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?

The taxpayer isn't paying for anyone's healthcare degree.

All those pisstaking millionaire NHS workers right user139328237? I know you're just being a goady fucker but give your head a wobble.

I think the point is that if you know in advance that you're going to be doing Saturday nights from midnight to 8am every other week or whatever, you can plan. The problem with case loading midwifery is that its unpredictable. Getting childcare at unsociable hours in advance is completely different to getting it at short notice.

user139328237 So you want it to go back t9 the time when only unmarried women could be nurses? Seriously? Wise the fuck up!

Also, trying to force clinicians to all work full time is a brilliant way to get even more of them to go and work abroad.

user139328237 I have already said I work unsociable hours and many of my hospital based colleagues work 12hrs shifts both day and nightshift. I work weekends, public holidays and work either Christmas day or New Years Day each year this is not us saying we do not want to cover our share of the unsociable hours but we are being told we will be working full time hours and being on call in addition to this. This means carrying a work phone at all times and being expected to attend a hospital 20 miles away to provide care night or day. Can you think of any other professional expected to do this? Doctors are legally not allowed to work the hours being proposed to us. The model being forced upon us is more Call the Midwife than an achieveable workforce plan.

Emigrate to Australia or nz.
They are crying out for people with your skills. It's not like you have family or ex support as an incentive to stay.

There must be something you can do with regular hours. My friend works doing baby scans for a private clinic 9-5 then maintains her registration by doing bank work to fit around 3 kids.

Research midwife - regular hours and part-time wouldn't be unusual. Might not be able to stay at the same trust but worth exploring? Really hope it all works out for you.

I think you could look at:
Au pair not nanny
Nursery for youngest
Job share
Agency
Bank.
I agree with other pp. This case load idea has been tried before. I am old enough to remember. It didn't work then and it won't work now.
The majority of midwives are women with children. That is unlikely to change.
My neighbour was in a similar situation working FT. She always had au pairs and it worked very well.

Bloody hell. The unions need to be fighting this. It's unworkable.

I sympathise, I really struggled as a midwife with young dc and wasn’t even single.

I took a role in the antenatal clinic and it was great. I stayed a long time and branched into teenage pregnancy and other areas of high risk. I became quite involved in child protection and also domestic abuse training.

I didn’t miss the shifts or weekends and though the money was lower because of the daytime hours the quality of life was so much better.

I do hope you find a way to make it work. To those who are saying ‘suck it up’, just be realistic: this period of a working life is relatively short and offering enough flexibility in shift patterns to stop experienced clinical staff from leaving makes complete economic sense. I’m really sad that this is still not happening when there are such awful retention issues.

The NHS is supposed to be a flexible employer, this is really unfair on families and single parents. Of course some people have lots of help from family and friends and can manage with a that or a combination of paid childcare and family help, but not everybody is that lucky.

I don’t know anything about the model but at least 2 people on this thread have said the model has been tried before and it didn’t work then. Typical NHS at its finest. My Trust is currently doing away with Community Hospital beds and implementing a ‘closer to home model’ no doubt this will all change again in a few years [hmmm]

I also feel for the other Midwife who posted to say she finds Hospital shifts stressful. A Midwife May have chosen Community work for a reason, I don’t see the point in forcing people into something they aren’t comfortable with. They’re very different jobs.

I had my children with an NHS caseloading team and I won't say that it wasn't an amazing experience. I built relationships, I was supported throughout my pregnancies by clinicians who knew me and my family, and my children were delivered by familiar midwives (although twice out of three times one of the twomidwives on duty wasn't one I'd met before). I do wish every woman could experience it and I can see why it's considered Gold Standard care.

But I also used to talk to the midwives about their jobs and they said that plenty of their colleague didn't want to work like that. They also said that many caseloading midwives could only do it when their home lives permitted.

Surely there is a way that the NHS could provide more continuity of care without requiring all midwives to work in the caseloading model? For example, set shift midwives who offer antenatal care to the same woman as much as possible, as some community midwives can already do, and delivery midwives who were able to meet local women in advance maybe? Or a handover between the antenatal and delivery teams so there was some knowledge sharing? Just one thought, I'm sure they are other ways it might be done, but surely just plunging into a different model that they must know won't work for many of their staff is a mistake?

EastEndQueen your set up sounds pretty much how my caseloading midwives worked, including the coffee mornings! They were a smaller team though. But they were home birth focused so didn't have delivery ward duties (but would attend women in the delivery ward if they were giving birth there) which I think would have made things a bit more intense in terms of needing two midwives, probably frequently staying beyond a shift etc (I once had three midwives as the new one had arrived but the old one didn't want to leave until the baby arrived) - although I know delivery ward midwives end up doing that too.

YANBU as you just want to continue a job you love, but you must see the benefits of continuity of care for pregnant women and their babies?
Personally I would have been really annoyed if I had a different midwife all the way through my high risk pregnancy. I saw one midwife all the way through my pregnancy, even in unscheduled appointments. We had a great relationship and she new my consultant. It had a massive impact on me getting the care I needed to have a healthy baby and deal with the stress of another potential outcome. I'm afraid in my view, that's more important than your ability to have a job that fits around your childcare. You will just have to be flexible until your circumstances change and you can return to your profession.

Is there really that much evidence to support the supposition that a familiar midwife makes a difference??

Do women really care that much in labour if they have met the midwife before?

It really was the last thing on my mind. I had great midwives both times and due to length of birth actually had 4 in total. No issues.

Maybe the nhs should pay midwives enough to afford childcare? If they want a 24/7 service.

I worked as a midwife in Australia. They will welcome you with open arms.

Find a different career. NHS services tend to be a bit shit. Could you start your own suplimentary midwifery business where women can pay for one off or regular appointments for a second opinion/reassurance? Or maybe you could stay your own antenatal classes? Or wrote a book or something? I can see a book complaining of everything that is wrong with midwifery (including how impossible it is to work with a family) selling the pretty well. Or maybe just move overseas. Or go into teaching? There must be something you can do with your skills.

We can’t have it all, we either have plentiful midwives with provision for families including sing,e parents or we have a work force of young less experienced midwives who can do the hours but will lack the expertise of more experienced staff.

Exactly. It's all well and good people saying "you knew what you were signing up for, if you don't like it, leave" but the entire pool of available staff is always going to be made up of human beings. Human beings with lives and families and other responsibilities.

Rather than expecting those humans to function as robots, perhaps it would actually be better and more cost effective to ensure there was adequate childcare provision and flexibility to enable as many of them as possible to join the workforce and contribute their skills and passion without trashing their own lives/health in the process?

Because the "tough luck" attitude is just going to exacerbate staffing shortages, leader to poorer outcomes, and cost us more in the long run. Which I don't think anybody sensible wants.

Just a wild thought.

Agree with everything Anouk said.

Oh goodness, so many replies.

I'd like to start with a reply to the goady poster. I qualified aged 21. My retirement age is 68. That is 47 years of employment. I will have an issue for 7/8 years. That still leaves a potential 40 years to work! It is short sighted to hold that kind of view. In addition, it is not a tax payer degree. People are now coming out with 50/60k debt.

Au pair isn't an option. My house is a small 3 bed semi, and the 3 bedrooms are all small. 2 little ones share in one room, and my teenager is in the 2m x 2m box room (it only fits a bed in it). In addition, my child with additional needs would need someone incredibly special to be able to manage him. I've just had to spend a morning dealing with angry emotional outbursts. He is currently in my arms as I type, exhausted from his own brain. That isn't something your average 18 year old can handle without losing it themselves. It is challenging.

I have looked in to HV training. It is an option. It makes me sad, as I don't want to be a HV. It won't give me any job satisfaction. It will pay the bills though...

My issue with going in to different fields is the study. I work 24 hours right now, and I'm stretched too thinly already. I can not give any more hours to anything else. Most things like teaching or HV would require me to study on top which would be full time (or even more than full time). I am also not academic. I am intelligent, but can not "study". I've recently done a course at work and didn't finish because I can't complete the assignment. This doesnt reflect my actual ability to do the job. I just can't write essays anymore apparently. This is one of the reasons why I don't think I can teach.
I am very much a practical, hands on person. I know I am good at what I do. I just need to find a way to make it work so that in hopefully 7 years, I can be a fully shift working midwife again.

I have just left the NHS and was involved, on a managerial level, in implementing the plans for this new continuity of care in midwifery. I'm a huge advocate of getting better antenatal and postnatal care for women, the health inequalities women face right now are diabolical. But what they're trying to get midwives to do (ironically mostly women) is shocking and I don't understand for a minute how it's going to work, unless you decide you no longer want a home life in any way shape or form. It's a big reason as to why I left, I just didn't believe in it and I can't push forward things I don't believe in. I will put my name to the fight for this to not happen. Continuity of care is great but not at the expense of HCPs and their health and rights, also how will continuity of care be delivered if half our midwives have to quit their jobs!

YANBU. There is so little respect or understanding for the fact that HCP are people too .

Babydreamer1 I do accept continuity is good for women and our women receive excellent continuity antenatally and postnatally with the midwifery staff working closely with consultants, physio, Gps, HV and social work for the benefit of women but what about my right to adequate rest? Protected time off and what about my children's need to have me there? My partner also works should his employer just be expected to accept that he needs to work around my job?
Would you expect to see the same GP every appointment? If you were unwell at the weekend would your GP leave their bed to attend to you? No other service works under the conditions.
My colleagues range from early 20's to their 60's. All have obligations away from work that prevent them from being available for work 24/7 . It is not as simple as saying commit to being available for all women in the caseload at any time or leave. Would you honestly rather a inexperienced midwife who is not confident dealing with an emergency caring for you over a skilled, effective labour ward midwife? Or a midwife who is exhausted because she has worked non stop for 24hrs? What about arriving at the hospital in labour and no-one being there to care for you until your named midwife arrives? Would you be satisfied with that?