On the way home from the hospital I started working in in October.
The town is absolutely stunning in spring!
It's the end of an era! Almost 14 months has passed since my midwifery registration came through and I attended my first birth as a registered midwife. I have so much to say about my experience choosing a non-traditional graduate year, and working in private practice directly from uni, but now I have sat down to write, I feel a little bit choked up and it's hard to get the words to flow as they usually do when I write. I think this is because it has been
such a big year for me, and it's hard to get my thoughts and experiences to behave themselves in my head so that I can make sense of them on paper.
I will start simply with this - I have had the absolute best graduate year that anyone could possibly have.
I feel so wonderfully privileged to work with women, to support them fully and wholeheartedly in their choices, to have physiological birth totally cemented in my practice as "the norm", with no fear of physiology. I've learned so much about women's bodies - the incredible feats they endure to bring their babies earthside and the incredible range of "normal" experiences. From the women who I didn't make it to in time because they birthed so fast, to the one that had a 4 four third stage and the one that had an 8 hour second stage with mum and baby totally fine clinically the whole way throughout. The women who love birthing, to the women who fight each contraction. The women who roar, and the women who breathe baby out quiet as a mouse. The women who have a tribe of support people around them when they birth, and that one woman who asked me for privacy and then pushed her baby out into her husband's loving arms.
Maggie the Midwifemobile all packed for a birth
Working in private practice in my graduate year has totally cemented physiological birth in my practice, and taught me to trust the birthing process with all of my heart and soul, but it's also taught me to use my critical thinking skills and clinical decision making skills wisely. When you're faced with normal all the time, the abnormal sticks out like a sore thumb. I've done a fair few hospital transfers this year, for many different reasons (the 8 hour second stage being one of them), and in almost every case I felt absolutely confident we as midwives had made a good and timely decision. Even after transfer, many of these women had vaginal births, just needing increased monitoring or pain relief that we couldn't provide at home.
Bron and I have been creative in the roles I take on at The Birth House to try to maximise my experience and knowledge while staying within the legal parameters of our current system, which requires Medicare endorsement for antenatal and postnatal care. Aside from attending births as a second midwife, I have done administration, reviewed pathology and ultrasound results and flagged anything abnormal, used the ACM Guidelines for Consultation and Referral to carry out risk assessments at different gestations and written referrals to obstetricians and paediatricians. I've contributed to collaborative care plans, done extensive antenatal education, debriefing and facilitated postnatal support groups. I've written policies, marketed, collated and published our statistics, communicated with women, doulas, photographers and other people who contact us through The Birth House. I've written articles and appeared on radio, and even took part in a documentary being made about home birth in our area, all as a apart of my role as a midwife at The Birth House. I've also been facilitating student placements from the UK and running student study days, whioch I've found incredibly rewarding.

With Manchester Uni student, Abby, at the Byron Lighthouse
In October, I started working in a small, country hospital on a permanent, 24 hour a fortnight contract to build up my hours towards endorsement and expand my skills as a midwife. The unit I'm working in has a truly lovely bunch of midwives, and low birth numbers mean that we are able to give the women so much one to one time, and support with breastfeeding and mothercrafting that I know we wouldn't have time for in a bigger and busier hospital. We also often care for the same women days in a row, giving a sense of continuity in an otherwise fragmented system. However, this particular hospital relies on locum obstetric and paediatric staff, and has high rates of intervention. It's been a challenging transition for me, from an 89% normal vaginal birth rate to a 35-ish% normal vaginal birth rate. I wanted to expand my skills while I'm there, but there are few births, so few opportunities to get better at suturing, cannulating and the likes, and while I've been performing these skills at home births (except suturing - I've only done that twice), and have the theory of the health district's learning packages done, I'm yet to sign off a single skill completely, which is frustratingly narrowing my scope of practice.
Compounding the difficulty of the transition, the hospital is a few hours away from where I live, so I travel down and stay in the accommodation centre, which is the original old nursing quarters of the hospital, where I often feel socially isolated, and miss home. Disrupting the natural rhythm of my weeks in this way has been huge. It feels as though it takes me days to recover. When I get home there is laundry to do, a house to clean and tidy, missed time with Jake and Lou to catch up on, and then before I know it it's time to go back again and I'm packing, bulk cooking and preparing to say goodbye again. Working away has meant missing home births with women that I've build trusting relationships with, which has been tough. Missed home births also mean missing a huge chunk of my regular income, which has meant needing to pick up more hospital shifts, and the cycle continues.
One of the rooms in the accommodation centre. Not the most homely!
Financially, the last few months have been tough, and sometimes I have wished I took a salaried graduate position with a regular income, but when it all boils down to it, there
are more important things than money, and doing it a bit tough this year has all been worth it for the wonderful experience I now have under my belt. Every day I am a midwife the fire in my belly for working with women burns brighter. When I look within myself, I know who I am as a midwife. I know how to support and nurture women. How to make them feel safe and strong at the same time. To find the power within them that helps them bring forth new life and builds their capacity as mothers. Midwifery isn't just a job - it's my calling. Money can't buy that level of satisfaction with life.
At the Lismore Art Gallery, admiring an exhibition of belly casts painted by local Bundjalung women