Prescribing considerations in midwifery practice

Prescribing considerations present specific challenges in midwifery practice in relation to the physiological changes that occur in pregnancy and the vulnerabilities of the fetal environment. There is a shortage of robust evidence on the safety of many medications in pregnancy and on the developing fetus. Additionally, pregnant women can be reluctant to take medications. As the number of midwives with an independent prescribing qualification increases, they need to be equipped to discuss the risks and benefits of treatment options. Building a therapeutic relationship is the cornerstone of shared decision-making, and the continuity model of midwifery care is ideally suited to support pregnant women and their families to make an informed choice. This article describes the management of two of the most common presentations in pregnancy: nausea and vomiting, and urinary tract infection. It also reviews relevant national and local frameworks for the use of appropriate pharmacological and non-pharmacological options.