----- Original Message -----
Sent: Wednesday, October 30, 2002 1:26
PM
Subject: Re: [ozmidwifery] 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 -----
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
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