Leaving midwifery, what’s next?

[TastingTheRainbow]

I have made the decision to leave my job as an NHS midwife. It breaks my heart but sadly I can no longer cope with the short staffing, increasingly busy days and my mental health is suffering. I am crying in bed most nights knowing that I gave terrible care to women as I just couldn’t split myself between the needs of 20 women and their babies when on my own on the ward. The anxiety that one day I’m going to make a mistake or miss something and cost someone their life as a result is crippling.

The question is what next? I have no qualifications or experience in anything other than midwifery as it’s what I’ve always done and always wanted to do. I’m also a direct entry midwife so didn’t qualify as a nurse first.

I can afford to take a pay cut for better work / life balance and I would save on childcare costs anyway so it would balance out.

Can anyone give me any suggestions of what (non NHS jobs) would be open to someone with a degree in midwifery?

@munchymunkin I would love to but I’m a direct entry midwife and not a nurse first so in order to maintain my registration (which I would need to in order to keep my job in sexual health) I have to prove that I have been doing midwifery work. Sexual health is considered nursing and proving nursing skills won’t maintain a midwifery registration so I’ll lose my registration and therefore my job.

It’s sadly well researched now that direct entry midwifery simply traps midwives, at the time I thought it was great. In hindsight it’s the worst thing I ever did. If I was a nurse / midwife I would have so many options now!

www.nursingtimes.net/direct-entry-now-means-no-exit-from-the-midwifery-profession/5015601.article

I left my qualified job in social care for very similar reasons, I really feel for you! I now work in the voluntary sector, the pay is less but I am much happier! You obviously have tremendous values and skills that would easily be transferable to a supportive role. It might be worth checking charityjob etc for vacancies local to you. Good luck ☺️

The COC thing is such dangerous rubbish. Apart from placing midwives under pressure, I don’t want to be cared for by a midwife who hasn’t slept for 36 hours because she’s been caring for another one of her caseloaded patients. Madness.

The way they are implementing continuity of carer depends on where you work. For me it will just mean working 1-2 shifts per month in the unit in line with my normal community days as we’ll be partnering up with delivery suite midwives.

@buddytheelf85 Exactly! It’s so dangerous and they don’t seem to recognise this.

Last week I worked an early shift, 7am - 2.30pm I was then on call from 5pm. At 5.40pm I was called out as labour was very busy and needed help. I worked on labour ward from 6pm when I arrived until 7am when I handed over to the day staff. I had been awake for 25 hours at that point and was in no way safe to be delivering babies.

Luckily the lady I cared for had a normal uncomplicated delivery, if there was an emergency I can guarantee I wouldn’t have handled it as well as I normally would.

I got back home at 7.30am and after my 25 hours of no sleep could only have 5 hours sleep before going back to work my late shift.

It’s unrealistic and midwives are leaving in huge numbers due to this. Midwifery is now a profession only those who are young, newly qualified and without children can reasonably do. All the experience of the elder midwives will be lost and care will become more and more unsafe. It’s heartbreaking to watch this happen.

@thatsnotmyotter For now! Currently 20% of women are case-loaded, that’s soon to change to 40%. Your 1-2 days will then at least double. They are also tightening up on continuity in a team where the woman has only met the midwife who delivers once in pregnancy and moving to a named midwife system. It’s going to get a LOT worse yet.

Could you become a midwife at a private wing/hospital? I recently had a baby in a private wing of a London hospital and had my own midwife 1:1 for first 24 hours and then 1:2 for the rest of my stay. It sounds a lot less stressful than your current workload.

Alternatively, look at private maternity nurse work through an agency. Or one of my friends hired a private midwife for her antenatal check ups at home and then took her to the hospital (as a companion) for her NHS birth.

Hope you find a less stressful alternative path 💐

You may have answered this already about the direct midwifery/nurse distinction, but many of the nurses at the fertility clinic I had ivf at were previously midwives. 8-4 Monday - Friday, Saturday mornings on a rota

2 year graduate accelerated nursing degree?

How sad for you that this is the situation. Very few people could cope with that amount of hours without sleep. It would be so difficult to combine with family life.

I work in health research. Some of my colleagues are from a midwifery background. It retains your registration and you do not have had to have been a midwife for a set number of years to go into research. I realise this is not for everyone.

Could you also do breastfeeding support. I know a midwife who is a lactation consultant and she retains her registration and works regular hours.

I do think that many trust will change the way they have interpreted the new frame when they start losing experienced staff.

I got back home at 7.30am and after my 25 hours of no sleep could only have 5 hours sleep before going back to work my late shift.

You are entitled to 11 hours rest between shifts, this includes on call work, you shouldn't have been back at work before 6pm. I'm lucky in that my trust are very good with the rest time (not a midwife but do 1 or 2 on calls shifts/week

Do private antenatal classes, postnatal care, lactation consultant. I have a friend who went to be a HV, she hated it and is about to start a job as an immunisation nurse (she’s direct entry).
You could do sexual health and top up with some bank shifts in midwifery

Could you try starting a doula business? I was looking for a doula, just so if needed I would have an additional birthing partner in hospital and my husband could do childcare if we needed. I was quoted around £650 for a birthing package by a student doula and £1000 for an experienced doula in the north west. You could choose how much work you take on.

I wouldn’t suggest doing a nursing degree at this stage. Seems a bit of a jumping from the fire to the frying pan scenario really if the nhs budget/staffing situation is the crux of the issue.

so why are your management not screaming out that this system will not work ? On any level ? I would imagine that any MW who has a family will not be able to work in that way ?

I had a 36 hour prem labour and three different MW - the last one out of kindness did stay past her shift - but as long I was being looked after and my baby was safe I would not have cared whether I had one or three. It sounds ridiculous .

so why are your management not screaming out that this system will not work ? On any level ? I would imagine that any MW who has a family will not be able to work in that way?

It’s a national change. Every maternity service will have to meet targets for the number of women who receive continuity of care. At the moment each service is defining it differently, mostly using teams of midwives to try and deliver it. Studies show that it leads to much better outcomes, which is great, but we don’t have the staff or the funding to pull it off.

I saw a job recently that was something to do with assessing teaching at the NMC. M
Or how about an inspector for CQC?

I had a 36 hour prem labour and three different MW - the last one out of kindness did stay past her shift - but as long I was being looked after and my baby was safe I would not have cared whether I had one or three. It sounds ridiculous

You wouldn’t have one midwife for your whole 36 hour labour. The idea is that you would have some contact during labour from a midwife that you know and have seen during your pregnancy, and that you’ll see again during your postnatal period.

That’s the aim anyway. Most places seem to be going with the team model, so you’ll have a named midwife but could see anyone from their small team (4-6) if they are not available.

So sorry to read about your experiences Op. I left midwifery and did wonder at the time if it was the right thing to do after the blood sweat and tears of the training.
Do what feels right for you, life is too short x

I'd check carefully with the NMC before commencing a doula role. If something was to go wrong I think you'd be considered a midwife, with all the responsibilities & expectations that go with it, rather than a doula. I'm a different kind of HCP & know this would be the case for me with my governing body. You'd also have to be very careful with your advertising to ensure no one could claim they'd been misled that you were attending in a professional role.
The plan for full case loading, like a lot of NHS initiatives, sounds wonderful in theory though is clearly a disaster waiting to happen. I don't blame you at all for looking at your options.

@TastingTheRainbow I know you said no NHS jobs, but why not join us on the ambulance? From what I've seen we get (slightly) Better looked after as we don't have time limits with patients and it's one on one care. You can join as a direct entry technician (currently band 4 and likely to be band 5 soon) and qualify as a paramedic via uni a few years later if you wish too. I'm sure they will snap your hand off at interview with previous medical experience.

Are you a member of a union OP? I’d approach your local rep and see what they advise in terms of what to do about those hours, they are unsafe and unacceptable.

There are opportunities for direct entry midwives in Ultrasound but it may mean moving trusts or, if you can’t get sponsored, taking a career break to train. I was lucky enough to be sponsored by my trust and have been a midwife sonographer now for 7 years. I love it, regular hours and still lots of contact with women and families which is why I went into midwifery in the first place.

Different trusts are implementing COC in different ways. There's no chance we will all be going to caseload! As in- it just won't happen, it's not physically possible for the midwives or the women. Certainly postnatal care can't be guaranteed continuity; many of our postnatal women deliver miles away in other units, their named midwives aren't going to trek all the way to see them. Even in 'full caseload' models like in parts of NZ you will always need core staff. (speaking as someone who's been a caseload midwife in a team and having friends who've worked in NZ in caseload and core).

If units decide it has to mean 'full caseload no exceptions' they're very foolish.

Where do you work ? It isn't like that everywhere I promise you xx

What about a breastfeeding consultant if you go through additional training? Probably depends on where you are what demand there would be.