International Day of the Midwife is a moment to recognise the work of midwives all over the world. It is led by the International Confederation of Midwives (ICM) and observed in over 50 countries, and it is a day when midwives, maternity support workers and student midwives join together to celebrate with the communities that they work within. This year’s theme is 100 Years of Progress, giving us the opportunity to reflect on how far midwifery has come in the last century.
As Tina, one of our Tommy’s midwives, says:
“Midwives do not stand still. You will find them at the forefront of research, innovation and quality improvement, always challenging policy makers and advocating for the families they care for. High-quality research underpins evidence-based care in the NHS, and midwives can be researchers or research midwives or choosing to complete their research or learning through supported Fellowships, Masters courses or a PhD.”
To mark International Day of the Midwife 2022, we spoke to Tina about her role at Tommy’s, as well as the clinical work and research she does in the NHS. Carry on reading to find out more.
How long have you been a midwife?
Midwifery was a career change for me 16 years ago after having my own 3 children, following roles in the pharmaceutical industry and private healthcare. After qualifying as a midwife, I initially worked in antenatal, day assessment and postnatal environments, before settling into a combination of work in the community and on a labour ward.
In 2012, I took on a new challenge working in Fetal Medicine at Queen Charlotte’s & Chelsea Hospital in London. A fetal medicine unit is specialist referral unit where pregnant women and people are seen when concerns arise about the growing baby, such as growth, history of inherited conditions or when complex pregnancies, such as monochorionic twins or triplets (siblings that share a placenta), that require additional monitoring by specialist doctors and midwives. In this role, I worked together with genetic counselling and fetal medicine specialists to develop new prenatal diagnostic testing, improving ways of detecting conditions in pregnancies using new cutting-edge technology such as rapid exome sequencing.
What do you enjoy about working at Tommy’s?
I started working for Tommy’s just under 3 years ago. It has been a real privilege to work as part of an organisation with such a diverse range of skills and expertise, and which funds vital research into miscarriage, stillbirth, and premature birth. As one of the biggest research networks in Europe, Tommy’s works with hundreds of doctors and midwives to improve the safety of pregnancy and birth for families across the UK. I feel proud to play a small role in that.
As one of the Tommy’s midwives, I sit on the Pregnancy Information team. Our job is to provide high-quality health information to women, birthing people, partners, families and fellow health professionals. We work collaboratively with other pregnancy and baby charities to provide the best possible support and information. I work with the most incredible team of midwives who are very experienced and very knowledgeable. I'm continually learning something new from them!
Like many of my colleagues at Tommy’s, I have my own personal experience of baby loss and I know that pain never fully leaves you. Some days can be very challenging, and we hear some heart-breaking stories when speaking to parents on our helpline. It can be hard to switch off some evenings, but whatever the day brings, I know that all of my colleagues are always there if I need some support.
One of the most important parts of our role as Tommy’s Midwives is making sure our community have access to the most up-to-date, evidenced-based information via our website and social media channels – and we know this support is really valued by those who need it.
What are you currently doing outside of Tommy’s?
I’m now a Senior Research Midwife within the Women’s Health Research Centre, Imperial College Healthcare NHS Trust, and Imperial College London, which is where I completed my MSc in Genomic Medicine.
I also spent time as a Research Champion for the National Institute of Health Research (NIHR) and, more recently, completed a NIHR Advanced Research Collaboration (ARC) Improvement Leader Fellowship. This Fellowship supports people who are interested in innovation and improving patient care and professional wellbeing within healthcare.
Can you tell us more about your NIHR ARC Fellowship?
Midwives are always striving to give families the best possible care before, during and after pregnancy – but as maternity changes, work undertaken by midwives in the UK is increasingly complex and demanding.
There is increasing evidence that patient safety outcomes and healthcare worker wellbeing are closely linked. Demanding working environments, together with a lack of support, can result in stress or burnout, and this can impact negatively on patient safety and patient satisfaction. Midwives usually work 12+ hour shifts, often without breaks, and become frustrated when they don’t have enough time to provide the high standards of care they have been trained to give.
Evidence shows, where relationships with colleagues are strong, and when midwives feel valued and supported, staff often report reduced levels of stress. Midwives are concerned about staffing levels and the quality of care they can deliver – which is why, worryingly, over 50% are considering leaving the workforce.
This is an area of particular interest for me, which is why I worked with colleagues at Imperial to develop a proposal for establishing a partnership between 2 midwives; that is, a ‘shift partner’ to collaborate with during a shift in the obstetric unit or labour ward. The Partnerships in Midwifery Study (PIMS) is a new way of working, building on the standards established in one-to-one care in labour (i.e., one midwife to one woman or birthing person). Under the new approach, there would be 2 midwives to 2 women.
Our primary objective for our improvement project was to enhance the working experience of midwives, aiming to reduce stress and absenteeism and improve staff retention, to ultimately improve the overall care for women, birthing people and babies.
What did you learn from your research?
We trialled our new concept to see if it would help midwives feel more supported and better equipped to cope with workplace stress. The data we collected revealed that more than 84% of midwives felt more supported when working in a partnership.
Midwives working in partnerships often happens organically in the midwifery-led birth space. We would encourage midwives to work in partnerships in other areas of maternity; there are no additional costs or staffing requirements, and our work showed that midwives felt better supported when working this way.
Our work on Partnerships in Midwifery has since led to a collaboration with a national team of researchers and maternity leaders, designing a study that will evaluate how we implement complex change, and the impact of this on midwives and services.
Maternity is in the spotlight. The recent Ockenden Maternity Review highlighted the potentially devastating things that can happen when there are failings within maternity services. It also recognises that maternity services have very significant challenges. Urgent action is required to keep highly skilled midwives in the NHS, promote better staff wellbeing and ultimately improve overall patient care and outcomes.
In additional to further funding, maternity teams, together with patient voices, should be encouraged to continue to explore and evaluate new ways of working to ensure that families receive the best possible care, under compassionate leadership and in a way that is safe for staff and the families we care for. Midwives will continue to ensure this progress continues for at least the next 100 years.