Overview:
At the NMC we were getting a lot of inquiries from senior midwives about two areas of concern. Firstly, what a midwife should do when a woman requests care which does not align with local guidance or declines care from a midwife, indicating they wish to freebirth. Secondly, that care in labour and birth was potentially being given by people who are not registered with us and could be in breech of Article 45 which specifies the Protected Function of the Midwife in the UK. We were concerned about what we were hearing but also recognised that our powers to act in this space were limited. However, we felt we needed to act as we were concerned to hear that midwives were facing very challenging situations and there were potential risks to the safety of women and newborn infants. Whilst our standards and human rights legislation uphold a woman's decision we recognised that midwives needed support in this area practice.

Aims and Objectives:
To ensure that we were carrying out our regulatory duties in respect of public safety and work with others to support midwives with local concerns.

Method:
We formed a group of a range of key stakeholders including the four country Chief Midwifery Officers, The Royal College of Midwives, a safeguarding midwife, a researcher, an educator Doula UK, Birthrights and the Police. We met on several occasions to discuss the issues and determine what our next steps might be. The issues were complex and it took time to work through the issues as well as considering the language used; crucially, we were committed to women's fundamental birthrights. We also needed to link into other stakeholders who had already started related work such as an NHS group looking at birth notification when a freebirth had occurred. Three subject Task and finish groups met on two occasions to discuss a line of enquiry in relation to principles for women, midwives and the Trusts/Health Boards. We discussed the issues from the perspectives of women, midwives and NHS Trusts/Health Boards.

Results:
Following detailed discussions we recognised that the provision personalised care was problematic and inconsistent across the UK so we concluded that we need to collaboratively develop some principles which considered how to support personalised care for all women to support their decision making.

Conclusion:
A principles document in relation to Personalised Care was produced to support this aspect of care has been produced to support. This will be available during the presentation. The value of collaborative working across multi-disciplinary and multiagency groups cannot be underestimated.