Arriving in Oz I joined an agency needing a salary as soon as possible.
First shift was a morning on the postnatal floor of a large public tertiary hospital, old building, no AC, stinking hot 35-degree day, white dress and tights clinging, sweat trickling down my back, working under the whir of multiple fans.
The women and babies were of course familiar, nothing else, paperwork, language, jargon all different and the over-worked midwives treated me like an idiot. I felt like one! Remember thinking “this is awful, ain’t coming back here!”
A full-time job offer in a small private hospital came quickly, i jumped at it, no IDEA what I was walking into. The private maternity system was a huge shock.
Orientation day, “obstetricians, paediatricians, anaesthetists and the women who employ them are our customers.”
Customers? Righto.
The midwives in this hospital welcomed me with open arms … reason I stayed so long … I was a source of entertainment with ma Scottish accent and jargon.
I could see the puzzled wide-eyed looks, what IS she talking about? Guthrie test? Pyrexia? Venflon? Viii … tamin K. Why are the women all grand?
And me trying to work out Oz terminology, “jug’s”of IV fluids, and “grab us a Kylie?” (plastic lined sheet for soaking up bodily fluids) “bub” for baby and instant promotion to “sister” a title in the NHS for the nurse in charge.
Morning breaks outside in the sun, under palm trees, jugs of iced water, coffee from a cafetière, Sao’s, butter, vegemite (🤢) a lifetime away from the crammed messy NHS staff rooms with their vats of powdered Nescafe and cheap-brand digestive biscuits.
In this small place rules were relaxed, staff a bit quirky, one midwife fostered baby possums, often producing a woolly bag from the nether regions of her bosom, teeny furry baby in situ. Kid you not! I’d visions of one falling out onto a placenta! 😩
As per Scotland, babies were lined up in the ward nursery in rows, swaddled tightly, adorned in bulky cloth nappies held on with big metal pins or three pronged plastic grabbers. No metal bowls, warm water, cotton balls for “top and tailing” the bubs? Nope.
Couldn’t get my head around what I was seeing at first, midwife with babe held over a sink, tiny bottom under the running tap , washing meconium off with her gloved hands.
Ok for a puppy in Pet Barn but a newborn baby? Workplace health and safety concerns not at the forefront but of course, this was a private facility, it saved money.
(Insensible losses of time hunting for necessary, locked away supplies in private hospitals is INFURIATING!)
37-38wk elective caesarean babies plucked unceremoniously from their mothers side after a cursory glance and quick cuddle then trundled in a humidicrib back to the nursery to be bathed, swaddled and placed under an overhead heater. The casual separation beggars belief now.
Older doctors with their white shorts and knee high socks looking like they’d come to fix the electrics never mind help women give birth. A world away from the white coated, bow-tie wearing docs in Edinburgh.
And calling DOCTOR’S to “deliver” spontaneously labouring women with straightforward, risk-free pregnancies took some getting used to.
Very different from the NHS system, uncomplicated labour and birth were the midwives domain, doctors called only when things went wrong.
Examination of the newborn, a basic midwifery skill in the UK, paediatricians consulted only if problem or abnormality suspected but here, ( scratches head) women paid CONSULTANT paediatricians to come in DAILY to do these checks.
Couldn’t get my head around it.
The private epidural service though was excellent, anaesthetists always available in a timely manner. One stood out in particular, always cheerful even in the middle of the night, placing epidurals quicker than I’d seen before or since.
Grabbing his own equipment, don’t THINK I saw him with syringe and needle in his mouth like vets in a cow paddock (did he??) gave off a relaxed, done this a million times before vibe. “All done sis!” off he’d go on his cheery way back to bed, woman pain free, me scratching my head, gobsmacked.
Onto the negatives and a disclaimer before I begin this rant.
Currently in 2022 i work in a large public hospital with dedicated, hard working obstetricians, there’s mutual respect and teamwork between us. Their job is hard, hours brutal, skill so necessary when things go wrong (what they train for, managing complications) ultimate responsibility immense, day in day out.
But.
Back in 1995, working in birth-suite alongside these old school private obstetricians as midwife was not enjoyable. All male, most perfectly nice humans but the old-fashioned practices, the interference in normal labour wasn’t nice at all, shocking to me.
Why was I admitting women in the middle of the night, in established labour with no information other than a scribbled note on an A4 sheet of paper?
Blood group? History from previous births?Mental health history? Medical history? Specific wishes? A pregnancy health record?
No info shared, we’d hand over to the doc on the phone then care for them for HOURS before he arrived for the birth.
When he DID arrive, if she’d been in a nice oxytocin zone it would soon be ruined 😫with talking, touching and directing (internally i’d be shouting “would you shut up!”)
Unnecessary episiotomy’s cut on beautifully stretching perineum’s?
Some would request IV pethidine for women screaming in the transition of labour, clearly about to deliver. Knowing pethidine would make them sleepy, not remember the first precious moments of their birth I would challenge, “are you suuure?”
Remember one particularly odious short-wearing- knee-high-socked-doc literally shouting at me to go get it. I did, blinking back tears of rage. Felt like abuse of the woman, and me. It was!
(These days i’d be having words, but back then felt powerless. The new country, the hierarchy, the woman PAYING doctors for this care. I said nothing, internalized all, made plans to leave)
And delivery of the placenta, i was used to active but CAREFUL management, hand resting GENTLY on the umbilicus after the birth, checking for signs of separation. These docs were impatient, their maneuvers brutal causing unnecessary pain, smiling and talking while firmly massaging the uterus, pulling too quickly on the cord, i could hardly look😣
Why was I working here? This was awwwful.
Glimmers of hope from a newer young obstetrician. Woman standing, leaning over the bed, baby imminent. Into the room he came, read it, didn’t bat an eyelid, gamely caught baby while she stood, shoes and shirt soaked in liquor.
Despite the lovely midwifery staff, after a year I couldn’t keep working in this place colluding with the obstetric practise.
Considered options, thought of independent practice, of home-birth midwifery. No kids of my own at the time, full of energy, idealistic, wanting to do the best for women.
Interviewed with a local independent midwife, could have walked into that role without any extra hoop-jumping other than my midwifery registration, gave it serious thought (still have the contract!) but ultimately followed my gut, my institutionalised hospital midwife self couldn’t make the leap (shame)
The local birth centre appealed too but no jobs at the time meant i ended up back where I said i’d never work, the original first – shift – in – Oz – hospital, in a permanent birth-suite role.
From there three years (same hospital) as Clinical Midwife on a midwifery continuity of care (MCOC) team, a government funded pilot study
In this role, the emotional work was magnified, huge highs, huge lows, many great births and outcomes for women, some not so good, me in the trenches with all of them. The responsibility felt huge.
I’m a lover not a fighter and back then just developing a backbone. My natural people-pleasing tendencies were tested by regular necessary confrontations with obstetricians, advocating for women who declined hospital policy intervention.
No supervisor of midwives to debrief with (UK) , working too hard, unprotected hours, not getting the sleep I needed to be sane and happy! After three years I was burnt out, needed to leave.
Vowed never to give myself to a workplace like that again, strong boundaries put up. 14yrs full -time shift work was enough, i was done.
Important question for every healthcare worker. How much of yourself are you willing /able to give to the job? Are you willing to cop the (documented) risks to your health from working night-shift? Don’t let it turn you into a basket case.
After the birth of my own first bub and a years maternity leave I joined the casual midwife/nurse pool (an option in Oz) of a large hospital in my city. Husband worked away on the regular, no family support, this seemed like the only option. 20 yrs later I’m still there, the hospital my work home.
Next, more of the joys, trials and tribulations of three years working as midwife on a MCOC team. I started the job living 10 minutes from the hospital, convenient with shift- work, night duty and on-call. Gave no real thought to the impact of our move a further 30 minute drive out of the city.
Lindsey Crossan Registered Nurse/ Midwife