Chappell L, Brocklehurst P, Green EM, Hunter R, Hardy P, Juszczak E, Linsell L, Chiocchia V, Greenland M, Placzek A, Townend J, Marlow N, Sandall J, Shennan A. Planned early delivery or expectant managemant for late preterm pre-eclapmsia (PHOENIX): a randomised controlled trial. The Lancet. 2019a; 394:1181-1990

Chappell L, Shennan A, Green M, Knight M, Conti-Ramsden F. Reducing maternal deaths from hypertensive disorders: learning from confidential inquiries. British Medical Journal. 2019b; 364:1-7

Hillan ME. ‘Making a difference in the world’. British Journal of Midwifery. 2017; 25:(6)

Homer ESC, Friberg KI, Dias BAM, Hoope-Bender TP, Sandall J, Speciale MA, Bartlett AL. The projected effect of scaling up midwifery. The Lancet. 2014; 384:(9948)1146-1157

MBRRACE-UK. Saving lives, improving mothers' care: lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2015-17. 2019. (accessed 12 June 2020)

National Institute for Health and Care Excellence. Hypertension in pregnancy: evidence review for monitoring gestational hypertension. 2019a. (accessed 12 June 2020)

National Institute for Health and Care Excellence. Hypertension in pregnancy: evidence review for prediction of complications in pre-eclampsia. 2019b. (accessed 12 June 2020)

Royal College of Obstetricians and Gynaecologists. BJOG release: children born prematurely have greater risk of cognitive, motor and behavioural difficulties. 2017. (accessed on 10 March 2020)

Tommy's Charity. Causes of premature birth. 2017. (accessed on 10 March 2020)

Tommy's Charity. Pre-eclampsia statisitics. 2020. (accessed 12 June 2020)

UNICEF. Maternal and newborn health disparties – Uganda. 2020. (accessed on 7 June 2020)

World Health Organization. Preterm birth factsheet. 2018. (accessed on 10 March 2020)

Tales of two midwives: medical conditions of pregnancy that changed our midwifery practice

02 September 2020
Volume 28 · Issue 9


The stories of our lives that bring each of us to a career in midwifery are unique. The stories, once we are midwives, that then influence our careers, are also unique. These stories of care for women characterise the course of our careers and ourselves. A short essay competition to attend the annual Medical Complications in Pregnancy conference 2019 at the Royal College of Obstetricians and Gynaecologists gave two colleagues from London the occasion to reflect on situations from practice where childbirth deviated from the realm of ‘normal’ and into disease. As we become increasingly floored by the global COVID-19 pandemic, the key role of midwives across health, well-being as well as disease is especially stark.

The outbreak of COVID-19 has meant that midwifery around the world is currently set against an ever-present backdrop of disease. Although pregnancy and childbirth are most often a healthy and normal part of a woman's life, medical conditions and disease can also feature in the midwifery care that is needed. Throughout the pandemic, the world's midwives have continued to care for women becoming mothers and continue, in turn, to be shaped by their midwifery experiences. In a midwifery career, COVID-19 and other medical complications in a pregnancy can present steep learning curves for midwives and even sometimes refocus or change practice entirely. This narrative article explores two midwives' recollections of medical conditions in pregnancy that changed their practice and considers the conditions that played a role. These are their stories.

In the Spring of 2019, I was running my usual weekly antenatal midwife clinic based in a community children's centre. A ‘low-risk’ woman and her partner attended whom I had met before. She was 28 weeks pregnant with her first child. She was an otherwise fit and healthy woman with no pre-existing medical conditions. Her pregnancy had so far been straightforward and under the sole care of the community midwives and her local GP.

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