The Future of Midwifery Starts Here | Life of a Midwife Ep. 12

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1:55Over this series, we've followed the experiences, challenges and unforgettable moments that shape the life of a midwife. For this final episode of the series, we look back across generations of midwives and explore how birth has changed. And what those changes have meant for the people at the very centre of it all. I'm Giovanna Fletcher and this is Life of a Midwife.

2:33When Sheena began her career, maternity care looked very different Over decades of experience, she's witnessed a major shift Women moving from being passive patients to active participants in their own births I was lucky enough to work in a maternity unit when I was training to be a midwife. There was a lot of good things happening, so women were free to be mobile, and I did really early on facilitate birth in upright positions, forward-leaning positions, which later on I realised that I was lucky to have had that experience. but there was still very much a do as you're told kind of attitude towards women in the 1970s and 80s you didn't ask permission to do anything not like today and something that I really work hard to promote is around informed choice and and absolutely you know women making the decision on what they do and then giving informed consent but back in the 70s and 80s you had a checklist when somebody came in in labour and you ticked it off.

3:47So we used to actually do awful things like shaving women's perineal area. And of course, many women choose to do that themselves now. But in those days, most people had pubic hair and you shaved it off. And you didn't ask commission to do that. You just said you were going to do it. And then you gave the woman an enema. And the enema was something really quite horrendous. It was routine across the country. you had a big funnel and a tube and soap soft soap in a big jar green soft soap and you diluted it with water and you and you actually passed two pints of this liquid into a woman's bowel area upper rectum and into a bowel and hopefully that cleaned out the whole area ready for the birth Even I did it with my sister because I was actually my sister's midwife for her third baby and she was saying to me, I don't want it, Sheena, and I said, you have to.

4:49This is really, really bad, isn't it? It's really bad. But we did it and we didn't ask any questions.

5:02I had two children in 1979 and then one in 1980 and I actually left work because I wanted to be at home with my baby so I left being a midwife for a while and I went back to work shortly after James II was born we had a huge mortgage and there'd been a financial crash so I had to go back to work. This was what changed my career. I don't think I'd still be practising today had I not gone to work in this particular place after James was born in 1980. It was a great big old Victorian house that had been transformed in the 1950s into a maternity home. Probably something similar today would be a birth centre and the only difference between the maternity homes in those days and birth centres now is that general practitioners, GPs, had a lot to do with them.

6:05It was a time when women, when they got pregnant, they went to the GP to confirm the pregnancy and then the GP would give them the options as to where they could give birth and if they wanted to go to the maternity hospital, then it was usually a small place, a homely environment, home cooked food. They gave birth there, they stayed there for 10 days afterwards and were looked after by midwives. The GP would come to the birth if he got there in time, he or her and also come and see the mum when she'd had a baby as well and discharge her to go home. And today that's the midwife that does that So there's been a big move.

6:48That was in the 90s that that changed.

6:54So I went to work in this place and I'd never seen anything like it. So midwives were working autonomously, really. So even though the GP came in for the birth if they were on time, midwives did all the care for the mum when she came in in labour and right through the birth and the postnatal period till they went home, mum and baby went home. My eyes were just completely open to how women were even more able to move and have choices on. So I heard, so women started to bring, you know, we used to have cassette players, you know, where they're little cassettes with music on. and I remember women bringing in Mozart to play whilst they were having babies.

7:43I'd never seen that before. And going on the floor on birth mats and we had a fantastic manager who introduced mats for the floor so if the woman didn't want to get on the bed she could actually go on the floor which really when I'd been doing my training if a woman wanted to go on all fours to give birth we had to pull the mattresses off the bed to do that or she had to do that on the bed, which was a bit dangerous. So this was a whole new concept of freedom of movement for women. And we also got a birthing chair, a birthing stool, which I'd never seen before, and I facilitated births on that.

8:23And it was really to enable women to be able to be upright during the birth, which we know now when a woman's giving birth, it's the interplay between the mum and the baby that matters, not necessarily the size of the baby. I saw for the very first time how when women were left to their own devices in these big, beautiful, spacious rooms, that they opted to do forward leaning or get on the floor or sit on a chair where they could be upright. And I also learnt from old midwives who didn't interfere. They sat and watched and listened to the mother. And in fact, I had two more babies there and I had that type of care.

9:07As a midwife giving birth to babies, the first two I was a newly qualified midwife and I kind of did what the women did in that time in that they did what they were told and I was very much wanting to make sure that the midwives caring for me even though they were my friends that I didn't cause them upset or I just kind of was very compliant. the only thing I did to dig my heels in was when Anna my first baby was born it with we put babies in nurseries in those days they were they weren't with the mums and um and I and I absolutely wanted her by my side and I said to them you're not taking my baby and they tried to and I said you are not taking my baby so I was like really angry and and they didn't in the end but I was the only mum in the ward that had the baby with her.

10:02My third child was born in 1983 and I'd worked then in this maternity home for three years and I'd watched women give birth in a completely different way and I was watching them thinking, wow, I'm learning more from you than I am from the year that I spent in my training and the year in the hospital because when women are allowed to use their own intuition and instinct, if they feel safe, right, they have to feel safe and not be afraid of, first of all, the pain. They have to be afraid of the pain. And that's not easy, right? And they have to feel safe in the room that they're in and the people that they're with.

10:47How a woman is treated during her labour and birth really matters and how the relationship between her partner and you and the environment all adds to the birth process. So I loved my midwife and my third and fourth baby. I absolutely adored her. She was the one that I'd learned the most from. And so I felt completely safe. So I was able to let go. I was able to not think about, you know, I had to cope with the pain, and the pain was the thing in my head. But I'd watched what some women did when they had pain, how they coped with it. And so I just copied them. I just literally copied them. And, you know, this is the first time I've talked about this.

11:35And, yeah, like really talked about it.

11:42In my career, I've lived through the whole thing, like four decades of starting off being where many women were induced. but there was one-to-one care and labour but it was very prescriptive and women didn't have choices and then moving into an era where there was a fight for women to have choices the National Childbirth Trust were fighting and women and midwives were coming together to try to make change happen and we had a period of even though we didn't know it we had a period where people's voices were heard and changes were made and and out of the whole world you know we had the best opportunities because of the policy guidance that came out in various years.

12:39Hello, I'm Monica Reinagle, host of the Nutrition Diva podcast. Summer is here and with it, the hot and sticky weather. A morning working in the garden or maybe on the golf course can leave you more depleted than you realize. And plain water isn't always the most efficient way to restore the balance. That's where Liquid IV comes in. Its science-backed formula is clinically proven to hydrate faster than water alone. Whether you're exercising, playing outside, or simply surviving a summer heat wave, it's an easy way to stay hydrated. Shop now at liquidiv.com. Liquid IV, hydration that goes wherever life takes you.

13:14This Monday.com ad was created by a team of people and AI agents. Reese, our content agent, wrote the copy based on our best practices, like mentioning Monday.com three times. That was the second. Johnny, our coordination agent, built the timeline and kept everyone aligned. Olivia, our human creative director, stayed in the loop. Because agents are great, but they don't always know when a joke lands. She had one note. Tell listeners it only takes minutes to build an agent. So, minutes. Create your own AI agent today on Monday.com.

13:54recognising the wisdom that comes from experience has travelled through generations of midwives for students like Demi though the experience begins somewhere quite different

14:07it's quite comical I know this shouldn't be funny but it is when you're a student midwife I remember a couple of episodes my first ever emergencies I didn't realise there were emergencies I just, I remember going home and thinking, I think that was a haemorrhage. Because then you're just a kind of waste of space in the nicest possible way and they just ask you to do running tasks which it was my first ever experience and I didn't really know what's happening. We hadn't learnt it yet. You're in there, you haven't even learnt second year midwifery, so you haven't learnt about haemorrhages, all these diabetics, you haven't learnt about it.

14:41All you know is normal. So when something's abnormal you're like, this isn't right, but I don't know what it is. So you would go home often as a student midwife lying in bed and think, that's what it was. Like, it's so silly. Obviously, when you're second, third year, it's very bizarre because second year, you're expected to be supported and manage a situation. Third year, you're eventually meant to do it independently. So you feel this pressure and eyes watching you, seeing if you're capable or not, you're tough enough or not.

15:21So you kind of just internally are like, it's like a duck paddling inside and then obviously above the surface you're just cool as a cucumber. Sometimes you do crumble, I was quite fortunate that I just kept pretty calm but I think it was again dissociation, it all happens very quickly, I couldn't really understand how people could make good decisions because it just happened so fast and I just went with what was happening in the situation. Same when you're nearly qualified you kind of like work your way through it and think did I do okay? What was that? I don't know. I don't really understand.

16:04Obviously you have it so strictly pushed into you that you role play it over and over and over when you're in a university setting and then when you qualify I will say this is fantastic what they do with midwives we hate it but we roleplay all the time to the point where they will prep a labour room like there's someone in there they will not tell you what it is and you have to run in like the buzzer's just gone off and then consultants will be there you know they'll like question you and say right this has happened what you're gonna do now and it's horrific but it's at the time you know you're you don't realize it but it does prepare you for when it does actually happen and then you kind of just go into automation mode but I think as well when you start to get a bit better and a bit more experienced and a bit more switched on I was always more excited to see how well I could do in terms of taking care of that women and being part of the team and you feel more and more part of the team you feel more and more that you can make decisions and the way I remember explaining to a junior doctor once it's a very bizarre way of coping but what I would do was sing in my head so so stupid so I would almost pretend that it was like a comedy show and everyone was racing around really quickly and I was just cool as a cucumber almost like I'd stopped time and I was just going along doing my thing doing what I had to do and it It was probably my best tool that I ever had because I was always very chill in a scenario and I usually, obviously quick and obviously urgent when I need to be urgent, but it was less room for error because I was able to think.

17:44Having worked across different healthcare settings, Fatma too has seen how support and choice can shape a woman's experience of birth. And while midwifery has changed greatly over the years, she believes one thing remains constant. Women remember the people who stood beside them.

18:09When I have a delivery, I am so excited that I forget the time. I always tell the husband, please look at the time for me, OK? Check the time. Because it's such a wonderful role, you know, to be there at the beginning of life. It's so wonderful, really. And to empower the women to get to the other side. And my team, which I love, we book them from the beginning. We see them antenatally, in labour and postnatally. So you follow that woman through that journey. So it's really, really great. Most of the time, as soon as the baby is born, we make sure the mother gets that first hug unless there's a problem.

18:59If there's a problem, of course, we have to take the baby to the resuscitate, resuscitate the baby and we'll talk to the mum about that. On the labour ward, you have one-to-one but on the postnatal ward, most hospitals they are so overwhelmed with so many women and not enough staff. So a lot of women are shy to ask so I advise my women, make sure you ask for help and they will draw the curtains and they are struggling there alone. I said, if you don't ask, most of the time the midwives don't know you're struggling. The one thing I really love about the delivery here is having their partners. In Africa, well, I don't know if with other countries, in my country, men don't come to the labor ward.

19:46Only the mothers. and most of the time it's just them alone or an auntie or a sister. They put them in this contraption of a bed, like Macintosh, no sheets. And you're supposed to stay on that bed to have the baby. I'm like, wow. My sister has a hospital at home, so when I went one time, one lady came in labour and then I had to take that woman to the labour ward and I saw their labour ward there. I was overwhelmed. I felt so sad. I said, wow, really? Whereas here they give you an opportunity to move around, you know, with the pull of gravity. If you're laying down, how can you push? Can you push up?

20:35So, oh, it's really good to be able to move and get that baby down, you know. So here when you see the partners, all you really need in labour is a familiar face, somebody that can reassure you when you're scared, you're worried, you're anxious. All you need is for somebody to say, it's okay darling, breathe, breathe. So we teach the husbands how to prompt the women to just relax. Now a lot of midwives understand what the women are going through, and all you really want is support. Somebody to remind you to breathe, talk to you gently, you know, just support you, just for them to know you're there, and having a familiar face.

21:24That's why I love my team, because we have that familiarity.

21:31When you know somebody already, You're relaxed already, isn't it? But when you have a new midwife in labour and you think, oh, I don't know this one, you know what I mean? You get that anxiety already.

21:47Once you breathe, you get that oxygen in your lungs, that oxytocin in your body. Once you relax, you're off and away.

22:00take a deep breath in your lungs fill up your lungs and out

22:10when you do that I'm telling you you relax already so if you keep doing that once you get a contraction you do that the next minute when you're having that break just close your eyes relax a minute the next minute the next contraction is coming again. So if you get that rhythm going, you're off and away.

22:42The question now is not only how far midwifery has come, but how we continue moving forward. Because the stories of those who came before, the experiences of those learning today and the voices of families who have been cared for all tell us the same thing. The best care begins when people are listened to. Here's Sheena. I know what's going on in maternity services right now. I know not because I'm working in them but because I'm in tune with what's going on from women and birthing people's perspective, from dad's perspectives, from midwives, from doulas. And so I know exactly what's going on, but I also know what works.

23:29And I also know that if only there was someone listening and that one person or several people listened properly and then put the resources in, and that's not just about financial resources, it's also about the right people knowing how to support others working in that environment, then we could have an amazing service and it's frustrating you know when you know and I'm not being patronizing or thinking that this isn't about me this is about me and many other people professors of midwifery obstetricians mothers who were experts in maternity care they actually know what what's needed and that's what's really frustrating for me right now and why I keep going because I'm 70 now right and and my family say to me for goodness sake Sheena like why don't you just let it go now leave it to the young ones and and I and I do leave it to the young ones don't get me wrong I don't think age means that you know best or anything like that my daughter is half my age and she's far wiser than I am but she's got the same passion so that's an amazing thing for me to be able to leave my life knowing that my daughter hopefully if she's still doing midwifery and if she's still here that she's able to continue doing work that I feel is absolutely essential for humankind for people like you

25:08childbirth matters to everybody even if you choose not to have children you've been born and we have to humanize that time and make it less prescriptive and less clinical and less damaging for for people i will continue speaking up and speaking out and supporting others and loving others That's my mission, I guess.

26:05Monday.com AI agents took over my work, and I absolutely love it. Chasing deadlines, writing status reports, updating stakeholders. Agents handle the daily grind now. I stay in the loop only when it matters. Create your own AI agent in minutes on Monday.com. Hello, I'm Monica Reinagle, host of the Nutrition Diva podcast. Summer is here, and with it, the hot and sticky weather. A morning working in the garden, or maybe on the golf course, can leave you more depleted than you realize. and plain water isn't always the most efficient way to restore the balance. That's where Liquid IV comes in. Its science-backed formula is clinically proven to hydrate faster than water alone.

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