Supporting women seeking care outside guidance
Personalised care is safer care, providing women with choice and control improves clinical outcomes for them and their babies. Midwives support informed decision making, but sometimes women choose care options that sit outside guidance.
Role of the midwife
Midwives have a key role as advocate and facilitator of women’s choices around the care they receive and where they receive it. This is particularly important when women and families are negotiating fragmented and under-resourced healthcare systems. Those systems bring challenges to midwives too, as they often have insufficient time to provide the high-quality care they would like to give.
RCM advice on care outside guidance
The RCM’s advice around care outside guidance provides midwives with guiding principles on facilitating personalised care and women’s choices, including when those fall outside clinical recommendations. Personalised care requires a relationship of mutual trust between a woman and her midwife, and multi-disciplinary collaboration, often facilitated by models of midwifery continuity of carer (MCoC). This RCM guidance helps support midwives working in different models and includes indications on how to support the implementation of personalised care and support plans (PCSP) for women seeking choices that fall outside medical recommendations. It is underpinned by the principles of consent as a fundamental right of individuals and by the changes in UK law due the landmark ruling of Montgomery v Lanarkshire.
This guidance looks to address those barriers by providing the knowledge necessary to midwives to feel able to provide personalised care. It was developed by the RCM with input from an independent advisory group of experts on the topic, from consultant midwives to academics.
