Leah Hazard photo, author of Hard Pushed

Author and midwife Leah Hazard

How do you write a love letter to thousands of women, many of whom you will never see again and whose names you have long since forgotten? Where do you begin? Do you start with the first one, the one whose baby slid, bawling and slippery, into your hands before you’d even had a chance to say hello? Or perhaps with the woman whose tears etched raw trails down her face as she told a tale of loss that stopped you in your tracks? Maybe you start with the one who made you cry with laughter as she powered through her labour with a torrent of highly imaginative expletives. Every woman – the wild, the unwell, the joyous and the grief-stricken – each one deserves to be honoured, but how?

In my time as a midwife, I’ve had the privilege of caring for countless women at various stages in their journeys to motherhood. Whether our encounters have lasted brisk, harried minutes or long, tender hours, each one has invited me into her world and in return I have administered more microdoses of love than I can possibly recall. I knew from my own experience of pregnancy and birth that the childbearing year could require untold reserves of strength, patience and resilience, but as I’ve passed through wards, clinics and operating theatres in a professional capacity, I’ve witnessed feats of everyday heroism on a massive scale. From the wide-eyed first-timer and the seasoned veteran, casually concealing the bulge of a baby’s head in her leggings, to the refugee with a shocking, globe-spanning tale of exploitation and endurance, the women in my care have taught me what it means to be human, to give love and to receive it, to triumph over unthinkable adversity, and sometimes, to accept defeat and loss with grace. Hard Pushed is, in part, a tribute to them.

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The women in my care have taught me what it means to be human, to give love and to receive it, to triumph over unthinkable adversity, and sometimes, to accept defeat and loss with grace.

But there are other women too. Women who have also laboured, but to little personal gain; who have spent every last scrap of energy and goodwill, with only small reward; who have weathered the depths of sorrow and the highest peaks of euphoria in a single shift. These, now, are the women who work alongside me: the midwives. We inhabit a world that is light-years away from the cobbled lanes, capes and bicycle bells of our predecessors. Ours is all too often a place where excessive workloads and scant resources converge to form a perfect storm. We do our best to hold a safe, quiet space for the women who seek our help while the maelstrom of modern maternity swirls around us, but increasingly these efforts come at great personal expense. We push hard – often through missed breaks, exhaustion and even illness. We support each other with wicked humour and hard-fought compassion, but in a broken system it’s not always enough. Some of us push on, but some of us burn out and fall away. To every midwife who has given everything, and wonders whether she can keep giving more, I offer my love, but also my rage and indignation. These warrior women deserve more.


Ours is all too often a place where excessive workloads and scant resources converge to form a perfect storm.

Ultimately, Hard Pushed is a love letter to that self-same system that has nearly defeated us. The system is there for one purpose – to care – and it, too, can be healed if we heed the stories of those working within it. But this book is also a warning shot, a battle cry. It’s for the thousands of women I’ve met and for the countless others still to come. 

  • Hard Pushed

    You haven't slept for twenty hours, haven't eaten for ten, and you're in charge of twenty heavily pregnant women at midnight.

    Welcome to the life of a midwife.

    Life on the NHS front line is tougher than you could imagine. Marathon shifts, endless birth complications, staffing shortages, pushy families, panicking mothers – and that's a quiet Thursday afternoon.

    But the strength and camaraderie of the women working under such intense pressure is a beautiful thing. Together, they must withstand one of the world's most difficult job, one that produces moments of pure, absolute joy and terrible, heart-wrenching grief.

    Through the experienced eyes of Leah Hazard, we meet women from all walks of life: the scared fifteen-year-old whose baby could be months premature, the same-sex couple whose child will be a miracle of modern medicine, the woman giving birth in a room drenched in essential oils and love, and the mother-to-be whose tale of exploitation and endurance has carried her thousands of miles to Leah’s ward.

    Moving, compassionate and intensely candid, Hard Pushed is a love letter to new mothers and to Leah’s fellow midwives – there for us at some of the most challenging, empowering and defining moments of our lives.

    'The stories in Hard Pushed highlight the bravery of our midwives, and the women they care for.' CHRISTIE WATSON, author of The Language of Kindness

    'Heart-rending, inspiring and funny, Hard Pushed brings alive the world of midwifery in all its complexity and radiates love and respect for women.' PROFESSOR LESLEY PAGE CBE, former president of the Royal College of Midwives

    'It is Leah Hazard's capacity to love and give so personally to the many thousands of women she has worked with which imbues this book with its power.' JULIA SAMUEL, author of Grief Works

    'Not only powerful but well written too . . . a worthwhile addition to a genre fast becoming as crowded as a busy maternity unit.' DAILY EXPRESS

    'A riveting read: heartwarming and heartbreaking' SHEENA BYROM OBE, midwifery consultant and author of Catching Babies

    'A beautifully written, intimate portrait of the extraordinary work that midwives carry out each and every day.' CAROLINE ELTON, author of Also Human: The Inner Lives of Doctors

  • Buy the book

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