“Safe is not enough. What is the point in safe if you die inside yourself? How can you ever be safe, unless first you are free?” – The Last Midwife

The woman didn’t speak English, and her husband was at home with their other two children. She was alone and vulnerable, admitted to the labour ward because her membranes had ruptured more than twenty-four hours ago. I was assigned as her midwife. I was newly-qualified, anxious to please my seniors, and scared of the labour ward coordinator.

The obstetric unit had numerous protocols, designed to minimise ‘risk’ and ensure ‘safety’. Every woman admitted in labour had to be labelled, bled, cannulated, and dressed in a hospital gown and anti-embolism stockings, just in case she should need an emergency c-section. Continuous CTG monitoring was required in all cases. I began by asking the woman to undress, miming my request in the absence of any shared language. She shook her head.

The woman was beautifully attired in multi-layered, traditional Afghan dress, her head veiled. She had no desire to change into a backless hospital gown, but I insisted. I got an interpreter on the phone and did my best to explain the ‘rationale’: infection control, the possibility of surgical intervention, and so on. The woman was clearly unhappy, but I stood my ground, and she complied. I was grateful; one less thing for Sister to scold me about.

Our interactions continued in the same uncomfortable vein. With fumbled translations, and expressions of frank disgust on the woman’s face, I persuaded her to put on the stockings, lie down on the bed, and submit to continuous monitoring. She obeyed, but refused to meet my gaze.

I stayed with the woman, filled in my records, and ticked all the boxes. A few hours later, she gave birth to a healthy baby boy. Physically, it was a straightforward delivery, but, spiritually and psychologically, it was a disaster. This was not the birth this woman would have chosen, and I had not been the midwife I aspired to be. Following the rules and submitting to the institution, I had allowed my fears to take precedence over the woman’s freedom.

A few months later, I left my job at the hospital, confused and disillusioned. I had learned how to keep women ‘safe’ in childbirth, but I knew this was not enough. There had to be more to birth than minimising medical risk. ...

This article was published in the AIMS Journal in June 2026. ISSN 2516-5852 (Online)

AIMS Journal, 2026, Vol 38, No 2.  Please follow the link below to read the full article.