Genomics and why it is important for midwives

By Donna Kirwan on 26 August 2021 Maternity Services Midwifery Digital Maturity

Genomics is at the cutting edge of technology and is an exciting and fast-moving science included within the 10-year strategy, the NHS Long Term Plan and more recently, Genome UK. This ground-breaking field can speed up diagnosis and improve treatment options for health conditions. As a fetal medicine midwife and recruiter to the landmark 100,000 Genomes Project, I’ve had first-hand experience of utilising genomics and know how getting a diagnosis for an unexpected rare genetic fetal or newborn condition for which options are available can change the lives of those involved.

As Lead Midwife for Genomics within the Nursing and Midwifery Genomics Team at NHS England, I encourage midwives to develop genomics awareness as it is vital that you can advise on, signpost and support pregnant women and their partners about tests that span all aspects of the maternity care pathway. Midwives must feel confident and be competent to have a conversation about tests and signpost parents to experts when appropriate and in meeting the requirements of the NMC standards.

What is genomics and how is it used in midwifery?

Genomics is the exploration of our entire genome and all the technology needed to analyse and interpret it providing options, such as tailored pharmaceutical or targeted therapy, a novel procedure or research, including trials or specialist care. Genomics looks at multiple genes with a deeper interrogation of our DNA using highly sophisticated genomic technology to search for very small alterations to each of 3.3 billion letters that make up our DNA.

Quite by default, genomics landed on the NHS when COVID-19 arrived last year. From information provision to vaccination is entrenched in genomics. Prior to COVID, midwives were already embraced in genomics from taking a booking history, antenatal and newborn screening, NIPT to caring for women with diabetes, epilepsy, heart disease and blood disorders. The new rapid fetal exome sequencing that tests for fetal conditions and rapid postnatal counterpart bring huge benefits for predicting outcomes, and diagnosis that can quickly inform on treatment and options. Knowing that a gene alteration is not inherited, provides parents with peace of mind as there is less chance of recurrence in another pregnancy.

Without a doubt, midwives may feel genomics is out of their comfort zone and beyond their scope of practice, only applicable to clinical scientists, academics or researchers.  Midwives, however, are not expected to be experts with a degree to demonstrate competence. Knowledge and skills will be depend on what they do in their area of clinical practice.

Learning resources

To ensure that genomics is embedded in midwifery care, the RCM, RCOG Genomics Taskforce and Health Education England are collaborating to invest enormously in educational resources for each profession. All resources are free and available online so it’s worth paying a visit to each site to explore the contents starting with our RCM i-learn platform!

Be curious and start your genomic learning journey today.