As a current Bachelor of Midwifery (aka direct entry)student, I can tell you a little bit about my course.
I think everybody here agrees that there is no such thing as the perfect woman, the perfect midwife, or the perfect midwifery course. That said, I can promise you all that we have learnt about working in partnersip with women, what is normal birth, and how the role of the midwife changes from autonomous practitioner to "member of the team" once labour is augmented.
One of the things that we struggle with most is the "theory-practice gap"... the evidence & what we are being taught at uni & then the lack of opportunity to practice in that way at present (ie we get taught about hands off or hands poised & most of us have yet to be supervised by a midwife with a birthing woman who doesn't firmly enourage us to keep a hand on the head &/or peri). Also caseload... to meet the ACMI standard, we have all completed (or are about to complete) 30 follow throughs. For many of us, that would be our preferred model of practice next year & at present, there is not one hospital in metropolitan Melbourne where we could pratice in that model.
I'm not saying that all is perfect at my uni (& can't speak for all unis), but I am certain that my lecturers are knowledgable of what is normal & passionate how to keep things that way.
The ACMI requirement is that we are the primary accouchuer (aka catching or delivering the baby) for 40 non-instrumental births. This is a lot of births! Many are struggling to attain this figure & many have done so in less than ideal circumstances. It is argued that this number should be reduced or that students should be able to "count" births that became instrumental, but the student remained the woman's midwife.
While the midwife's role in an instrumental birth, augmented labour, etc is just as important as in a "normal" labour or birth, it is very different. The midwife is no longer the autunomous practitioner & the student is no longer gaining experience with "normalcy".
Abby, I think the high standards that ACMI has set for us help ensure that we do know normal. Granted, this is still the hospital setting, but until community midwifery is more widely available to women & midwives, the reality is that the majority of student midwives cannot gain experience in this setting.
I cannot speak for the education of Graduate Diploma midwives (who are already nurses)... as their midwifery program is only 12 months (& their requirement is 20 births), I wonder if it is more difficult for them?
Anyway, I hope my current perspective as a student is helpful.
Jen
3rd year BMid, Melbourne
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