Celebrating Midwives: a vital climate solution on International Day of the Midwife 2024
This year’s International Day of the Midwife on Sunday, 5 May will see midwives around the world celebrate their role in women’s sexual and reproductive health within the broader context of environmental advocacy and action. Put succinctly, midwives have a crucial role in the fight against climate change and climate activism is embedded in midwife-led models of care.
‘Midwives are climate activists'. The challenges to the health of women and babies posed by climate change are unprecedented and range from extreme weather events and disruption to healthcare in vulnerable communities to food and water insecurity, disease and devastating psychological impact. In tackling these challenges, midwives are uniquely placed to impact beyond traditional healthcare and into climate sustainability and resilience.
As an organisation that champions sustainable care and climate resilience, we are passionate about driving sustainability within healthcare. Given that the NHS contributes to around 5% of carbon emissions, it is both part of the problem and the solution and we aim to be a leader by example in driving sustainability and delivering the greener NHS agenda. We play a key role in supporting other organisations in health and care to achieve the NHS net-zero goals for the benefit of populations and the planet.
To enact positive change, it is crucial to understand the impact maternity care provision in the UK has on climate change.
We recently worked with Bath, Swindon and Wiltshire (BSW) ICB to use the opportunity of moving towards a centralised maternity triage service to engage with stakeholders and come up with ideas to embed environmental sustainability thinking into the redesign of maternity services. Our multi-disciplinary team worked with BSW’s maternity services to support a pilot to test four principles of sustainable clinical practice defined by Mortimer (2010) as part of a low carbon care model framework.
The pilot had three distinct objectives:
- To understand how the low carbon care principles (prevention, patient self-care, lean service delivery and low carbon alternatives) can be applied in the design of changes to maternity pathways to help embed sustainability.
- To gather recommendations and ideas from stakeholders on how to decarbonise maternity triage within BSW.
- To share learning and summary of findings with other systems.
Consequently, the following key opportunities were identified during discussions:
- Standardisation of Clinical Care Guidelines: Aligning clinical care guidelines across BSW, which currently vary substantially across the three places, could lead to substantial carbon reductions through more consistent and low carbon care delivery.
- Strategic demand and capacity insights: Centralising triage will mean that BSW is able to better spot patterns of demand and capacity across all three places and care settings. This will help reduce duplication and help optimise care location and therefore will provide the opportunity to reduce carbon emissions.
- Getting it right first time: There is an opportunity to work more collaboratively with stakeholders and clinical services outside of maternity services e.g. primary care to deliver more general maternity care and advice. This aligns with the 'right care, right place, right time’ principle of low carbon care delivery. By reducing the need for onward referrals, BSW can reduce the environmental impact of additional specialist appointments or referrals where not required.
- Standardisation of information and self-management: Providing standardised advice and information to service users, partly through the call centre interactions but also through signposting to the Healthier Together app will help women to be able to better self-manage and keep well, reducing the need for health interventions and therefore the environmental impact.
The learning from this pilot will support the further development of this framework and help other systems understand how they can strategically consider environmental sustainability upstream within service change. Top tips include:
- Clinical leadership and engagement are key: It is important to get stakeholder buy-in and commitment to completing this work. Securing dedicated resource with expertise in the clinical pathway and some general sustainability knowledge is extremely valuable.
- Align priorities: Align with other clinical and strategic priorities and emphasise co-benefits of delivering low carbon principles to get engagement.
- Introduce the Low carbon principles and tool early within the project: Introduce these early to help establish sustainability as a core part of the service re-design process
- Don’t let perfect be the enemy of good: There is added value in just starting the conversation even if the answer or outcome is not immediately clear.
- Be adaptable and flexible in your approach: This applies generally to the project approach but also to using the Low carbon care principles and tool.
- Collaborate and learn from others: This will be a learning process; learn from others who have done similar pieces of work and lean on the Greener NHS team for their expertise and support.
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