Embracing advanced practice in midwifery
By Fiona Gibb on 30 July 2024 Midwifery Midwives Clinical practice
The RCM’s Director of Professional Midwifery, Fiona Gibb, says that, with the need for improved career pathways, the time for advanced practice in midwifery has come.
Earlier this year, the Nursing and Midwifery Council (NMC) announced plans to develop additional regulation for advanced practice nurses and midwives. This is a significant step towards ensuring that advanced practice is recognised but what exactly is advanced practice in midwifery? Our nursing colleagues have advocated for advanced practice for years, but it’s been less common in midwifery, with many debating that it wasn’t required. However, with regulation upon us, we can’t pass up the opportunity. It’s time to change the narrative and ensure the approach to regulation is what midwifery needs it to be.
As midwives, we start our journey with autonomy and accountability from the moment we qualify and register with the NMC. While this establishes us as competent professionals, it does not automatically make us advanced practitioners. Advanced practice involves building on the NMC standards of proficiency for midwives and creating pathways for career growth. The RCM has released a new position statement on advanced practice, believing that it enhances our knowledge, influence and positively impacts on healthcare outcomes.
The RCM defines advanced practice in midwifery as ‘a level of practice underpinned by experience and expertise and enhanced by master’s level education. It demonstrates influence and impact on midwifery practice across clinical practice, education, research and leadership. It is an opportunity for professional development and can support the midwife to accelerate into future career pathways.’
Advanced practice in midwifery doesn’t replace medical roles or allow us to perform clinical skills beyond our scope. Instead, it provides a much needed career pathway into other roles such an educators or researchers or senior clinical positions. Given the shortage of educators and researchers and the need for support in midwifery leadership roles, advanced practice can be the vehicle for succession planning. Additionally, it should be recognised for those working in clinical and non-clinical settings.
But what about consultant midwives or specialist midwives, I hear you cry? Senior or expert roles and advanced practice should not be seen as mutually exclusive. Midwives in these roles may or may not also be educated to advanced practice level across the four pillars of practice. Advanced practice midwives can collaborate and complement others, such as midwives working in speciality, consultant midwives, lead midwives for education and professors. In doing so, they may aspire to those roles in future.
Implementation of advanced practice may vary across the UK, with each country having at least a multi-professional advanced practice framework. However, the core idea remains the same; supporting experienced midwives to broaden their knowledge across the pillars of practice. This approach shifts the focus from climbing a hierarchical ladder to building diverse career portfolios and opening the doors to future career pathways in midwifery that many do not find easy to navigate.
While the benchmarks for demonstrating this level of expertise for additional regulation are yet to be determined, the RCM, as a key stakeholder in the NMC advanced practice steering group, advocates for an approach that benefits midwives, shapes the future of midwifery and ultimately contributes to improved healthcare outcomes