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The Many Pressures Midwives Face

It is no secret that the job of a midwife can be highly stressful, providing care and support for women and their families during what can be extremely tense, difficult, even frightening times. Add to this incredibly busy, often frantic working environments, and the role becomes all the more demanding. While the job can be greatly rewarding - perhaps the most satisfying there is - there can be little doubt that midwives are under major pressure to deliver in a role that will always be of the utmost importance.

The duties required of a midwife on an almost daily basis, such as providing care, support and education, and not to mention either helping with or actually conducting the delivery of a baby, are challenging enough. However, there are other pressures, perhaps less immediately obvious, that can make the role even more difficult.

Increasing birth rate and understaffing

Perhaps the biggest issue facing midwives, and one that has been well documented in the press, is the struggle of hospitals and other units to deal with the sheer number of births due to an increasing birth rate and understaffing. While the profession of midwife remains attractive to many, there are others who find the long, emotionally-draining hours too much to bear. Many either wish to, or have already, left the job, while other would-be midwives are deterred for the same reason.

It means that midwives are usually extremely busy during a shift, often caring for numerous women at any one time, unable to provide the one-to-one support they want to give. Should an expectant mother perceive a midwife to be rushed off their feet, there is a danger this might unsettle the patient and cause them to panic, in turn requiring more work from the midwife.

Those in the profession often work very long days of around 12 hours or more. These shifts are often hectic and involve the delivery of many different babies. Each birth can potentially have its own complications and may require different levels of support for both the mother and her family. Childbirth happens round-the-clock, there is no single time when everyone can finish for the day and head home, and many reception and phone services now operate 24/7 to cope with increasing demand.

Emotional challenges

The birth of a child is a highly-charged, emotional affair. Most of the time, a birth is a hugely joyous, loving occasion that will always be remembered by the mother, father and other members of the family present. Unfortunately, there are other times when complications arise, some of which can be truly devastating. While it is the role of the midwife to provide care and support at such times - and they are trained to deal with such scenarios - it would be inhumane to expect them not to be affected by tragedies of this type.

For instance, a stillbirth can be hugely upsetting for all involved. Undoubtedly, it is a devastating scenario for all of the family, and yet the midwife is required to maintain their professionalism throughout. Indeed, it can be at such times that families require the care and support of a midwife the most.

Difficulties with the mother

Often, the mother's health and personality can cause particular challenges. For instance, one increasing problem is the rise in obesity. If a woman is considerably overweight, it is much more difficult to conduct scans and can mean the mother is at greater risk of gestational diabetes and more likely to have a stillbirth or require a C-section delivery.

Issues can also arise if the woman has any other underlying medical conditions or mental health problems. If she cannot speak English, this makes it extremely difficult to converse, to relay instructions and to offer calming words - all vital parts of a midwife's role. If a woman is of a certain age, such as over 35, or particularly over 40, this can carry extra risk that the baby may be born with a chromosomal disorder. With many women marrying later, or remarrying following divorce, this particular problem could be set to escalate.

Each of these issues serve to make a midwife's role more difficult because such patients require more care and resources and, ultimately, more time. Also, many women today have higher expectations of the care they could and should receive, and of any drugs or treatment to which they are entitled.

The impact

With so many challenges facing midwives, and not to mention other responsibilities such as mounting paperwork, record keeping, supervising, training and indeed developing professionally to to progress their own careers, it can be no surprise that midwives are often rushed off their feet. One consequence is an inability to deliver the high standard of care for which they strive, another may be serious errors of judgement.

Given the seriousness of the situations in which midwives operate, any mistakes can have very serious consequences for either mother or baby, or both. An obvious solution to dealing with birth rate increases and midwife understaffing is to hire more midwives. But are there enough people out there now willing to perform this necessary role, and, if so, will hospitals and other units be able to afford to take on the required number?

This all remains to be seen. In the meantime, it is not only safe to assume that midwives will continue to be rushed, stressed and under mounting pressure as they perform their essential role, but that mistakes will continue to be made unless something changes soon.


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