Dear List,
I was thrilled to have this reply from Joy Johnson and have forwarded it to the list for you all to read and ponder, she is such an inspiration!
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Dear Dawn
I'm not able to reply to the ozmid list, as I am not registered. However
I saw your response, and am glad you have spoken in favour of midwife
continuity of care.  Please feel free to forward this to the list - if
you wish.  

I am not surprised at the direction this discussion has taken, but I am
very disappointed.  In my experience many of those who simply couldn't
possibly work on call for just a few women a month have never tried it,
yet they are willing to speak out against it.  Even when 4 babies are
born in a week, the midwife can only be in one place at one time, and
has to have arrangements to deal with such times.  There is a lot of
discretionary time in which the midwife has control over what she does,
and is able to read and write and counsel and all those other things we
do. 

Why is it that women do better with a known midwife?  Surely that should
carry some weight for a professional in deciding how she/he should
manage time.

Another point in this discussion that noone seems to have picked up is
the subtle put-down of midwives by the doctor who "supports midwifery
models of care, particularly those that offer integrated choice so that
midwives and obstetricians".  That's just using language - "integrated
choice" - to maintain the status quo of medical control.  This is the
argument that many obstetricians have been dishing up for years.
"Collaboration" is another way of saying the same thing.  What other
specialist doctor offers an integrated choice - like so that the school
teacher and the psychiatrist can work together at the primary teaching
level in case the kids develop psychiatric illness. 

I'm not anti-doctor.  When an obstetrician is needed I want someone who
is clear thinking, objective, and highly skilled.  I want her/him to
look with fresh eyes at the whole woman-child, and give specialist
advice and care.  I do NOT want an obstetrician to supervise the
practise of midwifery.    

I hope that when NMAP is implemented there will be enough midwives who
are willing to give it a go. (I declare my interest here, as one of the
contributing authors)  Midwives who hold strongly to a hospital/nursing
identity may in the future need to prove that they have the right to use
the title 'midwife'.  We in Australia can't afford to ignore
contemporary midwifery competence in the global scene, especially if we
care about the health and wellbeing of those in our care.

As you know the reality for most midwives is that even if they would be
willing to work as primary carer for a known group of women our system
prevents them.  I have had my own practice for the past decade, and I
have loved my work. I don't always have another midwife booked to attend
the birth with me, and I take up to 4 births per month.  I now have had
to quit, due to the insurance crisis.

That's my thoughts for now,
Joy Johnston

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:owner-ozmidwifery@;acegraphics.com.au] On Behalf Of Dawn Worgan
Sent: Friday, 1 November 2002 10:22 AM
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Obstetric Perception - Your thoughts?

Debby M wrote:

> I have recently been corresponding with a friend of mine who is an 
> obstetrician.  He supports midwifery models of care, particularly 
> those that offer integrated choice so that midwives and obstetricians 
> can work together.
>
> He did state to me however that he believes one of the great obstacles

> to such models is the reluctance of most midwives to work other than 
> an 8 hour shift, and to possibly have to do away with family time and 
> holidays and to be called out at odd hours to attend births. 
>
> I am sure there are probably some out there that do like the straight 
> forwardness of shifts however I would be interested to hear the 
> opinion of you ladies (and gentlemen) about your experience of the 
> dedication of midwives when they are expected to provide ongoing 
> antenatal, birth and postnatal support - outside the normal 8 hour 
> shift,  as my gut feeling is that the majority of midwives would love 
> the opportunity to be able to fully use their skills in the support 
> and care of pregnant and birthing women without unnecessary "guidance"

> or interferrence.
>
> Debby
>
>
>
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I work in a caseload model of care which means on call  plus all the 
things you mentioned, and personally I love it (most of the time) but 
when we are looking for other midwives to replace us for long service 
leave or whatever, we cant get midwives interested and we often have 
comments like "I dont know how you do it!" or" I have a life outside 
work" (so do I is my reply I fit work in around my life not the other 
way around) but its a long standing culture we need to work at changing 
my hope lies in the new direct entry midwives who believe what I do is 
the norm !So though I wish it wasn't the case I think your friend is
right.


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