What is evidence-informed midwifery?

Evidence-Informed Midwifery is predated by Evidence-Based Midwifery.

Evidence-Based Midwifery derived primarily from the concept of Evidence-Based Medicine.

Evidence-Based Medicine was articulated by David Sackett, in 1996, as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patients. It requires health care professionals, as Akobeng put it in 2005, to base clinical decisions on the best available evidence.

Definitions of evidence-based medicine accept science as the dominant meta-narrative, moving away from decisions based on opinions and past practice, and preferring to make more use of science, research, and evidence to guide decision-making.

This is exactly the kind of definition which midwives tend to reject.  Midwives understand that the past practices and precedent can, if used appropriately, be useful tools in informing practice decisions.

Learning from experience is a useful and neglected form of evidence in mainstream healthcare practice.

Midwives are well placed to inform this debate, primarily to ensure that the unique knowledge we have is both protected and validated for future generations.

Replacing the word “based” with the word “informed” derives from a realisation that midwifery is a process which is about far more than evidence.

First, we have to ask, what is evidence?

Indeed, there are as many different forms of evidence as our understanding of midwifery, and women will allow us to see.

Midwifery is certainly informed by evidence, whether we personally like the concept of Evidence-Informed Midwifery or not. But it is not based on this alone.

The key is to ensure that experience, as with all forms of evidence, is used appropriately, while it is never justifiable to practice in a certain way, simply because we have always practiced that way.

While science will continue to be useful in its own way, it could never give us all the answers.

There are clearly many gaps the evidence science is able to offer which need to be filled through other sources of knowledge.

Midwifery practice is actually a partnership with each individual woman in the spectacular nature-led experience of birthing.

Midwives support women making decisions. Women come to midwives because they need expert knowledge on which to base these decisions. Each question being asked by an individual woman is unique and informed by a variety of evidence.

The more knowledge and the understanding of women’s bodies we can assemble for ourselves, the more we can help those women make decisions which are right for their babies.

What constitutes evidence? Women’s experience, midwifery experience, life experience, insights, common sense reasoning, intuition, that is women and midwives, research, body knowledge, physiology, philosophy, policy and practice.

Consistent with Holistic Care, a concept advocated by the Nursing and Midwifery Council, 2024, which includes aspects such as physical, psychological, cognitive, behavioural, social, spiritual and wider factors, Evidence-informed practice is fast becoming the accepted standard in many fields of healthcare, including midwifery.