I was saddened to read a recent item from a Scottish newspaper about disciplinary action taken by the Nursing and Midwifery Council (NMC) against three midwives who failed to transfer a labouring woman from home to hospital, despite deterioration in the mother's and baby's condition. The delay in having an emergency Caesarean section apparently resulted in the baby suffering brain damage and multiple organ failure. It is stated that the midwife delayed the mother's transfer to hospital and awaited the arrival of another midwife trained in aromatherapy, although it is not clear whether the reason for the delay was because the midwife believed that aromatherapy would alleviate the mother's clinical condition, or why aromatherapy treatment was given at all in this situation. Without access to the NMC's disciplinary hearing report, which is not yet available in the public domain, it is difficult to understand whether the journalists were sensationalising the incident in respect of aromatherapy, although an earlier investigation into the case by the Scottish Ombudsman concluded that aromatherapy was inappropriate in this case.
I am however, gravely concerned if, indeed, aromatherapy treatment was given to this mother when her clinical condition clearly warranted medical intervention. If so, this is yet another example of midwives becoming so enthusiastic about the use of complementary therapies, particularly in labour, that the safety of mothers and babies is put at risk. I have written numerous papers on this subject over the past 30 years but there seems to be an exponential increase in problems related to the increased use of aromatherapy by midwives who do not fully understand how it fits within normal midwifery practice and NHS conventional maternity care.
An earlier case, in Wales in 2009, resulted in a midwife being removed from the NMC register for surreptitiously giving a mother aromatherapy oils for a headache in labour, which the mother mistakenly drank. Thankfully there were no ill effects for either mother or baby, but the midwife was struck off for failing to follow protocols relating to drug administration, record keeping and informed consent.
As I travel around the country teaching complementary therapies in maternity units, I increasingly hear of midwives whose practice of aromatherapy is at best formulaic, or worse, dangerous, largely because they have little or no understanding of the relevant safety or professional accountability issues. Having spent almost 35 years teaching aromatherapy and other therapies to midwives, I despair that my entire life's work is being jeopardised because midwives are coming to the attention of the NMC and the press through inappropriate use of aromatherapy. My own work has focused entirely on safety and accountability and ensuring that midwives who train with Expectancy truly understand the dangers of aromatherapy so that they can take steps to minimise them, allowing them to use aromatherapy for its undoubted benefits in aiding relaxation and easing pain, nausea and other symptoms. For example, midwives need to understand the risks of interactions of oils with drugs, the impact on the fetus and the very real dangers of using vaporisers or diffusers in the birth centre or maternity unit. when a midwife is also a trained aromatherapist does not always mean that s/he is able to apply the principles of aromatherapy to its practice within midwifery.
Furthermore, aromatherapy should never be used as a substitute for conventional midwifery or medical care and treatment. In this latest case, the aromatherapy is perhaps something of a red-herring in determining whether or not the midwives were at fault. If the mother's condition required her to be transferred to hospital, then aromatherapy would not have been appropriate nor safe. Similarly, in the case in Wales, the midwife had already come to managers' attention for her poor record keeping and compliance with medicines management regulations, and although giving the mother aromatherapy oils without instructions on administration precipiated the disciplinary action, it was the midwife's use of oils without permission, her failure to record the treatment and - in my opinion - inappropriate prescribing at the time which led to her removal from the NMC register.
Midwives' first accountability is to the mothers and babies and to their NMC registration, and they should explore fully the NMC Code of professional standards, practice and behaviour. It is cases like these that once again raise the subject of poor practice in relation to aromatherapy by midwives and, if this trend continues, could lead the NMC to take steps to prevent midwives using complementary therapies at all. Midwives who become such advocates for the therapy that they cannot see the "midwifery wood" for the "aromatherapy trees" are a danger to the mothers and babies, to themselves and to the professions of both midwifery and aromatherapy. It is all very well being enthusiastic for new innovative and pleasurable means of helping women, but these must be set in the context of midwifery practice and safe, accountable care for our clients.
For further details on our aromatherapy courses see www.http://expectancy.co.uk/professional