International Day of the Midwife 2025

Midwives have a critically important role in the safety of women / birthing people, and their babies. In celebration of International Day of the Midwife 2025, Katherine Hawes, Deputy Director at the MNSI programme, and Rebecca Daniels, MNSI Lead Midwifery Clinical Advisor, explore the contribution midwives make to patient safety.

Midwives are fully accountable as lead professionals for the care and support of women / birthing people, babies and, families. As clinicians, leaders, and educators, they are central to identifying risk, preventing harm, and promoting safety across every stage of the maternity journey.

Within the Maternity and Newborn Safety Investigations (MNSI) programme, we have a unique perspective on the role midwives play in complex and often high-pressure situations. Our investigations into maternity and newborn safety incidents across England consistently show how midwives help prevent avoidable harm—both through clinical actions and by working effectively within multidisciplinary teams.

Midwives, multidisciplinary teams and patient safety

Midwives are essential members of the multidisciplinary team, bringing a specialist skill set that prioritises safe, personalised, and relationship-based care for mothers / birthing people, their babies, and families. Their practice is underpinned by clinical expertise, and the ability to identify and respond to emerging risks. In accordance with the Nursing and Midwifery Council (NMC) Code (2018), midwives must “practise in line with the best available evidence” and “work co-operatively” with colleagues to ensure safe, high-quality care. This includes recognising the limits of their own competence and escalating concerns in a timely manner to senior midwifery, obstetric, neonatal, or anaesthetic colleagues when clinical situations require additional expertise.

Effective multidisciplinary working is a cornerstone of safe maternity care, and midwives often act as the first point of recognition and response when concerns arise. They play a key role in ensuring that communication across teams is clear, timely, and clinically relevant—particularly in the context of patient deterioration or emergencies.

MNSI investigations consistently highlight the impact that appropriate escalation and collaborative decision-making can have on clinical outcomes. Conversely, delays in escalation or breakdowns in communication are recurring themes in maternity and newborn safety events. This underlines the importance of midwives not only as clinical caregivers, but as coordinators of care who are central to ensuring the safety and continuity of the maternity care pathway.

MNSI midwives and safety

At MNSI, midwives bring essential insight to the investigation process. Their knowledge of clinical practice, system pressures, and maternity culture allows us to generate learning that goes beyond individual error, and instead addresses the conditions in which care is delivered.

Having midwives who understand the environment within which patient safety events can occur enables us to develop safety prompts that are implementable and take into account the system pressures. An example of this can be seen in record-keeping during the second stage of labour. A woman may be in a birthing pool, requiring the baby’s heart rate to be monitored every five minutes. In some trusts, midwives are expected to enter this data into a computer system located away from the pool, which may be slow to access and challenging to use—particularly with wet gloves. The second stage is a critical and demanding period, and a single midwife managing all necessary tasks may face difficulty maintaining appropriate oversight and identifying when escalation is required. Many of our recommendations focus on how trusts can support staff in managing such competing demands, which may not always be apparent to those outside clinical practice.

Midwives are vital to maternity and newborn safety. Their clinical expertise and contribution to learning are central to achieving better outcomes for birthing people and babies. If we are to continue improving safety in maternity care, we must ensure midwives are supported to fulfil this unique role—with systems that reflect the realities of their practice and value their insight at every level.