Kim Harris

Following the birth of my own twin boys in 2019, I have mainly worked in the day assessment unit as the hours were family friendly. I also felt that my brain wasn't as sharp as is required for the fast pace and rapid turnover of the delivery suite. Sadly, the support from colleagues was hit and miss.

However, on the DAU/ANC team, I learned more about myself and my practice than ever before in my career. The basics! Two ears, one mouth! If patients feel heard, they feel safe. If they feel safe, the fetus feels safe. Obviously, events occur that are out of our control and it is essential to know the correct management and treatment to limit trauma and prevent morbidity or, the unthinkable - loss of the foetus, newborn or mother.

This, of course, applies to all the members of the team equally responsible for providing a high standard of care to the service user. I have always spoken to, and respected people regardless of their age, sex, gender, weight, health, race, religion, job title etc. I, naively, believed that the majority of 'carers' communicated in this way. I have had my eyes opened up to the frightening fact that this is not true. It is the exact opposite. I can no longer work in such a toxic working environment where my own health was being put at risk.

I left my band 7 position in my previous post, and started as a band 6 in a busy, but out of date, maternity unit. This was to move "home", closer to my parents so they could assist with childcare.

Little did I know what a toxic environment I would be working in. However, as an autonomous practitioner, I continued to practice in my way within the guidelines.

I would describe myself as an exceptional birth support and care giver. Whether that is looking after a woman and her partner in a "home from home" birthing room on the MLU, or a high risk labourer on the consultant led unit. Or supporting a woman and her partner who had chosen an elective caesarean section. Birth is birth. The safe delivery of the baby in a calm environment is always my goal. Even obstetric emergencies can be handled in a calm, resourceful manner have better outcomes.

Some of the experiences that shaped my practice were:

A 34/40 twin delivery in the labour ward room. Twin 1 cephalic, Twin 2 breech. Supported by one of the amazing charge midwives, Laura Beattie. The medical team stayed out of the room. Both babies were breathing spontaneously at birth but went to the NNU for CPAP.

And, tragically, a fresh stillborn - baby Angus. Mismanaged antenatally and on admission to delivery suite. However, that was ignored, leaving my colleague (first midwife) and myself (second midwife) totally vulnerable and unsupported. An independent investigation was carried out and no cause of death was found. No errors in clinical judgement were made by myself or Nikki. Her documentation was not accurate but I was in so much shock and was completely devastated and confused. The paperwork was the furthest thing from my mind. There was no support at all from the delivery suite manager, the supervisor of midwives and no apology from the charge midwife on shift that night for opening up a CLOSED MLU for a high risk woman in latent phase with skeleton staff. I have recently reported these midwives to the NMC.

This was a smaller unit compared to Edinburgh Royal Infirmary and the University Hospital of Wales. I quickly learned how the unit operated and settled well as part of the multi disciplinary team.

It was small, but very busy. Obstetric emergencies were always handled quickly and efficiently. Management supported me as a mother of 2 under 3 with an offshore working husband. I worked for a year as the "scrub midwife" running theatre between 8am and 2pm covering the elective list and any emergencies. I was highly respected by all members of the delivering team and things ran smoothly more often than not.

Newly qualified and new to Wales, UHW was the perfect place to consolidate my practice and find my feet.

I learned to stand up to medical staff interfering for no reason, being an advocate for women who had no voice due to pain or fear. I became an expert in labour and delivery and initiating resuscitation on the newborn, when required.

I learned to care for women who spoke no, or little, English. Still managing to find a connection despite being from very different backgrounds. We know that most communication is non verbal so there is no such thing as a language barrier in a stressful situation. One can show a family that they are heard, supported, cared for and believed in without actual words.

I learned to care for women experiencing pregnancy loss which was heartbreaking. When a poor/bad outcome is out of our hands, we still have the opportunity to turn the experience from negative to moving forward. This can make a remarkable difference to the health of the woman and her family whether they choose to continue to grow their family, or not.

I learned how to call for help sooner rather than later. I watched in awe as the amazing team turned a frightening situation in to a calm and well managed, relaxed environment within minutes! I soon learned my role in this team and can recognise deviations from normality quickly. PROMPT is an invaluable training day. Especially during the last year where I have felt unskilled in delivery. A supportive learning environment, performing drills and completing scenarios, always improves my confidence levels.