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[Music] Often life begins not with certainty but with surprise and the same is true of the past we find ourselves on. In this episode two midwives trace the moments that pulled them into their work, one through a difficult first birth that left her needing answers, the other an early instinct she ignored for years until it returned. I'm Giovanna Fletcher and from Happy Mum Happy Baby this is Life of a Midwife. [Music] Marie's nearly 20 year career in midwifery has shown her birth in its many ordinary and unexpected forms. Birth often announces itself with drama, but sometimes as you'll see it barely announces itself at all. [Music] I resamied my four, it was just short of 20 years so I like to round it up to 20 years because that sounds better doesn't it? Round number. I got into midwifery because and I think this is like a very traditional thing now I'm going to show my age because somebody came to give us a talk at school and I was sat in the library next to my friend and this midwife was given us a talk about what midwifery was like and I remember thinking, oh my goodness, like A, I never really knew this existed but this is me, this is my job. I turned to my friend and I said, oh my god, I'd love this and the look on her face couldn't have been worse and she was like, oh my god, this disgusting. She was like, and she'd be terrible at it. I was so embarrassed to have that. I never mentioned it again. [Music] I followed a different path and I did my intervals moment university and then I dropped out of university and I joined the Air Force. Because the RAF liked you to be very well rounded they will pay you for you to do lots of different education or whatever. So I was doing a biology degree part time and thoroughly enjoying it but I was really loving the bits where we did about fetal conception and fetal development, all those kind of things. And I was walking to work one morning I worked in Whitehall in a bunker underneath the Ministry of Defence main building and I was walking to work and it was lovely weather. And I'd got off the tube a little bit early who's walking across Dr. Falkers Square thinking, oh, what do I need to do today? And I thought I need to put my paperwork in for my next year of university and then it just came to me like a moment of clarity. I was 25 and I thought, you know what, I really, really want to be a midwife and I've always really wanted to be a midwife and now is the time. [Music] If anybody's familiar with Dr. Falkers Square there's a big water stones on the corner and I went in there and I went downstairs to the career section and I picked up a textbook that I now know is like, you know, one of the seminal midwifery textbooks. Opened it. And there was a picture of a midwife with her hand in the placenta, checking the membranes and I shut the book and was like, that is my job. That's what I want to do. [Music] I worked at a hospital that we'd got some temporary road works outside the front of the hospital and it was a right nightmare, you know, because obviously, you know, you were either 20 minutes early or 20 minutes late and you know, you could never judge it. I turned up early for a night shift and the place was going like a fairground and the coordinator for the day saw me and said, oh, come, come, come, can you come and take this woman? And I remember thinking, oh, half an hour before I went to start, you know, it's precious time of being able to put my sandwiches in the fridge and just get my head into, you know, the space of obviously I can't say no. So I said, yeah, yeah, absolutely fine. So go down to the room and she'd had a baby before. And I don't even got the briefest sort of notes on her really her name and what not, went and introduced myself and I said, oh, I'm so sorry, you know, you've had to wait so long. And I said, well, you caught up in the road works at the top and I said, there meant to be there for eight months. And I think it's knocking on 18 months now. I mean, I said, every time I drive past, there's no one working there. So that might explain it, you know, check, check, check, check. But we'll start off. I said, we'll just do the basics. I'll do a temperature blood pressure pulse. I said, then I can have a feeling of your tummy. We can make plans. It was going on. At the time, we have these little plastic strips called tempered dots like really rubbish temperature thing, but you had to leave it under their tongue for a minute. So obviously I'd left it under the tongue and done a proper pulse, you know, done a blood pressure, chat, chat, chat, chat, chat. And then I said, oh, do you want to just hop up on the bed and have a feel of your tummy. And I don't know what made me sort of look down. But I just thought of something a bit odd in the way that the woman was moving. I can't really describe it. She just wasn't moving normally. And as I took her leggings to help to take her leggings down, the baby's head was out. There's just this little face looking at me. And I said, oh, did you want to give a push? And she did. And then the baby delivered. And I was like, oh, well, there's that then. Congratulations. And they said, you knew when I was wichring on to you about the road works, you could have mentioned it. It would have been completely appropriate. Just letting me carry on, you know, a minute under the tongue sat there with the pulse and, oh, you know, blah, blah, blah, if you've got a birth plan and I've always told lovely and how old you're other baby? Oh, nice, you know, how are they feeling about, you know, the standard, no, nothing. Just not mention it. The heads heads out. And she said, oh, your face was a picture. I mean, or a people who like that, you make it look easy. And that's the thing. There's such a spectrum. You know, I've looked after women in the pool that the heads, you know, fully crowning perinium, blanched. And I'm really trying to be mindful of my face because I'm busy thinking, oh, I'll, you know, and doing a few pelvic floor exercises myself while I remember. And people look at me in the face and said, oh, it's not as bad as I thought it was going to be. It's, you know, it's okay. And then there's a whole spectrum running down to, you know, screaming and shouting and climbing the walls. And it's just nuts. And so when I had my children, I remember thinking in labor, I don't understand how I'm not dead. Surely this is the level of pain where people die because I can't be in more pain and still be alive. But even that, I mean, I can laugh about it now. I didn't find it particularly traumatic. But even that thought, you imagine as a person who doesn't have any experience of, you know, maybe if not been in hospital before, maybe you've not even farted in front of your husband before. And then your first experience you have of this is, you know, doing a poo in front of him or throwing up or screaming and shouting and, you know, being completely out of control. That's nuts. That's massive for your relationship and for you and for your parents and journey. But we just don't give it any space. We're just, okay. Congratulations. Crap on. What I felt differently about was postnatal care. I didn't really have a birth plan necessarily. But that was the bit for me that I was like, what? And I was used to newborn care. But yeah, I remember being sat there thinking, what on earth is going on here? My first baby was awake and feeding till four o'clock in the morning. And I remember saying to, you know, one of the midwives that came in, he's just been awake all night. And I've been awake feeding him all night. And she said, yeah, it's hard or you know, something of all those lines. And I remember thinking, oh sorry, I never realised it was true. I thought like people were just maybe exaggerating a little bit or saying, oh, he's been awake for, I don't know, he's actually, as if he might be faulty, you know, as if you could, could you take him away and maybe get another one that, you know, doesn't do this. And that was the bit that blew my mind. I was like, oh my goodness. And then I have to go home and start worrying about him and wondering if this is normal. And that red patch was that there yesterday. And does that pull up normal? Yeah, that was my job. So I can only imagine what it's like for, you know, people who don't have that. So yeah, that's what you need. You need a postnatal plan, not a birth plan because postnatal is when it starts all, you know, the sleep deprivation kicks in and life is not the same again. I was an absolute and continue to be an absolute nerd about anything to do with birth. It's genuinely not me looking back with rose tinted glasses or anything like that. I loved it from day one. I was just like this is it. And just as an aside, when I said to my friend, who is the same friend that sat next to me in the library, 25 we were not 14 in a wall. I said, I'm leaving air force. I'm going to be a midwife. And she said, ugh, that's disgusting. What an awful job. You'll be terrible at it. So nice to see she was at least consistent. (gentle music) - Lear, a registered midwife for just over 12 years, began her midwifery journey in the aftermath of the birth that left her with a lingering question. - Like many midwives, I came to midwifery as a mature student because I had a bit of a rubbish birth. If you had told me growing up that I would be a midwife, I think I would have been very confused. Definitely wasn't something that was on my radar at all. In fact, having babies wasn't on my radar at all. I met the right person, got married, decided to start a family, and I had thought I was really well prepared for birth. I'd always had a bit of an interest in women's health, and I read widely around pregnancy and birth. I went to the antinatal classes, was privileged to be relatively kind of young, fit and healthy and thought I had a good chance of having a really good experience, and nothing could have been further from the truth. I had what I now know is kind of a classically rubbish first birth. It was a difficult, long labor with a back-to-back baby that couldn't be budged, failed manual rotation, and an emergency section at nearly fully dilated. Afterwards, I had a really difficult time as well. I struggled to breastfeed. I was quite socially isolated. I just felt like my whole body, identity, life, had just been hit by a truck. And I didn't really know why. I didn't understand why that had happened when I thought I'd been so well prepared. And the more I spoke to other women who had had babies around the same time as me, the more I realized we all had really similar stories. None of us had the birth that we had expected or hoped for. Why is this the case? Why is this happening to all of us when we should at least some of us should be having positive experiences? Why has the system let us all down? Now, it took me a while to kind of move away from the job I was in at that time, which could not have been more different. I was working for the BBC. I was behind the scenes in arts and factual entertainment, kind of coming up with program ideas and things. And when I went back to work part-time, kind of sitting in the office at my computer, churning out ideas for pilots and so on, I just thought this is not it. This is not where my heart is, you know, and that's no harm to anybody who feels that is where their heart is, but it just wasn't for me. And I thought, no, I need to step back from this and do something that really matters to me, which was birth. So it took me some time to kind of find my way to midwifery, because I had not long completed lots of university education in a different subject. I kind of thought about it for a while, and I found out about the role of a doula who is essentially just a lay-birth companion at somebody who provides practical and emotional and informational support around the perinatal period. And I thought, this sounds like a great way in for me as a mother of a young child and somebody who still needs to be kind of flexible. So I did some training around that and long story short, I was a doula and I provided birth companionship across central Scotland at home and hospital births for about six years, and then I had another baby. So one was kind of the classic really difficult birth and an emergency cesarean section in hospital, and then second birth was a planned home birth. Every person in the UK has the legal right to give birth wherever they want and to be attended by a professional in that place of birth. The rates of home birth are varying across the UK. They're generally quite a small proportion of overall births in any average health board. I'm just sort of estimating figures that tends to be between kind of two and four or five percent at a maximum, but obviously some boards will have a very dedicated home birth team and a more kind of publicised stream line service that the numbers will be more than that and other areas will be maybe less well equipped. I have had a baby at home and I can tell you, it does feel very different from having a baby in the hospital and as a doula, it had in the, you know, lots of different births and homes and hospitals. And yeah, absolutely being in somebody's home environment, it's much more intimate. The person generally feels more comfortable and a very, very different birth and it ended up being about 90 minutes of labour and she was born so quickly that my husband caught the baby so it couldn't have been more different. And ultimately I decided the time was right for me to go back to university and become the full package and do midwifery, so that's what I did. I qualified in 2013. I mean, they say you'd never forget your first time and I definitely remember my first birth as a student midwife. Most university training courses in the UK, you do roughly kind of 50/50 classroom instruction and then you do practical placement, you know, predominantly in and around hospital or community services. And for me, my first shift as a first year student midwife was a night shift, which was daunting in and of itself. Just going into that environment of the maternity hospital is terrifying. You know, you're navigating this strange space, you don't know where to get changed, you don't know where to put your stuff, everybody looks bigger, braver, stronger, tougher than you. You go into this room and get the handover from the day shift of all the ladies that are in labour at that moment and it is just absolutely bamboozling and terrifying, you don't speak the language, you don't understand most of the terms and then the coordinator for the shift kind of looks at you and rolls their eyes and says, "Right, you go with this midwife who will be your mentor for the shift." So this poor woman was assigned me as her student and I remember clearly walking down the corridor and it's the same hospital I'm working now, I even remember which room it was and we knocked on the door and we went in and there was a woman on all fours on the bed with a light shining on her tail end and it was very clear from what we could see and from the noises she was making and what she was doing that she was about to have a baby. Literally flung in at the business end of things, no lovely long labour, no time to get to know this person, just put your gloves on, put your hands here, we're having a baby. And that's how most student midwives will catch their first baby essentially they will put their hands on probably, you know, the baby's presenting part usually the head and the midwife will then put her hands on the student's hands and literally guide that birth and guide the student in catching that baby, which is actually so so special because when you think about all the generations of hands going back, I mean, how old is midwifery, hundreds of thousands of years probably. It's so special even though the actual situation might be quite terrifying and intimidating, it's so special to think that your mentor is putting her hands on your hands and somebody else put their hands on her hands and that's how we learn. Thank you so much for listening. Please do like, subscribe and leave us a review. We would love to know what you think. And if you're a midwife, I would like to take part in this series, you can find contact details in the podcast description.