Leah Hazard is a serving NHS midwife. Having studied at Harvard, she left a career in television to pursue her lifelong interest in women’s health after the birth of her first daughter. She soon began working as a doula, supporting women in pregnancy and attending numerous births in homes and hospitals across the country. The birth of Leah’s second daughter prompted Leah to make the leap into midwifery. Since qualifying, she has worked in a variety of clinical areas within the NHS maternity services, including antenatal clinics, triage units and labour wards.

What inspired you to write about your experience of being a NHS midwife here in the UK?

“From the earliest days of my training, it was clear that midwifery was stranger than fiction – funnier and more tragic; heroic and more compelling. Every single shift is a story in its own right, and every woman is unique – this variety is what makes it so easy and enjoyable to write about midwifery. Also, the longer I practiced, the clearer it became to me that there isn’t a great public understanding of what it really means to be an NHS midwife today. I wanted to show readers how complex and highly skilled our role is, and also how under-resourced we often are.”

How on earth did you find the time?

“Excellent question – I’m still not sure how I did it! It helped that I dropped my hours slightly at the start of last year, and I decided to use some of the time on my days off (always while my kids were at school) to noodle away on a bit of writing. That noodling became all-consuming at times, and during the summer holidays I had to wake up quite early to bash out my chapters before the rest of the family woke up, but I think if you’re passionate enough about something, you’ll always be able to carve out a chunk of time to do it.”

You were a Doula before training as a midwife, what made you decide to move into midwifery and how did you find the role changed?

“Being a doula was a fascinating introduction into the world of birthwork, and I was really privileged to be a part of dozens of home and hospital births for about six years. Ultimately, though, I wanted to be able to provide the whole package – clinical care and emotional support – and I suppose I had a naïve belief that maybe I could change the system in some small way. My girls were getting a bit older and it just seemed like the right time to make the leap.”

The stories throughout the book are just incredible. As a midwife when I read it I could relate to every single scenario you wrote about. Did you ever feel like you had said too much or wish you could have added more?

“When I was writing, I was constantly aware of treading this very tricky line between saying too much and not saying enough. Being a registered midwife adds a dimension of risk to being an author – I’m still bound by the NMC Code of Conduct, so my top priority is preserving women’s privacy and respecting their rights in my writing as well as in my actual clinical practice. I felt it was important, though, to be very honest about the challenges of working in a stretched system, and about some of the emotional low points I’ve had, as well as the highs. It’s been terrifying to make myself so exposed and vulnerable, but I wanted to do justice to the full midwifery experience, and not just write a rose-tinted version of reality.”

The response has been overwhelming so many of my colleagues have read it and loved the honestly. Have you received any backlash or negativity for exposing the realities of being a midwife for the NHS?

“Thankfully, the vast majority of feedback I’ve had has been warm and enthusiastic. I’ve had really moving messages on social media from mothers, midwives and student midwives who have connected to Hard Pushed on various levels – it’s been completely humbling. Having said that, I’m sure there will be readers who disagree with my views, and there will be colleagues who don’t understand or approve of my reasons for writing about our work. That’s to be expected, and I’m fine with it.”

How do you feel programmes such as One Born Every Minute have helped educate women about birth?

“It’s a funny one – I’ve certainly looked after women who’ve said that they didn’t bother going to antenatal classes because they’ve just been watching OBEM! It’s important to bear in mind that the programme – although it’s a documentary – is also an edited version of reality, and has to be entertaining as well as informative, so it’s not necessarily a true representation of what the birthing experience will be like for all women. As midwives, we have to accept that women get their information from all kinds of sources these days – television, the internet, etc – but we also have to help women make informed choices by directing them to sources that are accurate and comprehensive.”

How do you think your experience of being a mum first before training helped you develop your skills as a midwife?

“It’s certainly possible to be a wonderful midwife without having children, so I wouldn’t want to imply that motherhood is a prerequisite. However, I did have two very different birth experiences (an emergency caesarean section, and then a home birth so quick that my husband had to catch the baby), so I’d like to think that that’s given me a bit more compassion and understanding of what some women go through. Being a mother has also taught me about patience and perseverance..and how to handle sleep deprivation…all good qualities for a midwife!”

What one piece of advice would you give to anyone who is thinking of training to be a midwife?

“I’ve been asked this question a few times this year and it always makes me feel a bit unworthy, because I don’t think of myself as an expert or some kind of midwifery guru. However, I wish I’d had a better understanding of the importance of self care when I embarked on my midwifery journey – you can’t pour from an empty cup, etc etc – so I’d tell all new student midwives to remember to be kind to themselves. Know and respect your own limits, value your time and energy, and take a step back when you need to. Midwifery is so demanding these days that you can’t possibly have the stamina needed for a long career if you don’t look after yourself along the way.”

If I could give you infinite amount of money how would you change the way maternity services are run?

“First of all, I’d bring back the bursary for student midwives in England – it’s absolutely scandalous that it was ever withdrawn in the first place. Then I’d hire many more midwives across the board, build more midwifery led units, and upgrade the beds and resources in existing hospitals. Just a few small things!”

Any plans to write a second book?

“Yes! I’m fine-tuning the proposal for my next book now. Please keep all of your digits crossed over the next few weeks as it does the rounds of prospective publishers!”

Moving, compassionate and intensely candid, Hard Pushed is a love letter to new mothers and to Leah’s fellow midwives – there for us at some of the most challenging, empowering and defining moments of our lives. Hard Pushed is out now, published by Penguin.