Giving birth is not something that we do alone. While some women may choose a more hands off birth approach, having midwife advice throughout your pregnancy and birth journey is important.

But what is a midwife, and what is their role in the UK?

In our recent blog post about what health visitors are, we talked about how it takes a village to raise a child. While that phrase doesn’t ring quite as true as it might once have done, the community around us is still a very important factor for new parents. In addition to health visitors, a team of midwives is a crucial element of pregnancy, labour, birth and the postpartum period.

What is a Midwife?

A midwife is a registered nurse or midwife with specialised training in pregnancy, childbirth, and women’s health. They are experts in normal pregnancy and birth who give personalised care and guidance. Unlike obstetricians, doctors who specialise in pregnancy and childbirth and usually handle more complex medical situations, midwives are the key point of contact for families during pregnancy, birth and the immediate postpartum experience.

What Do Midwives Do in the UK?

Prenatal Care: Throughout your pregnancy, your community midwife will be your primary point of contact. They provide regular check ups to monitor your health and your baby’s development. These check ups include blood pressure checks, weight monitoring, listening to your baby’s heartbeat, and discussing any concerns you may have. Midwives also offer education and support on various topics like nutrition, exercise, and preparing for birth. At specific appointments, you may discuss your mental health, breastfeeding and creating a birth plan.

Labour and Birth: When you’re in labour, you will be supported by one or more midwives either at the hospital, midwife led birth unit or at a home birth, depending on your choice of birth location. This may be your familiar community midwife or one or more from a team of midwives. They will be able to monitor you throughout labour, offer pain management techniques, emotional support, and guidance to help you achieve a safe and positive birth experience. They can suggest and provide any interventions that may be required.

Postpartum Care: After giving birth, your midwife continues to provide support and guidance during the crucial postpartum recovery period. In the immediate time after birth, they will check you for tears and provide stitches if necessary. In the hours afterwards, a midwife will help to initiate breastfeeding or to support with bottle feeding, as well as providing guidance on caring for your newborn and monitoring your physical and mental health. They can also connect you with additional resources like health visitors or lactation consultants if needed.

Once you’ve been signed out of hospital or the birth unit, you will still remain under midwife care. There is usually an appointment within 36 hours at home, followed by another at 5 days. At these appointments, your baby will be weighed and some tests such as the Blood Spot test may be done. You are usually discharged from midwife care between 10 and 14 days after birth, but it may be up to 28 days if you still require this care.

Who are Independent Midwives?

In the UK, we have access to all the care described above as part of the NHS service, but families are able to choose to have the support of an independent midwife instead of or in addition to this. Independent midwives are registered midwives who operate outside the NHS system. They are highly skilled and experienced professionals with a passion for normal birth. While adhering to the same high standards of care as NHS midwives, they often offer greater flexibility and continuity of care throughout pregnancy, labour, and the postnatal period.

Families may choose to have an independent midwife as they can offer the opportunity to build a stronger relationship with more of a focus on individualised care since they can give more time than the standard NHS system can allow and there is a better guarantee of continuity of care. There may be a specific reason for a family to choose an independent midwife, such as a preference towards a home birth which they are not sure they’ll be able to manage with the NHS, or a potential complication such as twins or breech birth where a specific independent midwife may have been able to become more experienced.

Independent midwives do charge a fee though, and you’ll want to make sure that you choose one carefully who has all the right qualifications. There are websites such as Independent Midwives UK who can help you select someone who is right for you.

Cord Blood Collection and Midwives

If you’re considering cord blood collection at birth, this is something that midwives will be able to discuss with you, to help you weigh up whether it’s a choice you’d like to make. They can explain the benefits and potential uses of cord blood stem cells, as well as the collection process itself. They can also provide you with resources to learn more and help you make an informed decision. If it’s something you choose to do, your community midwife will assist you with incorporating it into your birth plan.

At the birth, midwives may be available to assist with the cord blood collection process. They will ensure the collection is done safely and efficiently, following the right protocol. Even if they are not involved in the collection itself, your midwife can help by holding the space for you while the collection is done, such as ensuring that you get the option to delay cord clamping before collection or keeping a quiet and peaceful golden hour environment after birth while the cord blood is collected.