Just because she ain’t playing Russian roulette with your baby

Sometimes the cure for a disease can be brutal.

Look, even on a really tough parenting day, it’d be wrong and mean to compare your kid to a bunch of tumour cells. I’m not doing that.

But… you know how sometimes the treatment for a disease seems worse than the disease… but you accept it because, well, the alternative doesn’t bear thinking about…? Childbirth is a bit like that. It’s not a perfect analogy, but bear with me…

When conception happens, and if you are lucky enough to live somewhere that gives you choices, you get to decide whether or not to proceed with the pregnancy. This is good. But there are zero pleasant ways of ending a pregnancy if that is your decision. Assuming you are well cared for (as is your right, and our duty) there will be bloodshed and discomfort. If you have to go illegal, it’s much much worse and no woman should have to endure an unsafe backstreet abortion. Nor should she ever have to carry an unwanted pregnancy to term. But, you understand, the cure, unpleasant as it is, is a no-brainer. And you can expect your medical team to treat you with compassion and kindness. Because an unplanned pregnancy can happen to (almost) anyone who has a premenopausal womb who has had sex with someone who doesn’t. Even when both parties have been careful. The womb bearer bears the consequences. And the consequences are consequential.  The treatment sucks.

Now let’s assume the pregnancy was planned and has got to full term without any complications. Hurrah! But wait, the womb-bearer still has to give birth.

Now I know this is the most natural thing in the world. I’m a midwife. I’m always in the room. And when the birth goes smoothly, I’m the only one in the room. I’m the one cheering you on, holding your hand, holding your vomit bowl, talking you through your contractions, urging to to keep breathing, guiding you through one of the most intense and difficult days of your life. Because natural sure don’t mean easy. Natural is tough and it leaves scars. And sometimes (sucky as this is) natural won’t allow for a healthy baby. The baby you chose to keep, and to whom I also have a duty of care. Thus, I’m also the one who calls the obstetrician when things aren’t going to plan.

I am hugely aware that you do not want the help you will be offered. You feel like your body has betrayed you, that you must have done something wrong, that you are already failing at motherhood. And now you are being punished. Because our assistance comes with instruments that look positively medieval, or a surgeon’s scalpel. And far too many needles. None of which were on the birth plan. We are so sorry about that. We understand that you do not trust us. We are sorry about that too. We know what you hear on the news. We know what you see on Tiktok. We do not take your distrust personally because we get it. You are exhausted and in pain. We get that you’re not at your best.

But, bottom line: we are trying to help you. It’s an unfortunate fact that the situation is now time- sensitive, if not critical. Your baby is small, and she has let us know that she has used up all her reserves of energy. She can no longer maintain her heartrate at a sensible level. Her placenta is no longer keeping up with her needs. She needs to be born so she can get some oxygen into her lungs. She may have got herself a wee bit tangled up in her cord, or she might have got into an awkward position. Maybe the geometry isn’t quite right, you know, like the proverbial square peg and the round hole… it isn’t her fault. It’s not her mother’s fault either.  But she’d be very grateful if someone would just get her some air so she can finally use her little lungs to express her displeasure. Loudly. She might not have chosen being dragged to safety by suction or by outsized metal spoons but she’s running out of time, she’ll be happy with whatever’s niftiest.

When I stand aside to let the obstetrician do her work, I am acknowledging that my expertise alone will not be enough in this situation. There’s always a moment of introspection: could I have done more to deliver this baby safely without intervention? Should I have held my nerve a little longer? After all, women and babies are designed with birth in mind, right? Mostly, yes. But I remind myself it’s not cool to play Russian roulette with someone’s baby. So I step aside. That’s an integral part of the job that I love: knowing when to ask for help.

But we get no thanks for this.

We get accused of not having enough faith in a woman’s body. Of causing the cascade of interventions. Of not listening. Not enabling. Not caring.

We do care.

We care despite all the myriad of factors that make our work ever harder. We are chronically underfunded. We are always short staffed. We work long days, sometimes without a break. We are always hunting for equipment. When we find it, it’s often broken. We are always begging the computer to grant us access to drugs,  to data, a printer, the correct page on which we can document our actions, our measurements, our assessments… we are cleaning, changing the bins, tidying, moving furniture, changing linen, checking equipment, measuring, recording… we are cajoling, negotiating, defusing, soothing… we feed and hydrate you, mobilise you, we attend to your hygiene needs, we even look after your exhausted partner.

We care.

And sometimes it isn’t enough and you need interventions that you do not want. It sucks. But don’t blame the midwife. She’s on your side. She’ll stay by your side. She’s still your advocate. But she knows, just like you do, that in the end, your baby’s life and future health is what’s at stake. And she will work her magic to keep you comfortable and calm and in control. She’s great at that.

And you will be ok.