Oxytocin Highs and Lonely Lows ~ For Midwives

Working this way gives me so much joy each and every day. From having full control over my business and my clients, to enjoying relationship-based in-home care, there are so many benefits and joys to this model. But as my experience grows in this space, I also experience the very, very hard moments.

As a midwife, we truly love women. We want the best for them and want to give them every opportunity to achieve their dreams. With this love for women also comes a vulnerability to compromise yourself, your family, your boundaries and your self care.

The Cost of Being On Call

Some of this is uncontrollable. On call life, unavailability, longer labours, we really do put a lot on the line to be with women. And it’s absolutely worth it. The beautiful midnight births. The women who fall outside of mainstream guidelines and go on to have a beautiful undisturbed birth. It’s so special, and the relationship is so strong after such an event.

That said, there are many struggles that bring us back to earth. Sleep deprivation. Stress. The emotional load of walking with women through all that birth brings. These are stressors that only truly a private midwife can understand.

But, and it’s a big one, when I worked in the system, the moral distress and emotional overload of working against my values was far stronger than anything I’ve experienced in private practice. So I never undermine the beauty and gift it is to work in the community. Still, I think we need to bring more awareness to the harder moments, and how we can manage them.

Outside Pressures

There is a lot of responsibility when working this way. Not necessarily from the relationship between client and midwife, but from outside influences.

As a small-town private midwife, I go out of my way to collaborate with local public services to enhance the experience for women. But I’ve also learned that with this comes pressure and stress to comply — something the women choosing this model of care are often actively avoiding. So as we buffer and protect our clients from unnecessary stress, I always return to the woman.

Every decision, right or wrong — is hers. The difference we make as PPMs is that we offer women all options and choices, give them the evidence, and they make the decision for themselves and their babies.

Coping Strategies That Help

One word, mentor.

Nothing has helped me more than having an amazing, experienced PPM to guide me through these challenges. A community of like-minded midwives all over Australia has also been invaluable — learning how others do things and what I might do differently next time. It’s all give and take. Collaboration and building good relationships are important to me, but from each experience I grow, learn and adapt for the future. Hopefully, these are things I’ll laugh about one day in 20 years of practice.

Boundaries, Self Care and Regulation

As someone who loves being with women, providing options and solving problems, there is nothing harder than saying no. It’s truly one of the hardest things. And something I still really struggle with.

Because we’re so close with the women we support, it can feel deeply personal to say no or to uphold professional boundaries. But what I’m learning is this — if you step outside the boundaries you’ve set for your business, you are often the one who pays. You, your family, your health.

As devastating as it is, I’ve learnt that boundaries are non-negotiable.

It still hurts. Saying no. Not solving the problems women bring to me. But I know holding those boundaries is what keeps me available, healthy, and able to serve more women long term.

And even with boundaries in place, episodes of stress and overwhelm are still to be expected. This work will inevitably be stressful at times. The strength of the relationship-based model, and the emotional give and take, means that moments of discomfort feel like part of the passage.

My Strategy: Learn, Debrief, Regulate, Repeat

The trick? Self care. Community. Debrief. Strong support. Growth. Learning.

Just like above, the lessons need to be integrated. I’m well on my way. But you also need to cope in the moment. For me, this looks like self care and regular debriefs.

My husband — the amazing human that he is — gifted me a mini sauna for my 30th birthday, just before I launched my business. It was the most perfect present. Now, I jump in the sauna three times a week, decompress, and always book something just for me.

I eat well. I talk. I talk until I feel resolution — often with other PPMs, my close support network, and my husband.

Then I remind myself of my vision, my why, and I move forward. Easier said than done, but I assure you — this work is worth every challenge, every hard conversation, and every awkward interaction.

Women are worth it.

Thinking of Stepping Outside the System?

Thinking of offering women community-based care?

Like I said earlier, even my lowest moment in private practice doesn’t remotely compare to what I felt in the system. The highs and the vision far exceed my expectations, and I know that with strong community, balance, and real relationships, my vision for this space is absolutely worth it.

Want to chat more? I’m always available to connect with future midwives who want support stepping into this model of care.

Until next time

Hannah x