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In what circumstances can a midwife be suspended from practice? Caroline Flint describes one midwife's nightmare I have just arrived back from the International Confederation of Midwives in the Hague - for the past week I have been talking to and meeting midwives from all over the world; from Spain and Malta, Holland' Sweden' France, Africa' Asia' Iceland' Canada and the United States. I have met midwives practicing illegally and midwives protected by law. I have been moved by the universality of our problems' the increasing medical takeover of birth throughout the world with its resultant increase in surgery for women having babies' and the universal struggle midwives are having because nursing organisations are trying to annexe them. I have felt part of a great sisterhood of dedicated women trying to improve childbirth for women' to make it safer and happier' to promote the health of women throughout the world - I have felt proud to be a midwife and I have felt very proud to be an English midwife, protected by our Rules and our Code of Practice. I felt happy and strong when I walked into my kitchen - I'd only been away for a week but in that week I had grown in knowledge' experience and understanding of midwifery in other countries. England isn't perfect, but it's not so bad really, it's a good place to be a midwife compared to many places - and then the phone rang. It was my friend Jilly, an independent midwife. `Caroline' I've been suspended from practice.' I couldn't bear to take it in - the nightmare was starting again. 'Why?' `Because I took a woman to hospital in private car instead of an ambulance as the nearest hospital was five minutes away and if I had called the obstetric flying squad it would have taken 20 minutes from leaving the hospital' much less getting ready to leave.' 'Jilly, are sure that you have been suspended from practice? How do you know?' 'The supervisor of midwives told me that she was suspending me from practice and she wrote it in a letter.' 'Jilly, a supervisor of midwives cannot suspend you from practice - only the Local Supervising Authority can do that. Have you had a letter from the English National Board telling you that they are investigating a case against you and asking you to give your side of the story?' 'No', said Jilly. `Then you have not been suspended legally and the whole thing is nullified.' According to the Midwives' Rules a midwife may be suspended from practice if a case against her has been reported for investigation to a board - the only way a midwife can be suspended immediately' as Jilly had been' was if she was likely to spread infection. I suggested that Jilly should ignore the `suspension' and carry on practising having told the supervisor why she was ignoring it. Easy enough to say, but as all midwives do in this situation' Jilly felt vulnerable and intimidated. She also couldn't contact the supervisor who was away on holiday and there was no other supervisor available in the health authority. The story was getting worse and worse - there should be a supervisor available at all times to be contacted by midwives in the area. The safety of every midwife's practice is overseen by the Local Supervising Authority - this body is usually referred to as the LSA and in practice it is invariably the regional health authority. It has the power to suspend a midwife from practice if she is the source of infection, if a case against her has been put before the investigating committee, the professional conduct committee or the health committee of the national boards. Only when a case against her has been brought may the LSA suspend a midwife and the midwife will always know if a case against her has gone to the board because she will always be notified by letter and asked to give her side of the case.To stem the tide of `suspensions' carried out by supervisors of midwives last year the UKCC issued a circular (PC/86/03) which stated, `It should be noted that it is the local supervising authority which has the power to suspend a midwife from practice in accordance with Council's rules and not the supervisor of midwives. Therefore no action will be taken by this Council on reports from supervisors of midwives.' Every time a midwife is `suspended' even if on further investigation that `suspension' is declared void, it hurts our profession it makes midwives feel intimidated, and our collective confidence is undermined. To suspend a midwife is an extremely serious action - the sentences available to the Boards and Council are very limited and consist mainly of striking off or not striking o1 the register. No action should be undertake lightly, especially as once the Board has been notified it cannot stop the proceedings again the midwife - they have to be seen through It should never be used to `teach someone lesson' or in a conflict of clinical judgement. Midwives universally need to support each other. At the International Confederation of Midwives I met supervisors of mid wives who were trying to do that, who ha stayed in the labour ward to support the mid wife who was supporting a woman who wa acting against medical advice, for example Supervisors are part of the great sisterhood of midwifery, but when we have rules w must all follow them - none of us is above the law. September 9, 1987 |
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