The future role for a diabetes specialist midwife.

In the United Kingdom diabetes is now the most common, pre-existing medical disorder in pregnancy [Jincoe A. Diabetes: monitoring maternal and fetal wellbeing. Br J Midwifery 2006;14(2):91-4], and still continues to have associated risks for the mother, fetus and neonate [Confidential Enquiry into Maternal and Child Health. Diabetes in pregnancy: are we providing the best care? Findings of a national enquiry: England, Wales and Northern Ireland. London: CEMACH; 2007]. Worldwide diabetes is becoming more prevalent [Macfarlane A. Diabetes and pregnancy. Br Med J 2006;333(7560):157-8] and there is the added new phenomenon of the increase in Type 2 diabetes in the childbearing population. The midwifery role in such pregnancies has come under question as some units have Diabetes Specialist Midwives and some do not and midwifery care is presently varied [Miller A. Diabetes: lessons for midwives. Pract Midwife 2005;8(11):4-5]. This review will specifically seek to address the midwifery role in relation to this client group with complex needs. It will explore how a specialist midwifery post could have an impact on improving care, how the role is developing and future perspectives. Aspects on how midwifery care is delivered to women with diabetes in the United Kingdom will be discussed and a brief international insight relayed.