At the start of February the first Chief Midwifery Officer’s National Maternity research strategy conference took place in the UK. Held as a hybrid event, with hubs nationally and online, ensured a large gathering of research based midwives to hear how the strategy is to be developed. Dr Jenny Hall, midwifery editor for the Maternity and Midwifery forum and Matflix, reports and reflects on the event
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The Chief Midwifery Officer’s National Maternity research strategy conference review
Published research by midwives is relatively new in comparison to other healthcare professions with less than 50 years under its belt. Lack of opportunity, funding and support for development have often been barriers for midwives to step into a research realm. All this time midwives both in clinical roles and academic fields have been quietly getting research work done, impacting on midwifery care. Midwifery research has been moving on apace globally during this time, with joint working to raise the profile of midwifery as important, such as in the Lancet series, and with the support of the World Health organisation. However, the appointment of Professor Jane Sandall to lead the midwifery research strategy for NHS England is bringing a sharp focus on a way forward.
At the start of February saw the first Chief Midwifery Officer’s National Maternity research strategy conference in the UK. This was the largest gathering of specifically research midwives across the country, since the Research and the Midwives conferences of the late 1980’s to 1990’s. The opportunity of a hybrid event meant that clinical and academic research midwives could meet together in hubs, or individually online, to join with the main event happening in London. For some, this also meant meeting after to discuss the event, share research and find a way forward locally.
The conference was led by Professor Jane Sandall, Head of Midwifery research for NHS England, with a remit to build capacity for research in midwifery, and asking how research can make a difference to service users, and how midwives may be supported to contribute to evidence-based practice. Professor Lucy Chappell, Chief Scientific Advisor for the Department of Health and Social care, presented the government’s women’s health strategy and where midwifery fit in that vision. Maternity was pointed to be influential on women’s health for the future and she challenged midwives to put women’s health at the heart of services and become champions to reduce disparity.
The next keynote was by Professor Emerita Mary Renfrew, University of Dundee who addressed the global and national impact of the Lancet series in midwifery. She highlighted with clarity that midwifery care makes a difference, pointing to the evidence that universal midwifery interventions across all countries could “avert two thirds of maternal and neonatal deaths and stillbirths”. She highlighted the impact the Lancet series publication has had globally in enabling policy change and supporting to strengthen midwifery practice and development.
The talk was followed by a powerful example of research in practice, with Professor Dame Tina Lavender, Liverpool School of Tropical medicine, sharing the work of the National Institute of Health and Care research (NIHR) global health unit on the impact of prevention and care of stillbirth across countries in Sub-Saharan Africa. She pointed to local systems change, alongside building research and clinical capacity and impact on education.
The next section in the programme focussed on career development for midwives in research. Professor Ruth Endacott, NIHR Director of Nursing and Midwifery, addressed current opportunities for midwives. She stated that 25% of the new Senior research programme are midwives, which is a step forward. She encouraged midwives to look for opportunities with Local Clinical research networks and Applied research collaborations (ARC) and for Trusts to get involved in research and developing staff going forward. Emeritus Professor Gina Awoko Higginbottom shared her inspirational journey to becoming a Professor, including the barriers and challenges she faced. She talked about the lack of representation of Black and Brown skinned people across research and pointed to ways to increase and encourage diversity.
A round table discussion then followed with researchers telling personal stories at different stages of their research journeys: Anna Marsh, NIHR Pre-doctoral fellow, Bournemouth University, Dr Hannah Rayment-Jones, post- doctoral research Fellow, King’s College London, Dr Kerry Evans, NIHR Clinical lecturer, University of Nottingham and Professor Sara Kenyon, NIHR senior investigator, University of Birmingham. They each highlighted their maps for their journey, demonstrating that for each person there are different lead ins and triggers to starting on research and challenges, including family and role changes.
The final section of the event focussed on the introduction to the CMidO research strategy. Professor Jacqueline Dunkley-Bent was joined by the National Speciality advisor for Obstetrics, Professor Donald Peebles, to launch the strategy and pointed to the evidence-based practice being “everybody’s business”. They talked about the role that research plays in safety across maternity care and called for Specialist Midwifery research roles to be given equal status in Trusts to ensure evidence is implemented.
Professor Jane Sandall introduced the research strategy, which will be officially launched in March. She explained the context behind the strategy, based on Better Births, 2016 and The NHS Long term plan, and talked about how there should be alignment between the different strategies being developed across maternity and the NHS. The aims of the strategy will be to:
- NHS England Maternity and CMidO policy and programmes are informed by the highest quality evidence to close the loop between evidence, policy and frontline practice
- NHS Engladn maternity and CMidO policy and programmes have access to information to inform and assess programme delivery improvement and impact
- Build research capacity, recognition and visibility of contribution of midwives to research and evidence base
She shares more about actions related to this strategy and encourages involvement in communities of practice going forward, via the NHS Futures Platform to be launched in March. Jane also shares the results of a survey of Senior Midwife research leaders, demonstrating differences of support and funding for roles across the country. She points out the challenges that midwives face in trying to take on PhDs without funding or support and working evenings and weekends. The session is rounded-up with a few comments from the audience and online chat.
Personally, it was very encouraging to hear that there will now be a strategy going forward to support research in midwifery, though these are baby steps in a vast and complex organisation such as the NHS. Pointed out in the day it is evident midwives in HEI are also struggling to prioritise and undertake research alongside heavy teaching loads. This seems illogical when academic institutions are meant to be the hot-bed of new knowledge. With shortage of midwives in both clinical practice and HEI it will be some time before some of these steps will be implemented. It is, however, necessary to ensure that the evidence-base presented on the day, that appropriate midwifery care has a significant impact on safety and wellbeing of mothers and babies, gets across into policy and practice quickly in order to improve care now and in the future.
On my reflection of the day the questions that are still needed to be addressed going forward are:
- How can research be translated into practice more effectively? More research is required on how to do this.
- Midwifery research is not just scientifically clinically based; work is needed more on the art, the philosophical, humanistic, relational, holistic, ethics and educational aspects. Where will funding and support for this come from?
- How will there be support for midwives who are often part-time, managing other aspects of their lives, to be encouraged and supported into a research career, particularly a PhD, without it taking up work over evenings and weekends? And for some, without it meaning moving to a different part of the country?
There will be more to come, but for now let us celebrate the incredible work that midwives have been doing in research over the past 40 odd years that has improved, and is improving, how women and babies are supported and cared for.
Dr Jenny Hall EdD
Midwifery editor, the Maternity and Midwifery forum and Matflix
February 2023