Midwife about the “second victim” phenomenon at work

It was a healthy pregnant woman with a healthy child. Nothing indicated any problems. When the baby’s heartbeat became briefly irregular twice, I referred her from the birthing center to the clinic. The specialists there were also calm, even when they decided to have a cesarean section. I spoke to the father. It’s a shame, we thought, that things turned out differently than planned, but now he’s about to hold his child in his arms. Then the baby in the operating room: limp, lifeless, immediately carried away, resuscitated. Intensive care units are running, unrest. I stand with the father, he turns pale. We’re waiting for the first scream. But he doesn’t come. I’m falling into a bottomless hole.

What did I miss?

I have been working as a midwife for around 15 years, including in clinics for many years. There were high-risk births and resuscitation. But no baby has ever died before. And never before have I been so shocked. Maybe it was because it was so unexpected, maybe it was because I had full responsibility in the birthing center. Or because it shattered my beliefs. I was so unshakably optimistic and thought: You can actually rely on nature. With good preparation and support, most women can give birth independently. And then nature allows for a complication that is so rare that it is not in any textbooks and no one recognizes it.

When I got out of the hospital I was walking in a fog. Everything was muffled. I was completely stunned and just cried for an entire weekend. I was still on call at the birthing center, but I knew that if a woman in labor called in now, I couldn’t do it. I can’t do this. I don’t know how I’ll ever talk to a pregnant woman again. I talked a lot on the phone with colleagues and went through the birth a thousand times in my head: What could I have done differently? What did I miss? A colleague sharply rebuked me: We midwives are not God and it was presumptuous of me to think I could prevent everything. That was good.

“Investigation into negligent homicide”

On Mondays work continued, I gave yoga classes for pregnant women, looked after women in the postpartum period and discovered that it was possible. It even distracted me. During the next birth, four weeks later, I managed to push back the images of the previous one and be completely with the woman. However, I was generally less confident at work than before, I asked my colleagues for a second opinion more often or referred women to the clinic. I gave up working at the birthing center four months later. I had already considered this before because, as a mother of two elementary school children, it was difficult for me to work on call. Now I no longer wanted to be solely responsible for a birth.

I was still thinking about the baby and its parents, but I was finally feeling better until six months later when two police officers rang our doorbell with an official summons. The clinic where the child was born reported me. “Investigation into negligent homicide” was written on the paper, with my name next to it. My own thoughts had already worn me down, now I read the accusation in black and white: A child died because of you.

Trapped in a nightmare

The bottomless hole opened up again and I fell right into it.

I was like trapped in a nightmare. Even as a child I was prone to brooding, and as an adult my thoughts often prevented me from falling asleep. I knew that, I could live with it, but now it was getting out of hand. My thoughts were racing.

I went over my documentation of the birth over and over again. The result remained the same: I found no errors. Still, I lost all faith in myself. Before, I thought I was a good, experienced midwife. Now I asked myself: Can I do anything? There were also existential concerns: What happens next? Will I lose my license? What should we live on then? We need my income!

I functioned in everyday life. I didn’t want to burden my two children, so I tried to hide everything from them. Also the feelings that threatened to overwhelm me. Sometimes they went from horror and fear to insane rage. I thought: What are they doing to me? What do they allow themselves? Part of me understood what was completely clear to my colleagues and my husband: the clinic only cared about protecting itself against possible financial claims from the parents and teaching the birthing center a lesson. I found it unbelievable that they carried this out on my back.

Put emotions in a box

I developed high blood pressure and cardiac arrhythmias. For the first time I realized that I needed help myself. I found her at the “Second Victim” association. He supports people in the healthcare system who have experienced something stressful. A psychosocial counselor advised me to write a memory log about my feelings during the birth. So I realized that I had been acting calmly and deliberately the whole time. I recorded daily what I felt and how I was doing in a journal. Visualizations also helped. When the emotions rushed at me while I was playing with my children, I imagined putting the emotions in a box and putting it in the corner. I have also learned to sense who is good for me and when: my analytical husband, who explains to me matter-of-factly why the accusation is absurd, or a friend who just listens.

The proceedings were discontinued after six months. When my lawyer called me with the news, I sobbed so loudly that it could be heard throughout the house. As soon as I hung up, I wanted to call him back to make sure it was really true. It was now officially clear: I had done nothing wrong. The worst year of my life, it was over. It still took some time to completely let go of the self-doubt, but now I can say again: I believe I am a good midwife.

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