Midwifery 2020: what's new?

Midwifery 2020 contains few new messages, but this is one of its strengths, as it shows the profession is already getting it right, reports Julie Griffiths.

The report Midwifery 2020 – Delivering expectations, which was launched in Edinburgh in September, sets out a vision of how midwives can meet the needs of service users in the future. 

But the report is a paradox. On the one hand, it is unique because it is the result of a UK-wide collaboration commissioned by the four chief nursing officers. In a devolved health economy, such a partnership approach by the four home nations is unusual.   

NMC chief executive and registrar Professor Dickon Weir-Hughes says this makes it impressive work: ‘This heralds a really exciting piece of consistency.’

On the other hand, the resulting report features few new messages on how midwives can best contribute to the health of women, their partners and babies. RCM general secretary Cathy Warwick admits many midwives might read the report and ask: what’s new?

But this is one of its great strengths, she says. It shows that the profession is already getting it right. What is needed now is more of the same and ensuring that the good practice outlined in the report is embedded in services. 

But meeting the needs of future service users is not without its challenges, as the report acknowledges.

One obstacle is an ageing workforce that is already predominantly part-time. Research carried out by Midwifery 2020 found that 40% to 45% of practising midwives will reach the current retirement age in the next ten years.  

Cathy hopes it may be possible for the four nations to join forces to plan the future workforce.

‘This year, Scotland found they had too many midwives... It paid for more than was actually needed. If you look at it on a UK-wide basis, then we may be able to iron out the peaks and troughs,’ she says.

The research is also an opportunity to look at the reasons behind some of the workforce trends. For example, part-time working may indicate good work/life balance and could be a 
powerful recruitment and retention tool. But it might also be a consequence of workplace stress or models of care that make midwives feel uncomfortable.

At the heart of the document are women and their families. Meeting women’s needs is the first key message. Researcher and user representative Dr Miranda Dodwell says this is as it should be. 

She was involved in a Midwifery 2020 group that looked at measuring the quality of midwife contribution – another central message in the report. Founder of BirthChoice UK Dr Dodwell says that any measurements must take account of users’ views and experiences as well as outcomes to ensure women are at the centre of maternity services.

It boils down to this, says Dr Dodwell: ‘If women don’t find their care to be a positive experience, then it doesn’t count as quality.’

The aim for midwives is to help a woman feel her birth experience is unique and positive while simultaneously ensuring there is nothing one-off about it; the same person-centred care is given to all.  

Perhaps it is appropriate that Midwifery 2020 is a paradox – sometimes that is what the best maternity care is all about.