October 20, 2024 • 44 mins
Today we chat with Kelli who is a midwife, mum, wife and beautiful human.
Kelli has recently released her memoir and professional journey of becoming a midwife. She discusses the good, the bad and the heartbreaking with honesty and a rawness that brings tears to your eyes.
Kelli took the time to chat with me on the podcast about her book, her life as a professional midwife and the stories of the beautiful families she assisted as a midwife.
We discuss issues that home birthing midwives face from insurance, lack of support, hospital policies, moral injury and PTSD.
Kelli’s book is available through the link below. It is a fabulous read!
https://checkout.square.site/merchant/MLTYBCGSH67F9/checkout/5MXSMXPDNVTGA7XF7BVTXCNI
Support the show: https://www.patreon.com/tendernessnurses
See omnystudio.com/listener for privacy information.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Apologie production.
Speaker 2 (00:11):
Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1 (00:15):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
nearly four years.
Speaker 3 (00:24):
We always have free will, We always get to choose.
We are autonomous.
Speaker 1 (00:28):
Hi.
Speaker 2 (00:28):
Everyone, thank you for tuning back into Tendness for Nurses Today.
I have Kelly Zakarov who very kindly sent me a
copy of her book called Midwife Crisis, and I haven't
been able to put the book down.
Speaker 3 (00:43):
And I actually picked it up today from work.
Speaker 2 (00:46):
It was delivered to work, So my poor husband's been
off doing his own things and I've been reading away.
It's fabulous and thank you so much for shooting that
through to me. I've been jumping from chapter to.
Speaker 3 (00:59):
Chapter, which you can do with your book.
Speaker 2 (01:02):
So just explain your background a little bit for everyone,
so that they get a little bit of an idea
of where you've come from to get to the point
of writing the book.
Speaker 1 (01:15):
So I am a midwife. So I was one of
the first Bachelor of midw free students in Australia. So
back in the year two thousand, the couple ofties throughout
Australia started the Bachelor of midw three degree, which meant
that you didn't need to be a nurse anymore to
(01:35):
become a midwife. I had always probably resonated with lots
of babies in my life. I was the eldest of
sort of ten grandchildren, and I was always looking after
my cousins when they were born and when they were babies.
I was always a nanny when I was younger, and
I had my first child and I had and as
(01:57):
you've read in the book back a pretty traumatic birth
with him. Then for my second child, I luckily had
a student midwife with me and she kind of gave
me some inspiration, I guess, and I decided to look for,
you know, some sort of course that could I could
get through to be a midwife. And I just happened
(02:20):
to stumble upon the Melbourne Exhibition Gardens building one day
when I was out pushing my second baby in a
pram through the Carlton Gardens and I saw the expo
and in the expo was the Bachelor midw free stand
and they were looking for students to take on and
you had to be a middle you basically couldn't be
(02:42):
a school leader. You had to be someone who'd actually
had life experience to actually apply for the course for
the degree. So yeah, So with a babe in arms,
I signed myself up and yeah, four years later I
registered as a midwife. So yeah, so I started midw
free and I started midw free in the Bachelor midw
with Free, where it was really designed to teach midwives
(03:07):
to be continuity of midwives. That meant that we actually
looked after women from all the way through their pregnancies,
right through their labors and births, and right through to
sort of an extensive postnatal period in their journey.
Speaker 3 (03:22):
So it was did you also help them with breastfeeding?
Speaker 1 (03:25):
Yep, always help them with breastfeeding, So sort of really
looked after them. And when I actually and skip, you know,
many many years later, when I became a private practicing
mid wife, my postnatal care extended out to six weeks,
so often when I worked, and I did a lot
of extensive breastfeeding and postpartum care with the women as well.
(03:47):
So yeah, I started out as a kind of a
student and there was fifty two students in that cohort,
and twenty five of us graduated.
Speaker 3 (03:56):
Wow. Yeah, that's a big attrition, right, huge.
Speaker 1 (03:59):
Yeah. Yeah, And I think around about probably ninety nine
percent of us went on too private practicing home birth
midwives at some point of our careers. So I still
sort of have some sort of in touch with some
of those midwives as well, And ironically, very recently, I
actually was the midwife to one of my student colleagues daughters.
Speaker 2 (04:21):
So thirty years ago, when you became a midwife, was
that due to your own traumatic birth experience that you
wanted to change it for other women or you wanted
to do it differently at that point, had you thought
about working outside of the hospital space, or you just
wanted to work in a hospital arena and try and
(04:43):
improve the process that was there.
Speaker 1 (04:45):
I guess all of that, Beck, I look to be
honest with you, I really didn't think much about it.
I just I always knew that I wanted to do
something in that realm. I always wanted to work with women.
I always wanted to work with babies. I love the
idea of pregnancy, and I loved my own pregnancies. I
didn't particularly love my birth because they were both quite traumatic.
(05:08):
But I probably didn't really set out in any shape
or form or way to do anything. In particular, I
just I liked the idea of being a midwife, So yeah,
I wasn't and I guess I was slightly influenced from
that particular student midwife that looked after me during my
second birth, But I didn't necessarily have any I guess
(05:31):
I didn't really have any goals. I mean that came
later though, like much later on in my career, when
I set out to become a private practicing midwife. When
I reached the level that I could gain Medicare eligibility
and endorsement as a midwife, that's when I probably had
(05:53):
the inclination to change the world and to change midwif
free and to change care. And probably in the last
four years, the last four years of my career is
when I really wanted to change the world and I
really wanted to change how women were cared for because
I worked through the pandemic and we lost so much connection,
(06:16):
so much emotion. There was so much disconnection as a
midwife with women during that phase of my career.
Speaker 2 (06:26):
Your book resonated so much with me, and no, I'm
not a midwife, but different things you've gone through I
can relate or no, people that you have had to
deal with opera and the regulatory.
Speaker 3 (06:44):
Board and that sort of thing.
Speaker 2 (06:46):
In hindsight, knowing what you know now, would have you
still done private practice?
Speaker 1 (06:52):
Absolutely absolutely, And even now if I ever chose to
go back to Midway Free, I would go back to
private practice if I could, but not necessarily. There's not
really an avenue for me to do that now. But no,
I don't. I actually do not regret any aspect of
(07:14):
my career at all, and I definitely would go back
to private practice if I had the opportunity to do so.
Speaker 3 (07:20):
Yes, So are you currently registered?
Speaker 1 (07:24):
Yes, yes, I'm registered, and I still hold my endorsement,
I still hold my Medicare eligibility. I hold all of that.
None of that was ever taken away from me. The
only thing that was taken away from me was the
right or the ability to practice as a home birth
my wife.
Speaker 2 (07:44):
Okay, so do you mind explaining a little bit about
what transpired for you to get to the situation you
are now and that you felt the need to write
And it is it's an amazing book and I'll be
going home to keep reading it.
Speaker 3 (08:00):
But you know, you're really.
Speaker 2 (08:02):
Honest and vulnerable in your book, and I take I
applaud you. I take my hat off to you.
Speaker 3 (08:08):
I mean, it must.
Speaker 2 (08:09):
Be unbelievably stressful having to go through what you're going through.
Speaker 1 (08:16):
Yeah, Beck, I guess, yes, it was, and it is,
and I guess that's Look, the reason for writing the
book was, was this exactly I wanted to, I guess,
tell people what I've been through. I wanted to and
like I say in the book, what I portrayed on
the outside was not happening on the inside. So I
(08:38):
guess not many of my friends, or my colleagues, or
my family, even my family didn't really know what I
had been through and what transpired and how or when
or what happened. And I still I still struggle to
tell the story. And I guess, hence why the book
is you know, out there now and I guess the
(08:59):
whole you know, the amount of people who are going
to read this book will know exactly what transpired, and
I guess people will go, wow, I didn't realize that
that happened to her. So I guess what basically what
happened was was that unfortunately a baby died during the
course of a home birth that I was the primary
(09:20):
midwife for. It was a very planned home birth. There
was a few a few reasons why this home birth
went the way that it did. But unfortunately, the baby
didn't survive and I unfortunately had to deliver a stillborn
(09:40):
baby at home. The parents obviously were very shocked as
I was, and it wasn't necessarily a known stillborn. The
baby was alive during the labor and then unfortunately she
just was not born alive. There were a number of
ambulance officers in the house at the time and this
(10:03):
baby could not be revived. So post that incident, I obviously,
as anyone, struggled to go back into normal practice. And
like you know, many nurses and midwives, we are expected
to just get up and do it all again tomorrow
when something like that happens. And I, yeah, I struggled.
(10:28):
And I was running a business I was running. I
was running two private practices at the time, and I
was you know, I was the director, I was the manager.
I had people who were relying on me. I had employees,
I had women who were you know, waiting for birth
to happen. I was on call for women, and I
just I couldn't do it anymore. Like every I walked
(10:52):
on eggshells back like I every every day, every night.
I just you know, I didn't know what was around
the corner. A couple of weeks after that incident, I
received a call from APRAH and they basically told me
that a complaint had been put in against me, and
(11:15):
they didn't necessarily say it was in relation to this
particular incident. I of course knew that that's what it
was about, but I also knew that it wasn't from
the family of that baby. I had had a really
incredible relationship with that family and supported them all the
way through and cared for them six even six weeks
post like I would any family. I cared for them
(11:37):
six weeks post their birth. I went to the funeral
of the baby. I supported that mum in stopping her milk,
did a lot of work with them, a lot of
grieving with them, And I eventually found out again many
weeks later, that it was actually the hospital that I
had transferred that mum to that night had put the
(11:58):
complaint in against me. Yeah, so I had to. So
I spent many many months fighting that. I had an
incredible lawyer who you have had on your podcast, Eyvon Smith.
I owe my life to that woman. She was like
a dog with a bone, and she was not going
to let it go. She even wrote me an email
very recently and knowing full well that I've written this book,
(12:21):
and she wrote me this incredible email telling me what
an incredible midwife I was and how incredible that I
was throughout that whole process. So you know that from
from the heart, like, I was just astounded that even
she remembered who I was. But yeah, so I had
Evon supporting me and helping me through all of that.
(12:41):
And again, long story short, it took almost two years
for that process to happen and for UPRA to basically
decide that, and between Yvon and Uperah, we made a
decision or what's called an undertaking. So I basically was
(13:01):
given a choice. My choice was hand in your regis
as a midwife and never practice as a midwife again,
or take this undertaking and say that you'll never practice
as a home birth midwife again. So of course I
took the latter. I wasn't prepared to give up my
registration at that point in my life or my career.
(13:22):
And yeah, so I took that took that path, and
that's it's kind of a you know, it's a blessing
in disguise. It's a blessing that I'm still able to
practice as a midwife and that I was still able
to provide all the care and the support that I
could and I have done for the past nearly eight
years since that incident. Eight years yeah, eight years ago,
(13:48):
that baby died, so you know, and it's just look,
it's an incredible and look, I live with that every day. Back.
I live with that. I live with that event my
whole entire every day of my life.
Speaker 3 (14:00):
I wait, no doubt.
Speaker 1 (14:02):
And hence why I wrote a book about it. I
wrote boo about I mean, that incident doesn't necessarily isn't
isn't necessarily in the book, But there is a there
is a there's a chapter on that, on the incident
around the incident, on that in the book. I couldn't
necessarily write about the incident for all sorts of other reasons,
legal and confidentiality. But I talk more about how the
(14:27):
incident affected me and how I had to keep moving.
I had to keep moving and I had to keep
practicing for myself, for women, for you know, my businesses,
and I eventually closed my businesses up. I eventually couldn't.
I couldn't do it any longer. I couldn't continue down.
(14:47):
And of course, because I couldn't practice as a home
birth midwife, I couldn't hold a home birth practice open.
Speaker 2 (14:56):
So yes, so can I ask a question if the
same thing happened to a doctor, what have they been
put through the same thing as you?
Speaker 1 (15:09):
Look, I don't know, but I'm going to assume No.
I'm very doubtful that a doctor would be put through
the same process and pressure and expectations that I was.
And the hoops that I had to jump through to
get to that point was quite ridiculous, to be honest.
(15:31):
I had to do a dozen courses. I had to
write an essay, I had to apologize, I had to
get literally, I had to get down on my knees
and beg for my registration. So, to answer your question,
I'm pretty doubtful that a doctor would ever ever have
(15:52):
to go through what I went through.
Speaker 3 (15:54):
Did you see counseling after?
Speaker 2 (15:57):
Was counseling offered to you by the nursing A bit
with freeboard?
Speaker 1 (16:02):
No? The nursing, No, I wasn't off anything Beck. I
was a private practicing midwife, and private practicing midwives kind
of don't get anything. Really, we don't. We aren't provided
with anything. We have to provide everything for ourselves, all
of our own education. We're never included in any of
education at all. We have to seek out all of
(16:24):
those things. I you know, even through our insurance. Nothing,
nothing was provided to me. The only really the only
support which I probably got. You know, I I sought
some level of counseling, but it was many years later.
(16:45):
It wasn't. I definitely didn't do any counseling at the time.
I just moved on, Beck like I had to keep going.
I had to. I had to provide for my family.
I had to provide, you know, for the women that
I was that I was looking after. My practice continued,
so that happened. That happened in November, and everything came
(17:08):
through in around about July, and then the following February
was when I was given the ultimatum, and then I
close the business up in that March.
Speaker 2 (17:24):
I'm so sorry to hear that. That just breaks my heart.
I'm not comparing asthetic nursing to midw free in the
slightest but working independently in my own practice and helping
so many other colleagues that don't get the support they
(17:44):
need from you know, whoever they're scripting, doctor may be
or whatever, and every bit of education. Obviously, because it's
my own business, I pay for myself. And even within
you know, the College of Nurse Practitioners, the asthetic space
and nurse practitioners are frowned upon the Nursing and Free Board.
(18:05):
I don't acknowledge asthetic nurse practitioners.
Speaker 3 (18:08):
It's and yet.
Speaker 2 (18:09):
There's this aesthetic medicine and gps that go and do
aesthetic medicine. So it makes it a little bit tough.
And so because I do so much dermatology, I just
say'm a dermatology nurse practitioner because it just it's easier
to navigate than it is to say that, you know, yes,
half your practice is aesthetics and half of it is dermatology, lasers, skin,
(18:32):
that sort of thing, because there's just so much.
Speaker 3 (18:37):
I don't know, people just have such an idea about it.
Speaker 2 (18:40):
And I know the same is for home birthing midwives.
Because I did some time at.
Speaker 3 (18:45):
The mater.
Speaker 2 (18:47):
In the theaters as a registered nurse. I was doing
the c sections and doing recovery and some HDU work.
And I know that the home birthing nurses were not
looked upon favorably at all at all, Whereas I think, Wow,
(19:08):
you guys were trial blazers, but not everyone thinks that way.
Speaker 1 (19:12):
People get really threatened, oh very threatened. And I look,
I worked in Brisbane for a long time. Both of
my practices, one was in Brisbane in East Brisbane and
one was in the Sunshine Coast, so both of my practices,
and I know a lot of the midwives at the Marta,
and look, I was probably one of the lucky home
both midwives. Not in that sense, but I was always
(19:33):
lucky that I knew a lot of the midwives in
the Martter. So if I ever transferred to the Marta,
I was always welcomed. I never felt unwelcomed the only
other you know, there were a couple of other hospitals
that I transferred to that I definitely didn't feel welcome at.
But the Marta was always an incredible space for private
practicing midwives, and they eventually kind of put in a
(19:55):
couple of private practicing midwives and I know those midwives
today are still working in that space. So but yeah,
it's yes, definitely. You know, we're out on our own,
we're on an island. We kind of you know, we
do everything for ourselves and we never provided anything, and
it's always we're always the last people they think of,
the last people that they actually provide for or look after,
(20:19):
and that is yeah. Look, and it's still happening today,
you know. And I mean I've been out of private
practice for nearly five years now, so you know it's
still happening. I know a lot of private practicing midwives
that can and particularly now what's happening in private practice.
I know a lot of them are closing up their
businesses because they can't continue.
Speaker 2 (20:39):
Do you think you have PTSD from a some of
the trauma around the births that you've attended, but also
from what you've been through by your governing body?
Speaker 1 (20:52):
Absolutely, and look, and to be honest with you, Beck,
I would never have labeled myself with that until I
wrote that book. And it wasn't until I wrote the
book that I even went wow, all of this. And
there's often times where I look back at the book now,
and often when I was proofreading the book, I have
no memory of actually writing some of those aspects of
(21:15):
the book, because I guess it just it came out
of me. It's honestly the most incredible therapy I've ever done,
and the most expensive therapy I've ever paid for. But seriously,
you just builed out of me. And I originally when
I set out to write the book, because when I
was a private practicing midwife, I used to write notes
(21:37):
and I used to write stories for the women, and
my clinical notes always turned into books for the women.
So I would make books for them and I would
have all the photographs of the birth and I would
put it all together, and at the end of the
six weeks after looking after them, after having a beautiful
home birth or not, or even a birth in the hospital,
I would hand them over the book and I would
(21:58):
keep a copy. Now I have hundreds of those books
in my office. And when I originally started out to
write the book, I thought, oh, I'll go and look
at all of those notes. Didn't look at one of them.
It all came out of my head and I just
recalled bursts, and I record moments, and I recalled incidences.
So yeah, so I never really had to go back
and look at anything it was just it clearly was
(22:20):
just all there and it just kind of tumbled out
of me.
Speaker 3 (22:23):
Keeping at that level all the time.
Speaker 2 (22:25):
It can cause burnout and depression and anxiety and so
many other things. And was burnout something you had considered
within your beam? Do you feel like you were burnt out?
Speaker 1 (22:40):
Yeah? Yeah, And even in the book, and you're probably
not up to that chapter yet, but there is a
chapter there where I do recognize that I was burnt out.
And I recognized that while I was still working. And
I recognized that because I made some really bad decisions,
and that really, once I moved through that, I realized
(23:00):
that that was burnout when I made some very difficult decisions,
when I made when I made decisions that probably I
shouldn't have made, because yeah, I probably just wasn't thinking
clearly and I probably wasn't behaving the way that I,
you know, probably should have behaved.
Speaker 3 (23:21):
Yeah.
Speaker 1 (23:21):
So I guess burnout probably came to me in a
very different way to most people. And I think, and
I don't know that burnout, you know, we have you know,
definitely have you know, ten steps of burnout. But and
I've looked at and I had looked at some of those.
But I never really fitted into any of those categories,
and none of those things were ever happening to me.
But it was particularly when I did make a random decision,
(23:45):
a clinical decision, you know that kind of I probably
recognized that, and I probably didn't recognize that till a
little later. But yeah, burnout in.
Speaker 3 (23:53):
That's that's insight as well. You know.
Speaker 2 (23:58):
I think that takes a strong person woman to have
insight into.
Speaker 3 (24:06):
Looking back at things.
Speaker 2 (24:07):
You've done, and it's not regret, it's just acceptance of
that there may have been a better option at that time.
Speaker 3 (24:16):
Yeah, And I think nurses really beat themselves up.
Speaker 1 (24:19):
They Yeah, we do, we do. And again, like you say,
you know, like even every every birth, when you know
something didn't go to plan or she you know, when
a woman might have you know, had a lead of
postpartum hemorrhage or a two leader of postpartum hemorrhage, even
though I knew deep in my soul and my heart
that that wasn't my fault, I would always say, what
(24:39):
could I have done better for that? Or what should
I have done to prevent that? Or should I have
done this earlier? Or should I have done that earlier?
Or should I press the emergency buzzer earlier? You know,
should I have practiced, you know, like a hospital midwife,
not like a home birth midwife, you know, because because
I wore those two hats for a really long time,
(25:01):
and when I when I eventually went back into a
hospital space, I found it very difficult to take that
home birth natural environment. Yeah, it was really hard because
I was closed into these walls and I was expected
to follow these policies, and I was expected to follow
these procedures, and I was expected to give this drug
at this time, whereas in home birth it's very fluid,
(25:24):
you know, and it's very woman led, and it's very
woman centered, and it's midwif free and woman led and centered.
And whereas when working in a hospital it's not. It's
very policy centered and very proscedure centered, and very much
this timeframe has to be and this has to be
done at this timeframe. So yeah, I found that very difficult.
And I recall when I first started working back in
(25:46):
the hospital, I was forever called into the manager's office
for doing it. And I remember the manager saying to
me one day, she said, Kelly, you need to stop
pressing the emergency buzzer, and I sort of said, sorry,
I don't understand. What do you mean I have to stop?
She said, you know what, some times, you know you
(26:07):
can use your skills here. And I was a bit
like wow, because it kind of got beaten out of
me to begin with, and now I'm allowed to use
my skills, so I was a bit kind of It
was a bit of a tug of war between sort
of what I was allowed to use and what I
wasn't allowed to use. So it took me a long time.
But it probably took me four solid years, which were
those four solid years that I worked in that hospital,
(26:27):
to work that out.
Speaker 2 (26:28):
I don't think I could go back and work in
a hospitle. I mean I would if I needed to,
but I would struggle. Fifteen years I've worked on my own,
so it wouldn't be easy. No, what do you think
needs to change in MIDWI three?
Speaker 1 (26:44):
I think so much needs to change back, and I
think what needs to change is the care. I think
we need to bring back care and care is just
such a vital part. It's a vital part of nursing,
it's a vital part of healthcare. And you know, we
have care at the end of health, but there is
no care. And that's something that always struck me. That
(27:05):
is such a massive piece of the puzzle that just
keeps getting missed and keeps getting forgotten to put back in,
and particularly through COVID, and particularly post COVID, I still
believe that, you know, we've lost so much of that care.
I'd love to see students being taught, particularly mid with
(27:29):
his students taught about natural birth. I'd love to see students.
And I worked at a university, as you've read in
the book, I taught students, and I get lots of calls,
and I've a lot of students are reading my book
right now, and I've had lots of messages saying, oh
my God, the most amazing things that I was taught.
I don't get taught that anymore. I just I'd love
(27:51):
to see midw free come back to its roots, to
actually being what midw free means, and being a midwife
means to be with women, and to actually be with
a woman while she's laboring, to be with a woman
while she's pregnant, to actually really be part of that
and to not just be kind of, you know, a
little bit on the side to really care about what's
(28:13):
going on with her, and to really care about what's happening,
and to physically be present. You know, we unfortunately put
cdgs on women and walk out the door and watch
them from a central monitoring system like that, to me
is just there's no care in that, and it becomes reactive.
So when a baby's heart rate starts to drop, that's
(28:33):
when the midwife will walk back into the room. Yeah,
I just I'd love to see that.
Speaker 2 (28:38):
So you must have really developed relationships with the ladies
and families that were in your care because you were
with them during the most intimate and profound time of
their life, and you were asked to be part of that.
Speaker 3 (28:56):
I mean, that is such a privilege.
Speaker 1 (28:58):
Wh I wore that badge with honor. I honestly, I
still can't believe the privilege I had was given to
work with these women and some very broken women back Like,
I met lots of women, particularly in my last part
of my career in that hospital. I met women who
(29:20):
had been so broken and so damaged by birth and
when yeah, I don't know, I just I just tried
to put them back together and I really wanted them
to experience birth as the most incredible thing and the
most empowering thing that they could ever do in their lives.
And many of them did have that opportunity. You know,
(29:43):
I met many women who you know, were forced to
have caesarean sections for their first babies and amazingly had
vaginal births on bathroom flows with no monitoring and no
you know, no drugs or anything. So, you know, I
guess I just as I said, like, I kind of
know what I'm doing. I knew what I was doing,
(30:04):
and I loved what I was doing, and I loved
being that midwife. And that to me is really being
with the woman and being physically in her space. And
even like especially for home birth's that's within their home.
That's the most incredible privilege that I think anybody consoletely
upon someone to come into their home and to trust
(30:24):
them to be part of. And I say it in
the book, you know, being present with a woman during
labor and birth is like watching somebody have sex. It's
the most intimate and it is a sexual dance. You know,
these women become they're so you know, vulnerable, but yet
so able to kind of open themselves up and their
(30:46):
bodies up and again, like I tell a story of
this incredible woman having a home birth, and I just
I watched. I just sat and watched her, and I
watched her body move, and I watched her body sway,
and I watched her body physically give birth to her baby.
I didn't touch her once. I didn't even touch her
when a baby was being born. I just sat and watched.
I took photos. I used to do that a lot,
(31:07):
is to take photos. We've got amazing camera roll the
photos of women having babies. And you'll see some of
those photos in the back of the book.
Speaker 3 (31:14):
Yeah, I've seen them already.
Speaker 2 (31:16):
I went straight there and just went, oh my god,
they're the most futile. See when the bubbas were born
in the operating theaters, and yes, it was clinical, and
some of them were very scared. And because I did
night duties, we often did the emergency caesars. And you know,
I think the fastest we had one out was three minutes.
We're all with the midwife, you know, being between that
(31:39):
lady's legs, holding that baby's head off the cord, you know,
And that felt pretty amazing. But every one of those babies,
I said a prayer for every single one that was
ever born. I said a prayer for them, and then
I went and worked in palliative care and same on
the other end of this guy. And it was both
of them were such privileges, you know, it just was,
(32:01):
it was such a beautiful tie of someone's life. And yes,
I was a scrub nurse, so it was very hard
for me to be part of that. But you know,
you can smile with your eyes, and you know, you
can say nice words and you can be kind and
I always tried to do that. So you know, I
(32:23):
didn't have the experience you have as a midwife, but
I saw and worked with some pretty remarkable midwives at
that time.
Speaker 1 (32:31):
So oh, there's many many out there. There are so
many midwives out there that again, you know, I have
had incredible encounters with midwives, and you know, I just
honor each one of them, even you know, every midwife's
special and I think every and I always say every
woman deserves a midwife.
Speaker 2 (32:50):
You know, you talk about moral injury in the book,
and it's something we've discussed at length here on the podcast.
I have no doubt that you have had to do
things that have absolutely gone against your belief system.
Speaker 3 (33:06):
How do you come back from that.
Speaker 1 (33:08):
I'm not sure you do. To be honest, I think
it just again, it just gets built up and it
just sits inside of you. And look, and even as
I say in the book, if midwives are if I
and I really will speak for myself, if I had
the opportunity to have clinical supervision, I would definitely be
able to manage moral injury. But I don't. We never had,
(33:30):
we still don't to this day. Midwives do not. We
don't get clinical supervision. And that is such a tragedy
in our world. And I think that moral injury is
going to be a constant and it will erode. It
definitely will erode, and it is eroding quite a number
(33:50):
of you know, practicing midwives at the moment. I'm not. Yeah,
I don't know, Becka, I really don't know how to
deal with it. And I still I don't know how
to deal with it. And I wish I could. I
wish I had a magic pill. I wish I had
a blueprint. I wish I had you know, all the
things that would make it go away or to make
it easier. But until I guess, you know, more people
(34:14):
read a book like mine, then they a lot of
them will put up their hands and go, oh, I've
experienced that too. Oh, I go home with that every
night too. That's not normal, and it's not normal. It's
not normal. It's not a normal way to live.
Speaker 2 (34:31):
I think because it was so discussed within the military
side of things, and only more recently has it been
attached to the healthcare profession. And honestly, all of us,
all of us, at some stage or another, have had
moral injury of some description.
Speaker 3 (34:52):
And to think we haven't, I think.
Speaker 2 (34:55):
Is foolish, foolish, because we've all had to make decisions
that don't sit or align with our beliefs, all of us,
you know, And and I truly believe that clinical supervision
is paramount. And I think not just for midwives, the nurses,
(35:18):
for health care providers. I mean, you know, they they
have to do it in psychology and psychiatry and in
other medical practices.
Speaker 3 (35:27):
Why isn't it offered to nurses? Why are we considered throwaway?
Speaker 1 (35:32):
Not sure? I still don't know. And again, like you
know that the level of you know, trauma that that
we see is incredible, you know, And I've met many
and midwives who just brush it off, who just think that, Oh,
that's that's what I do every day. But that's how
it goes, you know. Yeah, we see postpindal hemorrhages like
that every day. It's nothing kind of It doesn't seem
(35:54):
to bother them. But I think somewhere along the line
there will come a time where it won't be you know,
you can't necessarily live like that, and I definitely couldn't
live like that anymore. And as I said, that's probably
one of the motivations of my book, is to actually
tell people and say, guys, this is not normal, this
(36:15):
is not a normal way to live. So let's start
talking about it. Let's actually get it out there.
Speaker 3 (36:20):
So I did, I think.
Speaker 2 (36:23):
I remember at the Martyr, I was doing a night
duty shift and a lady came in that had a
footling breach and I was so out.
Speaker 3 (36:36):
Of my depth.
Speaker 2 (36:37):
You know when you you laugh when it's really inappropriate.
That was me, And I remember the obstetrician looked at
me and went back get out, But.
Speaker 3 (36:51):
I was doing this stupid laugh I because she was
I'm not.
Speaker 2 (36:56):
She was screaming, screaming like a hyena, and this foot
she walked in with no pants onto the ward and
she had this baby's foot hanging out of vagiant. Now
I had never seen anything like that, and I'd had
two kids.
Speaker 3 (37:10):
By this stage.
Speaker 2 (37:12):
I was so horrified and horrified at what was coming
out of this woman's mouth that I had to turn
around and walkway. Now, thankfully the obstetrician that was on
had had lots of experience in the UK, and.
Speaker 3 (37:28):
That baby was delivered safely. But of course, as you know.
Speaker 2 (37:32):
Could have could have ended tragically, absolutely tragically. But I look,
that has stayed with me a because I was so inappropriate,
because I was so out of my dare you know.
I was a theater nurse and I just happened to
be the wrong place at the wrong time and told
to get the theater set up and I start laughing
(37:54):
like a Hyaena as she's screaming like a Hyaena, and
oh my god, and the look on this obstetrician's face
and he was like, I'll get out of here now.
And but last time I remember laughing like that was
in church with my girlfriend. And the more my parents
looked at me to shut up, the more I laughed.
I was always laughing inappropriately.
Speaker 3 (38:16):
Oh my god.
Speaker 2 (38:17):
So I mean, there's no moral injury or PTSD for
me there. But imagine if that hadn't have gone so
well and an amazing obstetrician was in and able to
deliver that baby safely, you know, if that hadn't gone well,
and the staff that were with him, and if that
(38:38):
had gone to theater, the theater staff as well. Because
footlength breaches are very concerning.
Speaker 1 (38:46):
They are concerning. The unfortunate situation is in Australia though,
back that so many of our obstetricians don't have skills
in birthing breach babies and so this is why we
have quite a high level of caesarean sections because when
a baby, particularly in a hospital environment, has been found
(39:08):
out as being breach position, and particularly maybe at thirty
six or thirty seven weeks, these women are booked straight
in for caesars. They're not even given opportunities to you know,
possibly wait for their babies to turn or we do
offer them ECVS external Catholic versions. Some doctors can do them,
(39:29):
some doctors can't do them. Some doctors think they're great ideas,
some doctors don't think so it's all led by them,
by obstetricians. And if an obstetriction, isn't comfortable doing a
breach birth, then they don't happen, so they.
Speaker 3 (39:42):
Go straight did you do breach births?
Speaker 1 (39:44):
I never did a breach I did one breach berth.
I had a home birth couple who we discovered the
baby was breached, and through the requirements of a private
practicing midwife and a home birth. Even though we don't
have an insurance for the actual act of a home
birth at home, we do have requirement and one of
(40:05):
those requirements was is that we weren't necessarily allowed to
do breach births a known breach berth at home. So
if we had a woman who was planning to have
a home birth with us, we discovered the baby was breach,
our requirement was to book her into a hospital so
she could either have a breach birth in a hospital
or have a safe cesarean section. So I had one
(40:25):
woman who we discovered had a breach baby on board
by about thirty nine weeks, and she wasn't prepared to
have a cesarean section, and she wasn't prepared to have
an ECV. We labored at home and then we made
the decision to transfer to hospital. Now she very Luckily
on the night we had an incredible obstetrician on staff
(40:46):
that night who was very happy to support her in
a breach berth, which again is a very unusual. But yes,
so we actually did do a breach, but it was
in a hospital. But I've never done a breach berth
at home and only and again because of the time
frame that I was working as a private practicing midwife,
it was an absolute no no. She got reported for
(41:07):
a very similar case. But I did get a report
from OPRAH and where I transferred another woman who had
a footling breach in labor and I transferred her to hospital.
She ended up with a cesarean section. The hospital reported
me for doing a breach.
Speaker 3 (41:21):
Birth, but she didn't.
Speaker 1 (41:23):
But exactly so, she didn't. And this is where Evon
came into the beautiful you know, the beautiful Evon. She
thought that. She just kept saying, guys, she actually didn't
have a breach berth at home. You did a cesarean
section in the hospital for that woman. So yeah, but still,
you know, as a private practicing midwife, you take the
heat like you have to. So again I had to
(41:43):
fight that. I had to fight the reasons why I
transferred that woman at six centimeters dilated to hospital when
we discovered the baby was breach. But that again, that
was another fight with Oprah to do that.
Speaker 2 (41:56):
Why at the hospital's like, who within the hospital is
pushing these complaints? Is it because they don't it's competition
to them for money or.
Speaker 1 (42:11):
I don't know. I don't think so. I don't think so, Beck.
I don't think it's a competition thing. I just think
it's a whole you've done the wrong thing, or you
shouldn't be doing that or look to be honest, in
my era of being a home birth midwife, it was
a very regular thing to get reported. It wasn't an
(42:31):
unusual thing to get a report from a hospital if
you were a home birth midwife. There was just something,
there was something in the system that you know, there
were certain hospitals that didn't like homebirth practicing midwives. They
didn't want us in the system, I guess, and so
I just felt they, you know, the more they reported us,
hopefully the less of us would be out there in
(42:52):
the world. And eventually that has happened. Unfortunately that has actually.
Speaker 3 (42:56):
Can say it's worked, hasn't it.
Speaker 1 (42:58):
Yeah?
Speaker 2 (42:59):
Yeah, Well, Kelly, thank you so much for coming in
and chatting with me. This is the fabulous book Midwife Crisis.
Any nurse, midwife, layperson will love reading this and love
the stories in it. And look, Kelly hasn't asked me
to promote anything. I just love a good read and
(43:20):
I love a read that gets me in, and it's
got me in. And the fact that you've been vulnerable
open You've openly discussed the shame you felt by you know,
having to deal with Upper and the Nursing Midwifery Board,
how it has impacted you, your family, your husband. Like
(43:41):
I'm so impressed by your honesty and vulnerability in this book.
And honestly, when you described your nan passing, I just
sat there and had tears running out of my eyes.
Speaker 3 (43:51):
So thank you so so much. We need more of
this and I'm so grateful you reached out to me
to have a chat because I was so excited to
chat with you today. So thank you so much, Kelly.
Speaker 1 (44:05):
Oh with my pleasure. Thank you for having me.
Speaker 3 (44:07):
When are you coming to Brisbane for a book tour?
Speaker 1 (44:10):
I am doing my book tour on the third of November.
I have just a very intimate launch, but I'm more
than happy to do another one if I'm there for
the whole week from the third to the eighth of November.
But if anyone wants to promote my book or wants
me to come and do another launch somewhere else, I'm
(44:31):
very happy to do that
Apologie production.
Speaker 2 (00:11):
Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1 (00:15):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
nearly four years.
Speaker 3 (00:24):
We always have free will, We always get to choose.
We are autonomous.
Speaker 1 (00:28):
Hi.
Speaker 2 (00:28):
Everyone, thank you for tuning back into Tendness for Nurses Today.
I have Kelly Zakarov who very kindly sent me a
copy of her book called Midwife Crisis, and I haven't
been able to put the book down.
Speaker 3 (00:43):
And I actually picked it up today from work.
Speaker 2 (00:46):
It was delivered to work, So my poor husband's been
off doing his own things and I've been reading away.
It's fabulous and thank you so much for shooting that
through to me. I've been jumping from chapter to.
Speaker 3 (00:59):
Chapter, which you can do with your book.
Speaker 2 (01:02):
So just explain your background a little bit for everyone,
so that they get a little bit of an idea
of where you've come from to get to the point
of writing the book.
Speaker 1 (01:15):
So I am a midwife. So I was one of
the first Bachelor of midw free students in Australia. So
back in the year two thousand, the couple ofties throughout
Australia started the Bachelor of midw three degree, which meant
that you didn't need to be a nurse anymore to
(01:35):
become a midwife. I had always probably resonated with lots
of babies in my life. I was the eldest of
sort of ten grandchildren, and I was always looking after
my cousins when they were born and when they were babies.
I was always a nanny when I was younger, and
I had my first child and I had and as
(01:57):
you've read in the book back a pretty traumatic birth
with him. Then for my second child, I luckily had
a student midwife with me and she kind of gave
me some inspiration, I guess, and I decided to look for,
you know, some sort of course that could I could
get through to be a midwife. And I just happened
(02:20):
to stumble upon the Melbourne Exhibition Gardens building one day
when I was out pushing my second baby in a
pram through the Carlton Gardens and I saw the expo
and in the expo was the Bachelor midw free stand
and they were looking for students to take on and
you had to be a middle you basically couldn't be
(02:42):
a school leader. You had to be someone who'd actually
had life experience to actually apply for the course for
the degree. So yeah, So with a babe in arms,
I signed myself up and yeah, four years later I
registered as a midwife. So yeah, so I started midw
free and I started midw free in the Bachelor midw
with Free, where it was really designed to teach midwives
(03:07):
to be continuity of midwives. That meant that we actually
looked after women from all the way through their pregnancies,
right through their labors and births, and right through to
sort of an extensive postnatal period in their journey.
Speaker 3 (03:22):
So it was did you also help them with breastfeeding?
Speaker 1 (03:25):
Yep, always help them with breastfeeding, So sort of really
looked after them. And when I actually and skip, you know,
many many years later, when I became a private practicing
mid wife, my postnatal care extended out to six weeks,
so often when I worked, and I did a lot
of extensive breastfeeding and postpartum care with the women as well.
(03:47):
So yeah, I started out as a kind of a
student and there was fifty two students in that cohort,
and twenty five of us graduated.
Speaker 3 (03:56):
Wow. Yeah, that's a big attrition, right, huge.
Speaker 1 (03:59):
Yeah. Yeah, And I think around about probably ninety nine
percent of us went on too private practicing home birth
midwives at some point of our careers. So I still
sort of have some sort of in touch with some
of those midwives as well, And ironically, very recently, I
actually was the midwife to one of my student colleagues daughters.
Speaker 2 (04:21):
So thirty years ago, when you became a midwife, was
that due to your own traumatic birth experience that you
wanted to change it for other women or you wanted
to do it differently at that point, had you thought
about working outside of the hospital space, or you just
wanted to work in a hospital arena and try and
(04:43):
improve the process that was there.
Speaker 1 (04:45):
I guess all of that, Beck, I look to be
honest with you, I really didn't think much about it.
I just I always knew that I wanted to do
something in that realm. I always wanted to work with women.
I always wanted to work with babies. I love the
idea of pregnancy, and I loved my own pregnancies. I
didn't particularly love my birth because they were both quite traumatic.
(05:08):
But I probably didn't really set out in any shape
or form or way to do anything. In particular, I
just I liked the idea of being a midwife, So yeah,
I wasn't and I guess I was slightly influenced from
that particular student midwife that looked after me during my
second birth, But I didn't necessarily have any I guess
(05:31):
I didn't really have any goals. I mean that came
later though, like much later on in my career, when
I set out to become a private practicing midwife. When
I reached the level that I could gain Medicare eligibility
and endorsement as a midwife, that's when I probably had
(05:53):
the inclination to change the world and to change midwif
free and to change care. And probably in the last
four years, the last four years of my career is
when I really wanted to change the world and I
really wanted to change how women were cared for because
I worked through the pandemic and we lost so much connection,
(06:16):
so much emotion. There was so much disconnection as a
midwife with women during that phase of my career.
Speaker 2 (06:26):
Your book resonated so much with me, and no, I'm
not a midwife, but different things you've gone through I
can relate or no, people that you have had to
deal with opera and the regulatory.
Speaker 3 (06:44):
Board and that sort of thing.
Speaker 2 (06:46):
In hindsight, knowing what you know now, would have you
still done private practice?
Speaker 1 (06:52):
Absolutely absolutely, And even now if I ever chose to
go back to Midway Free, I would go back to
private practice if I could, but not necessarily. There's not
really an avenue for me to do that now. But no,
I don't. I actually do not regret any aspect of
(07:14):
my career at all, and I definitely would go back
to private practice if I had the opportunity to do so.
Speaker 3 (07:20):
Yes, So are you currently registered?
Speaker 1 (07:24):
Yes, yes, I'm registered, and I still hold my endorsement,
I still hold my Medicare eligibility. I hold all of that.
None of that was ever taken away from me. The
only thing that was taken away from me was the
right or the ability to practice as a home birth
my wife.
Speaker 2 (07:44):
Okay, so do you mind explaining a little bit about
what transpired for you to get to the situation you
are now and that you felt the need to write
And it is it's an amazing book and I'll be
going home to keep reading it.
Speaker 3 (08:00):
But you know, you're really.
Speaker 2 (08:02):
Honest and vulnerable in your book, and I take I
applaud you. I take my hat off to you.
Speaker 3 (08:08):
I mean, it must.
Speaker 2 (08:09):
Be unbelievably stressful having to go through what you're going through.
Speaker 1 (08:16):
Yeah, Beck, I guess, yes, it was, and it is,
and I guess that's Look, the reason for writing the
book was, was this exactly I wanted to, I guess,
tell people what I've been through. I wanted to and
like I say in the book, what I portrayed on
the outside was not happening on the inside. So I
(08:38):
guess not many of my friends, or my colleagues, or
my family, even my family didn't really know what I
had been through and what transpired and how or when
or what happened. And I still I still struggle to
tell the story. And I guess, hence why the book
is you know, out there now and I guess the
(08:59):
whole you know, the amount of people who are going
to read this book will know exactly what transpired, and
I guess people will go, wow, I didn't realize that
that happened to her. So I guess what basically what
happened was was that unfortunately a baby died during the
course of a home birth that I was the primary
(09:20):
midwife for. It was a very planned home birth. There
was a few a few reasons why this home birth
went the way that it did. But unfortunately, the baby
didn't survive and I unfortunately had to deliver a stillborn
(09:40):
baby at home. The parents obviously were very shocked as
I was, and it wasn't necessarily a known stillborn. The
baby was alive during the labor and then unfortunately she
just was not born alive. There were a number of
ambulance officers in the house at the time and this
(10:03):
baby could not be revived. So post that incident, I obviously,
as anyone, struggled to go back into normal practice. And
like you know, many nurses and midwives, we are expected
to just get up and do it all again tomorrow
when something like that happens. And I, yeah, I struggled.
(10:28):
And I was running a business I was running. I
was running two private practices at the time, and I
was you know, I was the director, I was the manager.
I had people who were relying on me. I had employees,
I had women who were you know, waiting for birth
to happen. I was on call for women, and I
just I couldn't do it anymore. Like every I walked
(10:52):
on eggshells back like I every every day, every night.
I just you know, I didn't know what was around
the corner. A couple of weeks after that incident, I
received a call from APRAH and they basically told me
that a complaint had been put in against me, and
(11:15):
they didn't necessarily say it was in relation to this
particular incident. I of course knew that that's what it
was about, but I also knew that it wasn't from
the family of that baby. I had had a really
incredible relationship with that family and supported them all the
way through and cared for them six even six weeks
post like I would any family. I cared for them
(11:37):
six weeks post their birth. I went to the funeral
of the baby. I supported that mum in stopping her milk,
did a lot of work with them, a lot of
grieving with them, And I eventually found out again many
weeks later, that it was actually the hospital that I
had transferred that mum to that night had put the
(11:58):
complaint in against me. Yeah, so I had to. So
I spent many many months fighting that. I had an
incredible lawyer who you have had on your podcast, Eyvon Smith.
I owe my life to that woman. She was like
a dog with a bone, and she was not going
to let it go. She even wrote me an email
very recently and knowing full well that I've written this book,
(12:21):
and she wrote me this incredible email telling me what
an incredible midwife I was and how incredible that I
was throughout that whole process. So you know that from
from the heart, like, I was just astounded that even
she remembered who I was. But yeah, so I had
Evon supporting me and helping me through all of that.
(12:41):
And again, long story short, it took almost two years
for that process to happen and for UPRA to basically
decide that, and between Yvon and Uperah, we made a
decision or what's called an undertaking. So I basically was
(13:01):
given a choice. My choice was hand in your regis
as a midwife and never practice as a midwife again,
or take this undertaking and say that you'll never practice
as a home birth midwife again. So of course I
took the latter. I wasn't prepared to give up my
registration at that point in my life or my career.
(13:22):
And yeah, so I took that took that path, and
that's it's kind of a you know, it's a blessing
in disguise. It's a blessing that I'm still able to
practice as a midwife and that I was still able
to provide all the care and the support that I
could and I have done for the past nearly eight
years since that incident. Eight years yeah, eight years ago,
(13:48):
that baby died, so you know, and it's just look,
it's an incredible and look, I live with that every day. Back.
I live with that. I live with that event my
whole entire every day of my life.
Speaker 3 (14:00):
I wait, no doubt.
Speaker 1 (14:02):
And hence why I wrote a book about it. I
wrote boo about I mean, that incident doesn't necessarily isn't
isn't necessarily in the book, But there is a there
is a there's a chapter on that, on the incident
around the incident, on that in the book. I couldn't
necessarily write about the incident for all sorts of other reasons,
legal and confidentiality. But I talk more about how the
(14:27):
incident affected me and how I had to keep moving.
I had to keep moving and I had to keep
practicing for myself, for women, for you know, my businesses,
and I eventually closed my businesses up. I eventually couldn't.
I couldn't do it any longer. I couldn't continue down.
(14:47):
And of course, because I couldn't practice as a home
birth midwife, I couldn't hold a home birth practice open.
Speaker 2 (14:56):
So yes, so can I ask a question if the
same thing happened to a doctor, what have they been
put through the same thing as you?
Speaker 1 (15:09):
Look, I don't know, but I'm going to assume No.
I'm very doubtful that a doctor would be put through
the same process and pressure and expectations that I was.
And the hoops that I had to jump through to
get to that point was quite ridiculous, to be honest.
(15:31):
I had to do a dozen courses. I had to
write an essay, I had to apologize, I had to
get literally, I had to get down on my knees
and beg for my registration. So, to answer your question,
I'm pretty doubtful that a doctor would ever ever have
(15:52):
to go through what I went through.
Speaker 3 (15:54):
Did you see counseling after?
Speaker 2 (15:57):
Was counseling offered to you by the nursing A bit
with freeboard?
Speaker 1 (16:02):
No? The nursing, No, I wasn't off anything Beck. I
was a private practicing midwife, and private practicing midwives kind
of don't get anything. Really, we don't. We aren't provided
with anything. We have to provide everything for ourselves, all
of our own education. We're never included in any of
education at all. We have to seek out all of
(16:24):
those things. I you know, even through our insurance. Nothing,
nothing was provided to me. The only really the only
support which I probably got. You know, I I sought
some level of counseling, but it was many years later.
(16:45):
It wasn't. I definitely didn't do any counseling at the time.
I just moved on, Beck like I had to keep going.
I had to. I had to provide for my family.
I had to provide, you know, for the women that
I was that I was looking after. My practice continued,
so that happened. That happened in November, and everything came
(17:08):
through in around about July, and then the following February
was when I was given the ultimatum, and then I
close the business up in that March.
Speaker 2 (17:24):
I'm so sorry to hear that. That just breaks my heart.
I'm not comparing asthetic nursing to midw free in the
slightest but working independently in my own practice and helping
so many other colleagues that don't get the support they
(17:44):
need from you know, whoever they're scripting, doctor may be
or whatever, and every bit of education. Obviously, because it's
my own business, I pay for myself. And even within
you know, the College of Nurse Practitioners, the asthetic space
and nurse practitioners are frowned upon the Nursing and Free Board.
(18:05):
I don't acknowledge asthetic nurse practitioners.
Speaker 3 (18:08):
It's and yet.
Speaker 2 (18:09):
There's this aesthetic medicine and gps that go and do
aesthetic medicine. So it makes it a little bit tough.
And so because I do so much dermatology, I just
say'm a dermatology nurse practitioner because it just it's easier
to navigate than it is to say that, you know, yes,
half your practice is aesthetics and half of it is dermatology, lasers, skin,
(18:32):
that sort of thing, because there's just so much.
Speaker 3 (18:37):
I don't know, people just have such an idea about it.
Speaker 2 (18:40):
And I know the same is for home birthing midwives.
Because I did some time at.
Speaker 3 (18:45):
The mater.
Speaker 2 (18:47):
In the theaters as a registered nurse. I was doing
the c sections and doing recovery and some HDU work.
And I know that the home birthing nurses were not
looked upon favorably at all at all, Whereas I think, Wow,
(19:08):
you guys were trial blazers, but not everyone thinks that way.
Speaker 1 (19:12):
People get really threatened, oh very threatened. And I look,
I worked in Brisbane for a long time. Both of
my practices, one was in Brisbane in East Brisbane and
one was in the Sunshine Coast, so both of my practices,
and I know a lot of the midwives at the Marta,
and look, I was probably one of the lucky home
both midwives. Not in that sense, but I was always
(19:33):
lucky that I knew a lot of the midwives in
the Martter. So if I ever transferred to the Marta,
I was always welcomed. I never felt unwelcomed the only
other you know, there were a couple of other hospitals
that I transferred to that I definitely didn't feel welcome at.
But the Marta was always an incredible space for private
practicing midwives, and they eventually kind of put in a
(19:55):
couple of private practicing midwives and I know those midwives
today are still working in that space. So but yeah,
it's yes, definitely. You know, we're out on our own,
we're on an island. We kind of you know, we
do everything for ourselves and we never provided anything, and
it's always we're always the last people they think of,
the last people that they actually provide for or look after,
(20:19):
and that is yeah. Look, and it's still happening today,
you know. And I mean I've been out of private
practice for nearly five years now, so you know it's
still happening. I know a lot of private practicing midwives
that can and particularly now what's happening in private practice.
I know a lot of them are closing up their
businesses because they can't continue.
Speaker 2 (20:39):
Do you think you have PTSD from a some of
the trauma around the births that you've attended, but also
from what you've been through by your governing body?
Speaker 1 (20:52):
Absolutely, and look, and to be honest with you, Beck,
I would never have labeled myself with that until I
wrote that book. And it wasn't until I wrote the
book that I even went wow, all of this. And
there's often times where I look back at the book now,
and often when I was proofreading the book, I have
no memory of actually writing some of those aspects of
(21:15):
the book, because I guess it just it came out
of me. It's honestly the most incredible therapy I've ever done,
and the most expensive therapy I've ever paid for. But seriously,
you just builed out of me. And I originally when
I set out to write the book, because when I
was a private practicing midwife, I used to write notes
(21:37):
and I used to write stories for the women, and
my clinical notes always turned into books for the women.
So I would make books for them and I would
have all the photographs of the birth and I would
put it all together, and at the end of the
six weeks after looking after them, after having a beautiful
home birth or not, or even a birth in the hospital,
I would hand them over the book and I would
(21:58):
keep a copy. Now I have hundreds of those books
in my office. And when I originally started out to
write the book, I thought, oh, I'll go and look
at all of those notes. Didn't look at one of them.
It all came out of my head and I just
recalled bursts, and I record moments, and I recalled incidences.
So yeah, so I never really had to go back
and look at anything it was just it clearly was
(22:20):
just all there and it just kind of tumbled out
of me.
Speaker 3 (22:23):
Keeping at that level all the time.
Speaker 2 (22:25):
It can cause burnout and depression and anxiety and so
many other things. And was burnout something you had considered
within your beam? Do you feel like you were burnt out?
Speaker 1 (22:40):
Yeah? Yeah, And even in the book, and you're probably
not up to that chapter yet, but there is a
chapter there where I do recognize that I was burnt out.
And I recognized that while I was still working. And
I recognized that because I made some really bad decisions,
and that really, once I moved through that, I realized
(23:00):
that that was burnout when I made some very difficult decisions,
when I made when I made decisions that probably I
shouldn't have made, because yeah, I probably just wasn't thinking
clearly and I probably wasn't behaving the way that I,
you know, probably should have behaved.
Speaker 3 (23:21):
Yeah.
Speaker 1 (23:21):
So I guess burnout probably came to me in a
very different way to most people. And I think, and
I don't know that burnout, you know, we have you know,
definitely have you know, ten steps of burnout. But and
I've looked at and I had looked at some of those.
But I never really fitted into any of those categories,
and none of those things were ever happening to me.
But it was particularly when I did make a random decision,
(23:45):
a clinical decision, you know that kind of I probably
recognized that, and I probably didn't recognize that till a
little later. But yeah, burnout in.
Speaker 3 (23:53):
That's that's insight as well. You know.
Speaker 2 (23:58):
I think that takes a strong person woman to have
insight into.
Speaker 3 (24:06):
Looking back at things.
Speaker 2 (24:07):
You've done, and it's not regret, it's just acceptance of
that there may have been a better option at that time.
Speaker 3 (24:16):
Yeah, And I think nurses really beat themselves up.
Speaker 1 (24:19):
They Yeah, we do, we do. And again, like you say,
you know, like even every every birth, when you know
something didn't go to plan or she you know, when
a woman might have you know, had a lead of
postpartum hemorrhage or a two leader of postpartum hemorrhage, even
though I knew deep in my soul and my heart
that that wasn't my fault, I would always say, what
(24:39):
could I have done better for that? Or what should
I have done to prevent that? Or should I have
done this earlier? Or should I have done that earlier?
Or should I press the emergency buzzer earlier? You know,
should I have practiced, you know, like a hospital midwife,
not like a home birth midwife, you know, because because
I wore those two hats for a really long time,
(25:01):
and when I when I eventually went back into a
hospital space, I found it very difficult to take that
home birth natural environment. Yeah, it was really hard because
I was closed into these walls and I was expected
to follow these policies, and I was expected to follow
these procedures, and I was expected to give this drug
at this time, whereas in home birth it's very fluid,
(25:24):
you know, and it's very woman led, and it's very
woman centered, and it's midwif free and woman led and centered.
And whereas when working in a hospital it's not. It's
very policy centered and very proscedure centered, and very much
this timeframe has to be and this has to be
done at this timeframe. So yeah, I found that very difficult.
And I recall when I first started working back in
(25:46):
the hospital, I was forever called into the manager's office
for doing it. And I remember the manager saying to
me one day, she said, Kelly, you need to stop
pressing the emergency buzzer, and I sort of said, sorry,
I don't understand. What do you mean I have to stop?
She said, you know what, some times, you know you
(26:07):
can use your skills here. And I was a bit
like wow, because it kind of got beaten out of
me to begin with, and now I'm allowed to use
my skills, so I was a bit kind of It
was a bit of a tug of war between sort
of what I was allowed to use and what I
wasn't allowed to use. So it took me a long time.
But it probably took me four solid years, which were
those four solid years that I worked in that hospital,
(26:27):
to work that out.
Speaker 2 (26:28):
I don't think I could go back and work in
a hospitle. I mean I would if I needed to,
but I would struggle. Fifteen years I've worked on my own,
so it wouldn't be easy. No, what do you think
needs to change in MIDWI three?
Speaker 1 (26:44):
I think so much needs to change back, and I
think what needs to change is the care. I think
we need to bring back care and care is just
such a vital part. It's a vital part of nursing,
it's a vital part of healthcare. And you know, we
have care at the end of health, but there is
no care. And that's something that always struck me. That
(27:05):
is such a massive piece of the puzzle that just
keeps getting missed and keeps getting forgotten to put back in,
and particularly through COVID, and particularly post COVID, I still
believe that, you know, we've lost so much of that care.
I'd love to see students being taught, particularly mid with
(27:29):
his students taught about natural birth. I'd love to see students.
And I worked at a university, as you've read in
the book, I taught students, and I get lots of calls,
and I've a lot of students are reading my book
right now, and I've had lots of messages saying, oh
my God, the most amazing things that I was taught.
I don't get taught that anymore. I just I'd love
(27:51):
to see midw free come back to its roots, to
actually being what midw free means, and being a midwife
means to be with women, and to actually be with
a woman while she's laboring, to be with a woman
while she's pregnant, to actually really be part of that
and to not just be kind of, you know, a
little bit on the side to really care about what's
(28:13):
going on with her, and to really care about what's happening,
and to physically be present. You know, we unfortunately put
cdgs on women and walk out the door and watch
them from a central monitoring system like that, to me
is just there's no care in that, and it becomes reactive.
So when a baby's heart rate starts to drop, that's
(28:33):
when the midwife will walk back into the room. Yeah,
I just I'd love to see that.
Speaker 2 (28:38):
So you must have really developed relationships with the ladies
and families that were in your care because you were
with them during the most intimate and profound time of
their life, and you were asked to be part of that.
Speaker 3 (28:56):
I mean, that is such a privilege.
Speaker 1 (28:58):
Wh I wore that badge with honor. I honestly, I
still can't believe the privilege I had was given to
work with these women and some very broken women back Like,
I met lots of women, particularly in my last part
of my career in that hospital. I met women who
(29:20):
had been so broken and so damaged by birth and
when yeah, I don't know, I just I just tried
to put them back together and I really wanted them
to experience birth as the most incredible thing and the
most empowering thing that they could ever do in their lives.
And many of them did have that opportunity. You know,
(29:43):
I met many women who you know, were forced to
have caesarean sections for their first babies and amazingly had
vaginal births on bathroom flows with no monitoring and no
you know, no drugs or anything. So, you know, I
guess I just as I said, like, I kind of
know what I'm doing. I knew what I was doing,
(30:04):
and I loved what I was doing, and I loved
being that midwife. And that to me is really being
with the woman and being physically in her space. And
even like especially for home birth's that's within their home.
That's the most incredible privilege that I think anybody consoletely
upon someone to come into their home and to trust
(30:24):
them to be part of. And I say it in
the book, you know, being present with a woman during
labor and birth is like watching somebody have sex. It's
the most intimate and it is a sexual dance. You know,
these women become they're so you know, vulnerable, but yet
so able to kind of open themselves up and their
(30:46):
bodies up and again, like I tell a story of
this incredible woman having a home birth, and I just
I watched. I just sat and watched her, and I
watched her body move, and I watched her body sway,
and I watched her body physically give birth to her baby.
I didn't touch her once. I didn't even touch her
when a baby was being born. I just sat and watched.
I took photos. I used to do that a lot,
(31:07):
is to take photos. We've got amazing camera roll the
photos of women having babies. And you'll see some of
those photos in the back of the book.
Speaker 3 (31:14):
Yeah, I've seen them already.
Speaker 2 (31:16):
I went straight there and just went, oh my god,
they're the most futile. See when the bubbas were born
in the operating theaters, and yes, it was clinical, and
some of them were very scared. And because I did
night duties, we often did the emergency caesars. And you know,
I think the fastest we had one out was three minutes.
We're all with the midwife, you know, being between that
(31:39):
lady's legs, holding that baby's head off the cord, you know,
And that felt pretty amazing. But every one of those babies,
I said a prayer for every single one that was
ever born. I said a prayer for them, and then
I went and worked in palliative care and same on
the other end of this guy. And it was both
of them were such privileges, you know, it just was,
(32:01):
it was such a beautiful tie of someone's life. And yes,
I was a scrub nurse, so it was very hard
for me to be part of that. But you know,
you can smile with your eyes, and you know, you
can say nice words and you can be kind and
I always tried to do that. So you know, I
(32:23):
didn't have the experience you have as a midwife, but
I saw and worked with some pretty remarkable midwives at
that time.
Speaker 1 (32:31):
So oh, there's many many out there. There are so
many midwives out there that again, you know, I have
had incredible encounters with midwives, and you know, I just
honor each one of them, even you know, every midwife's
special and I think every and I always say every
woman deserves a midwife.
Speaker 2 (32:50):
You know, you talk about moral injury in the book,
and it's something we've discussed at length here on the podcast.
I have no doubt that you have had to do
things that have absolutely gone against your belief system.
Speaker 3 (33:06):
How do you come back from that.
Speaker 1 (33:08):
I'm not sure you do. To be honest, I think
it just again, it just gets built up and it
just sits inside of you. And look, and even as
I say in the book, if midwives are if I
and I really will speak for myself, if I had
the opportunity to have clinical supervision, I would definitely be
able to manage moral injury. But I don't. We never had,
(33:30):
we still don't to this day. Midwives do not. We
don't get clinical supervision. And that is such a tragedy
in our world. And I think that moral injury is
going to be a constant and it will erode. It
definitely will erode, and it is eroding quite a number
(33:50):
of you know, practicing midwives at the moment. I'm not. Yeah,
I don't know, Becka, I really don't know how to
deal with it. And I still I don't know how
to deal with it. And I wish I could. I
wish I had a magic pill. I wish I had
a blueprint. I wish I had you know, all the
things that would make it go away or to make
it easier. But until I guess, you know, more people
(34:14):
read a book like mine, then they a lot of
them will put up their hands and go, oh, I've
experienced that too. Oh, I go home with that every
night too. That's not normal, and it's not normal. It's
not normal. It's not a normal way to live.
Speaker 2 (34:31):
I think because it was so discussed within the military
side of things, and only more recently has it been
attached to the healthcare profession. And honestly, all of us,
all of us, at some stage or another, have had
moral injury of some description.
Speaker 3 (34:52):
And to think we haven't, I think.
Speaker 2 (34:55):
Is foolish, foolish, because we've all had to make decisions
that don't sit or align with our beliefs, all of us,
you know, And and I truly believe that clinical supervision
is paramount. And I think not just for midwives, the nurses,
(35:18):
for health care providers. I mean, you know, they they
have to do it in psychology and psychiatry and in
other medical practices.
Speaker 3 (35:27):
Why isn't it offered to nurses? Why are we considered throwaway?
Speaker 1 (35:32):
Not sure? I still don't know. And again, like you
know that the level of you know, trauma that that
we see is incredible, you know, And I've met many
and midwives who just brush it off, who just think that, Oh,
that's that's what I do every day. But that's how
it goes, you know. Yeah, we see postpindal hemorrhages like
that every day. It's nothing kind of It doesn't seem
(35:54):
to bother them. But I think somewhere along the line
there will come a time where it won't be you know,
you can't necessarily live like that, and I definitely couldn't
live like that anymore. And as I said, that's probably
one of the motivations of my book, is to actually
tell people and say, guys, this is not normal, this
(36:15):
is not a normal way to live. So let's start
talking about it. Let's actually get it out there.
Speaker 3 (36:20):
So I did, I think.
Speaker 2 (36:23):
I remember at the Martyr, I was doing a night
duty shift and a lady came in that had a
footling breach and I was so out.
Speaker 3 (36:36):
Of my depth.
Speaker 2 (36:37):
You know when you you laugh when it's really inappropriate.
That was me, And I remember the obstetrician looked at
me and went back get out, But.
Speaker 3 (36:51):
I was doing this stupid laugh I because she was
I'm not.
Speaker 2 (36:56):
She was screaming, screaming like a hyena, and this foot
she walked in with no pants onto the ward and
she had this baby's foot hanging out of vagiant. Now
I had never seen anything like that, and I'd had
two kids.
Speaker 3 (37:10):
By this stage.
Speaker 2 (37:12):
I was so horrified and horrified at what was coming
out of this woman's mouth that I had to turn
around and walkway. Now, thankfully the obstetrician that was on
had had lots of experience in the UK, and.
Speaker 3 (37:28):
That baby was delivered safely. But of course, as you know.
Speaker 2 (37:32):
Could have could have ended tragically, absolutely tragically. But I look,
that has stayed with me a because I was so inappropriate,
because I was so out of my dare you know.
I was a theater nurse and I just happened to
be the wrong place at the wrong time and told
to get the theater set up and I start laughing
(37:54):
like a Hyaena as she's screaming like a Hyaena, and
oh my god, and the look on this obstetrician's face
and he was like, I'll get out of here now.
And but last time I remember laughing like that was
in church with my girlfriend. And the more my parents
looked at me to shut up, the more I laughed.
I was always laughing inappropriately.
Speaker 3 (38:16):
Oh my god.
Speaker 2 (38:17):
So I mean, there's no moral injury or PTSD for
me there. But imagine if that hadn't have gone so
well and an amazing obstetrician was in and able to
deliver that baby safely, you know, if that hadn't gone well,
and the staff that were with him, and if that
(38:38):
had gone to theater, the theater staff as well. Because
footlength breaches are very concerning.
Speaker 1 (38:46):
They are concerning. The unfortunate situation is in Australia though,
back that so many of our obstetricians don't have skills
in birthing breach babies and so this is why we
have quite a high level of caesarean sections because when
a baby, particularly in a hospital environment, has been found
(39:08):
out as being breach position, and particularly maybe at thirty
six or thirty seven weeks, these women are booked straight
in for caesars. They're not even given opportunities to you know,
possibly wait for their babies to turn or we do
offer them ECVS external Catholic versions. Some doctors can do them,
(39:29):
some doctors can't do them. Some doctors think they're great ideas,
some doctors don't think so it's all led by them,
by obstetricians. And if an obstetriction, isn't comfortable doing a
breach birth, then they don't happen, so they.
Speaker 3 (39:42):
Go straight did you do breach births?
Speaker 1 (39:44):
I never did a breach I did one breach berth.
I had a home birth couple who we discovered the
baby was breached, and through the requirements of a private
practicing midwife and a home birth. Even though we don't
have an insurance for the actual act of a home
birth at home, we do have requirement and one of
(40:05):
those requirements was is that we weren't necessarily allowed to
do breach births a known breach berth at home. So
if we had a woman who was planning to have
a home birth with us, we discovered the baby was breach,
our requirement was to book her into a hospital so
she could either have a breach birth in a hospital
or have a safe cesarean section. So I had one
(40:25):
woman who we discovered had a breach baby on board
by about thirty nine weeks, and she wasn't prepared to
have a cesarean section, and she wasn't prepared to have
an ECV. We labored at home and then we made
the decision to transfer to hospital. Now she very Luckily
on the night we had an incredible obstetrician on staff
(40:46):
that night who was very happy to support her in
a breach berth, which again is a very unusual. But yes,
so we actually did do a breach, but it was
in a hospital. But I've never done a breach berth
at home and only and again because of the time
frame that I was working as a private practicing midwife,
it was an absolute no no. She got reported for
(41:07):
a very similar case. But I did get a report
from OPRAH and where I transferred another woman who had
a footling breach in labor and I transferred her to hospital.
She ended up with a cesarean section. The hospital reported
me for doing a breach.
Speaker 3 (41:21):
Birth, but she didn't.
Speaker 1 (41:23):
But exactly so, she didn't. And this is where Evon
came into the beautiful you know, the beautiful Evon. She
thought that. She just kept saying, guys, she actually didn't
have a breach berth at home. You did a cesarean
section in the hospital for that woman. So yeah, but still,
you know, as a private practicing midwife, you take the
heat like you have to. So again I had to
(41:43):
fight that. I had to fight the reasons why I
transferred that woman at six centimeters dilated to hospital when
we discovered the baby was breach. But that again, that
was another fight with Oprah to do that.
Speaker 2 (41:56):
Why at the hospital's like, who within the hospital is
pushing these complaints? Is it because they don't it's competition
to them for money or.
Speaker 1 (42:11):
I don't know. I don't think so. I don't think so, Beck.
I don't think it's a competition thing. I just think
it's a whole you've done the wrong thing, or you
shouldn't be doing that or look to be honest, in
my era of being a home birth midwife, it was
a very regular thing to get reported. It wasn't an
(42:31):
unusual thing to get a report from a hospital if
you were a home birth midwife. There was just something,
there was something in the system that you know, there
were certain hospitals that didn't like homebirth practicing midwives. They
didn't want us in the system, I guess, and so
I just felt they, you know, the more they reported us,
hopefully the less of us would be out there in
(42:52):
the world. And eventually that has happened. Unfortunately that has actually.
Speaker 3 (42:56):
Can say it's worked, hasn't it.
Speaker 1 (42:58):
Yeah?
Speaker 2 (42:59):
Yeah, Well, Kelly, thank you so much for coming in
and chatting with me. This is the fabulous book Midwife Crisis.
Any nurse, midwife, layperson will love reading this and love
the stories in it. And look, Kelly hasn't asked me
to promote anything. I just love a good read and
(43:20):
I love a read that gets me in, and it's
got me in. And the fact that you've been vulnerable
open You've openly discussed the shame you felt by you know,
having to deal with Upper and the Nursing Midwifery Board,
how it has impacted you, your family, your husband. Like
(43:41):
I'm so impressed by your honesty and vulnerability in this book.
And honestly, when you described your nan passing, I just
sat there and had tears running out of my eyes.
Speaker 3 (43:51):
So thank you so so much. We need more of
this and I'm so grateful you reached out to me
to have a chat because I was so excited to
chat with you today. So thank you so much, Kelly.
Speaker 1 (44:05):
Oh with my pleasure. Thank you for having me.
Speaker 3 (44:07):
When are you coming to Brisbane for a book tour?
Speaker 1 (44:10):
I am doing my book tour on the third of November.
I have just a very intimate launch, but I'm more
than happy to do another one if I'm there for
the whole week from the third to the eighth of November.
But if anyone wants to promote my book or wants
me to come and do another launch somewhere else, I'm
(44:31):
very happy to do that
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On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!