Midwifery… what counts? A reflection on a labour ward placement
Siobhan Callaghan [she/her] – First-year student midwife, The University of the West of Scotland
Instagram @siobhan_midwifeinthemaking
Summary
In this blog, first-year midwifery student Siobhan Callaghan, reflects on her last month in placement on a labour ward, discussing her observation that as a student midwives, our value can feel intrinsically linked to the number of births we facilitate, which can lead to feelings of inadequacy. She explores how it would be much more powerful for us to hold on to the compassionate, holistic care of birthing women and people that we have the privilege to give, even if it cannot be measured numerically.
What is in a number?
So much of midwifery education relies on numbers. How many students are on the course? How many weeks in placement? How many miles do we have to travel? And the big question… How many babies have you caught?
At the moment, the magic number ‘40’ seems as elusive as the fabled forty weeks gestation.
Now, don’t get me wrong, it is difficult not to be swept up in these numbers. They become a standard, a measure of what you have achieved and everything you are capable of achieving. However, I think we need to be careful not to let them overshadow all of the positive, yet perhaps unquantifiable, achievements we are making as student midwives. As people.
An issue across disciplines
Numbers, for numbers’ sake, are something I have long struggled with. In my formal career working for the police, we were governed by the dreaded KPIs – Key Performance Indicators. The quantity of tickets that you could produce at the end of each shift was an indication of how hard you had worked. There was no space to consider traumatic events, no count of crimes averted by positive public interaction. I struggled with it then as I do now; why do we need to judge in absolutes? Whether in policing or midwifery, we are in the business of people, humans with complexities far beyond a simple numerical value.
I once spent a policing shift guarding Dumfries House, where HRH The Prince of Wales was in residence. When asked by my Sergeant at the close of my shift for the number of ‘returns’ I had to provide, I replied that I had protected the life of our future king. No harm had befallen him on my watch! I chose to focus on the positive, which arguably has far greater value than the negative. But, regrettably, positivity appears too difficult to quantify, which is a travesty when considering the negativity that maternity services are currently shrouded in.
And yet, despite my better sense, I find myself in this position again, where numbers are the focus. I have spent a month in a labour ward but still have no ‘catches’. I am reminded repeatedly not to worry by well-meaning students and staff that I will get my forty before I qualify. It does not concern me. Of course, I will meet the quota before I graduate, mainly because I simply can’t qualify until I reach that golden number! Ironically, the students trying to encourage me are relieved that they are no longer at zero, and staff on the opposite end of the spectrum have long lost count.
Refocusing
So, let’s not talk about the zero out of forty. Instead, let’s talk about the relationships I have had the chance to build. Let’s talk about the countless laughs, the times I have stroked backs, stroked hair, held hands, held space, been ‘with woman’, dancing the delicate balance between observer and supporter, sharing moments that are lifelong memories for the families I have cared for.
I would like to talk about the information I have been able to share, enabling informed choices and helping women and their families to understand the magic of oxytocin, the brilliance of the uterus and the wonder of breastmilk in an accessible way they haven’t heard before. I want to talk about the births that didn’t go according to plan. The births where I could see the potential trauma and acted instead of reacted, communicating to help families feel empowered and enabling them to maintain some control of the unknown.
Why don’t we talk about the indescribable feeling of being with a woman in moments of fear, of the connection as she looks into your eyes and trusts you implicitly to protect her? The gentle resting of her head on yours as you whisper words of encouragement, reminding her of her strength and your belief in her.
I am interested in the people who leave my care feeling emotionally and physically safe. Those who have avoided the crippling pain of birth trauma because I have listened, been compassionate, and because I genuinely cared. Let us forget the count; let us focus on the gratitude we have for being part of someone’s most precious memories. Let us not forget the privilege of this magnificent job.
Beyond numerical value
If, like me, you unintentionally find yourself questioning your ability based on numbers, remember the smiles, remember that glowing feeling in your heart when you receive words of praise for a job well done. A job you have carried out, overflowing with passion and love. Remember that your worth has no such limitation as mere quantity. Let numbers lose significance; prioritise people, not digits.
Keep smiling, caring, and sharing your compassion with love and integrity, and most importantly, trust in yourself the way those birthing women and people trust you. That’s what really counts.
