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confessions of a pragmatic midwife stuck between the NHS and a hard place

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Your entitled moaning may be entirely appropriate

Posted on November 5, 2018November 16, 2018 by Talia Ripley

“I know it’s not your fault  but it’s just that I really have a thing about waiting, It makes me really stressed. We’ve been waiting for hours now. If the doctors think it’s so important for me to be induced why have we been waiting for so long.”

There is no way on earth I can give her a complete answer on that. I could approach it with a  general discussion about the powering down of the NHS since austerity set in but I consciously avoid making myself too knowledgeable about that on the grounds that it’s too fucking depressing.

I could explain about the general principle of prioritising care. How there are women who have needed urgent medical reviews about their conditions, women who would rapidly become very ill if they didn’t take their medication on time, women who appeared to be already in full blown labour so if I didn’t check in on them risked delivering their baby on the antenatal bay. But who wants to be told that in the grand scheme of things the induction of their first born child is actually pretty unimportant?

I could tell her about the sad story of a woman sitting about ten feet away from her. The doctors suspect her of wasting everyone’s time with a non-specific abdominal pain that no scans or tests can find a cause for. How she has a folder of paperwork detailing the abuse that she had to deal with as a child and how she has subsequently been judged unable to look after her own children and had two of them removed. How when I managed to give her a few minutes of my time to just talk a little generally about how she was feeling she suddenly said, “Thanks for listening to me, I find it hard to tell people when I’m in pain because of when my father broke all the fingers in my hand once for complaining.” I couldn’t really just immediately bugger off to answer the phone at that point. But I think discussing that might have just been a tiny violation of confidentiality.

I could tell her that at least she will begin her induction today, unlike the woman who came all the way into hospital earlier to be told that her induction would have to be put off for another 2 days as we didn’t have bed space to accommodate her. I had to explain that being unable to walk 20 metres without excruciating pain from her hips that had loosened inappropriately due to the hormones of pregnancy just wasn’t a good enough reason to be induced today. You really needed a baby that had decided to stop growing, or maybe a placenta that getting geriatrically old. But this woman in front of me wasn’t really even that keen on her own baby being induced – not enough to actually refuse the induction but definitely enough to feel unhappy about it.

I could have just wallowed in self-pity and told her how I hadn’t eaten or drunk anything for just over ten hours. How although I had gone past the point of actually feeling hungry some time ago, I know I probably needed to have some sustenance soon as I was just beginning to feel the prickle of tears behind my eyes. I’ve been working in the hospital for too long to cry just because of a slightly grumpy women. It only happens now when my blood sugars are laughably low.

But why the hell should this poor woman have any of this crap thrown at her? She was genuinely anxious about the decision to induce her baby. The doctors had almost certainly used mildly manipulative language and she was now worried that she had made a mistake in going along with their recommendation. She was going to start what can be a long and difficult process of induction what would almost certainly put her in pain, and her vagina was soon to be poked and prodded in a way that was in no sense fun. When she talked about being stressed she probably wasn’t exaggerating and someone with her reasonable enough need for control is always going to be at a higher risk of postnatal depression, potentially even PTSD. She also couldn’t help being middle class, and if I was going to have a problem about the entitlement of the middle classes I should really start by looking in the fucking mirror first.

So I took a deep breath, made the best, more sincere eye contact I could and said, “I’m so sorry, I know it must be very difficult for you. I can only apologise that due to the activity on the ward I just haven’t been able to start things sooner,” I smiled again and tried to sound a tad more upbeat, “Let’s start monitoring this little one shall we and while we are doing that I can explain all about what we are going to do…”

God I’m such an insincere bitch.

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Rabbits in SwitzerlandMy novel Rabbits in Switzerland (co-authored with Ethan Crane), based on many of the real-life events from this blog, is now published. Available here (read a free extract here).

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