An interview with our Guest Contributor, Lesley Bland RM

Lesley, could you tell us about your journey into midwifery and what inspired you to pursue a career in this field?

I came into Midwifery later in life having had a previous background in sports and events management, recruitment and account management. I had three very young children and had a lightbulb moment that Midwifery was the career I had always been looking for. I was very interested in healthcare from a young age but knew I didn’t want to be a doctor, a nurse, physiotherapist or paramedic so to come to a point where all the stars aligned and I found a role I was passionate about just felt so right and so my training began a 1 year full time Access Course followed by a 3 year degree and a career-long CPD programme. My passion for Midwifery was definitely ignited when I had my own 3 babies all with very different experiences; I also suffered 2 early pregnancy losses and recognised that the care I received differed hugely from healthcare professional to healthcare professional and I wanted to make a positive difference to reflect the outstanding care I had received from the majority whilst improving the poor care I had been given by just a few.

Reflecting on your extensive career, what has been your proudest moment as a midwife, and why does it stand out to you?

One of the most significant moments that any Midwife can experience is the day your NMC (Nursing and Midwifery Council) PIN lands on your doormat which means you are no longer a Student Midwife but a Registered Midwife. The job title Registered Midwife is protected by law and you can only call yourself this if you have received you PIN and remain on the NMC register. I worked so hard to achieve my registration balancing work, study and home life that to finally be able to refer to myself as RM Lesley Bland brought me to tears; I knew at that moment it had been worth all the blood, sweat and tears.

What is one piece of advice you would share with aspiring midwives who are just starting their careers?

Don’t try to run before you can walk. If you are a student carry a notebook and pen everywhere and ask questions – no question is a daft question and all mentors will be more than happy to share their knowledge with you.

If you are a Newly Qualified Midwife observe, observe and observe – remember you are not alone you will be supported by a team of highly experienced Midwives who are there for you. You cannot be expected to know all the policies and guidelines so ask and search and never be afraid to say you don’t know how to do something or feel unsure about a decision; knowing your limits is a skill.

For everyone at all stages of your careers I would ask you to remember the phrase I was taught by one of my lovely mentors “Two Ears and One Mouth” and use them accordingly – in other words really listen to what a woman, or their partner is telling you and speak only if and when necessary and appropriate.

Lesley, you currently work with My Expert Midwife. Could you tell us about your role there and how your work with this organisation complements your broader mission in midwifery and healthcare?

I joined My Expert Midwife in 2022 on a very part-time basis whilst still working as a Band 7 Midwifery Clinical Educator within a local NHS Trust. I had extensive experience as a clinical midwife having rotated through Antenatal Clinics and Day Units, Labour Wards, Birth Centre, Induction of Labour Wards, Postnatal Wards and Community/Continuity of Care Teams at both a major Teaching Hospital and a smaller local District Hospital. I was also qualified as a Student Mentor and a Trainer of both Maternal AIMS and PROMPT (Emergency scenario training).

The more time I spent with the team at My Expert Midwife the more I saw the immense value they brought to women throughout the maternity journey; trying to conceive, pregnancy, labour, birth and the postpartum period, but also to the NHS through their unswerving commitment to education; a service which had been hit by funding and by Covid and had seen a steep decline in offerings. I took a leap of faith and left the NHS starting full-time at My Expert Midwife as a Consultant Midwife in January 2023.

My role within the business is varied and actually pulls from all of my previous careers both within Midwifery and actually prior to that time as well and so feels full-circle and very fulfilling for me. No two days are the same. For example we met at The Baby Show – an Industry event where we spend 3 days 4 times a year meeting, greeting and advising members of the public, raising brand awareness, selling our extensive range of products and networking. Not only do I attend these events but my background in Events Management has lent itself well to the organisation of them from transport, accommodation, printing, marketing and PR, stock, logistics and staff I have overall responsibility for ensuring the events run smoothly and are as productive for the business as they can be.

I also write a lot – mainly for our in-house marketeers who might want Midwifery advice and support for Social Media posts and our own website, but also for retailers, journalists and PR agencies, anything from a single sentence quote through to a 1200 word blog. Whatever I write has to be accurate, evidence-based and up-to-date so it is vital that I maintain my own research and knowledge-base – a key responsibility of any Registered Midwife.

I appear a couple of times a week on our TikTok Lives, something I never had any awareness of at all but absolutely love because Midwives can really chat(!) and so I get to talk with our viewers for a couple of hours responding to their questions with the most up-to-date evidence and referring them to their own healthcare professionals if out of my remit. You may also see me pop up on our other channels such as Facebook, YouTube and Instagram – taking over Social Media one channel at a time!

And last but not least I am also heavily involved in both in-house and retailer product training which I love because it’s back to my passion of education and knowing that I am doing so about products that genuinely benefit women and babies is just incredibly satisfying. As a part of the Midwifery Team at My Expert Midwife I am privileged to be able to use my clinical experience to support the improvement and development of both existing and new products liaising closely with our wonderful marketing, commercial and operations teams as well as with women and their families.

The For Baby’s Sake Trust aims to break the cycle of domestic abuse and provide a better start for babies. How important is it for midwives to take a multi-agency approach to their work to ensure the safety of mothers and babies in their care? 

The NHS has worked hard to instil multi-disciplinary and multi-agency working throughout Maternity Services, and this alongside Continuity of Carer has reaped the benefits of improved communication and more efficient and effective ways of working that not only improve working conditions for staff but have also proven to reduce risks for women, babies and their families. This means that staff are more readily equipped to identify and respond to concerns about issues such as mental health and domestic abuse which previously have been under-resourced leading to missed opportunities for referrals to be made and support put in place.

All women have a right to live abuse-free and Midwives are very often the first person to gain the confidence of a woman who has experienced domestic abuse. It is imperative that the Midwife gains the woman’s trust quickly and is sufficiently knowledgeable and equipped to gain consent which then enables them to help the woman to change her social situation. Having contacts and relationships within agencies external to the NHS is important when Midwives are signposting women; having access to agencies both locally and nationally can offer the maximum support options for women and their babies.

In your opinion, what are the most critical skills a midwife needs to effectively support women and families, especially in challenging situations like those addressed by The For Baby’s Sake Trust?

I will go back to one of my earlier answers for this and that is to remember the phrase “2 Ears and 1 Mouth” – listen attentively and that means truly listen to what the woman is telling you, and then when you respond do so carefully and knowledgeably without judgement or presumption. Maintain a professional approach but offer her the reassurance you are a safe and reliable person to speak with. Demonstrate an open mannerism that encourages trust and confidence.

If you say you will do something ensure you act on it; if a woman feels that you have not followed through on an action plan she will not trust you and the relationship of trust can be easily broken. Explain what the process is and what the timescales may be so that she understands who, why, when and what.

What advice would you give to any parent who is experiencing domestic abuse, and what can they expect if they disclose their experience to their midwife? 

Conversations between a Midwife and a parent disclosing domestic abuse need to be carried out in a space that provides privacy and should be scheduled for a longer appointment that allows sufficient time for disclosure, consent, and necessary planning and referrals to be made. If English is not your first language it is important that the Midwife has access to an official interpreter via an anonymous service such as Language Line to protect your identity.

Midwives play an essential part in ensuring that children and families receive the care, support and services they need and so will be able to offer you timely and appropriate referrals as required.
Midwives will be guided by The Care Act 2014 which lists 6 key safeguarding principles intended to form a core set of standards to ensure your care:

•  Accountability – in the event of a disclosure about domestic abuse, your Midwife must be clear with you that they are duty-bound to report the concern.
•  Empowerment – your Midwife should support and empower you to feel safe and listened to.
•  Partnership – your Midwife will work with local agencies to report any abuse you have declared – you will be fully informed of any referrals made.
•  Prevention – your Midwife’s priority is to ensure your safety and wellbeing and they will want to act early in order to prevent any situation from potentially causing you harm.
•  Proportionality – if your Midwife feels that you are in immediate danger they may call 999 in order to escalate their concerns.
•  Protection –Your Midwife will support and represent you to protect you from potential harm.

Your experience includes a strong focus on training and development. How do you ensure that your training programmes remain relevant and effective in the ever-changing healthcare environment?

My own personal background in Midwifery is very T&D based both on an individual basis as an autonomous practitioner it has always been  part of my role that I remain complaint with mandatory training but also take my CPD (Continuous Practice Development) seriously as well to ensure that I adhere to NMC’s The Code but also to protect my own practice, that of my colleagues and the women and babies under my care. When I became a Specialist Midwife (Clinical Educator) this stepped the T&D game up another level for me as I was taking on responsibility for ensuring that the Healthcare Workers, Maternity Support Worker, Midwives, ODPs, Anaesthetists and Obstetricians were receiving training that met their personal and Trust-wide needs, kept them engaged and motivated but that also met the requirements of the National guidance – not a small task and made even more demanding by the staff shortages and immediate demands of the post-covid era.

At My Expert Midwife I stay true to the principles of Midwifery but also to the Products which luckily take no selling – they do what they say on the tin and are formulated by myself and the rest of the Midwifery team and so I believe 100% in them because I know they are the best on the market and are actually making he positive impacts on pregnant, birthing and postpartum women and their babies.

Our OnDemand Antenatal Classes are probably the best available either NHS or Private because women and their partners get to watch them as often as needed whenever they want, wherever they want and have access to the team of MEM Midwives as well if they need to discuss anything from the classes in greater detail. 7.5 hours of everything you could possibly need to know including Emergency scenarios, pain relief including epidurals, postpartum recovery, breathing and relaxation techniques, baby cares and much much more resented by the team along with a Consultant Obstetrician and an Anaesthetist. The classes are based on best quality evidence and in line with national guidance. I cannot over-emphasise how important being prepared is in the lead-up to birthing your baby – knowledge is power and we are providing that along with a very experienced support network of highly experienced Midwives.

What policy changes would you advocate for to better support midwives and healthcare professionals in their mission to improve maternal and infant health?

As a private company but with extensive experience of working within the NHS our Midwives are perfectly placed to be able to offer support to both women, their families and back to the NHS. Unfortunately the red tape associated with the NHS means getting our support packages through to the staff is almost impossible which is a real pity because we can offer them plans that relieve the internal burden, and we can do that at no financial profit. Our NHS brothers and sisters are in a time of crisis and we can offer solutions to help them with some of their training; we are keeping on keeping on trying to talk to the right people about this.
During my time in the NHS I have to say I did see a significant shift towards investing in both Maternal and Infant Mental Health which was much needed and was making a positive difference to so many but I was also aware that training on the shop floor especially for junior midwives was sadly lacking and it is my wish that Universities spend more time supporting Student Midwives to develop skills in identifying and supporting women and their families through Mental Health. It is refreshing that trusts are now putting Specialist Midwives in post for Vulnerabilities but there is still much room for improvement. All Maternity should be given better vulnerabilities training and should be encouraged to spend time working with the external agencies who provide mental health support – true Multi-Disciplinary Team (MDT) working and upskilling providing Maternity staff with the confidence to have difficult conversations and understand what support is available locally and nationally.

How do you see the landscape of women’s health and midwifery evolving in the next decade? 

As much as it pains me as a former NHS Midwife to say it private companies need to be brought in as partners to support the staff and therefore women, their families and their babies. By outsourcing antenatal education and even Mandatory training to companies such as My Expert Midwife the pressures on NHS staff to be freed up to deliver the training should be relieved but it is important that Managers within the NHS understand that staff MUST be given the opportunities to attend training as scheduled and that continuously pulling staff away from training days makes for an out-of-date workforce who are outing the health and wellbeing of both mothers and babies at risk. Midwives will continue to provide a greater public health role. Iin order to reduce inequalities and improve maternal and family health.

Pregnancies continue to be more complex and Midwives, as autonomous practitioners have increased burdens of responsibility placed upon them. Midwifery education focuses on normality but must shift to ensure midwives are equipped to care for all women including those with complex medical, obstetric and social needs. MDT and multi-agency working has to be a priority to offer Midwives the opportunity to seek support and to be able to signpost women for the expert care they need.