What do you do, Monica?

Monica is a midwife and project manager for the South East London Local Maternity and Neonatal System. 

Colourful question marks drawn by a child

""May 2023

What do you do?

I am project manager for the South East London Local Maternity and Neonatal System. One of my projects involved setting up the perinatal pelvic health service across south east London, which is an NHS England pilot. I have been a midwife for 16 years and I have worked in all areas of midwifery in various operational and leadership roles. My passion is to improve maternity services and I believe that an ounce of prevention is better than a pound of cure. This is why I chose to work on the pelvic health project.

Our pelvic health service aims to prevent pelvic health issues before, during and after pregnancy and improve identification and treatment. To do this, we need to help people build their knowledge and confidence in recognising and managing their pelvic health conditions. Our service offers personalised support for women and birthing people and health care professionals.

What interested you about pelvic health?

Pelvic health issues are common, but not normal. Yet, we live in a culture that accepts and normalises incontinence. Research shows that up to one in three women experience urinary incontinence in the first year after giving birth, and up to three quarters of these women continue to experience this in the following 12 years after giving birth. Additionally, one in 10 women experience faecal incontinence and one in 12 women will have a pelvic organ prolapse. This means that over 10,000 women a year could be affected by pelvic health problems after giving birth. The true number is not known given the taboo around this issue. On a recent survey we conducted across south east London, only 27% of women had the courage to raise these issues with a healthcare professional.

As health care professionals, we have a responsibility to ensure that pelvic floor symptoms are discussed at every opportunity, especially after giving birth. Our pelvic health physiotherapists and midwives also provide training and support for local clinicians, including GPs and midwives. 

What is your proudest moment?

Engaging with women and birthing people in our local areas to find out their personal experiences. We really strived to include everyone in our local communities – for example we went to the Lewisham Islamic centre, and we spoke with people via the refugee resettlement programme. By working hard to engage people who are often not heard, we were able to gather views and input from right across the diverse communities living in South East London. This was really, really important to help identify and address health inequalities. We even held sessions in Spanish, as there is a big Latin-American community in south London. I am from Colombia myself so had an advantage here!

We found that women and birthing people have the same needs and wants in terms of pelvic health, but they unfortunately face many barriers including lack of understanding about NHS health care systems, and lack of information in their own language. This is why we have collaborated with physiotherapists across London to develop videos on pelvic health that have been translated into multiple languages.

What are you currently working on?

I am supporting the development of a south east London infant feeding strategy as part of my work supporting public health. I’ll also be consolidating the work that we have done on the pelvic health pilot in preparation for the national roll out next year, to make sure that the service is sustainable and can become ‘business as usual’.

I’m also preparing to present our work at an international continence society event in Canada this year. We have also been nominated for a Royal College of Midwifery award and we presented at the maternity and neonatal summit alongside the Chief Midwifery officer for England! So, we are very proud of our team.

Why did you become a midwife?

I became a midwife by accident!! We do not have midwives back home in Colombia. I met a midwife in a social event who told me all about her work. I was really inspired and volunteered in my local maternity unit for some time before embarking on my midwifery journey. I had to do a year of prep work as all of my GCSEs were in Spanish, so I attended my local college to complete an access to nursing course. I did both my diploma and degree in midwifery at King’s College University and I will be completing my masters in business administration this year. When I think about it, apart from a short break to have my second baby, I have been studying since 2003. I still love working clinically, and do some shifts on the labour ward at St Thomas’ Hospital. It really has been an amazing journey for me, so I am glad I fell into it by accident. 

Further information

Pelvic Health dedicated classes are now available for women and birthing people accessing maternity care at Guy's and St Thomas' who are at risk of pelvic floor dysfunction.

Find out more about the South East London Local Maternity and Neonatal System.

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