Real Talk: Midwives

Words by Charlotte Jansen

Photography by Hollie Fernando

The profession of midwifery is fascinating: midwives meet women at the most extreme moment of their life, sharing a very vulnerable, intimate and life-altering moment with them—only to probably never hear of them again. I was lucky enough to interview Meghan, and Claire and Ester—three midwives who between them have delivered thousands of babies—about their insights into birth and how it has shaped the way they view themselves and other women.

Meghan Roe – a midwife at Homerton Hospital and has helped to deliver close to 1,000 babies

What’s your usual shift like?

I work in the birthing centre at Homerton, so I meet women in labour, going into labour or who have just delivered. I used to be on the home birth team, so I was case-loading and on call. That was the dream really, getting to know families all the way through.

It must be strange for people to go through this epic, life-changing experience, when for you that was just another shift.

When you got in touch I remembered your name, but I had to go and look through notes to really remember the birth. I do remember most births, but you’re right it’s a daily event for me. But every birth is so different, every family is so different, and I always remember one thing about each. It’s a real honour, I don’t take it for granted.

Do you ever worry about doing the wrong thing for your patient since you don’t know most of the women who come to you at the birthing centre–how do you know what they need?

I read everyone as an individual, some need more than others, others are just happy for you to just be there, not too involved, but there in case you need someone or something. Sometimes we barely need to do anything as it’s a very natural process. Sometimes I hardly say a word.

Do you think we need to change the way we talk about birth – there’s a lot of censoring the details of birth stories, and then there’s also all this pressure to have a “natural” birth when sometimes that’s not a choice.

There’s definitely more a drive to have an intervention free birth, to let the body do it’s thing, but there’s a lot of judgement out there especially from social media, there’s a pressure to have a certain type of birth or experience. I’ve noticed the disappointment some women feel when it doesn’t go way they wanted, and that’s sad. It’s crazy to think you “haven’t really done it” unless you’ve had a vaginal birth. Having a c-section or other intervention means having more done to your body: you’re having layers cut into you to have your baby safely, it’s incredible, you’re totally surrendering your body. I think birth should be thought of as beautiful no matter what type of birth it is.

In ten years you’ve delivered close to a 1000 babies. Any births that really stick out in your memory?

Being punched in the nose was a good one! It wasn’t on purpose, but some women do get quite physical. It goes from that extreme to some women who I haven’t even noticed the baby is between their legs because they’re so silent!

What are the typical questions you get asked about birth?

The poo is definitely one. If i tell someone I’m a midwife, it’s one of first questions they ask me. 75% of women will open their bowels and that is a statistic I’ve just come up with from my experience.

It must be an amazing job though to share those first moments of a new person’s life, to welcome a new person to the world every day.

Aw, yeah… It’s so incredible to watch every time, the look on the parents’ faces the first time they see their baby. How could I ever complain about my job when I get to see that every day at work?

Claire Cousins – a midwife at St Mary's Hospital who has welcomed over 1,000 babies into the world

Why did you decide to become a midwife?

After turning 40 and experiencing the loss of my father from a terminal illness and a close friend from a road traffic accident I started to reevaluate my life. I had been working as a Graphic Designer all my working life, and I although I enjoyed it, I knew I could not continue in that line of work for the rest of my working life: it just didn’t fulfil me.

I was moved by the care my father had received during his illness from the NHS, how caring and patient the staff were, and how much any kindness meant to me and my family. My sister was a nurse and I also realised during this time how important her job was, she had real skills that she could use to help people, my job seemed superficial in comparison. I saw myself as a bit of a feminist with women’s issues being important to me – therefore midwifery was an obvious choice. It then took me a couple of years to get accepted onto a Midwifery course. My first two applications were unsuccessful. So, I started my training at 43 years old - with two daughters aged 15 and 9.

What interested you about midwifery and did that change when you started to practice?

The politics of childbirth interested me. Before my training I read Sheila Kitzinger’s book Birth Crisis in which she wrote about the risks of increased interventions in pregnancy and the shift from relationships to technology in childbirth. She was right – the effects are felt by women as more are experiencing traumatic stress and anxiety from their birth experiences. Yes, birth may be safer but women often feel disempowered by it. And no this did not change when I started to practice.

How do you see your role as a midwife?

My role changes depending on each woman and her needs. Some women need constant reassurance and encouragement, others don’t and just want you to be there quietly. The role is always as a facilitator – trying to ensure the right environment for labour and birth. It is always to try and create an atmosphere of minimal interruptions, quiet, and security.

Can you tell me any of the particularly memorable births you were present at?

Home births have been among the most memorable. Not only are women inviting you along to witness a hugely significant and intimate life event, but they are inviting you into their homes. One of the most memorable is of a woman who had set up an inflatable birth pool in the middle of her lounge which was so small and cluttered that we had to climb around the sofas and chairs to attend to her in labour. It was a real family affair, child, friend, partner and partners family on Skype from Brazil throughout. It was a real menagerie and two small frisky dogs were jumping around the place too – getting very excited. I kept thinking they were going to jump into the pool or puncture the pool. As soon as the baby was born, her other toddler was in the pool breastfeeding from one breast whilst the newborn was feeding from the other. It was chaos but wonderful.

How do you feel about the births you witness, what kind of connection do you feel to the mothers and children?

There is no doubt that I feel a strong emotional connection with the women and their birth partners during the birth. You are really there in the moment with them. I also feel a sense of responsibility. There are a handful of women with whom I have kept in touch over the years and I receive regular photos of the children, eg the first school uniform photograph. These are women for whom I also provided antenatal care so the emotional connection is stronger. The description of the midwife as a “professional friend” is a good one although I can’t remember who created it.

You had already had two children when you became a midwife. How were your own births? What role did your midwife play?

The first birth was pretty traumatic with a very quick labour. I was already fully dilated when I arrived at the hospital via ambulance. The unit was absolutely heaving, the only space for me was in the theatre. I was hooked to a monitor with a midwife coming in and out constantly, unable to commit to being with me. I was given an hour to push after which my daughter was delivered by a doctor with forceps and an episiotomy. So basically there was minimal midwife involvement. I imagine it could have been different if I had the support of a midwife. It was nobody’s fault – just the circumstances were against me. With my second daughter I was induced at 42 weeks. This was a much slower process, spending all day in hospital and having really good support from a midwife and senior student midwife, resulting in a straightforward vaginal birth with an intact perineum. There was the opportunity to build a rapport with the midwife and student and my husband felt really supported by them too. When I started my midwifery training I got a copy of my maternity notes from my first birth and found it helped to make sense of the birth. The contrast in the experiences just crystallised for me the difference a midwife can make.

What is the most common myth about birth?

One common question asked (most often the younger expectant mums) is… “Is it true you will poo when the baby is born? And will you poo onto the baby’s face?” The answer is yes, you most likely will open your bowels during the pushing stage – it’s a good sign that the birth is imminent and makes the midwife happy.

Ester Suso – a midwife at The Royal London Hospital and has attended over 500 births

When and why did you become a midwife?

I became a midwife in 2013 after being an A&E nurse for seven years. I’d wanted to be a midwife since I was a little girl. I studied nursing and became an A&E nurse (the complete opposite of midwifery!) and it was after becoming burned-out in the emergency environment that I decided to do midwifery.

What’s a regular working day like for you?

I work at the Royal London Hospital in East London and am in the team that looks after vulnerable pregnant women. It means working with women that have mental health problems, or who have come into contact

with social services because of substance misuse, prostitution, as refugees, or as victims of domestic violence or trafficking. I also work with women who have FGM (female genital mutilation) and teenagers. We see them before and after they have their babies and we do all the antenatal and postnatal checks for them.  I sometimes miss delivering babies but I much prefer the social and psychological aspects of midwifery to the technical side.

Have you seen anything that left a strong impression on you?

Because of the nature of my work, unfortunately I have to deal with the dark side of pregnancy and motherhood. Sadly I have to deal with babies that are removed from the care of the biological parents and I have seen some babies that have not made it to the end–but thankfully that is rare.

Does being a midwife change the way you see women?

Since I have been midwife I have become more feminist that I was before. What the body goes through is something that no one can understand unless they have been present at a birth. Women are the strongest gender, there is no doubt about it for me. We have to deal with the pregnancy (with all the hormonal, physical and psychological changes that come with it) and on top of that there is the childbirth pain.

You recently had your first child. How did what you’d seen affect the way you felt about your own birth?

I did not enjoy my pregnancy, I always thought that something wrong would happen to me and my baby and I attribute this to the knowledge I have from being a midwife. You can't help thinking the worst!

What was it like?

I went into labour on my due date (only 4% of births happen on the due date!) so I was lucky, but I did not actually give birth until two days later. I wanted to deliver in the water, as from my experience as a midwife water births are really beautiful and less painful, but because of the position of my baby in the womb (he had his both hands around his face) I had to have a medicalised birth and he came out with the help of a ventouse! It wasn't as I expected but overall the experience was very positive. One thing I enjoyed was my partner's face as our son was born (I have never seen him crying before!) and he had time to hold him and do skin to skin whilst the doctors were stitching my tear! It was beautiful seeing him bonding with the newborn. Oh, and the feeling you get when they hand your baby to you and the newborn suddenly goes and breastfeeds by themselves is something that I will never forget.

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