Midwives under scrutiny

December 8, 2013

It is becoming more and more apparent that the work we do as midwives is and will become under more and more scrutiny. Anyone who has undergone a recent CNST (Clinical Negligence Support for Trusts) assessment will understand. But since the Frances Report all nurses and midwives will have to look at how they work to assess whether what they are doing is right for that particular woman. Raising issues with management is no longer an expectation, it is a duty. If you don’t make the “management” aware of your concerns you may be just a liable as the people involved in the poor care you may have witnessed.

We as midwives have to pass competency tests; do annual updates on critical safety issues; we have to remain professionally competent to remain on the register; we have to read to be up-to-date with our practice; learn how new equipment works and ensure we are working in a safe environment at all times. We will be undergoing a more rigorous appraisal process where proving we are working to an acceptable professional level.

I have no problem with the above at all. I think this is what being a professional is all about.

But at the same time we are urged to normalise birth. To stop doing a lot of the interventions, that have become fundamental parts of a midwifery practise. These interventive practices are included in many an RCOG or NICE guidelines are what the law uses as benchmarks for competent practise.

So if you have tried to leave the woman alone to birth her baby by herself with minimal intervention and then something goes wrong, you will be criticised for not listening in as often as the guideline says.  The “when something goes wrong” may be rare, but will be devastating to the family. In our “blame” western culture we may have tried to do our best but this may be seen in hindsight as not doing enough.

It is a challenging time to be a midwife.  To give the woman what she wants. To work your way through the myriad of research papers that can all be criticised dependent upon your point of view.  The work you do as a midwife is very personal, but you have to be seen to have all the evidence and standards in your head and adapting them to the current circumstances of the woman you are caring for.

In these days of scrutiny I believe the only thing that can save us is our documentation. Be clear, as to why you might be stepping outside of a guideline; be specific as to what is happening that makes it appropriate to do so.  Be very explicit that the family are in agreement with your actions.  We have a great deal of power when caring for women in vulnerable situations during pregnancy, birth and afterwards. Let us take care that we are indeed doing what they need within the confines of our profession.


3 Responses to “Midwives under scrutiny”

  1. sarahjohnson222 Says:

    So so true, well written 👍

  2. […] wrote about a similar topic 2 years ago in Midwives under scrutiny Dec […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: