Midwife in the Making The Midwives

Hello, Ward 4, midwife speaking.

Ow!

Don't panic, it's going to be over soon.

With the highest birth rate in 40 years...

Look what you've done!

Oh, my God!

You were just amazing, look at him.

..midwives are under more pressure than ever before.

You are kidding me.

We have a lady on the table in theatre waiting to come out.

We filmed in busy maternity departments in Birmingham,

Manchester and Cardiff.

6, 11 I reckon.

He's about 6, 11 and a half.

..as the midwives deliver the next generation...

The scary bit is, you're all going to be midwives.

APPLAUSE AND CHEERING

..with care...

Oh, please help me.

We're here, we're here, we're here, we're here...

..and dedication.

My baby's life is in your guys' hands. I know. That's it now.

Not good for the stress levels, this job, at all.

You'll be absolutely fine, I told you I'll be with you. OK?

It does touch you. This is the reason we do what we do.

All right, it's OK.

You smell nice.

It's more than a job, it's...

You're part of somebody's life, and they never forget you.

There we go.

OK, Danni, is it all right if we have a look at Alex

and see how he's doing and make sure everything's OK?

Yeah, what are you going to be do with baby?

We'll do a top to toe and make sure everything's in the right place,

he's got ten fingers, ten toes. Is that all right?

Yeah, that's fine. Lovely, thank you.

This year, a record number of students are

training to become midwives.

You're going to feel for their posterior fontanelle

all over to their anterior fontanelle.

Feeling great, and there's no moulding, as well.

These new recruits are in their first year of a three-year degree

course at Birmingham City University.

Here's your Vitamin K.

I need two midwives to check it for me,

I'm actually not qualified to do so.

None of you are.

SHE LAUGHS

They'll split their time between academic study

in the classroom, and hospital and community training placements.

Thank you. So everything's fine and normal with baby?

Everything's absolutely perfect.

Well, bye, baby. That's it now.

First-year student Rebecca is from a family of midwives.

Both my grandma and my mum were midwives,

so it's something that I've grown up around.

They've been very open and honest about the role

and what can be expected and how difficult it is.

It's not all just, sort of, walking into a room,

delivering a gorgeous, healthy baby to a lovely, healthy,

fit mother, cos that's not what the job is, unfortunately.

She's been studying at the university for just three months.

Tonight, she's starting a four-week placement

at Birmingham Women's Hospital, on the night shift.

It's just going to take quite a lot of getting used to.

I've obviously never worked at night-time before, you know?

Am I going to get through the door and then become really tired?

It's very strange getting ready for a night shift.

Student midwives are recognised by their white uniforms.

A single chevron is sewn onto the sleeve for each year of training.

As a first year, I think it's highlighting, obviously,

with red, the fact that we might not

know everything quite yet.

I've never sewn on a sleeve in my life,

but, you know, we're going to be sewing up things like episiotomies

and torn perineums, so worth getting the practice in, I think.

WOMAN SCREAMS

Rebecca will train at Birmingham Women's Hospital's

high-risk delivery unit for three years

before she's qualified to deliver a baby on her own.

Well done. Oh!

(SOBBING) Oh, my God!

She'll rely on an experienced midwife to mentor her,

so she can practise on mums.

Hi. Hi.

Hi, are you Daisy? Yeah.

Daisy, I'm Rebecca, I'm your student.

Ah, hi, Rebecca. Hello. How are you? Are you OK?

I'm very well, yeah. I'm very, very excited. Fab.

To meet my mentor, as well!

You're going to be with me for the next four weeks?

Yes. OK. So is there going to be much for me to do as a student?

Lots for you to do. Have you put anybody on a CTG before?

No. We'll be doing lots of that tonight, then. OK.

Have you done blood pressures and things like that?

I'm not very good at blood pressures, so...

OK, we'll start showing you what to do.

Wonderful. Yeah? I'm very, very excited. Good.

So, you are, "I'm Rebecca, I'm a student midwife.

"Do you think you could do a urine sample for us?"

And then we're going to go into Room 2.

Before she gets hands-on, Rebecca must learn the basics.

Daisy has asked her to test a urine sample.

This one's really full, so be careful.

You have to have a lot of patience with a mentor,

especially with a first year, because they're learning

everything for the first time, and it's all very new.

So you're having to teach them right back, at the basics.

So sometimes you forget that they don't know how to do

a blood pressure, or that they aren't sure how to do a urine test.

She's got a bit of protein, but nothing else,

so this needs to go in the sluice.

Oh.

Oh, crap. Oh, dear.

She got one plus of protein,

and I also dropped a little bit of urine on the floor.

Huh? I dropped a little bit of urine on the floor,

what do I do with it? Have you wiped it up?

There should be alcohol wipes in there.

If not, there should be some in the room.

OK, I'm going to go and disinfect the floor.

THEY LAUGH

Bless her, her first day.

Oh. Mmm.

SHE LAUGHS

Hi, are you OK?

Rebecca needs to deliver 40 babies under supervision

over the next three years to qualify as a midwife.

My name's Daisy, and this is Rebecca,

and we're going to be looking after you tonight.

Lovely. Are you OK?

Rebecca's first mother is Gemma, who's having her first baby.

She's high-risk and being induced,

having developed gestational diabetes.

How are you feeling? I'm all right. Yeah?

Ask me that later.

THEY LAUGH

Do you know what you're having? A little boy.

A boy? What are you going to call him? Joel. Joel?

Ah, fabulous. Excited?

Nervous? I am excited.

And when they told me that I've the bed, I was like, "Yes!"

Gave them a cuddle, like, "Yeah!"

Then I called my mum.

Oh, no. "What's going to happen now?" Oh, gosh. Aww.

Right. Do you understand what we're going to do? Yeah.

We have to break your waters before we start the drip. OK.

Once the drip starts, we turn it up every half an hour

until you start getting good contractions.

Brilliant. OK? Yeah. Great stuff. Great.

'On the delivery suite, we can't always just have

'the normal women for Rebecca to look after,

'so we have to teach straightaway the abnormal as well.

'That can be a bit difficult for them to kind of get to grips with,'

because they're still trying to get to grips with what's normal.

And so, to throw in somebody that's higher risk,

and what to do when things are high-risk, I think can be

a bit too much for people to take in sometimes.

There, there we go, no prob.

Ah.

If it's not too painful, would you be happy for Rebecca

to examine you and see what one centimetre feels like?

Yeah. Yeah? Is that all right? Yeah. Brilliant.

This is the first time that I'm going to be doing

a vaginal examination, and I'm hoping

Daisy's going to talk it through with me as well,

whilst we're doing the exam. I will.

It's this gloves that's the tricky bit.

You think that's the tricky bit?

THEY LAUGH

Yes.

It's good we're not in an emergency, Rebecca.

I know, sorry.

Can you get them on?

Of course I can.

There we go, on.

OK.

It's very difficult to feel where the cervix is

and how far dilated it is.

So just to find the cervix for Gemma now is good enough,

that's all I want her to do, is just be able to feel where the cervix is.

So, just feel two fingers, so just inside.

Yeah, yeah.

And then keep your fingers upwards...

Yeah.

And then you reach right to the back, and you might feel

as if it's like the end of your nose, that little hard kind of...

And it's about a centimetre long.

Push, higher. And then it's like

just a tiny little hole. Can you feel that?

Sorry!

So you'll feel and if you put your finger inside it, you can

just press the baby's head,

and it's like you can feel a hard bit, his head. Yeah.

Can you feel it? Yeah. Yeah?

I can feel the baby boy.

Well done. Perfect.

Thank you very much, Gemma.

You're welcome.

Yes, we're on our way, ladies.

Yes, we're going to be doing it and we're going to be doing it tonight.

I've waited quite a while, but I'm hoping to get a birth.

And I've just done my first vaginal examination as well,

it went really well, yeah. Oh, did you get it?

Yeah. "Get it!"

Like, feel it. I did, I did.

She's really, really nice, they're a really lovely family.

I still haven't done one yet.

See you later! Bye! Bye!

SHE KNOCKS

It's only me.

AIR WHOOSHES

Four hours later, Gemma is in established labour.

As a first-year student midwife,

Rebecca's role is to support the mum.

I just want him out now.

I know, Gemma, but we can't rush him out either, can we?

He can't come out too quickly. I know, I know.

I need him out now, I've had enough. I know, I know.

GAS MACHINE WHEEZES

Daisy, I think I need to push!

Oh! Oh!

Use the gas, Gemma, keep using the gas.

GAS MACHINE WHEEZES

GEMMA GROANS

I'm going to get the doctor.

So Gemma's still about four, four to five centimetres dilated,

so she's made really good progress, because it's only been about

an hour, that she's likely dilated another centimetre, maybe two.

But there's some D cells on the CTG,

so it just means that baby needs a...

might be a little bit distressed.

So we're going to get the doctor just to have a little

look at the monitor and see what we can do. OK?

I'm not going to leave the room now.

OK. I'm not leaving the room, OK. Please don't leave me.

I'm not going to leave.

She's just got one of those urges to push.

I think she's going to be fast.

Becky, I need to push him out, I need to push.

Shall I just quickly examine you and see? Maybe you're fully dilated.

Please get him out! Please, please, please.

All right, Gemma.

Gemma, stay nice and calm.

Nice and calm, well done, well done.

GEMMA GROANS

Baby's heartbeat has dropped down.

If it doesn't pick up, we might need to go in for a Caesarean section.

Yeah, go, go, go! Please, any way, please.

GAS MACHINE AND GROANING DROWN OUT SPEECH

Have you got any questions?

I just want her to be all right.

Can someone stay with me?

Is it all right, Becky? Is everything OK, darling?

Everything's OK, we're just going to go into theatre.

Mum! Oh, please help me.

We're here, we're here, we're here. You're all right.

Gemma's baby is now in clear distress.

The doctors rush her to theatre to perform a C-section.

It was the one thing she said all along,

"I don't want a C-section."

And now she's got to have one.

Talk to me, because I'm in a fit.

I will, I'll talk to you. Stuart's here, hold Stuart's hand.

All right, and I'm going to stand.

It's probably easier for you to reach round, Stuart.

It's the first time Rebecca will have

responsibilities in theatre once the baby is born.

DOCTOR: No point in pushing now, baby's head is out, and baby's here.

There we go. Oh.

In just 15 minutes, baby Joel is delivered safely.

BABY CRIES

DOCTOR: Sounds it, good. There we go.

Thank you. Hello, baby.

BABY CRIES

Is he OK?

Come on.

Congratulations. Baby boy.

Hello. Hello. Congratulations. Thank you.

We haven't had to do anything - just dried him off,

kept him nice and warm.

He's just tiny.

He's beautiful.

God, your nanny's going to be so happy.

Both of them.

There you go, then.

OK, take him over and let's do a cuddle, and let them...

Let Gemma see his gorgeous face.

Aww, little one.

Gemma, look who I have got.

Oh, let me see him.

Can you see?

Oh, baby! Oh, look how little he is.

STUART: He is tiny. He is absolutely gorgeous.

Oh!

I love him.

What a beautiful family.

It's so nice to be there and be part of it. Beautiful.

Rebecca has assisted with her first emergency C-section.

Now she must get to grips with her first newborn baby.

I can't put his little hat on.

Come on, Joel.

Daisy, do the hats usually take this long to get on?

He looks like a Smurf.

No, stretch it.

Oh, OK. So I had the completely wrong technique.

Oh, come on.

I can't do baby hats.

I will perfect the technique another time. Not on baby Joel.

OK, so these are the midwifery Oscars.

STUDENTS BANG ON DESK

Oh, drum roll.

For the third-year students at Birmingham City University,

it's the end of their academic studies

and the last time they'll see each other in class.

Oh, Ashley's crying!

It's only cos we ran out of scotch eggs.

LAUGHTER

It's an emotional occasion.

Now they must complete their final four-week placement,

working in the community.

They must prove they can work on their own to qualify as a midwife.

And the scary bit is, you're all going to be midwives.

APPLAUSE AND CHEERING

21-year-old Melissa's final placement

is with the Quinton Lane Community Midwives.

Hiya, it's Melissa,

the student midwife that's coming out to see you shortly.

Hiya, sweet. I just needed to get your postcode, if that's all right.

When I first applied for midwifery,

I didn't realise how much responsibility was there.

There's more to it than just going to uni, you know, doing your essays.

We've got that other side of our course, where we're spending

time on placement, establishing ourselves as a practitioner

and gaining those clinical skills that we will need for the job, to be

a good midwife, to be able to care for those women and their babies,

and, I guess, to make a difference.

For the first time,

Melissa will be expected to carry out home visits on her own

to mums in Quinton, a large suburb of Birmingham.

It's important that all students are competent,

because, you know, it's part of protecting the public.

Pregnant mums in the future need to be confident that

their healthcare professionals are safe.

Over the next month, Ann will determine

whether Melissa is safe to practise on her own.

Failure means she won't qualify.

You do worry about going in on your own, don't you?

I'm a bit more nervous now we're actually on the way there.

I think I'm not nervous of myself, because I know I can do it.

I'm more nervous in the fact that, what are the parents going to think?

Are they going to be thinking,

"Oh, what's she doing? Is she doing it right?" You know?

So yeah, once we're in there, I'll be fine,

once we're in there. It's just getting there, isn't it?

Hopefully I won't have any shaking hands.

Good luck. Thank you.

And I'll see you in about half an hour.

OK, bye. Bye.

I'm looking for the right house that we need to be at.

It's a little bit daunting not knowing where I'm going

and what I'm walking into.

There it is.

But you've got to be confident, because...

..you kind of have to be.

So, I'm just going to check, I think it's number...

Oh, no, actually...

I always get the addresses wrong.

51, so we've gone too far now.

So that's that...

Oh, there.

Are you all right?

It's by those... I opened the window to get your attention.

That's all right. Sorry, I thought it might have been you,

but I wasn't sure. Yeah. Are you Lisa? Yeah, I am, yeah.

I'm Melissa, how are you? I'm fine. Good.

Well, I've got one concern at the minute.

I don't know if it's normal. I did speak to the doctor,

but I'm losing, like, a black discharge.

I explained to the doctor the other day, it's not like clots,

it's just like...

..like watery, blacky... and there's black bits in it.

And he turned round and he did say to me, "Don't worry about it,

"but obviously, if it gets worser,

"then have a word with the midwife about it."

And it is getting a bit worser than what it is, and I don't...

I don't know what it is.

OK, bear with me a second. OK.

It's not like all the time when I go.

Is it completely black or is it red?

Black, no, it's black.

I'd worry if it was red, obviously.

Sorry, I'm going to have to run off to the toilet.

It's all right.

Hi, Sarah, it's Melissa. I'm just doing this booking.

The lady's just informed me

that she's losing quite a watery discharge, but it's black in colour.

'I always doubt myself.

'I think my confidence has grown quite drastically

'since first year, but I've always had that doubt

'at the back of my mind, can I actually do this?

'Am I good enough to be a midwife?'

Thank you, all right, bye-bye.

OK.

This is a very personal question, and I do apologise for asking it,

but have you had sexual intercourse recently?

Yeah, obviously.

In the past few days?

Not in the past few days, no.

Because it could be old blood,

and sometimes it's quite normal to have a bleed after intercourse.

Right.

I think what we will need to do is get you to go and see the GP.

Right. Because I am quite worried, because I've had 17 miscarriages.

17? Yeah.

I'm sorry to hear that, Lisa, it's not very nice, is it? No.

So I think that's the best option, is to book an appointment today.

OK, then.

And if you can't see anybody today, then you need to try

and get to a walk-in GP centre.

Right, OK. OK?

It went well, but it was a tricky booking.

She had quite an extensive obstetric history,

in terms of her previous miscarriages, the number she had.

So I almost felt a little bit out of my depth.

It is quite scary, you know, it's really hard to think,

"Oh, my God, in a few months, I'm going to be out there on my own."

This time next year, I could potentially be in a blue dress,

out on the community, doing my own visits

with nobody to kind of go back to

in terms of a mentor-student relationship.

I may even have my own student!

It is mad, but it's really exciting at the same time.

You spend your life looking for things, like scales.

Rebecca is working the night shift on the high-risk delivery unit at Birmingham Women's Hospital.

'Night shifts are OK.'

I've been feeling quite uncomfortable, quite bloated.

And then you feel, when you're sleeping,

if I do a row of nights, that's four days that I'm sort of out of sync.

And you feel like nobody else knows that you're there or that

you're actually living, you know.

In a flat on my own, I feel like I'm quite secluded sometimes,

especially doing nights, when you're not awake with everybody else.

Irene, it's only me.

33-year-old Irene has been on the unit for five days,

and there's still no sign of labour starting.

I'm having a hospital holiday, I'm stuck here, so...

Do you know what you're having? Girl.

A girl? Yeah.

Wonderful, the baby's heartbeat looks beautiful at the moment.

So I'm just going to talk to the doctors and see

if we can start the drip now and then we'll get things going.

OK, sweetheart, I'll be back in a minute.

All right, OK, thank you.

To prevent Irene developing blood clots in her legs during labour,

Rebecca's first job is to fit her with compression stockings.

OK, are you going to try and pop these on?

Oh, my God.

They're tight, but you just have to really just pull them up.

Are these the ones that have the things inside as well,

like a little bit of plastic to help you put them on?

Can you do one and I'll do the other? You can do them both for practice.

OK. Okey-dokey!

because I've tried them before and failed.

Don't worry about lifting your foot or anything.

OK. And tell me if I'm hurting you, just let me know, OK?

It's all going on right now, let me know if it's sore.

No, it doesn't hurt at all, I feel sorry for you.

Grappling with this sock!

I feel like I want to help you, but I can't.

Oh, no, no, don't worry.

Rebecca's always worrying that the little things, you know,

is she doing it right, is there anything she could do better,

has she done it wrong?

Can you see the concentration on my face?

'Sometimes the best way to learn is just to go and do it,

'and sometimes, I think she holds back a little bit and thinks,

'oh, let me watch you again,'

and then I'll try next time.

But sometimes, the best way to learn is just by going and doing it.

Well, thank you very much.

There you go. Stockings on!

Ta-da, is that done OK?

Yay!

You do leave it like that, though, don't you?

We usually put it over the toes, but some people might want to toes out. Oh.

No, actually, you can do it for now.

Yeah?

Yeah, see if it looks nicer.

It looks nicer! It's all about how you look today.

Definitely.

THEY LAUGH

Many first-year students, like 19-year-old Molly,

are unlikely to have set foot on a maternity ward or witnessed a birth.

I don't think I should be allowed to do this for another few years yet,

but they just kind of chuck us in, so all I can really do is

what they show you on film - "Breathe, breathe."

That's it, really.

I saw someone have a Caesarean section on TV,

on Casualty, the other day, and it did scare me a bit.

And that's completely fake, so I'm not looking forward to that,

I don't know how I'll react in theatre, that's one of my worries.

Because I've seen a birth before

and I've seen the crash team have to come in to a birth before,

but I've never seen anyone be sliced open yet, so I don't know how

I'll react to that, it's a bit...

Bit squeamish of that, I think.

Molly is being mentored by Cathy Jones,

a midwife with over ten years' experience, at the Women's Hospital.

Just remind me where you are and what, what you've done so far.

I'm a first year, first placement in delivery so far.

First placement on delivery today? Have you had any deliveries at all?

I've seen two. You've seen two? OK.

'Because it's very difficult'

to get work experience in this sort of area,

you've had little or no exposure to this kind of environment at all

before your first day. So you really don't know

whether it's going to be something...

you think you've got an idea that it's what you want to do,

but you can't really know until you start doing it.

Molly is assisting with Suzanne, who's having her second baby.

The good news - well, you're fully dilated, OK?

Because I would probably, at this stage, probably wouldn't,

wouldn't necessarily do your epidural.

Oh, God.

Is it too late for pethidine?

Yeah, it wouldn't work, darling. I think you'll have a baby before.

Is it too late for anything?

It is, I'm afraid, at the moment, yeah. Shit. OK, but you'll be fine,

Sue, Sue, look at me. You're doing great with the gas.

You're going to be fine. OK? We're going to look after you.

I really didn't want this to happen. I know this is not what you wanted, sweetheart, but you'll be fine.

Give me a push, Sue, give me a push, OK?

SHE STRAINS

Hi, Suzanne, my name's Dr Chiu, I'm one of the registrars.

Hi, hi.

So the baby's heart rate's still quite low, actually, Suzanne, OK?

So I think what we really need to do is get the baby delivered.

The doctor will help Suzanne delivery her baby by ventouse,

a suction cup placed on the baby's head.

OK, we only get three pulls, OK?

So you must push, just like you just did, OK?

God, it's all going really quick.

I know.

You're doing a fantastic job, Sue, OK?

Come on, great big push until he tells you differently.

Push, push, push, push, push, keep going. Great job, well done.

SHE STRAINS

Fantastic, well done.

Well done, OK, just stop there for a second. Nearly there, OK?

So next contraction, we should have the baby delivered.

This is, this is coming.

If it feels like it's time and you know it now.

You'll know it before we will. Go on then, great big push, darling,

that's it. Listen carefully, keep going, keep it going.

SHE STRAINS

All the way, keep it going. Well done, Sue, you're doing brilliant.

OK, get ready to blow, OK?

DOCTOR: And another push for me.

MIDWIFE: There we go, great. The head is born!

Well done, mate.

Oh, my God. Little push and she's here, OK?

DOCTOR: OK, stop, stop, stop, stop, stop, just pause.

Good girl. Hello, happy birthday!

Oh, beautiful!

Happy birthday!

Hello. Oh, my God!

MIDWIFE: Well done, darling, nine minutes past five, OK? Well done!

You superstar, well done.

BABY CRIES

As Molly deals with the baby, the team attend to Suzanne,

whose blood pressure has suddenly dropped.

I think you feel a bit rubbish because your blood pressure's a bit low. OK? All right.

Can I just re-examine you again, Suzanne, just to make sure there's no more clots in there?

The problem is, if there's lots of clots in you, in your womb...

Yeah. It doesn't contract properly, so it doesn't work very well.

Yeah. And it fills up and fills up, and you're bleeding,

but we can't see it coming out, but you're bleeding onto the inside,

and that's what can make you feel unwell. Right.

So we need to make sure that that's not what's happening, OK?

Molly, just go and hold her hand, OK?

Sorry, Suzanne, you're doing great.

There's clots in the vagina.

There is?

Lots. It's still coming, Cathy, that's the problem.

Suzanne is haemorrhaging,

a rare complication that can happen after birth.

The team must get the bleeding under control or it could prove fatal.

Suzanne, are you OK?

You're shaking, you've just got quite a bit of adrenaline at the moment, OK?

It seems to have lessened a bit, we'll keep an eye on it, all right?

'Suzanne kind of went very shaky and pale,'

and her blood pressure went down loads, and her heart rate kind of raced up.

That was quite scary, just because I knew that a low blood pressure,

and with the amount of blood that she'd lost, and with

the raised heartbeat, that there was something definitely wrong.

In an emergency situation,

everyone's busy doing what they're doing, and they kind of explain it to the students after,

they just ask them to go grab little things.

So then you're kind of there, in the unknown about what the situation is

and what's going on, which is quite scary.

So, we'll send off these bloods and we'll just see what's going on.

Are you all right, Sue? Yeah. Sure?

'For Molly, who, during this placement,

'the idea is that you get as much exposure to normality as possible,'

wasn't quite what we had planned.

But I do think it's really important for the students to appreciate that

normal's great, but normal isn't for everybody and normal isn't every day,

particularly not when you do your training in a unit like this.

MOLLY: It's kind of taught me not to kind of trust the situation

until it's properly safe and handed over, that you can't kind of relax

completely and think that everything's OK.

Even if they look fine, they, obviously, aren't always all right.

Third-year Melissa is on her final work placement as a community midwife in Quinton, Birmingham.

Here, she will run her own antenatal clinic,

with sole responsibility for a full list of patients.

Karen Blanch?

She'll have to give appropriate care and run to time,

whilst mentor Ann takes a step back.

This is a big responsibility for Melissa,

because this is the first clinic on her own.

And in the future, you know, in a few months' time,

she'll be expected to do a clinic by herself, without any backup.

So it's good that she's getting the experience of conducting her own clinic

with me on hand in the room next door.

This is a crucial part of her practical assessment.

Melissa must pass this stage to qualify as a midwife.

Ann is here today, she's just in another room.

She's letting me be a midwife for the day.

Everything I do today has got to be right, because the women are

going to look at me and think, "She needs to know what she's on about."

I don't really want to feel like, "Oh, actually, I'll go and ask Ann."

I want to be able to do it on my own, because it was one of my objectives

for this placement, so fingers crossed.

Amy Michelins?

Her second patient, Amy, is only 15 weeks pregnant.

She's never heard her baby's heartbeat before.

We can try and have a little listen in today, to your baby's heartbeat.

But because they're so tiny, there's no guarantee that we will be able

to hear it, so it's completely your choice.

Because I don't want you to go away thinking something's wrong

if I can't pick it up. Yeah, that's fine, if you can have a go,

that would be lovely. Yeah? Yeah, of course, take a seat on the couch.

Even for experienced midwives, it's not always possible to find

the baby's heartbeat at such an early stage of pregnancy.

Sorry, I've got cold hands. That's all right.

That's baby moving around.

FOETAL MONITOR PULSATES

Do you know what, that is the most clear heartbeat I have picked up.

Good work.

Yeah, very good.

Lovely, thank you.

All right?

Yeah, perfect.

Thank you, Amy, take care.

Bye!

Oh, it was amazing. That is

the most clear heartbeat I've ever heard that early on.

She seemed really, really happy. Her face...

She had a big grin, didn't she?

It's nice to be able to make somebody smile like that.

Got it!

Patricia, hello, sorry to keep you waiting.

Melissa's next patient is 22-year-old Patricia.

Her pregnancy is overdue,

so she's been having regular check ups with the midwives.

How are you feeling?

I'm all right, but just lots of pain, like, on this side,

going down.

OK. Have you been feeling baby move, Patricia?

To be fair, from yesterday, don't want to move.

Not at all? OK.

Absolutely. He is so lazy, I know, but from...

Is it normal for him? Not from yesterday.

Not, not from yesterday, OK? Yeah, but always, he's like,

moving maximum two or three times a day. He's so lazy.

So, apart from yesterday, he normally has good movements, OK?

Yeah, yeah.

We'll probably send you up to triage, then, and get that checked out.

All right. All right?

We're always concerned where the foetal movements have changed

or reduced in any way.

That's not to say it, it's anything wrong,

but you just don't know, you know.

A baby can't tell you what's wrong,

so it's better to be on the safe side.

Do you know the seriousness of foetal movements?

Mmmm.

Did you try having a cold glass of water and sitting down?

I tried everything.

If that doesn't happen after a few hours, you must call triage.

All right.

OK? Because we don't know what's going on in there.

Hiya, can you put me through to triage, please?

Hiya, it's one of the students in clinic.

We've got a lady here who's not felt any foetal movements

since 2am. It's her first baby.

All right, thank you, thanks, bye.

Right, so just make your way there when you're ready.

All right. OK? Thank you. Thank you.

Thank you, bye.

Bye, take care.

Now she's left, I think I'm going to be,

sort of, thinking about her tonight, and I probably won't be able

to sleep, because my mind goes into overdrive.

You just don't know, and I think that's what's most scary.

Pregnancies are so unpredictable, you just never know.

Three hours later, it's clear that Melissa has made the right call.

Patricia has been rushed into theatre for an emergency C-section.

Patricia's been rushed round for a category one C-section.

It did happen really quick,

because she came in today in triage

to be induced for reduced foetal movements, and then, obviously,

when we've put her on the CTG, the baby's heart rate went down.

So the doctors made a decision to come round to theatre

and give her a Caesarean.

Congratulations, well done.

BABY CRIES

Yes, you're going to meet your mummy.

Somebody wants to say hello.

Don't cry, sweetie. We are... we are together now, yeah.

Don't cry, don't cry.

How are you feeling, Dad?

Stress!

Everything was fine by one second.

The heartbeat's gone, and automatically, they pressed

some buzz, lots of doctors came and says, you need to have a Caesarean.

So, they did a Caesarean, we are here, and he is with us.

So stressed, but so exciting at the same time.

Knowing that you've played a part in the outcome of somebody's baby,

sending them to triage and knowing that she hadn't felt her baby move

for 12 hours,

is a huge responsibility to think that,

if I hadn't sent her,

you know, would the outcome of that baby be as good as it is now?

It's quite overwhelming knowing that, if you're not doing your job

properly, that, you know, things, things can happen, you'd cause harm.

It was Rebecca?

Yeah. Do you want to go to 15? Yeah, lovely, thank you.

Nearly 3,000 babies will be delivered by students

at the Women's Hospital each year.

It's for suturing, isn't it?

For breast-feeding. You sit on it the other way round.

How is this for breast-feeding?

Not for the woman, for you, assisting her to breast-feed.

Oh, right, I see!

Rebecca is working the night shift with midwife Bobby.

Nine o'clock.

When you get, like, half past,

and it's five to, the time goes really, really fast.

Night shift midwives, can we come in? Hello.

They're looking after Janine, who's having her second baby.

Can I just feel your tummy? Is that all right?

You continue on the gas and air.

That's a nice, strong contraction you're having.

Keep going on the gas and air, you're doing really well.

That's the third in five minutes.

Just two hours into her shift,

Rebecca has the chance to assist on her third delivery in two weeks.

Well done.

JANINE CRIES OUT

I know, hang on in there.

Janine, do deep breaths on your gas and air.

JANINE CRIES IN DISTRESS

It's not so much distressing, the bit that gets me is

when the decibels go a little bit too high,

and it's more, sort of, just hurting your ears.

And you're very close to that woman and you have to then go closer to them to encourage them

whilst they're still screaming.

So it's not actually the fact that she's screaming, it's just the,

the actual noise and the impact on my ears that I find quite hard.

Just sit up for me again, because you've gone slightly sideways.

Oh, it really hurts, it's...

It's hurting?

It's comfortable here. It's comfortable here?

Well, we'll need to be careful that you don't roll off the bed.

Can I examine you in a minute?

Because you're pushing, aren't you? I know you are.

We can tell, Janine, that you've started pushing.

You have, haven't you? Yes!

Yes, you have!

How do you feel about getting hands-on with this delivery?

Yeah. I've done, I've done two, so yeah...

I'd really like to. Wicked.

I'm glad that you want to, that's good.

At least you're not shying away from it.

Do you mind just pressing the call buzzer as well, just for an extra hand?

Janine, I can see the top of the baby's head, OK?

So, if you have another contraction, give me a little push.

Are you having a contraction? Go on, go on.

That's it, go on, I think there is, well done, you!

Janine, keep these knees up for us.

Come on, keep on, keep going, go on.

Go on. More, more.

That's it, Janine, open up your legs as wide as you can, that's it.

Well done.

JANINE STRAINS

Well done, Janine, well done.

Hold on, no, don't push, just blow. Don't push.

Lovely, head's out, well done.

So just wait...

Give us a push.

Well done.

Congratulations!

Hello, little one! Well done.

Baby.

BABY CRIES

Here's your baby, she's beautiful.

My baby.

Beautiful, beautiful baby.

Oh, my God.

Hello, baby girl. Hello.

Well done. Oh, my gosh. That was amazing.

I've loved every minute of this placement, I have.

You know, even when you're tired and your eyes are streaming because

you've done too many nights, it's still loving it, really wonderful.

And you can just watch families change, you have, sort of,

mums in the room that are then grandparents and new parents,

and everybody's so happy, and it's just a really nice moment to be part of.

So happy.

I'm well proud of her.

It doesn't get much better than this.

This is just the cherry on the cake of life, really.

It's just banging!

We Brummies say banging!

I obviously don't know everything just yet,

but the more I learn, the more I can help.

And that's what I want to do, I want to help people.

One of Rebecca's final duties is to make tea

and toast for postnatal mums.

Oh, no, this must have stuck to the side.

Oh.

I've just annihilated the toaster.

Do you know the toaster is one of the most important pieces of equipment in the hospital?

I was very aware.

If you tell a postnatal mum that she can't have toast,

that's one of the biggest emergencies.

They're going to hunt me down, aren't they?

Yeah. Run...run and hide, Rebecca.

Now just pull back again,

to make sure that there's no air bubble at the top.

No, that's perfect.

You can ask anything.

I'm always asking you questions, constantly.

There's never a silly question, really.

Because it's never silly, is it, if it's bugging you?

And you're better to ask it now than to be coming

when you're qualified, because once you're qualified

and you do your little bit of rotations, you feel,

I think most students feel, I can't ask that, I should have known it.

And it could be a scenario happens that you haven't actually seen

and you could be qualified a year, months,

you could be qualified even longer.

Never to be complacent, because there is always a time

when you'll meet something you've never met before.

Hello.

With no guarantee of work after graduation,

the competition for a job is tough.

Now I'll update that for you as well.

22-year-old Hannah has swapped her student whites for blues,

having got her 40 births to qualify as a midwife.

It was the best feeling in the world when I found out I'd got

the job here, cos it was where I really wanted to work.

When you've got your white uniform on, you've sort of got that

to hide behind, so, and your mentor, you've got them to hide behind.

But now you've got your blue uniform, it's completely on you.

Which side is it you're getting your pain on? Is it your...?

It's the right side, isn't it?

I think, when you suddenly see the girls that you've trained,

and that have been your students,

and you suddenly see them in blue and they're all qualified,

it makes you feel really like,

"Oh, we made it, look at them, they did it."

You know, cos you've done it yourself,

what they've been through to get there and what they've achieved.

You've come so far and you know so much, and yet,

and it's just the beginning, so it's scary.

It's Irene's sixth day on the unit.

Her contractions have now started,

and Hannah will take charge of the delivery.

What I want you to do is we like you to get three

really good pushes with each contraction that you have.

So, what you need to imagine, it's going to sound not nice, imagine

you're really constipated and you really need to go to the toilet.

Just chin on your chest and just big push down into your bottom,

and fingers crossed, we'll see this baby.

That OK? Yeah.

OK? Getting one now.

That's it, fab, excellent.

That's it, keep it going, fab.

I'm really excited that

this could be my first birth in my blue uniform.

And it's really nice to be able to share it with a family that

'you've, you know, you've been looking after for a while

'and you've really got to know them.'

You've got another one now. I've got another one.

'The more you think about it, the more nervous you get.'

Fingers crossed, it will go nice and smoothly,

and we won't need any help, and she'll have a lovely delivery.

One more.

SHE STRAINS

Oh, fantastic, well done, brilliant.

Excellent.

Hannah can only let Irene push for a maximum of two hours.

Any longer, and the baby could become distressed.

With Irene close to her limit, Hannah needs to deliver the baby.

You're doing absolutely fab, be proud of yourself.

Still slowly.

No, it's not going to come quickly.

I'm afraid this baby wants to take its time.

Are you able to push again for me?

That's it.

Big push, right down.

Excellent, well done. There we go, head's out.

Well done, that's your baby's head. Head's out.

So, with the next contraction,

what we're going to do is deliver your baby. OK.

Got one brewing now, big push for me.

Big push. OK, push, yeah.

That's it, keep it going, keep it going.

Coming? I don't know if it's shoulders or not.

Is the neck free?

The neck's free, but can you push again for me?

There we go. That's it, well done.

SHE EXHALES

Come on, baby. Come on.

Come on, baby.

Come on, baby.

He's a little bit shocked, do you want to cut the cord? Yeah.

Come on.

BELL BEEPS

Can you press the call bell? The what?

Can you press the call bell?

Pull the emergency buzzer, thank you.

ALARM BEEPS

Have you got him? Yeah.

BABY CRIES

BABY GURGLES

Turn it off now. It's all right.

No, he's having a go. No, it's all right now.

Yeah, it's above 100. He's still really...

The tone's not brilliant. Yeah, yeah.

Yeah, we probably could do with, just, just bleep like normal. Yeah.

BABY CRIES

Come on, sweetheart.

Tone's improving.

Come on, darling.

BELL BEEPS

Come on, sweetheart.

Tone's improving.

BABY CRIES

She's come out a little bit shocked.

Ah, she's lovely. She's fine.

When you see that they're starting to respond to what you're doing,

it's absolutely amazing, because you know that's what

you're doing is... is obviously helping that baby.

And you know the baby is now a well baby and not...

not one that's going to potentially need to go to the neonatal unit.

Come on, sweetheart, let's go skin to skin with your mummy.

All right?

Congratulations. That's all right.

I'm tired, really tired and want to sleep.

I can't sleep, I'll watch, but we'll sleep in the night-time, yeah?

But it still will be better this night than the previous one.

How are you doing?

Well, I got a delivery, so first as in blue.

However, baby was born flat as a pancake. Oh, no.

Didn't respond to any stimulation at all,

so had to pull the emergency buzzer, take to the resuscitator,

five inflation breaths, and then it did respond.

Bless you. I know.

So it is a bit, I mean, the head delivered really slowly...

So was it? We delivered it to the eyebrows,

and then it took a while to get the rest of the face out,

so I don't know if that had anything to do with it or not.

I wouldn't have thought it did. It can, if it's sitting there for a little while.

Usually they respond fairly quickly...

Yeah, the crying and everything. Whereas this one did not? No.

So, Hannah, was that the first one then for you, love? Yes, it was.

Oh, bless. But you did it, sweetheart. We did.

First of many... I know.

And we get better and stronger and...

Yes, and if I get another resuscitation now,

I'll feel a bit more confident with it. Course you will.

Oh, dear.

BABY CRIES

I'm going to go home and eat lots of chocolate to relax,

because I'm absolutely knackered and emotionally drained today.

So I'm going to go home and eat lots of chocolate.

Oh, dear. You did cause us some grief, didn't you?

Yes, yes, you did.

Daisy, these are for you.

Oh, with these Ferrero Rocher, you are spoiling me.

They're my favourite.

It's the last day of Rebecca's placement.

In just four weeks, she's delivered five babies.

That's so nice, thank you, that's really sweet of you.

I just, I'm not going to do it for all my mentors,

you're my first mentor. Just me, just me. Yeah.

And, when you have other mentors, just still, just buy me the present.

Oh, Rebecca must have had another mentor recently,

another box of Ferrero Rocher.

That's such a good idea.

Rebecca has a confidence about her, and this lovely kind of fresh

kind of confidence that not many students have.

I think because some of them are a lot more frightened than she is.

But she...she seems to have overcome that quite quickly,

and that's nice, I think, because it doesn't hold her back.

I'm going to miss her, I've enjoyed working with her,

she's been really lovely to teach,

and I think she's going to make a really fabulous midwife.

Good luck. Give me a hug. Thank you, Daisy. Oh, thank you so much.

Take care and if you're ever worried about anything or need anything,

just give us a call.

I've got your mobile. You've got my number.

Thank you so much, Daisy, bye. Good luck, bye-bye.

Excellent attitude, good communication skills -

in fact, they're excellent.

It's the moment of truth for Melissa.

Today, she will find out

if she's done enough to pass her final placement.

So, well done, we've awarded you a grade of 80.4,

which is excellent, which is an A-grade, so well done. Thank you.

Do you want to comment on anything? Are you happy with that result?

Yeah, I'm really happy.

I just want to say thank you for making this last placement

a really good one.

Oh, bless you, give me a kiss.

I'm really thrilled.

I wasn't expecting an A grade, I was hoping to get at least a B,

but yeah.

It's nice to know that somebody's had that much trust in you

and supported me to be able to gain an A.

She's done really well in this last four weeks' placement,

and she's, she's an outstanding student.

And I'm quite proud of her,

cos I'm part of that process,

so I'm really pleased.

Oh, my God, it's the last ever placement that's going to be

ever assessed, and I got an A.

I just never thought I'd get here. Having a baby is one of the most

amazing things that anybody could have.

There are so many people out there

that can't go through that themselves.

And to be part of that experience for somebody is,

is a real privilege, it's a real privilege.

I'm getting all emotional now.

I guess it's just hit me that it's come to that point now where

I just want to get through it and finish it

and be able to make a difference to the public

and provide that care for women and their families and be a midwife.

Lovely to meet you. Lovely to meet you. Take care. Goodbye!

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