Midwife

Occupation overview

This occupation is found in a range of healthcare settings offering different models of care.  Most midwives are employed by the NHS while others work in the private sector, social enterprise or independently.  A midwife may work in the community such as in a woman’s home, community hubs, GP surgeries, clinics, midwife-led units and birth centres or in hospital maternity units. This means that they usually work shifts including evenings, weekends and nights and may be on-call to provide 24-hour care.

The broad purpose of the occupation is to be the first and main contact for a woman, her partner and family, recognised as a responsible and accountable professional, the midwife acts as an advocate for the woman, working in partnership with her and giving the necessary support, care and advice during pregnancy, labour and the postnatal period.  Midwives are lead co-ordinators of care as well as the first point of contact for a woman, her baby and family.  They offer support, care and advice and are responsible for facilitating births and providing care for the newborn. Midwives are experts in normal physiological birth and in supporting the woman through all birth outcomes.  The personalised care they provide includes preventative measures, the detection of complications in mother and baby, the promotion of normal birth, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. The midwife has an important role in public health, offering health counselling and education, not only for the woman, but also within the family and the community. This work involves antenatal education and preparation for parenthood and may extend to a woman’s health, sexual or reproductive health. A midwife provides full antenatal care for the woman, carrying out clinical examinations and screening.  They offer antenatal and parenting classes to help the woman, her partner and family prepare for the birth of the baby and to care for it once it has been born.  The midwife monitors and supports the woman, her partner and family during labour and the birthing process, helping the woman to birth her baby and assessing both the woman’s and the baby’s overall health and wellbeing.  Midwives can identify complex pregnancies and know when to refer to others or seek appropriate support.  They are able to offer guidance and support around issues such as stillbirth, miscarriage, termination, neonatal death or other complications. Following birth midwives offer support for infant feeding, recovery and may refer the woman to other services as required.

In their daily work, an employee in this occupation interacts with women and families from a range of backgrounds.  Midwives need to have excellent communication skills to support the woman, her partner and family through the emotional, physical and psychological process of childbirth. Midwives are part of the wider health and social care multidisciplinary team, working in partnership with colleagues as required.  A midwife must have excellent situational awareness and knowledge of other human factors.

An employee in this occupation will be responsible for caring for a number of women and may manage a caseload (continuity of carer).  Midwives are responsible and accountable autonomous practitioners who provide woman and family centred integrated care.  Midwives act as an advocate for the woman, enabling them and their families to make informed choices about the options and services available throughout pregnancy, labour and post-natal period.  The midwife is responsible for the health of both the mother and baby and refers to others if there are medical, social or other complications.  Midwives are regulated by the Nursing and Midwifery Council (NMC) and are responsible for their own practice and for keeping up to date with current knowledge and skills.

Skills

  • Practise in accordance with legislation, standards and code of conduct to support the woman, her partner and family through the pregnancy, labour, birth and postnatal period
  • Act as an advocate for the woman
  • Consult with and refer to colleagues when care requires expertise beyond own competence or when the woman or baby’s needs falls outside the scope of midwifery practice
  • Identify, respond to and report any unsafe practice
  • Take responsibility and accountability for own practice as a midwife, reviewing, developing and enhancing
  • knowledge, skills and maintaining your fitness to practice
  • Manage and prioritise competing demands
  • Create and maintain a healthy and safe environment, preventing and controlling infection and promoting health and wellbeing
  • Communicate in ways that are sensitive and appropriate, taking into account emotional, psychological, cognitive, language, social and other circumstances, checking you have been understood
  • Use interpersonal skills to build rapport with the woman, her partner and family
  • Facilitate informed decision making
  • Handle issues or complaints in line with national and local process and procedure
  • Undertake the initial consultation with the woman
  • Use a range of techniques to assess the physical, social and psychological needs of the woman
  • Give information surrounding options for screening and overall health and wellbeing
  • Work in partnership with woman to develop plans that are appropriate to the needs, contexts, culture and choices of the woman, her baby and family
  • Enable and empower the woman to consider plans for pre-pregnancy, pregnancy care, birth, place of birth, plans for feeding babies, needs for postnatal support and preparation for parenthood
  • Enable and empower the woman to think about their own health and that of their baby, partner and family and how this can be improved
  • Consider best available evidence and modify programmes of care to improve outcomes for the woman and her baby
  • Contribute to enhancing the health and social wellbeing of individuals and their communities
  • Contribute to audit in order to optimise the care of the woman, her baby and family as required
  • Act as lead carer in normal pregnancies supporting the woman
  • Carry out physiological measurement, psychological assessment and screening tests and refer the woman as appropriate
  • Contribute to providing support to the woman when her pregnancy is complex or if she has suffered pregnancy loss
  • Make critical decisions in partnership with the woman, her partner and family to support the appropriate referral of a woman or baby to other health professionals or agencies when required
  • Discuss and negotiate with other professionals about further interventions as appropriate
  • Use appropriate clinical and technical means to monitor the condition of the woman and the fetus to optimise birth outcomes
  • Facilitate the comfort of the woman during labour and birth
  • Promote trust with the mother and birthing partner to facilitate a positive birth experience
  • Care for the woman and the baby once she has given birth including assessing for risk indicators
  • Undertake appropriate emergency procedures to meet the health needs of the woman, fetus or baby
  • Raise concerns immediately in the event of an emergency
  • Prepare for and manage risks
  • Care for a woman in the postnatal period, facilitating her to manage her physical and psychological wellbeing and transition to motherhood
  • Care for a woman who is recovering following birth including post-operative care for those who have caesarean or assisted births
  • Support and advise the woman on parenting, relationship building, feeding and caring for her baby
  • Facilitate discussions about resuming intercourse and future reproductive choices
  • Care for a woman, her partner and family who are bereaved following pregnancy loss or death of a baby
  • Examine and care for babies immediately following birth, confirming vital signs and carrying out an assessment and physical examination
  • Screen babies and refer as required
  • Undertake continuing assessments and care for babies
  • Escalate and report safeguarding issues as required
  • Administer and manage medication and pain relief to the woman and baby safely, calculating accurately and in line with legislation and the limits of your competence and role
  • Complete, store and retain accurate and contemporaneous records, in line with legislation and best practice
  • Act as a role model for the profession to colleagues, enabling them to reflect on and develop their practice
  • Delegate tasks and duties appropriately
  • Work across professional boundaries, developing professional networks
  • Supervise or monitor the work of other members of the team

Knowledge

  • The national and professional standards, guidelines and current legislation that applies to midwives in the UK, local policies and procedures
  • The limits of your competence, experience and training
  • The importance of confidentiality and appropriate situations in which to disclose information
  • The importance of safeguarding, governance, ethical issues, a duty of care and a duty of candour
  • The importance of ongoing continuing professional development and being a reflective practitioner
  • The importance of building personal resilience within your professional life
  • Ways to promote a healthy, safe and secure environment
  • A range of communication methods and media, including verbal and non-verbal, written, electronic, listening skills, common barriers to communication, aides and services available to assist with communication
  • Ways to enable the woman to think through their feelings, building trust by responding to their concerns
  • The importance of acting in the best interest of the woman and her baby, maintaining their rights, understanding their preferences, gaining valid informed consent and assessing their capacity for decision making
  • The processes and procedures for dealing with and managing complaints
  • Ways to confirm pregnancy including recognising the indicators of the stage of progression
  • the information and techniques needed to diagnose a woman’s needs such as: taking a history, observation, physical examination, biophysical tests and social, cultural or emotional assessments
  • Anatomy and physiology relevant to midwifery including the physical, psychological, social, emotional, cultural and spiritual factors that may positively or adversely influence normal physiology
  • The importance of practising in a way that respects, promotes and supports individuals’ rights, interests, preferences, beliefs and culture
  • How to use best evidence and clinical judgment to determine and provide programmes of care
  • The importance of compassionate and woman-centred care
  • The importance of respecting a woman’s right to accept or refuse care and treatment
  • How to critically appraise knowledge, research and practice to improve the quality of care you offer
  • Midwifery care within the context of public health policies such as being aware of a range of programmes to improve sexual and reproductive health or reduce maternal and perinatal morbidity and mortality
  • Ways to involve users and local communities in service development and improvement
  • How to effectively analyse and share data that has been collected including the importance of seeking feedback from the woman, her partner and family
  • Ways to identify and target care for groups with particular health and maternity needs
  • Your role in relation to audit and multi-professional standard-setting
  • Ways to support parents and babies with additional or complex needs
  • A range of advice and guidance such as the fetus and baby’s development, lifestyle, holistic health and wellbeing, pregnancy, labour care, care of the newborn and mental wellbeing
  • What to do when physiological and psychological assessments are outside of expected parameters
  • A range of screening tests such as sickle cell disease, thalassaemia, infectious diseases or anomalies
  • A range of services and support available for a woman experiencing pregnancy loss, bereavement or complex pregnancies including recognising the ways that culture, context and preferences may affect a woman’s decisions
  • The importance of a timely referral and the risks of not doing so
  • A range of services and other professionals that have skills and experience to support the woman in your care such as health, social, financial, psychological, safeguarding or legal
  • Evidence based ways to facilitate all types of labour and childbirth and care for the fetus and newborn during a  labour and birth
  • Ways to recognise and respond appropriately to a woman who is anxious, in pain or distress
  • The importance of an active labour, ways to respect a woman’s choices and maintain a safe and calm environment
  • Way to check signs of normal and deteriorating physical or mental health including risk indicators
  • Signs and symptoms that indicate a potential emergency
  • Ways to recognise that an emergency needs further support or additional assistance
  • A range of emergency procedures including management until further assistance is available
  • Risk assessment and management processes including the importance of ensuring your own safety as well as that of those in your care
  • Physiology of the postnatal period
  • A range of signs and symptoms relating to a woman’s health, physical, mental and emotional wellbeing following birth
  • A range of support and advice on feeding methods and caring for babies
  • A range of issues that may affect a woman when considering resuming sexual intercourse following the birth of a baby and how to manage them, taking into account the woman’s rights, preferences, beliefs and culture
  • Ways to manage the different stages of bereavement or grief, ways to care for a woman whose baby has been removed due to safeguarding intervention or who relinquish their baby for adoption and a range of services or support groups available
  • The physical and behavioural assessments that need to be carried out on a newborn baby
  • A range of screening methods and how to recognise and refer when results are outside of normal parameters
  • Common congenital disorders and abnormalities
  • Ways to care for preterm babies and babies requiring monitoring and invasive procedures
  • Safeguarding babies and children as identified as suffering or likely to suffer harm, abuse or neglect including how to report and act upon your concerns
  • The principles of the safe management of medicines in midwifery including medications that are under midwives exemption or prescribed
  • A range of methods to administer medication, including oral, intravenous, intramuscular, topical and inhalation
  • The importance of completing written and electronic records accurately and in a timely manner, protecting data and maintaining confidentiality, and adhering to legal and local requirements for recording, storage and retention
  • Ways to inform and develop the practice of self and others using best available evidence and reflection techniques
  • How to provide honest, accurate and constructive feedback, respecting the view of others and behaving professionally at all times
  • The importance of only delegating tasks and duties that are within the other person’s scope of competence and that they fully understand what they are required to do
  • Understand the roles and remit of the multi-disciplinary team, the wider healthcare team and other agencies, identifying who is best placed and able to provide particular interventions to the woman and baby
  • How to raise and report concerns with service delivery including working across team or organisational boundaries

Behaviours

  • Treat people with dignity and respect
  • Be caring and compassionate
  • Have the courage to speak up and challenge
  • Be competent, reliable and committed
  • Display leadership qualities

Entry Requirements

Entry to the apprenticeship is set locally by individual employers but apprentices will also need to meet the entry requirements for the level 6 degree as set by the university.  If they already have degree at level 6 they will need to meet the entry requirements set by the university for the level 7 masters degree instead.  If an applicant is already a registered adult nurse they may take a level 7 qualification approved by the NMC instead of the level 6 degree. These requirements are based on guidance from the NMC and European law.

Duration

Duration (months): 48

Professional Qualifications/Recognition

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment.  For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL. 

Originally published on Gov.uk, this information has been re-used under the terms of the Open Government Licence.

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