This was an honest but gentle account of what it is like to be a midwife in the NHS in the UK. A peek into the world of the midwife, a job which is exhausting and exhilarating and requires superhuman strength of character and body.

As a registered nurse, I found Leah's story very interesting indeed. I recall my own first steps as a nurse, as well as a couple of placements in maternity during my training, and I am in awe of midwives everywhere.

Loved the stories of some of the different births she attended, as well as her honesty at the toll being a midwife has taken on her personal life and her body. Of course, she is right that funding is always decreasing for health and you have to do more, with less. It isn't fair and I hope that government realise that cutting funding to health services is really cutting off your nose despite your face!

Without courageous midwives like Leah and her colleagues (and my friend Wendy, who is also an amazing midwife), the world would be a far poorer place and women and their babies would be at risk, physically and psychologically.

5 stars from me.

Thank you to NetGalley and Random House UK.

This was a wonderful medical memoir written by a practising midwife.
Until I read this memoir I’d never thought about how hard mentally, emotionally and physically it is to be a midwife. Probably because before, during and after pregnancy all I was thinking about was the baby and how I was feeling. Never in a million years did I consider how the midwives were feeling or how their days were going.
This book was a real eye-opener and made me appreciate all the incredibly hard work that goes into being a midwife. Each chapters gives an account about a patient and their journey of pregnancy and birth, involving Leah and her colleagues. Some are uplifting, others are heartbreaking, but all are beautifully written and deserve to be shared far and wide.
One of my favourite chapters was ‘Olivia: Mother Knows Best’, the one about breastfeeding. This reminded me of when I struggled to begin breastfeeding my baby (now 18) and how I couldn’t have done it without the midwives help.
The saddest chapters were about stillbirths, and how heartbreaking it was for the mothers and midwives, it brought tears to my eyes.
If you enjoyed the Call The Midwife books and TV series I like I did, I definitely recommend this modern day equivalent.

Very honest book about been a midwife in this day and age with the hard pushed NHS, Leah Hazard is a real midwife who has written this book sharing her experiences as a student and on the labour ward to the present day.

As you can imagine it’s an emotional one, joy, sorrow, heartache and euphoria all rolled into one book. Makes you realise just how lucky we are to have the NHS and whilst it may be failing in parts it’s also a wonderful privilege to have.

Having 3 babies myself where 2 were emergency theatre it’s a fantastic read where you see it from their point of view also and just how hard working they are, along with how stressful it must be too.

Wonderful book I seriously loved it a lot 5 stars ⭐️

This beautiful non-fiction book follows Leah Hazard's journey as a midwife in the NHS and the trials and triumphs that involves.. It is no secret that medical memoirs like this are completely my kind of book, but I am often a little let down by them. This was not one of those books at all. I absolutely adored this book from start to finish. It was a real raw, genuine insight into the role of a midwife and the many challenges they face, particularly in an understaffed and underfunded health service. Yet the struggles and real lows of midwifery were well-balanced with fun and heartwarming stories of some of the amazing women and families that have been cared for. I just thought it was perfect and definitely confirmed my desire to one day go into this wonderful profession.

This is the story of a practicing midwife and the challenges she faces during her daily life. The ups and downs of the delivery suite and the parents who are at the centre of its function. Interesting story.

This was a well written memoir of a midwife and everything she faces on a day to day basis, working really long hours, training and helping women bring their miracle into the world safely, but this is not just a memoir of the good, obviously with being a midwife there are sad outcomes too.
I couldn’t put the book down, it gave me so many different emotions but it is real life, what really happens on the maternity wards.
I enjoyed reading Hard Pushed, it gives a true account on what it is like to be a midwife working in an NHS setting. They really are hard pushed.

I have had 3 children, all three I had complications and my children would not even be here without the quick thinking and kindness of the midwives who were with me throughout my labours. So it was obvious I would like to read this and see it from the midwives side of things.

Honest, heart breaking and at times funny. Leah tells the truth of the NHS and midwifery. A difficult read at times bear, but ultimately heart warming. Highly recommended.

Hard Pushed is a novel I could not put down fir so many reasons. Well written, it makes the reader want to delve more and more into the world of midwifery. It made me realise just how much a midwife does and how much of her life she gives up simply to help others give birth. A brilliant read, totally recommended.

A heart-warming story of a midwife, and all the things she faces on a daily basis. She tells about her training, and her love of the job, often to the detriment of her own health. Stories about successful deliveries, are varied, some amusing, some serious, and the varied people she encounters. First time fathers, and their anxieties, with some mothers lapsing into extremely bad language when the pains get too much.
Sh e also details the heart-breaking stories where babies are still born, and the effect this has on the parents who are obviously devastated.
There is hum our and heart in this book, and the varied encounters of people who all need her help and advice.

Hard Pushed was a book I just couldn't put down! Having been from a family of nurses and carers, I thought I had understood the taxing nature of this work but boy was I wrong! Nothing could prepare me from how fascinating the stories told in this novel were. I loved reading about the different women that Hazard helped over the years. The responsibility and pressure placed on midwives and nurses when the NHS is crumbling and unable to offer the financial support they deserve is heartbreaking.

I flew through this book incredibly quickly. The descriptions of complicated childbirth were so interesting! Hazard handles all stories sensitively and shows us both the good and the bad sides in her line of work. Truly an eye-opener. I'd recommend to anyone wanting to educate themselves on this field.

Thank you NetGalley and Leah Hazard for allowing me to read this eARC.

Hard Pushed by Leah Hazard is a memoir about being a midwife and all the challenges that that brings.

Hard Pushed is a novel I just didn’t want to put down, because the content – although not something I could relate to myself directly (I haven’t had any children or helped anyone give birth!) – and the stories and information within Hard Pushed’s pages are completely fascinating!

I loved reading about the different women (and their families) that author Leah Hazard has helped during her career, and also the shorter but no less interesting chapters on general musings or thoughts on being a midwife in the NHS today. It’s scary how much pressure is put on midwives and their teams with so little funding and support – and yet they do such an important and amazing job.

At times (in fact, a lot of the time!) it can be incredibly emotionally and physically draining, and this occupation – alongside of course nurses, doctors and other healthcare professionals – deserves far more support than is given to them by this current government. It never feels overly preachy, though – Leah Hazard makes it clear that there are elements to the job which need to be changed or altered if they are to do help women and their babies to the best of their ability, but she strikes the right balance between being clear on these issues and also reverting back to interesting, sometimes lighter stories and annecdotes.

I raced through this in a matter of hours, and only wish it had been longer; I’d happily sit and listen to Leah talk for much longer about her experiences, or read further books by her.

Having been a student midwife some thirty-plonk years ago I was fascinated to see if modern midwifery had moved on from my own time when midwives were overworked, underpaid and undervalued, and I am chastened to learn that in the intervening years since I took my first terrifying steps into the mysterious world of obstetrics, it would seem, however, that nothing much has really changed. Midwives still go without sleep, manage without a decent meal break, or a restorative cup of hot tea, in order to give the best possible service to a specialty which has always seemed to be the forgotten part of the health service.

I was immensely privileged to train as a student midwife and very proud of helping into the world brand new human beings, and I found that the same sense of pride and absolute commitment to duty comes across in Hard Pushed. The author has such a wonderful self-deprecating style, and absolutely tells it like it is, from the frustration and sheer slog of hard work, to the absolute joy, and yes, sometimes overwhelming heart break, but throughout the book all aspects of life are shown to be there, quite literally, warts and all.

I flew through this very readable book in the space of an afternoon, enjoying a well written memoir which put everything about what's happening in today's modern midwifery service into context. The descriptions are absolutely spot on, from the sick making terror of attending a complicated childbirth, to the absolute overwhelming pride in having an amazing skill which is so very precious and yet, so often undervalued.

There are several specific accounts of individual patients which the author encountered, and these are handled sensitively and compassionately and yet, they remind us so vividly of just what midwives are dealing with on an hour by hour, minute by minute basis. The author does use specific midwifery terminology and so, for those not familiar with obstetric jargon, these are explained at the end of the book.

Hard Pushed takes a look at our modern day maternity services by a midwife who has worked at the business end and who brings this specialty to life in a very passionate and thought-provoking way.

I've always been interested in medicine, yet know very little about midwifery. This was a very interesting account of what it's like to be a midwife today within the NHS, the challenges faced and how they can be (hopefully!) overcome. Not for people who are too squeamish, but for everyone else, it provides insight into the amazing work midwives do for women, their children, and families.

I liked this book. I found the stories really interesting and wish there was more stories as I couldn't get enough of the stories. The stories within were happy, heartbreaking and made me want to hug the people within each story. Leah does it all even till breaking point and still helps people and my hat goes off to her. I can't wait to read more from her.

Thanks goes to net galley and the publishers for providing me with. copy in exchange for an honest review

Deeply intimate and honest, Leah Hazard gives us an insiders view of modern midwifery in the UK.

The anecdotes she presents are funny and touching in turns, but regardless of the context she writes of the women (colleagues and patients) and their babies with a warmth and respect that make it easy to see why she chose this profession as her own.

Hazard doesn’t hold back from the more political aspects of the service too: staffing levels, financial struggles and bureaucratic meddling within the NHS, and she presents a clear and obvious case for burnout levels in midwifery specifically, and medicine in general.

My only criticism of the book is that each vignette is quite brief, so I felt like we dipped in and out of rooms without seeing the ‘characters’ through to a satisfactory conclusion. Which, as Hazard notes in the book, is pretty much what she faces as a triage midwife, so I definitely felt she captured not just the content, but the tone of her profession!

I’d recommend this book to anyone interested in midwifery, birth, or just looking for a quick, warm memoir.



Another night, another vagina.
It’s not unusual for me to spend the night between a stranger’s legs. Sometimes two or three strangers in the space of twelve hours. Tonight is a bit different, though. It’s 3.42 a.m. and things aren’t going to plan. Sitting in point-blank range of this particular vagina feels like staring down the barrel of a gun. Birth is inherently risky, a kind of physiological Russian roulette, but every midwife prays that she’ll dodge the bullet.

– Leah Hazard, Hard Pushed

Review by Steph Warren of Bookshine and Readbows blog

You stare into the eyes of that adorable baby, just a few weeks old. Their chubby cheeks, their unbelievably tiny fingers and toes.

You marvel at what the child's mother must have gone through to bring that precious being into this world. The long months of waiting, wondering, worrying. The pain of labor. The fear of something going wrong.

And it's true—these mothers are incredible. They are strong. Fierce. Inspirational.

But there's something—someone, rather—we're forgetting. We're forgetting the ones who are there from the very beginning to the very end. The ones who make it all possible. Who provide love, comfort, and medical attention. We're forgetting the miracle workers. The midwives.

Hard Pushed by Leah Hazard reminds us of the importance of these midwives. Hazard shows us the emotional and physical toll that midwifery can take on a person. The ups, the downs, the weird and the wonderful. It's all part of a job that, despite being absolutely crucial, often gets overlooked and is hugely under-appreciated.

Read on to find out why Hard Pushed should be at the top of your TBR list.

Unsung Heroes

The book is exceptionally well-written, flowing seamlessly from one aspect of midwifery to the other. The reader is simply a fly on the wall of the maternity ward, watching the highs and lows from a safe distance, but feeling them no less intensely than if we were right there in the room with her.

Hazard provides real-life examples for every observation or "note" she makes about the job, and it soon becomes clear that midwifery goes far beyond serving as a safe place for the baby to land. Each and every woman that ends up in the maternity ward has a unique story. Some are tragic, some are hopeful, some have barely had enough time on this earth to establish a story of her own.

All are powerful.

It's the midwife who cares for each of them, providing individual support, compassion, and understanding. It's the midwife who forsakes the warmth and comfort of her own home and family for the health and safety of strangers. She puts the wellbeing of her patients firsts, skipping meals and losing sleep because they are outnumbered.

Just Keep Swimming

And yet, despite being overworked, underpaid, and severely sleep-deprived, they keep going. They continue to come to work, day after day, night after night, keeping women and babies safe and warm when they're at their most vulnerable.

But, unless we give these midwives the support they deserve, we run the risk of losing their exceptional skill and dedication and exhausting them beyond the point of no return.

Leah Hazard's Hard Pushed opened my eyes to the battlefield that is an NHS maternity ward. It is full of gross bodily fluids, blood, sweat and tears. But most of all, it's full of love.

“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.

Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.

Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.

A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.

I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.

Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.

Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.


A few favorite passages:

“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”

“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”

“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”

There have been a lot of books written recently by various members of the medical profession and although this is "another one", it is right up there with the best. Ms Hazard is a writer of great depth who captures everything in her midwifery practice with humour, pathos and honesty. There are stories from her first shifts, to her hardest shifts, to her most beautiful and every colour of life in between. I laughed, I had tears in my eyes and I had total awe for midwives. This to describe the sound made by a mother who's baby has not survived:-

"Afterwards, after everything, the midwife carries the sound like a stone. The weight of it always with her, and sometimes she reaches for it willingly, turning it over, feeling its heft and smoothness, fingers searching its surface for a meaning. Every time she hears the sound, she adds another stone, each one a slightly different size and shape, until the weight is almost too much to bear - and she has built a little cairn in her heart."

But there is humour and beauty here too and the overall read is hugely uplifting. "She had evidently tried to contour her cheeks in line with the latest make up trend, but the stripes of bronzer across her face made her look like a child who'd fallen asleep in a bowl of Coco-Pops." This on a very young mother.

There are discussions about the mental health of new mums, the interference of mothers and mothers in law and the different way different women cope with the whole process of birthing and through it all, the midwife is stood there - tired and drained and always doing their best for every patient.

I was given a copy of this book by Netgalley in return for an honest review.

A true and brutally honest memoir from an NHS midwife. Working for the NHS although a different sector, I could relate a lot to the descriptions and tales in this book.

Well written, sensitive and honest

5 stars