direct entry

[Sally Tracy]

dear list
In response to the discussion re the nature of direct entry education.
No, it does not need to be obstetrically based ...in fact the ideal is for obstetrics to remain the domain of study for obstetricians and other tertiary level practitioners. The direct entry degree course for midwives would ideally educate a midwife in the primary care model as a 'watchful attendant ' to the woman in childbirth as opposed to a 'medical caregiver'. To get a better idea about the areas of study, they are closely related to courses presently taught in the departments of public health, Women's Studies, biological sciences and sociology. The aim of training midwives in this system is to educate midwives in the phenomenom of birth as a  physiological event based in the sociological context of the family. This of course contrasts strongly with the notion of birth as a medical procedure attended by nurses and doctors who are trained in the pathology of birth and assess birth in terms of risk.The midwife  must be trained to recognise danger signs, but the difference is she is not educated to be fearful of the process, but to be patient and confident in women's innate ability to give birth.
Sheila Kitzinger puts it far more eloquently than I can when she says
"In childbirth midwives touch the two worlds of the instinctual and the cultural, bringing them into harmony. Such a calling requires not domination and control, but careful observation and sensitive awareness. It needs patience and a willingness to wait for the unfolding of life. It requires skill in helping the labouring woman to have confidence in herself and the power of her uterus." Sheila Kitzinger The Midwife Challenge, 1991.Pandora.     
For a closer look at the subjects and the course of study for direct entry midwives have a look at the Christchurch (NZ) course which is up on the web at www.midwives.org.nz/college.html
And remember..........(I know I sound like a stuck record!)..... It was mainly women who made the differeence in new Zealand. Without women (consumers) midwives are nothing! So go out and demand your midwife should be better educated in the art and science of midwifery........not obstetrics.
sally t