Implementing A Framework for Maternity ... - Scottish Government

Appendix 3
Core Competencies for Health Professionals in
Acute Maternity Services
The EGAMS identified core competencies necessary for all staff providing intrapartum care in a
CMU or low-risk setting. A team approach was considered crucial to the delivery of maternity
services in each unit. Once competencies are achieved it is vital that the level of skill and
expertise is maintained. All competencies correlate to established good practice; implicit in this is
maintaining patient safety and clinical governance. It is important that all professionals working
in these environments have the confidence, clinical governance, skills and professional
judgement to provide a consistently high standard of care for the woman and her baby. This
appendix describes the core competencies required by obstetric professionals working in any
maternity facility and then identify additional competencies required by practitioners working
in specific types of maternity unit, according to the levels of care set out in A Framework for
Maternity Services in Scotland.
Promoting Normality – supporting normal labour and childbirth
This includes providing psychosocial and physical support to women in labour and the majority
of existing skills inventories include technical skills and competencies necessary in an emergency.
The identification and prioritisation of these skills is central to a quality midwifery service,
ensuring that midwives will have the confidence to work in these environments and make
clinical decisions about care (Downe, 2001).
The range of core skills required mainly by midwives but relevant to all staff in order to keep
birth normal are as follows (Hunter, 2000):
• Being confident to provide intrapartum care in a low technology setting
• Being comfortable to use embodied knowledge and skills to assess a woman and her baby
as opposed to using technology
• Being able to let labour ‘be’ and not interfere unnecessarily
• Being confident to avert or manage problems that might arise
• Being willing to employ other options to manage pain without access to epidurals
• Being solely responsible for outcomes without access to on site specialist assistance
• Being confident to trust the process of labour and be flexible with respect to time
• Being a midwife who enjoys practising what the participants call ‘real midwifery’.
Promoting normality also includes the use of available evidence to support care (one-to-one
care in labour). There are a variety of ways of ensuring that midwives have and maintain these
essential skills – but implicit in this must be the use of evidenced based care. Central to this is
team working and peer and multi-professional support.
page 44