Being able to make positive change in a patient’s journey is the driving force behind Jane Palmer’s career as a midwife.

“It mightn't always be massive differences, but certainly if there are people in the system or midwives in the system who can make positive change, then the outcomes for women are better. So yeah, I keep seeing possibilities to make a difference and that is what keeps me there.”

Ms Palmer told HealthTimes that across her 20+ year career, she has many fond memories of supporting women on their motherhood journey.

“I don't do continuity in care anymore – I stopped last year – but for 25 years I've done continuity of care. And being with women, watching them evolve as they learn and go through the challenges of birth and then come out the other side and they're parents and report such a positive experience – that's one thing that stays with me.”

“I had one woman who had a very bad tear with one of her births, and she looked at options and according to the guidelines, she shouldn't have planned a home birth.”

“But she decided to birth at home, she understood the risks, and when she gave birth she had the most fabulous birth. She was so excited. And only the tiniest little tear. She didn't have any major issues after that birth. And there’s so many more cases like that out there.”

Ms Palmer said that COVID-19 had presented serious challenges for both midwives and women preparing to give birth.

“Initially it was awful, because we had to pretty much decrease our face-to-face care, which for me was a little concerning.”

“What if you miss something? You need to lay your hands on and listen to a baby, feel the baby's growth, to know that this isn't going well. Or to assist women after the birth with breastfeeding.”

“I have since made the clinical decision in my private practice to now do everything face to face, but always trying to socially distance and wear masks.”

“But even that's hard enough, I feel like I'm trying to guess it. I was working with a little baby, trying to work out what was going on with his breastfeeding. I was trying to get him to stick his tongue out, and he couldn't see my face because of the mask.”

“It's inhibiting the communication, but not only that, women are coming in and feeling quite traumatised, because the hospitals are kicking them out quickly as they don't want them in the system, which I understand".

“But then that means that their follow-up care is less. So, there's no early childhood health or anything like that at the moment. They're only doing telehealth. It's very sad.”

Aside from the pandemic, Ms Palmer says the increased medicalisation of childbirth is having an impact on both women and those who care for them.

“When I first started, I thought intervention rates were high, and that's one of the reasons why I started. But looking back, because that's now almost 30 years ago, this rate's increasingly worsening.”

“I've just done a whole series of graphs from 1995 through to 2019 on ceasarean birth rates, normal birth rate, and inductions of labor. And normal birth is decreasing every time they do a new report, and the intervention rate is increasing.”

“So that's probably the biggest challenge. Whilst you can make changes, some of the really big stuff is getting worse.”

Ms Palmer said that when she thinks back to why she became a midwife, it was her own experience that was the turning point.

“Well, I'd say in the late eighties, I was pregnant with my first child and gave birth, that's where the fascination started.”

“I didn't have a positive experience, and I thought, ‘what can I do to make a difference?’”

“So I got involved with the consumer group at the time and then decided, ‘okay, I'm going to become either an obstetrician or a midwife’”.

“And I weighed it up and decided that becoming a midwife sat better with me. That’s why I originally started –  to make the options for women better, and more positive.”

For Ms Palmer, the joy of bringing new life into the world never wears off.

“If you've been with women and watched the, particularly that moment of birth where they gasp, and they look at what they've done, and it's such fun for everybody around them.”’

“It doesn't ever get old. I get bored very easily, and what I love about midwifery is that I'm always learning. It's never the same thing over and over and over. It's always something new to learn or a different way of doing things, which always keeps you interested."