Re: [ozmidwifery] Love of midwifery

[Sandra J. Eales]

Title: Love of midwifery

Dear Fiona Don't give up.  I'm sure you are making a difference for a lot of individual women and it is possible that you will be an agent of change in this unit.  It can seem like an  impossible task with insurmountable barriers (doctors and management) but you do have more power than you realise.  You do need to ensure that you maintain your strength however. Join forces with like-minded midwives and support each other and take regular nourishment for your midwife soul by meeting other midwives at conferences and workshops.  Make a plan of how you want to change your unit - you can't change everything at once but many small steps will get you a long way along the path ..plan small changes to start with - maybe simple changes in the physical layout - make up information sheets (referenced and evidence based) to hand out to the women about whatever issues you feel they need exposure to alternative views to that being presented by the MOs - having info in print will often add weight - might even shine some light into the closed MO minds. With regards to the admission CTG - if you can't at this point change the policy (though don't stop trying) then encourage and support women to refuse admission CTG as is their right - As you say there is plenty of evidence to support your view so if the policy makers aren't interested then ensure that the women get the information  - you could do up an info sheet about the CTGs as well as something on the Bill of Rights.  Others on the list have suggested starting your own childbirth ed classes this can be empowering for yourself as well as for those you are teaching. I have been a midwife for 15 years and have spent most of that time working in hospitals.  I fully understand what you are feeling.  I have had many sleepless nights and know well that feeling in the gut which churns with anger and frustration as I lay there and think about all the things I would like to have told some smart arse doctor who knows nothing of value about childbirth but seems to think he is an authority because he has a medical degree. A nursing background is a handicap that is difficult to overcome when it comes to being assertive!..but practice makes perfect..  I have often found it a challenge to have the confidence and strength of mind to resist and shake the obstinate belief some doctors seem to have that they are "the keepers of all knowledge". I know well the hissing. spitting, frustration of dealing with the arrogant young doctor with two minutes experience of childbirth who has denigrated the profound knowledge of midwives who have been deeply involved with childbirth for decades as being 'airy fairy nonsense'....But I also know the satisfaction of working in a cooperative team where there is mutual trust and respect.   It is important that passionate midwives continue to work in the mainstream services where the majority of women give birth.  Whilst we continue to fight to change the system these women need the support and protection that only a passionate midwife can give. We do have to protect the women from the contagion of fear and the skewed world view of the medicos who practice in fear.  We need to be there for support when a woman chooses not to take the advise given by the doctor.  We have to allow women access to the knowledge and wisdom contained in our art of midwifery rather than leave them exposed to the undiluted and so often self righteous "expert advice" in the medical system.  The advocacy role of the midwife in the hospital situation is so important for the health and well being of women and their families. It is a difficult path to walk for the midwife and can sometimes feel like you are working in a war zone, full of fear and conflict, when it should (and can) be positive, nurturing and cooperative   We need to keep tapping away to get the system changed so that all women have access to good midwifery care we have to arm ourselves with evidence - scientific facts and figures are what appeal to these folk so arm yourself and keep presenting it to them and arguing.  We need to be tenacious and dogged in our defence both of the birthing women we advocate for as well for the truth of midwifery knowledge.  We need to learn to be assertive as well diplomatic - we do need to have a cooperative team for the benefit of the woman as well as ourselves - it is often difficult to know when to bite your tongue and when to dig in and say no you are wrong and I am right.  We don't want a war of egos going on over the top of a woman who is labouring.  She needs to be allowed to focus on herself rather than on the conflict between midwife and doctor - we need to remember the woman is first consideration and our job is to protect her interests. We need to build an environment of mutual respect and trust between doctors and midwives.  Sometimes to achieve this you first have to belt them around the head a few times before that they get to realise that respect!!   Whilst I know the difficulties of your situation I also know that with perseverance ....you can change the world around you.    love Sandra    ----- Original Message ----- From: Smith, Anne To: [EMAIL PROTECTED] Sent: Monday, October 28, 2002 7:34 PM Subject: [ozmidwifery] Love of midwifery Dear list, I am a midwife who is very passionate and very for woman centred care.  I love being a midwife and can not imagine not being a midwife, but l have become so dissolusioned with the system that it is breaking my heart.  I have been a midwife for 5 years and feel that the system (especially where l work in a large country city) which is medical based has not changed.  It has actually become worse.  Despite being a strong advocate for evidence based practice and presenting this evidence to doctors and management, l have been walked all over, some midwives have been yelled at, 'put in their places' by RESIDENTS and we have basically have our hands tied.  The amount of autonomy we have is decreasing, which makes me feel sometimes that all the hospital wants are obstetric nurses.  They do not want midwives because they cause too much trouble.  Who cares about the women?  Management want to make the doctors happy and stuff the midwives.  One example, i am really against the use of CTG's in normal pregnancy and labour.  Because of one bad outcome, management wants to introduce admission CTGs for all women who present in labour.  I produced for them so much evidence based material which actually states that this is not a good idea, but they introduced it anyway.  I dont know why l try because nothing worse.  I dont know what to do and all my collegues feel like this as well.  We need different models of care, we need to take over the care of women in normal pregnancy and birth.  I fully endorse NMAP but will it have an effect in my workplace.  Will it really change the obnoxious doctors we work with and management who only care about beds and money?  Midwives have tried to get a midwives clinic in this town for 11 years, but has been blocked by the doctors (one in particular).  We have no free antenatal care except for one midwife who works with aboriginal women (who we also refer white women to).  If women only knew what was going on and they care they get from their doctors is less than substandard. I hate feeling like this.  Women are being ripped off, assulted, and their rights violated, and there is only so much l can do.  I do the best l can for these women but l feel that it is no where near enough. It makes me feel like l have a hollow pit in my stomach thinking of coming to work.  But l love midwifery, and l know that what ever happens, l need to go on... sorry, but l really needed to get this off my chest. MIdwife trying to make a difference Fiona Dunmore NOTICE: CONFIDENTIAL COMMUNICATION This e-mail message and any accompanying files may contain information that is confidential and subject to privilege. If you are not the intended recipient, and have received the e-mail in error, you are notified that any use, dissemination, distribution, forwarding, printing or copying of the message and any attached files is strictly prohibited. If you have received this e-mail message in error please immediately advise the sender by return e-mail, or telephone, listed below. You must destroy the original transmission and its contents. Any views expressed within this communication are those of the individual sender, except where the sender specifically states them to be the views of Ramsay Health Care. This communication should not be copied or disseminated without permission. ------------------------------------------------------------------------ "Mildura Base Hospital" a member of Ramsay Health Care Telephone: 61 3 5022 3333 Facsimile: 61 3 5022 3234