We sat down to interview Olivia, Registered Midwife and Safeguarding Champion at our clinic in Maidstone, Kent. She spoke with us about how and why she started working at MSI UK, her passion for safeguarding our clients, and the differences in her role now she works for MSI.
“People have such misconceptions about being a midwife working within abortion. If you really think about what you’re doing, and you have the right mindset for it, it’s such a positive place to be.“
How and why did you start working for MSI UK?
I found out that I was pregnant two months after I finished studying midwifery. I decided to have an abortion because it was not the right time for me at all; it was about a week before I was starting my first job as a qualified midwife in a hospital.
When I’d had my abortion, I was seen by a midwife. This surprised me, as I had the misconception that abortion care was more of a nurse-led treatment.
I worked at the hospital for about six months, before realising that it wasn’t what I wanted to do. Then, a colleague told me she was starting her career at MSI, and someone else I worked with had also recently started working there. I began to speak to them to find out what it was like.
“Eleven months after first being in that clinic for my abortion, I was starting there as a midwife”.
I was interested in abortion care and came to think that this could be the career for me. It was always something I had thought about when I was studying and had been in the back of my mind. I knew you could go into it, but at the time I didn’t know where or how.
Because I had had my abortion at an MSI clinic, I knew where it was and recognised some of the staff. Everyone was really lovely and encouraged me to apply. I applied, got my interview offer, and the person who interviewed me was the person I’d met during my own appointment – it was a full circle moment! It was so relaxed and felt like such a safe and calm environment. Obviously, the last time I’d been there I’d felt vulnerable and in a difficult situation – it was very different to be there for an interview. You do perhaps feel vulnerable, but in a completely different way.
It went very smoothly. I was offered the job, and eleven months after first being in that clinic for my abortion, I was starting there as a midwife. Almost two years later, I’m still here, at the same clinic.
“If I can make that experience a little bit better for them, or at least try and normalise it, reduce that stigma, then that’s a valuable thing for me to do.”
Working in abortion care had always been something I’d considered throughout my time studying, and a little bit before. I never thought it’d be this early on in my career. There was almost this ‘why not?’ feeling – if I wanted to give something back to the people that had seen me, and try and make things a bit easier for the women who are attending the clinic, then why not? One in three women will have an abortion in their life. If I can make that experience a little bit better for them, or at least try and normalise it, reduce that stigma, then that’s a valuable thing for me to do.
Have you always had an interest in reproductive rights?
I went to an all-female school, and there was a big push on female empowerment. One of the things I remember was during one lesson the topic of conversation was abortion. I’d always be fighting on the pro-choice side and abortion was never something I was afraid to talk about or stand up for. When you’re 14 or 15, you have to be quite confident in your stance to be able to talk about it, especially as it can be so stigmatised.
“Every day, people have abortions. Why not talk about it?”
I’d already been around people at that age who had had an abortion, so I remember feeling that it was completely normal. It’s not this big, scary thing that only happens to certain people. Every day, people have abortions. Why not talk about it?
When I was studying midwifery, I’d often be doing the first appointment and when women came in, I’d never automatically say congratulations. I was always conscious that people might not want to be pregnant. So, I’d set the tone. I’d ask, “How are you feeling?”, “How does this make you feel?” and I’d have people reply that they really didn’t want to be in this situation, and that it wasn’t what they wanted. This was absolutely fine. I’d direct them to other services. Abortion was something that I always knew was happening, and just because you’re pregnant and in a midwifery and maternity environment, doesn’t mean that you are happy to be there.
Could you tell me what a day in your life looks like as a midwife at MSI UK?
Day-to-day we will have different appointment types. We’ll have the first appointments for people coming in for a medical abortion, which are tablets they can take away with them. We see people who have maybe called up the day before, or the same day – it can move quite quickly.
“Obviously, clients come to us as they want an abortion, but I’m hoping they go away with just a little bit more than that”.
Another service is safeguarding. This is a big part of my role, as I’m a safeguarding champion at the clinic. In those 30 minutes that you speak with a client, you can cover a lot. For example, you can send someone home with contraception who’s never been on contraception before or help them learn about their reproductive system. They may have never opened up about a situation they have at home, and they can go away with so much information and hopefully feeling safer. It’s such an important appointment – not a lot of people will have the opportunity to discuss these things if they don’t come and see us. Obviously, clients come to us as they want an abortion, but I’m hoping they go away with just a little bit more than that.
“It’s all about providing individualised care to each person you’re seeing”.
Sometimes, we will see people who just aren’t sure of their decision, and we just need to provide information about all of their options. We stay true to what they want to do and reiterate that it is their choice. It’s possible that some people are influenced, and this can be the first time that they speak to a neutral party who has no influence over any part of their life. Sometimes, they may decide that they want to continue with the pregnancy or that they do want to proceed with the abortion. And that’s fine. We just need to be there for them.
It’s all about providing individualised care to each person you’re seeing, and understanding that everyone is there for their own reason.
What does your safeguarding role look like day-to-day?
I work as the safeguarding champion under the clinic’s Safeguarding Lead.
Day-to-day, my safeguarding role looks like this: I often go to the clinical list for the day, see if there’s anyone who has had an alert raised. This can be for things like mental health, domestic abuse or sexual abuse. Anything that could potentially impact their appointment. I’ll see what services we can offer them, going through and checking if we need to implement any plans. We’ll often get information sent from other organisations or clinics if they’ve been seen elsewhere, or if they’ve spoken to them over the phone.
There are sometimes referrals that need to be done – for example to the GP surgery. Often, when it is a mental health referral, we can offer the client a GP letter, which can tell the GP what they’ve been through, if they might need another appointment. Then, if they do contact their GP, there’s no need to explain what they’ve experienced – it’s already there on their record.
We’ll attend meetings as well, which are multidisciplinary. We can be there with social services and the police. If it is a domestic abuse case, we can potentially get them into refuges, where they are safe. All of these things can happen over a few days, and sometimes a few hours. It all depends on the level of severity.
“It’s nice to just be able to spend some time with someone and give them your full attention.”
Often, it’s nothing I can do all by myself, so I can get help from the nurse or midwives, our clinic Safeguarding Lead, or our national Safeguarding Lead.
The other thing I can do, if there is someone with specific safeguarding needs coming in, is to take them out of the clinic so that nurses and midwives can carry on with the lists. That client can then have an extended appointment. You’re not putting any time pressure on the client you’re with, and you’re not worrying about the people that are waiting to be seen – the other nurses and midwives can continue to deliver care for these clients. We have more private rooms, and I even took someone into the private garden recently because it was a lovely sunny day. It’s nice to just be able to spend some time with someone and give them your full attention.
Do you have a favourite part of your role?
Working with such a good team. No matter how bad your day is, or how good your day is, you always have someone to go to. You always have someone to speak to, to share experiences with – because it is a very unique job. You can’t share those experiences with anyone else outside of work.
Another one of my favourite parts is working on a surgical day, because clients are very grateful for your care. For some of them, they haven’t had a surgery before, they haven’t been with an anaesthetist before, they have never been with a doctor in those type of circumstances. We stay with them and talk them through the process. There’s something called a ‘vocal local’ (speaking with someone whilst they’re having treatment with a needle, to distract them) which we often use when they’re having a cannula – because no one likes needles!
“I’ve spoken about so many random things: tanning oils, tattoos, piercings!”
We talk to them, asking them about their job, what they do, what their life is like. Getting to know the women in that really short time period is really nice. They’re able to relax a bit and have the surgery. When they go out into the recovery, you’ll speak to them again after. I’ve spoken about so many random things: tanning oils, tattoos, piercings! It really shows the impact you have on the women when they do want to open up to you.
“I find their life after the treatment, after MSI, to be really important and interesting to me.”
There are so many different areas of my role that I really enjoy, and the safeguarding is another aspect because you’ve made someone feel safe, let them know they can talk to someone, they’ve accessed the care they need, and you’ve perhaps referred them on to additional support. Hopefully, they’re going away and taking those better experiences with them. There’s a lot of women that stay with me, that I still remember.
I’ve seen some challenging safeguarding issues come up, and I think that exposure has made me want to go into this area slightly more. I find their life after MSI, to be really important and interesting to me.
Is there anything you want people to know about working as a midwife for MSI?
““They told me I would regret it, that I was too good of a midwife. That was met with a stunned silence from me.”
Definitely, there’s lots of things I could speak on.
When I first told people within my previous role that I was leaving, I wouldn’t often tell people that I was going to work in abortion care. The first person I told said that I would regret it, that I was too good of a midwife. That was met with a stunned silence from me, I think.
Being a midwife means ‘with women’, so why is being a midwife for women having an abortion any different? I can spend more time with clients, and I can give them better support than I ever felt I could in a hospital environment.
If you have a positive mindset, you look at how many people you’re helping. How many families you’re helping.
“The teamwork here really keeps me going”
I’ve also been interested in advancing my role here. Doing extra things like safeguarding and qualifying as a mental health first aider. Even something as simple as organising gatherings and social events for people within the team who are leaving, going on maternity leave or going travelling. The teamwork here really keeps me going.
Sometimes new starters join, and they say that everyone is so nice – this shouldn’t be a shock! People have such misconceptions about being a midwife working within abortion. If you really think about what you’re doing, and you have the right mindset for it, it’s such a positive place to be.
Read more from our colleagues
At MSI UK, we love interviewing our colleagues to find out more about their work and how their roles contribute to our mission to deliver quality reproductive healthcare. You can read some of our latest interviews here.
