Andrea, and Cas, I fully concur with both your (list of) comments. And Nola, I hope you find something useful from my little rant.
I've simply run out of puff, and choose, after many, many years of being an open and enthusiastic labour ward midwife to not work there at present. Maybe later I'll go back to it, but for now i'm not sure. There is little joy to be found there on a daily basis. The joy that I found in working with women who marvelled at labour as an event in which they found strength and passion. And for women who could understand that one day of pain would impact positively on life events for years to come.I just dont see this anymore.And that was where my job satisfaction was found. It didnt matter if they went pain free or drug free so much, just that their psyche blossomed during the event.I gained immense pleasure in being part of that process. Now everywhere i see dread and foreboding of the pain process. so sad. The other lack of motivation stems from these issues: The barrage of medical dominance and oppression. Then the resulting intimidation by peers who want to 'keep the peace', and lastly as Cas commented, the women who snortingly believe that any desire to experience this event without any intervention marks you as 'crazy'. It's way too hard for me. Still, I cant help the desire to fight on as the further I go, the more I believe in the beauty of an 'active' birth. I've stopped sticking up for poor skills. I tell patients to ponder about paying their gaps if they've left hospital with massive pph's,wound infections,dodgy stitchwork. I tell them to ring their doctors and ask why, when they're paying a $5,000 gap do they only warrant one visit in 6 days? One father came to the desk of our unit the other day and wanted to know why his wife didnt get a private room because she was having a c/s. I just had to tell him that 50% of women any given week can have a c/s and unfortunately they're just not 'special' any more. In fact, we decided that it should be the women who labour long and ferociously with no intervention that should have the private rooms! However, I do believe things will change. This is a time of change and I firmly believe it wont be long before some woman sues her obstetrician ( or rather her partner does) because he never told her of the climbing rates of maternal mortality due to the increasing c/s rate when she requested her elective c/s. It's going to happen. I can feel it in my bones. But, Andrea, there are strong midwives still around. Midwives who've had a gutful of the nonsense they see and hear from all sides. Midwives who value less their job than their integrity for the profession. We're still out there and we're kicking up dust . Robin ----- Original Message ----- From: "Andrea Robertson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, September 16, 2003 8:09 PM Subject: Re: [ozmidwifery] presentation - words of wisdom? > Hello Nola, > > 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. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
