Presentation

With over a decade of midwifery experience in diverse settings—including community care including home births, obstetric-led units, and birthing centres—along with a master's in midwifery which focused on promoting physiological births in complex environments, I am well-positioned to enhance the consultant midwife role at NHS Tayside.

My background in leadership, education, and evidence-based practice aligns with NHS Tayside's priorities, including reducing health inequalities and improving maternity care. I am deeply passionate about advocating for the midwifery profession and ensuring better service provision for women and their families.

As a consultant midwife, I will strive to create meaningful change  at local and national level, supporting both midwives and the women in our care, while maintaining a dynamic and responsive working environment.

Prior to the implementation of the Best Start initiative, I co-pioneered a continuity of care model, collecting data and stakeholder feedback that demonstrated improved maternal outcomes. This experience was deeply rewarding and reinforced my commitment to high-quality maternity care.

However, the current continuity model is struggling, particularly surrounding continuity in the postnatal period. I propose a review of the existing framework to identify and implement improvements.

Additionally, staff burnout and sickness remain significant challenges. Strengthening well-being champions and facilitating protected time for midwives to engage in the civility group can create a better working environment and enhance the care provided to women.

In my current practice in the birthing unit I have witnessed midwives experiencing a lack of confidence or fear surrounding providing care to women who choose to birth out with guidelines.

To address this, I propose a structured approach through drop-in discussion sessions where midwives can express concerns, receive targeted guidance, and gain essential upskilling. This initiative will ensure that midwives feel empowered in their advocacy and decision-making, leading to better outcomes for both women and midwives.

By fostering an environment of continuous learning and confidence-building, we can reduce unnecessary transfers to high-risk care settings while ensuring that women remain informed and supported in their birth choices.

One of the most impactful ways to reduce health inequalities would be to integrate Keep Well health checks into maternity services focusing upon women from low socio-economic backgrounds and/or women were health risks were identified in their first pregnancy. By embedding these checks into postnatal care around 6-12 months postnatally, we can screen for risk factors such as high blood pressure, smoking, and diabetes, and provide targeted referrals to appropriate health services such as weight management / smoking cessation

The keep well checks is a framework that is already in place in primary care that maternity services could utilise which could have a positive impact for future pregnancies for these women as currently in maternity services there is a limited window of opportunity to make transformative change in the duration of a woman’s pregnancy and birth journey.  Will need to collaborate / engage with the local medical consuition {LMC}

By adopting an interdisciplinary approach  - working with women ,consultants , psychologists and women themselves , we can uncover the root cause of these decisions. Structured conservations with the women to allow them the safe space to be listened to and explore their decision making could be a key intervention alongside ensuring engagement / awareness of the birth debrief service with both midwives and obstetricians if previous traumatic birth experience.

The goal is to reduce unnecessary caesarean rates by ensuring women feel heard, supported, and confident in their birth choices. This approach not only benefits maternal health but also optimises NHS resources and improves long-term birth outcomes.

From my experience in community midwifery and facilitating parent education for over five years, I have observed that the women who would benefit the most from these classes are often the least likely to attend. A key priority should be making parent education more accessible, particularly for vulnerable and marginalised groups.

To achieve this, I propose redesigning education programs by delivering sessions in voluntary centres and within high-deprivation areas , could encourage participation from diverse backgrounds.

Inclusive education is about empowering women with the knowledge and confidence to prepare for pregnancy , birth and motherhood whilst being able to make informed decisions about their care. By ensuring that classes cater to various social and cultural needs , we enhance overall maternity experiences and improve health outcomes

Additionally, a pilot study involving women 6-12 months postpartum will assess real barriers to education access and explore what support they wished had been available before and after birth. Engaging directly with these women will allow us to create targeted, impactful education programs.

To ensure that parent education redesign truly addresses the needs of marginalised groups, I propose a research-driven approach that actively involves the public and patient groups. By consulting with postnatal women—particularly those who did not engage in existing education—we can identify real barriers and improve accessibility.

Feedback will play a crucial role in shaping the education model. A pre-evaluation and post-evaluation system, possibly using Likert scale surveys, will measure effectiveness and highlight necessary adjustments before scaling up.

Understanding ethical considerations is also key. I will ensure that all research follows IRAS and NHS trust approval processes, maintaining integrity and ensuring findings can be implemented effectively.

Measuring success is critical in ensuring long-term impact. Over the course of 12 months, I will implement both quantitative and qualitative evaluation methods to assess the effectiveness of the initiatives outlined.

Staff confidence and advocacy will be key indicators, with structured surveys evaluating how supported midwives feel in their roles whether that’s working within the continuity of care model or caring for women who chose to birth out with guidelines . Similarly, tracking uptake of Keep Well Checks will help measure our progress in addressing health inequalities, and we will monitor reductions in unnecessary elective C-sections to gauge the impact of our collaborative approach.

Addressing the accessibility to parent education for vulnerable women will enable me to measure the uptake  and researching the barriers and obtaining feedback will give me insight from the woman’s perspective and therefore the ability to perfect parent education that is tailored to women’s needs.

Personal and professional development will also play a role, utilising TURAS appraisals and reflective practice to ensure continuous learning and improvement. Whilst recognising in the first 12 months I will be embedded myself within the role and identifying myself to all health professionals within primary and secondary care as well as national level – networking.

To conclude, this presentation has outlined key initiatives aimed at transforming maternity care at NHS Tayside. From promoting physiological birth to supporting midwives, improving education, and reducing healthcare disparities, these strategies will ensure better outcomes for both mothers and professionals.

I am committed to continuous improvement through research, staff mentorship, and collaborative approaches. By listening to midwives and women, we can refine our services to meet real-world needs effectively.

I recognize that the consultant midwife role presents a significant learning curve. However, my passion for elevating services for both women and staff, along with my commitment to cultivating a dynamic work environment, will empower me to excel in any challenge that comes my way.