Tag: midwife

Hard Pushed: A Midwife’s Story by Leah Hazard

“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.

Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.

Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.

A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.

I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.

Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.

Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.

 

A few favorite passages:

“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”

“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”

“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”

My rating:

 


Hard Pushed was published in the UK on May 2nd (just a few days before International Midwives’ Day) by Hutchinson. My thanks to the publisher for the free proof copy for review.

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Wellcome Book Prize: Shortlist Recap

Tomorrow morning we will announce our Wellcome Book Prize 2018 shadow panel winner. Beforehand I wanted to do a quick recap of my reviews, especially for the two books that I read before the shortlist announcement. My full reviews are here:

Stay with Me by Ayobami Adebayo 

To Be a Machine by Mark O’Connell 

Mayhem by Sigrid Rausing  

The Vaccine Race by Meredith Wadman 

 

I give some extra thoughts on and favorite quotes from the other two below:

 

The Butchering Art by Lindsey Fitzharris

This is a great blend of medical history and popular science that should draw in readers who wouldn’t normally gravitate to either topic – provided they aren’t too squeamish. Fitzharris has recently returned to Oxford as a visiting academic, and this has also been nominated for the Wolfson History Prize. Follow her on Instagram (@drlindseyfitzharris) for a steady stream of gruesomely fascinating photos (I wish The Butchering Art had been illustrated!). Her next book will be much of a muchness, it seems, documenting the early years of plastic surgery after World War I through the story of pioneering surgeon Harold Gillies. 


In the days before Joseph Lister…

“Operating theaters were gateways to death. It was safer to have an operation at  home than in a hospital, where mortality rates were three to five times higher than they were in domestic settings.”

“The surgeon was very much viewed as a manual labourer who used his hands to make his living, much like a key cutter or plumber today.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[A]n extremely readable account of a ground-breaking career which led to real advances in hospital medicine. I enjoyed the whole, but particularly the grisly bits!”

Laura’s review: “It’s easy for me to feel a bit impatient with popular histories of periods or subjects that I know well, but Fitzharris strikes exactly the right note, writing clearly and accessibly with no dumbing down.”

Paul’s review: “It is one of the better books that I have read on medical history[;] Fitzharris writes in an engaging way on a subject that is not going to appeal to everyone, but in amongst all the blood is the fascinating story of Joseph Lister.”

 

With the End in Mind by Kathryn Mannix

“It’s time to talk about dying. This is my way of promoting the conversation,” Mannix writes in her introduction to this accessible and reassuring book about death. She believes we are afraid of death because of our misconception that it is inevitably painful and undignified. In her decades of working in hospice care, this has rarely been the case. (Thank goodness that, compared to the earlier nineteenth-century situation Fitzharris surveys, we have reliable pain control options.) Mannix sees the role of the hospice worker as being like a midwife for the dying, a helpful idea I first encountered in Henry Fersko-Weiss’s Caring for the Dying: The Doula Approach to a Meaningful Death


Many of the stories in this book are of peaceful deaths the patient and family had time to prepare for. Others are sad stories of denial. One, though, is quite gruesome, yet magnificently described. Alex, a young man with testicular teratoma, has a massive GI bleed:

“Alex’s head is thrown back, almost as though it is a voluntary movement. A huge, dark-red python slithers rapidly out of his mouth, pushing his head backwards as it coils itself onto the pillow beside him; the python is wet and gleaming and begins to stain the pillowcase and sheets with its red essence as Alex takes one snoring breath, and then stops breathing. His mother screams as he realises that the python is Alex’s blood. Probably all of his blood.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[I]t is helping patients, and their families and loved ones, to understand the process of dying, and dispelling the taboos around it that make this book such a valuable and compelling read. I wish I’d read something like this book before my mum died.”

Clare’s review: “For me, this enlightening book is a strong potential winner for the Wellcome Book Prize and I hope it brings comfort and guidance for those who need it.”

Laura’s review: “[The book is] written from her own experiences as a specialist in palliative care, and this proved, for me, both its strength and its downfall. … Mannix writes particularly well on the characteristic patterns of somebody who is entering a gradual decline.”

Paul’s review: “Can highly recommend this moving book and I think it should be essential reading for anyone who has any concerns about death.”

 


I wouldn’t be at all surprised to see either of these win the Wellcome Book Prize on Monday. Stay tuned for tomorrow’s shadow panel winner announcement, and Sunday’s write-up of a shortlist event I’m attending in London.