Protecting the Public: An Investigation of Midwives Perceptions of Regulation and the Regulator

•Midwives are generally supportive of regulatory standards.•Midwives perceive the regulator to be remote and often punitive.•Detailed appreciation of the role of the midwife is necessary to ensure safe and effective care provision.

Objectiveto investigate the perceptions of a group of midwifery registrants about the influence of regulation and the regulatory body, the Nursing and Midwifery Council, on the practice of midwives in the United KingdomDesignquantitative and qualitative research using an online survey and semi-structured interviewsSettingThe South East of England, which covers both urban and rural practice settings.Participants(a) 132 (n=70%) midwives responded to the online survey, and (b) 20 midwives participated in the semi-structured interviewsFindingsmidwives were generally supportive of the need to regulate practice; however, some participants had an uneasy relationship with the Nursing and Midwifery Council and claimed to practice defensively, due to a fear that they could be removed from the register, and believed the regulator to be remote and punitive. For other participants concerns were raised about fitness to practice procedures, particularly in terms of decision-making.Key Conclusionsthe participants felt that in order for midwifery regulation to be effective the regulator needs to have detailed knowledge and appreciation of the role of the midwife, and the needs of the pregnant woman.