“We tend to work on projects linked to a national demand for knowledge or wider themes in the workforce,” says Angela Cartwright, member of the RCN’s Midwifery Forum. “But we also link in with other forums to better understand where our roles overlap.”
Being actively involved with a forum gives members access to a diverse group of professionals, adds Francesca Steyn, Chair of the RCN Fertility Nursing Forum. “By having that access, we have insight into what information members might need,” she says.
Together, Angela and Francesca project-led the RCN’s Transition from Fertility to Maternity Care guidance, which aims to raise awareness of possible care pathways for pregnant people, their partners and support networks, as they travel through fertility treatment and on to maternity care.
Identifying need
Pregnancy following fertility treatment can be an exciting and challenging time for expectant parents.
Health care professionals may not always have detailed knowledge of the processes people have gone through to become pregnant, including surrogacy and the use of donor gametes.
“There isn't any type of handover from fertility care into maternity services,” Francesca explains. “Often, fertility patients will have gone through a very physically and emotionally demanding process and then if they do finally conceive, they can be quite anxious.
“It can also sometimes be a long wait. We typically discharge fertility patients at around seven weeks gestation, and they may not see their midwife until 12 weeks, which is a long time.”
We don’t want to assume that they’re the same as everyone else
Fertility services are excellent in their area of expertise, but once someone is pregnant, staff don’t always have comprehensive understanding of the care pathway that follows. It can be hard for them to explain to patients what the next steps will be.
“Similarly, as maternity staff, we sometimes don’t know what the patient has already experienced in terms of their care,” says Angela. “We may be caring for people who may or may not disclose if they have had fertility treatment and we might not know the effect that experience has had on them.
“We don’t want to assume that because they’re pregnant, they’re the same as everyone else.”
Publication process
“There has always been a gap in care when fertility patients leave our services and enter maternity care,” says Francesca. “We wanted to collaborate with our midwifery and early pregnancy colleagues to look at how we can bridge that gap.”
While different, but similar, nursing specialties often sit together within the RCN’s forum structure (such as women’s health), members aren’t necessarily aware of the different expertise and skillsets each person has. Having open conversations has been essential to bring the guidance to life.
“Once we identified a gap in our resources, we pulled together a project group to help finalise the key themes,” says Angela.
“We divided the work between us, from fertility to early pregnancy and then maternity. Then our professional lead guided us in how to compile the resource.”
Once the information was collected as a document it was reviewed by an extensive group of external stakeholders and the project team, then the RCN publications and design team took over to make the final product.
Up to the task
Angela understands that most members are stretched for time, but her forum work takes up approximately one day a month. Other forum members were also more than happy to get involved and share the workload.
Angela learned a lot from the process, improving her knowledge to feed back into her clinical role. However, initially she was daunted.
“I have imposter syndrome,” she says. “I always think everybody else knows more than I do, so actually joining the forum was a huge step for me.”
While being involved in a forum is positive for continuing professional development, it can also be very fulfilling, as well as an opportunity to get involved with the wider profession.
“Don’t steer away from work you don’t recognise,” Angela adds. “It’s an excellent opportunity to do some research and learn more. If you don’t have the expertise, forum work allows you to get the expertise in the room with you.”
Francesca also found the process rewarding, and she represents the forum at events and on other projects such as guideline committees and stakeholder groups.
She says: “It's a fantastic opportunity to have my finger on the pulse of what is going on in my sector and the wider nursing profession.”
