BEYOND BARRIERS: REIMAGINING ACCESS TO POST-PREGNANCY CONTRACEPTION A GUIDE FOR BEST PRACTICE
6. The Importance of Robust Workforce Training and Education “If midwives are expected to be effective as providers of quality contraceptive advice, then they deserve ongoing training and 6
South Tees recommends developing methods to show appreciation to staff who dedicate considerable time help with the implant service on the postnatal ward. They designed a certificate to give to staff who went above and beyond to provide PPC and when one staff member fitted 100 implants, the ward celebrated with balloons. Similar recommendations to prioritise and value training and education were frequent across England, for example in Greater Manchester: “Prioritising education for both staff and patients on the sub-dermal implant offer, has been a key success factor in the pilot. Early engagement and upskilling of staff have resulted in an enthusiastic and motivated workforce, which has contributed positively to the PPC offer.” Many contributors, including midwives delivering successful PPC schemes in Northwest London, Gloucestershire, and Norfolk and Waveney spoke to the potential need to review midwifery curriculum to ensure midwives have the relevant knowledge and skills required once qualified. 38 Embedding contraceptive content into the curriculum, potentially through assessed components, could help build a more confident and capable workforce. Many contributions, including from Gloucestershire overleaf emphasised the importance of healthcare practitioners being able to access CoSRH training and education to support PPC delivery. The Letter of Competence (LoCs) qualifications provide relevant training to support PPC. The CoSRH offers various LoCs, including those for specific contraceptive methods like subdermal implants (LoC SDI) and intrauterine devices (LoC IUT). In 2024 the CoSRH launched a charitable endeavour where the organisation is investing in a ‘two for the price of one’ offer on the LOC SDI-IO qualification to support the maternity and abortion provider workforce in being skilled to deliver PPC. More information on this scheme and other relevant training offered by the CoSRH can be found in Appendix 7. Particularly as some regions of England face a midwifery recruitment crisis, PPC should be presented locally as an opportunity for upskilling, professional development and specialism within the discipline. Overall, prioritising training and education for staff delivering PPC has been a key factor in the success of many schemes across England. Early engagement, ongoing development and upskilling of staff have resulted in an enthusiastic and motivated workforce, which has contributed positively to the PPC offer. Recommendation 6 Ongoing Workforce Training and Education Ensure that all clinicians working with pregnant people in any setting receive adequate ongoing training and education development opportunities with respect to contraception knowledge and provision, including fitting of implants and intrauterine contraception where appropriate, and protect time within their clinical schedules for professional development.
support.” 37 McCance et al.
There was strong unanimity from contributors on the importance of workforce training and education in developing, delivering, and maintaining a successful PPC service, and crucially to ensure that staff are fully equipped to provide high-quality contraceptive care that women need. “Traditional midwifery training and clinical care doesn’t involve provision of postnatal contraception. Hence there is always brokering and negotiations within tasks and job plans to incorporate post-natal contraception as part of routine maternity care.” Commissioner, Bedfordshire, Luton and Milton Keynes ICB In Bradford, education for staff was also central to the success of the service: “Many midwives had never been trained to counsel women on contraception, and most were unsure about the medical eligibility or side effects of different options. We developed a presentation summarising national and local guidance, which was shared widely across maternity staff.”
37 McCance K, Cameron S. Midwives’ experiences and views of giving postpartum contraceptive advice and providing long-acting reversible contraception: a qualitative study. J Fam Plann Reprod Health Care. 2014:40:177-183.
38 Comprehensive contraceptive education is not currently included in undergraduate midwifery courses at universities in England and Wales. See Matthews G, Cousins C, Regan L et al. Undergraduate midwifery contraception training in England and Wales. BMJSRH, 2024;51:242-243.
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