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Overview of the role

Giving the necessary support, care and advice during pregnancy, labour and the postnatal period

Midwife (degree)

Details of standard

Occupation summary

This occupation is found in a range of healthcare settings offering different models of care.  Most midwives are employed by the NHS while others work in the private sector, social enterprise or independently.  A midwife may work in the community such as in a woman’s home, community hubs, GP surgeries, clinics, midwife-led units and birth centres or in hospital maternity units. This means that they usually work shifts including evenings, weekends and nights and may be on-call to provide 24-hour care.

The broad purpose of the occupation is be the first and main contact for a woman, her partner and family, recognised as a responsible and accountable professional, the midwife acts as an advocate for the woman, working in partnership with her and giving the necessary support, care and advice during pregnancy, labour and the postnatal period.  Midwives are lead co-ordinators of care as well as the first point of contact for a woman, her baby and family.  They offer support, care and advice and are responsible for facilitating births and providing care for the newborn. Midwives are experts in normal physiological birth and in supporting the woman through all birth outcomes.  The personalised care they provide includes preventative measures, the detection of complications in mother and baby, the promotion of normal birth, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. The midwife has an important role in public health, offering health counselling and education, not only for the woman, but also within the family and the community. This work involves antenatal education and preparation for parenthood and may extend to a woman’s health, sexual or reproductive health. A midwife provides full antenatal care for the woman, carrying out clinical examinations and screening.  They offer antenatal and parenting classes to help the woman, her partner and family prepare for the birth of the baby and to care for it once it has been born.  The midwife monitors and supports the woman, her partner and family during labour and the birthing process, helping the woman to birth her baby and assessing both the woman’s and the baby’s overall health and wellbeing.  Midwives can identify complex pregnancies and know when to refer to others or seek appropriate support.  They are able to offer guidance and support around issues such as stillbirth, miscarriage, termination, neonatal death or other complications. Following birth midwives offer support for infant feeding, recovery and may refer the woman to other services as required.

In their daily work, an employee in this occupation interacts with women and families from a range of backgrounds.  Midwives need to have excellent communication skills to support the woman, her partner and family through the emotional, physical and psychological process of childbirth. Midwives are part of the wider health and social care multidisciplinary team, working in partnership with colleagues as required.  A midwife must have excellent situational awareness and knowledge of other human factors.

An employee in this occupation will be responsible for caring for a number of women and may manage a caseload (continuity of carer).  Midwives are responsible and accountable autonomous practitioners who provide woman and family centred integrated care.  Midwives act as an advocate for the woman, enabling them and their families to make informed choices about the options and services available throughout pregnancy, labour and post-natal period.  The midwife is responsible for the health of both the mother and baby and refers to others if there are medical, social or other complications.  Midwives are regulated by the Nursing and Midwifery Council (NMC) and are responsible for their own practice and for keeping up to date with current knowledge and skills.

Typical job titles include:

Midwife

Entry requirements

Entry to the apprenticeship is set locally by individual employers but apprentices will also need to meet the entry requirements for the level 6 degree as set by the university. If they already have degree at level 6 they will need to meet the entry requirements set by the university for the level 7 masters degree instead. If an applicant is already a registered adult nurse they may take a level 7 qualification approved by the NMC instead of the level 6 degree. These requirements are based on guidance from the NMC and European law.


Occupation duties

Duty

Criteria for measuring performance

KSBs

Duty 1 Practise in accordance with the NMC standards and within the limits of own competence, knowledge and sphere of professional practice, in line with legislation and local policy and procedures

Works in line with legislation, standards, codes of conduct, national and local policies and
procedures relevant to practice as a midwife

Delivers clear, concise and evidence-based information or advice to the woman, her partner and family

Makes valid and reliable judgements

Delivers appropriate, effective and consistent care to the woman

Makes appropriate and timely referrals

Delivers appropriate, effective and consistent care to the newborn

Administers medication safely

Maintain clear and accurate records

Works in partnership with the woman, her partner, family and members of the multi-disciplinary
team

K1 K2 K3 K4 K5 K6 K7

S1 S2 S3 S4 S5 S6 S7

B1 B2 B3 B4 B5

Duty 2 Communicate clearly and effectively with women, their partner and families

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Delivers clear, concise and evidence-based information or advice to the

K8 K9 K10 K11

S8 S9 S10 S11

B1 B2

Duty 3 Confirm pregnancy, assess and monitor women holistically using a range of assessment methods to reach valid, reliable and comprehensive conclusions

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Makes valid and reliable judgements

K12 K13 K14

S12 S13 S14

B1 B2 B4

Duty 4 Determine and provide programmes of care and support for women

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Delivers appropriate, effective and consistent care to the woman

K15 K16 K17 K18 K19 K20 K21 K22 K23 K24 K25

S15 S16 S17 S18 S19 S20

B1 B2 B5

Duty 5 Provide seamless care and, where appropriate, interventions, in partnership with women, their partner, families and other care providers during the antenatal period

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Delivers clear, concise and evidence-based information or advice to the woman, her partner and family

Delivers appropriate, effective and consistent care to the woman

Makes appropriate and timely referrals

Works in partnership with the woman, her partner, family and members of the multi-disciplinary
team

K26 K27 K28 K29

S21 S22 S23

B1 B2 B4

Duty 6 Refer women and babies in need of further care

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Makes valid and reliable judgements

Makes appropriate and timely referrals

Works in partnership with the woman, her partner, family and members of the multi-disciplinary
team

K30 K31

S24 S25

B1 B2 B3 B4 B5

Duty 7 Care for, monitor and support women during labour and birth, monitoring the condition of the fetus and providing immediate care of the newborn after birth

Performance Criteria

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Delivers appropriate, effective and consistent care to the woman

Delivers appropriate, effective and consistent care to the newborn

K32 K33 K34 K35

S26 S27 S28 S29

B1 B2 B4 B5

Duty 8 Prepare for and manage emergencies

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Makes valid and reliable judgements

Works in partnership with the
woman, her partner, family and members of the multi-disciplinary team

K36 K37 K38 K39

S30 S31 S32

B1 B2 B4 B5

Duty 9 Work in partnership with women and other care providers during the postnatal period to provide seamless care and interventions

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a
midwife

Delivers appropriate, effective and consistent care to the woman

Makes appropriate and timelyreferrals

K40 K41 K42 K43 K44

S33 S34 S35 S36 S37

B1 B2 B4

Duty 10 Examine and care for babies

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Makes valid and reliable judgements

Delivers appropriate, effective and consistent care to the newborn

K45 K46 K47 K48 K49

S38 S39 S40 S41

B1 B2 B3 B4

Duty 11 Advise on, supply and administer a range of permitted medications safely

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Administers medication safely

K50 K51

S42

B1 B2 B3 B4

Duty 12 Complete, store and retain records

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Maintain clear and accurate records

K51 K52

S43

B3 B4

Duty 13 Work as part of the wider health and social care team

Works in line with legislation, standards, codes of conduct, national and local policies and procedures relevant to practice as a midwife

Works in partnership with the woman, her partner, family and members of the multi-disciplinary
team

K53 K54 K55 K56 K57

S44 S45 S46 S47

B1 B3 B4 B5


KSBs

Knowledge

K1: The national and professional standards, guidelines and current legislation that applies to midwives in the UK, local policies and procedures Back to Duty

K2: The limits of your competence, experience and training Back to Duty

K3: The importance of confidentiality and appropriate situations in which to disclose information Back to Duty

K4: The importance of safeguarding, governance, ethical issues, a duty of care and a duty of candour Back to Duty

K5: The importance of ongoing continuing professional development and being a reflective practitioner Back to Duty

K6: The importance of building personal resilience within your professional life Back to Duty

K7: Ways to promote a healthy, safe and secure environment Back to Duty

K8: A range of communication methods and media, including verbal and non-verbal, written, electronic, listening skills, common barriers to communication, aides and services available to assist with communication Back to Duty

K9: Ways to enable the woman to think through their feelings, building trust by responding to their concerns Back to Duty

K10: The importance of acting in the best interest of the woman and her baby, maintaining their rights, understanding their preferences, gaining valid informed consent and assessing their capacity for decision making Back to Duty

K11: The processes and procedures for dealing with and managing complaints Back to Duty

K12: Ways to confirm pregnancy including recognising the indicators of the stage of progression Back to Duty

K13: the information and techniques needed to diagnose a woman’s needs such as: taking a history, observation, physical examination, biophysical tests and social, cultural or emotional assessments Back to Duty

K14: Anatomy and physiology relevant to midwifery including the physical, psychological, social, emotional, cultural and spiritual factors that may positively or adversely influence normal physiology Back to Duty

K15: The importance of practising in a way that respects, promotes and supports individuals’ rights, interests, preferences, beliefs and culture Back to Duty

K16: How to use best evidence and clinical judgment to determine and provide programmes of care Back to Duty

K17: The importance of compassionate and woman-centred care Back to Duty

K18: The importance of respecting a woman’s right to accept or refuse care and treatment Back to Duty

K19: How to critically appraise knowledge, research and practice to improve the quality of care you offer Back to Duty

K20: Midwifery care within the context of public health policies such as being aware of a range of programmes to improve sexual and reproductive health or reduce maternal and perinatal morbidity and mortality Back to Duty

K21: Ways to involve users and local communities in service development and improvement Back to Duty

K22: How to effectively analyse and share data that has been collected including the importance of seeking feedback from the woman, her partner and family Back to Duty

K23: Ways to identify and target care for groups with particular health and maternity needs Back to Duty

K24: Your role in relation to audit and multi-professional standard-setting Back to Duty

K25: Ways to support parents and babies with additional or complex needs Back to Duty

K26: A range of advice and guidance such as the fetus and baby’s development, lifestyle, holistic health and wellbeing, pregnancy, labour care, care of the newborn and mental wellbeing Back to Duty

K27: What to do when physiological and psychological assessments are outside of expected parameters Back to Duty

K28: A range of screening tests such as sickle cell disease, thalassaemia, infectious diseases or anomalies Back to Duty

K29: A range of services and support available for a woman experiencing pregnancy loss, bereavement or complex pregnancies including recognising the ways that culture, context and preferences may affect a woman’s decisions Back to Duty

K30: The importance of a timely referral and the risks of not doing so Back to Duty

K31: A range of services and other professionals that have skills and experience to support the woman in your care such as health, social, financial, psychological, safeguarding or legal Back to Duty

K32: Evidence based ways to facilitate all types of labour and childbirth and care for the fetus and newborn during a labour and birth Back to Duty

K33: Ways to recognise and respond appropriately to a woman who is anxious, in pain or distress Back to Duty

K34: The importance of an active labour, ways to respect a woman’s choices and maintain a safe and calm environment Back to Duty

K35: Way to check signs of normal and deteriorating physical or mental health including risk indicators Back to Duty

K36: Signs and symptoms that indicate a potential emergency Back to Duty

K37: Ways to recognise that an emergency needs further support or additional assistance Back to Duty

K38: A range of emergency procedures including management until further assistance is available Back to Duty

K39: Risk assessment and management processes including the importance of ensuring your own safety as well as that of those in your care Back to Duty

K40: Physiology of the postnatal period Back to Duty

K41: A range of signs and symptoms relating to a woman’s health, physical, mental and emotional wellbeing following birth Back to Duty

K42: A range of signs and symptoms relating to a woman’s health, physical, mental and emotional wellbeing following birth Back to Duty

K43: A range of issues that may affect a woman when considering resuming sexual intercourse following the birth of a baby and how to manage them, taking into account the woman’s rights, preferences, beliefs and culture Back to Duty

K44: Ways to manage the different stages of bereavement or grief, ways to care for a woman whose baby has been removed due to safeguarding intervention or who relinquish their baby for adoption and a range of services or support groups available Back to Duty

K45: The physical and behavioural assessments that need to be carried out on a newborn baby Back to Duty

K46: A range of screening methods and how to recognise and refer when results are outside of normal parameters Back to Duty

K47: Common congenital disorders and abnormalities Back to Duty

K48: Ways to care for preterm babies and babies requiring monitoring and invasive procedures Back to Duty

K49: Safeguarding babies and children as identified as suffering or likely to suffer harm, abuse or neglect including how to report and act upon your concerns Back to Duty

K50: The principles of the safe management of medicines in midwifery including medications that are under midwives exemption or prescribed Back to Duty

K51: A range of methods to administer medication, including oral, intravenous, intramuscular, topical and inhalation Back to Duty

K52: The importance of completing written and electronic records accurately and in a timely manner, protecting data and maintaining confidentiality, and adhering to legal and local requirements for recording, storage and retention Back to Duty

K53: Ways to inform and develop the practice of self and others using best available evidence and reflection techniques Back to Duty

K54: How to provide honest, accurate and constructive feedback, respecting the view of others and behaving professionally at all times Back to Duty

K55: The importance of only delegating tasks and duties that are within the other person’s scope of competence and that they fully understand what they are required to do Back to Duty

K56: Understand the roles and remit of the multi-disciplinary team, the wider healthcare team and other agencies, identifying who is best placed and able to provide particular interventions to the woman and baby Back to Duty

K57: How to raise and report concerns with service delivery including working across team or organisational boundaries Back to Duty

Skills

S1: Practise in accordance with legislation, standards and code of conduct to support the woman, her partner and family through the pregnancy, labour, birth and postnatal period Back to Duty

S2: Act as an advocate for the woman Back to Duty

S3: Consult with and refer to colleagues when care requires expertise beyond own competence or when the woman or baby’s needs falls outside the scope of midwifery practice Back to Duty

S4: Identify, respond to and report any unsafe practice Back to Duty

S5: Take responsibility and accountability for own practice as a midwife, reviewing, developing and enhancing knowledge, skills and maintaining your fitness to practice Back to Duty

S6: Manage and prioritise competing demands Back to Duty

S7: Create and maintain a healthy and safe environment, preventing and controlling infection and promoting health and wellbeing Back to Duty

S8: Communicate in ways that are sensitive and appropriate, taking into account emotional, psychological, cognitive, language, social and other circumstances, checking you have been understood Back to Duty

S9: Use interpersonal skills to build rapport with the woman, her partner and family Back to Duty

S10: Facilitate informed decision making Back to Duty

S11: Handle issues or complaints in line with national and local process and procedure Back to Duty

S12: Undertake the initial consultation with the woman Back to Duty

S13: Use a range of techniques to assess the physical, social and psychological needs of the woman Back to Duty

S14: Give information surrounding options for screening and overall health and wellbeing Back to Duty

S15: Work in partnership with woman to develop plans that are appropriate to the needs, contexts, culture and choices of the woman, her baby and family Back to Duty

S16: Enable and empower the woman to consider plans for pre-pregnancy, pregnancy care, birth, place of birth, plans for feeding babies, needs for postnatal support and preparation for parenthood Back to Duty

S17: Enable and empower the woman to think about their own health and that of their baby, partner and family and how this can be improved Back to Duty

S18: Consider best available evidence and modify programmes of care to improve outcomes for the woman and her baby Back to Duty

S19: Contribute to enhancing the health and social wellbeing of individuals and their communities Back to Duty

S20: Contribute to audit in order to optimise the care of the woman, her baby and family as required Back to Duty

S21: Act as lead carer in normal pregnancies supporting the woman Back to Duty

S22: Carry out physiological measurement, psychological assessment and screening tests and refer the woman as appropriate Back to Duty

S23: Contribute to providing support to the woman when her pregnancy is complex or if she has suffered pregnancy loss Back to Duty

S24: Make critical decisions in partnership with the woman, her partner and family to support the appropriate referral of a woman or baby to other health professionals or agencies when required Back to Duty

S25: Discuss and negotiate with other professionals about further interventions as appropriate Back to Duty

S26: Use appropriate clinical and technical means to monitor the condition of the woman and the fetus to optimise birth outcomes Back to Duty

S27: Facilitate the comfort of the woman during labour and birth Back to Duty

S28: Promote trust with the mother and birthing partner to facilitate a positive birth experience Back to Duty

S29: Care for the woman and the baby once she has given birth including assessing for risk indicators Back to Duty

S30: Undertake appropriate emergency procedures to meet the health needs of the woman, fetus or baby Back to Duty

S31: Raise concerns immediately in the event of an emergency Back to Duty

S32: Prepare for and manage risks Back to Duty

S33: Care for a woman in the postnatal period, facilitating her to manage her physical and psychological wellbeing and transition to motherhood Back to Duty

S34: Care for a woman who is recovering following birth including post-operative care for those who have caesarean or assisted births Back to Duty

S35: Support and advise the woman on parenting, relationship building, feeding and caring for her baby Back to Duty

S36: Facilitate discussions about resuming intercourse and future reproductive choices Back to Duty

S37: Care for a woman, her partner and family who are bereaved following pregnancy loss or death of a baby Back to Duty

S38: Examine and care for babies immediately following birth, confirming vital signs and carrying out an assessment and physical examination Back to Duty

S39: Screen babies and refer as required Back to Duty

S40: Undertake continuing assessments and care for babies Back to Duty

S41: Escalate and report safeguarding issues as required Back to Duty

S42: Administer and manage medication and pain relief to the woman and baby safely, calculating accurately and in line with legislation and the limits of your competence and role Back to Duty

S43: Complete, store and retain accurate and contemporaneous records, in line with legislation and best practice Back to Duty

S44: Act as a role model for the profession to colleagues, enabling them to reflect on and develop their practice Back to Duty

S45: Delegate tasks and duties appropriately Back to Duty

S46: Work across professional boundaries, developing professional networks Back to Duty

S47: Supervise or monitor the work of other members of the team Back to Duty

Behaviors

B1: Treat people with dignity and respect Back to Duty

B2: Be caring and compassionate Back to Duty

B3: Have the courage to speak up and challenge Back to Duty

B4: Be competent, reliable and committe Back to Duty

B5: Display leadership qualities Back to Duty


Qualifications

English & Maths

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment. For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL.

Other mandatory qualifications

A level 6 degree in Midwifery or (where an apprentice already holds a level 6 degree) a level 7 masters degree in Midwifery. Where the apprentice is already an NMC registered Adult Nurse, a Level 6 or 7 qualification approved by the NMC

Level: 6 (non-integrated degree)


Additional details


Regulated Standard

This is a Regulated occupation.

Regulator Body:

Nursing and Midwifery Council Training provider must be approved by regulator body must be approved by regulator body

Occupational Level:

6

Duration (months):

48

Review

This standard will be reviewed after three years.

Status: Approved for delivery
Level: 6
Degree: non-integrated degree
Reference: ST0794
Version: 1
Date updated: 19/12/2019
Approved for delivery: 5 December 2018
Route: Health and science
Typical duration: 48 months
Maximum funding: £27000
Regulated Standard:
This is a regulated occupation
Regulator Body:
Nursing and Midwifery Council Training provider must be approved by regulator body must be approved by regulator body
Employers involved in creating the standard: Barking, Havering and Redbridge University Hospitals NHS Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Buckinghamshire Healthcare NHS Trust, Chelsea & Westminster Hospital NHS Trust, Frimley Health NHS Foundation Trust, Leeds Teaching Hospital Trust, London North West University Healthcare NHS Trust, Medway NHS Foundation Trust, Neighbourhood Midwifes, Oxford University Hospitals NHS Foundation Trust, St Helens and Knowsley Teaching Hospitals NHS Trust, United Lincolnshire Hospitals NHS Trust, University Hospitals Morecambe Bay NHS.

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Version log

Version Date updated Change Previous version
1 19/12/2019 Updated structure Previous version
1 05/12/2018 Assessment plan and funding band first published - standard ready for delivery

Not available

1 19/10/2018 Standard first published

Not available

1 16/03/2018 Initial creation

Not available