This essay examines and outlines the roles and responsibilities of Practising Midwives in the United Kingdom, as well as exploring the role that the midwife plays in association with other Healthcare providers.
The basis that underpins the midwifery profession is that women should be at the forefront of their maternity care and valued as individuals with distinct and specific needs (Midris, 2012).
Practising midwives in the UK must follow and abide to a certain set of rules and guidelines set out by the Nursing and Midwifery Council (NMC) known as ‘The Code, Standards of Conduct, Performance and Ethics for Nurses and Midwives’ (NMC, 2008) (Baston et al., 2009).
Midwives are able to be the sole carer of a mother and baby from early pregnancy to around 28 days after the birth and attend over 75% of births in the UK (Baston et al., 2009) and generally view care from a holistic perspective and consider the care they offer from a psychological, emotional, spiritual, social and cultural context (Baston et a., 2009).
The word ‘midwife’ simply means ‘with women’ (Alberta Association of Midwives 2012).
According to the International Confederation of Midwives Council (2005) the midwife is a conscientious and accountable trained specialist in ‘normal’ pregnancy and birth. They work in ’partnership’ with the woman, her partner and family to offer the vital care, support and advice required during the prenatal, interpartum and postpartum period to independently guide the women through the pregnancy and birthing process and provide care for both the new born and infant. The scope of the midwife includes the support and encouragement of normal birth, identifying complications with the pregnancy and performing emergency procedures. Midwives play a significant and critical role in the delivery of health counselling and education which should include antenatal education not only with the women but with the family and network and wider community.
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Pregnancy and antenatal care are essential parts of midwifery care. A vital part of this care is carrying out assessments of well being which is not only a process to measure the woman’s and child’s health but is also effective in testing whether the wellbeing of the woman and child is at risk. In order to accurately assess wellbeing the midwife must have relevant practical skills such as, taking and recording blood pressure to screen for hypertension, listening to the foetal heartbeat, taking bloods which can for example determine her rubella immunity status, measuring the growth of the foetus, dating the pregnancy and administering medication (Mander, 2009).
The midwife is equipped with extensive knowledge and dexterity of the female anatomy, how the body works and the changes and processes in pregnancy as well as the ability to examine this competently. The midwife is expected to have comprehensive knowledge of the normal progression and different stages of pregnancy, the bodily and psychological changes and common discomforts women experience and has the ability to interpret results of basic screening laboratory tests, for example, urine tests which look for the presence of protein or glucose in the urine which can be an indicator of infection or diabetes (Mander and Fleming, 2009, Medford, 2011).
The midwife works jointly with other health care professionals to provide multidisciplinary care to the woman, these health care professionals include, obstetricians, general practitioners, paediatricians, health visitors and physiotherapists. The midwife is obligated to seek advice or turn to the appropriate professional if there is a complication within the pregnancy that falls outside the midwife’s scope of practice (ICM 2002, 2005).
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The clear and concise record keeping is an important aspect and legal requirement of midwifery practise and is a vital tool that supplements the care process, which include consultations and sometimes referrals by improving communication between the care providers and the clients, for example information that should be included if this is a full assessment and care plan that should be followed by the woman and child (Nursing and Midwifery Council (NMC), cited Medforth et al., 2011).
Midwives are only able to care for women for are deemed as experiencing a ‘normal’ healthy and physiological pregnancy although a midwife would be
aware and have knowledge of abnormal and pathological aspects of pregnancy. If a complication arises that is deem outside a midwife scope of practise the midwife would no longer be able to be the woman’s primary care provider and the care would be transferred over to an obstetrician. An obstetrician is a trained specialist in the foetal abnormalities and complications of pregnancies and childbirth and who are also legally allowed to deliver babies. Although the woman’s care has been transferred to the obstetrician the midwife still participates in her care to act as the woman’s avocate and offer her support (Mander and Fleming (2009).
The midwife can also expect to be in contact with the Health Visitor to discuss newly booked clients and at some point after the birth and to hand over the care of the woman and the child, the midwife will give the Health Visitor an extensive amount of information on the family during the pregnancy and birth experience so that the they can offer direct individual support. Modern midwifery sees midwives also working with social services as some women and their families have additional needs separate to those from the pregnancy.
Midwives may seek advice from a social workers for example, surrounding child protection issues, housing and benefit queries in order to offer the women adequate social support and to signpost them to appropriate services or work in partnership with the social services because the women belongs to a vulnerable group, for instance teenage mothers or disabled mothers or women at risk of domestic violence. It is common for a midwife to also work closely with GP’s, and in the community may be based within the GP surgery, woman may be referred to the GP from an antenatal clinic for minor problems, for example to symptomatic occurrence of urinary infection. (Peate and Hamilton, 2008).
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In conclusion, this essay looked into the roles and responsibilities of the midwife and the role they play in association to other health providers, the reoccurring theme upheld by this essay is that midwifery has to be a diverse and ever changing profession in order to meet the needs of modern society. Modern midwifery is not just about ‘delivering babies’ but encompasses so much more. Midwifes are often the primary care provider from early pregnancy and into the postnatal period. Midwives act as advocates for women to help them make informed choices and prepare for birth and parenthood. (Medford et al., 2011).
