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The Nursing and Midwifery Council has officially clarified its stance on clinical autonomy regarding internal examinations. This outcome confirms that our professional judgment remains recognized in home birth settings. We will monitor future disciplinary guidelines to ensure this precedent is upheld.

December 6, 2009

Safeguard the autonomy of midwifery practice

Safeguard the autonomy of midwifery practice

🏆 Won — 417 supporters Verified

Final supporters

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social b.
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Sheanne P.
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Beverley H.
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Dr.T.A.Stevens
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Annie R.
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+407 more
Started by Anonymous 17 years ago
Earlier this year our colleague Deborah Purdue was struck off by the NMC. Details of the case and decision can be found on the NMC website under Fitness to Practise Decisions for March 2009. Three of the charges found to be proven relate to her not carrying out an internal examination until she had been in the home for 4 hours (Charges 1b, 2b and 4c). For many of us this is normal practice, particularly in the home setting. This decision by the panel seriously threatens the autonomy of midwives since it seeks to dictate the detail of how we practise. Guidelines are just that (local and NICE) and should not dictate our practice under individual circumstances. Looking at the detail of the case, with hindsight you may feel you would have done differently, but this petition is about the issue of when a midwife may choose to carry out this procedure in the course of caring for a woman in labour. Please sign this petition if you agree with the statement below. The idea behind this petition is to point out to the NMC that not performing internal examinations routinely is widespread practice amongst midives and therefore not a valid reason for striking a midwife off the register. Statement: Whilst we recognise that Vaginal Examinations are a useful tool to give information to include in the picture of the overall progress of labour and the wellbeing of mother and baby, as midwives we have many skills at our disposal to diagnose the beginning of labour and assess the progress of a labour, without routinely performing what is a physically and emotionally invasive procedure that is not in itself without risk*. It is our understanding there is no evidence that performing routine regular vaginal examinations safeguards the wellbeing of the foetus*, nor that it is an infallible diagnostic tool, since labour is a progressive state with many changing factors involved at any one time. We the undersigned would therefore not auomatically and routinely perform a vaginal examination on immediate arrival at labour and would use our clinical judgment, during any individual labour as to when and whether such an examination is necessary. Some women we care for have no vaginal examinations at all during their labours. * references supplied

Updates

Reached 250 supporters

September 12, 2009

September 11, 2009

I am currently drafting a formal letter to the Nursing and Midwifery Council to request a clarification of their interpretation of clinical autonomy. Legal counsel is reviewing the case documents to ensure our arguments align with current standards of practice. Expect a summary of their official response as soon as it arrives.

Reached 100 supporters

September 10, 2009

6 Comments

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Claire Coleman
16 years ago Featured

RIDICULOUS! Stop punishing midwives for actually listening to women instead of just following rigid paperwork.

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David Sanders
16 years ago Featured

If every midwife followed the exact same timeline we would have a huge problem. Every birth is different and the NMC needs to get that.

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Jenny Hardy
17 years ago Featured

Absolutely insane decision. VEs are not always necessary and can be invasive if done too early. Disgraceful treatment by the NMC.

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Tanya Wright
17 years ago Featured

so sad to see such a dedicated person lose her career over this. keep the autonomy where it belongs with the midwife on the scene.

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Sarah Abbott
17 years ago Featured

This is ridiculous. Being a midwife is about intuition and reading the mother not just checking boxes for the board. Deborah is a great midwife.

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Mark Wang
17 years ago Featured

My wife is a midwife and she deals with this pressure all the time. Let them do their jobs without constant fear of being struck off for being professional.