Melissa, you are not alone in your frustration as this is going on all over the country and probably in fact all over the world. You have to feel sorry for the doctors really. You yourself feel new enough to midwifery to call yourself a baby midwife imadine what it feels like to be a baby doctor. Not only are they flung into a situation that they know nothing about but they have had it drummed into them that they are responsible for the whole thing. They in fact must be scared s...less. Not only don't they know what is going on but they know you do. So my thought is for you to 'try' and share this wealth of knowledge you have with them. Introduce them properly to the women and her team. I mean make it in a way that encourages them to see tham as individuals rather that a faceless blob. Include personal stuff. Give them a verbal running commentary on all the things that you can see that tell you that the woman is progressing or not as the case may be. The signs that you can see that tell you that she needs to go home or rest etc. It won't work the first time but it will penetrate the grey matter that you are there to help them (the doctor) and give them the words to repeat to their superiors who they have to justify their actions to. The VMO doesn't ask them "what does the midwife think" they want to know how the doctor knows what the woman is up to and the only way they know how to find ou is by doing a VE. We are not good recorders of this information on our partographs and this is another area where we can document our opinions. If you think a woman's contractions have gone off because she is tired and needs to rest write this on the partogram next to where you indicate the contraction pattern. Mostly the deteriorating contraction pattern is sitting there alone and necessiatates the need for a VE to find out why as the doctor is not on the room long enough to see that the woman is in fact making the most of a lull to catch a few zzz's before she gets going again but if the VMO comes in and you say with confidence Shh. and indicate she is resting as if its the best thing on earth then he can leave and say to his superiors with confidence its OK she is gathering strength for the next stage. I know it doesn't always work but the fact that you can already see there is a game to be played makes you a valuable team player and so don't quit but take promotion in my book. Where to childhood rapidly approaching adolescence probably and you know how ugly those years can be! The down side of the message is be careful when talking about your place of employment not to let it be identified as big brother is watching out there and they don't like it. You like me will think that they can go suck eggs but they can and will go after you so write the stories just don't link a location to your name. Andrea Quanchi -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
