From pressuring government bodies for adequate personal protective equipment (PPE) supplies to piloting programmes to promote better mental health, the Royal College of Midwives (RCM) has been at the forefront when it comes to ensuring midwives are receiving the necessary support to provide safer, quality care. Gill Walton, chief executive of the RCM, shares her insight into where things stand for midwives during the pandemic in the UK-and what more can still be done.
What have been the key areas the RCM have addressed during the pandemic?
Safety is always our number one priority whatever the circumstances; the safety of midwives, maternity support workers (MSW), student midwives, and women and babies. This meant moving really quickly to reassure our members, pre-empting the challenges they are facing by providing guidance where possible, as quickly as possible. Also, pressuring NHS bodies and governments for clarity about what services can and should be delivered, and to ensure staff had the right PPE, as well as training and guidance to use them. From the outset, we called for ring-fencing of maternity services so that maternity staff were not redeployed elsewhere. This was crucial to ensure that services could continue and be safe.
How effective have maternity services been in responding to the pandemic?
Midwives and MSWs are good at responding to the unexpected and adapting to whatever is thrown at them; their response throughout has been no different. Thanks to the enormous efforts of all maternity staff, key services have kept running. They have, of course, had to adapt services, reducing face-to-face contact as much as possible while keeping services safe and of high quality, and ensuring women get the right care at the right time. Technology has played an important role in that of course, with many appointments – antenatally and postnatally – done via telephone or video appointments. The way services are responding is a testament to the dedication of midwives, MSWs, student midwives and all the maternity team.
What have been the major concerns midwives have expressed on the frontline?
Concern around continuing to provide safe and high-quality care for women and babies while at the same time keeping themselves and their colleagues safe has been significant. This was against a background of a real lack of clear information from some employers. In a survey of our members over a month into the crisis, nearly a third said they had received no advice or training to care for women with coronavirus symptoms, with just 15% saying that they had received adequate support. The situation has improved and the RCM has continued to pressure and lobby governments and employers, and put out our own guidance and advice. Maternity staff must be kept safe from harm to be able to support women and babies through this.
How has the RCM addressed these concerns?
Right from the first days of the crisis, we were one of the first organisations to react to support our members. We have been really prolific in producing guidance and advice on issues such as PPE, information for student midwives and educators, and employment advice alongside Twitter Q&As and much more. We also produced information for pregnant women to reassure them, and to support efforts to keep services running, which they did brilliantly. We had over 500 questions for our Twitter Q&A for women which is incredible. I am also pleased that much of this was done in collaboration with the Royal College of Obstetricians and Gynaecologists, and other organisations; this was a multi-professional effort.
What more do you think can be done to try and eradicate midwives' fear of contracting the coronavirus on the frontline?
Our members have told us this and it is a real concern. Making sure they have the equipment and knowledge to keep themselves safe from harm while delivering care is crucial, as is the right support for their mental health and well-being. We are working with NHS England's Behavioural Insights team on a pilot programme aimed at boosting mental well-being. We also produced guidance to manage stress and promote well-being, and NHS in Mind is another resource that we are promoting. Employers also must step up here and support their staff. Mental health is just as important as physical health and both should be adequately cared for.
Do you have any advice for midwives on keeping mentally healthy during this time?
I know it is difficult for professionals for whom emotion and compassion are a fundamental part of their work but try not to take work home with you. Also, use the resources available to support you through this, such as those from the RCM, NHS and counselling services provided by employers. Don't forget family and friends; they care about you, they know how tough this is for you and other NHS staff, and they can be an important source of support.