This message is from Joy Johnson. Joy asked me to forward it to the list if
it hadn't come via the list. I am not sure if it was on the list. Can
someone let Joy know please if her messages are getting through?
thanks, Carolyn
-----Original Message-----
From: Johnston <[EMAIL PROTECTED]>
To: ozmidwyfs <[EMAIL PROTECTED]>; Carolyn Hastie
<[EMAIL PROTECTED]>
Date: Thursday, 19 August 1999 8:24 AM
Subject: RE: a woman's right to choose midwifery care
>Dear Carolyn
>I don't know if my messages are getting through to the list, so if this
does
>not come to you from ozmidwifery, would you please forward it on.
>
>thanks to everyone who has responded to my message of 7 August. Carolyn,
>Marina, Jenny, Trish, Andrea, Nigel and Cathy and anyone else. I have made
>copies of the messages for my client, as she doesn't have email, and she is
>overwhelmed at the thought of all that support and encouragement.
>
>My client phoned today to say that the hospital responded to her letter,
and
>made it clear once more that they would cancel her booking if she did not
>continue to visit the obstetrician. She phoned the nearest tertiary
>referral hospital, which accepts homebirth back-up bookings without any
>difficulty and provides an excellent referral service if there are concerns
>about growth, postmaturity, or any other complicating factors. that
>hospital told her that their bookings are FULL - they didn't want her
>either!
>
>My client says that everyone she spoke to agreed that what she is planning
>is 'best care' - that every woman should be able to be cared for by a
>midwife she knows. When she spoke to the obstetrician who she had
initially
>booked under, he said he also agreed that her plan was an optimal system.
>However, he said the public system could not support this model as it was
>too expensive! He also told her that there would not be enough midwives
for
>one-to-one models of care! (interesting)
>
>My client pleaded with the doctor to 'help' her achieve what she wants to
>do. He initially said she had to see him for all of the 5 remaining
>consultations, but conceded that one more visit to him would be enough to
>keep the booking open. He claimed that he has to take professional
>responsibility for her - even though he will not be consulted about her
>birth unless he is covering the hospital at the time that she needs
>obstetric referral. My client has agreed to visit him once more, in late
>pregnancy.
>
>The doctor told my client that if she wants this sort of care she needs to
>go into the private system. However that is not really true. No private
>hospital here allows a midwife to make a booking - all the admissions are
>done through doctors. We talk about evidence based practice. I know of no
>evidence to support fragmented care for well women, that is a mixture of
>obstetrics and midwifery. Conflict, confusion, and power struggles may
>result - even though this system is the best we have in many cases. I will
>insert here a couple of quotes from a response that I am working on to the
>recently released Victorian Review of Shared Obstetric Care.
>
>Enkin et al (1995) challenges the current trend towards control of
maternity
>care being the responsibility of specialist obstetricians, stating that
>"Optimal care can only occur when both primary and secondary caregivers
>recognise their complementary roles." and
>"As technical advances became more complex, care has come to be
increasingly
>controlled by, if not carried out by, specialist obstetricians. The
>benefits of this trend can be seriously challenged. It is inherently
>unwise, and perhaps unsafe, for women with normal pregnancies to be cared
>for by obstetric specialists, even if the required personnel were
>available."
>
>My client now has another list of people to write to, including the Vic
>Human Services Dept. She is very keen to do all she can.
>
>I have to agree with Carolyn's comment about how sad it is that women are
>being hurt in their efforts to bring about change. A woman who becomes
>active politically is allowing a big black mark to be put against her
name -
>'troublemaker - watch out'. Psychologist Jane Fisher commented about her
>finding of increased intervention, caesar &c in women who are educated,
>articulate, in a stable relationship, AND can afford private obstetric
care.
>Jane says that women who make it clear that they know what they want to do,
>and are up front in discussing this with their obstetricians, are probably
>at risk of a subtle power struggle, where the doctor seems to perceive a
>challenge to his / her authority, and makes sure that the woman finds out
>how much she needs the full treatment.
>
>I will keep you informed of developments.
>BTW, when my client phone the hospital she was asked if I am her midwife.
>What a reputation!
>
>all the best
>Joy Johnston
>Blackburn South, Vic
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