Bullied out - a midwife's story

Bullied out…a midwife’s journey…

As registration time rolls around again, I am seriously considering not renewing my midwife registration this year. Why? Certainly not by my own choice, but because others decided that I wasn’t good enough. In one breath saying my work was exemplary, but that they just had no place for me – in the midst of a midwife shortage!

We all know the saying – nurses and midwives eat their young. We’ve seen it, we’ve probably experienced it, and I dare say some of us are guilty of it, whether we realise it or not. We may even have tried to fight it. There is plenty of research proving that horizontal violence exists at high levels in healthcare settings. I won’t delve into the specifics of my case, as it is still, after 2 years, being fought. Suffice it to say that not only were my colleagues on the floor involved, but the intimidation and bullying also extended to management at a local and district level, and also to human resources. I followed union advice to the letter…and ended up terminated! As a result, I can no longer work in public health – despite a perfect work record and excellent references. That’s right, I did not have any performance issues, and my case involved an incident outside of work, yet I was still forced out and blacklisted, whilst on maternity leave. All because I fought back and stood up for myself.

What ensued for me personally, after the original incident that set off the “investigation” (and I use that term loosely), was a rollercoaster of emotional turmoil, disbelief, burnout, and a frightening vulnerability that I had never experienced before. I was at the mercy of those around me, and the harder I fought the accusations, the worse things became. You see, I am not one to just lay down and admit to things that just aren’t true, even if it destroys me in the process. To submit to the “findings” and subsequent working conditions would have been a lie, and went against the very fibre of my being. Many people told me to just submit and move on, but if everybody did that, nothing would ever change, and the bullying would just continue. One voice is not going to be a catalyst for systemic change, but maybe my story can create awareness and prevent even one other person going through this. Maybe it will encourage others to speak out – and THEN we can create some real change!

My biggest issue with the whole thing, was that I was never given the chance to properly defend myself. I received a written warning for one of the accusations, which was never even brought up at the one “interview” I was granted in the entire 9 month ordeal. My privacy was invaded, medical records were accessed, appointments changed without my permission - confidentiality was well and truly broken, and yet nobody would even listen to my side. I suffered through suspension, “alternate” duties, being blocked from returning to work after maternity leave, AND blocked from working in another local facility – all with an unblemished work record! I even moved 600km on the promise of a midwifery job, only to arrive and have HR put the kibosh on that, despite being in a completely different health district. So here I was, in a town where I knew nobody, broke, isolated and unable to work. Because other people, many of whom have never even spoken to me, let alone met me face to face, decided that I was dangerous. Yes, that is the word they used. Dangerous to patient care because I stood up for myself.

Dangerous? Far out. I have dealt with the end result of dangerous practice. I valued my registration too much to be dangerous! I annoyed doctors if I thought even the slightest thing was not right.  I got that “dangerous”  label because I fought back. I said no, I was not going to submit to unproven accusations, I wouldn’t agree to a lie. I would not comply with a “voluntary” mediation process that would have destroyed my already fragile mental health. And for that my career was  crucified.

The dark road that I walked is not one that I would wish on anybody. To this day I still do not understand much of what I was accused of. I never saw any of the “evidence” against me, despite asking for it, as I am legally entitled to do. I completely lost myself. I lost my desire to work as a midwife, even after working so hard to attain it. I questioned everything about myself – and I doubted everything . I lost valued friendships. I struggled to enjoy my pregnancy and to bond with my baby when he was born. I lost my income, and being the breadwinner, this put my children at risk. My mental health declined to the point that I could not function, and with a new baby on the way, this was even more disastrous. I did not sleep more than 3 hours a night since it all began, and the anxiety was so bad I couldn’t even answer the phone or my front door. I became a prisoner of my own mind. My children suffered immensely, in particular my autistic child.

So where to now? I no longer work as a midwife. I work in a nursing home. It’s a good recovery job, I enjoy working with the residents, and it encompasses my other passion of palliative care. But obviously it isn’t my first passion. I gained my nursing degree in order to continue on to be a midwife – and right now I am glad I chose to get a nursing degree first be ca  it meant that I could still get a job! It feels as though all the time and effort to first qualify as a midwife, and then to gain my Master of Midwifery degree, were wasted (and anyone who’s done the RN to RM year knows just how tough it is!). I am obviously in danger of losing my midwife registration if I cannot work as a midwife. I could go into private practice but I don’t have the recency of practice to upgrade my registration, and I don’t know if I have the heart for it now.

From my perspective, the system is set up to defend the multi-level bullying and intimidation, with the bullies free to continue their lives and careers. And I am not alone. There are many more stories like mine out there. Passionate, skilled nurses and midwives who have given up their careers after they couldn’t take any more. Ridiculous investigations that are not conducted by qualified people, and set the victim up to fail. New graduates who don’t even last the year before giving up – what a waste! (I endured plenty during my grad year, but I was able to tough it out.) We need change. We need it now. In a system that is crying out for skilled nurses and midwives, why do we keep pushing them away? I can’t believe that the health system would invest a lot of time and money into so many people, only to destroy them. It’s counter-intuitive.

The best advice I can give is to go in with your eyes wide open. Make those diaries, every day, and don’t be afraid to speak up at the slightest hint of trouble. Don’t let the shortcomings of others dim your fire. Be the sort of nurse or midwife that you would look up to and respect, that others can look up to. Lead by example. Speak up for yourself and others, because nobody else will. Maybe if we all start to speak up, change will happen – but always be aware that the system will not protect you. I had to learn that the hard way.

"Whatever the doctor says" - are us women our own worst enemies? A discussion on woman-centred care.

Too many times I have heard women say "I'll just do whatever the doctor tells me." I have been shut down by a woman in labour screaming this very phrase, despite the doctor straying completely from established guidelines - end result, caesarean with massive complications that almost resulted in a dead mother. With all my training and knowledge and instinct screaming at me that this course of action was wrong, being a professional, I had to listen to the woman and follow her wishes. While I understand the thinking that the doctor has all the training and experience, what the doctor does not know is YOU. They do not know your individual body. They do not know your instincts. Yet so many women just give up their autonomous adult status when it comes to maternity care. This makes no sense!

Women are autonomous adults, capable of making their own decisions. We know our bodies! We are the ones carrying that precious baby 24/7, and know what's normal for our baby and when things don't feel right. It is a health professionals job to advise options, and the risks and benefits of each, so their client can make their own decision. The woman should be her own lead carer, and she should decide which models of care suit her, her baby and her family. There is a HUGE body of evidence supporting woman-centred care. In my opinion, it is the ultimate goal of good maternity care. So why is it so inaccessible? It's not money, because all the evidence states that midwife-led care is cheaper, both short and long term.

Patriarchy. The entire medical system is based on a patriarchal model, where initially only men could be doctors and women (nurses) were handmaidens. The doctor was God, basically. It's the same reason that women's medical conditions are often ignored, and women's pain dismissed. The same reason that removal of the uterus is called "hysterectomy" - women are prone to hysterics and removal of her female organs will fix that. Imagine if we started doing that to men! Society is overmedicalised as a whole, but maternity care has to be the very worst. We have moved on somewhat from the doctor/handmaiden situation, but the system still runs on the patriarchal hierarchy that it was founded on.

But do women perpetuate this? We are socialised to the patriarchy, and often defend it. What is it that causes women to just give in to someone else's wishes, even when it doesn't feel right? I often hear women say things like "the doctor won't let me" as if they are children that require permission for everything. They allow the doctor to make the decisions. They spout the rhetoric that a healthy baby is all that matters. And if they refuse what the doctor says, they are ridiculed and coerced, often with the dead baby speech. And that's if they even realise that they can refuse! Many times I have had women tell me that they are unsure about an intervention, and when I tell them that they can decline, or ask for further information, they look at me with such bewilderment! Women are not afforded the right to informed consent. If you even mention the term "birth experience" you are branded selfish and risking your baby's life - mostly by OTHER WOMEN. But the evidence shows that the much-maligned birth experience actually makes birth safer.

Women spend our entire lives being told what to do with our bodies. Fashion choices, personal grooming regimens, what size we should be, etc etc. Girls are socialised to wear pink, be "good girls" and do what they are told. Pregnancy brings a whole new list of "rules" to abide by. Our biological functions have been reduced to a set of policies and procedures endorsed by the "system" that recognises only specific ideas of femininity and masculinity. Maternity care has become a production line. We are ignored, coerced, disrespected and humiliated in the name of "morality" and "safety," when the evidence says otherwise. The science is ignored to make way for fear mongering and control.

This will only end when we stand up and make it end. Women are the guardians of birth, not doctors. We need to say enough is enough. A healthy baby is not all that matters. No woman would ever knowingly risk her baby's life! We are the guardian of our baby, it grows inside us, but this does not make a woman an empty vessel for the purpose of a healthy baby. She is still a woman, with the right to make her own decisions with all the information given to her in a non biased fashion. Do we just give up if someone told us we were "not allowed" to get our driver's license because we might have an accident one day? No! Women need to stand up and take back our birthing rights. We need to demand the respect we deserve. We need to demand transparency and accountability in the care we receive. We need to be heard when we suffer birth trauma, listened to without fear of ridicule.

Women are not inferior. Our bodies are not defective. We need to stand together to fight the violations to our autonomy that continue to harm women. And we need to start with ourselves, for it is women that perpetuate the standard of care that we accept.

Your experience is not her experience

Following on from my clickbait post, I was reading another blog today, written by a woman who suffered birth trauma, and severe PTSD. She was still struggling 4 years down the track.

Cue the ill-informed comments. I couldn't count the times I saw "you got a healthy baby, that's all that matters" or "get over it/suck it up." None of this helps, in fact it makes women feel worse because they then think there is something wrong with how they feel.

 Then there were the women saying that they went through a similar experience and are fine. Well, that's good, for them. But remember, your experience is YOUR experience, not hers. YOU WERE NOT THERE. You have no right to assume that because you are happy with how your birth turned out, another woman should feel the same. She is not you.

And then there are the "so many women can't even have a baby and you're complaining about your birth not going to plan" comments. IRRELEVANT. Infertility and birth trauma have nothing to do with each other. Invalidating a woman's experience because you think she should be grateful that she got a baby is wrong, and does not help the situation. Both are equally valid situations, that can and do cause distress.

Psychological injury is as real as physical injury. It can debilitate a woman, to the point where she struggles to look after her baby. I find it particularly sad that the woman above was still having a rough time 4 years later. It is deplorable that she felt so isolated and judged that she could not seek support from other women - but I can see why. The internet has a lot to answer for, I believe. So many poorly informed and judgemental voices, hiding behind the security of keyboard anonymity. We would be better off supporting women through whatever rough stuff comes their way. It's amazing just how much a simple listening ear will help.

Please...avoid the click bait!

Yesterday, I read a post all about how we should stop telling women not to have epidurals. The writer followed with a rant clearly based on personal experience, and clearly lacking in evidence and understanding, even going so far as to claim that epidurals are perfectly safe. Then, of course, all the super defensive comments about who had an epidural, who didn't, and all the gory details of their personal experiences, and the judgements...oh, the judgements! Everybody knows what everybody else should do! Well, guess what? Everybody else is not you, and can make their own choices!

(ETA: The writer of the abovementioned article is not a birthing or medical professional.)

These articles are becoming commonplace, whether the topic be epidurals, caesareans, breastfeeding, bottlefeeding etc etc - all they do is add fuel to the "mummy wars" that are so prevalent these days. They are designed only to gather pageviews, and certainly not to provide unbiased, accurate information. Not to mention the ridiculous headlines designed to suck you in.

As a midwife, I advocate for normal birth. But as a midwife, I also advocate for women's choice, and facilitate that choice by providing information on the risks and benefits of the available choices. I would be negligent if I did not offer all the information. Epidurals do indeed have risks, as do any other interventions, no matter how benign they may seem. Thankfully, most of the time everyone is fine, but women do need to know that they aren't "perfectly safe." It is not our place to be telling women what they should or should not choose for their own birthing experience. We can make recommendations, we can share our knowledge, but we cannot influence or decide for her.

If you want an epidural, ask for one. If you don't want one, don't ask for one. If you are determined one way or the other but change your mind during labour, that's okay! But please, avoid the clickbait. These inflammatory articles don't help anyone. They just perpetuate the fear and control of women that infiltrates modern medical childbirth. Talk to your care provider, they will help you decide what's right for you, not some random article on the internet.

Scream all you like ladies!

I was reading this post after it appeared in my facebook feed, and it got me thinking. It is absolutely correct in that there are innumerable ways for women to labour and birth, and finding what suits you is as individual as your fingerprint. It then goes on to talk about women feeling that they have to be quiet once in the hospital birthing room - and whether we as birth professionals perpetuate this.

I have seen it in my own practice - women can and do feel self-conscious about the sounds they make. I am often asked if the room is soundproofed, to which I usually reply "no, but if people don't like it they don't have to listen" or something to that effect. Social conditioning is difficult to overcome, even when our body is giving signals that we can't ignore. Some women get into "the zone" and are quiet, others are moderately noisy, and others will bellow and howl and shake the walls with their noise. And they are ALL fine!

Women do best if they can let go of their conscious self during labour, and allow their instincts to take over. Some women are better at this than others. The worry about screaming and yelling is all part of our decorous self not easily giving in to our primal self. We see the "animal" part of us during labour, and it isn't always what we expect or want from ourselves. But it is there and is an essential part of who we are.

Partners and support people also find vocalisations difficult to bear. They can see that their loved one is in pain, or struggling to cope, or ready to give up - but feel powerless. I have seen many women try to cover up their instinctual reactions for the benefit of their support people. It's in the nature of many women to do this.

So for me as a midwife, all I can say is this: SCREAM IF YOU WANT TO! Let it all out. Labour is about YOU and nobody else, so do what you need to do.

The endless debate. Make it stop!

Of course "breast is best." It's normal. But what do you do when it doesn't work? Valiantly try to soldier on because it is expected, becoming more and more stressed and anxious as the days go by, or do you face the wrath of the breastapo and bottle feed?

Well guess what? It is YOUR BABY and YOUR CHOICE!

For me personally, I can't understand why a woman who IS capable of breastfeeding would go to the expense and extra work of formula feeding. The stuff is expensive, even more so when you take into account buying all the equipment that goes with it. And then there's the extra washing up! But each to their own. In Australia today, infant formula is a safe and acceptable way to feed babies. Breast is best is the catchcry, but that doesn't mean formula is worst.

Another thing I don't understand, is that as soon as anyone mentions infant feeding, super defensive comments from both sides appear, and the arguments start. Why do we do this to ourselves?! It makes no difference to any of us that another woman chose something different for her baby. There is no point to prove here. Mind your own business and concentrate on yourself.

And never, ever feed your baby in public. If you breastfeed a baby in public, you are an exhibitionist flashing yourself for attention, or a filthy grub who should go and hide in a toilet to do that disgusting thing! If you whip out a bottle, you are a terrible, selfish mother who obviously doesn't have her child's best interests at heart because you chose that evil formula. Whichever way you feed, you are the subject of ridicule.

Women! STOP. Just stop this crap. And make sure your partners do to. This feeding war is not doing anyone any favours, least of all our babies. The risks and benefits of both methods are well known, and easy to find. Make your choice based on those, and what works best for you and your child, and don't let anyone bring you down.

Make your decision and own it. It's nobody else's business.

Hello, and welcome to my new blog!

Select Midwifery is all about choice. Sadly, in Australian maternity care, choice is often lacking. Women often end up in the production line, one-size-fits-all approach, especially in rural areas. We need to stand up and change this, because every woman and every baby are different!

Having experienced "the system" as both a consumer and a midwife, the blog may reflect either, or both, of these perspectives. I hope to also include guest bloggers from time to time, so please feel free to contact me if you have something to share that is related to pregnancy and babies.

Please enjoy my blog!