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Editorial: Staying positive

2 December, 2013

Editorial: Staying positive

The RCM chief executive Cathy Warwick on the need for midwives to stay positive.
Midwives magazine: Issue 6 :: 2013

RCM chief executive Cathy Warwick on the need for midwives to stay positive.

Cathy Warwick Sketch Portrait

This year has flown by and has been full of debate and discussion about the state of our health services, how we provide the highest quality of care and how decreasing resources can provide for increasing need.


So what has this meant for maternity services? Choice, continuity and control (principles expressed in the Changing childbirth report 20 years ago) still underpin maternity policy, midwife numbers are holding their own, there is a slight shift towards more women giving birth outside of our obstetric services and, despite gloomy headlines, the number of freestanding midwife-led units has been maintained.

On the other hand, reconfigurations are creating larger obstetric units with little evidence as to the impact on services. Only 2% of women give birth at home despite evidence that, especially for low-risk multips, home birth is a positive, cost-effective choice. Postnatal care services are evaluated poorly as hard-pressed community midwives and MSWs struggle to provide even a minimum number of visits, which is not so positive. 

With both good and bad news, how should the RCM’s members react as we head into 2014? Firstly, let’s stay positive. Our maternity services have midwives as their backbone, our policies are women centred, our regulatory system is robust and the multi-professional team gets on well. This is a far cry from situations in many other countries – we do not need to be fearful for women or our profession.

Secondly, let’s remember that the care women experience daily depends mainly on interactions with clinically based midwives and MSWs. Women value being treated with respect and kindness above all else and, regardless of the model of service delivery, if each midwife and MSW makes every contact one in which communication is positive, we can make things better – a smile goes a long way. 

Thirdly, if we want to see positive improvements in maternity services in 2014, we must all recognise our individual and collective ability to influence change. We need the ‘powers that be’ to be on the same page, but continuity of carer will only happen if we embrace working differently. Midwife-led units will only thrive if we support them. Home birth services will only develop if we explain this choice positively to women. Women in obstetric units need us to promote normality. Evidence will only affect practice if we implement it. 

In other words, let’s head to the end of 2013 recognising our own accountability for making UK maternity services even higher quality than they are already.

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