The heart of midwifery

By Professor Caroline Homer 

As the International Day of the Midwife approaches on 5 May 2016, our Associate Dean (International and Development) for UTS:Health reflects on its theme: ‘Women and Newborns: The Heart of Midwifery’.

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As a midwife, you certainly use both your head and your heart.

You need your head, because every day you need to make good clinical decisions, provide sound evidence-based advice and guidance to women, collaborate with other disciplines, plan, evaluate and reflect on practice and understand and keep within the legal, professional and ethical standards that direct midwifery practice.

Midwives also have an amazing capacity to influence the psyche of women throughout pregnancy, labour and birth and after the birth.

One of the most important ways to build on women’s inherent strengths is to build their confidence in their ability to grow a baby, give birth to a baby and mother a new baby.

Walking alongside women and providing care, support and information through the experience means that midwives are in the best position to support women to achieve the best for them.

For many women that will be a normal birth and for some it will be a caesarean section. It is the role of the midwife to ensure that regardless of how women give birth, they feel strong and confident in the decision making process and have control over their experience and choices.

But, in midwifery, there is also the heart – the passion for what we do, the desire for every woman to have the best pregnancy, labour and birth and postnatal experience she can have so that she starts motherhood strong and confident.

The heart is the joy of seeing a woman see and hold her baby for the first time and the delight at getting to know this amazing human being that her body grew. 

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The heart is also walking alongside women in their darkest moments – those that are filled with unmeasurable grief and loss.

Being a midwife is rarely grey – it is joyful bright white most of the time, but there are moments of blackness – and these extremes can tear at your heart.

In the 25 years since I became a midwife, we have become so much more focussed on the woman, her baby and her partner.

I have seen a real shift; from being taught how to practice according to the rules of the institution, to focussing on being in a partnership with the woman – making sure she is kept at the centre of care.

It is not yet perfect and there are sadly still plenty of rules put in place – many to service the institution rather than the woman – but the focus certainly has changed.

In the past 25 years there has also been a huge shift to recognising the importance of continuity of care.

There is now very good evidence that midwife-led continuity of care is the gold standard of maternity care and should be available to all women.

I am very proud that my PhD work contributed to this evidence and I know how satisfying it is to work in this way as a midwife and how beneficial these models of care are for women.

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The other area that I think has changed is a focus on the midwife being well educated, well informed, being resilient and having emotional intelligence.

We need to make sure that midwives have all these qualities so that they can provide quality care that is thoughtful, respectful to women and satisfying for them.

Being a midwife is the most rewarding role that anyone could have. It is filled with opportunities and amazing experiences. 

It is an extraordinary privilege to share this special time with a woman and her partner as they grow and welcome and new person into the world.

I hope that every midwife never forgets that for the family she is attending, this is a most special and important experience and never to lose the wonder of the time.

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