The Nursing and Midwifery Council has a duty to review the standards of proficiency that we set for the professions we regulate on a regular basis.
This is to ensure that standards remain contemporary and fit for purpose. In reviewing these standards, new evidence and the changes that are taking place in society, midwifery, maternity and neonatal care services have been considered, along with the implications these have for the role of midwives of the future.
The standards of proficiency in this document specify the knowledge, understanding and skills that midwives must demonstrate at the point of qualification, when caring for women across the maternity journey, newborn infants, partners and families across all care settings. They reflect what the public can expect midwives to know and be able to do in order to deliver safe, effective, respectful, kind, compassionate, person-centred midwifery care.
They also provide a benchmark for midwives from overseas wishing to join the UK register, as well as for those who plan to return to practice after a period of absence.
Midwifery globally
Midwifery is a global profession. Childbearing women, newborn infants, and families share similar needs wherever they live and midwives make a vital contribution to their survival, health and wellbeing across the world. The World Health Organisation has stated that ‘strengthening midwifery education is a key step to improving quality of care and reducing maternal and newborn mortality and morbidity’.
These standards of proficiency are in alignment with the International Confederation of Midwives’ definition of the midwife:
‘A midwife is a person who has successfully completed a midwifery education programme that is based on the ICM Essential Competencies for Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education and is recognised in the country where it is located; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery’.
The role and scope of the midwife in the 21st century
The role of the midwife is to provide skilled, knowledgeable, respectful, and compassionate care for all women, newborn infants and their families. Midwives work across the continuum from pre-pregnancy, pregnancy, labour and birth, postpartum, and the early weeks of newborn infants’ life.
This includes women’s future reproductive health, wellbeing, and decisions and in promoting very early child development and the parents’ transition to parenthood. Midwives respect and enable the human rights of women and children, and their priority is to ensure that care always focuses on the needs, views, preferences, and decisions of the woman and the needs of the newborn infant.
Midwives are fully accountable as the lead professional for the care and support of women and newborn infants, and partners and families. They provide care based on the best available evidence, and keep up to date with current knowledge and skills, thereby helping to ensure that their care is responsive to emerging evidence and future developments. They work in partnership with women, enabling their views, preferences, and decisions, and helping to strengthen their capabilities.
Midwives optimise normal physiological processes, and support safe physical, psychological, social, cultural and spiritual situations, working to promote positive outcomes and to anticipate and prevent complications.
Midwives make a vital contribution to the quality and safety of maternity care. They combine clinical knowledge, understanding, and skills with interpersonal and cultural competence. They make an important contribution to population health and understand social and health inequalities, and how to work to mitigate them through good midwifery care. They provide health education, health promotion and health protection to promote psychological and physical health and wellbeing and prevent complications. Evidence shows the positive contribution midwives make to the short and long-term
health and wellbeing of women, newborn infants, and families. Midwives provide and evaluate care in partnership with women, and their partners and families if appropriate, referring to and collaborating with other health and social care professionals as needed.
Midwives are ideally placed to anticipate and to recognise any changes that may lead to complications and additional care needs; these maybe physical, psychological, social, cultural, or spiritual, and include perinatal loss and end of life care. When such situations arise, the
midwife is responsible for recognising these and for immediate response, management, and escalation, involving, collaborating with and referring to interdisciplinary and multiagency colleagues. In such circumstances, the midwife has specific responsibility for continuity and coordination of care, providing ongoing midwifery care as part of the multidisciplinary team,
and acting as an advocate to ensure that care always focuses on the needs, views, preferences, and decisions of the woman and the needs of the newborn infant.
Midwives provide safe, respectful, empowering, and equitable care irrespective of social context and setting and including wider reproductive health services. In all settings, the midwife is responsible for creating an environment that is safe, respectful, kind, nurturing, and empowering.
Critical thinking, problem solving, positive role modelling, and leadership development are fundamental components of safe and effective midwifery practice. Midwives play a leading role in enabling effective management and team working, promoting continuous improvement, and encouraging a learning culture. Midwives recognise their own strengths, as well as the strengths of others. They take responsibility for their own continuing professional development and know how they can contribute to others’ development and education, including students and colleagues. They have the ability to develop in their careers in directions that can include practice, education, research, management, leadership, and policy settings. They continue to develop and refine their knowledge, skills, resourcefulness, flexibility and strength, self-care, critical and strategic thinking, emotional intelligence, and leadership skills throughout their career.
