Call The Midwife: what does it take to get into modern midwifery?

working as a midwifeThe 11.6% rise in applications for midwifery at Anglia Ruskin University could be linked to the popularity of Call The Midwife. But does the picture of 1950s east end midwifery give a false impression of this career in 2013?

Call The Midwife illustrates how midwives have a broad role, encompassing the care of women and newborns, as well as promoting and protecting the public health of families and the wider community. But the route into midwifery is vastly different in 2013 from how Jennifer Worth found her way to Nonnatus House.

Unlike nurse Jenny, applicants may now apply for midwifery without qualifying as a nurse first, but they must have an undergraduate degree. That said, if you know that midwifery is what you’d like to do, you can study it to become a direct-entry-registered midwife. This involves three years of training – half academic study in university and half in clinical placements.

Training as a midwife is demanding. Academic rigour is juxtaposed with learning both technical skills and developing a holistic philosophy of woman-centred care. This might require being on a 12 and a half hour night shift on a labour ward, facilitating the birth of several babies, or a 6,000-word assignment.

To ensure they get the right candidates, the majority of universities hold interviews as part of a selection day, with numeracy tests, a timed essay and group interview commonplace to reduce the numbers going through to individual interviews in the afternoon.

Places on midwifery degrees are very competitive. For example, Anglia Ruskin receives more than 1,000 applications per intake, of which 300 are interviewed for approximately 100 places. Entry requirements are also high, with some courses requiring around 300 Ucas points from A-levels or an equivalent. Mature students may also need to satisfy criteria for recent study.

The personal statement is key and needs to demonstrate a thorough understanding of the role and how you’re equipped for this challenging career. Most universities expect relevant health or care experience, for example, part-time or voluntary work in a care home or day centre, volunteering as a breastfeeding supporter, observing antenatal classes or meeting with a practising midwife. Enhanced criminal records bureau disclosure is imperative and occupational health clearance must be obtained.

In the 1950s, midwifery practice appears to have been based more on the way things are done, rather than the rigorous evidence base that is required today. Students must learn how to find, appraise and critique research to inform their practice.

You may also be required to present an evidence-based rationale for care decisions to doctors, who are now considered to be colleagues rather than superiors. Many women nowadays are also becoming pregnant with pre-existing medical conditions, which requires a broad knowledge base for students, allowing them to work within a multidisciplinary team to care for women with a multitude of needs.

‘Call The Midwife’ highlights how midwifery is less about cuddling babies and more about the blood, sweat and tears of the childbirth continuum. It does not pull any punches when it comes to showing that midwives need a strong stomach to cope with vomit, blood and conditions of poverty and ill health. But strong hearts and minds are also needed to deal with the emotions of a job that can see birth and death collide.

The midwives in the series represent all of the positive traits of the profession – dedication, passion, warmth, and understanding. Perhaps most importantly to midwives, it shows a time when midwives were able to be truly “with woman” (the meaning of the word midwife), centred in the community and offering continuity of both care and carer.

Modern day midwifery is burdened by a high birth rate, staff shortages and economic constraints. The number of births has risen by 124,000 since 2001 – a 22% increase – according to a recent report by the Royal College of Midwives. But in some areas such as Corby, Northamptonshire, the increase is as much as 63%.

Despite an increase in the number of midwives in England, there is still a huge shortage in those practising. This means that the care midwives might like to deliver – on demand, at a relaxed pace, in the homes of women they have ridden to on bicycles – is not always possible. Midwifery care now is increasingly located in healthcare institutions and appointments are limited on time and duration.

In an irony which many find hard to swallow, despite the shortage of midwives and increasing birth rate, there are far more applicants for midwifery than training places available and, more worryingly, newly qualified midwives are reporting a shortage of jobs on graduation.

But births continue to be life changing for families and they are a privilege to be part of – just as much now as in the 1950s. The way in which many of the babies are born on ‘Call The Midwife’ is the way that babies are born today, using the same midwifery skills, even though we have far more advanced medical and surgical techniques.

Elizabeth Blamire is a second year midwifery student at Anglia Ruskin University and president of the Mindful Midwifery Society.

Thanks to The Guardian for allowing icould.com to republish this article. You can view the original version on the Guardian website.