eldest child you stored the cord blood for him or her and for some reason your second child develops an illness where they need cord blood you know stem cell transplant down the track the cord blood stem cells from your oldest child could be transplanted into your younger child even if it's not a perfect match so that's really the big value of them. How many opportunities are there to collect these cells? One time one time and that's like within the first five to ten minutes after the baby's born that's it and it's gone. How long can the cord blood be stored for? indefinitely like we've got situations in America where it's been stored for 28 years to frost at a hundred percent viability of the cells and you mentioned there that they may become a situation where someone might need these as what typically are some of the conditions you can treat with these. At the moment it's your your blood disorders like your anemia some of your thalassemia is lymphomas leukemia leukemia is some yeah leukemias yes. How can cord blood stem cells being used to treat cerebral palsy? I mean hearing stuff about this now. Yes well yes what they're doing is they're they're transfusing the cord blood stem cells into the children and what they're seeing overseas they've just started a trial here in Melbourne actually but overseas they've been doing trials for about five or ten years but they're seeing that the children are improving in their cognitive and motor skills so improving their quality of life. So do we know how that happens? I mean I know you're not a doctor but not exactly no they don't know exactly how it happens but one of the things with stem cells is they've got an anti-inflammatory effect so they reduce they dampen down any inflammation so and help rebuild and regenerate. Oh that's not quite magical about all these these things then. So how did you become involved in this? How did this become a thing for you? Oh well um quite by accident again Richard I seemed to trip into things don't I? But I'd been in a position as a nursing director of the Queen Science Fiscal Screening program for about eight years and then my position was made redundant so it was like well what do I do now? What do I do now? So I didn't particularly want to go back to shift work and still having a phobia of squeamishishness and blood and all the rest of it. So I saw an ad to for a private called blood bank so that's how I got into it and then of course I got in I'd heard a little bit about it but not a lot about it so it wasn't until I was I was actually employed and in the area that I learnt a lot more but I still realised there wasn't a lot of information out there. And when you go in to collect the cord blood do you still get teary? Yes I get teary. Look the baby's born of tears flow and I score a cloud of the baby and I've sort of got to go off the cord blood the cord blood it's like oh yes that's my job that's my job and I can I can do it yeah concentrating no problem yeah but I don't like watching other people collect the cord blood it's like oh and the placenta they'll put the placenta in front of me and I go oh do I have to look but it's okay Richard if I'm concentrating if I've got my tongue in the right position I'm fine. It's been great to speak with you Lisa the accidental midwife I think it's been fabulous thank you so much for being my guest today. Oh thank you very much Richard. This is Conversations on ABC Radio. I spoke with Lisa Pevity in 2017 at least this memoir the accidental midwife was published earlier this year. Today's conversation was made on the lands of the Gadigal Tour Abel and Jaggera peoples the episode was produced by Jenna Coda and the executive producer was Pam O'Brien. I'm Richard Fidler thanks for listening. ABC listen podcasts radio news music and more