The midwife is known as an accountable and responsible person that works hand in hand with women to render the needed support, advise and care when they are pregnant, are in labour and the immediate period after delivery, to conduct births and provide care for the mother and infant ( midwiffery, 2012). Midwives are regarded as specialists in normal pregnancy and births. The midwife looks after the pregnant woman and her baby throughout the duration of the pregnancy, during labour and for about five weeks after the delivery of the baby (NCT, 2012).
A midwife is allowed to provide all the antenatal care as long as all things are normal. Once complications or abnormalities are noticed, the pregnant woman is referred to the appropriate quarters, most times an obstetrician. The care entails preventive measures, promoting normal births, detecting threats to the life of mother and foetus, carrying out emergency services and accessing medical care. In the U.K, midwives offer their services at home, in the community, clinics or health centres and hospitals. Their importance cannot be overemphasized in the health care system. Midwives, maternity care networks, general practitioners, primary healthcare providers and specialist obstetricians all work hand in hand to make the experience of pregnancy pleasant and a worthwhile one for the pregnant woman. Pregnant women receive either shared care between GPs and midwives or sole care from either a GP or a midwife. Pregnant women are examined at first contact after the pregnancy has been confirmed and further tests conducted and history are taken. Blood tests for blood group, anaemia, rhesus state, syphilis, rubella, hepatitis B, thalassemias, sickle cell disease, downs syndrome and HIV are done. The midwives assess the pregnant woman for familial or existing medical conditions which may require referral to the specialist for intervention. This may be in the course of carrying the pregnancy or during labour. Women with existing grave mental and health conditions which may be aggravated by pregnancy such as diabetes, epilepsy, various acquired or congenital cardiac diseases, obesity, auto immune disorders, cancers and severe mental illness. Also, women with poor obstetrics history, those with smoking problems, drug abusers and those suffering from hypertension. In addition, pregnant women are referred to the alcohol and drugs specialist midwives from drug and alcohol services, GPs, maternity services, gynaecology and termination of pregnancy services, mental health services, voluntary agencies, needle exchange services, homeless families, styal prison, probation, greater Manchester police, probation services, friends and family members, domestic abuse agencies and self-referral. They are all assessed and reassessed by the receiving midwives. Their various conditions are noted and documented and appropriate decisions are made. They could be managed in their facilities or referred to obstetricians in the hospitals. The collaborator efforts between the midwives, the GPs, and other specialists in different fields makes referrals easy and possible. Often times, the managing midwife must have discussed the pregnant clients situation with the GP or the specialist. Referrals to GPs and specialists could be in the form of the conventional referral slips, by telephone, e-mail or through fax. However, sometimes, emergencies like congestive cardiac failure, pre-eclampsia/eclampsia and leaking ectopic pregnancies may occur in patients. When such occurs, the conventional referral slips are jettisoned and a faster means of communication is employed.
In conclusion, midwives are an integral part of the whole process of antenatal care, child birth and the immediate post partum period. They take utmost care of their pregnant clients but refer them to GPs and obstetricians whenever a problem is noticed which they cannot tackle or a complication arises.
(2010) A. Masterson Core and developing role of the midwife http://www.midwifery2020.org/documents/2020/Core_Role_Lit_review.pdf
(2012) Midwifery 2020 Programme Core Role of the Midwife Workstream Final Report http://www.midwifery2020.org/documents/2020/Core_Role_Lit_review.pdf
(2012) Maternity care pathways NHS http://www.londonhp.nhs.uk/wp-content/uploads/2011/03/Maternity-services-care-pathways1.pdf
(2010) National guidance on collaborative maternity care
(2010) National Institute for Health and Clinical Excellence Descriptions of services for pregnant women with complex social factors http://www.nice.org.uk/nicemedia/live/13167/51326/51326.pdf
(2012) The role of a midwife http://www.nct.org.uk/pregnancy/role-midwife