I have to add a comment on this one, as I have been the main promoter of active birth in Australia for 20 years! I think an active birth is becoming a rarity in the bigger hospitals around Australia (but not impossible) for a number of reasons, some of which are:
* A lack of skills (and sometimes motivation) amongst midwives. As epidurals take hold, midwives forget how to get a woman through transition, how to do observations with her off the bed and certainly how to support her in an upright labour and birth, to name a few exsamples.
* The perception that active birth is "old hat" when it is just as fresh and vital as every woman that will give birth today and tomorrow. I feel that midwives should be reminded regularly of the basics and underpinning philosophy because it is so easy for standards to slip and "tricks of the trade" to be forgotten.
* A lack of support from experienced midwives, who could show the students and graduates how it is done. Every student I have ever had in a workshop over the years has said that they were not taught the basics in their training, so it is imperative that the necessary knowledge and practical skills be passed on my midwives on the job.
* The chronic shortage of staff (often a problem in non woman or midwife -friendly workplaces) puts additional pressure on the midwives left to face the daily struggle. It may seem easier to just fill the labouring woman up with an epidural, plug in the electronic baby-sitter (CTG) and get on with the paperwork. Interventions add to the midwives' workload, not reduce it.
* The inability (unwillingness?) of midwifery managers to rid the maternity staff of "dinosaur" midwives who are resistant to change and block innovations, improved services and supportive practices. This would never happen in other areas of medicine, where staff who did not keep up with evidence based care and demonstrate best practice would be asked to leave pronto. These undermining midwives are not necessarily the older staff, but are often nervous, insecure, timid and scared practitioners who need support, re-education, and understanding. If this doesn't help, then it would do everyone, icnluding them, a favour if they left the profession that clearly is not for them.
Must stop (I could go on!) - you can tell I have just been doing another active birth workshop today in Sydney - a city I find is peculiar in that there is are some pockets of terrifice innovation and progressive leadership (South Eastern Sydney Area Health Service, for example) and areas of massive inertia (South Western Sydney Area Health Service for example). I always find it interesting that few midwives in Sydney ever attend our events, especially compared with midwives in other cities. Maybe it is a function of the size of the city, which could have a dehumanising effect, or else it could just be disinterest and apathy. Whatever, I find it very disturbing, and rather sad.
I will be interested to read what others have to say on this topic.....
Regards
Andrea
At 01:55 PM 14/09/2003, Nola Aicken wrote:
I am currently preparing a presentation for a study day coming up soon. Just wondering if anyone would like to make some comments to this question, so I can use some quotes (anonymous) in presentation:
"Active birth: is it possible in a public hospital?"
Regards Nola
----- Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education
e-mail: [EMAIL PROTECTED] web: www.birthinternational.com
-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
