----- Original Message ----- 
From: "Johnston" <[EMAIL PROTECTED]>
To: "'Dawn Worgan'" <[EMAIL PROTECTED]>
Sent: Friday, November 01, 2002 3:37 PM
Subject: RE: [ozmidwifery] Obstetric Perception - Your thoughts?


> 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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