Book Review: Hard Pushed

Hard Pushed: A Midwife’s Story, by Leah Hazard, provides a timely reminder of how valuable the NHS is, and of the appalling demands currently being made of front-line staff. The author is a working midwife and shares stories of cases she has dealt with, and the conflicts regularly faced due to the spectre of rules and a lack of resources. It is not, however, polemic. Written with grace and generosity, this candid memoir presents the business of birth with clear-eyed understanding of expectations and reality. There may be a great many bodily fluids to contend with but bringing a baby into the world remains an emotional event.

The births described are those that were memorable, mostly due to complications, many unforeseen. These include: the young mother who is still a child herself; the woman who became pregnant thanks to IVF and whose partner now has cancer; the rape victim; the prospective mother suffering a serious illness. Between each case study are notes in which the author muses on such subjects as: thwarted assumptions; being human; the many challenges of the job. She has to deal courteously with colleagues who have contentious opinions. When mistakes are made they can have far reaching consequences.

The author writes of a new mother whose own mother undermines her confidence with well-meaning suggestions, and how a midwife must support but never interfere. She writes of: birth plans, birthing pools, FGM and death. She describes the mind-numbing exhaustion faced by staff working lengthy shifts in over-crowded wards where medical emergencies leave labouring women unattended. The professional script she must follow is designed to both minimise patient concern and protect the midwife.

The intense and unpredictable daily demands lead to regular burn-outs, something to which the author is not immune. The job takes a physical and mental toll that can be a challenge to sustain.

This is a fluently structured and fascinating account of a job that, even as a mother of three, I had not fully appreciated. I feel angry on behalf of these hard working professionals for the way our healthcare system is being managed and funded.

Yet the warmth and compassion with which this book is written provides a beguiling and entertaining read. The balance achieved is impressive – recommended for all.

My copy of this book was provided gratis by the publisher, Hutchinson.

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