Midwives and students are all unique and have their own personal challenges and struggles. In this powerful article Gemma Cromwell, third year student midwife at the University of Bedfordshire, shares her story of becoming and achieving as a student with a mental health condition with the support of all around her.
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Borderline personality disorder (BPD) is a mental health condition, that can affect how you process your emotions and social interaction with others in either an extreme positive or an extreme negative view. We can also be incredibly self-critical. There are a variety of treatments available to manage the disorder. The following article introduces readers to my personal experience of starting a midwifery degree following a diagnosis.
Me, myself and BPD:
It is 2019, as I stare at the laptop screen with the screen open to my UCAS application for a Midwifery degree, I paused, my finger hovering over the “enter” button. Self-doubt gnaws at my thoughts and intrusive thoughts flood my brain: “you are not clever enough to do this”, “how could someone like you be a midwife” or even “No one would want you to look after them”. I swallowed, closed my eyes and ignoring the nagging intrusive thoughts I pressed enter…
A little about me, I was not just nervous to apply for a Midwifery degree, I was convinced that my Mental health condition would prevent me from being capable of completing it and whether trusts would actually employ an individual such as myself. In early 2018 I was diagnosed as having emotionally unstable borderline personality disorder (BPD) but prior to that my behaviours had gone undiagnosed and untreated which made it very difficult for myself in day-to-day life. Ever so self-critical I failed to see the potential I could have and could not push myself to achieve my dreams of becoming a midwife. That annoying inner monologue was incredibly vocal at times and extraordinarily convincing. It was only following intervention from clinical psychologists following a brief hospital stay and a diagnosis that I was able to address any issues I had. It is an ongoing condition and a lot of living with it requires me to be vocal about what I am feeling or struggling with in order to process and amend the way I emotionally respond.
University life with borderline personality disorder:
I applied to two universities and received an email offering me an interview for a different course from one University. This manifested itself in my feeling unwanted and useless and that perhaps my intrusive thoughts had been correct and that I was not competent enough for a degree let alone one in Midwifery. I held out a very small slither of hope from the final university and was rewarded in my patience with an interview and subsequently a place offered to myself on the course.
I now felt I had something to prove to myself, that I could do this. That I would not let the way I manage obstacles, however unintentionally, dictate my completion of the course. I ensured that my university and lecturers were aware of my condition and at times opened up to fellow students about my struggles. I do understand it cannot always be easy working with me because I get hyper focused and I have to fully know and understand a topic or else intrusive thoughts can discourage or impede my understanding. I am therefore quite vocal and ask a lot of questions. If I am silent, I can zone out and would get agitated with myself, so I have had to adapt my way of learning by embracing my disorder.
I will admit, the prospect of university did scare me. I had completed an access course prior to starting the degree and at times had struggled. Because I get so focused, I can write and re-write work. I can almost obsess around getting a specific point across or a desired grade. I was determined that I would not spend the next three years being unnecessarily hard on myself. What has worked for myself (and may not for everyone) is to have a notebook where I make notes in preparation for assignments; key areas to explore within the topic and a saved reading list in a folder on my laptop. Time management is also key, I cannot stress this enough, by setting target dates for example to get my reading done by or my first draft completed and so on, I do not enter a state of panic whereby I feel overwhelmed by the workload. It is almost like creating little bite size chunks that slowly build and meet an assignment brief. Not forgetting as well that (at my university) we are allocated a “personal academic tutor” who is there to support us throughout not only assignments but on practical aspects of the course and not forgetting the option of mitigation if I needed extra time for an assignment.
Placement with borderline personality disorder:
As I have continued my studies, I have become acutely aware that many students suffer in silence. With insecurities around how their mental health might be perceived by colleagues or service users and perhaps their ability to perform their professional role and this can hold potential students back. The first step towards your vocation within Nursing and Midwifery is acknowledging we can do this; we are strong and we will be supported. My being emotionally dysregulated does not mean I cannot provide care and assistance to families; it may just mean I need to access support within trust when triggered by an emotional event.
A recent example of this for me personally was to provide a family with palliative care following birth of a live infant who was not compatible with life. At the time, I was able to act professionally, the baby was delivered and treated with dignity and mum was cared for and supported. However, following the event I experienced emotional extremes, vivid dreams and almost a fear of it happening again. I was working with a fellow student at this birth and it concreted for me, that despite what we think at times, we are a valuable team – not just for the families in our care but for each other. The fellow student I was with, was aware of my mental health condition; together we were able to talk through the experience, have a little cry and believe me when I say a hug does wonders. I genuinely believe had she not been there I may have struggled a lot more. I was able to reach out to my university and the lecturers were fantastic providing me an avenue to debrief and regulate as well as a referral for a counsellor. When on placement, I experienced an anxiety attack when a low-risk birth developed into a fetal bradycardia emergency. The band 7 on shift spent time with me and follow up checks were initiated by the trusts professional midwifery advocates (PMA) to ensure I processed what I had experienced and to grow professionally as well as emotionally. My concerns at the time were, if I cannot cope with the emotional overload from negative experiences how will I be able to complete my course or progress as a Midwife? I was assured though that I can do this and that the care I provided helped that family, helped them accept their loss and kept them safe from harm.
What do I hope to achieve by writing this article, I hear you asking!
So, yes, I am a third-year student with emotional dysregulation. Did I let this stop me from pursuing my dreams of becoming a midwife? Yes, for many years I did. Do I regret that now? Yes! I now have the benefit of hindsight, hindsight to acknowledge that despite my own personal mental health difficulties, I can provide a safe, caring and supportive environment. My diagnosis does not stop me from learning and growing and if anything at times having the condition has heightened my experiences. Yes, the lows are hard – but I have learnt that you are not alone, many others have similar conditions or feelings around experiences and the trusts are gradually becoming more and more geared to identify and support their team members mental health. And the highs? The feeling you get at the end of a shift when a family tells you they were glad of your care and that they will miss you or when you submit a piece of work to university that you have been agonising over… those feelings, that “high”, they never go away, they stay somewhere deep and warm inside of you and you just know, that on that day – you made a difference. Had you let your condition stop you, that family would not have had you there to improve their experience, or that assignment you submitted would now not be ingratiated into your mindset to hopefully improve your professional knowledge and evidence-based care. So, for any students or perspective students balancing on that fine line of should I do this or not… trust your gut and do it. We are a team and together we will be the future.
Gemma Cromwell
Student Midwife
University of Bedfordshire
February 2024