Fundamentals of Midwifery: A Textbook for Students (4 page)

Interactive multiple-choice questions

Interactive true/false questions

Case studies to test your knowledge

Glossary of key termsScan this QR code to visit the companion website:
Chapter 1‌
To be a midwifeNicky Clark
University of Hull, Hull, UK
Carol Paeglis
Former Supervisor of Midwives and Local Supervising Authority Midwifery Officer,
Yorkshire and the Humber, UK
Learning outcomesBy the end of this chapter the reader will be able to:

understand how midwifery has evolved as a profession

examine how midwifery as a profession is regulated in the united kingdom

identify the support processes available to student midwives undertaking a pre-registrationmidwifery programme

be cognisant of the demands working within the midwifery profession

identify factors that can facilitate successful course completion.
Introduction
Midwifery is a dynamic profession that is responsive to change. In recent years, the social, eco-nomic and technological forces have altered the context of midwifery significantly. The scale of healthcare provision has changed greatly; philosophies and values have been adjusted and the restructuring of healthcare provision has been dramatic. Public expectation regarding involve- ment in care and opportunities for informed choice has increased; consequently women and their babies expect more than ever before to be partners in the care process.Midwives provide high-quality professional care to women and their families, acting autono- mously, accountably and responsibly within their sphere of practice. This chapter aims to explore the development of midwifery and its professional regulation with the subsequent evolution of the role and responsibilities of a midwife. The quality of midwifery education and the supervi- sion of midwifery will also be examined.
Fundamentals of Midwifery: A Textbook for Students
, First Edition. Edited by Louise Lewis.© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd. Companion website: www.wileyfundamentalseries.com/midwifery
Activity 1.1 ‌2 Ask yourself why you wanted to become a midwife. It will be useful to revisit this as youprogress on your programme. At difficult times within your programme these statements can be very helpful.To be a midwife is to understand the role and responsibilities of being a midwife. The mid- wifery profession is recognised globally and is defined by the International Confederation of Midwives (ICM) (2011) as:
. . . A midwife is a person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; 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...
This definition is complex; therefore the professional status and regulation of midwifery nationally and internationally will now be clarified.
The professional status and regulation of midwifery
Historically the professional status of midwifery in England and Wales began with The MidwivesAct 1902. This enabled the state enrolment of midwives and established the Central Midwives Board (CMB) for England and Wales. The Midwives Institute was established in the 1880s and was instrumental in the application of the Midwives Act. The Midwives Institute became known as the Royal College of Midwives (RCM) in 1941. All practising midwives were enrolled with the CMB by 1910. A Midwives Act was not passed in Scotland until 1915, which built on the experi- ence of the CMB for England and Wales when setting up the CMB for Scotland.The CMB produced an annual Roll of Midwives, which was a list of qualified midwives, indicating which were practising. The CMB was independent from nursing, although many midwives were nurses. In 1983 the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) replaced the General Nursing Council (Nursing) and the CMB (Midwifery), which brought the nursing, and midwifery records together for the first time. The Nursing Midwifery Council (NMC) was established under the Nursing and Midwifery Order 2001 (‘the order’) (SI:2002/253) and came into being on 1 April 2002, abolishing the UKCC and its four National Boards.Midwifery, as a profession is recognised globally, although there are wide variations in educa- tion and scope of practice between the different continents. Currently, in the United Kingdom, the NMC is the nursing and midwifery regulator for England, Wales, Scotland, Northern Ireland and the Islands. The aims of the NMC are outlined in Box 1.1.
The NMC
The NMC are governed by legislation approved by the Houses of Parliament and this is detailedin what is known as the Statutory Instruments (SIs). SIs allow an Act of Parliament to be brought
Box 1.1 Aims of the NMC3

Exist to safeguard the health and wellbeing of the public.

Set standards of education, training, conduct and performance so that nurses and midwives candeliver high quality healthcare consistently throughout their careers.

Ensure that nurses and midwives keep their skills and knowledge up to date and uphold the professional standards.

Have clear and transparent processes to investigate nurses and midwives who fall short of thestandards.into force or altered. The Statutory Instrument 2002 No. 253 is The Nursing and Midwifery Order 2001, and replaced the Nurses, Midwives and Health Visitors Act 1997.The main objective of the NMC in exercising its functions under The Order is to safeguard the health and wellbeing of persons using or needing the services of registrants. The principal func- tions of the Council are to establish from time to time standards of education, training, conduct and performance for nurses and midwives and to ensure the maintenance of those standards.Part VIII of the Nursing and Midwifery Order is specific to Midwifery and is concerned with:

The Midwifery Committee.

Rules as to midwifery practice.

Local supervision of midwives.Since 1 December 2012, following the Health and Social Care Act (2012) the NMC has been regulated by the Professional Standards Authority for Health and Social Care (PSA). The PSA replaced the Council for Healthcare Regulatory Excellence (CHRE). The PSA’s function is to ensure that the NMC and other healthcare regulators promote the best interests of patients and the public and ensure consistency across the professions (Yearley and Dawson-Goodey 2014).
European Union
The UK became part of the European community in 1973, and after the Maastricht Treaty wassigned in 1992, the European Union (EU) was formed. As a member state of the EU, all EU legisla- tion must be enforced and UK law must adhere to the EU framework and refer to the European Court of Justice. The NMC maintains close partnerships with colleagues and decision makers in Europe to ensure they can influence EU legislation in the interests of patients and the public in the UK.There are three main institutions involved in EU legislation:

The European Parliament, which represents the EU’s citizens and is directly elected by them.

The Council of the European Union, which represents the governments of the individualmember countries. The Presidency of the Council is shared by the member states on a rotat- ing basis.