The midwife’s role in caring for the needs of bereaved parents following a stillbirth
Lecturer in midwifery at the University of Salford(June 2016)
The unexpected loss of a baby can be both a devastating and traumatic experience for parents. Inadequate care and support can potentially lead to mental health problems such as complicated or traumatic grief. This article will review the midwife’s role in providing more effective meaningful and supportive care for bereaved parents following a stillbirth. It will also highlight the educational needs of student midwives to ensure they are equipped with the necessary knowledge and skills to support bereaved parents
Are staffing shortages changing the culture of midwifery?
Nadine Edwards, Arianna Gilbert, Rosemary Mander, Nessa McHugh, Jo Murphy-Lawless and Jenny Patterson
All members of the Birth Project Group(March 2016)
The effects of budgetary changes on midwives' practice environment have raised concerns in many settings. A survey of midwives and student midwives in the UK and Republic of Ireland in 2014 produced 280 responses. Staffing shortages were regarded as underpinning many changes, one of which was that of previously optional 'extra' activities, such as unpaid overtime, becoming mandatory. Shortages were aggravated in less acute areas by the transfer of midwives to more acute settings. One of the fears expressed by midwives was that a permanent change in the culture of midwifery would result. These phenomena are the everyday experiences of practising midwives, but they have failed to be addressed in the documents published by regulatory and review bodies.
Humanising midwifery care
Dr Susan Way
Associate professor of midwifery at Bournemouth University
Dr Janet Scammell
Associate professor of nursing at Bournemouth University
Since the publication of the Francis Report (2013), providing care that is kind and compassionate is high on the agenda of all NHS services, including maternity. This article introduces the humanising values framework that explores aspects of what it is to be human and offers practical examples of how it can be incorporated into midwifery care. Susan Way and Janet Scammell consider the advantages of woman-centred care, highlighting the benefits of humanising care
What about next time? A series of reflections The value of reflection
Midwife for the Isles of Scilly(March 2016)
In this article, one of an occasional series, Jude Davis encourages a colleague to reflect on her experiences in order to enhance her sensitivity
Improving workplace behaviour in maternity services
Royal College of Midwives, Director for England
Gillian Smith MBE
Royal College of Midwives, Director for Scotland(February 2016)
It is tragic that in the midwifery and medical professions we are still witnessing bullying and poor workplace behaviours in the NHS. The Royal College of Midwives (RCM) and Royal College of Obstetricians and Gynaecologists (RCOG) have been discussing this since the early 2000s as midwifery and obstetrics feature at the top of General Medical Council (GMC) reporting and NHS surveys. It has come to the point that, as royal colleges, we need to take responsibility, show leadership and do something about this, before waiting for the next set of survey results. Through a joint project, both royal colleges are optimistic that the juggernaut of poor workplace behaviour can be turned around and improved in a generation, if we all work together.
Midwives’ Rules: professional safeguard or relic of a bygone era?
Principal lecturer in Midwifery, University of Brighton(February 2016)
It appears likely that, as a result of the dismantling of the system of statutory midwifery supervision by the Nursing and Midwifery Council, the Midwives’ Rules are also likely to disappear. This article explores the development and meaning of the Rules and wonders whether they are a necessary part of modern midwifery practice or an historical relic that no longer serves a purpose. It argues that they were designed to serve, control and discipline midwives and that there may be better ways for midwifery to delineate and develop the profession.
What about next time? A series of reflections New and old
Midwife for the Isles of Scilly(December 2015)
In this article, one of an occasional series, Jude Davis reflects on the changing face of midwifery and finds the essence of woman-centred care
Unexpected consequence of midwifery in the NHS
Midwife at George Eliot NHS Trust, Nuneaton(November 2015)
This article presents information from the Caring for the Carers conference held at George Eliot Hospital, Nuneaton in July 2015. For many midwives, feelings of stress are an unexpected consequence of rising birth rates, low staffing levels and negative organisational cultures, so our aim was that delegates would take away skills for ‘surviving’ in maternity services. The conference was the catalyst to a project at George Eliot NHS Trust to improve the wellbeing of staff so that they can develop a positive outlook towards the care which they offer. As part of the project, a toolkit for survival was produced which helps to prompt maternity workers to remember their own wellbeing. This project is continuing to grow and the results will be available next year.
Applying personal reflective cycle: On running for supervisor
Clinical academic midwife at Portsmouth Hospitals NHS Trust and PhD student at Bournemouth University(November 2015)
As reflection has become a firmly integrated element of good practice, and fundamental to the concept of learning from experience, individuals frequently utilise their own creativity and unique thought processes to make sense of their personal challenges. This paper uses the analogy of running a race to explore the personal challenge of undertaking preparation and study to become a supervisor of midwives (SoM), and to consider the unknown challenges ahead. This analogy gave rise to a unique and personal reflective cycle that incorporates traditional and familiar reflective models alongside acknowledgement of the physical and emotional advantages of physical exertion.
What about next time? A series of reflections Wavering enthusiasm
Student midwife at Bournemouth University(November 2015)
This reflection focuses on an experience I had whilst on my community placement involving my first birth, a home birth. I attended as a student midwife. I have mulled over my feelings about the first birth I witnessed, and midwifery as my future career and, most importantly, the role of the midwife at a home birth. To maintain confidentiality I have used pseudonyms throughout.
Keeping the shining roads open: intuition in midwifery practice
Co-ordinator of Master of midwifery practice at Edith Cowan University
Co-ordinator of Bachelor of nursing at Charles Darwin University(November 2015)
Within the midwifery profession, intuition has been discussed for many years and examined as both an obstructive and productive element of clinical practice. Intuitive ability is perceived by some to diminish the basis from which good clinical decisions are made, based upon the argument that intuitive knowledge is not evidence based. However, research has shown that midwives frequently rely on their ‘gut’ instincts or intuitive insights as the foundation of a judgement or action within the clinical practice setting.
The rise of remifentanil and the decline of midwifery autonomy
Practice development midwife
both at Blackpool Teaching Hospitals NHS Foundation Trust(January 2015)
Since the 1980s epidural analgesia has been considered the gold standard for pain relief in labour. Over the past decade there has been a growing trend in UK maternity units to offer remifentanil PCA as a fast, safe alternative for women where epidural analgesia is contraindicated. Increasingly more obstetric units and anaesthetists are extending the use of remifentanil and in many units it is now preferred over central neuroaxial blocks (Stocki et al 2014). It would appear that remifentanil is being hailed as the panacea for labour pain. Whilst discussion around the use and effects of remifentanil is very well documented in anaesthetic journals, there is very little midwifery research around this subject. Following a review of the current evidence, this article will explore the use of remifentanil in labour, consequences for women and neonates and implications for midwifery practice.
LOOKING AFTER YOUR HEALTH 2. Avoiding constipation at work
Midwife at Watford General Hospital and an osteopath and lactation consultant(January 2015)
This article is to summarise key concepts for the health of the midwife, with particular focus on constipation. This is often a taboo subject even amongst women who aren’t midwives, so they do not always freely discuss the issue. It is a key discussion when talking through iron supplementation, hormonal changes and nutrition within the realm of the midwife. Raising awareness and taking care of your own bowel habits is key to enjoying future health and wellbeing.
Examining compassion and resilience through various lenses
Professor of perinatal education
Fiona Oliver, Laura McIntosh and Jodie Lee, student midwives
All at the University of Worcester(September 2014)
In the aftermath of the Mid-Staffs Enquiry, as part of our midwifery students’ enquiry-based learning curriculum, a session was devised with the aim of enabling the students to harness the energy for change of the Francis report (Francis 2013) to explore their understanding and experience of compassion. In this article, Mary Nolan describes the structure of the sessions, and three of the students give an account of the work they undertook in small groups to explore strategies for remaining resilient in the face of the inevitable challenges they will meet once qualified. While they were already keenly aware of threats to compassion in midwifery, they were optimistic that their passion for their chosen profession, and their increased understanding of factors promoting resilience, would be protective.