If you are a midwife referred to the NMC, contact the Royal College of Midwives (RCM) or your union straight away, and take advice before you reply. Midwives go through the same Fitness to Practise process as nurses and nursing associates. In 2024–2025, 252 of the NMC's 4,749 new referrals broken down by registration type concerned midwives. The NMC's Careline offers free, confidential, independent support 24 hours a day on 0800 587 7396.
Key takeaways
- Contact the RCM or your union immediately, and check your membership covered the date of the incident.
- Same process as nurses and nursing associates, under the same Code.
- Your reflection should speak to both the woman or birthing person and the baby, where relevant.
- The Careline is free, independent and confidential: 0800 587 7396.
Midwifery is a profession built on trust, often at the most intense moments of a family's life. When a concern is raised about your practice, it can feel deeply personal. You may also be dealing with grief about an outcome, a local maternity investigation and the NMC process all at once. That is a lot to carry.
This guide stays general, because every case is different. It is general information, not legal advice.
Is the NMC process different for midwives?
No. The NMC regulates nurses and midwives across the UK and nursing associates in England, and its Fitness to Practise process is the same for all of them: screening, investigation, case examiners and, in some cases, a hearing. You are held to the same Code. On 31 March 2025 there were 46,606 midwives on the register, plus 6,245 people dual registered as a nurse and a midwife.
In 2024–2025, 252 of the NMC's 4,749 new referrals broken down by registration type concerned midwives, and 19 concerned dual registrants. The NMC also says that a significant majority of the cases it receives conclude without action on a professional's registration.
What should I do first?
- Contact the RCM, or your union, as soon as you hear from the NMC. The NMC's own support page advises contacting your union or professional body immediately.
- Check your membership dates. Formal representation usually depends on having been a member when the incident happened.
- Note the deadline: you have 14 days from the date on the NMC's letter to respond, but you do not have to respond to the allegations within that time. You do need to complete the personal details form and give your employer's details.
- Write a private, factual timeline while your memory is fresh, including the shift, staffing, escalation and who was present.
- Do not contact the family or colleagues involved about the case.
For more on the first weeks, see your first five steps after an NMC referral and how to complete the NMC context form.
How can the RCM help?
The NMC lists the Royal College of Midwives among the unions and professional bodies registrants should contact. It says a union or professional body can give legal and objective advice and expert representation during the investigation and hearing stages, advise on how to respond, and offer wellbeing and emotional support. Some midwives are members of another union, such as Unison or Unite, so check where you are covered.
If you are not in a union, the NMC encourages you to seek advice from a regulated legal professional with experience in regulation as early as possible, and signposts free options including Citizens Advice, LawWorks, Advocate and the Queen Mary Legal Advice Centre.
What is different about reflecting as a midwife?
The structure of a good reflection is the same, but a few things are worth thinking about in midwifery.
- Two people in your care: where relevant, reflect on the impact for both the woman or birthing person and the baby, and on the wider family.
- Shared care: births often involve obstetricians, neonatal teams and other midwives. Be clear about your own role and decisions without blaming others or taking on responsibility that was not yours.
- Escalation and advocacy: many concerns involve when and how to escalate. Reflect honestly on what you knew, what you did and what you would do now.
- Fast-moving situations: explain the context briefly and factually. Context helps; it never replaces owning your part.
- Records written afterwards: if notes were written retrospectively, say so honestly and reflect on good practice.
For the structure, see how to structure an NMC reflective statement, and for help getting started try the free reflection builder.
What about local maternity investigations?
Midwives are often involved in a local investigation by their employer at the same time as, or before, the NMC process. Keep copies of any statements you give, and take advice before you write them, because the NMC may see them later. Make sure what you say is consistent and accurate. The NMC's guidance says it is important to tell your employer if you have been referred, as they may be able to help you strengthen your practice and support you through the process.
Do I need to self-refer as a midwife?
Some things must be reported, such as a criminal charge. Others do not need to be: the NMC's own self-referral case studies include a midwife with a speeding fixed penalty notice and a parking charge, and say the NMC does not investigate fixed penalty notices or parking contraventions. If you are unsure, talk to the RCM or your union first.
A referral is about a concern, not the whole of your midwifery career.
Where can I get emotional support?
The NMC's Careline is open to anyone involved in the Fitness to Practise process. It is free, confidential and independent of the NMC, available 24 hours a day on 0800 587 7396, and it will not tell the NMC you have called. The NMC's support page also lists midwifery networks, including the Association of South Asian Midwives and the Society of African Caribbean Midwives, as well as Samaritans (116 123) and NHS Practitioner Health in England and Scotland. If a birth outcome is part of your case, it is okay to need support for grief as well as for the process.
When to get advice
Take advice from the RCM or your union, your indemnity provider or a regulatory solicitor before you send anything to the NMC or give a statement in a local investigation. Our Navigating NMC Fitness to Practise course explains each stage, and 1:1 mentorship offers support from someone who has been through FtP.
Frequently asked questions
The NMC says unions and professional bodies, including the RCM, can provide legal advice and expert representation during investigation and hearing stages. Contact the RCM directly to check what your membership covers.
Often, yes. A referral does not automatically stop you working. Restrictions only apply if an interim order is made, undertakings are agreed, or a final sanction is imposed. Your employer may also make local decisions.
The same Fitness to Practise process applies. Your representative can advise how the concern relates to each part of your registration, and how any outcome might affect your nursing and midwifery practice.
Yes. The NMC says the Careline is for anyone involved in the fitness to practise process, midwives included. It is free, confidential, independent of the NMC and open 24 hours a day on 0800 587 7396.
