“No matter what year it is, the heart of being a Midwife does not change”
With over 70 years of experience between them, three midwives from Manchester reflect on how maternity services have advanced over recent years.
Saint Mary’s maternity units, ran by Manchester University NHS Foundation Trust (MFT), help to deliver over 16,500 babies a year across their three sites. Three midwives, Kirsty Yates, Gail Ballance and Jenni Mason, live and breathe their profession, and have seen how important the recent advancements in knowledge, technology and research have improved outcomes for pregnant women in Manchester.
Kirsty, who first qualified back in 2001, said: “Everything about midwifery has changed since I began. Women have more knowledge about their bodies than they ever have before and there are far more investigations and testing as to why some pregnancies become more complex.
“There is a lot more choice in pregnancy and how women give birth; and it’s all for the good of the woman.”
Jenni began her training in 2003 and works at Saint Mary’s Hospital at MFT’s Oxford Road Campus. She said: “You’ve got to keep up with the times more than any other aspect of medicine. Our research and our clinical practice are changing all the time, especially at Saint Mary’s.
“Sometimes it can be hard to keep up, but our staff are used to change and being on top of their game. It’s a profession that’s never standing still.”
One huge advancement in maternity is the introduction of a wide range of specialist clinics supporting expectant mothers, with Saint Mary’s providing care to pregnant women with health conditions such as diabetes, pre-eclampsia and cystic fibrosis.
Gail began training as a midwife in 1988 and works in the Antenatal Clinic at Wythenshawe Hospital. She said: “The opening of so many specialist services didn’t happen overnight, but it just shows how much our knowledge has grown. You didn’t really see ladies with these medical conditions having babies when I first started my career.
“30 years ago, the only specialist midwives were working towards reducing teenage pregnancy rates. Although these roles still exist, now, we care for a much wider range of ages, and it’s not unusual for someone to be 35 having their first baby.”
There has also been an increase in the rate of caesarean sections performed. Previously, a maternity unit with a high rate of natural births was considered more successful, however there has been a shift in attitude.
Jenni said: “Women with complex conditions tend to deliver via a caesarean section rather than natural birth, so an increase in c-section rates actually shows that these women are having more successful pregnancies.
“We are aware that there is a public perception that one method of birth is ‘better’ than the other, but you have to take all factors into account with what you recommend – the best method of birth is what is safest for the woman and baby”.
20 years ago, it wasn’t unusual for a woman to stay in hospital for up to five days after giving birth to her baby. Now, due to the growth in research and knowledge, women can be discharged within 24 hours so they can be at home with their new baby quicker.
Kirsty said: “Unless women have a condition, pregnancy isn’t an illness, and lots are healthy who want to go home”.
Outside cultural changes have also impacted maternity services and how women give birth. The growth of social media has changed society as we know it and has made knowledge a lot more accessible to patients, but this also comes with drawbacks as expectant parents compare themselves to influencers.
Gail said: “Social media has only emerged in the past 15 years or so. It’s a great thing that people have more information on their health, but it also means that people are more likely to compare their pregnancy and births with others – which can cause more anxiety. I advise everyone who I care for to not look at influencers as it’s only one little snapshot of a wider picture.”
There have been various technological advancements which have dramatically improved patient outcomes.
Jenni said: “Around three years ago, we introduced screening tests to find out the baby’s blood group based on fetal DNA found in the mother’s blood.
“In layman’s terms, if a mum and baby have mismatched blood types, this can mean that the mother builds antibodies against the baby. This could affect around 15% of the population and can even lead to miscarriages. Now we can detect and treat with an injection known as Anti-D Immunoglobulin to protect against the incompatibility.”
Kirsty works as a Delivery Suite Coordinator at the North Manchester site of Saint Mary’s Managed Clinical Service. Recently, this site hosted a study trial where pregnant women were offered rapid bedside testing for Group B Streptococcus (GBS), a life-threatening form of bacteria.
Kirsty said: “This test meant that women could be tested for the bacteria before they give birth and, if it’s positive, we can quickly administer antibiotics to protect the baby. Hopefully, this will be rolled out across the country soon.
“When I was studying, I’d heard of Strep B and the damage that it can cause, but never thought we would have such advanced technology to detect it so quickly and easily.”
Prescribing magnesium sulphate to treat pre-eclampsia has been around since the early twentieth century, but within the past ten years, it was proven that there were also benefits on premature babies from developing neurological conditions.
Kirsty said: “I was speaking with a family friend who is currently applying to be a midwife. Her sister has a mild form of cerebral palsy, so when I was discussing the benefits of using magnesium with her, she was absolutely fascinated to learn that if her mother received this treatment, then there could have been a chance that she wouldn’t have this condition.
“I saw the passion in her eyes, and I told her to never lose that feeling while she works as a midwife.”
Student midwives have always been an essential part of the maternity team. Gail said: “In emergency situations, student midwives are part of the team and are a lot more involved than I was as a student. This means that they are far more prepared in a crisis and makes for more experienced midwives.”
Kirsty said: “When I first did my training, some units even had separate break rooms for students and fully qualified midwives. Whereas now, the culture is so different and there isn’t a hierarchy. Everyone’s opinion on the ward is just as valid as each other’s”.
Jenni now works as a Retention Midwife, a specialist role designed to support recruit and retain midwives. She said: “I remember my aunty gave me a midwifery textbook when I was around 12 years old and from that age I understood the gravity of being a midwife.
“The birth rate of Saint Mary’s has doubled since I started in 2003. There are a lot more students and patients with complex cases.
“My role means that I may not be delivering babies everyday, but I am supporting the pregnant women in Manchester by supporting our midwives.”
One thing that never changes for these midwives is their passion and dedication to the role. Kirsty said: “It sounds cliché but I’ve known since I was tiny that I would work with new born babies. I’m really fortunate that I love my job – it’s why I was put on Earth”.
Gail said: “When I watch call the midwife, a lot of the same themes and feelings still apply. Even though it’s set in the 1950s and 60s, it just shows that no matter what year it is, the heart of being a midwife does not change.”
Lean more about our midwifery colleagues…
Watch the video below to learn more about Jenni and her role as a Recruitment & Retention Midwife.