Call the Midwife

  Call the Midwife!

just how far has midwifery advanced?

four midwives from surrey discuss how they are still ‘over worked and underpaid.’

The first series of Call the Midwife earlier this year was a huge success, starring the popular comedienne Miranda Hart. The series is based on the 2002-bestselling memoirs of Jennifer Worth, set in East London in the 1950’s. The series reveals the past of midwifery and the horrific conditions some midwives had to work in in the days of homebirths. The series also stresses the dreadful situations some women found themselves in, before high awareness and wide availability of contraception. The director Philippa Lowthorpe commented on the series, “In birth the midwife is forgotten,” she wanted to work with the program because “in reality, midwifes are the unsung heroes.”

       

To find out more about midwifery in the twenty first century I spoke to four midwives at Frimley Park Hospital in Surrey. The women were of varied ages and experience and all had different concerns about the conditions they work in now, and the advancement of midwifery. 

I questioned the women as to what they think is the biggest change in childbirth since Jennifer Worth’s days of midwifery. They agreed that the awareness of contraception and accessibility of abortion has been the main change since the 1950’s and the most significant advance. One midwife explained that as deliveries are now primarily is hospital they are better dealt with and women are now more informed. Another midwife stated: “I find most girls are aware of birth control choice now.”

With the advance of technology in hospitals and drugs used during childbirth one midwife is concerned that this is having a damaging effect on the way we see childbirth. “I believe the NHS has advanced in technological terms, saving lives, however reducing the amount of ‘trust’ women have in themselves and their bodies to give birth to their infants naturally without relying on technology/drugs.” Perhaps Call the Midwife is so popular because it celebrates women having successful births and healthy babies in the most trying of circumstances. The midwives in the series are likeable because they show resourcefulness and initiative, in current day practice this is not as necessary. One of the midwives who has been practicing thirty two years clarified this, ‘we are grounded by guidelines and protocols, midwives however, like the TV program, are usually superb people who will go the extra mile for women in their care.’        

As technology advances perhaps midwives are less reliant on their initiative, there is room for speculation on how well trained they are to cope with a crisis outside a hospital. Likewise there is an argument that nurses and midwives training is now too academic based.  Both are university degrees, whereas they used to learn on the job with part-time college education.  One midwife observed “midwifery and nursing has changed a lot, it is now an academic course. I feel this is sad and excludes a lot of people from midwifery/nursing who are not so academic but would make a good midwife/nurse.” With university entry requirements and fees, this isolates some people who would make good midwives.

The terrible conditions the women in the days of Call the Midwife had to put up during homebirths resulted in poor hygiene and infection levels. I asked the midwives how they find the conditions now. One of them replied, “Hygiene is not as much of an issue as when I started my nursing or when I worked in London. It varies with each area.” The most experienced midwife said that “the biggest cause of maternal morbidity is sepsis, so cleanliness should be high in agenda.” 5.2 million cases of maternal sepsis occur each year with 62,000 dying. In Africa sepsis is the leading cause of maternal death. All the women agreed that the hygiene in their hospital was to a high level.

The staff midwives at the hospital all told me that they were unhappy with their working hours; some shifts are up to fifteen hours with a lack of breaks. When I asked one midwife whether she was happy with her hours she responded, “No, I would prefer 12.5 hour shifts, I’m currently working 15 hours.” Another midwife explained that there is a “rapid turn around from day/night shifts.” They described that the maternity unit is very busy and often they are overwhelmed with the responsibility placed on them. So maybe midwifery hasn’t advanced as much as we thought.

I questioned the women as to whether they stereotypically felt, ‘overworked and underpaid.’ One midwife stated, “constantly, but I would still never work anywhere else or in any other job.” It seems that these women are dedicated to their jobs and therefore more likely to put with bad working conditions. One midwife explained: “for the amount of money we are paid as a midwife the responsibility is often too great.” Midwives are key workers in the community that we simply couldn’t do without, alike doctors, if they feel underpaid why isn’t this issue being addressed? Perhaps because midwives are too busy delivering babies to be pulling strikes.