Midwives
Provide care and advice to women during pregnancy, labour and childbirth, and postnatal care for women and babies in a range of settings such as the home, community, hospitals, clinics and health units.
Morning shift on the birth unit
You are a midwife on the morning shift in a regional birth unit, looking after two women at very different stages. It is 7:30am. Handover is done. One woman is in early labour and wants you close, and another has a new baby and a long list of questions. The unit is one midwife short.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
My contractions are getting stronger and I am scared. Please don't leave me alone. My husband has gone to move the car, and I think I can't do this.
Stay close for a while, and ask a colleague to check on your other patient
Amira settles when she sees you are not going anywhere. Your colleague looks in on the new mother, and nobody is left unattended. Asking for help is a normal part of midwifery.
Tell her you will be back soon and go to deal with your other patient first
Your other patient is sorted quickly, but Amira has been alone and frightened for longer than she needed to be. Her husband returns to find her in tears.
Tell her that being scared is normal and that she is doing fine, then carry on with the paperwork
It is true, but she needed you with her, not a sentence from across the room. She stops trusting that she can ask for anything, and her labour gets harder.
She hasn't slept in two days and the baby just won't stop crying. Can't we go home now? She's had enough of this place and she says it's your decision, not hers.
Say they are free to go and wish them well, since they have asked and it is their choice
They leave, but no one has checked that feeding is working or that they have support at home. A day later they ring the unit for advice they could have had before leaving.
Ask how they are both feeling, check feeding, and plan the leaving together
Daniel admits he is as worried as she is. You find a safe plan with a follow-up visit booked. Families are the experts on their own lives, and your job is to help them leave feeling ready.
Tell them the doctor has to discharge her, and that nothing can happen until then
Neither of them feels listened to, and the afternoon stretches on. A midwife can often explain what happens next and what is actually in her hands.
Midwife, I was told there is a concern with Amira. I am coming up in ten minutes, but I want the story before I arrive. Please keep it short.
Give a short report: who she is, what you noticed and what you suggest
Dr Alvarez arrives already knowing what to look for. Amira hears the same plan from both of you. Clear handover is part of keeping birth safe.
Say you would rather explain once she is in the room so you can show her the notes
The doctor arrives with no picture of the situation and spends the first minutes asking questions. Amira hears two different versions of events, and it unsettles her.
Read the full chart out loud from start to finish, in case anything is missed along the way
Everything is in there, but the doctor loses the thread and says it is easier to read it themselves. A short, focused summary is a skill that takes practice.
How it went
By lunchtime, Amira's labour has moved on, the family in room 6 has a plan and a doctor has been brought in at the right moment. Midwifery asks for calm, clear talking and the ability to be fully with one person while keeping an eye on everyone else. Could you hold both of those at once?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The home visit that was only meant to be a check
A fictional case set in a birth unit and community clinic at a fictional regional hospital.
The situation
Mele was a community midwife in a small coastal town. She called in on Jess, a first-time mum, three days after the baby came home. The baby was feeding well and Jess said everything was fine. But Mele noticed the house was very quiet, the curtains were closed, and Jess had not eaten the sandwich her partner had left for her. The visit was booked for twenty minutes, and the next family was already waiting.
What they did
Mele put the checklist down and asked Jess how she was, not how the baby was. Jess admitted she was exhausted and felt alone, because her family lived far away and her partner had gone back to work. Mele stayed longer than planned. She helped with a feeding position, then talked about local parent groups and the nurse who could visit again, and she wrote clear notes for the next visit.
How it turned out
Jess was nervous about asking for help but agreed to a follow-up call. She started going to a weekly group and later told Mele the visit was the first time she felt someone was looking after her as well as the baby. Mele ran late for the rest of her day and did not mind.
What would you do?
- What might you have noticed in that house that a checklist would miss?
- How would you decide when to stay longer and when to move on?
- Why might a new mother say she is fine when she is not?