Midwives will always have a voice at the NMC

Donna Ockenden, senior midwifery advisor to the chief executive of the Nursing and Midwifery Council (NMC), discusses the changing representation of midwives at the regulator. 

As midwifery advisor to the NMC and also a registered midwife, I understand that this may feel like an uncertain time for some midwives. The midwifery profession is going through a period of historic change. Changes to the NMC’s legislation are due to be introduced in the spring, which will mean the end of statutory supervision along with the removal of the NMC’s Midwifery Committee. In addition, the NMC has embarked on a radical programme of change for education, which will mean new standards of proficiency for the future graduate registered midwife. 

It is my role to provide midwifery advice to the NMC, but also to ensure that the voice of the midwife is heard throughout the organisation. I passionately believe that the only way to do this effectively is through two-way communication, and I want to hear directly from as many midwives as possible about what matters to them. 

One of the ways I am doing this is to personally visit maternity services across the four countries of the UK on behalf of the NMC to better understand the challenges that midwives face on a day-to-day basis and to listen to what midwives have to say about how their profession is evolving. 

As part of this work, I recently travelled to the maternity unit at Portsmouth’s Queen Alexandra Hospital where I spent a 12-hour shift shadowing and listening to the midwives and student midwives working there. This gave me the opportunity to see and hear first-hand from midwives and student mid-wives about the challenges they face on a day-to-day basis. Throughout the shift I took part in a safety ‘huddle’, observed multidisciplinary handovers and care delivery, supported the care provided to a number of postnatal mothers and walked 16,000 steps.  

My day in Portsmouth provided me with a really valuable opportunity to receive feedback directly from midwives and student midwives about their views on the changes and challenges to the midwifery profession. This is all vital information that, as promised, I have already taken back and shared with the NMC. Being a midwife is both a challenging and hugely rewarding job. The shifts can be long and the work is both physically and emotionally taxing. But it is clear the work that midwives at Portsmouth Hospitals NHS Trust and at midwifery units across the four countries – are doing is immensely appreciated by the women and families they care for, the communities they serve and the wider healthcare system in which they deliver care. 

A very significant way that the NMC is continuing to ensure that the voice of midwives is heard is through the Midwifery Panel. The Panel was introduced by the NMC chief executive, Jackie Smith, to provide the regulator with high-level advice on key midwifery issues throughout this period of change for the profession. It also provides a forum for midwifery leaders to develop strategic thinking on the NMC’s future approach to midwifery regulation. 

Members of the Midwifery Panel include the chief nursing officers from the four countries of the UK, representation from the Royal College of Mid-wives and other leading figures from the world of maternity care including Dr Bill Kirkup, who led the review into maternity failings at Morecambe Bay. Collectively, the Panel has a vast amount of experience and knowledge and is determined to ensure that the voice of the midwifery profession is clearly articulated in the work that the NMC does going forward. 

I know that some midwives were extremely disappointed by the decision to remove the function of statutory supervision, but it is important to know that work is already progressing to establish a new model of supervision, no longer linked to regulation. This new model will be very important in helping to ensure that midwives retain those elements of supervision which they value most. 

In addition to the important changes to legislation, the NMC is also embarking on an exciting programme of change for midwifery education. As part of this work, Professor Mary Renfrew, midwife and leading academic from the University of Dundee, will be leading on the development of new standards of proficiency for the future graduate-registered midwife. 

Over the coming months, there will be lots of opportunities for midwives to be involved in this and other work being undertaken by the NMC. The regulator will be holding focus groups, listening events and stakeholder workshops, many held within the workplace, to enable midwives at all levels to contribute to (and remain informed about) the changes ahead. Midwives have told us that it is important that these events are held in the workplace where they are located. The NMC has listened to this as we plan more ‘shadow’ opportunities similar to the Portsmouth visit, that we have received such positive feedback on. 

As a registered midwife, I feel confident about the journey ahead and look forward to engaging with fellow midwifery colleagues, women, their families and our multi-professional maternity colleagues   as together we shape the future of the midwifery profession. 




Dominique Mylod   23/03/2017 at 16:04

Dear Donna I recently responded to your e-mail with a letter where I outlined my deep concerns about the representation of midwifery in the NMC, the lack of understanding of the midwife's role by the CEO of the NMC and the fact that, as a registered midwife, I may not even birth partner my own daughter, niece, friend or colleague. I am disappointed that you have not bothered to respond to my comments and concerns.

Lesley   25/03/2017 at 09:22

Saddening to note these comments made by you. The vast majority of midwives voted against changes to supervision and the restructuring of midwifery and its protected role. Those were fundamentally ignored when the NMC proceeded to dismantle supervision and midwives protected role. This statement smacks of rhetoric and political posturing; shame on you ms Ockendon

Margaret Jowitt   25/03/2017 at 10:41

As a member of the public I am anything but confident for the journey ahead for midwifery and therefore for women and their families. It seems to me that the NMC is going headlong in the opposite direction to that proposed in Better Births, continuity of carer - establishing a relationship with women before birth so that they can have true choice and personal control during the birth. The NMC seems to be regarding midwives as merely obstetric nurses trained to follow routine obstetric guidelines. The Birthplace Study showed clearly that care is safer for mothers under midwifery led care, i.e. where midwives are practising autonomously and supporting the physiology of birth rather than robotically following computer algorithms and ticking boxes. Midwives need a regulator which recognises the ICM Definition of a Midwife. The UK must not go down the USA route but instead follow the example of New Zealand, Canada and the Scandinavian countries which respect midwifery as a separate profession from nursing. Midwifery care produces confident happy mothers which gives babies the best start in life and cost less in the short term and the long term. It will also reduce litigation costs.

Anon   26/03/2017 at 08:18

As a registered midwife are you telling women in your care that you're uncertain how to go forward supporting a homebirth against guidelines as the trust you work for have told you as of April 1st you'll have no legal backing? Are you upset seeing more and more of your contact with women eroded away as your role is doled out amongst other care professionals??? Did you do any work in community or are we just simply focusing on the 2/3 days women spend in hospital and forgetting the care they receive up to then?

Gabrielle   26/03/2017 at 12:15

As a member of the public who is pregnant, I find it quite frightening that the current system of supervision is being changed and will no longer be linked to regulation. The supervision system gave essential backing and support to midwives supporting women in their informed choices. It seems highly likely that without this valuable function women will lose the right to make their own choices about how to birth. As you no doubt know, there was immense opposition from across the profession to removing the statutory supervision system. There is also a complete lack of clarity about what will be happening instead. Given the timeframes of pregnancy and birth, those of us who are currently pregnant have absolutely no idea of the system that we will find ourselves landed with when it's time to give birth. Neither do the midwives supporting us. The uncertainty (and the fact that the decision went against most of the feedback from the consultation process) does not speak well for NMC.

Elizabeth Collins   27/03/2017 at 10:55

As a pregnant woman, I have no confidence in you. You have dismissed the current plight of Independent Midwives and it seems that those who speak out against the unfair practices of the NMC and work outside the NHS are irrelevant to you. You might be able to put together a well timed PR statement, but you are not supporting midwives, but furthering your own career and agenda. Lets stop the pretence.

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