As the Nursing Times states, “safeguarding is central to everything nurses do”. It is part and parcel of the job to make sure that those in their care are safe and happy, both during their hospital experience and elsewhere in their lives.
Safeguarding adults in nursing practice can be challenging, especially when things are happening that one does not want to own up to. However, for those who can’t speak for themselves – especially those who cannot speak at all yet – the necessity to safeguard is even more vital.
Safeguarding in Midwifery
Midwifery is among the most stressful and underappreciated jobs in the world. Typically, midwives have to work long hours – sometimes over 12 hour shifts with maybe a half hour break – and are constantly rushed off their feet with antenatal, labour and postnatal care. It is becoming less common for one midwife to support a family throughout the entire pregnancy and birth process, especially on the NHS.
Midwives are in a position of trust and care, so it is vital that recruiters ensure that only the highest quality candidates take on this role. To ensure that only the right type of person becomes a midwife, they are given intensive training and must partake in DBS checks before they start the process.
However, the most challenging part of the role of the midwife is not normally the hectic working hours or the growing depersonalisation of the job. It’s not even the amount of stress that they are put under. The most difficult part of a midwife’s job is the safeguarding practices. These include:
- vetting each parent for possible issues that make them unfit to have the baby
- aiding social services in the relocation of the baby
- knowing when is the best time to take said baby away
- emotionally supporting parents who have stillborn babies
- advising of financial support to unstable couples
- being aware of any ongoing issues during the 28 days after the birth
Safeguarding Procedures with Children
Recognising and reporting unfit parents is possibly the most stressful, yet important, part of a midwife’s job. As Parent24 states, parenting “takes planning, thought and responsibility” and “children have rights too”. Knowing what these rights are starts during the pregnancy, as midwives are trained to look for any problems in both parents. These could include:
- Whether either parent has drug or alcohol addiction.
- If either parent is a victim or perpetrator of domestic violence.
- With especially young parents, the procedures that are in place to properly care for the baby.
- What kind of lifestyle the parents lead, and whether it is suitable for a baby to grow up in.
One of the biggest problems with the modern midwifery climate, especially in NHS hospitals, is the fact that when a mother is served by multiple midwives it becomes harder to personally get to know each couple and sense these issues. This means that midwives are less likely or able to report potentially dangerous parents.
Drug or Alcohol Addiction
This is possibly one of the biggest dangers that a new-born baby faces. A home where anyone is dependent on drugs or alcohol – even if they are not violent – is a completely unsuitable place for a young child to be raised.
Of course, this doesn’t even touch on the fact that if the mother is dependent on substances, it could cause serious biological problems for the baby. Tragically, babies can be born addicted to heroin and develop a condition called Neonatal Abstinence Syndrome, which in its most severe cases can cause seizures and death.
The foetus can also go through withdrawal if a woman quits heroin ‘cold turkey’ while pregnant, which can in turn result in the foetus’s death before even being born. If the midwife becomes aware of this, it is her duty to make sure that the mother gets in touch with her doctor to discuss quitting the drug during pregnancy. The earlier drug addiction is found, the better.
It is up to the midwife to decide if the home is an appropriate place for the child to be raised. This depends on the substance that either parent is addicted to and the support that they are getting to curb the dependence.
Domestic violence is obviously a huge factor that the midwife must consider when safeguarding parents and their children. In pregnancy, domestic violence could seriously affect the mother and the baby, and in postnatal situations the baby would be taken into an inappropriate household. The United Nations Children’s Fund states that 80% of child abusers are their biological parents, so it is vital that each parent is vetted to ensure that they do not have these kinds of traits.
Even if a partner does not abuse existing children, or will not harm the unborn child, it is vital that a baby is not raised in this kind of atmosphere. This is a difficult problem for the midwife to spot, as the mother is often unlikely to mention any domestic abuse. Midwives are trained to look for bruises, scratches or marks that the mother struggles to explain and to gently coax for information if the mother does not offer it willingly.
While some teenagers become excellent mothers and fathers, many need extra support. Luckily, the midwife can guide these parents from day one and offer them the emotional and physical guidance that they need.
The midwife is responsible for determining if the parents can financially provide for their child, the mother’s smoking status, the reason that they became pregnant, and the relationship status of the parents. The mother must also be made aware about the increased likelihood of complications: the infant mortality rate, the importance of breastfeeding and the potential of increased postnatal depression are all affected when the parents are young.
The midwife assesses whether the parents are suitable to have a child, and if they are, he or she points them towards the necessary services to be able to provide for their baby. There is more information in this helpful Gov UK booklet.
The Parent’s Lifestyle
The midwife must assess what kind of life the parents live and deem whether it is suitable to raise a baby in. Assessment may include criminal checks and in some cases, an assessment of their house.
Prospective parents who have had children taken away in the past, have children with their names on the child protection register, may have abused a child, do not have the ability to protect a child or are otherwise deemed incapable parents can have their children taken away.
Safeguarding Procedures with Adults
While a lot of the safeguarding procedures for midwives include looking after the baby, the nurse’s role in safeguarding vulnerable adults is an essential part of the job. A birth is generally a happy time, bringing love and light to the mother’s life – but even then they will need practical advice. Sometimes the outlook is not as positive and dealing with these occasions are some of the most difficult parts of the midwife’s career.
Taking a baby from its mother
There is never a right time to remove a baby from its mother. Some midwifes compare it to stillbirth, saying it is one of the most horrific things a person can experience. The bond between mother and baby is widely thought to be the strongest in the world, and the fact that the midwife sometimes has to break this bond (even though it is in the baby’s very best interests), is absolutely harrowing.
The midwife’s duties include knowing when an appropriate time is – whether the mother is permitted to hold her baby for a minute, ten minutes, or an hour - being sensitive to the mother in this situation and knowing when to draw the line. The mother has every right to be upset, but the midwife should not have to cope with any verbal or physical abuse.
Having a stillborn is one of the most traumatic things a mother can endure. One of the midwife’s safeguarding duties is to be very receptive to the needs and wishes of the parent. Many instinctively know whether they do or do not want to see their baby.
The midwife or the parents will often wash or dress the baby if they can. Some parents take solace in having a keepsake, such as a handprint, footprint, photograph or lock of hair. The wishes of each parent are vastly different and the midwife must provide adaptable emotional support during this incredibly difficult time.
If the mother is unable to provide financially for the baby but is still a capable parent, the midwife should direct them to the relevant support. This is done throughout the antenatal and postnatal process.
Of course, new mothers can have all sorts of questions, fears, and concerns throughout the pregnancy and postnatal days. Midwives often provide the answers to these questions or tell them where they can get more information and offer support in any way possible.
While the job of a midwife is incredibly rewarding, it is no surprise that the safeguarding nurse role can be stressful and difficult. Combined with the pressure of anything going wrong on the ward (like the Furness Hospital Baby Deaths), the safeguarding procedures for nurses make working on the labour ward an incredibly challenging job. These midwifery measures keep our children and vulnerable adults safe, making a huge difference to the start of baby’s lives. I think the midwifes of the UK deserve a round of applause for that!