I am just very thankful that I have a wonderful GP who hopefully will attend (not deliver) my third bub in a few weeks time. I'm happy with midwife care, but my husband tends to think differently. Thus I have chosen hospital, but a doctor who doesn't intervene readily and doesn't work on the 1 cm per hour regime (thankfully).
Caseload can certainly work for those committed to it. But some of us probably need to stay in the hospital system, and as I like to keep my hand in on the nursing skills as well, that's for me at the moment.
Cheryl
From: [EMAIL PROTECTED]
Reply-To: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Obstetric Perception - Your thoughts?
Date: Sat, 2 Nov 2002 20:37:07 EST
In a message dated 1/11/02 10:26:26 AM AUS Eastern Daylight Time,
[EMAIL PROTECTED] writes:
> 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.
>
>
Hi Dawn and all....
saw your posting Dawn and as a first year B Mid student (nearlly 2nd year oh
my goddess :-)))) I felt compelled to reply....Yes, for me personally,
independent practice, continuity and woman centred care is what I am to do. I
keep saying the 'powers that be' have two years to sort out all this
insurance crap...Midwifery by its very nature, doesn't sit comfortably within
a nine to five working day.....sadly the system imposes that on us and
women.....I agree with you....its the nursing/midwifery culture that we have
to change...
Here in Victoria a year or so ago...the Government did a review of the
'Maternity Services Enhancement Plans'.....this report confirms many of
Debby's friends sentiments...Part of its findings were that that the biggest
'barriers' to developing and implementing midwifery-led models of care were
midwives themselves...
In the context of developing and extending on current models of team
midwifery Eg like that at Southern Health, the report states...."Some of
these achievements are not yet systematic but they are nevertheless,
significant developments because they demonstrate ways forward as maternity
services work towards goals about the continuity of care for all woman. The
potential for expansion of these models is noted, as are the barriers to
expansion. Barriers include a shortage of midwives who both embrace team
midwifery models of care and are available to work on the rosters required
for team work, as well as resistence from midwives themselves, to change
their practice from obstetric maternity practices to new models of care."
The B Mid is aimed as you have suggested Dawn....to educate midwives that
continuity of care IS the 'norm'....it aims to address this very issue
described by this report...that until we have a workforce of highly motived,
confident and competent midwives willing to work across the continnuum of
pregnancy and birth....not just with 'expertise' in one area of
midwifery....will we have the ability to change maternity services on a
larger scale....
Lastly...Joys comments sit very comforably with me.....I have midwifery
friends in NZ....who work a fulltime caseload (4-5 women a month for 10
months/year) with young familes...They argue the reverse is true.....that
they couldn't work designated shifts...of bewteen 8-10-12hours....this
inflexibility they argue dosn't sit comforably with family life. They
structure their work around their family and the women they work with. Small
group practices seem to work well so they have support for one another and
back each other up when needed.....They have worked as both employed and self
employed midwives....so they can speak from experience in this regard....and
they all say that working with caseload of known women is far better to
proving fragmented, inflexible system focused care from both the woman's and
the midiwfe's perspective!!..They argue that if they are happier in their
work, as some midiwves have said here already...it makes for a happier family
life.
Yours in reforming midwifery,
Tina Pettigrew.
B Mid Student
Victoria University
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