AIBU to think I am being forced out of midwifery?

[ThisMustBeMyDream]

I've been a midwife for 12 years. I have a wealth of experience and skills.
But I am also a single parent (not through choice).
I have no family support. Ex husband doesn't involve himself with the children.
I'm in so much debt from paying for a Nanny so I can keep on working.
I can't do it anymore.
Work won't help.
I feel absolutely lost and distraught that for 12 years, I have fought hard to make this work (I was a teenage mum when I started my training). And now I can feel it slipping out of my fingers.
All I wanted was to work as a community midwife so I can use regular childcare. But no, this can not be accomodated due to the government deciding 80% of women should have continuity of carer (Better Births recommendation, which was then used in the NHS Long Term Plan). The traditional community model is going to go to a caseloading model which involves community days, along side hospital shift work. My employer has stated even if I could do the caseloading model, I can not stay part time either (I am currently part time as I have 3 children to manage, and one has additional needs).
These changes are allegedly happening in all Trusts as a result.
I'm going to lose my career. What the hell am I going to do?

Another midwife here who has just finished a 12.5hr shift with no break as not enough staff and too busy. Stayed on an extra hour to be with my lady at birth of her baby. We only met each other last night at 7pm but over the 13.5hrs we were together we built up a rapport and no way was I going to leave her at the last hurdle. She couldn't have given a monkey's that she had never met me before last night and was so grateful I stayed to assist her birth her baby.
Our trust also pushing for COC teams to be set up. I've only 3-4 years left till I retire but a lot of the younger midwives with children are already looking to do something else as unable to commit to 3-4 on calls a week.

We are already short of midwives but it seems this government is oblivious to this as no bursary now so the numbers of applications have fallen especially amongst the more mature students.

I have been a labour ward midwife for over 25 years so if they want me to work in community they would have to retrain me in what they do and vice versa for our community staff to work in labour ward with high risk cases.
I really feel for you OP I am in a lucky position that I can just retire if they try to push me out to COC team but lots of younger midwives don't have this option.

I personally think women need good continuity antenatally and postnatally but during intrapartum care all that is required is a caring and competent midwife. For the vast majority of women this is what they want.
I cannot see how they are going to fund this as we will all need cars and equipment. They cannot make you use your own car and for some who car share with partner or don't have a car this is not an option anyway. They tried to do this year's ago and it failed as too expensive. Proud to work in the NHS but each government seems hell bent on wrecking it and making life impossible for those working in it. I will always do my best for the women in my care but we have lives and families too.

Gold standard service being fudged together on a shoe-string budget. That’s the bottom line.

Currently the service works/stays safe due to the good will of midwives going above and beyond every day to stay late, be there for women, forgo breaks, log incidents etc. This good will and energy is about to disappear by forcing the square peg of CoC into the round hole of our current workforce, the vast majority of whom are part time (due to the level of unsociable hours) and have families of different shapes and forms.

CoC is being (I think) set up to fail where I am. I’ve been asked to do more on calls than my contracts stipulates. 3-4 oncalls a week makes my blood run cold. I’ve said no. Am a LP with a child with SN. If could do those oncalls I’d be on a contract with more hours. I have refused to do more than my contract states. Very glad to be a member of Unison, not RCM, right now. I feel for you, OP. I don’t know where NHS CoC lead midwifery. Over the precipice maybe. Sad for everyone.

ThisMustBeMyDream
This is terrible! I am so sorry! And angry! And the country is short of Midwives, yet is forcing out a very dedicated career Midwife with huge experience! [shocked]
I think it is time for a letter to your MP.
And time for a Mumsnet Petition - not sure how we could arrange this or if MN does this (I would understand if not) but if necessary, could we somehow independently get a petition together of those of us who see the damage this Government Proposal is doing and that it is not working and is losing good Midwives against their wishes?
How shall we start?
Do not give up. Never. All my thoughts and prayers are with you. Elle

I’m not sure a MN petition would have enough support . Maybe I’m too cynical but look at all the threads about maternity care on here. IME the majority don’t have much support for midwives, I see (and hear IRL) a lot of complaints about wanting COC and in fact the same midwife all the way though, plus people complaining about staff pay and conditions get told to suck it up as that is the job. I hope I’m wrong. It’s nice to see some support on this thread though.

I also tried to get a MN petition off the ground about something completely unrelated to this and couldn’t do it; I found it surprisingly hard. Can’t hurt to try though.

I find it interesting that there is a thread on here atm about someone being asked to work a 24 hour day just once where posters are saying it is crazy, impossible, unsafe for driving etc. Yet as a society we are happy for our HCP to do it regularly .

icannotremember. I agree with you! I had three very different delivery experiences. But all that mattered was having a good Midwife. One that was not exhausted! I think every mother would agree with this! I can imagine the survey the Govt did when getting their data in order to devise this system. They would have worded the questions in such a way as to make it sound as if it were easily possible for thee same Midwife to see you right through. They would not have explained that this would mean she would be under immense pressure, often to the point of making her life impossible. I did a lot of Post Graduate research and I know that how you ask a question will influence the reply. Of course the women said "they wanted that" regarding the CoC plan! They were not given the full story or they would have said "no - it isn't workable." If asked "At delivery, would you like the CoC Midwife even if your Midwife was exhausted, in preference to a Midwife you had only just met who was awake and alert? What would the majority have answered?

TooStressyForMyOwnGood That's very sad to hear, but you are wise to be realistic. I can't imagine how anybody can be so horrible about working conditions of this kind for a dedicated Midwife. But you are right, there are people who are just selfish. Or even who had a bad experience wit a bad Midwife, because it can happen, as I know with my third delivery.
BUT!
What if all those of us who care were to cut and paste the parts of replies and the OP's letter and - email our MP, asking him/her to take this up with Matt Hancock MP, Secretary of State for Health and Social Care?

It's quite easy. Google who is my MP and how to contact.

Please everyone write to your MP ask them to contact Matt Hancock, The Health Minister

Ellyess, yes it is clear that many (most?) people just answer the question rather than thinking about it critically then answering.

I’m happy to write to my MP. It’s been at least two minutes since he’s heard one of my rants on health and education .

What is everyone else saying/doing, you can't be the only one affected by the new system? Contact Union as it seems like unfair treatment to change your working conditions so radically without there being Union involvement.

Write to www.linkedin.com/in/james-kent-162b7418/?originalSubdomain=uk

Ellyess - I agree with your mistrust of surveys. Probably designed by junior management consultants just out of Oxbridge. Or perhaps by someone used to asking consumers whether they prefer their washing up liquid to be orange or green.

I sympathise with you... but the problem is all the midwives want the same thing - shifts at times you can easily access childcare, predictability etc. However.... pregnant ladies go in to labour or have problems requiring hospitalisation etc 24 hours a day, 7 days a week. I would have expected this was known when you joined the job (although I appreciate if roles are changing this is difficult).

From the patients perspective, when I was pregnant with DS the local community MW only worked part time and it was a nightmare, either I saw someone I had never met before who knew none of my history, or I struggled to get appointments with my own MW who was only in 2 days a week. Fine for the MW, not so good for the patient.

as a follow up, I do agree that there aren't enough midwives. but I think sometimes people in the health service don't realise lots of jobs/career paths simply don't allow any part time working and don't allow flexible hours etc. These issues around childcare etc affect us all.

There is a bit of an issue with PT working in the NHS and it probably needs to move to a model of fewer PT workers.

Everybody!
I've emailed my MP. You can only write to your MP in whose Constituency you live - or so I understand, but you can ask them to take up a subject with the appropriate Minister. I sent an email along these lines:
to [email protected]
Subject: Midwives being reluctantly forced to leave

Dear

Although you (are very busy - or words appropriate to their activities, I mentioned something my MP is involved with) at this time, please may I ask you to take a moment to speak to Matt Hancock MP, Secretary of State for Health and Social Care about the serious problem I outline below?

It was directed to me via a question addressed to MumsNet. It concerns the new CoC plan for Midwives. I have promised to do what I can to help find a solution for them regarding the unworkable hours this new plan has placed before them. It has affected, in the main, those Midwives who have children of their own and need regular hours or dependable hours. The best way I can explain it is if I cut and paste the plea written by the original Poster on MumsNet and then a few replies which may explain their dilemma.

I do hope the Minister takes their predicament to heart and puts in place some arrangements to cover their needs. We simply cannot afford to lose good experienced Midwives and neither must we turn away applicants for this calling.

Here are the Posts from MumsNet:

The Original Post, Sunday 27th January, says:

I am being forced out of midwifery
I've been a midwife for 12 years. I have a wealth of experience and skills.
But I am also a single parent (not through choice).
I have no family support. Ex husband doesn't involve himself with the children.
I'm in so much debt from paying for a Nanny so I can keep on working.
I can't do it anymore.
Work won't help.
I feel absolutely lost and distraught that for 12 years, I have fought hard to make this work (I was a teenage mum when I started my training). And now I can feel it slipping out of my fingers.
All I wanted was to work as a community midwife so I can use regular childcare. But no, this can not be accomodated due to the government deciding 80% of women should have continuity of carer (Better Births recommendation, which was then used in the NHS Long Term Plan). The traditional community model is going to go to a caseloading model which involves community days, along side hospital shift work. My employer has stated even if I could do the caseloading model, I can not stay part time either (I am currently part time as I have 3 children to manage, and one has additional needs).
These changes are allegedly happening in all Trusts as a result.
I'm going to lose my career. What the hell am I going to do?

Another Post says:
I chose one about the service works/stays safe due to the good will of midwives CoC making life impossible for Mdwives

Another Post says: I put in one re. Mwive's staying on at end of shift/not meeting mother until delivery but that works fine etc.

Another post says: one about already short of midwives and no bursary now so the numbers of applications have fallen

Another Post says: one about how mothers will get worse care and midwives will leave

Another Post says:
I chose one about how it was unworkable financially as well as for the Midwives

Another Post says: I chose one about the CoC seeming to be chosen by mums but said they didn't know their Midwife would be exhausted.

I hope these letters to Mumsnet give a good description of the problem. As we know, most people just give up and get another job. There are indeed many people on this mumsnet feed suggesting alternative jobs for the Midwife since the Government’s CoC model is forcing her out of her job.

I am not nor have ever been a Midwife. My last post was as a NeuroPsychologist in which I did a lot of Research.

I do hope you can help these Midwives. As you can see, the one who started asking for help is dedicated to her job. We must not lose Midwives like her.

With thanks,
Yours sincerely
My/your name
My/your address (must add)

It is perfectly possible to organise teams of health care staff even if all the team members work part time.
Some people want to work nights, some want to work weekends.
I worked with a colleague who could only do 1 ten hour shift a week. She made a valuable contribution. After I changed jobs I still came back and did a 12 hour NHS shift every Saturday night. I don't recall anyone telling me not to bother.
This nonsense is about poor planning and management.
Same old same old about the people in charge having no idea what the people doing the work actually do.
I managed an entire community service with part time staff.

PS I cut an pasted the posts I quoted onto a Word file so I could just copy them all in one go onto my email. Sorry if I'm stating the obvious! I remember a time when I hadn't thought of that! Maybe I'm particularly dim!

endoftheline Continuity of Care does matter to most people though.

I don’t think everyone does want the same thing. I prefer to work nights, suits my body rhythm better, the idea of going into work 5 days a week mon-fri office hours is my idea of hell. I’m not permitted to do permanent nights because ‘everyone must work a mixture of days and nights’. I have colleagues who prefer working at the weekend as that is when childcare is easier for them. But they can’t because everyone must do their share of weekends and week days. Likewise there are those who the usual model of mon-fri works best for. It’s undair to say that everyone wants the same and you can’t have it so tough. Everyone wants something different, and actually there probably are ways of working around but they won’t be implemented. COC is just an extension of that. Staff being forced into ways of working that just aren’t compatible with their situation nor the situation of the trust. But hey ho. It’s what the government have mandated so it’s what has to happen.

It’s not in general cost effective to use PT workers. Fair enough if HCPs want to work PT when their DC are very young in order to maintain their skills, but PT workers are a less good ROI in training.

I have to say that my GP that's Doctor not Grand parent! was part time and it was very hard to get an appointment with her. She was often booked up for as long as they took bookings so they wouldn't even give you a booking! I gave up and went to a full time GP and of course that one happens to be a man! I'm still a bit happier to see a woman if it's a "lady problem" though. Just hoping I don't get any (lady probs). But we need to organise part-time work - in general, and for women with children especially. Great to hear what endofthelinefinally says!

And whilst COC undoubtedly does matter to some people, does it matter more than safe care? Because I can genuinely see that being the trade off. And that doesn’t sit will with me.

TooStressyForMyOwnGood. I love you!

Yes I also moved practices because the only female GP worked 2 days a week and was impossible to see.

Can you create a room in your house for an au pair? Either by putting kids in one room? Converting a dining room? Or could you move to a house with an extra room? Au pairs are much cheaper than nanny's, you could work shifts, they are much better support at home as they help out with washing, cooking etc & this could be a long term solution for you? But they have to have their own bedroom.

COC by an individual midwife even working FT won't equate to improved access in the community setting as she'll be working clinically at short notice delivering labour care. Therefore community AN appointments will very likely be postponed at short notice making it a less reliable service for women.