The Royal College of Midwives (RCM), who represent and support over 50,000 midwives, student midwives and maternity support workers have expressed valid concerns about embedding PPC as a midwifery responsibility considering their crucial role in much of the pregnancy journey and current workload pressures. These worries are reasonable and justified, demonstrating the acute need for resource and capacity to alleviate pressure on midwives and ensure they can continue to deliver PPC alongside other aspects of their vital role: “We should be making it as easy as possible for women to get suitable contraception after childbirth, using the existing points of contact with the NHS. In some areas, contraceptive services are embedded within maternity services and midwives are trained and confident in providing it. I applaud the fantastic midwives who are going the extra mile to meet the needs of women and their families by doing this.”
Somerset and South Gloucestershire, Greater Manchester, The Wirral, Derbyshire and South Tees. In each the PPC service is delivered chiefly by midwives or nurses and are crucially supported by other disciplines, and by obstetricians and SRH professionals on the maternity ward, efficiently embedding contraception provision into routine maternity care: “Embedding contraception into routine maternity care is both effective and well- received.” Specialist Nurse, Bristol, North Somerset and South Gloucestershire Additionally, midwives and nurses often provide care in community or clinic settings, making access to advice more convenient, especially for women in rural or underserved areas. Whilst meeting the needs of women locally, shifting more midwifery care into the community will also ease mounting pressures on primary care.
In focus: the Royal College of Midwives Midwives see everyday the benefits of post childbirth contraception: mothers’ bodies are more rested and recovered before starting another pregnancy, families are stabilised, health risks are reduced. The postnatal period is often a turbulent time, as sleep is disrupted, routines are established and everyone in the household adjusts to the new arrival. It’s not usually a time when mothers’ self-care is given priority, and that includes taking care of their reproductive health needs. We should be making it as easy as possible for women to get suitable contraception after childbirth, using the existing points of contact with the NHS. In some areas, contraceptive services are embedded within maternity services and midwives are trained and confident in providing it. I applaud the fantastic midwives who are going the extra mile to meet the needs of women and their families by doing this. They are part of an army of midwives across the UK who are committed to maximising the public health potential of the first 1000 days of life. There are so many ways in which midwives are unsung heroes of public health – not just by providing post birth contraception, but also extended support with breastfeeding, mental wellbeing and more. It is impressive what can be achieved when midwives are resourced and supported to fulfil their contribution, and deeply disappointing that current workforce and resource shortages prevent this being realised everywhere. At a time when resources are so stretched that commissioners are focusing on the basics of safe clinical care, and when what happens in labour ward must be prioritised over what comes after, the public health potential of midwifery care is curtailed. Let’s hope this won’t always be so, and that the inspiring midwives and doctors cited in this report will one day become the norm, not the pioneers.
Fiona Gibb, Director of Professional Midwifery, Royal College of Midwives (RCM)
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