Specialist Midwife Pelvic Health

The Pelvic Health Specialist Midwife will be required to develop sound working relationships with external agencies, primary health providers and the Local Maternity & Neonatal System (LMNS) to ensure that clear pathways are established, and education is provided. They will also form contacts with others in similar posts at other Trusts in the LMNS geography to develop an environment of sharing learning and ultimately form a clinical network. Key priority areas for action are: Antenatal: setting up and running the provision of additional midwifery enhanced support for pregnant women with complex needs such as previous anal sphincter injury and recommendation of mode of next delivery. They will be designing and then use a clear pathway in collaboration with the colorectal and obstetric teams.

**Intrapartum**: Support midwives to suture first and second-degree tears and episiotomies. Support midwives/obstetricians to prevent obstetric anal sphincter injuries and if happens to identify and manage appropriately. Postnatal follow up: stablishing referral pathways for enhanced support for women who have sustained an Obstetric Anal Sphincter Injury (OASI) or have a perineal breakdown promoting a healthy and quick recovery using evidence-based research and multidisciplinary working. Learning and Development: Audit women sustaining an OASI and integrate recommendations into colleagues training to reduce rates.

Perform a service evaluation of this training programme and cascade to OASI care bundle if appropriate. Education of enhanced skills of OASI prevention to Midwives, Students, Obstetricians, Multidisciplinary team and the LMNS. Suturing skills to local staff and develop whether this teaching can be opened to those external to the Trust. The role of Pelvic Health Specialist Midwife will not be limited to these current priority areas, but they will develop over time.

This will ensure that future priorities can be addressed. The purpose of this post is to: Embed evidence-based practice in antenatal, intrapartum and postnatal care to prevent and mitigate pelvic floor dysfunction resulting from pregnancy and childbirth. This will include: Strengthening the antenatal education package for women on the likelihood of Pelvic Floor (PF) dysfunction. This will include staff training to introduce a baseline self-assessment of pelvic health around booking, and ensuring understanding, adoption and adherence to PFMT at all antenatal contacts as a preventative measure.

Additional antenatal support for those experiencing issues or identified as being more likely to experience issues (antenatally or postpartum). Adopting shared practice to mitigate the risks of obstetric injury during birth, and provide quality wound care (this includes episiotomy, perineal tears, bruising and birth trauma). Improve the rate of identification of pelvic floor issues antenatally and postnatally. This should include: Provision of quality, consistent and accessible information for all women, midwives, obstetricians and GPs on common issues, how to assess PF function and how to identify, manage and refer problems locally in various formats.

Use of assessment tools to help them do this consistently and with confidence. Ensure timely access to NICE-recommended treatment for common pelvic health issues antenatally and postnatally. This should include: The establishment of a Perinatal Pelvic Health Service, with a single point of access for all common issues antenatally, postnatally and for an agreed period following discharge from midwifery services. Reducing referral to treatment times by streamlining referral processes and increasing local establishment of specialist womens health physiotherapists to better meet demand.

Providing leadership in the local planning, provision, and improvement of perinatal pelvic health care.