Roles and Responsibilities of a Midwife

Midwives provide advice, information, care and support for women and their babies during pregnancy, labour and the early postnatal period. They help women make their own decisions about the care and service they receive, they also make them feel comfortable and reassured through their pregnancy.
They provide care for new-born children, they give health education and parenting support immediately after birth, until their care is moved to a health visitor.
Midwives are responsible for the health of the mother and child and only if there are medical complications does the responsibility move to another health and social care worker.
Responsibilities
A midwife has many responsibilities including the care of mother and baby, adhering to hospital policy and maintaining an awareness of issues such as health and safety, other duties include: * Diagnosing, monitoring and examining women throughout their pregnancy. * Developing, assessing and evaluating individual programmes of care. * Providing full antenatal care, including screening tests in hospital, community and the home. * Identifying high risk pregnancies and making referrals to doctors and other medical specialists. * Arranging and providing parenting and health education. * Providing counselling and advice before and after screening and tests. * Offering support and advice following events such as miscarriage, termination, stillbirth, neonatal abnormality and neonatal death. * Supervising and assisting mothers in labour, monitoring the condition of the foetus and using knowledge of drugs and pain management. * Giving support and advice on the daily care of the baby, including breastfeeding, bathing and making up feeds. * Liaising with agencies and other health and social are professionals to ensure continuity of care. * Engaging in professional development to meet PREP (Post-Registration Education Practice) requirements. * Participating in the training and supervision of junior colleagues.
Salary and working hours
The minimum starting salary for newly qualified midwives in the NHS IS £21,388 at band 5. Midwives usually progress to Band 6, which starts at £25,783, after a minimum of 12 months and a maximum of 24. Subject to attainment within the NHS Career Framework salaries can rise up to £34,530. Salaries at a senior level, for example those managing team, research or teaching activities, or with specialist knowledge is £30,764 to £40,558 at Band 7. Working hours typically include unsocial hours. The working week is usually 37.5 hours and is likely to include day and night shifts. Community and independent midwives are regularly on call 24 hours and should expect to be part of an on-call rota at some point in the career.
Job description * Midwives can work in maternity units of big hospitals, smaller stand-alone maternity units, private maternity hospitals, group practices, birth centres, general practices and in the community. * Self-employment or working freelance is sometimes available and many midwives will work in independent practice, which could offer more opportunities or continuity of care. Most midwives however prefer to work part time. * Career breaks, assistance with accommodation and childcare facilities may be available. * High percentage of women in this profession. * Midwives are given jobs all over the UK, but specialist roles may be focused in certain areas. * The work can be physically and mentally demanding, it involves exposure to sensitive situations such as bereavement and domestic abuse. * Sometimes a midwife will have to travel to a service user’s home, or attend births at day or night, but overnight absences from home and overseas travel are unlikely.
Qualifications
To become a midwife a person will need to gain a degree from an approved midwifery course that then leads to registration with the Nursing & Midwifery Council (NMC). Most programmes are usually three years in length and are full-time. Qualified nurses can complete a shortened programme, which lasts 78 weeks full-time. A small number of universities offer a part-time option. Both of these routes are known as pre-registration programmes. Applicants must have a minimum of five GCSEs (or equivalent) and at least two A-levels (or equivalent) for degree programmes. Course entry is also possible through recognised access programmes, or in England, foundation degrees in healthcare or related subjects. Applications for degrees and diplomas in England and Scotland are made through the Universities and Colleges Admissions Service (UCAS). Information on degrees in Wales is available from Health in Wales and applications should be made through UCAS. Acceptance on a course will be subject to satisfactory health clearance and a disclosure and barring service (DBS) check. Some medical conditions can exclude entry. Courses cover applied psychology and sociology as well as biological sciences and professional practice. Most modules are continually assessed. Gaining a place on a direct entry course to midwifery is highly competitive, so you should aim to apply early.
Skills
To become a midwife an applicant will need to show evidence of the following: * An intuitive, caring, objective and flexible approach; * Strong teamworking and advocacy skills; * A calm and alert manner, especially in stressful situations; * The ability to react quickly and effectively; * Strength, stamina and physical fitness; * A commitment to equal treatment for all women, irrespective of their background or circumstances.
Work experience
Pre-entry experience in a caring role within health and social care is a good advantage. Many midwives with previous nursing experience believe that it was useful when they started midwifery training. Useful voluntary experience for direct entrants might include supporting teenage parents, working with breastfeeding groups or charities dealing with issues such as birth defects, bereavement or miscarriage.
Employers
Most Midwives in England are employed by: * National Health Service (NHS). * Hospitals and acute trusts. * Foundation trusts. * Through clinical commissioning groups (CCGs). * Local area teams (LATs) working in GP practices or in the community.
Other employers may include: * Private hospitals. * Independent practices. * The armed forces.
Currently there is a shortage of midwives in England, a report from the Roya College of Midwives (RCM) states that 2,300 ore midwives are needed. Some midwives are self-employed. University hospitals also employ midwives in joint partnerships between the trust and the university to work in lecture-practitioner positions or to conduct research.
Professional development
In order to practice a midwife must be registered with the Nursing and Midwifery Council (NMC). Newly qualified midwives are usually given some support and are under the guidance of another more experienced employee, they will offer support and guidance for the first few months of professional practice. There are many opportunities to extend a midwifes role by taking specialist courses in areas including: enhanced midwifery practice, family planning, teaching in clinical practice and research. A midwife can also further there study at degree, masters and PhD level.
Career pathways
Midwives can work in a number of different healthcare settings to develop experience and knowledge, which can lead to a range of career paths. By becoming a clinical specialist in areas like: home birthing, breast feeding advice, labour ward supervision and antenatal screening. You could also become a consultant midwife, dividing your time between midwifery practice and training and leading improvements in practice. Higher management opportunities may be available. Also you could go into teaching or research within a healthcare setting or university. There are also specialist roles in areas such as public health, parenting education, intensive care neonatal units, ultrasound and foetal medicine.
Code of conduct
The Code contains a series of statements that taken together signify what good nursing and midwifery practice looks like. It puts the interests of patients and service users first, is safe and effective, and promotes trust through professionalism.
Prioritise people - You put the interests of people using or needing nursing or midwifery services first. You make their care and safety your main concern and make sure that their dignity is preserved and their needs are recognised, assessed and responded to. You make sure that those receiving care are treated with respect, that their rights are upheld and that any discriminatory attitudes and behaviours towards those receiving care are challenged. 1) Treat people as individuals and uphold their dignity
To achieve this, you must: * treat people with kindness, respect and compassion * make sure you deliver the fundamentals of care effectively * avoid making assumptions and recognise diversity and individual choice * make sure that any treatment, assistance or care for which you are responsible is delivered without undue delay, and * respect and uphold people’s human rights. 2) Listen to people and respond to their preferences and concerns
To achieve this, you must: * work in partnership with people to make sure you deliver care effectively * recognise and respect the contribution that people can make to their own health and wellbeing * encourage and empower people to share decision about their treatment and care * respect the level to which people receiving care want to be involved in decisions about their own health, wellbeing and care * respect, support and document a person’s right to accept or refuse care and treatment, and * recognise when people are anxious or in distress and respond compassionately and politely. 3) Make sure that people’s physical, social and psychological needs are assessed and responded to
To achieve this, you must: * pay special attention to promoting wellbeing, preventing ill health and meeting the changing health and care needs of people during all life stages * recognise and respond compassionately to the needs of those who are in the last few days and hours of life * act in partnership with those receiving care, helping them to access relevant health and social care, information and support when they need it, and * act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care. 4) Act in the best interests of people at all times
To achieve this, you must: * balance the need to act in the best interests of people at all times with the requirement to respect a person’s right to accept or refuse treatment Nursing and Midwifery Council * make sure that you get properly informed consent and document it before carrying out any action * keep to all relevant laws about mental capacity that apply in the country in which you are practising, and make sure that the rights and best interests of those who lack capacity are still at the centre of the decision-making process, and * tell colleagues, your manager and the person receiving care if you have a conscientious objection to a particular procedure and arrange for a suitably qualified colleague to take over responsibility for that person’s care (see the note below). 5) Respect people’s right to privacy and confidentiality
As a nurse or midwife, you owe a duty of confidentiality to all those who are receiving care. This includes making sure that they are informed about their care and that information about them is shared appropriately.
To achieve this, you must: * respect a person’s right to privacy in all aspects of their care * make sure that people are informed about how and why information is used and shared by those who will be providing care * respect that a person’s right to privacy and confidentiality continues after they have died * share necessary information with other healthcare professionals and agencies only when the interests of patient safety and public protection override the need for confidentiality, and * share with people, their families and their carers, as far as the law allows, the information they want or need to know about their health, care and ongoing treatment sensitively and in a way they can understand.
Practise effectively
You assess need and deliver or advise on treatment, or give help (including preventative or rehabilitative care) without too much delay and to the best of your abilities, on the basis of the best evidence available and best practice. You communicate effectively, keeping clear and accurate records and sharing skills, knowledge and experience where appropriate. You reflect and act on any feedback you receive to improve your practice. 1) Always practise in line with the best available evidence
To achieve this, you must: * make sure that any information or advice given is evidence-based, including information relating to using any healthcare products or services, and * maintain the knowledge and skills you need for safe and effective practice. 2) Communicate clearly
To achieve this, you must: * use terms that people in your care, colleagues and the public can understand * take reasonable steps to meet people’s language and communication needs, providing, wherever possible, assistance to those who need help to communicate their own or other people’s needs * use a range of verbal and non-verbal communication methods, and consider cultural sensitivities, to better understand and respond to people’s personal and health needs * check people’s understanding from time to time to keep misunderstanding or mistakes to a minimum, and be able to communicate clearly and effectively in English. 3) Work cooperatively
To achieve this, you must: * Respect the skills, expertise and contributions of your colleagues, referring matters to them when appropriate * Maintain effective communication with colleague * Keep colleagues informed when you are sharing the care on individuals with other healthcare professionals and staff * Work with colleagues to evaluate the quality of your work and that of the team * Work with colleagues to preserve the safety of those receiving care * Share information to identify and reduce risk, and be supportive of colleagues who are encountering health or performance problems. However, this support must never compromise or be at the expense of patient or public safety. 4) Share your skills, knowledge and experience for the benefit of people receiving care and your colleagues
To achieve this, you must: * Provide honest, accurate and constructive feedback to colleagues * Gather and reflect on feedback from a variety of sources, using it to improve your practice and performance * Deal with differences of professional opinion with colleagues by discussion and informed debate, respecting their views and opinions and behaving in a professional way at all times, and support students’ and colleagues’ learning to help them develop their professional competence and confidence. 5) Keep clear and accurate records relevant to your practice, this includes but is not limited to patient records. It includes all records that are relevant to your scope of practice.
To achieve this, you must * Complete all records at the time or as soon as possible after an event, recording if the notes are written some time after the event * Identify any risks or problems that have arisen and the steps taken to deal with them, so that colleagues who use the records have all the information they need * Complete all records accurately and without any falsification, taking immediate and appropriate action if you become aware that someone has not kept to these requirements * Attribute any entries you make in any paper or electronic records to yourself, making sure they are clearly written, dated and timed, and do not include unnecessary abbreviations, jargon or speculation * Take all steps to make sure that all records are kept securely, and collect, treat and store all data and research findings appropriately. 6) Nursing and Midwifery Council – Be accountable for your decisions to delegate tasks and duties to other people
To achieve this, you must: * Only delegate tasks and duties that are within the other person’s scope of competence, making sure that they fully understand your instructions * Make sure that everyone you delegate tasks to is adequately supervised and supported so they can provide safe and compassionate care, and confirm that the outcome of any task you have delegated to someone else meets the required standard. 7) Have in place an indemnity arrangement which provides appropriate cover for any practice you take on as a nurse or midwife in the United Kingdom
To achieve this, you must: * Make sure that you have an appropriate indemnity arrangement in place relevant to your scope of practice. * Preserve safety – you make sure that patient and public safety is protected. You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk. You take necessary action to deal with any concerns where appropriate. 8) Recognise and work within the limits of your competence
To achieve this, you must: * Accurately assess signs of normal or worsening physical and mental health in the person receiving care * Make a timely and appropriate referral to another practitioner when it is in the best interests of the individual needing any action, care or treatment * Ask for help from a suitably qualified and experienced healthcare professional to carry out any action or procedure that is beyond the limits of your competence * Take account of your own personal safety as well as the safety of people in your care, and complete the necessary training before carrying out a new role. 9) Be open and candid with all service users about all aspects of care and treatment, including when any mistakes or harm have taken place
To achieve this, you must: * Act immediately to put right the situation if someone has suffered actual harm for any reason or an incident has happened which had the potential for harm * Explain fully and promptly what has happened, including the likely effects, and apologise to the person affected and, where appropriate, their advocate, family or carers, and document all these events formally and take further action (escalate) if appropriate so they can be dealt with quickly. 10) Always offer help if an emergency arises in your practice setting or anywhere else
To achieve this, you must: * Only act in an emergency within the limits of your knowledge and competence * Arrange, wherever possible, for emergency care to be accessed and provided promptly, and take account of your own safety, the safety of others and the availability of other options for providing care. 11) Act without delay if you believe that there is a risk to patient safety or public protection
To achieve this, you must: * Raise and, if necessary, escalate any concerns you may have about patient or public safety, or the level of care people are receiving in your workplace or any other healthcare setting and use the channels available to you in line with our guidance and your local working practice * Raise your concerns immediately if you are being asked to practise beyond your role, experience and training * Tell someone in authority at the first reasonable opportunity * Acknowledge and act on all concerns raised to you, investigating, escalating or dealing with those concerns where it is appropriate for you to do so * Not obstruct, intimidate, victimise or in any way hinder a colleague, member of staff, person you care for or member of the public who wants to raise a concern, and * Protect anyone you have management responsibility for from any harm, detriment, victimisation or unwarranted treatment after a concern is raised. 12) Raise concerns immediately if you believe a person is vulnerable or at risk and needs extra support and protection
To achieve this, you must: * Take all reasonable steps to protect people who are vulnerable or at risk from harm, neglect or abuse 13) 17.2 share information if you believe someone may be at risk of harm, in line with the laws relating to the disclosure of information, and 14) 17.3 have knowledge of and keep to the relevant laws and policies about protecting and caring for vulnerable people. 15) 18 Advise on, prescribe, supply, dispense or administer medicines 16) within the limits of your training and competence, the law, our 17) guidance and other relevant policies, guidance and regulations 18) To achieve this, you must: 19) 18.1 prescribe, advise on, or provide medicines or treatment, including repeat prescriptions (only if you are suitably qualified) if you have enough knowledge of that person’s 20) health and are satisfied that the medicines or treatment serve that person’s health needs 21) Nursing and Midwifery Council 22) 18.2 keep to appropriate guidelines when giving advice on using 23) controlled drugs and recording the prescribing, supply, 24) dispensing or administration of controlled drugs 25) 18.3 make sure that the care or treatment you advise on, prescribe, 26) supply, dispense or administer for each person is compatible 27) with any other care or treatment they are receiving, including 28) (where possible) over-the-counter medicines 29) 18.4 take all steps to keep medicines stored securely, and 30) 18.5 wherever possible, avoid prescribing for yourself or for anyone 31) with whom you have a close personal relationship. 32) For more information, please visit: www.nmc-uk.org/standards. 33) 19 Be aware of, and reduce as far as possible, any potential for 34) harm associated with your practice 35) To achieve this, you must: 36) 19.1 take measures to reduce as far as possible, the likelihood 37) of mistakes, near misses, harm and the effect of harm 38) if it takes place 39) 19.2 take account of current evidence, knowledge and 40) developments in reducing mistakes and the effect of them 41) and the impact of human factors and system failures 42) (see the note below) 43) 19.3 keep to and promote recommended practice in relation 44) to controlling and preventing infection, and 45) 19.4 take all reasonable personal precautions necessary to avoid 46) any potential health risks to colleagues, people receiving 47) care and the public. 48) Human factors refer to environmental, organisational and job factors, and 49) human and individual characteristics, which influence behaviour at work in a way 50) which can affect health and safety – Health and Safety Executive. You can find 51) more information at www.hse.gov.uk.