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.
About this resource
This resource provides information on the following:
• The role of the midwife
• Who can be a midwife?
• What are the qualities needed to become a midwife?
• Entry requirements to midwifery degree courses
• Midwifery education – academic and clinical course content
• Preparation for application on a pre-registration midwifery programme
• Financial support while you are at university
• Application forms and the interview process
• Post-registration career development
At the end of the resource is a section that provides additional information and resources, which can help to increase your understanding and awareness. Some of these have been used to compile this information; others are well known resources used within midwifery practice and education.
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.