[ozmidwifery] Students, training and other things was Re: uterine rupture 1998

[Abby and Toby]

Hi Trish,   >>Abby, could I ask where you are studying midwifery???   I'm not studying midwifery, nor did I say that I was. I do know quite a few students and midwives and have had numerous discussions with them about what they do and don't learn.    >>I've read a fair bit about 'wise' women, don't romanticise some half-forgotten past. Don't idealise a model of training and education that isn't open to the scrutiny and evaluation of all its stakeholders. To talk about traditionally trained midwives is like talking about clouds.   I think people have misunderstood what I am saying. I am not saying that traditional midwives are amazing godesses from the planet of enlightenment, I am saying that there is a difference between the way women use to learn and the way they learn now. Midwives are trained differently now, is that not correct? There is a difference in learning, there are big differences in what is taught etc etc.   I do think it is very sad that student midwives no longer learn traditional methods in their training, wouldn't people agree with that? Why does "traditional" ways of learning mean that they are not open to "scrutiny and evaluation of all its stakeholders" Why not have a training program, apprenticeships etc for midwives that want to work with women at home or that was based on trusting a woman to birth and then have training for midwives that want to work in the hospital system etc? Why not have training that focuses on non intervention rather than focusing on intervention and having medical "tools" rather than natural tools? I know of midwives that couldn't give a stuff about the women they are caring for and want to work in an interventionistic way in hospitals and then I know midwives that want to work with women in their homes but don't feel like they got the training to support that.   >>Similarly, to say most student midwives in Australia are taught obstetric nursing is an affront to those of us who struggle very hard to create curricula and learning opportunities to subvert systems that oppress women and midwives while allowing them to work safely in the system that is out there.   Isn't it true though, that what is taught is more about working in the system than being with the women. From what I have heard, from conversations between student midwives and some qualified midwives is that they wished they had learnt more about being with women, natural ways of dealing with challenging, unexpected situations in labour and also to trust more in a womans ability to birth her baby.   >>Would you have them learn for some ideal world in the future while the women of today suffer a lack of midwives who can work with them now?   Why not learn for the ideal now, foster the trust of birth and then learn all the other stuff, why does it have to be the other way around. Why not teach student midwives the reverence of birth and women rather than foster the belief that birth is something that needs to be meddled with and fixed? I am not saying that this is what you in particular do, but isn't it true to say that a lot of universities do that? To be honest, I do think women already "suffer a lack of midwives who can work with them now". Have you listened to the incredible amount of stories coming from women who had their babies in a hospital setting, you know 6 months down the track when they start really thinking about what happened to them? Horrible "midwives", being treated like crap, not being acknowledged. I think that the majority of hospital "midwives"  are not trained to work with women now, they are trained to work with the system, not the women.   >>I'm with Belinda. While I believe not all midwives have the same qualities or levels of skill, it serves no purpose to create a schism, to pit us one against the other, but rather we should walk a mile in each others shoes and learn to critically evaluate why we are as we are, and determine how to make it better.... without blame and finger-pointing.   I think that people are missing what I am saying because of already a set defensive attitude. I am not putting one AGAINST another, merely pointing out that yes, there are differences. I think it is hard to disagree with there being differences. Any blame and finger pointing I have is at the system not at any particular category of midwives.   >>The 'lay' midwives I know, the homebirth midwives I have been priveleged to work alongside, and the 'direct entry' midwives I have met and am now helping to educate, are expected to be able to provide the spectrum of care.... not just for well women, but also for those who have emergencies and illness. These women need competent, fast thinking, appropriately acting midwives with a heart, and who can use EVERY tool at their disposal.   I agree with the above completely, but I would ask, does the current training program for student midwives equip them with every tool? From what I have heard, no. I was at a very basic workshop for midwives and their was a large range of midwives there from a woman that had worked for 25years to a student, there were about 10 midwives all together. Out of the ten midwives plus me, there was only 3 people that knew or had learned anything about the basics of natural birth, one midwife that had worked for 25years, a direct entry midwife that was a doula before she became a midwife and had learnt all about natural ways in her doula course and me. To say I was SHOCKED is an understatement, I couldn't believe it. It made me realise why birthing practices in this country, in general, are the way they are. If the women that care for women don't have the knowledge to trust in birth and support naturally, how would the women they are caring for?   >>As to interventions, we in the one-third of the world with good nutrition, hygiene and public sanitation, freedom from poverty and with good shelter and education might be complacent about midwives only needing to guard normal. But ask the women in the developing world, and the 'third world' whose greatest threat to life is PPH, who have almost 100% morbidity, whose infant mortality rate is off the scale, and who would sell their body for a chance to birth in a well-equipped and clean facility what they want. Bet you can't guess? It's not always a midwife.   So lets help those countries become clean, give them the knowledge, financial assistance and education to create a better living space etc rather than spend the money on very expensive facilities that in the end can create more damage than good. This very much reminds me of the Inuit women getting shipped of to birth in a "safe" facility. The impact on their community was catastrophic eg. high rates of caesereans and interventions, high rates of child molestation, domestic violence, alcohol and drug addiction and youth suicide. When they bought birting back to their community, trained the local women and created a birthing centre in their own community everything changed for the positive. Wouldn't it be better to spend $5million, or whatever it is to create a clean facility for birthing, on a new water and sewage system for a town, or on life education for people giving them a chance to create a better life for themselves rather than here you go, we have the medical answer to fix your problem. Spend the money teaching the local birth attendants that nutrition and health are vitaly important, teach them about herbs and all the amazing natural ways we have to avoid PPH. Plant fields of food, train the community in making a sustainable life for themselves. Taking birth away from womens homes and communities then putting them into a "facility" is not helping them in the long run. It doesn not change living circumstances or empower them. It's like the immunisation plan in India. Various international groups have spent lots of money on immunising against polio to irradicate the disease. It is brilliant that they are doing something about it, but work on a wholistic view. ust immunising is not going to irradicate the disease. Same things as above, spend the money on clean water systems, community education, empower the people to look after themselves and to live sustainably.   >>Wisdom doesn't always fall out of women's mouths or reside fully in the practices of the past. Books have lots of it, and there are many complementary paths to wisdom, not one single way. To choose merely one is to turn one's back on all other possibilities.   No wisdom does not always fall out of the mouths of women, especially these days, the lines have been broken. I think there is a place for medical practices in birth, when in those 1 or 2 % of cases that really need it. I also think that while training of student midwives continues to be the way it is in Australia birthing practices will not be wise and will be following one path, thus turning backs on other possibilities. Do you honestly believe that what is being taught, on a whole, is wise words of wisdom, true education, true equipping of being "with women"?   It is not only midwives that are affected by this, the people mostly affected are the women in their care. When the majority of training ceases to be on the medical and midwives once again become fully equipped with all the tools, not just the medical, that is when women will get the support they deserve.   I do believe there are differences in training of midwives, I am sure there is differences from one school to the next. I think it is sad that traditional ways of learning to be with women are now illegal in this country. Obviously not all lay midwives are wonderful just as all "trained" midwives aren't wonderful, but we are missing out. Missing out on so many wonderful women being with women. Since training and birth has been taken into "professional" buildings, the spirit and wonderment of birth has also been taken away ( in general I am speaking).   Hmmmm.....haven't written an essay in a while! lol   Please don't misunderstand me. I am not trying to say an "us and them" kind of thing. I think it is sad that there is that, but it is the system I am against, not midwives.   Love Abby