To mark International Day of the Midwife, we asked Denise Barnes, a midwife based in Leeds, to tell us about her career. Denise is the lead midwife for the North East & Yorkshire Genomic Medicine Service Alliance on a project to transform feto-maternal care pathways, and writes below about why she is passionate about the impact genomic medicine can have on the care for pregnant women and new mothers.


I have trained and worked as a Midwife in Leeds since 1998. A long time!

Whilst the first part of my career involved general midwifery, the last 10 years have seen me specialise in the offer and support of screening and diagnostic tests to women and their families.

Equity of access

I’ve long been passionate about ensuring timely and equitable access for women and their families to screening and diagnostic tests, and the counselling and support surrounding them. This passion was further increased when I became the Team Leader for the Fetal Medicine Unit.

A catalyst

When I was still new to my role, I was approached by a woman whose baby had been diagnosed with a condition that meant it had a low chance of survival. She asked me what support was available to help both her and her family with this difficult diagnosis. I had no idea.

I tried to support her, to prepare her for the birth and determine who would support her afterwards. However, I couldn’t give her the support I wanted to as I didn’t know where to access it. I felt overwhelmed, under-prepared, and unable to be an advocate for her due to my lack of knowledge.

I vowed to improve this in the future.

A change

With support from the management group, we developed a team of midwives with a similar vision, and we explored the most appropriate way to care for women who receive unexpected information during pregnancy.

As with most areas of healthcare, a Multi-Disciplinary Team (MDT) approach was required to ensure the best outcome. This included the Fetal Cardiac Team, Genetic Counsellors and Consultants, the Fetal Medicine Consultants, the Neonatal Consultants and the local Hospices.

As a team of Midwives, we are now able to be an advocate for the women and their families, by exploring and directing them to the most relevant support and information.

A genomic journey

More recently I was able to expand my learning and education to cover genomics. Particularly important at a time when the availability and range of genetic and genomic tests is progressing.

For the last 10 months I’ve worked as the Matron for maternity outpatients, and the midwifery lead on a regional fetal genomic transformation project.

The project aims to explore existing pathways and make recommendations for best practice for women who have a fetal anomaly in a current pregnancy, pregnancy loss where a genetic reason is suspected, or families with an increased risk of a genetic diagnosis. Its an important project and exciting role, especially as genomics is a rapidly emerging area of medicine.

The knowledge I’ve gained allows me to continue ensuring that women receive the best information and support when considering genetic counselling and testing, as well as supporting fellow midwives as they begin their own genomic journey.