Find out what our healthcare professionals involved in your care do
Midwives are the lead professionals in normal pregnancy and childbirth. If you are considered “low risk” (i.e. no medical conditions or complications of previous or current pregnancy), your care is likely to be “midwife-led” (MLC) and provided almost entirely by midwives. Midwives will refer to another specialist practitioner if complications in pregnancy or labour arise. This may mean you are transferred to consultant led care (CLC).
Whether your care is midwife-led or consultant-led, you will have a named community midwife. Look for her name on the front of your green pregnancy notes. She is responsible for co-ordinating your antenatal care, guiding you through pregnancy, and explaining your care pathway and your options. Your named community midwife (or one of her team) is your first contact for anything but serious emergencies. The contact numbers for all members of your community midwife team are on the front of your green pregnancy notes.
In Buckinghamshire, midwives work in the community, birth centres or hospital. A few midwives combine work in both the community and birth centres. There are also specialist midwives in diabetes care, bereavement support, antenatal screening and perineal care. Our managers, supervisors of midwives, educators, and consultant midwife are all practising midwives.
Midwives are independent practitioners and can give a range of medicines and intravenous fluids without medical prescription; these are approved by the Nursing and Midwifery Council (NMC) and are known as midwives’ exemptions medicines after the relevant section of the Medicines Act. This group of drugs includes some types of pain relief and other medications that are usually available “over the counter” to the public.
Midwives can also supply or administer another small group of medicines using Patient Group Directions (PGDs), a legal framework that allows important drugs to be given to a certain group of patients under specific circumstances. This group of drugs includes pain relief, intravenous fluids, baby vaccination for BCG, antacids and anti sickness medication.
The majority of student midwives nowadays are not nurses, although some have been previously. Student midwives are based between a local university and NHS Trust. Student midwives who are not registered nurses undertake midwifery training that is a three year degree course. Student midwives who are already registered as nurses complete their education in 18 months. All student midwives undertake the clinical aspects of their education alongside registered midwives in hospitals, birth centres and the community. Student midwives are always guided and supervised by experienced midwives. Towards the end of their training, students start to work more independently; their mentor may not always be physically present in the room but will always be involved in assessing and planning care.
In the hospital, student midwives wear white tunics, midwives wear mid blue or royal blue dresses or tunics, and matrons wear very dark blue dresses.
Consultant obstetricians will have completed a minimum of nine years of training; often a lot more. If you are not suitable for midwife-led care, you will have a named consultant. Although you may or may not meet him or her face-to-face, your consultant is ultimately responsible for your obstetric care and will be closely involved along with senior specialist trainee doctors.
Specialist trainees (ST) in their 3 – 7 years studying (also called “registrars”) are the front line doctors in obstetrics and gynaecology, particularly in emergencies. Depending on their level, they will be supervised, mentored, and assessed by more senior obstetricians, as they gain confidence and expertise in all areas of maternity care. Out of hours, junior specialist trainees will always have the support of a more senior ST or a consultant obstetrician. These doctors will be working towards their Membership of the Royal College of Obstetricians and Gynaecologists (RCOG).
Medical training takes five or six years. Although we are not a teaching hospital for doctors, medical students join us for a few weeks to gain experience in maternity care – and, hopefully, become inspired to make a career in obstetrics. Medical students will always be working under direct supervision of a doctor or midwife.
After qualification, doctors spend two years in hospitals or general practice being closely supervised and assessed whilst deciding their future specialist area. These are the foundation Years 1 and 2; often abbreviated on name badges to FY1 and FY2.
At the end of FY2, doctors embark on specialist training years 1 and 2 (ST1 and 2). The doctors you meet in the maternity services at this level will usually be training to become GPs or obstetricians. They will work alongside midwives and more senior doctors in clinics and wards; taking histories, examining patients, and helping to plan and initiate treatment. ST1 and ST2 doctors will always consult with a senior midwife or obstetrician on maternity matters, although many will have considerable experience in medicine, general surgery, or paediatric care.
FY and junior ST doctors are sometimes called “senior house officers” or “SHO”, although this terminology is now out-dated.
There will be a range of other professionals that you might encounter during your pregnancy.
Maternity care assistants (MCAs) are important members of the maternity care team, working in clinics, birth centres, wards, and the community. They are not nationally registered (as are midwives and doctors) but are trained locally to give supportive care to mothers and well babies. They assist with hygiene and comfort, help with infant feeding, support new parents, advice on smoking cessation and other health promotion initiatives, keep the clinical environment orderly and clean, and much more.
Some MCAs also perform more technical tasks (physiological observations, post-operative care, assisting with midwifery and obstetric procedures) but only when trained to do so and delegated by midwives. A few specialise in breastfeeding or supporting young mothers or vulnerable families. MCAs are not allowed to give any medicines.
MCAs wear grey tunics, or their own clothes in the community. To find out more about midwives and MCAs, please visit the websites of the NMC and the Royal College of Midwives (RCM).
The maternity care team includes nursery nurses (NNs) based on our postnatal ward. NNs have all achieved a nationally recognised qualification in infant and child care. They work under the direction of midwives and paediatricians in the care of well babies and others needing investigations, regular monitoring, treatment for jaundice or infection, or specialist feeding input.
NNs wear grey dresses or tunics.
Newborn hearing screeners conduct hearing tests on all babies born in our area.
Newborn hearing screeners wear blue tunics.
Ultrasonographers are based in the antenatal clinics. They perform antenatal scans and you will meet them when you have your pregnancy scans.
Ultrasonographers wear maroon tunics.
Housekeepers keep the clinical areas running smoothly by organising stores, maintaining equipment, tidying and sorting, assisting at meal times.
Housekeepers wear green tunics.
Domestic staff help keep everywhere clean and also serve food on Rothschild Ward.
Domestic staff wear purple tunics.
Clerical staff “meet and greet” in the wards and clinic, maintain central computer records of admissions and discharges, assist with data entry, generate computerised letters, organise appointments, order stationary and other administrative tasks.
Depending on where they work, clerical staff may wear pale blue tops or their own clothes.
- MCAs wear grey tunics, scrubs when on Labour Ward, or their own clothes in the community. To find out more about midwives and MCAs, please visit the websites of the NMC and the Royal
- College of Midwives (RCM).
- NNs wear grey dresses or tunics.
- Newborn hearing screeners wear blue tunics.
- Ultrasonographers wear maroon tunics.
- Housekeepers wear green tunics.
- Domestic staff wear purple tunics.
- Clerical staff, depending on where they work, may wear pale blue tops or their own clothes.