A definition that sets out the role and responsibilities of a midwife on an international level has 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 practise 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 role of the midwife
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 Preregistration 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 below.
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).
Click the links below for general information on midwifery, applying for courses and more.