• The Fit Midwife

The side of midwifery you don't see.....

Insolant. Bossy. Loud. Obstructive. Intimidating. Opinionated.

These are just a few of the words that I have been called whilst working as a midwife in UAE hospitals. Not by patients… No they are usually aware of what we do for them and what it takes out of us.

I, like many midwives and nurses in the UAE have been called these things by our management, by our Doctors. All those people who are supposed to support us are the ones who are actually tearing us down.

As a patient you’d never know it. Well, if I have cared for you or delivered your baby here in Dubai then you will have seen several eye rolls when a Manager or Doctor says something stupid. Or I will have told them to stop what they are doing if I know they are going against policies. But most of the time we have a happy, smiley face on. Because at the time we see you, you are at your most vulnerable and all your focus should be on you and your baby!

But nurses and midwives here are treated disgracefully. The real reason I left clinical practice was because I did not want to be part of this culture. It breeds such low morale in health care workers. Ask any of them.

I couldn’t stand to be in an environment that operates by allowing senior staff to belittle people based on their job role or the country they come from. “Just a nurse”and “Just a midwife”. These were phrases I heard a lot. This was heard from many different professionals. Mangaers, practitioners, patients.

Let me start by saying I have worked with some exceptional Doctors here. Incredible women and men who are hands on and really care. They work as a team and show respect to their peers. If you are ever stuck when choosing an OBGYN then I can point you in the right direction. I can honestly say a good, competent and confident Doctor listens to her nurses and midwives. We are all cogs in the same machine. Or at least that’s how it should be. But sometimes that machine never worked from the get go.

As a Midwife in the UK I never once faced this problem. I mean yes, there were a few ‘dragons’. But even if I didn’t like them personally I sure as hell respected them professionally. I knew they had my back and I knew that I could learn from them. Bullying was not tolerated. We were not seen as intimidating. We were respected for our knowledge, experience, opinions and our passion. Even if we got on our high horse sometimes.

Let’s just look at the origins of our job titles. Midwife means “with woman”. The word “obstetric” (As in obstetrician) is from the Latin obstetrix, meaning “one who stands opposite “ and is related to the word “obstacle”. I rest my case.

Patient care is not just about a good outcome at the end. It is about making women feel safe and secure and supported every second of their journey. Listening to their requests and fears and meeting them in the middle when there is a compromise on safety. This can only be acheived when there is team work. And each member of the team respects the others.

It is not about making money. Scheduling surgeries to fit in with annual leave or lying on examinations so that you can do a quick C/S and get back to bed (The UAE in a nutshell). This is why midwives struggle. We don’t operate in a way that the private healthcare sector understands. We are not money driven. If we were we sure as hell wouldn’t have picked this underpaid and oversubscribed job for a living!

The thing about midwives and nurses is that for the most part, in most countries, we are not trained to be subservient to Doctors.

We are professionals in our own right, we work with Doctors. We are experienced and knowledgeable. We can predict the unpredictable sometimes just off ‘gut feeling’.

We will fiercely support each other and our women often (in the UAE) to our own detriment. What gets me every time is that when we are called insolant or bossy it is usually because we are making Doctors, the seemingly all knowledgable professionals, doubt their decisions.

If you have had a baby, think back to your labour… was it the Doctor or ward manager who rubbed your back? Held a bowl whilst you vomited? Recorded your observations every 30 minutes? Helped you to the toilet? Scooped your poo out of the pool. Comforted you? No… didn’t think so. That was your midwife or OB nurse right? We get to know you. And that’s what makes us so good at our job.

So if you are a midwife who is being pressured to be anything less than what you were trained to be…. don’t give in. All you can do is stay true to your women and ensure their safety and their happiness. If you don’t piss people off doing that then you aren’t doing it right! I know you think it is easy for me to say this but I have had my fair share of drama here too.......

A Doctor here reported me to the Ministry of Labour because I “Caused trouble for them”…. I kid you not. This was the complaint filed. WTAF. What was this trouble you ask? I advised a women and her husband to seek a second opinion from another Doctor in the hospital. She was due to be induced (unnecessarily with no clinical indication) and she was terrified and in tears saying she didn’t want this to happen to her. Seeing someone in that state doesn’t sit well with me at all. Anyway, giving this advice led to her labouring naturally and achieving a beautiful normal delivery which she very much wanted, with a lovely Doctor. But for me it led to months of unemployment and worry. All because this Doctor’s pride was hurt because she was contradicted by someone she felt was beneath her. Given the opportunity I would still do everything the same way because it highlighted to me why Midwives are so important and why I won’t ever let another woman be walked over by her healthcare providers.

So if you are reading this as a patient… if you see a midwife or nurse on a shift, don’t give her too hard a time. They are all fighting battles for you that you don’t even know are happening!

Nikki xx

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