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Celebrating Past, Present and Future Midwives

From the 1990s to present day, the Faculty of Health and Social Sciences has a long history of employing, training and collaborating with midwives who make a substantial contribution to the profession. We are delighted to share some of their work here.

Professor Paul Lewis OBE: Emeritus Professor of Midwifery

Practice and professional development

In terms of aspirations, achievements and the development of BU’s approach to Midwifery Education, Practice and Research, much of what happens in our lives is down to being in the right place, at the right time; alongside likeminded individuals who are prepared to accept negotiated change, identify opportunities for improvement and commit to new ways of working.

In July 1995, I was interviewed for the post of BU’s Academic Head of Midwifery and was asked the question ‘if appointed, what change are we likely to see after a year of you being in post.’ My answer was to expect ‘a significant change in the independence and leadership of the midwifery team with a separation from nursing that would enable midwife educators and practice colleagues to strengthen our unique differences and contribution to mothers and babies within the continuum of maternity care as an essential part of a wider healthcare system.

In 1996, the NHS Regional Authority decided to review the provision and delivery of pre and post registration education for Healthcare Practitioners across the Wessex and South West Region. This competitive process would impact the how and where nurse, midwife and allied healthcare professionals would be taught.

In response, BU’s midwifery educators had in a short period developed and began to deliver post registration education designed to meet the practice priorities and future needs of NHS Trusts, Maternity Services and individual Midwives. Similarly, our pre-registration programme focused on the ‘Centrality of Normality’ and pioneered the introduction of ‘Student Case Loads’ and Advanced Life Support in Obstetrics techniques within the undergraduate curriculum. These achievements led to BU being awarded the sole contract for midwifery education in Hampshire, Dorset, South Somerset and Salisbury NHS Trust. 

An additional site of midwifery education was developed in Portsmouth and BU’s Student Midwife numbers increased significantly across both sites. The development of courses for Ventouse Practitioners and Examination of the Newborn also met the changing needs of Registered Midwives in practice and BU’s ratings as a leading provider of midwifery education was greatly enhanced.

The appointment of Dr Jo Alexander further strengthened the leadership and the team’s aspirations with the creation of a research hub focused on Women, Mothers and Babies (WOMB). A Midwifery Forum was also developed to ensure a close working relationship with the Heads of Midwifery to ensure improved provision of support in clinical placements and that BU was best placed to respond to future needs, new ideas and developments within the NHS.

Emeritus Professor Jo Alexander

Development of research at Bournemouth University to inform practice and education

Emeritus Professor Jo Alexander Emeritus Professor Jo Alexander

In September 1998 I was appointed as Reader and subsequently Professor of Midwifery, Maternal and Perinatal Research. The WOMB (WOMen, Babies and their Families) Research Group was set up, one aim being to undertake work to underpin practice, policy making and education. Department of Health (England) grants were won to explore the supplementation of breastfed babies and to evaluate an innovative breastfeeding support group run by mothers.

Following a sabbatical at the National Perinatal Epidemiology Unit a collaboration was formed with the Personal Experiences of Health and Illness Research Group (University of Oxford) and a Senior Research Fellow recruited from New Zealand to conduct interviews throughout the UK. The resulting Healthtalkonline module (Women’s Experiences of Breastfeeding) still receives thousands of hits each year.

Grants from the Iolanthe and the Royal College of Midwives Research Funds were received by three PhD students and doctoral theses relating to practice and education resulted in published work and presentations at consumer-led and international conferences (a British Academy Travel award was received). Work previously conducted informed the development of WHO guidelines concerning postnatal care. Two Visiting Chairs were appointed and a sabbatical visitor from New Zealand was hosted. I received a life-time achievement award for Evidence Based Midwifery Practice from the British Journal of Midwifery in 2008. Books from the edited eight book series of literature reviews (‘Midwifery Practice’) were published in Canada and translated into Polish and Indonesian thus further contributing to the underpinning of practice and education.

Suzanne Cunningham OBE: Director of Midwifery & Professional Lead for Neonatal Services,

University Hospital Southampton, NHS Foundation Trust

Suzanne Cunningham OBE

When I was a student midwife the first time we discussed research and how long it takes to translate research findings into practise I was hooked. I had noticed the difference between the midwifery text books, the teaching in the class room and what actually happened in practise. I look back now after 34 years as a midwife and realise that every role I have applied for has involved translating research into practise.

As a lecturer at BU in the early 1990’s I developed the first post registration midwifery course locally. The course was very popular and many of the leaders you will see in services today started with this course! Modules available included preparing for case loading practice, neonatal examination and evidence based care all of which would not be out of place today.

Working with Professor Lewis I led the implementation of training for midwives to perform Ventouse deliveries in Birth Centres where transferring to a consultant unit was challenging. An innovation sometimes seen as controversial at the time highlighted BU’s commitment to work with services to provide local solutions to challenging circumstances. 

I left BU to take up one of the first Consultant Midwife posts in the UK, the opportunity to spend every day influencing the adoption of research into practise and building a culture of trust and respect in which midwives could work in partnership with their obstetric colleagues was the highlight of my career. My partnership with BU continued and we implemented the first multiprofessional birth environment lead.

Dr Jane Fry, Senior Lecturer and Dr Stella Rawnson, Senior Lecturer, Bournemouth University

We have both taken a keen interest in relational continuity of care and have actively led the continuing development of caseload holding practice for student midwives at the university. This has included leading relevant units associated with this practice and researching extensively both the student and woman’s experience when involved in either offering or receiving this type of care, which has most recently culminating in a PhD study titled, ‘The stories of companionship and trust: women’s narratives of their student midwife caseloading experience (Rawnson 2017).

The concept of caseload holding at Bournemouth University began in collaboration with student midwives and the midwifery team. The aim was to afford students an opportunity to experience relational continuity of care with women across the childbirth journey. A successful project was piloted in 1996 and in 1999 the decision was made to include student caseload practice within midwifery education for all students (Lewis et al. 2008). This was recognised as an example of good practice in the report ‘Delivering the Best: Midwives Contribution to the NHS Plan’ (Department of Health 2003). In 2009, it became a requirement within the Nursing and Midwifery Council’s documentation for pre-registration midwifery education, that midwifery curricula must include the opportunity for students to experience continuity of carer (Nursing and Midwifery Council 2009).

At Bournemouth University, the emphasis is on the learning to be gained from being involved in the woman’s childbearing journey and the relational continuity of care this offers. The very nature of caseload practice, where students work flexibly to provide individualised woman-centred care under the supervision of a midwife mentor, is likely to promote opportunities for independent working (Rawnson 2011). This way of working could support student confidence development and is considered appropriate where clinical care can be safely delegated to senior students (NMC 2009).

Within contemporary practice, focus is placed on the primacy of humanised, woman-centred holistic care (Way and Scammell 2016). A growing body of evidence highlights how relational continuity with a student facilitates this provision.

References

Department of Health., 2003. Delivering the Best: Midwives contribution to the NHS Plan. London: DH.

Lewis, P. Fry, J. and Rawnson, S., 2008. Student midwife caseloading – a new approach to midwifery education. British Journal of Midwifery, 16(8), 499-502.

Nursing and Midwifery Council., 2009. Standards for Pre-registration Midwifery Education. London: NMC.

Rawnson, S., 2011. A qualitative study exploring student midwives experience of carrying a caseload as part of their midwifery education in England. Midwifery, 27, 786-792.

Way, S. and Scammell, J., 2016. Humanising midwifery care. The Practising Midwife, 19(3), 27-29.

Wendy Marsh: Deputy Director of Midwifery,

Portsmouth Hospital NHS Foundation Trust

Wendy Marsh, Deputy Director of Midwifery (Portsmouth Hospital)

Since graduating as a midwife from Bournemouth University in 2005 I have had a keen interest in all aspects of safeguarding children and child protection. My first post as a qualified midwife was in a geographical area that included a significant number of women with children and unborn babies who were subject to child protection plans. This experience enabled me to understand in greater depth the complexity and challenges that working with this group of women entailed. When a specialist post in safeguarding children within the local hospital was advertised, I applied and was successful. I combined this post with a lecturer role at Bournemouth University.

Providing care to women who had, or were expected to have their babies removed at birth was an integral part of my role over the next few years and one I reflected upon often. I was fortunate enough to be funded by The University of Surrey to undertake primary research in this area and through collaborative supervision with Bournemouth University I achieved my PhD in 2016. My research has been published and a digital resource, ‘Mother’s experience of having their baby removed at birth: a digital story’ can be accessed via Bournemouth University website here. I am currently working with significant stakeholders to develop national guidance in this area.

Prior to taking up post at Portsmouth Hospitals I was employed as a Consultant Midwife for public health and safeguarding at University Hospital Southampton. A role in which I felt I was able to combine all the research, clinical and educational skills I had developed.

Helen Williams, Chief Midwife South West

I graduated from Bournemouth University in 2012 with a Master’s Degree, with Distinction, in Public Health. I undertook my Masters over a five-year period having previously studied for an advanced Diploma in Professional Midwifery Studies and various degree level modules. I truly am an example of lifelong learning. During my years studying at BU, I built a valuable professional network and many of those people I still count as professional friends today.

Shortly after graduating with a Master’s degree, an opportunity arose at Public Health England to work on the national nursing strategy Compassion in Practice – “the 6 C’s”. Through this role, I was able to combine my midwifery experience, and public health specialist knowledge gained through my studies. This was a hugely influential period where I gained the confidence to work at a national level shaping and influencing both nursing and midwifery practice. 

Graduating with a Master’s degree at BU definitely opened doors for me. At the time, I was a Deputy Head of Midwifery and then went on to become a Head of Midwifery – a role I have been in for 5 years. I have always taken opportunities for professional development. I have written for publication, which I really enjoy and would like to write more in the future. The service I lead has been an early adopter site for the national maternity transformation programme, which again enabled me to work with the national team.

My career has now reached another level, having just been appointed as the first Regional Chief Midwife in the South West. I believe I am a forward thinking leader with the vision, drive and energy to proactively move services forward, bring teams together and lead them through a period of transformational change.  Most importantly, I will be there for the women and families we care for to ensure that they receive the very best maternity services can offer - safe, high quality and personalised care.

My midwifery career journey has lasted 31 years so far and there is still so much more to do.