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Nursing and Midwifery Council (NMC) is the professional regulatory body.
Midwives should provide women-centred care and respect the needs of women and
their families. The woman must be looked after and supported for throughout all
stages of pregnancy including the pre-conception, antenatal, intrapartum and
postnatal periods. Midwives have many tasks, an important task is in educating
and health counselling the woman. This is to the woman, family and the community
which includes providing antenatal education and preparing parents for
parenthood. The care the woman receives antenatally is vital in order for the
woman to prepare herself for the intrapartum and postnatal stage. It is
important to build a rapport relationship with the woman as some woman find it
difficult to share their personal problems with someone they have never met.
Also, when working in a multidisciplinary team communication with the woman
must be upheld. Antenatal care is vital for the fetus as well as the mother,
this is to ensure the health and well being of the baby.  

rate of still births in England have dropped by 16% since 2010 and the rate of
neonatal deaths have dropped by 10%. Approximately 50 women die each year due
to pregnancy in England, with a significant fall of 20% in maternal deaths
since 2011. The impact on the midwifery care has been overwhelming, the data
provided shows the actions which were made were inspirational and have had a
positive impact in practice. Safer Care are continuing to improve care in maternity
after seeing significant changes in practice.

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care in maternity has impacted midwifery care rapidly. The number of
stillbirths and deaths soon after birth were extremely high. This experience is
devastating when losing a loved one, especially when the matter could have been
controlled and prevented from taking place. The NHS services have high quantity
of positive outcomes which must be upheld and improved in the upcoming years. A
lot of time and effort is used to ensure England is a safe place to have a
baby. An action plan was set out and published by the Department of Health to
halve the number of stillbirths and deaths. The action plan focused on five key
headings. These are as follows Focus on leadership, focus on learning and best
practice, focus on teams, focus on data and focus on innovation. National
Maternity Review Report, Better Births launched as well as the Maternity
Transformation Programme (MTP) ensuring all women received high quality care
regardless of their circumstances. Better Births was launched in order to give
woman a wider choice of care and control over their right as well as providing
a safer care according to their needs. Better Births Implementation Plans are
being developed further by Forty-Four Local Maternity Systems (LMS). LMS are
putting into place how a more personalised and safer maternity care can be
delivered by the end of 2020/21.


Antenatal classes are
held for pregnant women which can help you prepare for birth. These classes
take place around 8-10 weeks before the baby is due, from 30-32 weeks gestation.
The classes are offered to all women at their regular antenatal appointments
with the midwife. The women will be given
details of where they can find the classes for the woman to choose whether she
would like to attend. Antenatal
classes consist of exercises, relaxation and caring for your baby which you can
attend with your partner and friends.

abdominal examination is carried out during the antenatal period. The midwives
role requires her to assess the wellbeing and growth of the fetus from 36 weeks
gestation (NICE). The midwife must perform an abdominal examination by
observing, palpating and auscultation. This may be uncomfortable and
embarrassing for the woman, therefore the midwife must ensure privacy and
comfort at all times (MacDonald, Johnson and Warwick, 2017). If any
deviations from the normal are detected, they must be acted upon and referrals should
be made to the correct department. When
information needs to be shared it must be shared appropriately with other
healthcare professionals or agencies. Practice in line using the best available
evidence, making sure all information given to people is evidence based (NMC,

in pregnancy is advised to stop consuming as it causes harm to the fetus (,
2017). The
midwife should document history of alcohol use and act accordingly to trust
policy (NMC, 2015).

woman must be offered evidence based choices for the types of screening
available at the first appointment. The standard dating scan or the nuchal
scan. The nuchal scan is tested for Down’ s syndrome, Edwards syndrome, and
Patau’s syndrome. The woman must make an informed decision at the time in order
for her to receive the care she wants (MacDonald, Johnson and
Warwick, 2017).

A set
of bloods are offered at early stages of pregnancy from 8 to 12 weeks. The
midwife must discuss and gain consent according to NMC guidelines and trust policy.
These testing for three infectious diseases hepatitis B, HIV and Syphilis.
Detecting the blood group in case a blood transfusion is needed due to heavy
bleeding during pregnancy or birth, to detect sickle cell and thalassemia
carriers and rhesus disease. A gestational diabetes will also be offered to
woman from a specific origin, overweight, diabetes in previous pregnancies,
close family with diabetes or previous births 4.5kg or over. (,

each antenatal visit blood pressure and a urine sample is taken. Blood pressure
is taken to assess the wellbeing of the woman, to detect any deviations from
the normal, and as a baseline observation. The midwife must carry this out during
the appointment and record readings according to the trust policy. Urine is
tested for protein. The sample is tested by the midwife in the presence of the
woman. A urine sample must be brought to every antenatal appointment the woman
attends, this is to detect any deviations from the normal. The midwife must
ensure the urine is fresh, as urine which has been stored deteriorates very
fast, this affecting the accuracy of the results. The urine is tested by
dipping a reagent strip into the sample, if any abnormal substances are
detected the reagent strip will change colour as they are impregnated with
chemicals. If abnormalities are detected the sample must be sent to the labs to
be tested further. Once further testing has been completed, the system will update
with the results. Depending on the results action will be taken. If the woman
is suffering from infection the midwife must contact the woman discussing the
results and treatment. Results are recorded according to NMC guidelines (MacDonald,
Johnson and Warwick, 2017).

midwives job is to book the woman in for a booking appointment. The booking appointment
is a detailed appointment where the midwife will go through a booklet asking
various questions on the social, emotional, psychological, medical conditions,
family history and information regarding previous and current pregnancy. The
midwife must make sure the woman understands clearly what is being asked as the
information provided must be accurate (MacDonald, Johnson and
Warwick, 2017). The
booking appointment is the foundation appointment of the pregnancy, it is
important the midwife has good communication skills and is committed in
building a rapport relationship with the woman. The environment setting where
the appointment is going to take place must be suitable (NMC,
2015). The
midwife’s role requires her to make the woman feel comfortable and not closely
questioned, open questions must be asked which results in positive feedback. It
is vital the midwife provides a holistic approach to the woman, all the woman’s
needs, problems and issues must be taken into consideration (MacDonald,
Johnson and Warwick, 2017).

to the NMC the midwives role requires her to deliver the best advice to the
woman at every appointment making sure the advice delivered is being taken into
consideration (NMC, 2015). Woman
are encouraged in pregnancy to reduce or stop smoking, this is for the woman’s,
fetus and unborn babies benefit. All information provided must be unbiased and
evidence based. The role of the midwife is to give information in a positive
manner in order to receive a positive outcome from the woman. The woman must be
told about all the help available regarding smoking. Help such as the NHS stop
smoking services and the NHS pregnancy smoking helpline. Smoking in pregnancy
increases the risk of miscarriages, preterm birth, still birth, placental
abruption, perinatal death, sudden death and congenital abnormalities in

midwife must check the woman’s blood pressure at some point in the appointment,
this is to check anything from the norm. The midwife must check the height and
weight of the woman, this will be recorded onto the form. The reason as to why
the weight and height must be checked is to work out the BMI. The BMI reassures
the midwife that you are within the risk factors and healthy. If the woman is
high risk she is eligible for an anaesthetic referral, the midwife’s role is to
do this. The midwife’s role requires her to discuss the types of scan which are
available (MacDonald, Johnson and Warwick, 2017).

woman will be asked the first day of her last menstrual period also known as
the ‘LMP’, using this approximate date the woman’s estimated due date will be
calculated using the gestation chart. The midwives job is to then advice the
woman she must take folic acid tablets up until 16 weeks of pregnancy, this is
very important to help prevent neural tube defects in the first stage of
pregnancy. Vitamin D is also recommended to take throughout pregnancy for the
health and wellbeing of the woman as well as the fetus. The midwife’s duty is
to provide the woman with evidence based information. Telling the woman, she
might not have her baby on the EDD (estimated due date). The fetus is full term
from 38 weeks so the woman could go into labour from 38 weeks up until 42 weeks
gestation (MacDonald, Johnson and Warwick, 2017).

woman’s history on previous pregnancies, miscarriages, terminations if any are
documented. If the woman has had previous pregnancies she must provide the
child’s full name, date of birth, gestation of the baby, where the baby was
born, type of birth, birth weight and any complications which occurred during
pregnancy, intrapartum and postnatally. All previous pregnancies are dealt with
in chronological order, notes of each pregnancy must be present from where care
was delivered. Documentation must be done according to trust policy (NMC,
2015). For
obstetric or paediatric complications referrals to the correct department must
be made for regular examinations due to previous complications (MacDonald,
Johnson and Warwick, 2017).

midwives role requires her to introduce herself to the woman, it is important
the midwife explains what she is going to do at the appointment and what is
going to happen next. The midwife must make sure the room the appointment is
taking place in is suitable for privacy and confidentiality reasons, if it is
safe and provides the facilities needed (NMC, 2015). The midwives job is to fill in the “First
point of contact form” with the woman. This form contains general information
of the woman such as full name, date of birth, address, GP, ethnicity,
religion, occupation and the woman’s status single/married/partner, to show if
the woman is in a stable, supported relationship or seeks help (MacDonald,
Johnson and Warwick, 2017).

care is the care provided to the woman throughout the pregnancy by the midwife.
The woman will contact the GP to book an appointment with the midwife or GP
regarding the pregnancy. Antenatal care could take place is various settings
such as an antenatal clinic in the hospital, home, GP surgery and health centre
(MacDonald, Johnson and Warwick, 2017). The midwives job is to then follow up
previous records of the woman ready for the first appointment with the woman.
The NMC states the midwives role requires her to provide a holistic approach to
the woman and woman centred care (NMC, 2015). The
midwife must deliver the best care making sure the woman is receiving all the
care and support she needs.  It is vital
the midwife shows compassion, care, respect, non-judgemental and supportive
attitude towards the woman (MacDonald, Johnson and Warwick, 2017). Good communication skills are important
in order for the woman to feel at ease and comfortable with sharing personal
information with the midwife. In order for the best care to be given you must
work in partnership with people and make sure their physical, social and
psychological needs are assessed and answered (NMC,
2015). Interpreters
are arranged for women whose first language is not English and are not
confident with understanding or speaking English, the midwife must act on this
in order for the woman to assess and understand the situation.

role of the midwife is to ensure the woman is receiving physical, emotional and
mental care. This woman is cared for throughout antenatal care, labour, birth
and postnatal care. The midwife is responsible for the continuity of care and
providing a holistic approach when other health professionals are present. The
midwives role requires her to promote a positive experience for the woman in
order for her to feel comfortable. The midwives role
requires her to respect the woman’s problems, rights and decisions towards her
own health to promote a positive experience for the woman. The NMC states the privacy
and confidentiality of each individual is vital, the individual receiving care
must be informed when and why their information is being disclosed.

Nursing and Midwifery Council Legalisation is set out to regulate the role,
responsibilities, rights and how they are approached. Registered nurses and
midwives must uphold the code which covers the professional standards. It is
vital that UK nurses and midwives act in line with the code. This is when they
are delivering direct care, group care or community care. The NMC ensures all
nurses and midwives keep their knowledge and skills up to date in order for
them to deliver superlative care and uphold the professional standards. Nurses
and midwives must have the correct knowledge, experience and health to meet the
requirements of the NMC. The code is used by nurses and midwives to promote
safe and deliver the best care, organisations who support their staff in
upholding the standards of the NMC and educators who use the code to show
students the importance of the NMC and how to achieve these standards (NMC,

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