Introduction: The incidence and prevalence of diabetes is increasing in pregnant women. Midwives manage a substantial proportion of care of these women. Currently it is notknown whether midwives have sufficient competence in managing these patients well. The Diabetes Care Trust commissioned a survey to assess the diabetes education and training needs of midwives who look after pregnant women with diabetes.Material and methods: A freedom of information request was made to all the NHS Trusts in the UK to gather relevant information about the roles and responsibilities of midwives in thematernity units in the UK. This was followed by a Survey Monkey questionnaire to midwives in the UK who are members of the Royal College of Midwives to assess their education and training level, needs, desires and views preceded by a test survey on nine midwives.Results: The survey revealed considerable variation in the roles and responsibilities, current levels of training and education needs of midwives. Over 85% of midwives expressed a desire to access additional education on diabetes management in different areas. Training in insulin initiation and titration, management during labour and ability to contribute to the antenatal clinic was desired by over 85% of midwives surveyed. Conclusions: There is an unmet need for structured education and training programmes for midwives in the management of diabetes in pregnancy. We recommend further work in producing tailored and accredited training programmes at different levels to suit the differing needs of midwives and diabetes specialist midwives in the UK.

Medicines management for midwives is confusing and evidence suggests that widespread drug administration in the absence of valid prescriptions occurs in midwifery practice. This article explores the historic, political, social, legal and ethical aspects behind this in the context of medicines legislation, the midwifery profession, clinical governance and existing midwifery supervision framework. The function of the prescription is also considered. Synthesis of these concepts offers an explanation for the professional milieu in relation to the issues, demonstrating historic lack of attention. Supervisors of midwives are ideally placed to influence change in this area at a local level by promoting multi-professional team engagement and safe midwifery practice. Consideration of the national picture is needed to generate understanding and a consistent approach to medication issues, in order to improve safety and promote informed, integrated, individualised care for women.