Thursday 5th May 2022 is International Day of the Midwife. To celebrate, five midwives have documented what their role consists of here at Gateshead Health NHS Foundation Trust. There is a wide range of roles within Maternity and below are some examples of the fantastic work they do to support families across Gateshead.
Louise Milburn, a day in the life of a pregnancy assessment unit midwife and ward manager
As a manager, my role as a pregnancy assessment unit midwife and ward manager consists of spending time working clinically within our pregnancy assessment unit and in an office-based environment. We work closely with our senior leadership team to ensure we lead and manage all aspects of our maternity services for staff and patients.
On a normal day I work clinically I generally start my day at 7:30am. We clock in then go to the pregnancy assessment unit and check the workload for the day. We have elective work in our diary such as pre-operative assessments and blood pressure profiles. However, we also receive a lot of phone calls throughout the day from our patients who we triage and invite up to the unit based on their clinical needs.
Once we have done this, we spend the first 20-30 minutes checking all our emergency equipment as this is vital to ensure all equipment is fully stocked and in date ready to use should an emergency arise. This gives me confidence the workspace is prepped, safe, and ready for the day.
I then generally start to print any blood requests from our system and ensure all patient notes are ready for the day ahead and ensure the day runs as smoothly as possible as I like to say ‘to be prepared is half of the victory’!
At 8:30am I attend the unit safety huddle; this is where a representative from each area within maternity comes together to discuss their workload and any pressures, we may have that day so we can support our colleagues as one department. We also share key themes and safety messages as a way of communication amongst the staff. I then share these messages with the staff I am working with that day.
It is generally from about 9am that patients will start to attend the unit, and this can be for all matter of different things such as reduced fetal movements, blood pressure management, labour, rupture of membranes, scan reviews, and much more.
There is no set pattern to how the day can plan out. Everything we do with our patients then has to be followed up by documenting on our Badger maternity care record. We try to get our lunch individually around 13:00 however that can vary based on our workload throughout the day.
My day generally ends around 8:30pm if I am on a long shift. Any patients that remain on our pregnancy assessment unit will be relayed to our night duty midwives in a handover between 8:15pm and 8:30pm.
Andrea Barber, a day in the life of a Specialist Midwife for antenatal and new-born screening
The role of the antenatal and new-born screening coordinator is a comprehensive and varied one, and generally, no two days are the same. Daily duties include the review of results following maternal antenatal screening for infectious diseases in pregnancy such as sickle cell, and thalassemia, and fetal anomaly screening. As well as the monitoring of national failsafe platforms to monitor the offer, appropriate follow-up, and conclusion of new-born screening episodes for all babies following new-born hearing screening, new-born physical examination, and new-born bloodspot screening.
We counsel women who have screened with positive or increased chance results; and then make follow-up referrals to the respective specialist agencies in line with national screening programme standards and maternal choice.
A substantial aspect of this role includes leading multi-disciplinary training to inform and update midwifery staff regarding local operating procedures that comply with the recommended standards across the six antenatal and new-born programmes; to maintain a safe and effective screening service for local mothers and their babies.
We also compile and submit local KPI data to the national programme leads and devise many failsafe mechanisms to mitigate against any screening safety incidents; working closely with regional quality assurance and commissioning leads also, regarding the sharing of best practices and the sharing of lessons learned in the event of a safety incident is identified.
Tracey Powell, a day in the life of a practice development midwife
The role of a Practice Development Midwife is to facilitate the development of practice across maternity services and other specialities.
it is to recognise the potential in our staff and the service, ensuring that we attain a supportive learning culture, where we support staff to achieve their professional goals.
Practice development underpins clinical excellence, which ensures quality and safety in the care we deliver to our families.
Jackie Wotherspoon, a day in the life of a community midwife
I cover a lot of Low Fell and many other parts of Gateshead as part of my role as a community midwife. On a typical day, I’ll start off in the office, with a coffee, always a coffee… and this is where we are given any new visits of women who have gone home from hospital the day prior.
We will always visit women and their babies on that first full day home to check on how they are feeling and how their first night home has gone. It’s lovely and such a special feeling seeing families with their new baby after I have seen them at every appointment and all the way throughout their pregnancy. I have been very fortunate to care for several pregnancies and babies and it’s an honour to be part of their growing family.
The first visit at home is essential for going through events of their labour and ensuring they understood everything that happened. The electronic record, Badger, can help me debrief women and their birthing partners about the events of labour, if needed.
I will check the mother’s physical and mental health and also check the new baby. Most babies just don’t like to sleep at night, and that first night home with a new baby can be very daunting and exhausting. I will see how the feeding is going, whether that be formula or breastfeeding and offer support if required.
We also have amazing maternity support workers who can visit mother’s for feeding support and I may contact one to request further support and guidance, often on the same day, so that new families aren’t struggling for another day. We offer 7-day cover so there will always be a midwife available, no matter when a mother discharges home the from hospital.
Other visits may include a day 5 visit, where I will perform all the routine checks and also weigh the baby and offer to take the heel prick test which is offered to all babies on day 5. If the baby has lost more than 10% weight loss, or I have any other concerns such as jaundice, I will then liaise with the paediatrician to arrange a review if required.
I will also see families on day 10 where I may discharge them to the care of the health visitor or often, continue visiting for a little longer to offer further support for Mum or their baby.
I also see women undertake their ‘booking appointment’. This is often my first contact with her, and sometimes their family or partner. I will see women at home or in a convenient venue and try to work around their schedule as many women, obviously, haven’t informed work that they are pregnant and want to try and avoid taking time off for this initial appointment.
This can be a lengthy appointment, often lasting one hour or longer. It is essential I gather all relevant information to ensure we support the woman and her baby as safely as possible and refer her to the appropriate clinics or support avenues.
I may also have a birth plan/ preferences visit where we can discuss and explore any worries, concerns, or wishes for labour, and write them down or if needed, arrange a consultant appointment to take the discussions further.
I may also need to attend a social service meeting through the day, this is to ensure mam and her baby’s safety and well-being are being monitored, and reviewed and appropriate actions, support and referrals are made in a timely manner. This may also involve writing a report prior to sharing information with the whole multidisciplinary team and the parents of the baby.
Depending on the day of the week I may have my antenatal clinic. This is where I see women at specific gestations throughout their pregnancy to check Mums health and well-being and check the baby’s heartbeat and growth. I may need to refer to the hospital for a growth scan or for further review of perhaps blood pressure. I generally see women antenatally at the GP surgery however I will also see women at home or at the children’s centre where we are based if this is more convenient. Whilst at my clinic I may have a catch-up with the GP to discuss any concerns or questions either of us may have.
After my clinic, I’ll head home for a coffee and some downtime, and I may be required to be on-call for home births. We are on call for any women in Gateshead requesting a home birth and are on call around once a week. This covers the night too, so we will have our phones near us from 4.30pm till 8.30am the next morning ready to jump into action and go to a woman’s home for what can be an amazing experience for midwives as well as the families we care for.
Kerrie Page, a day in the life of a Horizon midwife
I am part of a small group of like-minded midwives on the Horizon team, who aim to provide continuity of care to women throughout their maternity experience. No two days at work in this role are the same, we are working dynamically day to day, with the unpredictability of our caseload and birth, keeping us on our toes.
We begin the day by making sure all visits needed are distributed and if there is any way we can support each other. We talk about what we each have on for the day.
We highlight if there are any women, we know to be showing signs of labour onset, or are scheduled for care in the maternity unit.
We are integrated within the community midwifery team based in a children’s centre. In any working week, we are each on-call to the hospital one night and one day, our team does their best to provide on-call cover 24/7 so there is a continuity midwife available to attend the labour and birth of women from our caseloads.
If we are not called into the maternity unit on our on-call days, we can pick up postnatal visits, catch up on safeguarding tasks, make well-being calls, and complete ongoing tasks such as tracking and referrals.
We are providing care to diverse communities of women, we promote individualised care, adapting the way we work to meet specific needs. We see women for their appointments at home or in children’s centres making maternity care as accessible as we can.
We offer a standard pathway of care and additional well-being visits as needed. We also link closely with GPs, health visitors, and the wider obstetric and maternity team to provide seamless care.
We do all we can to put a plan in place to give intrapartum care to women we have known throughout their antenatal care. We provide antenatal classes, and we do some shared appointments to make opportunities for women to meet other members of the team.
Continuity of care helps support women to have a positive experience of birth where they feel safe, empowered, and proud of their achievements in becoming mothers.
Our role gives us the opportunity to build strong bonds and caring relationships with women and families, which makes it really rewarding when they have a good experience, and when things don’t go to plan, we are there to offer more intensive support. We get the chance to keep our skills up in all areas of care, so we are always upskilling and always learning.
It took a while to adapt and get used to this new way of working. We enjoy the variety of care we undertake. As a small team, we take care of each other and are mindful of self-care. For the most part, I feel that I have more time with my family. We are now self-rostering, which means we are able to fit work more considerately around our family lives.