The Midwifery Unit Network: creating a community of practice to enhance maternity services.

The Midwifery Unit Network (MUNet) is a community of practice which aims to promote and support the implementation and improvement of midwifery units (MUs) in the UK and internationally. It was launched in April 2016 and has been growing fast since its inception. In this article, three co-leads of MUNet describe why they set up the network and how they established it. The aim of the article is to inspire more midwives to consider establishing a community of practice, and to offer some guidance in doing so.

Developing the midwife's role in public health.

There is widespread acceptance that health can be shaped by factors occurring as far back as infancy, and even before birth. In September 2010 the document Midwifery 2020: Delivering Expectations was launched in Edinburgh. The aim of the report was to establish the future direction for midwifery in the UK, and included specific reference to the midwife's public health role. The report notes that experiences from in utero development until eight years of age lay critical foundations for the entire life course. The report reiterates previous debate on the important contribution maternity services have in addressing health inequalities, and emphasises the importance of midwives striving to address the needs of the most vulnerable communities they serve.

Women's perceptions of being pregnant and having pregestational diabetes.

OBJECTIVE: to explore the experiences of White British and South East Asian women with type 1 and type 2 diabetes, and the perceived impact of diabetes on their reproductive health. DESIGN: a hermeneutic phenomenological approach was used to explore the perceptions of women with diabetes from two different cultural backgrounds with varied reproductive health experiences. Focus groups and one-to-one interviews were used to elicit women's experiences. An interpretive analytical approach was conducted by two researchers. SETTING: obstetric and diabetes clinics in three hospital sites in the North West of England. PARTICIPANTS: a purposive sample of 22 women with type 1 or type 2 diabetes of different parity and ethnicity. FINDINGS: the main themes were relinquishing personal control, pregnancy overshadowed by diabetes and haphazard preconception care. KEY CONCLUSIONS: strategies should be developed to ensure that whilst safety is maintained, the pregnancy focus is not lost. Women should be supported to optimise their experience as well as clinical outcomes. The convergence of professional roles needs consideration; individual members of multidisciplinary diabetes teams should provide a unique and complementary contribution to care. Preconception care needs to be accessible and responsive to women; this should include recognition of socio-cultural differences.

'She sort of shines': midwives' accounts of 'good' midwifery and 'good' leadership.

OBJECTIVE: to explore midwives' accounts of the characteristics of 'good' leadership and 'good' midwifery. DESIGN AND METHODS: a phenomenological interview survey. Participants were asked about what made both good and poor midwives and leaders. SETTING: two maternity departments within National Health Service trusts in the North West of England. PARTICIPANTS: qualified midwives, selected by random sampling stratified to encompass senior and junior grades. ANALYSIS: thematic analysis, carried out manually. FINDINGS: ten midwives were interviewed. Sixteen codes and six sub-themes were generated. Across the responses, two clear dimensions (themes) were identified, relating on the one hand to aspects of knowledge, skill and competence (termed 'skilled competence'), and on the other hand to specific personality characteristics (termed 'emotional intelligence'). This study suggests that the ability to act knowledgeably, safely and competently was seen as a basic requirement for both clinical midwives and midwife leaders. The added element which made both the midwife and the leader 'good' was the extent of their emotional capability. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: this small-scale in-depth study could form the basis for hypothesis generation for larger scale work in this area in future. The findings offer some reinforcement for the potential applicability of theories of transformational leadership to midwifery management and practice.