I’m Jaki, Director, the Royal College of Midwives (RCM) Scotland
and formerly Head of Midwifery in Argyll and Bute and Professional
Midwifery Advisor to the Scottish Government.


I have always had an interest in women’s health and women
having control over their own bodies. I lead by building
networks, relationships and connections that ensure no midwife
is isolated and every midwife can feel confident in providing the
best care.

I advocate for midwives so they can advocate for women.

This means the midwifery service across remote and rural
Scotland is collaborative and supportive, providing professional, holistic
care for Mothers and babies.


When I have been with women giving
birth and they feel absolutely in control of
their choice and their experience and
don’t doubt themselves, it’s a very
different space than you very often get an
opportunity to see.

And I believe every woman should have
that opportunity, and every midwife
should understand what that relationship
feels like.


In a remote and rural service, you’re not a
specialist midwife, you are an expert
generalist. You have to use every aspect of
your training across all parts of what
you’ve learned. And you apply them all.


A positive birth experience goes with you
for life. And it’s not about everything
always being ‘normal’ or perfect. It’s
actually about feeling in control, and
about being part of something and
having a voice, rather than things
happening to you.

That is really key to why I do it.


For me, it’s about being able to support
the development of the career structure
for midwives.

It’s looking at all the things to do with the
profession and the development of the
profession, and ensuring that government
have appropriate and up-to-date advice
on midwifery.


We have networks within each team,
across teams, and also across Scotland,
so that it’s no longer about being in one
building somewhere. It’s about being
virtually connected. It crosses boundaries,
it crosses borders.

There’s something about working in away
like this, you’re not isolated in practice.


Seeing midwives find solutions, seeing
midwives being able to see what’s
possible, finding the solutions to
something and looking at what can be
done. That’s the culture that we have here.

You don’t have to have all the answers,
you just have to give people the space to
find the answers. And that is really satisfying.


It’s about making sure there are so many
connections that even if one breaks down,
there are other ways that people are
connected in. And that means that you
know that there’s a consistent level of
midwifery care being provided, but that
it’s individualised to that woman.

Everything’s about relationships.


One of the most important things is that if
there is a problem with a woman or her
newborn baby we have really good,
effective systems set up to make sure the
woman is in the right place for the baby to be
born.


Our relationship with ScotSTAR, the
paediatric intensive care transport service,
is invaluable. We train together, we have
mutual respect and good communication,
and if we have a situation we know that
we’re talking to people who understand
where we’re working, what equipment we
have, and are also able, on screen, to
observe that baby alongside us.

It has revolutionised the way we can
provide care in a remote rural area.


A lot of what we do here as midwives has
equal application elsewhere, because it
can take as long to travel across London as
it can to travel from one part of a rural
area to another. So if we apply the way
that we work here to other settings, it
increases the possibilities of how you can
provide care close to home, in a way that’s
safe, effective and professional.


I’d say my greatest achievement was
seeing my grandson being born at home,
10 miles away from here. I wasn’t there as
a midwife, but what was really wonderful
was to see
the impact the freedom to choose had on
my daughter-in-law, on my son, and the
lasting impact it had on them being
parents and feeling that they had their
choices respected.

I was hugely proud. As a midwife, what a
pleasure to see your grandchild being
born in their own community, and
recognise that the way we work here
made that possible.


There’s something about being a midwife
within a community, where you’re part of
that community, that makes you very
much want to provide what the
community needs.


I would hope that the way that we work here
becomes normal and becomes the way other
midwives can enjoy working.

Where they can work to the full scope of the
profession and provide the care they want to
provide in their own context and in their own
environments.


My former government advisory role was to
look at the professional role of a midwife,
as well as to guide the national implementation
of the relationship-based care approach
we have here.

Care that can be provided close to home,
with good networks and hubs you can
access locally.


It probably was sort of unusual that I was
the midwifery advisor to the Scottish
government and I come from a remote
and rural setting.

But actually, it’s because of the remote
and rural setting that I’ve had
opportunities to develop. In remote and
rural, there
isn’t space for people not to innovate
and develop.