Sarah

Sarah retrained to become a midwife when she was aged 25. After qualifying as a midwife, she worked clinically for a couple of years. Sarah then took a position as a Clinical Research Network midwife and held a post which involved her working on around 20 different clinical trials. These studies spanned across many topics, different stages of pregnancy and clinical settings. Sarah enjoyed building up relationships with and providing continuity of care to pregnant women who took part in several studies, and felt it gave her a deeper insight into changes across pregnancies – including how a condition can develop over time. She is now employed on a different post as a research midwife which involves coordinating a large clinical trial.

In her first research midwife role, Sarah sometimes felt uncomfortable about the emphasis on recruiting participants. She knew that other research midwifes took clipboards with them when they approached a person for a study, but Sarah preferred not to take any materials with her initially. If a participant was interested in taking part, she would then go and get an information leaflet about the research. When she met with a potential study participant for the first time, Sarah thought it was important to ask what they understood about their situation. This helped avoid patronising the person and it gave her an opportunity to share some of her midwifery knowledge if there were gaps in the pregnant woman’s understanding. 

Sarah’s current job is to coordinate a clinical trial, and this involves her supporting research midwives at various sites to deliver the research. This means that she does not have a lot of patient contact on a daily basis any more, but she has a crucial role in connecting trial managers, researchers and clinicians involved in the study. Sarah explained that “[this role] allowed me to not just work on the trials, but actually hopefully shape the trial that I'm working on”. Sarah highlighted that ‘good’ research is about more than adhering to the ‘Good Clinical Practice’ guidelines. For example, she thinks there is potential to improve research practices to make them more effective and efficient, and to help potential participants “digest the information” more easily.

In Sarah’s experience, there are important differences between clinical and research cultures, and this can make working as a research midwife challenging. Sarah thinks there are also practical barriers as a result of differences between research and clinical ways of working, including around combining both aspects in employment contracts. She feels strongly that research and clinical experiences and skills can complement one another, and that the combination can have benefits for patients, but suggests that there needs to be more support for this to become a widespread reality. 

Sarah thinks it can be challenging to make sense of her professional identity as a research midwife: “you are still a midwife, you’re just a different kind of midwife”. She feels there is a strong emphasis in midwifery on completing physical and visible care tasks. In contrast, she explains that the work required of research midwives differs in various ways: “you need time to think about things and time for things to percolate through. You need time to communicate with people”. As a research midwife, Sarah thinks it can be difficult seeing clinical colleagues under pressure and “not helping out” to the full extent, although she sometimes does occasional tasks “to make the process more seamless”.

Sarah is not sure about her next job or longer-term career plans. She hopes to continue working on interesting studies and would ideally like a role which combines patient contact with shaping higher-level policy around providing quality patient care. In order to develop and sustain a strong workforce of research midwives, Sarah thinks there needs to be more of a career trajectory in place and opportunities for developing as well as recognising expertise.