I understand your frustration and amazement about the different styles of "midwifery" that are out there. I agree with Mary that the environemnt in the hospital has a powerful effect on the midwives who work there, as well as the women and the comment from Micehlle (the student) backs up Mary's observations (and my own).
As someone who provides the course that teaches midwives "how to provide woman/family centred care" I can report that these courses are very much needed. The midwives who attend are all aware of the need to re-discover their midwifery roots and how woman centred care works in practice. They need strategies for overcoming the hospital system, how to get around the protocols whilst protecting themselves and the labouring woman and how to work as a team to maintain morale and effect change. Achieving cultural change in a hospital is difficult until a critical mass of midwives all begin the think the same. Around 65% of the staff form a critical mass, and if this number can all begin thinking alike, a strong cohesive body can achieve a lot. There have been many hospitals (mainly in the UK these days) who have asked me to present my Active Birth workshops for their entire staff, over a number of trips, so that this cultural change can occur. It has been very rewarding to see the growth and development of a team philosophy of care and receive feedback from successful midwifery units.
Way back in the late 80s and early 90s I did a number of similar multiple programs for hospitals in the Sydney area, with good results. Since then, I have noted that of the many cities where I travel regularly, Sydney has become the one place that seems resistant to change - where an attitude of "we're OK, don't challenge us" seems to be the norm. Although one Area Health Service (SESAHS) has understood the need for regular updating and moral boosting programs for their staff, no other Area Health Service has seen the light. I am not surprised that the lack of insight underlying the rejection of midwifery programs in most hospitals in Sydney - they have forgotten what midwifery is all about and furthermore, don't want to know. In Sydney, for the most part, a midwife is an obstetric nurse, and I wonder if this will ever change.
Meanwhile, I have just had a long opinion piece published in The Practising Midwife called "Changing the Birth Culture in Britain" (April issue). Next month I will put this onto my web site - the ten steps outlined are equally applicable in Australia. I will let everyone know when it is up on the site.
Meanwhile, hang in there Nicole - the reforms that the MC are pushing through in NSW will neatly bypass the whole AHS and hospital system, and make real birth choice available to every woman. In the end, it will be the women who will forge the changes,as they have ever done.
Regards,
Andrea
At 11:01 PM 10/04/2004, you wrote:
I have been feeling exactly the same way - especially of late.... Unfortunately, there is a huge distinction between true woman centered midwives and obstet nurses......
After working for the most part of two years on trying to set up a midwfery-led model at our local hospital... have just been told that it won't go ahead.... reason = fear factor ie. Camden/Campbeltown fiasco... and many of our midwives have had a change of heart.....
After being explained what the new model will entail (or rather NOT entail)....(from someone from our Area Health Service) I was flabergasted to hear that the midwives would be provided with extra training/courses - including one which teaches them how to provide woman/family centred care.... I remember my jaw dropping.....and initially being unable to speak....
once I regained brain power... I remarked on what a sorry state midwifery is in today ... where the core of midwifery.....the real essence of midwifery care... has been lost amongst the myriad of intervention and subserviance....
What do they teach at uni??? Is this a reflection on hospital midwifery care today - that we need to provide midwives with an "extra" or "refresher" course on the essence of midwifery ie. midwife= 'with woman' ???!!!!!
I would like to add, that I hold true woman centered midwives in the highest regard... I have had 2 hospital births and 1 homebirth. One out of the two hospital births was with a fantastic midwife... and my homebirth was AMAZING!!!! The way I feel about the midwives in those 2 different settings is almost like a teenager who idolises a lead singer of a band... I am awe struck and will forever feel a strong sense of a spiritual connection to them. They were a huge part of three of the happiest days of our lives!!
My beautiful birth experiences have opened my eyes, heart and mind to the wonder of birth and in turn, have charged me with passion for woman centered midwifery...
kind regards, Nicole
Original Message ----- From: <mailto:[EMAIL PROTECTED]>Jo & Dean Bainbridge To: <mailto:[EMAIL PROTECTED]>[EMAIL PROTECTED] Sent: Friday, April 09, 2004 1:25 PM Subject: [ozmidwifery] midwife is a midwife...?
I read this today and wanted to chat about this without fear of being lynched! lol
And given a birth I attended last week with the worst hospital midwife I have ever met who was SO much less good than the obstetrician I am totally off the idea
of a midwife is a midwife....
I am totally off the idea of a midwife is a midwife....
I would like to hazard a discussion that one of the problems we encounter is that there ARE a proportion of midwives who do not support what our definition of a midwives role/responsibility and so forth and these midwives are firmly entrenched in the system...so when a woman births in a hospital (as so many do) and go down the ob model (as so many do) they encounter some of these midwives and leave the woman thinking the midwife was "awful".
I know a that there are those wonderful woman focused midwives who still work labour ward and so on, so I am not suggesting they are all 'bad'; but would you say that the midwives who do fit our definition are the ones who put their hands up for birth centre care and so on, thus leaving the 'obstetric nurse type' who are less supportive to actively assisting the woman in any other way other than increasing the drip or topping up the drugs.
In a long winded, public holiday type way I am saying that : there are a few people who would read a sticker like "I chose carefully: I chose a midwife" and say "the midwife I had was a bitch! I would never chose her!" The public are almost blind to the fact midwives are midwives not nurses, so to then extend that understanding to the two types of midwives (which I call ob nurses -"yes doctor, no doctor type" and the with woman midwife) is an ask.
Perhaps we need to suggest a system that does define the midwife from the obstetric nurse?? I have heard from practicing midwives that they are not supportive to things like case load or community midwifery because "...don't want that type of responsibility" (actual quote). I have no idea of how this would be done and not suggesting it would even work; but we must be aware when addressing the general public we are aware that there is a difference between those midwives who see women as someone to be empowered and those who see the woman as someone to be rescued: but do the general public??
"My Midwife empowered me to birth beautifully!"
(awaiting the hate mail! lol) Jo Bainbridge
----- Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education
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