Fulfilling its meaning of ‘with woman’, midwifery has been present throughout the centuries. The International Confederation of Midwives (ICM, 2011) refers to midwifery as one of the oldest and most respected professions in the world. Midwives have a long history of providing care for childbearing women, and the concept of woman-centred care has been a theme that has remained in midwifery throughout the centuries. The recently published report from the National Maternity Review (2016), Better Births: Improving outcomes of maternity services in England, highlighted personalised care as a key theme. It suggested that a woman's maternity care should be tailored and personalised to her individual needs and those of her baby and family.
Focusing on the women
In the UK today, midwives have a duty to act as ambassadors for women during the childbirth continuum. It is the duty of a midwife to prioritise people, practise effectively, preserve safety and promote professionalism and trust. The National Institute for Health and Care Excellence (NICE, 2010; 2015; 2016), the Nursing and Midwifery Council (2015) and the Royal College of Midwives (2014) have all issued guidance, support and recommendations for a woman-centred care approach in all maternity settings.
The National Maternity Review (2016) advocated a service in which women are able to make their own choices about their own care. There has been much discussion about the definition of woman-centred care and how it is implemented in practice; fundamentally, a woman-centred care approach is simply a holistic approach in which the women in our care are at the centre of all decisions and care plans.
Every day is a special day in midwifery, and it is always important to reflect and remember that; no two births, no two days, and no two women are ever the same. The mechanisms that aid childbirth remain the same, but every woman and birth is unique and can never be recreated. Therefore, it would be wrong of us to generalise midwifery care and assume every childbearing woman wants the same thing. We live in a diverse nation where women come from many different backgrounds and may have many complex physical, social and emotional needs. As midwives, we have to promote woman-centred care to the extent that every woman is made to feel unique. All maternity staff should have an understanding that every woman is an individual and will require specific care that is suited to her needs.
Throughout its history, midwifery practice has seen a number of changes owing to the introduction of new technology and equipment, changes in midwifery regulators, and the publication of significant documents and government policies. Midwives and maternity services have frequently been in the spotlight across the UK, and I'm sure there will continue to be changes to maternity services in future. However, I am a firm believer in what, I think, should be every midwife's fundamental philosophy: woman-centred care. This should never be compromised; the women we care for ought to be paramount (Cliffe, 2015).
Privileged people
Midwives are faced with the ever-changing nature of day-to-day practice, the demands of meeting targets, completing paperwork, staff shortages, reconfiguration of maternity services and the constant government financial budgets that impact maternity and health services across the UK. Yet, above all this, it should still be the hope of all midwives to support, listen to, advocate for and empower women in their childbirth experience.
It is an immense privilege to be a midwife. I always aim to place the needs of the woman and her family first. Let us not forget, midwives are privileged people, who get to share precious moments with women, and we are entrusted by them to play a vital role in their childbirth experience.