Midwifery

SO YOU WANT TO BE A MIDWIFE?
I don’t blame you it’s a great job but very hard work
But and with all the bad publicity the profession is receiving why would people want to join this profession. If the government would only support and help us to care for our women and babies! Instead they put hurdles in our way, make it difficult for the newly qualified to get jobs, allowing us to struggle with staff shortages etc

However don’t believe all you read in the papers. Let me tell you more about the profession and let’s hope if you really feel able to take on such a demanding but rewarding career you will join me in ensuring women’s health care is at the forefront!

MIDWIVES ROLE
As a midwife you could be assisting a woman in delivering a new life into the world. How wonderful is that? But a midwife does much more than deliver babies.

Midwives are practitioners in their own right and are responsible for the antenatal, intrapartum and postnatal care of women, up until 28 days after the birth, or longer if required. They are the lead healthcare professional attending the majority of births, mostly in a hospital setting although home birth is an option.

They teach mothers parent craft skills to enable them to feel confident in caring for their newborn. Teaching a mother how to feed her baby, changing nappies, bathing babies are a few skills required. The role of the midwife is very diverse. It also involves supporting the mother and her family throughout the childbearing process to help them adjust to their parental role by providing health and parenting education. Midwives also work with other health and social care services to meet the mother's needs including, teenage mothers; mothers who are socially excluded; disabled mothers and mothers from diverse ethnic backgrounds.

As experts in normal pregnancy and birth, midwives are usually the first and main contact for the expectant mother during her pregnancy, and the postnatal period. Midwives are the lead professional at over 75% of births in the UK. They help the mothers make informed choices about the services and options available to them by providing as much information as possible.

Midwives care for and support pregnant women, their partners and babies, before, during and after the birth. Some midwives give advice before a baby is conceived, but most will support the mother after pregnancy has been confirmed.

The work of a midwife includes:
Monitoring the health of the mother and baby with physical examinations and ultrasound scanners
Counselling the expectant mother on issues such as healthy eating, giving up smoking, giving up drinking, domestic abuse, exercise
Exploring the mother’s options for the birth, for example natural childbirth, pain controlling drugs, hospital or home delivery
Looking after the mother and baby during labour and birth, and for around one month after the birth.
Advice on method of feeding baby, in particular encouraging and supporting women to choose breastfeeding. Although at the same time supporting the mother if she chooses to bottle feed her baby.
Midwives often run antenatal and parenting classes which involves teaching expectant and new parents the essential skills needed to care for their baby.

These are a range of skills and knowledge you need in order to think about a midwifery career.

1. Excellent people skills;
You will provide professional support and reassurance to women from a variety of backgrounds and cultures, during a most emotionally and intense time.

2. Good communication skills;
This is a very important part of the midwives’ role, you are not only communicating with other health professionals, but you must be able to listen to women and ensure their full understanding of what is happening to them. During pregnancy, labour and the postnatal period women are very vulnerable and need to know what their options are and understand these options. This period of their lives is not only highly emotional but never leaves them, and as a midwife you want them to have fond memories of such a life enhancing event.

3. Excellent knowledge of the physiology of childbirth
Anatomy and physiology is not easy, but it is imperative that you have a full understanding of this area of midwifery.

4. Confident with your knowledge and ability to offer advice and answer questions fluently
Midwives are the most frequent point of contact for parents to be, so you must be able to answer their questions, share your knowledge and skills with women and their partners and make sure their needs are recognised by the rest of the care team. You will also have students and care assistants under your wing who will look up to you for advice and guidance. Therefore it is imperative that you constantly update your knowledge and skills throughout your career.

5. A good team worker
As a midwife you will be part of a multi-disciplinary team liaising with GPs, health visitors, obstetricians, paediatricians, social workers ( the list is endless) You will also work alongside the parents and baby. The better you know each other, the more rewarding the birth experience will be.

6. Able to deal with difficult situations
You will have to stay calm and alert in times of stress, and enable women to feel confident and in control. On the rare occasions where something goes wrong, you have to be ready to react quickly and effectively.

The term midwife means “with woman” and can be either a female or male, although there are very few male midwives within the profession. Midwifery is the term traditionally used to describe the art of assisting a woman through childbirth. In the modern context, midwives are experts in women's health care which involves giving prenatal care and advice to pregnant women. They attend and assist the woman with the birth of her infant and also provide postnatal care to the mother and her infant.

Midwives are autonomous practitioners who are specialists in normal pregnancy, childbirth and the postnatal period. They strive to ensure women have a healthy pregnancy and natural birth experience. Midwives are also primary care givers providing general women's health care, and are trained to recognize and deal with deviations from the norm.

Obstetricians are specialists in illness related to childbearing. The two professions can be complementary, but often are at odds because obstetricians are taught to "actively manage" labour, whereas midwives prefer not to intervene unless necessary. Childbirth is a normal healthy experience and not to be medicalised unless necessary. If a woman requires care beyond the area of midwifery expertise, then an obstetrician should be called, but many midwives are trained to handle situations which are considered abnormal, such as breech delivery

Midwives are recognized as responsible and accountable professionals who work in partnership with women to give support, care and advice during pregnancy, labour and the postnatal period They conduct births independently and provide care for the newborn and mother. This care includes preventive measures, the promotion of normal birth, the detection of complications in mother and child, accessing of medical or other appropriate assistance and the carrying out of emergency measures.

The midwife has a valuable task in health education and counselling for the women and their family. This work also involves antenatal education and preparation for parenthood within the community and schools and may extend to women's health, sexual or reproductive health and childcare.

THE HISTORY OF MIDWIFERY
Midwifery is one of the few health care professions dominated by female practitioners. From Agnodice in ancient Greece to the 18th century in Europe, the care of mothers and delivery of infants has been considered a female orientated profession. As women gave birth, they sought and received care from supportive females. At an unknown point in the cultural evolution, some experienced women became designated as the wise women to be birth attendants. Thus, the profession of midwifery began. Indeed, as historians have noted, midwifery has been characterized as a social role throughout recorded history, regardless of culture or time. In the 18th century however, a division between doctors and midwives arose, as medical men began to contend that their modern scientific practices were better for mothers and infants than the folk-medical midwives. During 18th century England most babies were delivered by a midwife, but by the onset of the 19th century the majority of babies were delivered by surgeons.

It is thought that midwives became a target because not only did they possess excellent knowledge and expertise in childbirth but they were also knowledgeable about contraception and abortion. This concept went against their role and they were known as witches who wanted to depopulate society. This persecution only improved the midwives stance and the first midwifery course was started in America, which has only improved over decades and now midwifery is a recognized and respected profession.

TRAINING
There are a variety of routes to qualifying as a midwife. Most midwives now qualify via a direct entry course, which refers to a three- or four year course undertaken at university that leads to either a degree or a diploma of higher education in midwifery, and entitles them to apply for admission to the register.

Following completion of nurse training, a nurse may become a registered midwife by completing an eighteen month course post-registration course (leading to a degree qualification), however this route is only available to adult branch nurses, and any child, mental health, or learning disability branch nurse must complete the full three year course to qualify as a midwife. Midwifery students do not pay tuition fees, and are eligible for financial support for living costs while training. Funding varies slightly depending on which country within the UK the student is in, and whether the course they are undertaking is a degree or diploma course. For direct entry students funding is in the form of either a non-means-tested bursary or a combination of student loan and means-tested bursary, while post-registration students are normally seconded by their employer and may be paid a salary and have their fees paid for them.

ENTRY QUALIFICATIONS
(Taken from the Nursing, Midwifery Council NMC)
To qualify as a registered midwife, you need to achieve one of the following:
Diploma of Higher Education in Midwifery
Degree in Midwifery
Diploma of Higher Education in Nursing (adult branch) followed by a 78 week midwifery conversion course.
You will need general requirements set by the Nursing and Midwifery Council (NMC). These include:

Good literacy and numeracy skills, good health and good character, and recent successful study experience.
The minimum age requirement for training - 17.5 years old in England, 17 in Scotland, and 18 in Northern Ireland and Wales.
You must agree to undergo a criminal records bureau check; however, a criminal conviction does not automatically exclude you from working in the NHS.
Course providers can set their own academic entry requirements, which can include:
Midwifery diploma or degree - five GCSEs (A-C)/S grades (1-3) in English and maths/science, plus two A levels/H grades possibly including biology or human biology
Nursing diploma - five GCSEs (A-C)/S grades (1-3) preferably in English, maths or a science-based subject.
If you do not meet the course entry requirements listed please check with universities because alternatives, such as an Access to Higher Education course, may be accepted.

As a trainee midwife on an approved course, you will divide your time between university and supervised work placements including antenatal wards and clinics, delivery units, postnatal wards and the community.

HOURS AND ENVIRONMENT
(Taken from NMC)
Midwives in the NHS work 37.5 hours a week, which can include evening, weekend and night shifts. Many hospitals offer flexible or part-time hours. Some midwives work extra hours, either as overtime or with an agency.
As a midwife you can work in a variety of settings including hospital maternity units, GP surgeries, health centres, clinics, and in the homes of patients.
In some NHS trusts you will split your time between working in the community and working in hospitals. In other trusts, you will be rotated every six months between ante-natal, delivery, post-natal and community settings. As a midwife in the community you will travel between different clients in your area, so a driving licence will be useful.

YOU STILL WANT TO BE A MIDWIFE?
It truly is a rewarding career; you have the privilege of being a welcome guest at a most wonderful time during a couple’s life and witnessing the start of a new life. You are a teacher, providing education to women and their families who are anxious for as much information as you can provide. You also share your knowledge and skills with other healthcare workers and students. You have to keep updated yourself which keeps you interested and knowledgeable. I am now furthering my career with an MSC; there are so many training options once you become qualified. As I said it is hard work, there can be long hours with no breaks, you never know what is going to come through the door. Every day is different and you never get that Monday morning feeling. If you have what it takes look into the job more closely and read as much as you can.

Good Luck