Midwife

Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period

As well as the essential antenatal and postnatal care you'll provide, as a midwife, you'll also help women make their own decisions about the support and services they access during pregnancy and labour. You'll continue to give health education and parenting advice until care is transferred to a health visitor.

You're responsible for the health of both mother and child and will only refer to obstetricians if there are medical complications. Work is carried out in multidisciplinary teams in both hospital and, increasingly, community healthcare settings.

Responsibilities

As a midwife, you'll need to:

• monitor and examine women during pregnancy and birth
• develop, assess and evaluate individual programmes of care
• provide full antenatal care, including screening tests, examinations and parenting classes
• identify high risk pregnancies and make referrals to doctors and other medical specialists
• arrange and provide parenting and health education
• provide counselling and advice before and after screening and tests
• offer support and advice following events such as miscarriage, termination, stillbirth, neonatal abnormality and neonatal death
• supervise and assist mothers in labour, monitoring the condition of the foetus and applying knowledge of drugs and pain management
• give support and advice on the daily care of the baby, including breastfeeding, bathing and making up feeds
• promote health and wellbeing, providing unbiased information to pregnant mothers and their families
• liaise with agencies and other health and social care professionals to ensure continuity of care
• keep up to date with the latest developments in the profession so that their skills and knowledge remain current
• participate in the training and supervision of junior colleagues.

Salary

• Midwives working for the NHS are paid according to a fixed pay scale, known as Agenda for Change. Salaries for newly qualified midwives are set at Band 5, which starts at £28,407.
• You can then progress to Band 6, which ranges from £35,392 to £42,618.
• Salaries at Band 7, where you'll be working at a more senior level, e.g. managing a team, are in the region of £43,742 to £50,056.
• One of the highest-paid positions in nursing is as a nurse consultant where salaries start on Band 8b to 8c, which ranges from £50,952 to £81,138.

There are variations between England, Scotland, Wales and Northern Ireland, so you’ll need to check for the country in which you wish to work.

Income data from NHS Agenda for Change. Figures are intended as a guide only.

Working hours

Working hours typically include unsocial hours. The full-time working week is usually 37.5 hours and is likely to include day and night shifts, weekends and bank holidays. Shifts are usually between 8 to 12 hours in length. Community and independent midwives are regularly on call across 24 hours and you should expect to be part of an on-call rota at some point in your career.

Part-time work is available. Self-employment or freelance working is sometimes possible, and you can choose to work in independent practice, which could offer more opportunities for continuity of care. Career breaks may be available depending on your employer.

What to expect

• You can work in maternity units of large hospitals, smaller stand-alone maternity units, private maternity hospitals, group practices, birth centres, general practices and in the community.
• You'll work as part of a team, liaising with a range of medical and health professionals such as maternity support workers, gynaecologists, health visitors, GPs and neonatal nurses.
• Although men have been allowed to train as midwives since 1975, there are still only a very small number of men in the profession. People from ethnic minorities are also underrepresented. For more information on what the Nursing and Midwifery Council (NMC) is doing to address equality, diversity and inclusion in the profession, see Together in Practice.
• The work can be physically and mentally demanding, and involves exposure to sensitive situations such as bereavement and domestic abuse.
• You may have to travel to patients' homes or attend births during the day or night, but overnight absences from home and overseas travel are unlikely.

Qualifications

To practise as a midwife in the UK, you must be registered with the Nursing & Midwifery Council (NMC). To register, you must complete an approved pre-registration degree-level programme - in the form of a midwifery undergraduate or postgraduate degree or a degree apprenticeship.

Full-time courses last three years. Half of the course is spent studying at university, while the other half is spent on clinical placements to provide you with hands-on experience. You'll learn how to understand and facilitate normal childbirth, as well as to identify potential complications, carry out emergency measures and ask for help from other professionals when needed.

Midwifery degree-apprenticeships combine paid work in a relevant role with academic study. Search for vacancies on NHS Jobs and Find an apprenticeship.

Part-time courses are available for those who are working in a relevant role and usually take five to six years. If you're already a registered (adult) nurse, you can take a shortened midwifery training programme, which allows dual registration with the NMC.

Search for NMC-approved midwifery programmes. For part-time courses, contact universities direct.

Acceptance on to a course is subject to satisfactory health clearance and a criminal records check. Having a criminal conviction or caution won't automatically bar you from working in the NHS.

Eligible pre-registration midwifery students studying at a university in England can receive funding support of at least £5,000 per year. You don't have to pay it back and are still able to access funding for tuition and maintenance loans from the Student Loans Company. Find out more at Health Careers: Financial support at university.

Eligible midwifery students studying in Scotland can also apply for a bursary worth £10,000 for years one to three of the course and £7,500 for fourth year of the course if you are studying a four year honours degree. Contact SAAS for more information.

Gaining a place on a midwifery course is competitive, so you should aim to apply as early as possible. Applications for full-time courses are made through UCAS. For part-time courses, contact universities direct.

Skills

You will need to have:

• excellent communication and interpersonal skills to be able to communicate clearly with a range of women, their partners and families
• a caring and calm manner for dealing with emotional situations
• the ability to react quickly, decisively and effectively in times of stress or when immediate decisions need to be made during labour
• a methodical and disciplined approach to work with the ability to be assertive when necessary
• strong teamworking skills for liaising effectively with a range of health and social care professionals
• strength, stamina and physical fitness
• a commitment to equal treatment for all women, irrespective of their background or circumstances.

Work experience

Pre-entry experience in a healthcare or social care setting is a distinct advantage. Useful experience, either paid or voluntary, might include supporting parents, working with breastfeeding groups or with charities supporting women who have experienced, a bereavement or miscarriage.

During your interview for a place on a course, you will need to show that you understand the role of a midwife and the work they do. It can be difficult to find a work placement in a midwifery setting, but you could ask to work shadow or talk to a midwife to find out more about their work.

For free mentoring resources and experiences designed to support aspiring healthcare professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

Most midwives are employed by the NHS, working in:

• hospitals - on antenatal wards, labour wards (obstetric units), postnatal wards and neonatal units, as well as in triage and assessment
• midwifery-led maternity units and birthing centres
• the community - at GP surgeries, clinics, children's centres and in women's homes.

You can also find employment in private hospitals, independent practices and the armed forces.

Self-employment is possible. University hospitals employ midwives in joint partnerships between the trust and the university to work in lecturer-practitioner positions, or to conduct research. Look for job vacancies at:

• Jobs.hscni.net - health and social care jobs in Northern Ireland.
• Midwives Jobs
• NHS Jobs
• NHSScotland Jobs
• Nursing Times Jobs

Specialist recruitment agencies, such as Pulse, also handle vacancies. A searchable directory is available at Nursing Agencies List.

Information on becoming a midwife and making your application stand out is available from Midwife Career.

Professional development

As a newly qualified midwife, you'll be given a formal period of support under the guidance of an experienced professional colleague. They'll be on hand to offer advice and help in the first few months of professional practice.

Throughout your career, you'll need to maintain your registration with the Nursing and Midwifery Council (NMC), which must be renewed every three years. To do this you must show you've met the NMC revalidation requirements within that time. These include:

• 450 practice hours (or 900 if you are dual registered as both a nurse and midwife)
• 35 hours of continuing professional development (CPD), including 20 hours of participatory learning
• five pieces of practice-related feedback
• five written reflective accounts
• reflective discussion
• health and character declaration
• professional indemnity arrangement
• confirmation - you must demonstrate to an appropriate 'confirmer' that you've met the revalidation requirements.

The revalidation process ensures that you're keeping your skills and knowledge up to date and carrying out safe and effective practice.

CPD participatory learning must involve interaction with at least one other professional and can include attending conferences, workshops or relevant training courses and events. This can be in a virtual or in-person setting. Find out more at NMC Revalidation.

There are opportunities to extend your role by taking specialist courses in areas such as enhanced midwifery practice, family planning, teaching in clinical practice, and research. Information on relevant events, courses and resources is available from The Royal College of Midwives.

There are also opportunities for further study at degree, Masters and PhD level. Search for postgraduate courses in midwifery.

Career prospects

You can develop experience and knowledge in a number of different healthcare settings, including becoming a clinical specialist in an area, such as:

• antenatal screening
• breastfeeding advice
• home birthing
• intensive care neonatal units
• labour ward supervision
• parenting education
• public health
• ultrasound and foetal medicine.

You might become a consultant midwife, dividing your time between working directly with patients and training and leading improvements in practice.

Or you may seek a higher management opportunity, such as the position of head of midwifery services, or as a supervisor of midwives with the local supervising authority. Alternatively, you could go into teaching or research within a healthcare setting or a university.

There are some opportunities to find work abroad with organisations such as Voluntary Service Overseas (VSO) or Médecins Sans Frontières. In some countries, midwives must also hold registered nurse status in order to practise, so you should check this before applying.