Standards for preregistration midwifery education · 2016-09-26 · 2 . Foreword. The Nursing and...

Standards for Pre-Registration:Pre-Registration 10/02/2009 10:14

Standards for pre-registration midwifery education

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ForewordThe Nursing and Midwifery Council exists to protect the public. We do this by maintaining a register of nurses, midwives and nursing associates, setting standards for education and practice, and giving guidance to professionals. We aim to inspire the confidence of our stakeholders by ensuring that nurses, midwives and nursing associates on our register are fit to practise and by dealing swiftly and fairly with those who are not.

Standards for pre-registration midwifery education updates and replaces Standards of proficiency for pre-registration midwifery education (2004). European Directives have been incorporated into this edition, along with NMC standards and guidance that relate to the outcome of two NMC consultations: Fitness for practice at the point of registration, and Pre-registration midwifery education. Included also are the Essential Skills Clusters for midwifery education. The revised title reflects the scope of the standards and guidance for pre-registration midwifery education.

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ContentsIntroduction .................................................................................................................... 4

The role of the Nursing and Midwifery Council ....................................................... 4Midwifery – the guiding principles ........................................................................... 4

Standards for the lead midwife for education ................................................................ 8Standard 1 – Appointment of the lead midwife for education ................................. 8Standard 2 – Development, delivery and management of midwifery education programmes............................................................................................................ 9Standard 3 – Signing the supporting declaration of good health and good character ................................................................................................................. 10

Standards for admission to, and continued participation in, pre-registration midwifery programmes .................................................................................................................. 11

Standard 4 – General requirements relating to selection for and continued participation in approved programmes, and entry to the register ........................... 11 Standard 5 – Interruptions to pre-registration midwifery education programmes ... 15Standard 6 – Admission with advanced standing ................................................... 15Standard 7 – Transfer between approved educational institutions ......................... 16Standard 8 – Stepping off and stepping on to pre-registration midwifery education programmes............................................................................................................ 16

Standards for the structure and nature of pre-registration midwifery programmes ....... 17Standard 9 – Academic standard of programme .................................................... 17Standard 10 – Length of programme ...................................................................... 17Standard 11 – Student support ............................................................................... 18Standard 12 – Balance between clinical practice and theory ................................. 19Standard 13 – Scope of practice experience .......................................................... 19Standard 14 – Supernumerary status during clinical placements .......................... 20Standard 15 – Assessment strategy ....................................................................... 20Standard 16 – Ongoing record of achievement ...................................................... 22

Achieving the NMC standards ....................................................................................... 22Standard 17 – Competencies required to achieve the NMC standards ................. 23The Essential Skills Clusters .................................................................................. 35

AnnexeDirective 2005/36/EC of the European Parliament and of the Council (2005) on the recognition of professional qualifications ................................................................ 68

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IntroductionThe role of the Nursing and Midwifery Council

The Nursing and Midwifery Council (NMC) is required by the Nursing and Midwifery Order 20011 (the Order) to establish and maintain a register of qualified nurses, midwives and nursing associates [Article 5(1)]. It is required to establish the standards necessary to be admitted to the different parts of the register [Article 5(2)(a)], including the standards of education and training necessary to qualify as a midwife [Article 15(1)].

This book details the standards of education and training required for pre-registration midwifery education programmes. Their status is mandatory and they gain their authority from legislation, in this case, the Order and the Nursing and Midwifery Council (Education, Registration and Registration Appeals) Rules 20042 (the Registration Rules).

The standards in this booklet have either been consulted on, in accordance with Article 3(14) of the Order, or transferred from previous rules, standards and guidance.

Midwifery – the guiding principles

The standards for pre-registration midwifery education have been guided by the international definition of a midwife and the requirements of the European Union Directive Recognition of Professional Qualifications 2005/36/EC Article 40 (by 2013/55/EU).

The international definition of a midwife

The definition of a midwife as adopted by the International Confederation of Midwives (ICM), the International Federation of Gynaecology and Obstetrics (FIGO) and the World Health Organization (WHO):

A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.

The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the post-partum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.

1 The Nursing and Midwifery Order 2001 (SI 2002/253) as amended by the (www.opsi.gov.uk/si/si2007/20073101) European Qualifications (Health and Social Care Professions) Regulations 2007 (SI 2007/3101), and the (www.opsi.gov.uk/si/si2008/pdf/uksi_20081485_en.pdf) Nursing and Midwifery (Amendment) Order 2008 (SI 2008/1485), The Stationery Office, Norwich, (www.hmso.gov.uk) 2 Nursing and Midwifery Council (Education, Registration and Registration Appeals) Rules 2004 (SI 2004/1767) as amended by the Nursing and Midwifery Council, (www.opsi.gov.uk/si/si2005/uksi_20053354_en.pdf) (Education, Registration and Registration Appeals) (Amendment) Rules 2005 (SI 2005/3354) and the (www.opsi.gov.uk/si/si2007/20073101.htm) European Qualifications (Health and Social Care Professions) Regulations 2007 (SI 2007/3101), The Stationery Office, Norwich, (www.hmso.gov.uk)

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The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.

A midwife may practise in any setting including the home, community, hospitals, clinics or health units.

(Adopted at the International Confederation of Midwives Council meeting in Brisbane, Australia, on 19 July, 2005)

Safe and effective practice

Education programmes must be designed to prepare students to practise safely and effectively so that, on registration, they can assume full responsibility and accountability for their practice as midwives.

The following guiding principles relate to professional competence and fitness for practice, and the promotion and facilitation of the normal physiological process of childbirth. This includes competence in identifying any complications that may arise, accessing appropriate assistance, and implementing correct emergency measures.

Students must demonstrate competence in:

• sound, evidence-based knowledge of facilitating the physiology of childbirth and thenewborn, and be competent in applying this in practice

• a knowledge of psychological, social, emotional and spiritual factors that maypositively or adversely influence normal physiology, and be competent in applyingthis in practice

• appropriate interpersonal skills (as identified in the Essential Skills Cluster –Communication) to support women and their families

• skills in managing obstetric and neonatal emergencies, underpinned by appropriateknowledge

• being autonomous practitioners and lead carers to women experiencing normalchildbirth and being able to support women throughout their pregnancy, labour, birthand postnatal period, in all settings including midwife-led units, birthing centres andthe home

• being able to undertake critical decision-making to support appropriate referral ofeither the woman or baby to other health professionals or agencies when there isrecognition of normal processes being adversely affected and compromised.

Note: childbirth in this context means the antenatal, intranatal and postnatal periods.

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Students must understand and practise competently:

Provision of women-centred care

Midwifery practice must be women-centred and responsive to the needs of women and their families in a variety of care settings. This will be reflected in the midwife’s ability to assess the needs of women, and to determine and provide programmes of care and support for women throughout the pre-conception, antenatal, intrapartum and postnatal periods.

The education process will prepare the student to provide midwifery care. It will also prepare them to accept responsibility for the effective and efficient management of care for women by managing and prioritising competing demands. The student will develop the capacity to work collaboratively within the multi-disciplinary care team, whilst demonstrating overall competence in fulfilling the midwife’s role.

The emphasis must be on the provision of holistic care for women and their families, which respects their individual needs, contexts, cultures and choices. Principles of equity and fairness are fundamental values, which must be addressed in all programmes of preparation.

Ethical and legal obligations

The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates3 requires all midwives to conduct themselves and practise within an ethical framework based on respect for the wellbeing of women and their families. While various rule-orientated and principle-based ethical models may assist in informing ethical decisions, many ethical dilemmas are complex. They may not easily be resolved by using one ethical approach. Midwives must recognise their moral obligations and the need to accept personal responsibility for their own ethical choices within specific situations based on their own professional judgment. In making such choices, midwives must be aware of, and adhere to, legal as well as professional requirements.

Respect for individuals and communities

Midwives must always demonstrate respect for persons and communities, and not discriminate in any way against those in their care. No midwife should convey any allegiance to any individual or group which opposes or threatens the human rights, safety or dignity of individuals or communities, irrespective of whether such individuals or groups are recipients of midwifery care.

3 The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates,

Nursing and Midwifery Council, London (www.nmc.org.uk)

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Quality and excellence

The practice-based standards required of midwives are not separate and insular professional aspirations. They are directly linked to the wider goals of achieving clinical effectiveness within healthcare teams and agencies, with the ultimate aim of providing high-quality midwifery care for women and their families. Assuring the quality of midwifery care is one of the fundamental underpinnings of clinical governance. It is essential that the midwifery standards set out in this book enable the student to promote and facilitate the physiological process of childbirth, identify complications that can arise in women and their babies, communicate and refer in a timely manner to and from appropriate colleagues, and implement emergency measures and transfer of care.

The changing nature and context of midwifery practice

As the nature and context of midwifery practice changes, it is essential that all midwives are prepared for and understand the need to update and enhance their knowledge and skills, in response to the changing needs of women and their families. Midwives, working within the limitations of their own competence, must have the capacity to adapt to change, but also be able to identify the need for change and initiate it. Midwives need to adapt to changes in technology and new systems of care delivery as they are introduced.

Lifelong learning

Midwives must be prepared for and understand the need for continuing professional and personal development throughout their career, including the acquisition and development of new knowledge and skills. Programmes must prepare the midwife with the communication skills with which to deliver effective care in a multicultural environment. Midwives must be prepared for partnership working with other members of the healthcare team, working across professional boundaries in the best interests of women and their families.

Evidence-based practice and learning

Within the complex and rapidly changing healthcare environment, it is essential that the best available evidence informs midwifery practice. This is achieved by searching the evidence base; analysing, critiquing and using evidence in practice; disseminating research findings; and adapting and changing practice where appropriate. This must be reflected throughout education programmes.

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Standards for the lead midwife for educationThis section provides standards and guidance relating to the lead midwife for education. The lead midwife for education is a requirement for approval of midwifery education programmes that lead to application to the midwives’ part of the register or a recordable midwifery qualification. The lead midwife for education forms an essential part of the quality assurance process and she must demonstrate to the NMC that the standards leading to either registration or a recording on the midwives’ part of the register are being maintained.

Standard 1 – Appointment of the lead midwife for education

The NMC requires an approved educational institution to do the following:

• appoint a lead midwife for education who is a practising midwife and has a recorded midwifery teaching qualification on the NMC register

• confirm the appointment of a lead midwife for education with the NMC

• use the lead midwife for education for strategic liaison with external agencies such as purchasers of education provision for all matters affecting midwifery education.

Guidance

The lead midwife for education is a practising midwife and therefore must notify her intention to practise each year. She must also meet the NMC requirements for updating and continuing professional development in order to remain on the register as a midwife. Having a recorded teaching qualification on the NMC register demonstrates that the lead midwife for education has met the NMC’s standards for teaching.

The approved educational institution should notify the NMC of the appointment of the lead midwife for education on the appropriate form (accessed via the NMC website www.nmc.org.uk), so that we can get in contact with them as and when necessary.

Examples of external agencies with whom the lead midwife may need to communicate include the NMC and its strategic reference groups, commissioners and purchasers of education, maternity units, Departments of Health, other higher educationinstitutions, professional organisations, and voluntary sector and private sector employers.

The lead midwife for education should be supported to attend the NMC’s UK-wide lead midwife for education strategic reference group. Working collaboratively with external agencies, the lead midwife for education will ensure training meets current and future midwifery education programme requirements, in line with NMC requirements for the preparation of midwives fit for practice.

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Standard 2 – Development, delivery and management of midwifery education programmes

The lead midwife for education shall lead the development, delivery and management of the midwifery education programmes provided by the approved educational institution, ensuring that they comply with the standards established by the NMC.

The approved educational institution will:

• consult with the lead midwife for education on all matters that affect midwiferyeducation

The lead midwife for education will:

• contribute to the internal systems that inform the quality assurance of midwiferyeducation programmes

• collaborate with maternity services, service users and user groups in all mattersthat affect midwifery education

• provide professional input at strategic and operational levels within the approvededucational institution to ensure the NMC’s requirements for due regard are met

• work at a strategic level with heads of midwifery, and purchasers of education provisionin all matters that affect midwifery education

Guidance

The lead midwife for education is an expert in midwifery education and has the knowledge and skills to develop policy, as well as to advise others on all matters relating to midwifery education. She should liaise directly with commissioning and purchasing agencies for midwifery education, as well as being involved in any decisions regarding midwifery education. It is essential that midwifery education programmes meet the needs of users of maternity services, as well as students. It is therefore important that women who use maternity services are involved in all stages of curriculum planning, development and programme evaluation. This will enable student midwives, at the point of registration, to meet the needs of women and their babies. Strategic collaboration is necessary because midwifery education impacts on midwifery care, workforce planning and commissioning of student numbers.

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Standard 3 – Signing the supporting declaration of good health and good character

In accordance with rule 6(1)(a)(ii) of the registration rules, the lead midwife for education shall be responsible, at her discretion, for signing the supporting declarations of good health and good character for all midwifery applications to the register.

The lead midwife for education will:

• ensure processes are in place to satisfy the NMC’s entry requirements for:(a) admission to a midwifery programme of education that leads to initial registrationor readmission to the register following a return to practice programme(b) the continued participation of a student in a midwifery programme of educationthat leads to initial registration or readmission to the register following a return topractice programme(c) any person being admitted to the midwives’ part of the register for the first timeor readmission to the register following a return to practice programme

• be accountable for her signature on the supporting declaration of good health andgood character

• have the right to refuse to sign any supporting declaration of good health and goodcharacter where the available evidence identifies that the student may not be ofsufficient good health and/or good character to carry out safe and effective practiceas a midwife.

Guidance

The lead midwife for education is accountable for her practice in accordance with The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates.4

If a lead midwife for education cannot be assured of a student’s good health and good character she must not sign the supporting declaration required by the NMC. The student therefore cannot be recommended for admission to the midwives’ part of the register. In such cases, it it would be regarded as good practice to inform the NMCwhy the student is not being recommended for admission to the register and confirmthe student has left the midwifery programme.This section describes standards and guidance on admission to and continued participation in NMC approved pre-registration midwifery education programmes, in accordance with Article 15(1)(b) of the Order.

4 The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council, London, (www.nmc.org.uk)

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Standards for admission to, and continued participation in, pre-registration midwifery programmesAge of entry

There is no longer a minimum age requirement, although the following guidance remains relevant.

Guidance

Education providers must comply with:

• Article 40(2)(a)(b) of Directive 2005/36/EC (The Recognition of ProfessionalQualifications, updated by 2013/55/EU) which requires access to training as amidwife to be dependent upon either completion of at least the first 10 years ofgeneral school education (for a programme comprising of at least three years full-time theoretical and practical study), or possession of evidence of formalqualifications as a general nurse (for a full-time programme of a minimum 18months’ duration).

• Health and Safety at Work Act 2004, which restricts the manner in which youngpeople may be deployed. In this context a ‘young person’ is defined as ‘any personwho has not attained the age of 18 years’.

The key documents relating to this are the Health and Safety (Training for Employment) Regulations 1990, the Management of Health and Safety at Work Regulations 1999, and the Management of Health and Safety at Work Regulations (Northern Ireland) 2000.

Standard 4 – General requirements relating to selection for and continued participation in approved programmes, and entry to the register

4.1 Selection

The following requirements for selection should be read and operated alongside programme providers’ existing policies and procedures:

• wherever practicable, the selection process should include a face-to-face meeting

• programme providers (approved educational institutions and their service partners)are encouraged, wherever possible, to involve lay people and midwifery studentsin the selection process. Depending on local circumstances they may be involveddirectly or indirectly in selection, eg:

• in planning for recruitment and selection

• in assessing or determining interview and selection criteria

• in monitoring the effectiveness of selection processes

• in giving presentations or meeting with potential applicants

• as part of the selection panel• all individuals involved in the selection process should receive appropriate

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training, preparation and updating which includes equality and diversity. Careful consideration should be given to the support and training of lay people (those who are not, and never have been registered with the NMC) and/or midwifery students involved in the process

• representatives of partner service provider organisations should be directly involved in the selection process

• the views of the individuals directly involved in selecting applicants should be taken into account when making final decisions on whether to accept or reject an applicant.

4.2 Literacy and numeracy

Approved educational institutions are required to ensure that applicants for pre-registration midwifery education programmes have provided evidence of literacy and numeracy that includes prior achievement of basic skills sufficient to undertake a pre-registration midwifery programme of education to a satisfactory level of attainment.

For numeracy this includes evidence of ability to:

• manipulate numbers accurately as applied to volume, weight, and length (including addition, subtraction, division, multiplication, use of decimals, fractions and percentages), including using a calculator.

For literacy this includes evidence of ability to:

• read and comprehend (in English or Welsh) and communicate clearly and effectively in writing, including using a computer.

If a student has a disability, the above criteria can be met through the use of reasonable adjustments.

For quality assurance purposes, the NMC requires access to information about, and evidence of the application of systems and policies developed to assess the literacy and numeracy of applicants to pre-registration programmes of midwifery education.

Applicants who hold an existing NMC registration may be deemed to have met the NMC’s requirements at their initial registration.

Guidance

The NMC’s requirements help safeguard the public by ensuring that entrants to pre-registration programmes have a foundation of literacy and numeracy from which to develop communication skills and competency with regard to drug calculations. Evidence of literacy and numeracy may be determined from academic or vocational qualifications, through evidence such as key skills abilities, or through the approved educational institution’s own processes, which may include portfolios or tests.

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to set their own standards but must satisfy the NMC that there is sufficient evidence to meet its requirements. It would be regarded as best practice if the educational entry requirements were agreed jointly by the approved educational institution, service providers and education commissioners.

Wherever possible, the means of evidencing requirements for literacy and numeracy should enable feedback to be provided to applicants and those admitted to a programme. This should allow developmental needs to be identified, and where appropriate to be addressed as part of the programme.

When applicants from outside the European Economic Area (EEA) offer the International English Language Testing System (IELTS) or Occupational English Test (OET) as evidence of literacy, AEIs should apply NMC requirements for overseas applicants to the register. In these cases, the NMC will accept:

- IELTS examination results (academic or general) where the overall score is at least 7.0, with a score of at least 6.5 in the writing section and at least 7 in the in the reading, listening and speaking sections.

- OET examination certificate that confirms at least a B grade in the writing, reading, listening and speaking sections.

4.3 Good health and good character

Applicants must demonstrate that they have good health and good character sufficient for safe and effective practice as a midwife, on entry to, and for continued participation in, programmes leading to registration with the NMC.

Applicants from overseas must meet the good health and good character as defined for UK applicants and additionally those requirements set out by the UK government for healthcare workers from overseas.

If an applicant has a conviction or formal caution issued by the police, this must be declared.

Approved educational institutions must obtain evidence of the applicant’s good health and good character as part of their selection, admission and ongoing monitoring processes.

A student already registered with the NMC on a different part of the register is not exempt from this requirement.

Programme providers are required to monitor the progress of all students and to take appropriate action if any issues relating to good health or good character arise. All programme providers are required to have Fitness to Practise panels from January 2009 to consider any health or character issues and to ensure that public protection is maintained.

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The NMC requires programme providers to ensure that processes are in place for assessing each applicant’s/student’s good health and good character at admission to, during and on completion of pre-registration midwifery programmes. Such processes may involve a combination of self-assessment health questionnaires, self-declaration of good character, routine health screening, occupational health assessment, character references, Criminal Record Bureau checks and other measures agreed between the programme providers.

Students who declare on application that they have a disability should submit a formal assessment of their condition and specific needs, from a GP or other medical or recognised authority, to the relevant occupational health department. Programme providers should apply local policy in accordance with the Disability Discrimination Act 20055 for the selection and recruitment of students/employees with disabilities. Where appropriate, the institution’s student support services should also be involved. The NMC would require evidence of how such students would be supported in both academic and practice environments to ensure safe and effective practice sufficient for future registration.

4.4 Entry to the register

The NMC requires a self-declaration of good health and good character from all those entering the register for the first time. On completion of the midwifery programme the student will submit this self-declaration. The declaration is either supported by the lead midwife for education, whose name has been notified to the Council and who is responsible for midwifery education in the relevant approved educational institution, or by her designated registered midwife substitute. Approved educational institutions must be able to provide evidence of having fulfilled this requirement.

Guidance

When confirming a student’s declaration of good health and good character on completion of the programme, the lead midwife for education must have knowledge of that student. She is accountable for her decision to sign the declaration.

Throughout the programme the NMC would expect that students develop their practice in accordance with The Code: Standards of conduct, performance and ethics for nurses, midwives and nursing associates.6

5 The Disability Discrimination Act was repealed and replaced with the Equality Act 2010.

6 The Code: Professional standards of practice and behaviour for nurses, midwives and nursing

associates. Nursing and Midwifery Council, London. (www.nmc.org.uk)

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Standard 5 – Interruptions to pre-registration midwifery education programmes

When a student returns to a programme it is recommended they have a period of orientation appropriate to the length of interruption. Programme providers must ensure that the student’s acquired knowledge and skills remain valid, enabling them to achieve the necessary standards required on completion of the course.

Guidance

For the purpose of this standard, interruption means any absence from a programme of education other than annual leave, statutory or public holidays.

See also Standard 10 – Length of programme.

Standard 6 – Admission with advanced standing

All applicants, other than those registered as a nurse level 1 (adult), must complete a minimum three years full-time pre-registration midwifery programme of education.

Where a student is already registered with the NMC as a nurse level 1 (adult), the length of the pre-registration midwifery education programme shall be no less than 18 months full time (equivalent to 78 weeks full time).

Guidance

Advanced standing is where a student enters a pre-registration programme as a result of prior registration with the NMC, thus being able to undertake a shortened programme. This standard complies with Directive 2005/36/EC Article 40 (1)(b) (as updated by 2013/55/EU) where applicants are entitled to undertake a shortened programme by virtue of previous registration as a nurse level 1 (adult) with the NMC. Applicants who are registered with the NMC as a nurse level 1 in other branches of nursing (mental health, learning disabilities or children) are not entitled to undertake a shortened midwifery programme.

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Standard 7 – Transfer between approved educational institutions

It is the responsibility of educational institutions to decide whether or not to accept an application for transfer. Students may transfer their programme with credit for prior learning only where:

• they transfer from one NMC approved pre-registration midwifery programme toanother

• the relevant NMC requirements for good health and good character are met

• the student’s prior learning can be mapped against the programme they wish totransfer to, enabling them to go on to meet all necessary outcomes and standardson completion of the course.

Standard 8 – Stepping off and stepping on to pre-registration midwifery education programmes

Students can ‘step off’ a pre-registration midwifery programme of education if they have:

• completed a period of study successfully

• taken leave from a programme before its completion

• been awarded education and practice credits from the original programme provider(this would be at the discretion of the approved educational institution)

and

• have not been discontinued from the programme by the education provider.

Students can ‘step on’ to a pre-registration midwifery programme of education when:

• they have met the requirements for ‘stepping off’

and

• the pre-registration midwifery programme they wish to join is comparable, be it atthe same or another NMC approved educational institution

• they are able to complete the outstanding part of the pre-registration programmewithin the time frame set out by the NMC, the commencement date being the datethe student started the original programme

• they have met the NMC’s requirements for good health and good character

• satisfactory references have been taken up from the lead midwife for education atthe original approved educational institution

• a period of orientation is undertaken by the student appropriate to the periodbetween stepping off and stepping back on. The lead midwife for education at thenew approved educational institution will determine the length of this in relation tothe length of time between the leaving of and starting again on the programme.

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Guidance The terms ‘stepping on’ and ‘stepping off’ refer to student midwives who decide to discontinue their pre-registration midwifery programme of education and then wish to recommence their studies at a later date.

The amount of credit that may be taken into account in relation to students stepping back on to a pre-registration programme is for the NMC approved educational institution to determine.

This section describes standards for pre-registration midwifery education programmes, in accordance with Article 15(1)(a) of the Order.

Standards for the structure and nature of pre-registration midwifery programmes Standard 9 – Academic standard of programme

Since September 2008 the minimum academic level for entry to the midwives’ part of the register for those entering pre-registration midwifery programmes is degree level (NMC Circular 14/2007).

Guidance

Degree level is a minimum of:

• Scotland – 360 academic credits, 60 of which must be at level 9

• England, Wales and Northern Ireland – 300 academic credits, 60 of which must be

at level H. Programme providers may determine higher academic levels where appropriate. This should be done in consultation with education commissioners.

Standard 10 – Length of programme

The length of a pre-registration midwifery programme of education should be no less than three years and 4,600 hours as set down in EU Directive 2005/36/EC. Where the student is already registered with the NMC as a nurse level 1 (adult), the length of the pre-registration midwifery programme of education shall not be less than 18 months and 3,000 hours (as set down in EU Directive 2005/36/EC) or an equivalent pro-rata part-time period.

Guidance

A full-time programme containing a minimum of 4,600 hours includes any annual leave as part of the programme. It would be for the programme provider and relevant commissioner(s) to determine whether a greater minimum length was required to meet local needs.

(See also Standard 5 – Interruption in pre-registration midwifery education programmes).

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Standard 11 – Student support

Midwife teachers and midwife mentors must meet the NMC’s standards to support learning and assessment in practice.7

Guidance

Student midwives should be supported in both academic and practice learning environments. Midwife teachers and midwife mentors have the knowledge, skills and expertise to provide appropriate support to student midwives. As such they should be able to identify appropriate learning opportunities for student midwives and offer advice and guidance to develop safe woman-centred practice that enables students to become midwives.

The NMC publication Standards to support learning and assessment in practice (2008) explains that the NMC expects midwife teachers to be able to support learning and assessment in both academic and practice learning environments. There is also the expectation that midwife teachers will have contemporary experience in order to support learning and assessment in practice settings. Such experience may take a variety of forms, including:

• acting as a link tutor

• supporting mentor development and updating

• having a part-time clinical role

• supporting clinical staff in their professional development in practice

• being involved in practice development to support the evidence base from which students draw

• contributing to practice-based research

Teachers are therefore expected to spend a proportion of their time supporting student learning in practice, and this should represent approximately 20 per cent of their normal teaching hours. This would be monitored through the NMC’s quality assurance framework.

A range of members of the teaching and healthcare team may contribute to students’ learning, but to enable the application of theory to practice, the majority of the teaching/academic input must be from a midwife teacher. Inter-professional learning must be in the context of its relevance to midwifery knowledge and skills and must ensure the EU Directives are met in terms of midwifery hours and content.

Approved educational institutions must carry out regular audits of the learning environments that students are placed in. One of the outcomes of these audits will be to identify the number of students that an environment can support effectively, from both the number of midwife mentors available and the amount of normal pregnancy and birth experience available.

7 Standards to support learning and assessment in practice (2008). Nursing and Midwifery Council, London, (www.nmc.org.uk)

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Standard 12 – Balance between clinical practice and theory

Since September 2008, the practice to theory ratio of each programme is required to be no less than 50 per cent practice and no less than 40 per cent theory. The clinical practice experience must be sufficient to enable students to achieve the standards required by the NMC.

The programme must have a variety of learning and teaching strategies, which may include simulation. All of the clinical practice part of the programme must involve direct contact with the care of women and babies. The application of theory to midwifery practice in the academic learning environment must be undertaken by a midwife teacher. This would not exclude midwives undertaking teacher preparation programmes.

Guidance

A minimum of 50 per cent of the available curriculum hours must be spent in clinical practice. This takes into account the variable hours per working week that approved educational institutions apply to the programme.

Clinical practice is that part of the midwifery programme of education where the student midwife is under the direct or indirect supervision of a midwife when providing care to women and babies. The student is in direct contact with women and babies, planning, providing and assessing the need for and extent of midwifery care on the basis of their acquired knowledge and skills.

Direct supervision is where the practising midwife would normally be in close proximity to the student, either by working directly with them or close enough to directly monitor their activities. Whereas indirect supervision enables students to develop confidence and independence, this approach should only be taken to support students who are more senior and where there is evidence that complex activities can be safely and responsibly delegated. Even so, indirect supervision requires that the midwife is easily contactable and can provide the level of support needed to ensure public protection and maintain the safety of both the women and the student.

Standard 13 – Scope of practice experience

Where the opportunity is available, students should be involved in supporting women birthing in a variety of settings.

Student midwives must be involved in the care of a small group of women throughout their childbirth experience, including antenatal, intrapartum and postnatal care. The skills required for taking on the role of lead carer for women with complex medical and/or obstetric needs is developmental and competence is to be achieved after initial registration.

Guidance

Women experience normal childbirth in a variety of settings. Students should gain experience of supporting women birthing in settings other than acute maternity units, such as at home, at birth centres and at midwife-led units. In exceptional circumstances, it is accepted that this may not be possible. However, the NMC would expect all opportunities to be utilised to support students in obtaining a breadth of experience.

20

Clinical practice should provide students with the opportunity to experience 24-hour/seven-day care, enabling them to develop an understanding of the needs and experiences of women and babies throughout a 24-hour period.

Whilst it is essential that students are able to access a full range of practice experiences to achieve the necessary standards, it is for the midwife to decide whether delegation of tasks is appropriate in the care of a woman or her baby. The midwife remains accountable for the appropriateness of any delegation of care.

The primary focus of pre-registration midwifery programmes is to ensure that students are safe and effective in practice when supporting women experiencing normal childbirth. The programme must develop the knowledge and skills of student midwives, so that at the point of registration they are competent and confident in supporting women in normal childbirth. Included in this focus must be skills in critical decision-making to support appropriate referral to other health professionals or agencies when there is recognition of normal processes being adversely affected and compromised. Midwives must know when it is necessary to refer women or their babies to other health professionals, such as obstetricians or paediatricians, to ensure they receive the appropriate care. When women require referral, midwives must also be skilled in working as part of an inter-professional/multi-agency team. Competence in the role of lead midwife carer for women with complex medical or obstetric needs is to be achieved after initial registration.

The student midwife is working towards autonomous practice at the point of registration. She should be assisted to develop the skills needed to work as an effective member of an interprofessional/multi-agency team in which she will provide the lead for midwifery care.

Students must provide care and support to a group of women from early in their pregnancy, throughout the antenatal period, during the labour and birth and then into the postnatal period until care by the midwife is complete. This may take the form of caseload holding. Providing this experience to all student midwives enables them to better understand the impact of pregnancy, birth and the integration of a new baby into family life, as well as learning about the practicalities of planning, implementing and evaluating midwifery care in a way that is relevant to women.

Standard 14 – Supernumerary status during clinical placement

Students undertaking pre-registration midwifery education programmes cannot be employed to provide midwifery care during their training – all clinical experience should be education-led with students having supernumerary status for the duration.

Standard 15 – Assessment strategy

Clinical practice must be graded and be counted as part of the academic award.

All outcomes within a progression point period (for example an academic year) have to be achieved and confirmed within 12 weeks of entering the next academic level. All assessments must be completed and have been passed prior to successful completion of the programme. This is designed to confirm that the student has the theoretical knowledge, practical skills and attitude to achieve the standards required for entry to the midwives’ part of the register.

21

A student midwife shall achieve these standards under the supervision of a sign-off mentor, whose role it will be to confirm when the said standards have been met. The sign-off mentor must be a practising midwife.

Guidance

The learning students undertake in pre-registration midwifery education programmes occurs in the university and in clinical practice. Assessment of practice, which is direct hands-on care, must be graded. The grades achieved must contribute to the outcome of the final academic award. If the assessment of clinical practice involves a variety of components and the student fails to achieve competence in one of the components, then the student must fail.

New programmes approved since 1 September 2008 must be compliant with the standards to grade practice. All programmes approved prior to September 2008 must be compliant with the standard by 1 September 2009.

A progression point is defined as ‘a point (or points) established for the purpose of making summative judgments about safe and effective practice in a programme’. The 12-week time limit includes both theory and practice. It applies equally to full- and part-time programmes and pre-registration short and long programmes. The 12-week period also includes holidays. No extensions to the 12-week period are permitted.

A range of assessment strategies should be used to assess midwifery knowledge, practical skills and attitude. This should include at least one unseen examination. An examination is defined as an unseen piece of work completed under supervised conditions that tests the student’s theoretical knowledge, practical skills and attitude. The form may vary, for example for students with specific learning needs such as dyslexia, or to meet subject needs, eg through the use of objective structured clinical examinations.

Both midwife teachers and midwife mentors shall be involved in assessing the student’s ability to enter the midwives’ part of the register. Although other members of the teaching and health team may contribute to the assessment of student midwives’ theory and practice, they should not undertake summative assessments of the standards required for entry to the midwives’ part of the register. The principles of due regard must be adhered to. The challenges of applying due regard to learning and assessment in practice for student midwives, and ways in which this can be applied more flexibly without compromising the assessment of student competence, are the subject of NMC Circular 2/2008, which can be viewed on the NMC website.

A student who is unsuccessful in passing all elements of the assessment strategy approved by the NMC, including the agreed processes for re-testing, will not be eligible to register as a midwife at the end of the programme.

22

Standard 16 – Ongoing record of achievement

An ongoing record of achievement, including comments from mentors, must be passed from one placement to the next to enable judgments to be made on the student’s progress.

Guidance

The ongoing record of achievement forms part of the Assessment of Practice document and needs to be sufficiently detailed to enable the midwife sign-off mentors to confirm that a student is proficient at designated points in the programme. All actions must be taken with the full knowledge of the student. Mentors should not keep their own separate student progress records; everything should be contained within the Assessment of Practice document.

Education providers must ensure that:

• they obtain the student’s consent to the processing or sharing of confidential data between successive mentors and with relevant education providers in the process of assessing fitness for practice

• robust processes are in place to ensure that where there are issues or concerns about a student’s progress these are promptly and appropriately dealt with

• where there are serious concerns about a student’s health or character, these should be reported promptly using established university procedures

• students are actively supported in addressing issues and concerns through a well defined and time limited development plan, either within a placement or across successive placements

• disabled students are appropriately assessed and supported in addressing the requirements of any development plan.

23

Achieving the NMC standardsStudents need to be proficient in all standards by the end of their training in order to practise safely and effectively as a midwife without the need for direct supervision. A student must demonstrate competence in these standards to enter the register as a midwife. Each of the following statements is followed by some examples of outcomes that must go towards the achievement of these standards. The examples used are not an exhaustive list.

Standard 17 – Competencies required to achieve the NMC standards

These are divided into four domains:

• effective midwifery practice

• professional and ethical practice

• developing the individual midwife and others

• achieving quality care through evaluation and research.

Each category under these headings should be read in conjunction with the relevant Essential Skills Clusters (ESCs), as listed. The ESCs themselves follow this section, beginning on page 36.

Domain: Effective midwifery practiceCommunicate effectively with women and their families throughout the pre-conception, antenatal, intrapartum and postnatal periods. Communication will include:

• listening to women and helping them to identify their feelings and anxieties about their pregnancies, the birth and the related changes to themselves and their lives

• enabling women to think through their feelings

• enabling women to make informed choices about their health and health care

• actively encouraging women to think about their own health and the health of their babies and families, and how this can be improved

• communicating with women throughout their pregnancy, labour and the period following birth.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines management

24

Diagnose pregnancy and assess and monitor women holistically throughout the pre-conception, antenatal, intrapartum and postnatal period using a range of assessment methods and reaching valid, reliable and comprehensive conclusions. The different assessment methods will include:

• history taking

• observation

• physical examination

• biophysical tests

• social, cultural and emotional assessments.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeedingDetermine and provide programmes of care and support for women which:

• are appropriate to the needs, contexts, culture and choices of women, babies and their families

• are made in partnership with women

• are ethical

• are based on best evidence and clinical judgment

• involve other healthcare professionals when this will improve health outcomes.

This will include consideration of:

• plans for birth

• place of birth

• plans for feeding babies

• needs for postnatal support

• preparation for parenthood needs.


25

Provide seamless care and, where appropriate, interventions, in partnership with women and other care providers during the antenatal period which:

• are appropriate for women’s assessed needs, context and culture

• promote their continuing health and wellbeing

• are evidence based

• are consistent with the management of risk

• draw upon the skills of others to optimise health outcomes and resource use.

These will include:

• acting as lead carer in normal pregnancies

• contributing to providing support to women when their pregnancies are in difficulty (such as women who will need operative or assisted delivery)

• providing care for women who have suffered pregnancy loss

• discussion/negotiation with other professionals about further interventions which are appropriate for individual women, considering their wishes, context and culture

• ensuring that current research findings and other evidence are incorporated into practice

• team-working in the best interests of individual women.

ESC – Communication, Initial consultation between the woman and the midwife, Medicines management

26

Refer women who would benefit from the skills and knowledge of other individuals:

• to an individual who is likely to have the requisite skills and experience to assist

• at the earliest possible time

• supported by accurate, legible and complete information which contains the reasoning behind making the referral and describes the woman’s needs and preferences.

Referrals might relate to:

• women’s choices

• health issues

• social issues

• financial issues

• psychological issues

• child protection matters

• the law.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeedingCare for, monitor and support women during labour and monitor the condition of the fetus, supporting spontaneous births. This will include:

• communicating with women throughout and supporting them through the experience

• ensuring that the care is sensitive to individual women’s culture and preferences

• using appropriate clinical and technical means to monitor the condition of mother and fetus

• providing appropriate pain management.

• providing appropriate care to women once they have given birth.

ESC – Communication, Normal labour and birth, Medicines management

27

Undertake appropriate emergency procedures to meet the health needs of women and babies. Emergency procedures will include:

• manual removal of the placenta

• manual examination of the uterus

• managing post-partum haemorrhage

• resuscitation of mother and/or baby

• undiagnosed breech.

ESC – Communication, Normal labour and birth, Medicines managementExamine and care for babies immediately following birth. This will include:

• confirming their vital signs and taking appropriate action

• carrying out a full assessment and physical examination.

ESC – Communication, Normal labour and birth, Medicines management

28

Work in partnership with women and other care providers during the postnatal period to provide seamless care and interventions which:

• are appropriate to the woman’s assessed needs, context and culture

• promote her continuing health and wellbeing

• are evidence based

• are consistent with the management of risk

• are undertaken by the midwife because she is the person best placed to do them and is competent to act

• draw on the skills of others to optimise health outcomes and resource use.

Care will include:

• providing support and advice to women as they start to feed and care for the baby

• providing any particular support which is needed to women who have disabilities

• providing post-operative care for women who have had Caesarean and operative deliveries

• providing pain relief to women

• team-working in the best interests of women and their babies

• facilitating discussion about future reproductive choices

• providing care for women who have suffered pregnancy loss, stillbirth or neonatal death.

ESC – Communication, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines managementExamine and care for babies with specific health or social needs and refer to other professionals or agencies as appropriate. These needs will include:

• child protection

• congenital disorders

• birth defects

• low birth weight

• pathological conditions (such as babies with vertical transmission of HIV and drug-affected babies).

ESC – Communication, Normal labour and birth, Initiation and continuance of breastfeeding

29

Care for and monitor women during the puerperium, offering the necessary evidence-based advice and support regarding the baby and self-care. This will include:

• providing advice and support on feeding babies and teaching women about the importance of nutrition in child development

• providing advice and support on hygiene, safety, protection, security and child development

• enabling women to address issues about their own, their babies’ and their families’ health and social wellbeing

• monitoring and supporting women who have postnatal depression or other mental illnesses

• providing advice on bladder control

• advising women on recuperation

• providing advice on contraception

• supporting women to care for ill/pre-term babies or those with disabilities.

ESC – Communication, Initiation and continuance of breastfeeding, Medicines managementSelect, acquire and administer safely a range of permitted drugs consistent with legislation, applying knowledge and skills to the situation which pertains at the time. Methods of administration will include:

• oral

• intravenous

• intramuscular

• topical

• inhalation.

ESC – Communication, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines Management

30

Complete, store and retain records of practice which:

• are accurate, legible and continuous

• detail the reasoning behind any actions taken

• contain the information necessary for the record’s purpose.

Records will include:

• biographical details of women and babies

• assessments made, outcomes of assessments and action taken as a result

• outcomes of discussions with women and advice offered

• any drugs administered

• action plans and commentary on their evaluation.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines managementMonitor and evaluate the effectiveness of programmes of care and modify them to improve the outcomes for women, babies and their families. This will include:

• consideration of the effectiveness of the above and making the necessary modifications to improve outcomes for women and their babies.

ESC – Communication, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines ManagementContribute to enhancing the health and social wellbeing of individuals and their communities. This will include:

• planning and offering midwifery care within the context of public health policies

• contributing midwifery expertise and information to local health strategies

• identifying and targeting care for groups with particular health and maternity needs and maintaining communication with appropriate agencies

• involving users and local communities in service development and improvement

• informing practice using the best evidence which is shown to prevent and reduce maternal and perinatal morbidity and mortality

• utilising a range of effective, appropriate and sensitive programmes to improve sexual and reproductive health.

ESC – Communication, Initial consultation between the woman and the midwife, Initiation and continuance of breastfeeding

31

Domain: Professional and ethical practicePractise in accordance with The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates,8 within the limitations of the individual’s own competence, knowledge and sphere of professional practice, consistent with the legislation relating to midwifery practice. This will include:

• using professional standards of practice to self-assess performance

• consulting with the most appropriate professional colleagues when care requiresexpertise beyond the midwife’s current competence

• consulting other health care professionals when the woman’s and baby’s needsfall outside the scope of midwifery practice

• identifying unsafe practice and responding appropriately.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines managementPractise in a way which respects, promotes and supports individuals’ rights, interests, preferences, beliefs and cultures. This will include:

• offering culturally sensitive family planning advice

• ensuring that women’s labour is consistent with their religious and cultural beliefsand preferences

• the different roles and relationships in families, and reflecting different religiousand cultural beliefs, preferences and experiences.


8 The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates, Nursing and Midwifery Council, London, (www.nmc.org.uk)

32

Practise in accordance with relevant legislation. This will include:

• practising within the contemporary legal framework of midwifery

• demonstrating knowledge of legislation relating to human rights, equalopportunities, equality and diversity, and access to client records

• demonstrating knowledge of legislation relating to health and social policy relevantto midwifery practice

• demonstrating knowledge of contemporary ethical issues and their impact onmidwifery practice

• managing the complexities arising from ethical and legal dilemmas.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeeding, Medicines managementMaintain confidentiality of information. This will include:

• ensuring the confidentiality and security of written and verbal information acquiredin a professional capacity

• disclosing information about individuals and organisations only to those who havea right and need to know this information, and only once proof of identity and rightto disclosure has been obtained.


33

Work collaboratively with the wider healthcare team and agencies in ways which:

• value their contribution to health and care

• enable them to participate effectively in the care of women, babies and their families

• acknowledge the nature of their work and the context in which it is placed.

The wider healthcare team and agencies will include those who work in:

• health care

• social care

• social security, benefits and housing

• advice, guidance and counselling

• child protection

• the law.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeedingManage and prioritise competing demands. This will include:

• deciding who is best placed and best able to provide particular interventions to women, babies and their families

• alerting managers to difficulties and issues in service delivery.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeedingSupport the creation and maintenance of environments that promote the health, safety and wellbeing of women, babies and others. This will include:

• preventing and controlling infection

• promoting health, safety and security in the environment in which the midwife is working, whether it be at a woman’s home, in the community, a clinic, or in a hospital.


34

Contribute to the development and evaluation of guidelines and policies and make recommendations for change in the interests of women, babies and their families. Evaluating policies will include:

• consideration of best available evidence

• providing feedback to managers on service policies

• representing the midwife’s own considered views and experiences within the context of broader health and social care policies in the interests of women, babies and their families.

ESC – Communication

Domain: Developing the individual midwife and othersReview, develop and enhance the midwife’s own knowledge, skills and fitness to practise. This will include:

• meeting the NMC ’s continuing professional development and practice standards

•

reflecting on the midwife’s own practice and making the necessary changes as a result

•

attending conferences, presentations and other learning events.


Demonstrate effective working across professional boundaries and develop professional networks. This will include:

• effective collaboration and communication

• sharing skills

• multi-professional standard-setting and audit.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeeding

35

Domain: Achieving quality care through evaluation and researchApply relevant knowledge to the midwife’s own practice in structured ways which are capable of evaluation. This will include:

• critical appraisal of knowledge and research evidence

• critical appraisal of the midwife’s own practice

• gaining feedback from women and their families and appropriately applying this to practice

• disseminating critically appraised good practice.

ESC – CommunicationInform and develop the midwife’s own practice and the practice of others through using the best available evidence and reflecting on practice. This will include:

• keeping up to date with evidence

• applying evidence to practice

• alerting others to new evidence for them to apply to their own practice.

ESC – CommunicationManage and develop care utilising the most appropriate information technology (IT) systems. This will include:

• recording practice in consistent formats on IT systems for wider-scale analysis

• using analysis of data from IT systems and applying this to practice

• evaluating practice based on data analysis.

ESC – Communication, Initial consultation between the woman and the midwife, Normal labour and birth, Initiation and continuance of breastfeedingContribute to the audit of practice in order to optimise the care of women, babies and their families. This will include:

• auditing the individual’s own practice

• contributing to the audit of team practice.


The Essential Skills Clusters

Essential Skills Clusters (ESCs) came into force in September 2008. All new programmes approved from 1 September 2008 must be compliant with them. All programmes approved prior to 1 September 2008 must be compliant with them by 1 September 2009.

36

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thei

r car

e by

info

rmin

g w

omen

of t

he c

hoic

es

avai

labl

e to

them

and

pr

ovid

ing

evid

ence

ba

sed

info

rmat

ion

abou

t ben

efits

and

ris

ks o

f opt

ions

so

that

w

omen

can

mak

e a

fully

in

form

ed d

ecis

ion.

Par

ticip

ates

in s

harin

g ev

iden

ce-b

ased

in

form

atio

n w

ith w

omen

in o

rder

for t

hem

to

mak

e an

info

rmed

dec

isio

n ab

out t

heir

care

Res

pect

s th

e ro

le o

f wom

en a

s pa

rtner

s in

th

eir c

are

and

cont

ribut

ions

they

can

mak

e to

it

Use

s ap

prop

riate

stra

tegi

es to

enc

oura

ge

and

prom

ote

choi

ce fo

r all

wom

en

Pro

vide

s ac

cura

te, t

ruth

ful a

nd b

alan

ced

info

rmat

ion

that

is p

rese

nted

in s

uch

a w

ay

as to

mak

e it

easi

ly u

nder

stoo

d

Res

pect

s w

omen

’s a

uton

omy

whe

n m

akin

g a

deci

sion

, eve

n w

here

a p

artic

ular

cho

ice

may

resu

lt in

har

m to

them

selv

es o

r the

ir un

born

chi

ld, u

nles

s a

cour

t of l

aw o

rder

s th

e co

ntra

ry

Dis

cuss

es w

ith w

omen

loca

l/nat

iona

l in

form

atio

n to

ass

ist w

ith m

akin

g ch

oice

s,

incl

udin

g lo

cal a

nd n

atio

nal v

olun

tary

ag

enci

es a

nd w

ebsi

tes

39

Com

mun

icat

ion

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

4.En

sure

that

con

sent

will

be

soug

ht fr

om th

ew

oman

prio

r to

care

bein

g gi

ven

and

that

the

right

s of

wom

en a

rere

spec

ted.

App

lies

prin

cipl

es o

f con

sent

in a

ccor

danc

e w

ith T

he C

ode:

Pro

fess

iona

l sta

ndar

ds o

f pr

actic

e an

d be

havi

our f

or n

urse

s, m

idw

ives

an

d nu

rsin

g as

soci

ates

Par

ticip

ates

in e

nsur

ing

that

the

mea

ning

of

cons

ent i

s un

ders

tood

by

the

wom

an

Wor

ks w

ithin

lega

l fra

mew

orks

whe

n se

ekin

g co

nsen

t

See

ks c

onse

nt p

rior t

o sh

arin

g co

nfide

ntia

l in

form

atio

n ou

tsid

e of

the

prof

essi

onal

ca

re te

am (s

ubje

ct to

agr

eed

safe

guar

ding

/pr

otec

tion

proc

edur

es)

Use

s ap

prop

riate

stra

tegi

es to

ena

ble

wom

en to

und

erst

and

treat

men

ts a

nd

inte

rven

tions

in o

rder

to g

ive

info

rmed

co

nsen

t

Dem

onst

rate

s re

spec

t for

clie

nt a

uton

omy

and

the

right

s of

wom

en to

with

hold

con

sent

in

rela

tion

to c

are

and

treat

men

t with

in le

gal

fram

ewor

ks5.

Trea

t wom

en w

ithdi

gnity

and

resp

ect t

hem

as in

divi

dual

s.

Take

s a

wom

an-c

entre

d ap

proa

ch to

car

e

Dem

onst

rate

s re

spec

t for

div

ersi

ty a

nd

indi

vidu

al p

refe

renc

es

App

lies

the

conc

ept o

f dig

nity

Act

s pr

ofes

sion

ally

to e

nsur

e th

at p

erso

nal

judg

men

ts, p

reju

dice

s, v

alue

s, a

ttitu

des

and

belie

fs d

o no

t com

prom

ise

the

care

pr

ovid

ed

Is p

roac

tive

in m

aint

aini

ng d

igni

ty

Cha

lleng

es s

ituat

ions

/oth

ers

whe

re th

e di

gnity

of t

he w

oman

may

be

com

prom

ised

40

Com

mun

icat

ion

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Del

iver

s ca

re w

ith d

igni

ty m

akin

g us

e of

the

envi

ronm

ent,

self,

ski

lls a

nd a

ttitu

de

Iden

tifies

fact

ors

whi

ch m

aint

ain

the

dign

ity

of w

omen

Act

s in

a w

ay th

at d

emon

stra

tes

resp

ect

for o

ther

s an

d th

at p

rom

otes

and

val

ues

diffe

renc

es

Sha

res

info

rmat

ion

confi

dent

ly w

ith w

omen

w

ho h

ave

phys

ical

, cog

nitiv

e or

sen

sory

di

sabi

litie

s an

d th

ose

who

do

not s

peak

or

read

Eng

lish

6.W

ork

in p

artn

ersh

ipw

ith w

omen

in a

man

ner t

hat i

s di

vers

ityse

nsiti

ve a

nd is

free

from

dis

crim

inat

ion,

hara

ssm

ent a

ndex

ploi

tatio

n.

Par

ticip

ates

in w

orki

ng in

par

tner

ship

with

w

omen

in a

way

that

is s

ensi

tive

to a

ge,

cultu

re, r

elig

ion,

spi

ritua

l bel

iefs

, dis

abili

ty,

gend

er a

nd s

exua

l orie

ntat

ion

Res

pect

s pe

ople

’s ri

ghts

Ado

pts

a pr

inci

pled

app

roac

h to

car

e un

derp

inne

d by

The

Cod

e: P

rofe

ssio

nal

stan

dard

s of

pra

ctic

e an

d be

havi

our f

or

nurs

es, m

idw

ives

and

nur

sing

ass

ocia

tes

Uph

olds

the

right

s of

the

wom

en a

nd

spea

ks o

ut w

hen

thes

e ar

e at

risk

of b

eing

co

mpr

omis

ed

Take

s in

to a

ccou

nt U

K le

gal f

ram

ewor

ks

and

prof

essi

onal

eth

ics

whe

n pl

anni

ng c

are

Is p

roac

tive

in p

rom

otin

g ca

re e

nviro

nmen

ts

that

are

div

ersi

ty s

ensi

tive

and

free

from

ex

ploi

tatio

n, d

iscr

imin

atio

n an

d ha

rass

men

t

Man

ages

cha

lleng

ing

situ

atio

ns e

ffect

ivel

y

41

Com

mun

icat

ion

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

7. P

rovi

de c

are

that

is

del

iver

ed in

a

war

m, s

ensi

tive

and

com

pass

iona

te w

ay.

Is a

ttent

ive

and

acts

with

kin

dnes

s an

d di

gnity

Rec

ogni

ses

the

appr

opria

tene

ss o

f sile

nce

in c

erta

in s

ituat

ions

Is a

ble

to in

itiat

e a

conv

ersa

tion

Take

s in

to a

ccou

nt th

e w

oman

’s re

spon

ses

Talk

s in

a m

anne

r tha

t is

inte

rpre

ted

by

the

wom

an a

s w

arm

, sen

sitiv

e, k

ind

and

com

pass

iona

te

Mai

ntai

ns a

sup

porti

ve re

latio

nshi

p w

ith

wom

en a

nd th

eir f

amili

es

Ant

icip

ates

how

a w

oman

mig

ht fe

el in

a

give

n si

tuat

ion

and

resp

onds

with

kin

dnes

s an

d em

path

y to

pro

vide

phy

sica

l and

em

otio

nal c

omfo

rt

Mak

es a

ppro

pria

te u

se o

f tou

ch

List

ens

to, w

atch

es fo

r, an

d re

spon

ds to

ve

rbal

and

non

-ver

bal c

ues

Del

iver

s ca

re th

at re

cogn

ises

nee

d an

d pr

ovid

es b

oth

prac

tical

and

em

otio

nal

supp

ort

Has

insi

ght i

nto

own

valu

es a

nd h

ow th

ese

may

impa

ct o

n in

tera

ctio

ns w

ith w

omen

Doe

s no

t allo

w p

erso

nal f

eelin

gs to

war

ds a

cl

ient

or o

ther

s to

com

prom

ise

care

Rec

ogni

ses

and

resp

onds

to e

mot

iona

l di

scom

fort/

dist

ress

of s

elf a

nd o

ther

s

Thro

ugh

refle

ctio

n an

d ev

alua

tion

dem

onst

rate

s co

mm

itmen

t to

pers

onal

and

pr

ofes

sion

al d

evel

opm

ent

42

Com

mun

icat

ion

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

mid

wife

to:

For e

ntry

to th

e re

gist

er

thei

r ow

n ro

le w

ithin

a

mul

ti-di

scip

linar

y/

mul

ti-ag

ency

team

.

Wor

ks w

ithin

The

Cod

e: P

rofe

ssio

nal

stan

dard

s o f

prac

tice

and

beh

avio

ur fo

r nu

rses

,mid

wiv

es a

nd n

ursi

ng a

ssoc

iate

s

Wor

ks a

s an

act

ive

team

mem

ber

Supp

orts

and

ass

ists

oth

ers

appr

opria

tely

Valu

es o

ther

s’ ro

les

and

resp

onsi

bilit

ies

with

in th

e te

am a

nd in

tera

cts

appr

opria

tely

Com

mun

icat

es w

ith c

olle

ague

s ve

rbal

ly

(face

-to-fa

ce a

nd b

y te

leph

one)

and

in

writ

ing

and

elec

troni

cally

and

che

cks

that

the

com

mun

icat

ion

has

been

fully

un

ders

tood

issu

es w

ith o

ther

mem

bers

of t

he te

am to

en

hanc

e le

arni

ng

Cons

ults

and

exp

lore

s so

lutio

ns a

nd id

eas

appr

opria

tely

with

oth

ers

to e

nhan

ce c

are

Chal

leng

es th

e pr

actic

e of

sel

f and

oth

ers

acro

ss th

e m

ulti-

prof

essi

onal

team

Act

s as

an

e�ec

tive

role

mod

el in

dec

isio

n m

akin

g, ta

king

act

ion

and

supp

ortin

g m

ore

juni

or s

ta�

Wor

ks in

ter-

prof

essi

onal

ly a

s a

mea

ns o

f ac

hiev

ing

optim

um o

utco

mes

for w

omen

43

Esse

ntia

l Ski

lls C

lust

ers

(ESC

s) fo

r pre

-reg

istr

atio

n m

idw

ifery

edu

catio

n2.

Initi

al c

onsu

ltatio

n be

twee

n th

e w

oman

and

the

mid

wife

Initi

al c

onsu

ltatio

n be

twee

n th

e w

oman

and

the

mid

wife

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

Fo

r ent

ry to

the

regi

ster

1. B

e co

nfide

nt in

sh

arin

g in

form

atio

n ab

out c

omm

on a

nten

atal

sc

reen

ing

test

s.

Is a

war

e of

the

mai

n N

HS

-man

aged

an

tena

tal s

cree

ning

pro

gram

mes

that

are

of

fere

d to

pre

gnan

t wom

en

Par

ticip

ates

in s

harin

g in

form

atio

n w

ith

wom

en a

bout

com

mon

ant

enat

al s

cree

ning

te

sts

Can

resp

ect t

he d

ecis

ion

of w

omen

to

decl

ine

serv

ices

or t

reat

men

t

Act

s pr

ofes

sion

ally

to e

nsur

e th

at p

erso

nal

judg

men

ts, p

reju

dice

s, v

alue

s, a

ttitu

des

and

belie

fs d

o no

t com

prom

ise

the

prov

isio

n of

ca

re

Faci

litat

es in

form

ed c

hoic

es re

gard

ing

ante

nata

l scr

eeni

ng te

sts

ensu

ring

wom

en

fully

und

erst

and

the

purp

ose

of a

ll te

sts

befo

re th

ey a

re ta

ken

Inte

rpre

ts d

ata/

resu

lts a

ccur

atel

y an

d sh

ares

this

info

rmat

ion

sens

itive

ly w

ith

wom

en, i

nclu

ding

the

abili

ty to

dis

cuss

any

fu

rther

act

ion/

cons

eque

nces

as

nece

ssar

y

Con

duct

s ge

nera

l inf

orm

atio

n sh

arin

g,

eg o

ptim

um ti

mes

for t

estin

g, a

s ap

prop

riate

th

roug

h a

varie

ty o

f mul

ti-m

edia

cha

nnel

s,

such

as

text

ing

Sha

res

info

rmat

ion

effe

ctiv

ely

in c

halle

ngin

g ci

rcum

stan

ces,

suc

h as

a p

revi

ous

bere

avem

ent,

or a

ffect

ed/h

igh

risk

scre

enin

g re

sult

Dis

cuss

es w

ith w

omen

loca

l/nat

iona

l in

form

atio

n to

ass

ist w

ith m

akin

g ch

oice

s,

incl

udin

g lo

cal a

nd n

atio

nal v

olun

tary

ag

enci

es a

nd w

ebsi

tes

44

Initi

al c

onsu

ltatio

n be

twee

n th

e w

oman

and

the

mid

wife

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Is a

ble

to s

eek

out r

equi

red

info

rmat

ion

abou

t les

s co

mm

on/s

peci

alis

ed a

nten

atal

sc

reen

ing

test

s2.

Com

plet

e an

initi

al

cons

ulta

tion

accu

rate

ly

ensu

ring

wom

en a

re a

t th

e ce

ntre

of c

are.

Ens

ures

con

sent

is o

btai

ned

befo

re a

ny

care

is in

itiat

ed

Ass

ists

in d

eter

min

ing

pref

eren

ces

to

max

imis

e an

indi

vidu

al a

ppro

ach

to c

are

Par

ticip

ates

in e

xpla

inin

g to

wom

en th

e ai

m o

f the

initi

al c

onsu

ltatio

n re

leva

nt to

ge

stat

ion

Par

ticip

ates

in a

sses

sing

mat

erna

l and

fe

tal w

ellb

eing

, rel

evan

t to

the

stag

e of

pr

egna

ncy

Par

ticip

ates

in e

xpla

inin

g fin

ding

s in

a

sens

itive

man

ner a

nd e

ncou

rage

s w

omen

to

ask

que

stio

ns

Par

ticip

ates

in e

xpla

inin

g to

wom

en li

fest

yle

cons

ider

atio

ns in

rela

tion

to d

iet,

smok

ing

and

drug

s

Sho

ws

the

abili

ty c

onsi

sten

tly to

:

shar

e in

form

atio

n w

ith w

omen

asse

ss m

ater

nal a

nd fe

tal w

ellb

eing

re

leva

nt to

ges

tatio

n, a

nd a

cts

upon

the

need

to re

fer t

o ap

prop

riate

indi

vidu

als

whe

re n

eces

sary

plan

, in

partn

ersh

ip w

ith w

omen

, a c

are

path

way

to e

nsur

e in

divi

dual

nee

ds a

re m

et

Exp

lore

effe

ctiv

ely

the

soci

al, r

elig

ious

and

cu

ltura

l fac

tors

that

info

rm a

n in

divi

dual

ised

an

tena

tal c

are

path

way

for w

omen

that

is

dive

rsity

sen

sitiv

e

Is c

ompe

tent

in re

cogn

isin

g an

d ad

visi

ng

wom

en w

ho w

ould

ben

efit f

rom

mor

e sp

ecia

list s

ervi

ces

Em

pow

ers

wom

en to

reco

gnis

e no

rmal

pr

egna

ncy

deve

lopm

ent a

nd w

hen

to s

eek

advi

ce

Is s

kille

d in

pro

vidi

ng th

e op

portu

nity

to

wom

en to

dis

clos

e do

mes

tic a

buse

and

is

able

to re

spon

d ap

prop

riate

ly

45

Initi

al c

onsu

ltatio

n be

twee

n th

e w

oman

and

the

mid

wife

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Is a

ble

to s

eek

out r

equi

red

info

rmat

ion

abou

t les

s co

mm

on/s

peci

alis

ed a

nten

atal

sc

reen

ing

test

s2.

Com

plet

e an

initi

al

cons

ulta

tion

accu

rate

ly

ensu

ring

wom

en a

re a

t th

e ce

ntre

of c

are.

Ens

ures

con

sent

is o

btai

ned

befo

re a

ny

care

is in

itiat

ed

Ass

ists

in d

eter

min

ing

pref

eren

ces

to

max

imis

e an

indi

vidu

al a

ppro

ach

to c

are

Par

ticip

ates

in e

xpla

inin

g to

wom

en th

e ai

m o

f the

initi

al c

onsu

ltatio

n re

leva

nt to

ge

stat

ion

Par

ticip

ates

in a

sses

sing

mat

erna

l and

fe

tal w

ellb

eing

, rel

evan

t to

the

stag

e of

pr

egna

ncy

Par

ticip

ates

in e

xpla

inin

g fin

ding

s in

a

sens

itive

man

ner a

nd e

ncou

rage

s w

omen

to

ask

que

stio

ns

Par

ticip

ates

in e

xpla

inin

g to

wom

en li

fest

yle

cons

ider

atio

ns in

rela

tion

to d

iet,

smok

ing

and

drug

s

Sho

ws

the

abili

ty c

onsi

sten

tly to

:

shar

e in

form

atio

n w

ith w

omen

asse

ss m

ater

nal a

nd fe

tal w

ellb

eing

re

leva

nt to

ges

tatio

n, a

nd a

cts

upon

the

need

to re

fer t

o ap

prop

riate

indi

vidu

als

whe

re n

eces

sary

plan

, in

partn

ersh

ip w

ith w

omen

, a c

are

path

way

to e

nsur

e in

divi

dual

nee

ds a

re m

et

Exp

lore

effe

ctiv

ely

the

soci

al, r

elig

ious

and

cu

ltura

l fac

tors

that

info

rm a

n in

divi

dual

ised

an

tena

tal c

are

path

way

for w

omen

that

is

dive

rsity

sen

sitiv

e

Is c

ompe

tent

in re

cogn

isin

g an

d ad

visi

ng

wom

en w

ho w

ould

ben

efit f

rom

mor

e sp

ecia

list s

ervi

ces

Em

pow

ers

wom

en to

reco

gnis

e no

rmal

pr

egna

ncy

deve

lopm

ent a

nd w

hen

to s

eek

advi

ce

Is s

kille

d in

pro

vidi

ng th

e op

portu

nity

to

wom

en to

dis

clos

e do

mes

tic a

buse

and

is

able

to re

spon

d ap

prop

riate

ly

Initi

al c

onsu

ltatio

n be

twee

n th

e w

oman

and

the

mid

wife

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Is c

ompe

tent

in s

harin

g in

form

atio

n ab

out

the

preg

nanc

y ca

re s

ervi

ces

and

optio

ns

avai

labl

e, li

fest

yle

cons

ider

atio

ns, i

nclu

ding

di

etar

y in

form

atio

n, a

nd s

cree

ning

test

s3.

Wor

k co

llabo

rativ

ely

with

oth

er h

ealth

care

pr

ofes

sion

als

and

exte

rnal

age

ncie

s.

Wor

ks a

long

side

oth

er h

ealth

care

pr

ofes

sion

als

who

inpu

t int

o an

tena

tal c

are

Is c

ompe

tent

to re

fer w

omen

who

wou

ld

bene

fit fr

om m

ore

spec

ialis

t ser

vice

s, s

uch

as a

loca

l sub

stan

ce m

isus

e su

ppor

t uni

t

Is a

ble

to c

olla

bora

te e

ffect

ivel

y w

ith th

e w

ider

hea

lthca

re te

am a

nd a

genc

ies

as

requ

ired

4. B

e th

e fir

st p

oint

of

con

tact

whe

n se

ekin

g ad

vice

and

/or

info

rmat

ion

abou

t bei

ng

preg

nant

.

Dem

onst

rate

s ho

w a

nd w

here

mid

wiv

es c

an

be a

cces

sed

as th

e fir

st p

oint

of c

onta

ctW

here

ava

ilabl

e, is

act

ivel

y in

volv

ed

in b

eing

acc

essi

ble

for w

omen

in

envi

ronm

ents

oth

er th

an tr

aditi

onal

NH

S

setti

ngs,

suc

h as

sho

ps, s

uper

mar

kets

, le

isur

e ce

ntre

s

Is c

onfid

ent i

n w

orki

ng in

a v

arie

ty o

f m

odel

s of

ser

vice

del

iver

y w

hich

enc

oura

ge

early

acc

ess

to c

are

46

Esse

ntia

l Ski

lls C

lust

ers

(ESC

s) fo

r pre

-reg

istr

atio

n m

idw

ifery

edu

catio

n3.

Nor

mal

labo

ur a

nd b

irth

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

1. W

ork

in p

artn

ersh

ip

with

wom

en to

faci

litat

e a

birt

h en

viro

nmen

t tha

t su

ppor

ts th

eir n

eeds

.

Ens

ures

a w

oman

-cen

tred

appr

oach

to c

are

Is s

ensi

tive

to c

ultu

ral a

nd s

ocia

l fac

tors

w

hen

prov

idin

g ca

re fo

r wom

en

Res

pect

s th

e rig

hts

of w

omen

Ens

ures

priv

acy

and

prov

ides

car

e w

ith

dign

ity m

akin

g ap

prop

riate

use

of t

he

envi

ronm

ent

Par

ticip

ates

in ‘b

eing

with

wom

en’ d

urin

g th

eir l

abou

r and

birt

h to

pro

vide

saf

e an

d se

nsiti

ve c

are

Inco

rpor

ates

birt

h pl

ans

or w

ritte

n in

stru

ctio

ns th

at id

entif

y th

e w

ishe

s of

w

omen

, in

any

care

pro

vide

d

Res

pect

s si

lenc

e

Par

ticip

ates

in c

hang

ing

the

phys

ical

en

viro

nmen

t to

mee

t the

nee

ds o

f wom

en,

such

as

light

ing,

furn

iture

, tem

pera

ture

Sup

ports

the

heal

th, s

afet

y an

d w

ellb

eing

of

wom

en in

a v

arie

ty o

f birt

h se

tting

s ot

her

than

the

acut

e ho

spita

l env

ironm

ent

Ens

ures

that

wom

en’s

labo

ur a

nd b

irth

is

dive

rsity

sen

sitiv

e, m

eetin

g th

eir i

ndiv

idua

l ne

eds

and

pref

eren

ces

Ant

icip

ates

and

pro

vide

for t

he n

eeds

of

wom

en

Insp

ires

confi

denc

e, b

ases

dec

isio

ns o

n ev

iden

ce a

nd u

ses

expe

rienc

e to

gui

de

deci

sion

mak

ing

Ack

now

ledg

es th

e ro

les

and

rela

tions

hips

in

fam

ilies

, dep

ende

nt u

pon

relig

ious

an

d cu

ltura

l bel

iefs

, pre

fere

nces

and

ex

perie

nces

Pra

ctis

es in

acc

orda

nce

with

rele

vant

le

gisl

atio

n

47

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

2. B

e at

tent

ive

to th

e co

mfo

rt n

eeds

of w

omen

be

fore

, dur

ing

and

afte

r th

e bi

rth.

Par

ticip

ates

in e

nsur

ing

the

com

fort

need

s of

wom

en a

re m

et, s

uch

as:

• bl

adde

r car

e

• ap

prop

riate

hyd

ratio

n

• nu

tritio

nal i

ntak

e

• hy

gien

e re

quire

men

ts

• pr

even

tion

of in

fect

ion

• as

sess

men

t of s

kin

inte

grity

Par

ticip

ates

in w

orki

ng w

ith w

omen

to

dete

rmin

e th

eir c

opin

g st

rate

gies

in o

rder

to

sup

port

thei

r pre

fere

nces

for p

ain

man

agem

ent,

such

as

mob

ilisi

ng, d

iffer

ent

posi

tions

, use

of w

ater

, sile

nce

List

ens

to, w

atch

es fo

r, an

d re

spon

ds to

ve

rbal

and

non

-ver

bal c

ues

App

lies

in-d

epth

kno

wle

dge

of th

e ph

ysio

logy

of l

abou

r and

birt

h

Use

s sk

ills

of o

bser

vatio

n an

d ac

tive

liste

ning

in o

rder

to a

naly

se th

e ef

fect

iven

ess

of c

are

bein

g pr

ovid

ed

3. D

eter

min

e th

e on

set

of la

bour

.P

artic

ipat

es in

usi

ng o

bser

vatio

n, h

isto

ry

taki

ng a

nd c

linic

al a

sses

smen

t to

dete

rmin

e th

e on

set o

f lab

our

Iden

tifies

the

onse

t of l

abou

r, di

scus

ses

the

findi

ngs

accu

rate

ly a

nd s

hare

s th

is

info

rmat

ion

with

wom

en, i

nclu

ding

the

abili

ty

to d

iscu

ss a

ny fu

rther

act

ion/

cons

eque

nces

as

nec

essa

ry

48

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

4. D

eter

min

e th

e w

ellb

eing

of w

omen

and

th

eir u

nbor

n ba

bies

.

Par

ticip

ates

in th

e m

onito

ring

of m

ater

nal

vita

l sig

ns, s

uch

as m

ater

nal p

ulse

and

bl

ood

pres

sure

Par

ticip

ates

in m

onito

ring

feta

l wel

lbei

ng

whi

ch in

clud

es a

sses

smen

t of l

iquo

r vol

ume

and

colo

ur a

nd in

term

itten

t aus

culta

tion

of

the

feta

l hea

rt us

ing

a P

inar

d st

etho

scop

e

Ass

esse

s m

ater

nal w

ellb

eing

, int

erpr

ets

the

findi

ngs

accu

rate

ly a

nd s

hare

s th

is

info

rmat

ion

with

wom

en, a

nd h

as th

e ab

ility

to

dis

cuss

any

furth

er a

ctio

n/co

nseq

uenc

es

as n

eces

sary

Iden

tifies

and

man

ages

risk

saf

ely

Ref

ers

wom

en w

ho w

ould

ben

efit f

rom

the

skill

s an

d kn

owle

dge

of o

ther

indi

vidu

als

Ass

esse

s an

d im

plem

ents

mea

sure

s to

m

anag

e, re

duce

or r

emov

e ris

k th

at c

ould

be

det

rimen

tal t

o w

omen

, sel

f and

oth

ers

5. M

easu

re, a

sses

s an

d fa

cilit

ate

the

prog

ress

of

norm

al la

bour

.

Par

ticip

ates

in a

sses

sing

the

prog

ress

of

labo

ur u

sing

:

• ob

serv

atio

n, s

uch

as b

ehav

iour

• ab

dom

inal

exa

min

atio

n

• va

gina

l exa

min

atio

n w

here

app

ropr

iate

Par

ticip

ates

in in

form

ing

wom

en s

ensi

tivel

y ab

out t

heir

prog

ress

, giv

ing

feed

back

in a

po

sitiv

e m

anne

r

Iden

tifies

and

app

ropr

iate

ly m

anag

es la

tent

an

d ac

tive

phas

e of

labo

ur

Mak

es a

n ac

cura

te a

sses

smen

t of t

he

prog

ress

of l

abou

r, sh

ares

this

info

rmat

ion

with

wom

en, a

nd h

as th

e ab

ility

to d

iscu

ss

any

furth

er a

ctio

n/co

nseq

uenc

es a

s ne

cess

ary

49

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Ass

ists

in s

uppo

rting

wom

en to

use

a

varie

ty o

f birt

hing

aid

s, s

uch

as b

irthi

ng

balls

Is a

ble

to d

iscu

ss w

ith w

omen

the

prog

ress

of

labo

ur in

rela

tion

to th

eir b

irth

plan

/writ

ten

wis

hes

and

mod

ify in

par

tner

ship

with

w

omen

, as

need

dic

tate

s

Crit

ical

ly a

ppra

ises

and

just

ifies

the

use

of

any

inte

rven

tion,

suc

h as

arti

ficia

l rup

ture

of

mem

bran

es, c

ontin

uous

ele

ctro

nic

feta

l m

onito

ring,

urin

ary

cath

eter

isat

ion,

in o

rder

to

faci

litat

e a

spon

tane

ous

vagi

nal b

irth

See

ks in

form

ed c

onse

nt p

rior t

o un

derta

king

any

pro

cedu

re

Rec

ogni

ses

any

devi

atio

n fro

m th

e no

rmal

pr

ogre

ss o

f lab

our o

r wel

lbei

ng o

f the

w

oman

or f

etus

Initi

ates

tim

ely

refe

rral

of w

omen

who

wou

ld

bene

fit fr

om th

e sk

ills

and

know

ledg

e of

ot

hers

As

part

of a

mul

ti-di

scip

linar

y te

am

cont

inue

s to

pro

vide

car

e to

wom

en

unde

rgoi

ng c

ompl

icat

ions

50

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

6. S

uppo

rt w

omen

and

th

eir p

artn

ers

in th

e bi

rth

of th

eir b

abie

s.

Rec

ogni

ses

the

impo

rtanc

e of

offe

ring

choi

ces

rela

ted

to th

is p

hase

and

sen

sitiv

ely

info

rms

wom

en o

f the

ir pr

ogre

ss

Rec

ogni

ses

the

late

nt a

nd a

ctiv

e ph

ase

of

birth

Ass

ists

in p

repa

ring

nece

ssar

y eq

uipm

ent

for t

he b

irth

Ass

ists

in m

onito

ring

mat

erna

l and

feta

l w

ellb

eing

Ass

esse

s ac

cura

tely

the

prog

ress

of l

abou

r an

d sh

ares

this

info

rmat

ion

with

wom

en,

and

has

the

abili

ty to

dis

cuss

any

furth

er

actio

n/co

nseq

uenc

es a

s ne

cess

ary

Pre

pare

s th

e en

viro

nmen

t rea

dy fo

r the

bi

rth

Car

es fo

r wom

en s

ensi

tivel

y an

d is

at

tent

ive

to th

e ‘m

omen

t of b

irth’

, cre

atin

g an

env

ironm

ent t

hat i

s re

spon

sive

to th

e w

oman

’s n

eeds

Sup

ports

wom

en s

afel

y in

the

birth

of t

heir

baby

Initi

ates

em

erge

ncy

mea

sure

s if

requ

ired,

su

ch a

s ep

isio

tom

y

Initi

ates

tim

ely

refe

rral

of w

omen

who

wou

ld

bene

fit fr

om th

e sk

ills

and

know

ledg

e of

ot

hers

As

part

of a

mul

ti-di

scip

linar

y te

am

cont

inue

s to

pro

vide

car

e to

wom

en

unde

rgoi

ng c

ompl

icat

ions

51

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:B

y th

e fir

st p

rogr

essi

on p

oint

For e

ntry

to th

e re

gist

er

Ass

ess

and

mon

itor t

he w

oman

’s c

ondi

tion

thro

ugho

ut th

e th

ird s

tage

of l

abou

r fa

cilit

atin

g sa

fe d

eliv

ery

of th

e pl

acen

ta

and

mem

bran

es b

y ph

ysio

logi

cal o

r act

ive

man

agem

ent

7. F

acili

tate

the

mot

her

and

baby

to re

mai

n to

geth

er.

Ass

ists

in a

sses

sing

the

wel

lbei

ng o

f the

ba

by

Sup

ports

feed

ing

whe

n th

e ba

by is

read

y,

mon

itorin

g cl

ose

prox

imity

of t

he m

othe

r to

the

baby

Del

ays

any

unne

cess

ary

sepa

ratio

n of

m

othe

r and

bab

y, a

void

ing

early

rout

ine

proc

edur

es s

uch

as w

eigh

ing

Ass

esse

s ac

cura

tely

the

heal

th a

nd

wel

lbei

ng o

f the

new

born

bab

y

Initi

ates

em

erge

ncy

mea

sure

s if

requ

ired

In a

cul

tura

lly s

ensi

tive

man

ner,

crea

tes

an e

nviro

nmen

t tha

t is

prot

ectiv

e of

the

mat

erna

l inf

ant a

ttach

men

t pro

cess

, su

ch a

s m

inim

al h

andl

ing

of th

e ba

by,

disc

over

ing

gend

er, f

oste

ring

mat

erna

l in

fant

eye

con

tact

, ski

n-to

-ski

n co

ntac

t8.

Iden

tify

and

safe

ly

man

age

appr

opria

te

emer

genc

y pr

oced

ures

.

Par

ticip

ates

in ‘d

rills

and

ski

lls’ p

roce

dure

s re

late

d to

adu

lt re

susc

itatio

n

Is c

onfid

ent i

n in

itiat

ing

basi

c em

erge

ncy

call

proc

edur

es re

leva

nt to

loca

l pol

icy

Initi

ates

em

erge

ncy

mea

sure

s in

bot

h pr

imar

y an

d se

cond

ary

care

set

tings

Sus

tain

s em

erge

ncy

mea

sure

s un

til h

elp

arriv

es

52

Nor

mal

labo

ur a

nd b

irth

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

mid

wife

to:

For e

ntry

to th

e re

gist

er

9.W

orks

col

labo

rativ

ely

with

oth

er p

ract

ition

ers.

Act

s in

acc

orda

nce

with

The

Cod

e:

Prof

essi

onal

stan

dard

s of

pra

ctic

e an

d b

ehav

iour

for n

urse

s, m

idw

ives

and

nur

sing

as

soci

ates

Is a

n ad

voca

te fo

r wom

en

Neg

otia

tes

with

oth

ers

in re

latio

n to

Art

icul

ates

pro

fess

iona

l lim

itatio

ns a

nd

boun

darie

s

rega

rdle

ss o

f hie

rarc

hy, w

hen

care

requ

ires

expe

rtis

e be

yond

the

mid

wife

’s cu

rren

t pr

actic

e, o

r the

nee

ds o

f the

wom

en o

r bab

y fa

ll ou

tsid

e th

e sc

ope

of m

idw

ifery

pra

ctic

e

10 K

eep

accu

rate

re

cord

s.A

ssis

ts in

kee

ping

acc

urat

e an

d le

gibl

e re

cord

s w

hich

incl

ude

plan

ning

, im

plem

enta

tion

and

eval

uatio

n of

car

e,

Det

ails

reas

onin

g be

hind

any

act

ions

or

inte

rven

tions

take

n

53

Esse

ntia

l Ski

lls C

lust

ers

(ESC

s) fo

r pre

-reg

istr

atio

n m

idw

ifery

edu

catio

n4.

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

g

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

1. U

nder

stan

d an

d sh

are

info

rmat

ion

that

is c

lear

, ac

cura

te a

nd m

eani

ngfu

l at

a le

vel w

hich

wom

en,

thei

r par

tner

s an

d fa

mily

ca

n un

ders

tand

.

Par

ticip

ates

in c

omm

unic

atin

g se

nsiti

vely

th

e im

porta

nce

of b

reas

tfeed

ing,

and

the

cons

eque

nces

of n

ot b

reas

tfeed

ing,

in

term

s of

hea

lth o

utco

mes

(BFI

)

Obs

erve

s a

varie

ty o

f for

ums

whe

re

info

rmat

ion

is s

hare

d in

resp

ect o

f the

ad

vant

ages

and

dis

adva

ntag

es o

f diff

eren

t in

fant

feed

ing

met

hods

List

ens

to, w

atch

es fo

r, an

d re

spon

ds to

ve

rbal

and

non

-ver

bal c

ues

Use

s sk

ills

of b

eing

atte

ntiv

e, o

pen

ende

d qu

estio

ning

and

par

aphr

asin

g to

sup

port

info

rmat

ion

shar

ing

with

wom

en

Is a

ble

to le

ad a

var

iety

of f

orum

s w

here

in

form

atio

n is

sha

red

with

wom

en a

bout

the

adva

ntag

es a

nd d

isad

vant

ages

of d

iffer

ent

infa

nt fe

edin

g m

etho

ds, w

ithou

t reg

ardi

ng

brea

stfe

edin

g an

d ar

tifici

al fe

edin

g as

‘e

qual

’ cho

ices

Und

erst

ands

the

impo

rtanc

e of

exc

lusi

ve

brea

stfe

edin

g an

d th

e co

nseq

uenc

es o

f of

ferin

g ar

tifici

al m

ilk to

bre

astfe

d ba

bies

Crit

ical

ly a

ppra

ises

the

natu

re a

nd s

treng

th

of b

reas

tfeed

ing

prom

otio

nal a

nd s

uppo

rt in

terv

entio

ns

Und

erst

ands

the

natu

re o

f evi

denc

e an

d ho

w to

eva

luat

e th

e st

reng

th o

f res

earc

h ev

iden

ce u

sed

to b

ack

info

rmat

ion

Key

: (B

FI) =

rela

te to

Bab

y Fr

iend

ly E

duca

tion

Sta

ndar

ds le

arni

ng o

utco

mes

(ww

w.b

abyf

riend

ly.o

rg.u

k)

54

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

Kee

p ac

cura

te re

cord

s of

the

wom

an

and

her b

aby

rela

ting

to b

reas

tfeed

ing,

in

clud

ing

plan

s of

car

e an

d an

y pr

oble

ms

enco

unte

red

or re

ferr

als

mad

e2.

Res

pect

soc

ial a

nd

cultu

ral f

acto

rs th

at m

ay

influ

ence

the

deci

sion

to

brea

stfe

ed.

Has

an

awar

enes

s of

ow

n th

ough

ts a

nd

feel

ings

abo

ut in

fant

feed

ing

in o

rder

to

faci

litat

e in

form

atio

n sh

arin

g to

be

ethi

cal

and

non-

judg

men

tal

Is s

ensi

tive

to is

sues

of d

iver

sity

whe

n sh

arin

g in

form

atio

n w

ith w

omen

Res

pect

s th

e rig

hts

of w

omen

Dem

onst

rate

s a

wor

king

kno

wle

dge

of

the

loca

l dem

ogra

phic

are

a an

d ex

plor

es

stra

tegi

es to

sup

port

brea

stfe

edin

g in

itiat

ives

with

in th

e lo

calit

y

Exp

lore

ski

llful

ly a

ttitu

des

to b

reas

tfeed

ing

Take

s in

to a

ccou

nt d

iffer

ing

cultu

ral

tradi

tions

, bel

iefs

and

pro

fess

iona

l eth

ics

whe

n co

mm

unic

atin

g w

ith w

omen

3. S

uppo

rt w

omen

to

brea

stfe

ed.

Has

a w

illin

gnes

s to

lear

n fro

m w

omen

Ass

ists

in e

nsur

ing

that

the

need

s of

wom

en

are

met

in d

evel

opin

g a

clea

r car

e pa

thw

ay

Par

ticip

ates

in e

xpla

inin

g to

wom

en th

e im

porta

nce

of b

aby-

led

feed

ing

in re

latio

n to

the

esta

blis

hmen

t and

mai

nten

ance

of

brea

stfe

edin

g (B

FI)

App

lies

in-d

epth

kno

wle

dge

of th

e ph

ysio

logy

of l

acta

tion

to p

ract

ical

situ

atio

ns

(BFI

)

Rec

ogni

ses

effe

ctiv

e po

sitio

ning

, at

tach

men

t, su

cklin

g an

d m

ilk tr

ansf

er

Use

s sk

ills

of o

bser

vatio

n, a

ctiv

e lis

teni

ng

and

on-g

oing

crit

ical

app

rais

al in

ord

er to

an

alys

e th

e ef

fect

iven

ess

of b

reas

tfeed

ing

prac

tices

Key

: (B

FI) =

rela

te to

Bab

y Fr

iend

ly E

duca

tion

Sta

ndar

ds le

arni

ng o

utco

mes

(ww

w.b

abyf

riend

ly.o

rg.u

k)

55

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

Rec

ogni

ses

effe

ctiv

e po

sitio

ning

, at

tach

men

t, su

cklin

g an

d m

ilk tr

ansf

er

Is a

ble

to h

elp

teac

h m

othe

rs th

e ne

cess

ary

skill

s to

ena

ble

them

to p

ositi

on a

nd a

ttach

th

eir b

aby

effe

ctiv

ely

for b

reas

tfeed

ing

(BFI

)

Exp

lain

s to

wom

en th

e im

porta

nce

of

thei

r bab

y ro

omin

g-in

with

them

and

bab

y ho

ldin

g in

the

post

nata

l per

iod

as a

mea

ns

of fa

cilit

atin

g br

east

feed

ing

(BFI

)

Rec

ogni

ses

com

mon

com

plic

atio

ns

of b

reas

tfeed

ing,

how

thes

e ar

ise

and

dem

onst

rate

s ho

w w

omen

may

be

help

ed

to a

void

them

(BFI

)

Par

ticip

ates

in te

achi

ng w

omen

how

to

hand

exp

ress

thei

r bre

ast m

ilk a

nd h

ow to

st

ore,

free

ze a

nd w

arm

it w

ith c

onsi

dera

tion

to a

spec

ts o

f inf

ectio

n co

ntro

l (B

FI)

Is c

onfid

ent a

t exp

lorin

g w

ith w

omen

the

pote

ntia

l im

pact

of d

eliv

ery

room

pra

ctic

es,

such

as

the

effe

ct o

f diff

eren

t pai

n re

lief

met

hods

and

the

impo

rtanc

e of

ski

n-to

-ski

n co

ntac

t, on

the

wel

lbei

ng o

f the

ir ba

by a

nd

them

selv

es, a

nd o

n th

e es

tabl

ishm

ent o

f br

east

feed

ing

in p

artic

ular

(BFI

)

Use

s ap

prop

riate

ski

lls to

sup

port

wom

en to

be

suc

cess

ful a

t bre

astfe

edin

g fo

r the

firs

t si

x m

onth

s of

life

(BFI

)

Em

pow

ers

wom

en to

reco

gnis

e ef

fect

ive

posi

tioni

ng, a

ttach

men

t, su

cklin

g an

d m

ilk

trans

fer f

or th

emse

lves

(BFI

)

Exp

lore

s w

ith w

omen

the

evid

ence

bas

e un

derp

inni

ng in

form

atio

n, w

hich

may

hav

e an

impa

ct o

n br

east

feed

ing

such

as

be

d-sh

arin

g an

d th

e us

e of

dum

mie

s (B

FI)

Is s

kille

d at

adv

isin

g w

omen

ove

r the

te

leph

one

whe

n co

ntac

ted

for a

dvic

e on

br

east

feed

ing

issu

es

56

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

4.R

ecog

nise

app

ropr

iate

infa

nt g

row

th a

ndde

velo

pmen

t, in

clud

ing

whe

re re

ferr

al fo

rfu

rthe

r adv

ice/

actio

n is

requ

ired.

Par

ticip

ates

in a

sses

sing

app

ropr

iate

gr

owth

and

dev

elop

men

t of t

he n

eona

te

Par

ticip

ates

in c

arry

ing

out p

hysi

cal

exam

inat

ions

as

nece

ssar

y, w

ith p

aren

t’s

cons

ent

Info

rms

wom

en o

f the

find

ings

from

any

as

sess

men

t/exa

min

atio

n pe

rform

ed, i

n a

man

ner t

hat i

s un

ders

tood

by

the

wom

en

Act

s up

on th

e ne

ed to

refe

r whe

n th

ere

is a

de

viat

ion

from

app

ropr

iate

infa

nt g

row

th

Dem

onst

rate

s sk

ills

to e

mpo

wer

wom

en

to re

cogn

ise

appr

opria

te in

fant

gro

wth

and

de

velo

pmen

t and

to s

eek

advi

ce w

hen

they

ha

ve c

once

rns

5.W

ork

colla

bora

tivel

yw

ith o

ther

pra

ctiti

oner

san

d ex

tern

al a

genc

ies.

Wor

ks w

ithin

The

Cod

e: P

rofe

ssio

nal s

tan-

da

rds

of p

ract

ice

and

beha

viou

r for

nur

ses,

m

idw

ives

and

nur

sing

ass

ocia

tes

Wor

ks a

ctiv

ely

as a

team

mem

ber

Valu

es o

ther

s’ ro

les

and

resp

onsi

bilit

ies

in

supp

ortin

g w

omen

to b

reas

tfeed

Pra

ctis

es w

ithin

the

limita

tions

of t

heir

own

com

pete

nce,

kno

wle

dge

and

sphe

re o

f pr

ofes

sion

al p

ract

ice,

con

sist

ent w

ith th

e le

gisl

atio

n re

latin

g to

mid

wife

ry p

ract

ice

Wor

ks c

onfid

ently

, col

labo

rativ

ely

and

in

partn

ersh

ip w

ith w

omen

and

oth

ers

to

ensu

re th

e ne

eds

of w

omen

are

met

57

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

Sha

res

info

rmat

ion

abou

t nat

iona

l and

loca

l ag

enci

es a

nd n

etw

orks

that

are

ava

ilabl

e to

sup

port

wom

en in

the

cont

inua

tion

of b

reas

tfeed

ing,

for e

xam

ple

Lact

atio

n C

onsu

ltant

s, N

atio

nal C

hild

birth

Tru

st a

nd

La L

eche

Lea

gue

Und

erst

ands

the

impo

rtanc

e of

com

mun

ity

supp

ort f

or b

reas

tfeed

ing

and

refe

rs w

omen

to

com

mun

ity-b

ased

sup

port

netw

orks

, bot

h in

sup

porti

ng w

omen

to b

reas

tfeed

and

as

a re

sour

ce fo

r hea

lth p

rofe

ssio

nals

(BFI

)

Wor

ks a

ctiv

ely

with

oth

er h

ealth

pr

ofes

sion

als

and

exte

rnal

age

ncie

s to

pr

omot

e br

east

feed

ing

and

supp

ort w

omen

in

thei

r cho

ice

to b

reas

tfeed

Is a

ble

to d

iscu

ss w

ith w

omen

the

impo

rtanc

e of

exc

lusi

ve b

reas

tfeed

ing

for s

ix m

onth

s an

d tim

ely

intro

duct

ion

of c

ompl

emen

tary

food

s an

d co

ntin

uing

br

east

feed

ing

durin

g th

e w

eani

ng p

erio

d,

into

the

seco

nd y

ear o

f life

and

bey

ond

6.Su

ppor

t wom

ento

bre

astfe

edin

cha

lleng

ing

circ

umst

ance

s.

Is a

war

e of

the

limite

d nu

mbe

r of s

ituat

ions

in

whi

ch e

xclu

sive

bre

astfe

edin

g is

not

po

ssib

le a

nd p

artic

ipat

e in

sup

porti

ng

wom

en to

par

tially

bre

astfe

ed o

r arti

ficia

lly

feed

(BFI

)

Is s

ensi

tive

to th

e ne

eds

of w

omen

and

thei

r pa

rtner

s

Invo

lves

app

ropr

iate

hel

p, s

uch

as a

la

ctat

ion

cons

ulta

nt, w

here

spe

cial

ised

ski

lls

are

requ

ired,

in o

rder

to s

uppo

rt w

omen

to

succ

essf

ully

bre

astfe

ed

Act

s up

on th

e ne

ed to

refe

r to

appr

opria

te

heal

th p

rofe

ssio

nals

whe

re d

evia

tion

from

ap

prop

riate

infa

nt fe

edin

g an

d gr

owth

pa

ttern

s ar

e ap

pare

nt

58

Initi

atio

n an

d co

ntin

uanc

e of

bre

astfe

edin

gW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

poi

ntFo

r ent

ry to

the

regi

ster

Sup

ports

wom

en w

ho a

re s

epar

ated

from

th

eir b

abie

s (o

n ad

mis

sion

to S

CB

U –

a

spec

ial c

are

baby

uni

t, w

omen

rece

ivin

g hi

gh d

epen

denc

y ca

re in

a s

epar

ate

envi

ronm

ent)

to in

itiat

e an

d m

aint

ain

thei

r la

ctat

ion

and

feed

thei

r bab

ies

optim

ally

(B

FI)

Feed

s ex

pres

sed

brea

st m

ilk to

a b

aby,

us

ing

a cu

p an

d/or

syr

inge

as

appr

opria

te

(BFI

)

Teac

hes

wom

en h

ow to

exp

ress

thei

r bre

ast

milk

by

hand

59

Esse

ntia

l Ski

lls C

lust

ers

(ESC

s) fo

r pre

-reg

istr

atio

n

mid

wife

ry e

duca

tion

5.M

edic

ines

man

agem

ent

Sum

mat

ive

heal

th-r

elat

ed n

umer

ical

ass

essm

ents

are

requ

ired

to te

st s

kills

iden

tified

(*) w

ithin

the

ES

Cs

that

en

com

pass

cal

cula

tions

ass

ocia

ted

with

med

icin

es. A

100

per

cen

t pas

s m

ark

is re

quire

d an

d as

sess

men

t mus

t tak

e pl

ace

in th

e pr

actic

e se

tting

.

Med

icin

es m

anag

emen

t in

the

cont

ext o

f mid

wife

ry p

ract

ice

is b

ased

on

a pa

rtne

rshi

p ap

proa

ch b

etw

een

the

wom

an a

nd th

e m

idw

ife. I

ts p

urpo

se is

to p

rovi

de th

erap

eutic

inte

rven

tion

whe

n ne

cess

ary

thro

ugho

ut

child

birt

h to

faci

litat

e a

posi

tive

outc

ome.

Med

ical

pro

duct

s m

anag

emen

tW

omen

can

trus

t/exp

ect

a ne

wly

regi

ster

ed

mid

wife

to:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

1.W

ithin

the

para

met

ers

of n

orm

al c

hild

birt

h,en

sure

saf

e an

def

fect

ive

prac

tice

thro

ugh

com

preh

ensi

vekn

owle

dge

of m

edic

inal

prod

ucts

, the

ir ac

tions

,ris

ks a

nd b

enefi

tsin

clud

ing

the

abili

ty to

reco

gnis

e an

d re

spon

dsa

fely

to a

dver

se d

rug

reac

tions

and

adv

erse

drug

eve

nts.

App

lies

an u

nder

stan

ding

of

bas

ic p

harm

acol

ogy,

how

m

edic

inal

pro

duct

s ac

t and

in

tera

ct in

the

syst

ems

of

the

body

as

wel

l as

thei

r th

erap

eutic

act

ion

in a

ll as

pect

s re

late

d to

mid

wife

ry

prac

tice

Use

s kn

owle

dge

and

unde

rsta

ndin

g of

com

mon

ly

supp

lied

or a

dmin

iste

red

med

icin

al p

rodu

cts

to th

e w

oman

or b

aby

in o

rder

to

act p

rom

ptly

in c

ases

whe

re

side

effe

cts

and

adve

rse

reac

tions

occ

ur

Man

ages

dru

g ad

min

istra

tion

and

safe

ly

mon

itors

its

effe

ct*

Ana

tom

y an

d ph

ysio

logy

re

leva

nt to

nor

mal

m

idw

ifery

pra

ctic

e

Dru

g pa

thw

ays

– ho

w

med

icin

al p

rodu

cts

act

Pha

rmac

o-th

erap

eutic

s –

wha

t are

ther

apeu

ticac

tions

of c

erta

in m

edic

inal

prod

ucts

. Ris

ks v

ersu

sbe

nefit

s of

med

icat

ion

Pha

rmac

o-ki

netic

s an

d ho

w

dose

s ar

e de

term

ined

by

dyna

mic

s/sy

stem

s in

bod

y

Rol

e an

d fu

nctio

n of

bod

ies

that

regu

late

and

ens

ure

the

safe

ty a

nd e

ffect

iven

ess

of m

edic

inal

pro

duct

s

60

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Rep

orts

adv

erse

inci

dent

s an

d ne

ar m

isse

s an

d ad

vers

e dr

ug re

actio

ns

Man

ages

ana

phyl

axis

sa

fely

Effe

cts

on p

regn

ancy

, la

bour

, birt

h, la

ctat

ion

and

neon

ate

Res

idua

l effe

cts

of m

ater

nal

med

icin

al p

rodu

cts

on th

e ne

onat

e2.

Und

erta

ke m

edic

inal

prod

uct c

alcu

latio

nsco

rrec

tly a

nd s

afel

y.

Com

pete

nt in

cal

cula

ting

com

mon

dos

ages

of m

edic

inal

pr

oduc

ts u

sed

in n

orm

al

mid

wife

ry p

ract

ice*

Cal

cula

tes

accu

rate

ly

the

med

icin

al p

rodu

cts

frequ

ently

enc

ount

ered

w

ithin

fiel

d of

pra

ctic

e*

Num

erac

y sk

ills,

dru

g ca

lcul

atio

ns, r

equi

red

to a

dmin

iste

r med

icin

al

prod

ucts

to w

omen

sa

fely

via

app

ropr

iate

ro

utes

incl

udin

g sp

ecifi

c re

quire

men

ts fo

r neo

nate

s3.

In th

e co

urse

of t

heir

prof

essi

onal

mid

wife

rypr

actic

e, s

uppl

y an

dad

min

iste

r med

icin

alpr

oduc

ts s

afel

y an

d in

atim

ely

man

ner,

incl

udin

gco

ntro

lled

drug

s.

Adm

inis

ters

ora

l med

icat

ion

to w

omen

saf

ely

unde

r dire

ct

supe

rvis

ion

Util

ises

and

dis

pose

s of

eq

uipm

ent n

eede

d to

pr

epar

e/ad

min

iste

r med

icat

ion

(eg

need

les,

syr

inge

s, g

love

s)

safe

ly

Sel

ects

, acq

uire

s an

d ad

min

iste

rs m

edic

inal

pr

oduc

ts s

afel

y an

d ef

ficie

ntly

via

rout

es a

nd

met

hods

com

mon

ly u

sed

with

in m

idw

ifery

pra

ctic

e,

and

mai

ntai

ns a

ccur

ate

reco

rds

Use

s pr

escr

iptio

n ch

arts

co

rrec

tly a

nd m

aint

ains

ac

cura

te re

cord

s

Wom

en-c

entre

d fo

cus,

in

form

atio

n sh

arin

g,

alle

viat

ing

fear

and

anx

iety

of

the

wom

an in

rela

tion

to

adm

inis

tratio

n, im

porta

nce

of n

on-v

erba

l and

ver

bal

com

mun

icat

ion

Use

of p

resc

riptio

n ch

arts

in

clud

ing

how

to p

repa

re,

read

and

inte

rpre

t the

m a

nd

reco

rd a

dmin

istra

tion

and

non-

adm

inis

tratio

n. T

his

incl

udes

Mid

wiv

es S

uppl

y O

rder

s

61

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Util

ises

and

inte

rpre

ts

med

icin

e le

gisl

atio

n re

late

d to

mid

wiv

es e

xem

ptio

ns

accu

rate

ly

Prep

arin

g an

d ad

min

iste

ring

med

icat

ion

in d

iffer

ing

envi

ronm

ents

, hyg

iene

, in

fect

ion

cont

rol

Saf

e tra

nspo

rt of

med

icin

al

prod

ucts

suc

h as

nitr

ous

oxid

e an

d ox

ygen

Dis

posa

l of m

edic

inal

pr

oduc

ts a

nd e

quip

men

t in

clud

ing

cont

rolle

d dr

ugs

Saf

ety,

che

ckin

g th

e id

entit

y of

wom

en/n

eona

tes,

last

do

se, t

ime,

dos

e, ro

ute,

al

lerg

ies,

pre

viou

s ad

vers

e re

actio

ns

Ana

phyl

axis

, pol

ypha

rmac

y,

mon

itorin

g of

effe

ct o

f m

edic

ines

, rec

ord

keep

ing

Whe

re a

nd h

ow to

repo

rt co

ntra

indi

catio

ns, s

ide

effe

cts,

adv

erse

reac

tions

62

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Ski

lls n

eede

d to

adm

inis

ter

safe

ly v

ia v

ario

us m

eans

, eg

ora

l, to

pica

l, by

infu

sion

, in

ject

ion,

syr

inge

driv

er a

nd

pum

ps

Awar

e of

ow

n lim

itatio

ns

and

whe

n to

refe

r on

Lega

l req

uire

men

ts,

mec

hani

sms

for s

uppl

y,

sale

and

adm

inis

tratio

n of

med

icat

ion,

sel

f-ad

min

istra

tion

4.K

eep

and

mai

ntai

nac

cura

te re

cord

s, w

hich

incl

udes

whe

n w

orki

ngw

ithin

a m

ultid

isci

plin

ary

fram

ewor

k an

d as

par

t of

a te

am.

Dem

onst

rate

s an

un

ders

tand

ing

of p

rofe

ssio

nal

resp

onsi

bilit

y in

mai

ntai

ning

ac

cura

te re

cord

s in

clud

ing

regu

latio

n, n

atio

nal a

nd lo

cal

polic

y an

d gu

idel

ines

Dem

onst

rate

s an

un

ders

tand

ing

of ro

les

and

resp

onsi

bilit

ies

with

in

the

mul

ti-di

scip

linar

y te

am

for m

edic

inal

pro

duct

s m

anag

emen

t, in

clud

ing

how

and

in w

hat w

ays

info

rmat

ion

is s

hare

d

Link

s to

legi

slat

ion,

use

of

cont

rolle

d dr

ugs,

The

Cod

e in

rela

tion

to c

onfid

entia

lity

cons

ent a

nd re

cord

kee

ping

63

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Und

er s

uper

visi

on is

abl

e to

ta

ke a

med

icin

e hi

stor

yK

eeps

effe

ctiv

e re

cord

s of

in

form

atio

n sh

arin

g w

ith

wom

en a

bout

the

bene

fits

and

risks

of r

elev

ant

med

icat

ion

Kee

ps e

ffect

ive

reco

rds

of

med

icat

ion

supp

lied

and/

or

adm

inis

tere

d an

d om

itted

, in

clud

ing

cont

rolle

d dr

ugs

Use

of e

lect

roni

c re

cord

s,

text

ing,

facs

imile

, ver

bal

inst

ruct

ions

5.W

ork

with

in th

e le

gal

and

ethi

cal f

ram

ewor

kth

at u

nder

pins

saf

ean

d ef

fect

ive

med

icin

alpr

oduc

ts m

anag

emen

t,as

wel

l as

in c

onju

nctio

nw

ith n

atio

nal g

uide

lines

,an

d lo

cal p

olic

ies.

Dem

onst

rate

s an

un

ders

tand

ing

of th

e le

gal a

nd

ethi

cal f

ram

ewor

ks re

latin

g to

saf

e ad

min

istra

tion

of

med

icin

al p

rodu

cts

in p

ract

ice

Is c

onve

rsan

t with

le

gisl

atio

n re

late

d to

m

idw

ives

exe

mpt

ions

, P

harm

acy

only

and

Gen

eral

S

ales

Lis

ts m

edic

inal

pr

oduc

ts, M

idw

ives

Sup

ply

Ord

ers,

des

truct

ion

of

cont

rolle

d dr

ugs

and

Pat

ient

Gro

up D

irect

ions

Is a

war

e of

per

sona

l ac

coun

tabi

lity

in re

spec

t of

supp

lyin

g an

d ad

min

iste

ring

unlic

ense

d pr

oduc

ts

Dem

onst

rate

s th

e ab

ility

to

use

rele

vant

med

icin

es

legi

slat

ion

to s

uppo

rt m

idw

ifery

pra

ctic

e w

ithin

Law

, con

sent

, co

nfide

ntia

lity,

eth

ics,

ac

coun

tabi

lity

Res

pons

ibili

ties

unde

r law

, ap

plic

atio

n of

med

icin

al

prod

ucts

legi

slat

ion

to

prac

tice

incl

udin

g us

e of

co

ntro

lled

drug

s, m

idw

ives

ex

empt

ion

orde

rs, P

atie

nt

Gro

up D

irect

ions

(PG

D)

and

Mid

wife

s S

uppl

y O

rder

s

Reg

ulat

ory

requ

irem

ents

: N

MC

Sta

ndar

ds fo

r m

edic

ines

man

agem

ent

and

The

Cod

e (2

015)

64

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

mid

wife

to:

poin

tFo

r ent

ry to

the

regi

ster

Indi

cativ

e co

nten

t

the

NH

S in

bot

h th

e pr

imar

y an

d se

cond

ary

care

se

ttin

gs, a

s w

ell a

s du

ring

self-

empl

oyed

pra

ctic

e

App

lies

legi

slat

ion

in

prac

tice

to s

afe

and

e�ec

tive

orde

ring,

re

ceiv

ing,

sto

ring,

ad

min

iste

ring

and

disp

osal

of

med

icin

al p

rodu

cts

and

drug

s, in

clud

ing

cont

rolle

d dr

ugs

in b

oth

prim

ary

and

seco

ndar

y ca

re s

ettin

gs

6.W

ork

in p

artn

ersh

ipw

ith w

omen

to s

hare

info

rmat

ion

in a

ssis

ting

them

to m

ake

safe

and

info

rmed

cho

ices

abo

utm

edic

inal

pro

duct

sre

late

d to

them

selv

es,

thei

r unb

orn

child

ren

orth

eir b

abie

s.

Part

icip

ates

in in

volv

ing

wom

en in

adm

inis

trat

ion

an

d/or

the

self-

adm

inis

tratio

n of

med

icin

al p

rodu

cts

Ensu

res

info

rmat

ion

shar

ing

is w

oman

-cen

tred

an

d pr

ovid

es c

lear

and

ac

cura

te in

form

atio

n

Ass

ists

wom

en to

mak

e sa

fe a

nd in

form

ed c

hoic

es

abou

t the

ir m

edic

inal

pr

oduc

ts

Ass

esse

s th

e w

oman

’s ab

ility

to s

elf-a

dmin

iste

r th

eir m

edic

inal

pro

duct

s sa

fely

Cultu

ral,

relig

ious

, eth

ical

, ra

cial

and

vul

nera

ble

grou

ps a

nd s

ensi

tiviti

es

arou

nd m

edic

atio

n

Self-

adm

inis

trat

ion,

wom

en

asse

ssm

ent e

xpla

natio

n an

d m

onito

ring

Wom

an a

dmin

iste

ring

med

icat

ion

to h

er b

aby

65

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

the

NH

S in

bot

h th

e pr

imar

y an

d se

cond

ary

care

se

tting

s, a

s w

ell a

s du

ring

self-

empl

oyed

pra

ctic

e

App

lies

legi

slat

ion

in

prac

tice

to s

afe

and

effe

ctiv

e or

derin

g,

rece

ivin

g, s

torin

g,

adm

inis

terin

g an

d di

spos

al

of m

edic

inal

pro

duct

s an

d dr

ugs,

incl

udin

g co

ntro

lled

drug

s in

bot

h pr

imar

y an

d se

cond

ary

care

set

tings

and

ethi

cs fo

r nur

ses

and

mid

wiv

es fo

r con

duct

, pe

rform

ance

and

eth

ics,

N

MC

Mid

wiv

es ru

les

and

stan

dard

s

Cou

ntry

spe

cific

gui

danc

e

6. W

ork

in p

artn

ersh

ip

with

wom

en to

sha

re

info

rmat

ion

in a

ssis

ting

them

to m

ake

safe

and

in

form

ed c

hoic

es a

bout

m

edic

inal

pro

duct

s re

late

d to

them

selv

es,

thei

r unb

orn

child

ren

or

thei

r bab

ies.

Par

ticip

ates

in in

volv

ing

wom

en in

adm

inis

tratio

n an

d/or

the

self-

adm

inis

tratio

n of

med

icin

al p

rodu

cts

Ens

ures

info

rmat

ion

shar

ing

is w

oman

-cen

tred

and

prov

ides

cle

ar a

nd

accu

rate

info

rmat

ion

Ass

ists

wom

en to

mak

e sa

fe a

nd in

form

ed c

hoic

es

abou

t the

ir m

edic

inal

pr

oduc

ts

Ass

esse

s th

e w

oman

’s

abili

ty to

sel

f-adm

inis

ter

thei

r med

icin

al p

rodu

cts

safe

ly

Cul

tura

l, re

ligio

us, e

thic

al,

raci

al a

nd v

ulne

rabl

e gr

oups

and

sen

sitiv

ities

ar

ound

med

icat

ion

Sel

f-adm

inis

tratio

n, w

omen

as

sess

men

t exp

lana

tion

and

mon

itorin

g

Wom

an a

dmin

iste

ring

med

icat

ion

to h

er b

aby

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Giv

es c

lear

inst

ruct

ion

and

expl

anat

ion

and

chec

ks

unde

rsta

ndin

g re

latin

g to

us

e of

med

icin

al p

rodu

cts

and

treat

men

t opt

ions

Mee

ting

need

s of

spe

cific

gr

oups

incl

udin

g

self-

adm

inis

tratio

n, e

g th

e m

enta

lly il

l, le

arni

ng

disa

bled

, vul

nera

ble

grou

ps

The

use

of p

atie

nt d

rug

info

rmat

ion

leafl

ets

7.W

ork

in p

artn

ersh

ipw

ith w

omen

to s

hare

info

rmat

ion

abou

tal

tern

ativ

e ap

proa

ches

to u

sing

med

icat

ion,

whe

re a

ppro

pria

te.

Dem

onst

rate

s aw

aren

ess

of a

rang

e of

com

mon

ly

reco

gnis

ed a

ppro

ache

s to

su

ppor

ting

wom

en th

roug

hout

ch

ildbi

rth, e

g re

laxa

tion,

di

stra

ctio

n, li

fe s

tyle

adv

ice

Que

stio

ns, c

ritic

ally

ap

prai

ses

and

uses

ev

iden

ce to

sup

port

an

argu

men

t in

dete

rmin

ing

whe

n m

edic

inal

pro

duct

s m

ay o

r may

not

be

an

appr

opria

te c

hoic

e

App

ropr

iate

ly re

fers

to a

re

gist

ered

com

plem

enta

ry

ther

apis

t

Is a

war

e of

the

dang

ers

of g

ivin

g co

mpl

emen

tary

th

erap

y ad

vice

whe

n no

t qu

alifi

ed, e

g ra

spbe

rry

leaf

, ov

er-th

e-co

unte

r her

bal

prod

ucts

Hea

lth p

rom

otio

n, li

fest

yle

advi

ce, o

ver-

the-

coun

ter

med

icin

al p

rodu

cts,

se

lf-ad

min

istra

tion

of

med

icin

al p

rodu

cts

and

othe

r the

rapi

es

Obs

erva

tion

and

asse

ssm

ent.

Effe

ct o

f m

edic

inal

pro

duct

s an

d ot

her o

ptio

ns, i

nclu

ding

di

et, d

istra

ctio

n, p

ositi

onin

g,

com

plem

enta

ry th

erap

ies,

et

c.

Ass

ess,

pla

n, im

plem

ent

and

eval

uate

cho

ices

giv

ing

feed

back

66

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

8.O

rder

, rec

eive

, sto

re,

tran

spor

t and

dis

pose

of m

edic

inal

pro

duct

ssa

fely

and

in a

ccor

danc

ew

ith re

leva

nt le

gisl

atio

n,in

any

mid

wife

ry s

ettin

g(in

clud

ing

cont

rolle

ddr

ugs)

.

App

lies

know

ledg

e of

loca

l po

licie

s to

saf

e st

orag

e an

d tra

nspo

rt of

med

icin

al

prod

ucts

Dem

onst

rate

s ab

ility

to s

tore

m

edic

inal

pro

duct

s sa

fely

Ord

ers,

rece

ives

, sto

res

and

disp

oses

of m

edic

inal

pr

oduc

ts s

afel

y, in

clud

ing

cont

rolle

d dr

ugs

Legi

slat

ion

that

und

erpi

ns

prac

tice,

rela

ted

to a

wid

e ra

nge

of m

edic

inal

pro

duct

s in

clud

ing

cont

rolle

d dr

ugs,

in

fusi

ons,

oxy

gen,

nitr

ous

oxid

e an

d ox

ygen

etc

.

Sui

tabl

e co

nditi

ons

for

stor

age,

man

agin

g

out-o

f-dat

e st

ock,

saf

e ha

ndlin

g m

edic

atio

n,

man

agin

g di

scre

panc

ies

in

stoc

k, o

mis

sion

s

ww

w.d

h.gs

i.gov

.uk

and

sear

ch fo

r Saf

er

man

agem

ent o

f con

trolle

d dr

ugs

(200

7) G

uida

nce

on s

tand

ard

oper

atin

g pr

oced

ures

9.U

se a

nd e

valu

ate

up-to

-dat

e in

form

atio

non

med

icin

al p

rodu

cts

man

agem

ent a

nd w

ork

with

in n

atio

nal a

nd lo

cal

polic

ies

and

guid

elin

esus

ing

appr

opria

tere

fere

nce.

Is a

ble

to a

cces

s co

mm

only

us

ed e

vide

nce-

base

d so

urce

s of

info

rmat

ion

rela

ting

to th

e sa

fe a

nd e

ffect

ive

man

agem

ent o

f med

icin

al

prod

ucts

Is c

onfid

ent i

n ac

cess

ing

com

mon

ly u

sed

ev

iden

ce-b

ased

sou

rces

of

info

rmat

ion

rela

ting

to th

e sa

fe a

nd e

ffect

ive

man

agem

ent o

f med

icin

al

prod

ucts

Evi

denc

e-ba

sed

prac

tice,

id

entifi

catio

n of

reso

urce

s,

the

‘exp

ert’

wom

an,

phar

mac

y, lo

cal m

edic

ine

cent

re

67

Med

ical

pro

duct

s m

anag

emen

t

Wom

en c

an tr

ust/e

xpec

t a

new

ly re

gist

ered

m

idw

ife to

:

By

the

first

pro

gres

sion

po

int

For e

ntry

to th

e re

gist

erIn

dica

tive

cont

ent

Wor

ks w

ithin

nat

iona

l and

lo

cal p

olic

ies

Usi

ng s

ourc

es o

f in

form

atio

n, n

atio

nal a

nd

loca

l pol

icie

s, c

linic

al

gove

rnan

ce, f

orm

ular

ies,

eg

Brit

ish

Nat

iona

l Fo

rmul

ary

10. R

ecog

nise

and

co

rrec

tly re

spon

d to

ob

stet

ric e

mer

genc

ies

in

the

cont

ext o

f med

icin

es

man

agem

ent.

Rec

ogni

ses

and

acts

ac

cord

ingl

y w

hen

conf

ront

ed w

ith o

bste

tric

emer

genc

ies,

in b

oth

prim

ary

and

seco

ndar

y ca

re

setti

ngs

Med

icin

al p

rodu

cts

rela

ted

to s

afe

and

effe

ctiv

e m

anag

emen

t of o

bste

tric

emer

genc

ies

68

AnnexeFrom the Directive 2005/36/EC of the European Parliament and of the Council (2005) on the recognition of professional qualifications (updated by 2013/55/EU):

Annexe V, Point 5.5.1

1) The European Union and Article 40 (training of midwives) of Directive 2005/36/EU

• advising of pregnant women, involving at least 100 prenatal examinations

• supervision and care of at least 40 women in labour

• the student should personally carry out at least 40 deliveries; where thisnumber cannot be reached owing to the lack of available women in labour, itmay be reduced to a minimum of 30, provided that the student participatesactively in 20 further deliveries

• active participation with breech deliveries. Where this is not possible becauseof lack of breech deliveries practice may be in a simulated situation

• performance of episiotomy and initiation into suturing. Initiation shall includetheoretical instruction and clinical practice. The practice of suturing includessuturing of the wound following an episiotomy and a simple perineal laceration.This may be in a simulated situation if absolutely necessary

• supervision and care of 40 women at risk in pregnancy, or labour or postnatalperiod

• supervision and care (including examination) of at least 100 postnatal womenand healthy newborn infants

• observation and care of the newborn requiring special care including thoseborn pre-term, post-term, underweight or ill

• care of women with pathological conditions in the fields of gynaecology andobstetrics

• initiation into care in the field of medicine and surgery. Initiation shall includetheoretical instruction and clinical practice.

69

The standards for pre-registration midwifery education have been set at the point of registration, so that the student will be able to fulfil the requirements of a midwife as laid down in the definition of a midwife and will comply with Article 42 of Directive 2005/36/EU which states:

Member States shall ensure that midwives are at least entitled to take up and pursue the following activities:

• to provide sound family planning information and advice

• to diagnose pregnancies and monitor normal pregnancies; to carry outexaminations necessary for the monitoring of the development of normalpregnancies

• to prescribe or advise on the examinations necessary for the earliest possiblediagnosis of pregnancies at risk

• to provide a programme of parenthood preparation and a complete preparationfor childbirth including advice on hygiene and nutrition

• to care for and assist the mother during labour and to monitor the condition ofthe fetus in utero by the appropriate clinical and technical means

• to conduct spontaneous deliveries including where required an episiotomy and,in urgent cases, a breech delivery

• to recognise the warning signs of abnormality in the mother or infant whichnecessitate referral to a doctor and to assist the latter where appropriate; totake the necessary emergency measures in the doctor’s absence, in particularthe manual removal of the placenta, possibly followed by a manual examinationof the uterus

• to examine and care for the newborn infant; to take all initiatives which arenecessary in case of need and to carry out where necessary immediateresuscitation

• to care for and monitor the progress of the mother in the postnatal periodand to give all necessary advice to the mother on infant care to enable her toensure the optimum progress of the newborn infant

• to carry out treatment prescribed by a doctor

• to maintain all necessary records.

70

Contact usNursing and Midwifery Council23 Portland PlaceLondon W1B 1PZ020 7333 9333www.nmc.org.uk

This edition of Standards for pre-registration midwifery education was published in 2009. It replaces Standards of proficiency for pre-registration midwifery education (2004).

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