Introduction
This reflective essay explores my experience as a student midwife during an emergency Caesarean section (C-section) on a birth ward. The purpose of this piece is to critically reflect on the clinical, emotional, and professional aspects of this high-stakes situation, drawing on theoretical frameworks and evidence-based practice to contextualise my learning. Emergency C-sections are often unpredictable and require swift decision-making, teamwork, and emotional resilience, all of which are central to midwifery practice. This essay will discuss the events of the emergency, my role and feelings during the procedure, the importance of communication and multidisciplinary collaboration, and the impact on my personal and professional development. By reflecting on this experience, I aim to identify areas for improvement and demonstrate an understanding of midwifery competencies as outlined by the Nursing and Midwifery Council (NMC) (NMC, 2018). The reflection will follow a structured approach, using relevant headings to ensure clarity and depth in my analysis.
Context of the Emergency C-Section
The incident occurred during a clinical placement on a busy maternity ward. I was shadowing a senior midwife when a woman at 38 weeks gestation was admitted in active labour. Initially, her labour progressed normally, but continuous fetal monitoring revealed persistent fetal distress, indicated by a non-reassuring cardiotocograph (CTG) trace with prolonged decelerations. According to NICE guidelines, such patterns necessitate urgent intervention to prevent adverse outcomes like hypoxia (NICE, 2017). After consultation with the obstetric team, an emergency C-section was deemed necessary under category 1 classification, indicating an immediate threat to the life of the mother or baby (Lucas et al., 2000). Witnessing the rapid escalation from routine labour to a critical emergency was both alarming and enlightening, highlighting the unpredictable nature of childbirth and the need for readiness in midwifery practice.
Personal Role and Emotional Response
As a student midwife, my role during the emergency was primarily observational, though I assisted with minor tasks such as preparing equipment and providing reassurance to the woman and her partner under supervision. I felt a mixture of anxiety and awe as the situation unfolded; the urgency of the moment was palpable, and I was acutely aware of my limited experience in managing such a crisis. Reflecting on Gibbs’ (1988) reflective cycle, particularly the ‘feelings’ stage, I recognise that my initial anxiety stemmed from a fear of the unknown and concern for the baby’s wellbeing. However, observing the calm professionalism of the team helped me manage these emotions and focus on learning. Indeed, the experience underscored the importance of emotional resilience, a key attribute for midwives facing high-pressure scenarios (Hunter and Warren, 2014). While I felt somewhat helpless due to my novice status, I also appreciated the opportunity to witness clinical decision-making at its most critical, which deepened my respect for the expertise around me.
Communication and Multidisciplinary Teamwork
One of the most striking aspects of the emergency C-section was the seamless communication and collaboration within the multidisciplinary team (MDT). The midwives, obstetricians, anaesthetists, and theatre staff operated with precision, each member fulfilling their role while maintaining clear dialogue. For instance, the lead obstetrician provided concise updates on the procedure, ensuring everyone was aligned on the urgency of the situation. Effective communication is widely recognised as a cornerstone of safe maternity care; poor communication can lead to errors, whereas cohesive teamwork enhances outcomes (RCM, 2018). Reflecting on this, I noted how the team adhered to SBAR (Situation, Background, Assessment, Recommendation) protocols during handovers, a tool recommended by the NHS to structure critical information (NHS England, 2017). As a student, I felt inspired by this synergy but also aware of my limited contribution to the dialogue. This experience has motivated me to develop my communication skills further, ensuring I can participate confidently in such scenarios in the future.
Clinical Learning and Evidence-Based Practice
From a clinical perspective, the emergency C-section provided a practical insight into the application of evidence-based guidelines. The decision to proceed with a category 1 C-section aligned with NICE recommendations, which advocate for delivery within 30 minutes of identifying fetal distress (NICE, 2017). Observing the procedure, I learned about the importance of rapid preparation, including the administration of anaesthesia and the sterile setup of the theatre. Furthermore, I noted the post-operative care protocols, such as monitoring for maternal haemorrhage, which remains a significant risk following C-sections (Knight et al., 2016). While my theoretical knowledge of these processes was sound, witnessing them in real time highlighted the complexity of translating guidelines into practice under pressure. Arguably, this experience bridged a gap between classroom learning and clinical reality, though I remain aware of the limitations of my understanding at this stage of my training. For instance, I struggled to fully grasp the nuances of anaesthetic dosing, which signals a need for further study in this area.
Implications for Professional Development
Reflecting on this emergency, I have identified several implications for my professional growth as a student midwife. Firstly, the experience reinforced the importance of preparedness and adaptability, qualities central to midwifery (NMC, 2018). I plan to engage more actively in simulation-based training to build confidence in emergency scenarios, as studies suggest that such exercises improve clinical competence (Cooper et al., 2012). Secondly, I aim to enhance my emotional resilience by seeking mentorship and reflecting on challenging experiences through debriefing sessions, a practice supported by Hunter and Warren (2014). Lastly, this reflection has highlighted the value of lifelong learning; while I demonstrated a basic understanding of C-section protocols, I must deepen my knowledge of associated complications and interventions. Typically, such development will involve engaging with current research and clinical guidelines to ensure my practice remains evidence-based.
Conclusion
In conclusion, reflecting on my experience of an emergency Caesarean section on the birth ward has been profoundly instructive, offering insights into clinical practice, teamwork, and personal growth. The event underscored the unpredictability of midwifery and the critical role of swift, evidence-based decision-making in ensuring maternal and fetal safety. While my role was limited as a student, the emotional and professional impact of the experience has shaped my understanding of resilience and communication within a multidisciplinary context. Moreover, it has highlighted areas for improvement, such as deepening my clinical knowledge and building confidence in high-pressure situations. Ultimately, this reflection aligns with the NMC’s emphasis on continuous professional development, and I am committed to addressing the identified gaps as I progress in my training (NMC, 2018). The implications of this experience extend beyond a single event, informing my approach to midwifery as a dynamic, challenging, and rewarding profession.
References
- Cooper, S., Cant, R., Porter, J., Sellick, K., Somers, G., Kinsman, L. and Nestel, D. (2012) Simulation based learning in midwifery education: A systematic review. Women and Birth, 25(2), pp. 64-78.
- Gibbs, G. (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Further Education Unit, Oxford Polytechnic.
- Hunter, B. and Warren, L. (2014) Midwives’ experiences of workplace resilience. Midwifery, 30(8), pp. 926-934.
- Knight, M., Nair, M., Tuffnell, D., Kenyon, S., Shakespeare, J., Brocklehurst, P. and Kurinczuk, J.J. (2016) Saving Lives, Improving Mothers’ Care: Surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care. MBRRACE-UK. Oxford: National Perinatal Epidemiology Unit.
- Lucas, D.N., Yentis, S.M., Kinsella, S.M., Holdcroft, A., May, A.E., Wee, M. and Robinson, P.N. (2000) Urgency of caesarean section: A new classification. Journal of the Royal Society of Medicine, 93(7), pp. 346-350.
- NHS England (2017) SBAR communication tool – Situation, Background, Assessment, Recommendation. London: NHS England.
- National Institute for Health and Care Excellence (NICE) (2017) Intrapartum care for healthy women and babies. Clinical Guideline [CG190]. London: NICE.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: NMC.
- Royal College of Midwives (RCM) (2018) State of Maternity Services Report 2018. London: RCM.
