International Day of the Midwife: Vivienne Cannons lifts the lid on life as a research midwife

To celebrate International Day of the Midwife, CRN Kent, Surrey and Sussex spoke to Research Midwives about their roles and why research is important to them.

What is your role as a research midwife?

First and foremost it's about recruiting pregnant women and new mothers onto clinical trials. The hospital takes on NIHR studies and I offer maternity patients at our trust the opportunity to take part. Once they've consented to be part of a study, I collect their details and upload them for the project sponsor. Day to day, this means lots of conversations with pregnant women, new mums and clinical colleagues. It also involves some desk-based work such as data input.

"But it's not just about recruitment and monitoring. It's also about informing my clinical colleagues and the hospital's maternity patients about the results. Findings can then be integrated into care to help us provide the best possible maternity service, and women are well placed to make informed decisions about their own care.

As a research midwife, there's also the opportunity to design your own studies, but this isn't something I am doing at the moment.

What studies have you been working on recently?

We've been largely focused of COVID-19 studies during the pandemic. The largest one being PAN-COVID (Pregnancy and Neonatal Outcomes in COVID-19). This is a global study collecting details of women with suspected or confirmed COVID-19 in pregnancy and their newborn babies. It aims to find patterns between COVID-19 in pregnant women with miscarriage, foetal growth restriction and stillbirth, pre-term delivery and whether expectant mothers pass the virus to their unborn babies. It is hoped that by discovering more about these associations, doctors and scientists can better guide treatment and prevention.

The Big Baby Study has also been a significant study for us and we are one of the top recruiters for this study in the Kent, Surrey, Sussex region. This study seeks to find out if starting labour earlier than usual, at 38 weeks, for women whose babies appear to be large makes it less likely that the baby's shoulder will get stuck during delivery, known as shoulder dystocia. Women between the 35th and 38th week of pregnancy who look to be expecting a baby over the 90th centile are invited to be part of this study. They are then randomised onto either the early induction arm or the expectant management arm, where they receive usual treatment which, at this hospital, means we start to talk about induction at 40 weeks.

We've also just launched a new study looking at timing of delivery for women with high blood pressure. It is widely known that the quality of the placenta degrades earlier in women who have high blood pressure during pregnancy. It is also well known that the earlier babies are delivered, the more likely they are to end up on a special care ward with breathing difficulties. This study is weighing up the risks and benefits of an early delivery to determine the optimal delivery time for women with high blood pressure."
How did you first get into research?

I was a labour ward midwife when I saw a poster appealing for midwives to work on a trial investigating potential drug treatment for epilepsy in pregnancy. I was interested in epilepsy so made contact with the hospital research team running the study.

At first, I did some bank hours recruiting pregnant women to the study and really enjoyed it. It turned into a secondment post, during which time we opened up another couple of studies and it then just evolved into a permanent post.

What do you enjoy about being a research midwife?

I enjoy the autonomy of the post. I have my own workload, I know all the studies inside out and specialise in recruiting to them. I like being able to discuss and offer maternity studies to the women, many don't even realise that we are a research active trust. Much as I loved being a midwife, I like that being a research midwife is less hectic and stressful, it's a different type of stress as we still have targets and deadlines to meet. I enjoy promoting research and the challenge of getting clinicians on board.

I feel fortunate to be involved in answering research questions that can improve maternity care. It's great to get results and to help share these.

What do you find challenging?

The biggest challenge has been engaging staff. Doctors and Midwives don't tend to get involved in research for the money. Most healthcare workers get involved in research because they are interested in it. It can sometimes be difficult to spark an interest, but I like the challenge and have found highlighting the benefits research brings to patients can get doctors' attention.

Fitting the work needed for all our recruiting studies into part-time hours can be tricky too. I only work 22.5 hours a week and there's a lot to squeeze in!

Starting up a new study can be a challenge as well. There's lots of stages and paperwork which means it can take a long time to get a study off the ground.

What would be your advice to midwives considering a career in research?

The most important thing is that you need to have an interest in research to begin with. Some midwives I've spoken to are naturally inquisitive about research studies, while others are not keen at the thought of research.

You've also got to consider whether you want to take on your own research and answer questions in your mind about improving care, or, if you are happier recruiting to other people's studies regardless of whether you are interested in the specific research question, like I do. There are career options for both. If you have your own research question in mind then you should consider a more academic avenue and funding routes for your own studies.

Finally, like most jobs, there is a wide variety of tasks. It's not all about talking to pregnant women and new mums, so get a thorough understanding of the whole job before taking the plunge. You can do this by contacting your research team to see if you can spend some time with the research midwife.