Midwives leading the way

02 December 2015
2 min read
Volume 23 · Issue 12

Last month, at the annual conference of the Royal College of Midwives (RCM), I was one of many delegates privileged to hear a selection of excellent speakers including Karen Guilliland, chief executive of the New Zealand College of Midwives. Her opening address on ‘leading the way for maternity care’ was not only illuminating but inspirational, and was rightly met with a standing ovation. She described the journey of the midwifery profession in New Zealand and spoke more broadly about midwifery in general, particularly regarding standards, safety and quality of care.

One element of her address that will, I'm sure, resonate with the majority of midwives here in the UK, was the subject of understaffing. In New Zealand, as in the UK, there is concern over the shortage of midwives—and Karen made it clear that the priorities of policy makers are somewhat responsible for this:

‘It seems to be a neoliberal government thing… There's not enough money to provide actual staff who provide actual care to actual women, but we'll put in all this stuff [guidelines, protocols and so on] to keep you safe… But the number-one thing that keeps a woman safe is having you there, by her side, as a midwife.’

The key to providing safe, woman-centred care, she emphasised, is the relationship between midwives and women. There is a huge weight of expectation on midwives to provide all aspects of care to pregnant women and babies in the antenatal, intrapartum and postnatal periods, along with the provision of public health information to encourage healthy pregnancy and reduce complications. The rise of maternal obesity and the increase in births to older women add yet more strain to already-stretched midwifery services. Acknowledging these pressures, Karen suggested that the best thing for midwives to do is build a relationship with each woman and make a difference on a one-to-one basis. She also urged midwives to ‘speak as one voice’ in promoting the essential work they do.

A boost for the promotion of midwifery is the inclusion of midwives in the BBC's 100 Women 2015 list. French midwife Aissa Edon, Malawian midwife Eveles Chimala and BJM editor-in-chief Professor Dame Tina Lavender have been included in this year's list of influential women. Aissa has been recognised for her work with women affected by female genital mutilation. Eveles made the list for her expertise in the partograph, which she studies as part of research aimed at tackling Malawi's high maternal mortality rate. Having noted that many African midwives struggle to use a partograph, Dame Tina has led a project to develop a board game that could be used as a teaching aid. The game, called Progression, requires players to move around the board answering questions and plotting a woman's progress on the partograph. It enables midwives to develop new knowledge and revise what they already know, and when played in small teams it encourages debate and discussion around how to provide optimum care for women. A pilot scheme introducing the game to 165 midwives in Africa earlier this year generated positive feedback.

I'm sure you will all join me in congratulating Aissa, Eveles and Dame Tina for the honour of being listed among the world's 100 most influential women. As Karen Guilliland said at the RCM conference, every single midwife can make a difference. The midwifery profession may be understaffed and overstretched, but it is great to see individual achievements being celebrated and hard work acknowledged, as it offers a beacon of inspiration for everyone.