More than just a midwife: everyday life of a midwife

Our labour ward is very large. Over 2,400 children are born here every year. There are four midwives per shift. During the day shift, we meet in the ward room at 7.10 a.m. for the report. The midwife from the previous shift briefly talks about the women who are currently in the labour ward. This way we are informed about the current situation and can allocate the women for care. It is often necessary for one midwife to care for several women, so we have to coordinate well in advance. After the allocation, a detailed report is made with the new midwife about each woman and her situation. This is very important in order to be informed about the birth process, the risks and the individual needs of the woman.

I am looking after Mrs M., a second-time mother who is at the beginning of her labour. She came into the delivery room an hour ago with contractions. After the handover, I take stock of the situation myself, build up a trusting relationship with the couple, then observe the woman during labour and ask how she is doing. Mrs M is still coping well with the pain at the moment and is breathing calmly through the contractions. I motivate her to persevere. It is very important that the women feel comfortable and are always well informed about the process. I monitor the baby's heartbeat with a CTG device (cardiotocography), show the partner how to give his wife a cross massage and bring Mrs M. a bed bottle to relieve the abdominal pain a little. I then set up a venous line and take blood samples to determine the entry laboratory. As soon as I can make sure that Mrs M. doesn't need anything else from me at the moment, I set off to continue caring for Mrs H.

Mrs H gave birth to her first child just under an hour ago. I congratulate the new parents and help the mother with breastfeeding. I then check how her uterus is regressing and monitor the vaginal bleeding. While Mrs M. is telling me how she experienced the birth, an alarm suddenly sounds from outside.

A colleague in the next room needs help as the baby's heartbeat is poor. Several midwives and doctors immediately gather in her room. They all know exactly what to do. The baby's heartbeat does not recover, so an emergency caesarean section has to be performed. Although things are very hectic, we attach great importance to briefly informing the couple about what is happening. The woman is taken to the emergency operating theatre and the baby is delivered by caesarean section within eight minutes. The paediatricians are on site immediately and the baby is examined and monitored by the midwife in charge together with the paediatricians. I help my colleague until everything has calmed down. We are overjoyed that the baby and mum are doing well and the team can breathe a sigh of relief. I now have a short time to document my previous work and the findings.

After the documentation, I go back into Mrs M 's room because I can already hear her from outside. She tells me that the contractions have become much stronger and that my waters have just broken. Mrs M. asks me for painkillers. I assess the amount and colour of the amniotic fluid and check the baby's heartbeat again with the CTG device. With her consent, I carry out a vaginal examination to find out how the labour is progressing and to give her more information about possible painkillers. As Mrs M. is expecting her second child, I estimate from experience that the birth will be quick. The vaginal examination shows an opening of the cervix of 5 cm. This means that the labour has already progressed. I feel that the baby's head is correctly positioned in the pelvic inlet. Mrs M. is pleased with the progress, but requests epidural anaesthesia (epidural) as a painkiller, as she had already given birth to her first baby with an epidural. I inform the mother about the procedure for an epidural anaesthetic. I then inform the gynaecologist on duty about the progress and the further procedure that I have agreed with Mrs M..

While we are waiting for the anaesthetist, I call our nursing assistant and ask her to bring breakfast for Mrs H., who is lying next door. I assist the anaesthetist with the epidural and monitor Mrs M. for a while afterwards. When she is pain-free, I place her in a position that favours the progress of the birth and helps the baby to descend.

Now I have time to carry out the initial examination of Mrs H 's baby. During the initial examination, I weigh, measure and monitor the newborn and then help Mrs H. to shower and freshen up. I always have Mrs M. in the back of my mind, who might call in because the birth is progressing quickly. I therefore organise Mrs H 's transfer to the postnatal ward, as she has nothing more to do and we have to prepare the delivery room for the next woman in labour.

Immediately after Mrs H 's transfer, Mrs M reports that she is now feeling downward pressure. I also notice changes in the baby's heart rate curve on the CTG, which indicate a lowering of the head. I carry out another vaginal examination and feel that the cervix is fully open and the baby's head is in the correct position, in the centre of the pelvis. I prepare everything for the birth and inform the doctor on duty about the progress of the birth.

I now stay with Mrs M., who feels more and more downward pressure with every contraction and soon starts to push. Before the baby's head is out, I call the doctor in for the birth. Everything proceeds normally and Mrs M. is soon able to hold her baby in her arms. All the pain is suddenly forgotten and Mrs M. knows that every contraction was worth it. This is a magical moment and I do my best to make this moment as calm as possible for the family. After the placenta has been delivered and the birth injury has been treated, I hand over the care of Mrs M. to the next shift and can now finish my documentation.

During my shift, I have to keep coordinating with my midwife colleagues, redistribute the work, take phone calls, keep in touch with the postnatal ward, organise myself and document my work on the computer and on paper. I always work independently, inform the doctor in charge about what I'm doing and liaise with her. Even though the services are often very hectic, we try to cater to every woman and make her birth experience as positive as possible. We care for women regardless of their background or faith. Thanks to our broad knowledge, midwives can act in critical situations for the benefit of mother and child. Because how we are born is important.