Midwives and IT

April 3, 2015

Having recently moved employment and having to deal with yet another computer system, it has caused me to reflect on midwives and how they relate to modern technology. It is my experience that we are still not too far forward from research published by the Royal College of Midwives – Gary Latchford in 2003

I cannot remember when computers became part of my routine life as a midwife. I remember using paper records only initially and feeling overworked by having to complete the woman’s “Co-Op” card as well as the records kept at the hospital.  As a community midwife this card was often your only record of the pregnancy.

The women loved them as they got to keep them at the end of their pregnancy and could keep a whole history of their pregnancy and babies.

I don’t remember any computers in my first role back in 1986 in Manchester. But then over the years they were gradually introduced as administration systems in the first instance for admission and discharge but then purpose built IT systems for maternity care arrived.  I am sure many midwives worked with STORK.  The goal of a system that links with other systems to provide maternity data is still yet a while away.  Some old systems I view with more fondness than others, at one point the doctors were completing their paper record in the hospital notes, we were completing the mothers “hand held” record and then replicating the data in the computer.  I am sure this still happens today in some services.  Oh and let us not forget the GP computer records that need to be completed too.

The future has to be a record that the mother, the midwife and doctors (whether Obstetrician or GP, if necessary can access, that is updated simultaneously as care is given whatever the setting. I can but dream!

The issue of computers, which many of my colleagues still regard with horror and trepidation, is that it takes the midwife away from the mother. Away from the close, caring, physical, and social character of our work.  The computer is a complicated box. No wonder many midwives are reluctant to fully engage.  It is so against where our heart lies.

There has been much research and complaints from women to suggest that many midwives spend more time at the computer screen than by the woman’s side.  This clearly is not acceptable. Myself and others find it very frustrating trying to complete a computer task whilst the woman is waiting to go home.  Waiting for the computer to do its stuff, if it manages it all, can cause delays in care.

So, I am currently faced with a new computer system that was in my old Trust, just used for administration. It now has midwifery sections that I have to learn to complete and print out. Yes, this does save me the duplication of writing but results in messy notes when print outs are added to the paper records.  Not sure how this fits with general documentation standards.

Oh, but by the way many midwives are engaged in social media, they use computers via laptops or smart phones at home.  It appears that the computers that are available on wards is where the problem lies. The logging on and off to ensure the computer recognises each user is an added work pressure. I am not sure IT departments understand how we work, constantly on and off the machine not sat there for hours at a time.  Several midwives will be accessing a few individual computers many times during a shift. If you make a mistake with your password it can log you off for hours, which is really irritating when you need to complete a piece of work.

So I urge the NHS to move forward quickly give us all tablets that we can all use in real time with the woman. Ensure all women have the same basic record type across the UK so that all midwives and medical staff in all areas are using the same.  I still cannot understand why National Maternity Notes are still not up and running.  We could also give woman access to their records via an NHS app.  But of course we need to ensure we have secure Wi fi access all over the UK, this will be fundamental but is outside of NHS but not Government control.

In many ways we just need to get back to that simple Co-Op card that the woman used to carry around, but of course now in IT style.  I know the technology is out there to do this but is there the will and of course the money? But surely we are wasting vast amounts printing records, duplicating records and ineffective use of midwives time.

Midwives and IT – we just have to get better at it so as not to affect our relationship with women. We can of course exploit websites and apps of course to engage and educate women. The women who are pregnant now have grown up with technology.  They expect to access services this way.  So as midwives we have to be prepared to move where they are to use information technology wherever possible. Sending text messages and keeping in contact with women in developing countries has been shown to improve outcomes (Grameen Health). We need to move away from purely record systems to information technology that reflects our social relationships with women to improve care and the monitoring of pregnancies.