‘I witness daily acts of heroism on a massive scale’

Leah Hazard swapped a glamorous career in TV for the maternity ward. The gory glory is worth it, she tells Margarette Driscoll

The birth of Leah Hazard’s first daughter left her traumatised. Hours of exhausting labour led to an emergency caesarean section and, as he struggled into hospital scrubs, her husband was afraid she and the baby would die. Yet their second daughter came so quickly and easily, she had to be caught by that selfsame husband at home, even before the midwife had arrived. “First time round I thought, ‘This is a nightmare’,” she says. “Then to have this joyful, positive experience… it was night and day.”

Hazard was intrigued that two births could be so different – which eventually led her to leave a glamorous job in TV production and enter the labour ward. Today, she works in a busy hospital in Scotland; part of an understaffed, overstretched public health system that she says is a million miles from the cosy world of Call the Midwife.

“You see comments on social media after an episode saying ‘I love midwives, they’re amazing!’” she says. “Most people seem to think you get to cuddle babies all day long. Very few have any idea of the depth and complexity of modern midwifery.”

Hazard, 41, has deftly distilled that complexity into a new book, Hard

Pushed – a “love letter” to midwives everywhere – which brings the maternity ward to life in all its gory, humorous and touching glory; from the mother-to-be panicking that a spray tan will harm her baby to the heart-wrenching howl of one whose newborn has died.

Episiotomies with blunt scissors? Entitled middle-class mothers who think they know more about childbirth than you? All part of a midwife’s day, according to Hazard’s book, which was the subject of a seven-way publishing auction and is set to be a summer bestseller.

It can be a fabulous job, of course. Hazard writes: “I’ve witnessed feats of everyday heroism on a massive scale… the women in my care have taught me what it means to be human.”

But there’s little doubt that the pressure on midwives keeps ratcheting up – from overcrowding on wards to the women coming through the doors; some in their 40s, others who’ve scored a multiple pregnancy after years of IVF, teenagers who are barely out of childhood. Pregnant women with a body mass index of 40-plus have become common (the healthy range is 18.5 to 24.9). What’s more, birth injuries generate big money lawsuits against the NHS – negligence claims cost around £2 billion a year.

Every birth feels like Russian roulette: “The midwife just prays she’ll dodge the bullet,” Hazard says. “It is possible to have a wonderful birth on the NHS and get goldstandard, world-class care. But if you come in on a day when it’s all going on… in an understaffed environment, the stress can’t help but take its toll, emotionally and physically. At the end of a 12-hour shift you feel as though you’ve run a half-marathon.”

A report last week found that one in four medics has been diagnosed with depression or anxiety, sometimes leading to drink problems. Hazard recently came across a young colleague crying in the corridor, who confessed she was having nightmares about women and babies dying. Her GP prescribed antidepressants. Others find their own means of coping: “A startling number of healthcare professionals are only too happy to throw themselves into substance abuse, using whatever means necessary to counteract the permanent state of jet lag induced by shift work and emotional exhaustion,” Hazard writes. “I am now an expert at self-medicating with entirely legal uppers (coffee) and downers (gumnumbingly cold white wine).”

An ambitious, Americanborn Harvard graduate,

Hazard intended to work in theatre, but a week after moving to Scotland to study for a Master’s degree she met her husband. She got a job as a TV production assistant, but when the first of her two daughters (now 16 and 12) was born, things changed: “The culture of long hours and socialising wasn’t for me. If I was going to spend time away from my family it had to be for something worthwhile.”

That turned out to be supporting other women in childbirth; first as a doula, then as a midwife. She was entering a profession in crisis. In England, 3,000 midwives quit last year, with only 2,000 trainees to replace them, a pattern repeated across the UK, with a significant proportion of midwives now aged over 40.

“Virtually everybody I know who is still able to take their pension at 55 has run for the hills,” she says. “Staff who aren’t near retirement age are saying ‘As soon as I pay off my mortgage/send my kids to university, I will leave’.”

The most damning thing one midwife can say of another, adds Hazard, is that she’s “too nice”. “The reality of working in the NHS now is that you have to be tough,” she says.

What would improve the situation? “Money,” she says. “More staff, more beds, more time and space to do your job. It’s a nice feeling when someone says ‘Thanks, I feel so much better now’. Sometimes that’s all it takes to get through a really hellish shift. You have to grab on to these little moments.”

Her book portrays a job that is as much psychologist and social worker, as midwife. She comforts one woman whose critical mother has reduced her to tears as she tries to breastfeed; attempts to find accommodation for a victim of sex trafficking; and reassures a woman who hasn’t felt her baby move for 20 minutes. Most women, she says, dream of having a “perfect” birth, in a birthing pool, surrounded by candles. The reality is often very different.

More than one in 10 women develop mental illness during pregnancy, or their baby’s first year of life, an issue that will be highlighted by medical professionals this Wednesday, on World Maternal Mental Health Day. The emotional and physical upheaval of birth can trigger anxiety, through to full-blown psychosis.

The pressures modern mothers put on themselves are immense, and she thinks social media has only increased this: “Everybody’s very keen to get home, get the house in order, have visitors, get out and about. Women don’t give themselves that interlude where they can be in their pyjamas all day and just feed the baby, and not bother with their hair and make-up.” As we talk, her mind drifts back to a woman she looked after a week ago, whose newborn didn’t make it. “I can tell you the name of every woman I’ve looked after whose baby has died. It stays in your head.”

Once or twice, Hazard has come close to burnout, but the rollercoaster of fear and euphoria keeps drawing her back: “I keep composing that letter of resignation in my head but it hasn’t reached paper yet,” she says. “It’s a passion, a vocation. Even in the darkest moments I never think ‘I wish I hadn’t done this’.”

‘Every birth feels like Russian roulette. The midwife just prays she’ll dodge the bullet’