Few professions can claim to be in contact with the entire population and encounter the unspoken challenges of every social strata like midwifery 
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A midwife, a term from the middle English “mid-wife” that literally means “with-woman”, is a professional who is with women through the early journey into motherhood. It is a multi-faceted role of supporting, educating, caring, empowering, advocating and simply walking alongside women through the journey of pregnancy, birth and the postnatal period. 
This world of midwifery is grounded in the essence of life itself, a place of both beauty and drama. Not a romantic utopia of teddies and flowers as some may think, but a reminder of the earthly purpose and the delicate balance of life. Many people ask me “so how many babies did you deliver today?” I smile back and respond “that’s only a small part of my job.” 
In the UK, midwives are the main practitioners in caring for women throughout the maternity period: booking them in, monitoring them throughout their pregnancies, assisting in the birth of their babies and visiting them at home post-natally to ensure that both mother and baby are well. At some point, every member of our society would have passed through the hands of a midwife, every newborn and his or her mother receiving our care. Midwives are key professionals during this period as they are able to access vital support and help for women in their care. 
I have spent over six years as a midwife at a busy central London hospital, nurturing my craft in every maternity department. My life has been immersed in these moments: of waiting rooms buzzing with life, medical notes containing life-secrets and instances filled with every conceivable human emotion. In my current role as an antenatal clinic midwife, a day’s work can include seeing between 18 to 22 women. They come expectant, happy, impatient, anxious, sad, angry; every load that they are carrying on that day arrives in our consultation rooms. 
Women bring in much more than just their pregnancies. At our clinics, we are offering women a vital line, a place for them to quell anxieties, manoeuvre through life-struggles and even discuss relationship problems. In addition to medical tasks, our time is largely spent with non-medical so-called “soft” skills: the interpersonal element of our job. It is in this particular art of midwifery where we perhaps find some of our greatest challenges. Even the most difficult medical complication does not always test us as much as dealing with complex social issues. Any and every woman, regardless who they are, can become a mother, but the stories which most move us are those where motherhood is in itself a struggle for survival. 
This struggle was well captured in the recent BBC adaptation of Jennifer Worth’s book, Call the Midwife, which followed the lives of midwives in the 1950s and detailed life in the East End, where social deprivation and poverty were prevalent. It is alarming to think that, despite society changing almost beyond recognition, midwives still witness many scenes of poverty similar to those depicted in the series. Most community midwives today will have visited homes where they have witnessed families living in shockingly poor conditions, without basic necessities. Poverty, drug addiction and prostitution are issues still affecting women throughout the maternity period. 
During my time on the postnatal wards, I saw the faces of families filled with joy at new arrivals, bearing gifts and flowers. However, I also worked with the unseen and untold maternity stories. Often these would be stories of women with addictions, some of whom had also been involved in sex work, others with HIV and others awaiting decisions about their babies futures, whether or not they would be allowed to remain in their care. There were babies born addicted to whatever substance the mother had been taking during pregnancy, often the methadone prescribed to heroin addicts. There were babies resulting from gang rapes, incest or abuse. Such are the narratives that society would prefer not to be shared, told or celebrated. 
Most of us working within inner city settings have worked with mothers struggling with drugs. We can all identify the distinctive, high-pitched cry and fractious behaviour of a newborn born with addiction. For these women, and babies, who very often remain as inpatients for days or even weeks, there are few balloons or teddies, and during this time it is we, the maternity staff, who become their surrogate family. Each of us take turns to cuddle, rock, settle and feed these unsettled little ones, whilst at the same time providing non-judgemental support for their mothers who are also in need of our care. We are the ones wiping tears by bedsides when babies are taken by social workers, listening without judgement and offering the compassion and perhaps the support that they have never had, thus their plight. We are the ones who are with these vulnerable women, walking this precarious terrain. 
I find myself making half-joking flippant remarks such as “if there is anything lurking in the background, you can be sure it will come up in pregnancy!” This is because the cruel fact is that being pregnant or a new mother does not inoculate against misfortune. Indeed, women can find themselves with many things “lurking in the background” that suddenly emerge: depression, anxiety, domestic abuse and violence and even suicide. Frustratingly, misfortune does not inoculate against pregnancy either, and many women in the most unfortunate circumstances find themselves repeatedly pregnant. 
Midwives are the ones who witness every social “ill” and need to become rather flippant in order not to be crushed by the harsh realities we routinely see. We, better than anyone, know that any woman with any amount of issues “lurking” can find herself pregnant. It is our job to manage whatever comes through the door to the best of our ability, without judgment and with respect for the dignity and individuality of the women in our care. And perhaps adopting a rather flippant exterior protects us from being crushed by what we see. 
It is both rewarding and satisfying to witness the emergence of a new life into this world, and to be able to serve humanity in this way. To realise the wondrous, contrasting, complex and intriguing patterns interlacing the fabric our society and the depths of human resilience and ability to face struggles beyond even our own imagination. 
I thank God for the honour of being in a profession that enables us to be able to see the passing of every member of society through our hands and to bear witness that life itself is a precious gift.  Amen. 
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<pre>Image from: http://english4midwifery.blogspot.co.uk/2012/06/some-pictures-about-midwifery.html</pre>

Nabila Fowles-Gutierrez