‘The only thing that is constant is change’ according to the ancient Greek philosopher, Heraclitus of Ephesus writing around 500BC. So it’s true – change is inevitable in healthcare. A significant change in the midwifery profession is currently being enacted through statutory process to separate midwifery regulation and supervision of midwives. A Section 60 Order (of the Health Act, 1999) to remove midwifery supervision from statute and revoke the Midwives Rules & Standards (The Nursing & Midwifery Council, 2012) is expected to come into force in spring 2017. The regulation of our profession will remain with the NMC, but there will be a re-focus of midwifery supervision.1 Task forces led by the chief nursing officers of the four UK countries are in progress to review how supervision can continue to provide development and support for midwives and add to the quality of services and outcomes for women, babies and families. There is also discussion of how the valuable aspects of supervision can be preserved and integrated across the nursing profession. The changes inevitably affect midwifery education, so midwives need to be ready to respond to consultation on changes when they are published.
We cannot fail to notice the impact of political issues on our profession either, from reconfiguration of maternity services to the recent announcement of the spending review in England. This may well change the bursary funding for student midwives and other healthcare students. The Scottish First Minister has announced retention of the bursary; the Welsh Government is facing elections in May, and Northern Ireland has yet to state its position. The implications of any change have not been fully explored, although midwifery educators are debating their concerns as we speak. Watch this space!
The independent report on mental health services in England2 launched in February 2016 highlights again the importance of mental health and the lack of services in comparison to services for physical illness. Perinatal mental health is vitally important, particularly when suicide remains a leading cause of maternal death and the mental health of the mother having a significant effect on the cognitive and emotional development of the child.3
Across the country, there are various initiatives to develop perinatal mental health services – be sure that you know what is available in your locality, meet up with colleagues in mental health services and be proactive in raising awareness to keep mental health at the same priority level as physical health. Women need midwives to provide respectful, knowledgeable and caring support during this vulnerable time of their lives. The one constant in a changing world that is expected of us as midwives is professionalism. We can all consider what this means as individuals, but articulating exactly what we mean is challenging. Professionalism is included in the education of healthcare professionals at all higher education institutions and essential values are caring, kindness and honesty.4 This to me is the very essence of midwifery and what women and families expect and deserve from us, along with safe and knowledgeable practice.
1. Department of Health. 2016 Policy paper: Proposals for changing the system of midwifery supervision in the UK. gov.uk/government/publications/changes-to-midwife-supervision-in-the-uk (accessed 19 February 2016).
2. Independent Mental Health Taskforce. The Five Year Forward View for Mental Health. england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf (accessed 19 February 2016).
3. A learning programme for midwives. Identifying women at high risk of severe mental health illness. beatingbipolar.org/perinataltraining/ (accessed 19 February 2016).
4. Morgan J, Hopkins W, Acreman S, Jewell K, Garwood L, Candy E. What does professionalism look like? Attitudes and behaviours derived from a Delphi study. Royal College of Nursing, Nursing Management 2014;21(7):28-40.