World Patient Safety Day: safety in maternity care

Published on 17 September 2020

Dr Jacqui Williams, Senior Midwifery Adviser (Education) at the NMC, reflects on our Future Midwife standards and safety in maternity care

As midwives, each of us knows how much women, their partners and their families value safe maternity services. This means that all of us in the midwifery profession should be continually striving to deliver the best, safest care for every woman, newborn baby and family.

While the vast majority of maternity services provide excellent, safe, person centred care, there have sadly been occasions where the standard of care has fallen short of what is expected. On these occasions it is for the whole maternity community to work together to improve. And that includes us here at the NMC. So one of the key things at the forefront of our minds as we developed our new Future Midwife standards was how they could promote safer care.

World Patient Safety Day therefore feels like the perfect time to reflect on what the standards say about safety. When we developed them, it gave us a really good opportunity to consider what safe care really means. The new standards define safety during maternity care as ‘the physical, psychological, social, cultural and spiritual safety of women and newborn infants.’

But what does that mean in practice?

I asked Sascha Munro-Wells, Deputy Chief Midwifery Officer for England, who has worked on maternity improvement and is an authority on the subject. Sascha told me:

“Leadership and good governance are essential to safe midwifery care. The top four most important factors in ensuring safe care are:

1. The right leadership at all times

2. A positive culture that focuses on improving safety

3. A maternity service committed to continuing to learn and improve

4. When a mistake is made, everyone learns from it.

These are reflected in domain 5 of our Future Midwife standards and we expect all midwives to be able to demonstrate these from the first day they join our register. Right from the start, the standards set out that being able to lead others in delivering safe care is a vital skill for all midwives:

Safely and effectively lead and manage midwifery care, demonstrating appropriate prioritising, delegation and assignment of care responsibilities to others involved in providing care (5.19)

For me, reflecting on learning that comes from working with others is one of the most vital things a midwife must do. It’s really important that we advocate for change where improvement is needed, as we all bear a responsibility not to accept things staying as they are.  

This means that we must all work with colleagues to promote quality improvement in maternity services – and in my experience, it really helps to draw on the knowledge of others such as groups who advocate for women in pregnancy and childbirth. Here is what it says in the standards:

Demonstrate knowledge of quality improvement methodologies and the skills required to actively engage in evidence-informed quality improvement processes to promote quality care for all (5.1)

Sascha also emphasises that midwives need to, “Continue to listen and really hear what women are saying. Care needs to be personalised and individualised to the specific needs of each woman and baby. This is critical to promoting safety.”

That’s why the theme of enabling and advocating for the views, preferences and decisions of women, partners and families runs so strongly through the standards. As midwives, we need to ensure women and families have all the information they need to make fully-informed decisions.

If there is one thing we can do this World Patient Safety Day, take a brief moment to reflect. Use today to pause and think how we can all improve midwifery care and keep women and newborn babies safe. Also, have a look at the new midwifery standards, and some of the supporting materials in our new web hub.

As midwives, we all want to do something amazing every time we go to work, so we all need to reflect on what steps we can take each day to make things even better and safer.

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