In a message dated 5/10/01 9:12:16 AM AUS Eastern Standard Time,
[EMAIL PROTECTED] writes:
<< 1. The letter to the editor titled - 'Midwifery and Nursing - a Tension
for
rural area" so neatly puts into a package what I think a lot of rural
midwives/nurses feel. The single strand mid degree will leave little or no
midwives able (or wanting) to work in county areas >>
Hi all fellow listers. I've been a bit quiet of late so though it time to
jump in here and comment on a subject I'm passionate about !!!
According to the Discussion paper, "Reforming Midwifery - A Discussion Paper
on the Introduction of B Mid Programs into Victoria" (ACMI - Victorian Branch
1999), the research/literature is inadequate with regard to any analysis
which specifically addresses the industrial implications associated with
midwives who are graduates of a B Mid programs ( 3 year undergraduate
university degree). However the ACMI, comments in this paper on a number of
related issues of importance which have industrial implications to the B Mid
graduate and the practice of midwives - particularly relating to the issue of
the attractiveness of employment of the B Mid graduate as opposed to nurse
midwives. In the paper Reforming Midwifery, the ACMI Vic, states;
" Anecdotal evidence suggests that uppermost in the minds of many maternity
services managers, who are prospective employers of B Mid graduates, is the
issue of suitability of these midwives for employment. ...........Common
sentiments are echoed that these practitioners would not be able to provide
care for women with complicated pregnancies due to their lack of a nursing
background, ....that they would not be able to practice in
non-metropolitan/regional hospitals due to too few women requiring maternity
services, and thus a midwife/nurse would be more versatile and employable, "
(ACMI 1999 pg 14).
In response to these concerns the ACMI argues;
" ....Such claims reflect a lack of information about and a misunderstanding
of B Mid education. Midwives who are graduates of a B Mid programs which not
only addresses all aspects of the role of the midwife, but includes studies
in the biophysical, medical and nursing sciences relevant to uncomplicated
and complicated pregnancy, childbirth and the newborn
infant............................
..........As for the belief that non-nurse midwives are not suitable to
practise in non-metropolitan/regional hospitals, the Vic 'Branch of the
College argues that the reverse is true. In fact, the contractual employment
of these midwives as primary caregivers or as team members of collaborative
group practices with medical practitioners is a solution to the many problems
currently facing maternity service providers in regional hospitals in rural
Victoria. Caseload or 'Know your Midwife' models provides an attractive
alternative for low-risk women in regional Victoria compared to the current
costly and problematic, roster-based system".
Thinking 'outside the square' of the current maternity service delivery will
allow a greater flexibility for prospective employers with regards to their
midwifery workforce. Caseload and team midwifery is proving very attractive
to many employers of midwives already, and of course more importantly to
women.
Further to this, recent Departmental working documents (DHS - Vic) on the
funding of maternity services in the State of Victoria, have identified that
one of the biggest barriers to successfully developing midwife-led and
continuity of midwifery models of care, are in fact midwives themselves. The
reports identify the difficulty employers have in recruiting midwives for
these programs, given the 'on call' nature of the work involved.
It is anticipated that B Mid graduates who are educated within a continuity
of carer framework and philosophy of midwifery practice and are already use
to the concept of "following women through" and being "on call" will be a
more
attractive graduate for employment for these types of models of care, than
the current nurse-midwife who is orientated to a systematic, nursing-based,
inflexible, non-woman-centred, roster-based system of service provision.
Coupled with this, I then also see an ongoing benefit to prospective
employers, being their ability to retain competent, skilled midwives who are
passionate, committed midwives, dedicated to the provision of a high
standard/quality of woman-centred midwifery care.
Currently in the state of Victoria, there are approximately 13,100 'Endorsed
Midwives' (nurse midwives), of which only 3,496 are practicing midwives (NBV
2000). Add this to the ageing midwife population (average age of midwives in
Vic. is 48 years), and the current costly and lengthy education system for
the education of midwives via a 1 year post nursing graduate degree, (it
currently takes 5 years to become a midwife), research shows we are heading
towards a shortage of midwives for the available workforce. Rural or not !!
This is of huge concern, as all women having a baby, require the care of a
competent, skilled midwife. Obstetric nurses and personal care attendants
(PCA's) will not suffice. Women need and deserve the expert care midwives can
provide. The Draft Report of the Victorian Nurse Labour Force Planning Task
Force (DHS Vic, 1998) also highlights and expresses its concerns about the
shortage of midwives and its potential implications.
The education of midwives via a 3 year undergraduate degree, ie, B Mid, is
cheaper and quicker, in 'producing' midwifery graduates who are confident and
competent midwives. Compelling evidence from the evaluation of 'direct entry'
programs in Europe, the UK, NZ and North America, also shows that B Mid
graduates are confident and competent midwives, and when compared with their
nurse/midwife peers educated via post-registration (nursing) programs,
possess similar academic and practice performance/standards. The biggest
difference between the two education pathways found from this research, is as
I highlighted earlier, is in the retention of midwives to the profession. B
Mid educated midwives tend to stay in midwifery. This can only improve the
employment prospects for non-nurse midwives who, by choosing to undertake the
B Mid (3 year degree program), have consciously and obviously,
declared their commitment to midwifery and thus to the women they serve.
Yours in birth,
Tina Pettigrew
Birthworks
Independent CBE and aspiring B.Mid Midwife.
Convenor, Aust B. Mid Student Collective.
[EMAIL PROTECTED]
" As we trust the flowers to open to new life
- So we can trust birth"
Harriette Hartigan.
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