Case study: International Day of the Midwife: Rachael Gardner explains why she is passionate about research

What is your role as a Research Midwife?

My role is varied, as I am involved throughout the whole research process, from when we are expressing an interest in becoming a site, through to set-up and overseeing the governance for a study. Then, I am primarily recruiting the women and babies onto the studies.

I think it is important to get colleagues in the maternity unit engaged early on when setting up a study. I spend much of my time on the unit promoting the research we do at Medway, speaking to key people and the staff who may end up working on a study. If a study is going to last one to two years there will normally be a specialist midwife attached to it, so I engage them early and closely work alongside them to streamline the current pathway and implement the study protocol.

Which studies have you worked on recently?

Over the last year our research focused on COVID-19, with involvement in the large ground-breaking studies - RECOVERY and PAN-COVID (Pregnancy and Neonatal Outcomes in COVID-19). For RECOVERY, my role was to set up a maternity pathway if a woman came into the delivery suite and then needed to go into ITU once she had delivered her baby. I would make that connection between departments so the team was ready and waiting to receive her in ITU and consent her there. As a team, we would try to go through the patient participant information with her before she reached ITU. For the PAN-COVID study, I ensured suitable women were consented and then their information entered into the study database. We also supported a smaller study called periCOVID that looks to understand if pregnant women who test positive for COVID-19 can transmit the infection to their unborn babies.

We are in the process of setting up the Pfizer maternal COVID-19 vaccine study in pregnant women. Medway is the only site to be selected in Kent, Surrey and Sussex and we are so proud of that achievement. We are delighted that we will be able to offer the vaccine to our pregnant women as part of the study.

We were fortunate that we did not have to suspend research activities during the first and second waves. We managed to maintain our recruitment on non-COVID studies and were able to offer research during unprecedented times. Studies running include one called COPE (COPE: The Carboprost or Oxytocin Postpartum haemorrhage Effectiveness Study) which is a randomised control trial looking at Carboprost vs Oxytocin as the first line treatment of primary postpartum haemorrhage. We’ve also had the POOL study running which is evaluating the safety of water births.

How did you get into research?

It just happened. When I first qualified and joined Medway I was a rotational midwife, where I would spend three to six months within each area. During this time, we had a mandatory training day and had a presentation from the research midwife. I remember thinking that is my dream job. A few months later, a secondment position became available within the research team and I’ve never looked back. I am now a permanent member of that team and feel like I’ve found my home.

What do you enjoy about your job?

As a research midwife, I am afforded the opportunity to have additional time to support women through difficult circumstances, such as a new diagnosis or treatment. We work alongside our fetal medicine department and some of the referrals will come from that team. Because we are co-located we get to see the women straight away. Once the women are given their results, we go through them with the women in greater detail than a normal clinic might have time for and then remain a point of contact for them.

Many people think that as research midwives we have to give up our clinical work but we do not. We are still patient facing and get to run a clinic, albeit one a bit more niche. Therefore, I get to remain clinical but also get involved in driving better evidence-based care forward.

I enjoy knowing that I am making a difference for the future. If I think back to the changes that have happened in pathways in my relative short midwifery career, those changes have happened because of research. Research highlights that there are potential improvements in care. Knowing I can be an active part in that change is inspiring and I know that when I look back at my career in years to come I will be proud of it.

What challenges do you face?

When you take on a study, you have to become an expert in that topic area very quickly. If you are promoting the study to your colleagues or trying to recruit a woman, they will expect you to know the answers, or at least know where to find the answers quickly. I find that a challenge sometimes, especially if you are taking on multiple new studies in quite quick succession.

My other big challenge is that not everyone shares my passion for research and I struggle with that, as I love research so much, but I do understand the change that research can bring can sometimes be difficult for colleagues to embrace. I have made sure a big part of my role is to do research promotion within the maternity department so colleagues can see first-hand the benefits research often brings

What advice would you give to other midwives considering a career in research?

I would say to anyone wanting to start a career in research, but who is not sure, to just try it. In research there are typically secondments or job shares available so you do not have to give up your clinical work, go into research, and realise it is not for you. Dip your toe in and try it. Speak to your local research team within your unit to see how you can get involved, which could include identifying women to take part. We can bring someone into our research world, without someone over committing at the early stage.