Introducing Jan Butler, Consultant Midwife

Jan Butler was appointed as the Rosie's first Consultant Midwife on 12 April, and is one of only three in this role in the East of England. She talks about the leadership role and her vision for midwifery at the maternity hospital.

 

 

What is a Consultant Midwife?
A Consultant Midwife is a skilled expert in midwifery practice, with a significant part of her role involved directly in clinical care. It provides opportunities to improve career pathways in midwifery, strengthen midwifery leadership, develop high-quality practice and improve training opportunities for midwives.

 

 

What's a normal childbirth?
There is an ongoing debate about the definition of "normal birth". If you ask women what it is, it may be totally different to how it is perceived by midwives and clinicians - this is our challenge. The way forward is to define it as a normal physiological birth, without complications - childbirth should be considered normal until proven otherwise!

 

An important part of my remit is to work closely with the Head of Midwifery, Anna Shasha, in developing a culture of normalising birth, improving quality and safe care for mothers and their babies. It is also about working as a multidisciplinary team to reduce the C-section rate – currently 27% at the Rosie - through positive leadership, which means supporting all our staff and a commitment to evidence-based practice.

 

 

What does this actually mean for pregnant women in Cambridgeshire?
Thanks to media and the internet, women are more informed about their options, and come armed with questions and expectations. For example, many healthy women who have had a normal, uncomplicated pregnancy may not have considered a home birth – we need to be giving them up-to-date evidence that supports normal birth rather than exposing themselves to unnecessary interventions. This is an issue very close to my heart – I'm currently finishing my thesis on the impact of clinical leadership on women's choice about place of birth.

 

 

What do you think drives women's choices?
It's a variety of factors: the resources and culture of the maternity services, women's family or societal experience, personal expectations and the needs of the local population. Many pregnant women now have mothers who have given birth in an era of highly medicalised maternity care, after the NHS was established. So for them that's considered normal. We've seen so many technological advances and many women want an epidural, they want the security blanket of hospital.

 

Normalising birth is about encouraging a positive mindset in women that gives them the confidence and courage to believe that their bodies can birth naturally, that a pregnancy and birth is normal until proven otherwise. We've got to get back to basics.

 

Even for women with complicated pregnancies or serious conditions, their birth journeys should be just as satisfying. We have to give all women that quality experience and try to normalise the birth process, whatever it throws at us.

 

 

What are your priorities?

• To increase the normal birth rate and significantly reduce unnecessary caesarean sections through midwives taking the lead role in the care of normal physiological pregnancy and birth.
• Since arriving I have developed a pathway of care for women who have had a previous C-section.
• I am currently leading an audit to establish whether women are getting 1:1 midwifery support while in labour
• In July, as a member of the Royal College of Midwives (RCM) consultant midwifes' forum, I promoted The Rosie as a site for conducting a "national snapshot" of labour and birth positions. This will provide us with local evidence-based data to empower midwives, giving them the information they require to support women. I would like to thank all the midwives for their input and support with this.

 

Who will you be working with?
Everyone! In both a strategic and a clinical leadership role, as part of a visionary team approach.

 

 

I consider it a privilege to be the Consultant Midwife at the Rosie Hospital and look forward to being able to influence midwifery practice for women in my locality.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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