I have been working in a rural setting for some 18 months now where we have 
just one ward for all and in my opinion it just doesn't work for both the 
mothers and their newborns and the midwives.  A couple of things that come 
to mind are the aesthetics of a full on hospital ward as compared to the 
usual softer decor associated with maternity.  The problem of wandering 
elderly and the biggest complaint from the mothers the buzzers and general 
continuous noise.  The midwives themselves often get frustrated as they 
battle to justify the time required to spend with a new mother to other 
staff who are not midwives and can also feel they are short changing their 
general patients.  At the end of the day it all comes down to the size of 
the unit and no of births, as has been raised on this list before caseload 
would probably be the best solution. yours in midwifery pete malavisi

Pier Leone Malavisi


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