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, an old building, with no AC, a stinking hot 35-degree day, white dress and tights clinging as I worked under the whir of multiple fans, sweat trickling down my back.
The women and babies familiar territory but 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 with 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. I was a source of entertainment with ma Scottish accent and jargon. 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?
I had to get used to the 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 were outside in the sun, sitting under palm trees with jugs of iced water, cafetiere coffee, Sao’s, butter and vegemite (🤢) a lifetime away from the crammed messy NHS staff rooms with the vats of powdered Nescafe, and digestive biscuits.
In this small place rules were relaxed, staff a bit quirky, one of them fostered baby possums often producing a bag from the nether regions of her bra, displaying teeny furry baby in situ, kid you not!! 😆 Had visions of one falling out on the bed along with 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 actual pins or three pronged plastic grabbers. No metal bowls of warm water and cotton balls for “top and tailing” these ‘bubs.”
Instead couldn’t get my head around what I was witnessing here? A midwife with babe dangled casually (but securely) in one arm holding it over a sink, tiny bottom under the running tap , washing meconium off with gloved hands.
Maybe okay for washing a puppy in Pet Barn, but a precious newborn? Eeek! Workplace health and safety concerns not at the forefront and more importantly, it saved money!
(The insensible loss of time hunting for necessary supplies in private hospitals is INFURIATING)
37-38wk elective caesarean babies plucked unceremoniously from their mothers after a cursory glance and a quick cuddle then trundled in a humidicrib back to the nursery to be bathed, swaddled and placed under an overhead heater. This casual separation beggars belief now.
The older doctors with their white shorts and knee high socks looked 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” women with straightforward, risk-free pregnancies and spontaneous labour took some getting used to.
Very different from the NHS system where uncomplicated labour and birth were the midwives domain, doctors called only when things went wrong.
Examination of the newborn is a basic midwifery skill in the UK, paediatricians consulted 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 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??) but he gave off a relaxed, done this a million times before vibe. “All done sis!” and off he’d go on his cheery way back to bed, the 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, the hours brutal, ultimate responsibility is immense managing obstetric complications day in day out.
But
Back in 1995, working in the birth-suite alongside ( some) of these old school private obstetricians as midwife was not enjoyable. All were 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 sure?”
Remember one particularly odious doc literally shouting at me to go get it. I did, blinking back tears of rage.
(These days i’d be having words with anyone who spoke to me like that but back then felt powerless. My relatively junior status, the new country, the hierarchy, the fact that the woman herself was paying this doctor, meant 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 baby was born checking for signs of separation. These docs were often impatient, their maneuvers brutal causing unnecessary pain, firm massaging of the uterus, pulling too quickly on the cord, i could hardly look😣
What was I doing working here? This was awful.
Glimmers of hope from a newer young obstetrician, a woman standing, leaning over the bed, baby imminent, he came into the room, didn’t bat an eyelid and gamely caught baby while she stood, his 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.
Considering options I 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 lack of vacancies 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 of midwifing 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 the 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 work like that again, develop boundaries, find a way to stop shift – work, 14yrs full – time was enough, i was done.
An important question every healthcare worker needs to ask regularly. How much of yourself are you willing /able to give to this job? Don’t let it turn you into a basket case.
After the birth of my own little 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 and with no family support, this seemed like the only option. 20 yrs later I’m still there, that hospital is my work home.
Next, more about the joys, trials and tribulations of those three years working as midwife in the MCOC team.
Lindsey Crossan Registered Nurse/ Midwife
Learning to be a midwife 1980’s Scotland