Action checklist for midwifery practice

• Every midwife should revisit and be familiar with, the Nursing and Midwifery Council (NMC) Code of Professional Conduct and the Midwives Rules and Standards.
• There should be a comprehensive, accessible directory relevant to local needs and available in different mediums of the other key professional contacts for the care of vulnerable and high risk women.
• All women should receive care that is embedded in the local maternity network, ensuring that they have an individualised care pathway throughout their pregnancy..
• Mandatory and regular training should emphasise the importance of baseline observations and include the recognition of differential diagnoses in pregnancy and the appropriate action to be taken.
• All clinicians have a responsibility to ensure they know how to contact appropriate help in an emergency and are competent to administer emergency treatment.
• There should be explicit emergency systems in place which should include routine checking of emergency equipment, clear siting of equipment and knowledge of appropriate emergency responses.
• The BMI should be recorded for all women and an explicit plan of care developed for women with sever obesity, i.e. a BMI of 35 or more. These women are unsuitable for midwifery only care.
• Key personnel e.g. GPs, supervisors of midwives and other relevant agencies should be included on local review panels. Recommendations and lessons learnt from local reviews into maternal deaths and serious untoward incidents should be widely disseminated to all staff including community staff and GPs.
• Letters and communications involving a woman’s care should be copied to all clinicians, including midwives and GPs.
• All trusts should ensure that the emergency telephone number 2222 is universally implemented.
• The Strategic Health Authority (SHA) should develop a clear standardised process for sharing good practice and investigating serious untoward incidents.