By Jak Burke, Baby Does NYC,
I wanted to know what it was like to be a midwife. So I caught up with Lucia Diaz a Spanish midwife working in England.
When I was 7 years old everyone kept asking me the magic question of what do you want to become when you grow up? And I did not hesitate to answer them clearly that I wanted to became a midwife. I could not clearly explain why that was or where I got the idea from but I just knew it.
A few years later I did not change my mind, but I had a better idea of what the role of a midwife was: I will be delivering babies. Now many years later and after lots of personal effort, I am one of the lucky ones that wakes up every morning to go to work thinking I love my job. I grew up in Spain and as their universities work out, I had to study nursing before I could apply to my midwifery studies. At the beginning, I was really upset as that wasn’t what I really wanted to do in my life. That wasn’t my dream. But I went to university for 3 years and then worked for 2 years as a nurse.
Now looking back in time I do not regret a single thing I did back then. Becoming a nurse was one of the best things that happened to me. I grew up as a person and realized how important health care work is and I also understood the nature of caring for someone. Someone that just needs a hand when bad news is being said, someone to clean their wounds, and specially someone that cares for them. I loved nursing and the job, but I knew that that was not my dream. Therefore I did my personal research and found out that in the UK midwifery was giving a more women and family approach to their midwifery care.
The UK was known to have a very natural approach towards pregnancy and midwifery. Therefore, one day I woke up and decided to try my best to come to the UK for my midwifery studies. I had to work hard, I had to practice my English and I was advised to work as a nurse within their national health service to familiarize with their way of work. I packed my bags and moved to the UK. I was then officially a nurse in the UK. I missed my family, my house and my friends but I could see my dream was getting closer and closer. After a year as a nurse, I then applied for university and got a place as a student midwife. It is an 18 months course.
The most exciting but stressful 18 months in my life so far. I had to compress a full extension of knowledge into 18 months and combine that with working hours in hospital to gain practice. We are required to meet a certain criteria prior to being able to qualify, including: leading 40 vaginal deliveries, caring for 100 low risk cases, 100 high risk cases… It was not easy, I found myself in a new country, with a different language, a different way of studying and training, but I was heading towards my dream.
And today after hard work, I can say out loud and proud that I am a midwife. After my years as a student and then as a qualified midwife, I can now clearly explain and understand what got me to want to become a midwife.
What’s your daily routine?
Midwives and midwifery is much more than just the moment of the delivery. It is a long journey, a change and transition in someone’s life, not only the new mum, but her whole environment.
I’ve learned that midwives are lucky to be invited to be part of someone’s unique experience. No matter their stories, no matter if it’s the first or second baby, they will always look back to check that their midwife is there to support them and encourage them to go through this amazing journey. It’s like when a toddler starts to crawl, that will always look back and check on his parents for that comforting support and security. Midwives can have an amazing impact on someone’s experience and on someone’s life.
And I have also realized that I can do much more for all of the women. I want to help them, support them, and make sure their memories about their pregnancy are the best ones.
I have been working as a qualified midwife for the last 4 years and each one of the women that has come across my pathway has made a small change in my life. Midwifery can be the best and worst work in the world and I have been able to learn this.
When I first qualified, I rotated between delivery suite/labor ward, and the postnatal and antenatal ward, to be able to gain confidence and experience in each of the areas.
On the labor ward, my duties included:
- Planned admissions for women that were undergoing elective procedures such as caesarean section, external caephalic versions (offered to women whose babies were in breech positions),
- Emergency admissions, for women coming with an emergency situation such as vaginal bleed, high blood pressure.
- Semielective admissions, for women requesting strong pain relief, such as epidural in labor
- Care in labor, for women that needed augmentation, induction, or were in active labor
- Continuous monitoring, intermitent auscultation, water births, births in all fours, birth on a stool, hypnobirths.
I am now based in an antenatal and postnatal ward in a public hospital.
My daily duties in this hospital are:
- Deal with day cases in which women have to be admitted during pregnancy due to a condition that needs to be closely monitored, as well as regular observations, such as unexpected vaginal bleed, reduced fetal movements, changes in their blood results
- Deal with inductions of labor due to any unexpected reasons as: reduced fetal movements, gestational diabetes, prolonged pregnancy, maternal age.
- Deal with postnatal women that have had a normal vaginal delivery, and instrumental delivery or a caesarean section. Most of the normal deliveries can be discharged home within the first 6 hours post-delivery if they wish to. Other deliveries if all is well with mum and baby can go home within the 24first hours.
- Act as their advocate, informing them of the latest information and studies, so they can then make an inform consent towards their care.
We are a baby friendly hospital, therefore we support our women when deciding to breastfeed, we advise them on best approach and positioning and step by step teach them on how to get their own and unique babies to breastfeed. We advocate hand expressing, skin to skin and kangaroo hold for a new-born to get the best within the first hours.
I have recently been promoted to be a ward leader/manager. I do not only advocate for women but I also now advocate for other midwives working with me. My duties include:
- Ensure we have the right number of staff working on the ward to make it a safe environment. It is not only important to have the right number of midwives but the right mixture of qualifications within the same working shift
- Monitor sickness levels within members of staff according to the hospital policies- which include return to work interviews, lease with occupational health departments and do the correct adjustments when required.
- Ensure everyone has the appropriate and up to date training, as we have a very strict yearly mandatory training.
- Deal with managers and coordinate work
- Call for meetings to explain new projects, needs, or improvements of care. As well as addressing any concerns from any member of the team.
I have had the opportunity to step in to a role, in which I have become a role model for my colleagues, supporting other midwives and health care professionals to empower women with their own choices and needs. I learn from all of the women and their views, and try to make a better service for everyone. I work alongside women and colleagues to be able to provide them their unique and personal experiences respecting their choices and supporting them.
Midwifery has opened my eyes to a new world in which the most knowledgeable person is sacred of the unknown. No matter how many times someone tells you how painful labor pains can be, how many hours you are going to be without sleeping once baby is born, how uncomfortable stitches can be, how much your body is going to change… no one will be able to understand them until they experience that themselves. Midwives do not have to experience that in their own bodies. We as midwives are able to empathize with the women and their families to the point that we use our muscles to push with them to deliver their babies, we feel their pain when we see them in agony and screaming… we are their rock. We are there for good and for bad
I have learned about new cultures, being able to adapt my care to them. Moreover, now I am able to provide individualized care, as women and families grow up in different environments, with different perceptions and different ways in which they want things to happen. I am responsible for ensuring that their needs are met and if I have to bend backwards and forward to make sure this is accomplished, then I will do so.
My biggest issue is when women come with a plan of care and an idea of what should happen. It is easy to think positively and think that you want the nicest thing and the most normal ones to happen to you. As a midwife I have to make sure women I take care for is open minded, is aware of possibilities and aware of changes that can take place. And I have to make sure these changes get integrated within their plan of care and their development.
I am also a qualified infant massage instructor, teaching parents the art of baby massage. I completely believe in the importance of nurturing and the influence of touching in the developmental period. Babies need to feel they are loved.
In the UK you have to be registered under the official nursing and midwifery colleague (NMC). They are in charge of ensuring that every midwife has the appropriate qualification to be fit to practice. We also have our local Supervision on Midwives. This entity deals with all of the supervision issues, ensure that yearly the midwives are up to date with their trainings and that if there is any issue, they get the appropriate support. If there is a specific case, the supervision will act locally undergoing an investigation and then they will ensure the appropriate action is put in place.