So you want to be a midwife?

14/06/2012

Midwife handing a women her baby Contemporary midwifery involves providing maternity care to a wide
and diverse range of women, their babies, partners and families. The women with whom midwives come
into daily contact will be of different ages, cultural backgrounds, socio-economic circumstances,
and will have varying care needs and expectations. With advances in scientific medicine and
technology, the profile of women accessing UK maternity services is also changing. Increasingly,
women with complex social issues (eg asylum seekers/refugees, pregnant adolescents and those with
substance misuse problems) are requiring both midwifery and specialist care and support. Similarly,
women with underlying medical conditions are entering into pregnancy, where in past years this
would have not been an option for them. Midwives are therefore required to act as skilled,
independent practitioners, but equally, need to be able to work alongside a wide range of
multi-professional health care practitioners. Midwives are also integral to ensuring that women
receive the information and support they need to make the right choices for them and their baby,
although at times, these choices may be significantly limited by the woman’s individual
circumstances.

If these challenges and the potential rewards of being a midwife appeal to you and you are
considering a career in midwifery the following information should be helpful to you. This material
applies to individuals who are interested in undertaking midwifery education programmes in England,
Scotland, Wales and Northern Ireland.

The role of the midwife

The Nursing and Midwifery Council (NMC) is the statutory body that oversees the educational content
of university courses leading to a Degree in Midwifery. The NMC is also responsible for confirming
the professional registration of each midwife upon qualification and ensuring their continuing
competence throughout their ongoing midwifery practice. This framework is vital in making sure that
each woman and her baby receive safe, competent care from skilled and knowledgeable midwives during
pregnancy, childbirth and into the postnatal period (NMC 2004). A definition that sets out the role
and responsibilities of a midwife on an international level has also been agreed by the
International Confederation of Midwives (ICM 2005). This organisation represents the professional
status of midwives worldwide.

Definition of the midwife

‘A midwife is a person who, having been regularly admitted to a midwifery educational programme,
duly recognised in the country in which it is located, has successfully completed the prescribed
course of studies in midwifery and has acquired the requisite qualifications to be registered
and/or legally licensed to practise midwifery.

The midwife is recognised as a responsible and accountable professional who works in partnership
with women to give the necessary support, care and advice during pregnancy, labour and the
postpartum period, to conduct births on the midwife’s own responsibility and to provide care for
the newborn and the infant. This care includes preventative measures, the promotion of normal
birth, the detection of complications in mother and child, the accessing of medical care or other
appropriate assistance and the carrying out of emergency measures.

The midwife has an important task in health counselling and education, not only for the woman, but
also within the family and the community. This work should involve antenatal education and
preparation for parenthood and may extend to women’s health, sexual or reproductive health and
child care.

A midwife may practise in any setting including the home, community, hospitals, clinics or health
units’ (ICM 2005).

Adopted by the International Confederation of Midwives Council meeting, 19th July, 2005, Brisbane,
Australia. Supersedes the ICM “Definition of the Midwife” 1972 and its amendments of 1990.

Once qualified, registered midwives have direct responsibility for their actions; this is called
‘professional accountability’. This involves midwives undertaking, on their own responsibility, the
care of a woman who has no apparent complications in her pregnancy, without needing to refer to, or
obtain consent from, a medical practitioner about the plan of care. As a result of this, a midwife
can be self-employed and choose to practice outside the National Health Service (NHS) as an
Independent Midwife. However, all practising midwives are regulated by the NMC through a named
Supervisor of Midwives (SOM), who can assist them with updating their knowledge and skills, ensure
their practice is safe and competent, and support them in their professional role (NMC 2007a).
Currently, midwifery is the only health care profession that has statutory supervision to protect
the public from unsafe and incompetent practitioners, as well as promoting the need for continuing
professional development through lifelong learning (NMC 2004, 2007b).

If you want to be a midwife, it is important for you to understand what this encompasses for the
midwife practising in the UK. The Royal College of Midwives (RCM) is a professional organisation
and trade union that promotes the profession of midwifery, as well as looking after employment
issues for midwives. The RCM’s website provides very good information about the work of the
midwife, also dispelling the common perception that midwives ‘just deliver babies’ (RCM 2007). The
place of the midwife within the community is explained, where a midwife is present at every birth
regardless of the location for this, highlighting how the involvement of a midwife touches
everyone’s life.

A midwife forms a constant contact with health service provision for women during pregnancy, and
throughout labour and the postnatal period. Midwives also need to have sufficient knowledge to help
women and their partners make informed choices about the services and options available to them.
This involves providing clear and relevant information, as well as sometimes requiring the midwife
to transpose complex and technical information into a format that the woman and her partner can
understand, and use as a basis for their decision making.

The RCM describe the role of the midwife as very diverse, because practitioners are involved in
direct care in the form of clinical examinations, screening tests, health advice and parent
education. The midwife offers support to the woman and her family throughout the childbearing
process, as well as during the first few weeks after the birth when women and their partners are
adjusting to their parental role. The midwifery profession feels very strongly that women should be
at the centre of their maternity care and recognised as individuals with specific needs; this
underpins much of the organisation, provision and management of UK maternity services. Midwives
also need to be able to offer support to women, their partners and families where a pregnancy has
not ended in a healthy baby, and where there is a need to acknowledge disability or death. The
educational framework of the midwifery degree should enable the qualified midwife to be competent
and confident in supporting women in normal childbirth as part of their role. However, midwives
will also be required to give care to women who have complications around their pregnancy, birth or
afterwards. While newly qualified midwives may not necessarily be competent in the management of
the care for these women, ongoing support provided (called ‘Preceptorship’) will help to ensure
that they receive guidance and support so that they are able to gain experience which will help
develop their confidence and competence in these aspects of care (Standards for Pre-registration
Midwifery Education (NMC 2009b)).

The role of the midwife has evolved considerably over time. If you are interested in the history of
midwifery, or the current framework that regulates midwifery in England, Wales, Scotland and
Northern Ireland, suggestions for further reading are provided at the end of this resource.

Who can be a midwife?

Application for a midwifery course is no longer subject to a minimum age requirement and is open to
anyone holding the academic qualifications required for course entry. However, the educational and
Health and Safety requirements mean that in reality, the youngest applicants are approaching 18
years at the point of entry to a midwifery degree programme. The Health and Safety at Work Act
2004, defines a young person as: ‘any person who has not attained the age of 18 years’ and the
manner in which young people may be deployed to work is restricted by this legislation (NMC 2009b).
There are no gender specifications either, although there are considerably fewer men than women
working as practising midwives. Information from the NMC shows that at 31st March 2008, there were
just 132 male midwives registered to practice, compared with 35,169 female midwives (NMC 2007b). If
you have an interest in the background to male midwives, there is more information about this in
the additional information section at the end of this resource.

What are the qualities needed to become a midwife?

Being a midwife is an inspiring and immensely fulfilling role that requires someone who is able to
develop a relationship of trust and confidence with those in their care. Every day is different,
bringing with it assorted experiences and challenges, and midwives needs to have the skills to be
able to respond to all of these appropriately and competently.

Any role that involves care for another person will require kindness, intuition and empathy, as
well as a certain degree of objectivity. It is this objectivity that enables a midwife to act as an
advocate for women, while also being flexible and adaptable to each woman’s individual
circumstances and needs. Being a midwife means being able to take responsibility for your own
actions, as well as recognising when to refer to others for assistance and guidance. This results
in being able to communicate effectively and work in partnership with your peers, as well as with
other allied health care professionals and agencies. It is essential that midwives are accepting of
women and the circumstances in which they live. Midwives should treat all women and their partners
with respect, irrespective of class, creed, economic status, race, sexuality or age, seeing them as
individuals and tailoring their care appropriately.

By attaining the standard of a professional, this also requires you to maintain accurate, legible
and contemporaneous documentation, as evidence of the care you have given. This includes recording
the clinical indications for this care, as well as any information/advice that you have offered,
and, where it is appropriate, that the woman has given her informed consent. Guidance on record
keeping for nurses and midwives is available from the NMC website; details of NMC publications can
be found at the end of this resource.

Source: https://www.midirs.org/home-page/about-midirs/, accessed March 2014