Midwifery and the act of looking forward

02 April 2017
Volume 25 · Issue 4

I became the new editor of the British Journal of Midwifery just days after the March issue was published, so I had a long time to look forward to releasing an issue of my own. The most important lesson I've learned in my first month is the virtue of forward planning. No matter how far ahead of schedule you feel you are, there is no such thing as too early. Articles cannot be submitted too soon, layouts cannot be mapped out too quickly, and editing cannot be done fast enough. Working on BJM has refreshed my respect for the power of foresight, and for anyone who has the wisdom to make advance plans.

Indeed, forward planning is an important skill for a midwife and the virtues of thinking ahead pervade this month's edition.

Nowhere is this more obvious than in David Green's article Prevention of neonatal whooping cough in Engand: The essential role of the midwife, which discusses the importance of vaccination in avoiding pertussis. Whooping cough is a disease so old-fashioned that it's hard to believe we should still have to consider it all, yet that complacent attitude led to a 2011 spike in infant mortalities from pertussis that we are still battling to subdue. There are many stages of a child's development—from fetus to 3-year-old—at which whooping cough can be stopped, meaning that prevention plans can be tailored to the needs of each family. Mindful forethought is the most potent weapon against preventable diseases such as pertussis.

Alison Power and Jonathan Murray expound on the virtues of thinking ahead to create more opportunities for students. How can universities ‘ASSIST’ student midwives with additional needs to achieve? explores the power of forward planning in welcoming disabled practitioners into the midwifery profession, as well as students whose extra needs might have otherwise barred them from qualifying. Making minor adjustments to curricula or teaching styles ahead of time allows people from a whole spectrum of different backgrounds to access the profession, which in turn makes midwifery more inclusive and representative of the community it serves.

Marjan Khajehei encourages forethought in her exploration of the effects of Syntocin in her article Labour and beyond: The roles of synthetic and endogenous oxytocin in transition to motherhood. She argues that Syntocin is a useful substitute but not an equivalent to the endogenous chemical, and that we should be cognisant enough of the after-effects to use only in conjunction with foresight and percipience.

Other articles explore how forward planning also involves contemplating the worst case scenarios we never want to find ourselves.

Jo Hathaway shows us how to plan for a midwife's worst nightmare in her article What midwives need to know about NMC Fitness to Practice hearings. Hathaway talks us through Nursing and Midwifery Council procedure in her step-by-step guide to navigating a hearing, as well as all the practical and emotional preparations a midwife should make to ensure the best possible outcome for herself. Not only is the ability to turn reflection into foresight a vital competency for improving your prospects during NMC proceedings, but it also allows a midwife under investigation to avoid the same pitfalls in the future and improve on past performance.

Mary Huntley and Janice Dickinson Smith walk us through shoulder dystocia, one of the most difficult and dangerous medical emergencies a midwife can encounter with a woman in labour. Their practical instruction of the HELPERR technique, illustrated with a comprehensive set of photographs, allows us to turn even the most menacing birth circumstances into a simple set of manoeuvres that can be memorised, practiced and employed to ensure a safe and healthy birth for mother and child.