Bristol midwife: ‘The system is broken and is breaking us with it’

Staff shortages, increased pressure and mental health issues are threatening to cause a mass exodus from midwifery. A Bristol midwife explains why she and her colleagues are taking to the streets this weekend to call for urgent action.

Voices 19th November, 2021

A Bristol midwife

Midwifery has changed so much in the short time I’ve been part of it. I began my training in 2016 before qualifying as a midwife in 2019. In that time, we have become less and less “with women” and more rushing around, juggling too many patients with a mountain of paperwork.

As our work pressures increase, we still love our jobs but the original basis of our role of being with women in pregnancy, labour and post-birth, and supporting breastfeeding has been diluted because of the strain caused by an overworked service. 

Alongside this ever-changing demand, is the ever-increasing midwife shortage. According to the Office of National Statistics, England was short of 2,500 midwives in 2019. The latest National Midwifery Council register suggests the number of midwives is going up, but that doesn’t account for those on maternity leave having their own babies, those on the brink of quitting or those who have already left and are waiting for their registration to expire.

We feel less and less satisfied with the quality of care we are physically able to give and the resources at our disposal. It’s heart-breaking to hear that someone we cared for gave up breastfeeding, not out of choice, but because she thought we were too busy to help her, and she struggled. In truth, it is possible we were.

Since March 2020 especially, staffing problems have gotten even worse. In the last 18 months, a significant portion of midwives have been on long-term sick leave for mental health concerns and Long Covid. Midwives are more affected than ever with burnout, stress, mental health issues, anxiety and fear. 

We go home unable to sleep wondering if we missed anything because we were rushing from bed to bed trying to facilitate basic care, when what we want to give is so much more. We wake up in a cold sweat trying to remember if we documented x, y and z, and praying we aren’t hit with litigation if we didn’t. The fact is that we didn’t go to the toilet that whole shift. We may have had to shovel our lunch down 8 hours into a 12-hour shift if we were lucky. 

I am among many of my colleagues who began taking medication to support our mental health. The small sip of water I take in a shift accompanied with sertraline: a desperate attempt to keep my spirits high enough to stop me quitting the most wonderful job in the world.

That’s the sad thing, it’s the most wonderful job in the world, but the system is broken, and it is breaking us with it. The Royal College of Midwives reported in 2018 that for every one midwife that starts practising, 29 leave the service. More recently, a RCM survey found more than half of midwives were considering quitting their job, with the most common reason being staffing levels. That shouldn’t be a reality. 

There are nowhere near enough student midwives qualifying in that time to replace those leaving the profession either. How can we inspire the next generation of midwives when there is no one left to teach them? How can we possibly give basic care with no midwives to give it? This is not a new problem, it’s a long-term systemic issue that has lasted decades, and it needs serious investment to change things.

This is why I will be joining other midwives in protest this weekend as part of the #marchwithmidwives movement. Across the country, midwives, maternity care assistants, student midwives and doulas stand together not just to attract attention, but as a cry for help.

We are desperate, we are tired, we are broken. I stand on Sunday 21 November, not just for my job, but for my life. We give everything to our clients: our time, our energy, our sleep, our health, our love. All we ask is the government show their appreciation, not with a weekly round of applause, but with the resources and workforce needed to give the British public what we believe they deserve.