Midwife (2019 NMC standards)

KSBs

Knowledge

K1: Relevant legal, regulatory, and governance requirements, policies, and ethical frameworks including any mandatory reporting duties and differentiations between the devolved legislatures of the United Kingdom Back to Duty

K2: The continuum of care, the importance of safeguarding, the human rights of women and newborn infants, women’s sexual and reproductive rights including how and when to raise concerns Back to Duty

K3: The scope of their own role including the extent and limits of own competence, ways to manage stress and resourcefulness and the importance of maintaining safe and effective practice irrespective of the situation Back to Duty

K4: The rationale that influences their own judgements and decisions, recognising, reflecting on and addressing any personal and external factors that may unduly influence their own decision-making in routine, complex, and challenging situations Back to Duty

K5: The professional responsibility to maintain the level of personal health, fitness, and wellbeing required to meet the needs of women, newborn infants and families for psychological and physical care Back to Duty

K6: How to critically analyse and interpret research evidence, local, national, and international data and reports and how they inform decision making and best practice Back to Duty

K7: When and how to challenge and escalate concerns and de-escalate situations, taking account of the views and decisions made by others Back to Duty

K8: The importance of continuity of care and carer and the impact it has on women, newborn infants and their families Back to Duty

K9: The importance of being compassionate and acting in a non-discriminatory manner that respects diversity and upholds the rights, dignity and autonomy of others Back to Duty

K10: The health and social care system, the principles of sustainable healthcare, the different ways of organising care, the range of settings for maternity care, the roles of different professions, teams and agencies and the impact these have on women, newborn infants, partners and families Back to Duty

K11: The importance of universal midwifery care including ways of identifying and reaching out to women who may find it difficult to access services, and how to adapt care provision to meet their needs Back to Duty

K12: The physical, psychological, social, cultural, and spiritual context in which women and their families live and how it informs their needs and preferences Back to Duty

K13: The need to work with other professionals, agencies, and communities including the importance of woman-centred care plans and the need for accurate and timely records Back to Duty

K14: The importance of universal care for all women, fetuses and newborn infants, the impact it has on them, the different ways to provide care that is appropriate to each woman and ways to avoid and reduce trauma where possible Back to Duty

K15: The importance of informed consent, the woman’s right to decline consent and ways to offer appropriate care and support in those instances Back to Duty

K16: Women’s relationships, individual family circumstances and how it may impact on decisions about her care and the care of the newborn infant Back to Duty

K17: The importance of privacy, dignity, safety and wellbeing including ways to provide a welcoming environment for the woman, partner/birth companion, and family, and to create the conditions needed for the birth and subsequent care to be as gentle as possible for the newborn infant Back to Duty

K18: The principles of infection prevention and control, communicable disease surveillance, and antimicrobial resistance and stewardship Back to Duty

K19: Anatomy, physiology, genetics, genomics, epigenetics and psychology and how it informs the assessment, planning and provision of care for the woman and newborn infant Back to Duty

K20: The measures, tests and checks needed to provide safe and effective care to women including transfer of care Back to Duty

K21: Changes to psychological, behavioural, and cognitive factors during pregnancy, labour, birth and the postnatal period, infant feeding and relationship building, the transition to parenthood and positive family attachment Back to Duty

K22: The woman’s everyday life and the importance of promoting public health, encouraging prevention, supporting well-being across the life course and sharing information about care appropriately. Back to Duty

K23: The range of factors affecting women, newborn infants, partners, and families and the impact these factors may have, their determinants and ways to mitigate health and social care inequalities and mental health issues Back to Duty

K24: Historical and social developments and trends, cultural and media influences on public and professional understanding and how these may impact individual attitudes Back to Duty

K25: How to recognise safeguarding issues and the risks to public protection and quality of care including how to escalate concerns in line with local/national guidelines Back to Duty

K26: The importance of human milk and breastfeeding to public health and well-being, and protect, promote and enable breastfeeding with the woman, her partner and family Back to Duty

K27: The importance of promoting, supporting and protecting breastfeeding in all settings and the issues, dilemmas and difficulties that women face when feeding their newborn infant including newborn infants receiving neonatal care Back to Duty

K28: How to support and provide parent education and preparation for parenthood to individuals and groups, offering advice relating to areas such as immunisation, infant feeding (both breast and formula) food safety, weight management, exercise, sexual and reproductive health Back to Duty

K29: The importance of basing care on individual women’s needs, views, preferences, and decisions, and working to strengthen women’s own ability to care for themselves and their newborn infant Back to Duty

K30: The psychological, behavioural, and cognitive factors that affect adolescents, adults and newborn infants and the changes that take place during the childbirth continuum Back to Duty

K31: The importance of planning care that is responsive and reflects the preferences and needs of the individual woman, fetus and newborn infant Back to Duty

K32: National screening and diagnostic tests for women, fetuses and newborn infants and associated ethical dilemmas Back to Duty

K33: The importance of and ways to encourage reciprocity between the woman, her partner and the newborn infant and their ability to respond to cues for closeness, love, comfort and feeding Back to Duty

K34: The physiology and psychology of lactation Back to Duty

K35: The implications of the different types of infant feeding including formula feeding and their impact on health Back to Duty

K36: Normal physiological processes at each stage of pregnancy, labour and birth, common symptoms and problems and ways to anticipate and deal with them Back to Duty

K37: How factors in the care environment can impact on normal physiological processes and how the midwife can work to promote and protect an active, positive and safe environment Back to Duty

K38: Normal labour and evidence-based ways to safely conduct a birth whilst acknowledging the woman’s individual circumstances and preferences Back to Duty

K39: The immediate and ongoing assessments that need to be made upon the woman and newborn infant at and after birth, including ways to interpret the findings and take appropriate actions on findings including working in collaboration with the neonatal team Back to Duty

K40: When additional care or support is needed and how to consult and make referrals for additional care or support needs when necessary for conditions such as female genital mutilation, urinary incontinence, surrogacy or adoption and caesarean section. Back to Duty

K41: The range of medical and surgical interventions relevant to pregnancy and the childbearing continuum Back to Duty

K42: Data on local, national, and international prevalence and risk to develop knowledge and awareness of complications and additional care needs that may affect women, newborn infants, and families Back to Duty

K43: Pre-existing, current and emerging complications and additional care needs that affect the woman or her newborn infant, including their potential impact on the woman’s health and wellbeing, and the ability to recognise and provide any care, support or referral that may be required as a result of any such complications or needs such as working in collaboration with the neonatal team when carrying out transitional care Back to Duty

K44: Current best practice for managing complications and additional care needs of women, newborn infants, partners and families including those that may relate to physical, psychological, social, cultural, and spiritual factors Back to Duty

K45: The escalation policy within your own organisation including when and who to refer to for routine and emergency situations Back to Duty

K46: A midwife’s professional accountability for working in partnership with women to ensure the safe administration of medicines Back to Duty

K47: Pharmacology and the principles of safe and effective administration of medication Back to Duty

K48: Evidence-based techniques for pain management including comfort measures, non-pharmacological and pharmacological methods Back to Duty

K49: The various procedural routes under which medicines can be prescribed, supplied, dispensed, administered, stored and disposed of and the laws, policies, regulations and guidance that underpin them Back to Duty

K50: Normal, adverse and abnormal reactions to medications, the impact of these and ways to manage symptoms and escalate concerns as required Back to Duty

K51: The impact of medicines on the woman, the fetus, newborn infant, in breast milk and on the breastfed infant Back to Duty

K52: Ways to safely administer medicines and intravenous fluids, transfusion of blood and blood products including in an emergency Back to Duty

K53: How to identify and work in collaboration with relevant services, multi-professional and multi-agency teams to provide continuity of care and carer Back to Duty

K54: The importance for women and newborn infants of being considered together in all settings to enable contact, skin-to-skin/kangaroo care, reciprocity and appropriate feeding supporting women who are separated from their newborn infants and enabling contact with the newborn infant to maximise the time they can spend together Back to Duty

K55: Palliative, postmortem and post-discharge services required for women and/or families experiencing pregnancy loss, neonatal or maternal death, bereavement, perinatal loss or maternal death with support with lactation suppression, postmortem examination, registration of death and funeral arrangements. Back to Duty

K56: Trauma and its impact on physical and mental health and well-being Back to Duty

K57: The importance of keeping up to date, reflection, ongoing professional and personal development and incorporating changes to own practice and behaviour including performing delegated duties Back to Duty

K58: The importance of midwives’ awareness of and contribution to the knowledge base for practice and policy such as through research, audit and service evaluation, engagement and consultation Back to Duty

K59: Why inter-disciplinary, multi-disciplinary team and multi-agency working and learning matters acknowledging the leadership role of the midwife Back to Duty

K60: The principles of human factors, environmental factors, and strength-based approaches when working with colleagues Back to Duty

K61: Ways to manage vulnerability in self and others including reflection, seeking support, strength-based approaches and compassionate self-care Back to Duty

K62: The importance of developing effective improvement strategies for quality, safety and change, and sharing feedback and learning from positive and adverse outcomes and experiences Back to Duty

K63: The importance of delegation protocols and managing, escalating and reporting on concerns and de-escalating conflict Back to Duty

K64: A range of communication methods and media including the need for confidentiality and application of information governance Back to Duty

K65: The application of up to date, relevant and accurate information Back to Duty

K66: The importance of providing culturally sensitive and person-centred care and information across the continuum of care for all women, their partners and families to make informed decisions and the importance of accurate record keeping Back to Duty

K67: The importance of enabling women, their partners and families to make informed decisions Back to Duty

K68: The importance of engaging effectively with others to build trust and develop a relationship including ways to manage difficult conversations about potentially sensitive issues and decisions Back to Duty

K69: The importance of record keeping via a range of methods and its implications for communication Back to Duty

K70: When and how to advocate for women and newborn infants who are vulnerable due to physical, psychological, social, cultural, or spiritual circumstances Back to Duty

K71: Ways to advocate for women when their decisions are outside of clinical guidance enabling and advocating for their human rights, views, preferences and decisions Back to Duty

Skills

S1: Act in accordance with relevant legal, regulatory, and governance requirements, policies, and ethical frameworks to provide universal midwifery care Back to Duty

S2: Act in the best interests of women and newborn infants at all times across the continuum of care, promoting and enabling safe physical, psychological, social, cultural, and spiritual care Back to Duty

S3: Apply the resourcefulness, and flexibility needed to work as an accountable, autonomous and professional midwife in all situations including stressful and difficult ones by developing strategies that contribute to safe and effective practice Back to Duty

S4: Apply evidence-based practice to decision making Back to Duty

S5: Apply the principles of compassionate care, courage, integrity, transparency, and the professional duty of candour, recognising, reporting any situations, behaviours, or errors and escalating concerns Back to Duty

S6: Act as an ambassador, uphold public trust and promote confidence in midwifery and health and care services Back to Duty

S7: Be accountable and autonomous in providing midwifery care and support across the continuum of care Back to Duty

S8: Provide and promote non-discriminatory, respectful, compassionate, and kind universal care that takes into account any need for adjustments Back to Duty

S9: Provide continuity of carer across the continuum of care for women and newborn infants with and without complications and additional care needs Back to Duty

S10: Inform, support, and assist in meeting women’s needs and preferences Back to Duty

S11: Coordinate care within the wider inter-disciplinary, multi-disciplinary and multi-agency teams, arranging a seamless transfer of care and promoting continuity of care and carer Back to Duty

S12: Inform and update inter-disciplinary, multi-disciplinary and multi-agency colleagues about changes in care needs and care planning, updating records accordingly Back to Duty

S13: Care for and support the woman, fetus and newborn infant across the continuum of care ensuring safety and well-being, optimising the normal processes of reproduction and early life, avoiding and reducing trauma where possible Back to Duty

S14: Seek informed consent from the woman for herself and/or her partner in relation to the newborn infant Back to Duty

S15: Involve women in assessment, planning and evaluating their own care and that of their newborn infant, promoting her confidence in her own body, health and well-being Back to Duty

S16: Assess the environment to maximise safety, privacy, dignity, optimising normal physiological processes and well-being Back to Duty

S17: Apply infection prevention and control procedures, following local and national policies and protocols Back to Duty

S18: Engage women, partners, and families in understanding and applying principles of infection control and antimicrobial stewardship Back to Duty

S19: Undertake appropriate examinations and assessments to provide care for women and newborn infants, using technological aids where appropriate Back to Duty

S20: Implement appropriate responses and decisions including responding to deviations from normal physiological processes and choice of place of birth Back to Duty

S21: Assess, promote, and encourage the development of the mother-newborn infant relationship, and opportunities for attachment, contact, interaction, mental wellbeing and relationship building between the women, newborn infant, partner and family Back to Duty

S22: Share information on public health, health promotion and protection with women, empowering them to make decisions, and facilitating access to resources and services Back to Duty

S23: Assess, interpret, record, and offer tailored information and access to resources or community-based services for women and families that promote their physical, mental, social health and wellbeing Back to Duty

S24: Share information and access to resources and services for women and families in regard to violence, abuse, poverty homelessness, refugees, victims of trafficking and safeguarding, acting appropriately and raising concerns as required Back to Duty

S25: Share information with women and families about national and local information and networks that are available to support women in the continuation of breastfeeding Back to Duty

S26: Share information with women and families about national and local information and networks that are available to support women in safe and responsive formula feeding where appropriate Back to Duty

S27: Provide parent education that is informed by current evidence on public health promotion strategies and best practice Back to Duty

S28: Work with other professionals, agencies, and communities to promote, support and protect breastfeeding, including neonatal ward and other settings encouraging skin to skin / kangaroo care, enabling the newborn to receive human milk if needed Back to Duty

S29: Involve the woman in the assessment, planning and evaluation of their own care, promoting health and well-being, recognising the diversity of individual circumstances and the woman’s own expertise of any pre-existing conditions including mental health issues, learning and physical disabilities Back to Duty

S30: Conduct holistic assessments of physical, psychological, social, cultural, and spiritual health and well-being of the woman and the newborn infant across the continuum of care, involving her partner and family as appropriate Back to Duty

S31: Plan and provide individualised, culturally sensitive evidence-based care Back to Duty

S32: Offer and conduct screening programmes, interpret, and record findings in pregnancy, during labour, at birth and in the postnatal period for the woman, fetus and newborn infant including mental health, behaviour, emotional needs and those in the criminal justice system Back to Duty

S33: Observe, assess, and promote the woman’s, and partner’s response to the newborn infant and ability to respond to cues for closeness, love, comfort and feeding Back to Duty

S34: Assess, observe and provide support on all aspects of infant feeding including formula feeding Back to Duty

S35: Implement care that optimises normal physiological processes across the continuum of care, manages common symptoms and problems, anticipates and prevents complications Back to Duty

S36: Use evidence-informed physiological and active techniques as appropriate to safely manage all stages of labour and birth, encouraging mobility and optimal positions Back to Duty

S37: Guide and support the woman as she gives birth, using evidence-based approaches to safely conduct the birth, and seeking to avoid and reduce trauma where possible, while responding to the woman’s own preferences Back to Duty

S38: Conduct an immediate assessment of the newborn infant at birth and after birth, interpreting, recording and acting appropriately on findings including working with the working in collaboration with the neonatal team Back to Duty

S39: Conduct a full systematic physical examination of the newborn infant in line with local and national evidence-based protocols Back to Duty

S40: Conduct ongoing assessments of the health and well-being of the newborn infant, involving the mother and partner as appropriate, providing relevant explanations as required Back to Duty

S41: Assess interpret and record the health and well-being of the woman postnatally Back to Duty

S42: Involve the inter-disciplinary, multi-disciplinary and multi-agency team where appropriate, consulting and making referrals for additional care or support needs as required for conditions such as female genital mutilation incontinences, surrogacy or adoption and caesarean section Back to Duty

S43: Provide midwifery care for women and newborn infants before, during, and after medical and surgical interventions such as epidural analgesia, anesthesia, fetal blood sampling, instrumental births, caesarean section and haemorrhage Back to Duty

S44: Recognise complications and additional care needs such as fertility, fetal development, adaptation to life, the newborn infant, very early child development, feeding, the transition to parenthood and positive family attachment Back to Duty

S45: Recognise and provide care, support or referral that may be required as a result of any pre-existing, current and emerging complications or care needs such as working in collaboration with the neonatal team when carrying out transitional care Back to Duty

S46: Use evidence and best practice approaches to manage emergency situations and respond to signs of compromise and/or deterioration in the woman, fetus, and newborn infant to make clinical decisions based on the findings and act on those decisions Back to Duty

S47: Consult with, seek help from, and refer to other health and social care professionals both in routine and emergency situations Back to Duty

S48: Use the principles of safe remote prescribing and directions to administer medicines including accurate drug calculations, safe storage, transportation and disposal of medicinal products Back to Duty

S49: Safely supply and administer medicines listed in the midwives’ exemptions and other relevant legislation Back to Duty

S50: Work in partnership with the woman and multi-disciplinary team to assess, plan and provide care and support in regard to her experience of and response to pain and her need for pain management Back to Duty

S51: Administer injections using intramuscular, subcutaneous, intradermal and intravenous routes and manage equipment required to administer drugs safely Back to Duty

S52: Recognise and respond to adverse or abnormal reactions to medications Back to Duty

S53: Recognise the impact of medicines in breastmilk and support the woman to continue to responsively feed her newborn infant and/or to express breastmilk Back to Duty

S54: Collaborate effectively with multi-disciplinary teams and work in partnership with women to assess, provide care and support when emergency situations or clinical complications arise to ensure the safe administration of medicines Back to Duty

S55: Work collaboratively with women and the inter-disciplinary, multi-disciplinary or multi-agency team to plan and implement midwifery care for women and newborn infants requiring other services, and support women to access these as needed Back to Duty

S56: Ensure that the needs of women and newborn infants are considered together as a priority in all settings, encouraging immediate skin-to-skin contact at birth, even when women and infants have to be cared for separately, supporting women who are separated from their newborn infants and enabling contact with the newborn infant to maximise the time they can spend together Back to Duty

S57: Plan and implement midwifery care for women and/or partners and families following traumatic experiences, conveying respect, compassion and sensitivity when supporting women, their partners and families who are emotionally vulnerable, distressed and/or experiencing mental health issues Back to Duty

S58: Plan and implement compassionate, respectful, empathetic, dignified midwifery care for women and/or partners and families experiencing perinatal loss or maternal death miscarriage, bereavement, perinatal loss or maternal death with support with lactation suppression, postmortem examination, registration of death and funeral arrangements Back to Duty

S59: Be a reflective practitioner, committed to developing as a midwife, taking personal responsibility for ongoing learning and development and for engaging in education and professional development opportunities and the feelings around positive and negative feedback Back to Duty

S60: Keep up to date by identifying, critically analysing, and interpreting research evidence and local, national, and international data and reports Back to Duty

S61: Provide leadership and role modelling including the ability to guide, support, motivate, collaborate and share learning with and refer to inter-disciplinary, multi-disciplinary and multi-agency colleagues appropriately Back to Duty

S62: Recognise and respond to signs of personal and professional vulnerability in themselves or their colleagues and take action to minimise risks Back to Duty

S63: Work with inter-disciplinary, multi-disciplinary and multi-agency colleagues, advocacy groups and stakeholders to promote and develop quality or safety improvements and manage change Back to Duty

S64: Provide safe team management when supervising, supporting, teaching and delegating midwifery care Back to Duty

S65: Use appropriate and responsive communication with women, newborn infants, partners, families and colleagues, respecting confidentiality Back to Duty

S66: Access oral, written and digital information including published evidence, data and reports to inform conversations with women, partners, and families Back to Duty

S67: Conduct person-centred, sensitive and compassionate conversations with women, their partners and families on women’s and children’s health across the life continuum of care Back to Duty

S68: Involve the woman and her partner and family in discussions and decisions about her care and the care of the newborn infant, always respecting the woman’s preferences and decisions about who to involve and the extent of involvement and communication Back to Duty

S69: Use evidence-based approaches to build person-centred relationships with women, their partners and families that respect and enable their needs, views, preferences, and decisions Back to Duty

S70: Maintain consistent, complete, clear, accurate, secure, and timely records and responsibly share data within teams and between agencies Back to Duty

S71: Act as an advocate to ensure that care continues to focus on the needs, views, preferences and decisions of women, and the needs of newborn infants Back to Duty

S72: Develop and maintain relationships with colleagues from the inter-disciplinary, multi-disciplinary and multi-agency team Back to Duty

Behaviours

B1: Treat people with dignity and respect Back to Duty

B2: Be caring and compassionate Back to Duty

B3: Have the courage to speak up and challenge appropriately Back to Duty

B4: Be competent, reliable and committed Back to Duty

B5: Display leadership qualities Back to Duty

B6: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates Back to Duty