Wonderfully saod trish. Please don't give up. marilyn ----- Original Message ----- From: "Trish David" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, October 04, 2004 6:27 PM Subject: Re: [ozmidwifery] Students, training and other things was Re: uterinerupture 1998
> Abby, if I didn't think I was trying to impart a degree of wisdom, and > assist students to find their own wisdom, together with the women (heard > of the follow-through experience???) and the lovely midwives in > hospitals who assist them with onsite learning, and the VERY occassional > homebirth midwife who can take a student... then I would give it up. > With (diminishing) respect, evaluate a curriculum or two, enrol in a > midwifery program, and don't generalise what you see in a workshop of 10 > midwives to what is taught in every curriculum in Australia. > > Every curriculum I have evaluated has a focus on non-intervention for > 'normal' childbearing and that includes programs from 4 states in > Australia, both postgraduate and undergraduate. I have participated in > curriculum development at undergraduate, grad dip and masters level > midwifery and used programs from NZ, Holland, Scandinavia and UK and > Canada for inspiration and international comparison. And I know many > colleagues in other universities who have done the same. In addition, we > now have Standards to which we are held that are based in international > benchmarks for midwifery education, and there are moves now to develop > more national benchmarks in what is offered in midwifery programs. Your > criticisms are hollow in the face of this real work. Your rhetoric is > empty of real examples. > > My students learn active birth, pelvic mapping, physiological processes, > support for all of this and many have also been to 'workshops' with ten > midwives and say they learned little new that wasn't offered in their > program..... hmmm. I encourage them to go, though, because they > sometimes bring something new back for me, too. > > As to the third world, yes, I have seen the Birthrites video, too, it is > wonderful, but only a very small sample of what is out there and > certainly can't be generalised to the rest of the world. Through ICM/WHO > documents etc as well as direct communication with women and midwives > know that the problems in many countries cannot be fixed with a few > herbs, no matter how good their public health and nutrition. Have a look > at another fabulous video "Celebrations" about the role of midwives > across cultures and contexts. Women die because they don't have access > to a 'facility' that can offer them antibiotics, anaesthesia and > operative birth. They die of tetanus and pnuemonia, of septicaemia and > blood loss, of obstructed labour and AIDS. Planting crops and fixing > plumbing is one aspect of what is needed here, but good nutrition and > education take two-three generations to improve the health of a > population. In the meantime these individual women are just trying to > stay alive. > > Women in these contexts want good drugs, skilled users of instruments > and operative procedures, immunisation and contraception, safe abortion, > nutritional supplements and freedom from patriarchal, economic, > religious and political oppression. They want TBAs with western as well > as traditional learning, they want access to western trained doctors and > midwives, nurses and dentists, etc. Midwifery cannot stand alone to > deliver, we need to put aside a moral highground and work with all > sectors of health and education, etc to achieve outcomes in thees > contexts. > > Dare I say it, the same is true here. In many, many gov't reports women > in Australia want an integrated maternity service that uses the best > talents of all practitioners working together to offer choice (including > all the unpalatable ones like epidural, induction and LUSCS on demand, > all of which I would cringe at). > > Yes, midwives are 'trained' differently now. Now we have to learn how to > be discerning consumers of research, to critique all forms of dogma, to > understand the physiology, not just rote-learn something, we must also > understand a rationale for actions and learn to be fully accountable for > them, we must commit to lifelong learning, to participate in quality > improvement of services, and to work in a multi-disciplinary environment > with a wide variety of women. We no longer have the excuse of this is > the way I was taught.... I believe we are coming to quite a good > balance, though we are not there yet. I look forward to the day when > there are enough homebirths for students to participate in, enough > homebirth midwives for them to learn from, and enough midwife-led > programs for them to work in whilst in hospitals. For now, we don't have > that, but we sure teach students what that is about. Every program I > have read has whole units devoted to political issues and professional > issues in midwifery and maternity. The scope is much wider than ever > before. And yes, we do give students survival skills and knowledge for > working in the system, would you have us sacrifice them? It is our duty > to them to support and help them survive the system, while assisting > them to decide what is bad about it... and what is good (and there is > some good out there). I don't think it's true to say a lot of > universities teach students how to intervene, or fail to impart > reverence and trust. I wouldn't presume to know what goes on in > individual classrooms because I am not there. And many graduates I speak > to, many lecturers, and many students have a very midwifery philosophy > and strive hard to keep that alive. Perhaps we can't give them every > tool, no one knows everything, and our training programs are short but > overstuffed with content. Perhaps we could improve, and we continually > strive to. > > Now, give me some examples. Back yourself up. What traditional ways are > you talking about specifically? What specific wisdom is missing and how > would you provide it? Not just a blanket statement like working with > women, this has no meaning beyond what the individual determines it to > mean, give an example. Teach me. > > What traditional herbs would prevent PPH (we use one, ergot, that has > been in use for 4000 years but is now much more reliable quality because > of what modern pharmacology has done to it) and where is the proof? > > Where are you going to find independent midwives to apprentice the 1500 > midwives + per year we need (Vic)? Where are you going to find the women > willing to have students follow them through, because we are certainly > having problems doing this now? > > Abby, please, get out there and find some good examples for us. We think > we have many of them on offer, poorly resourced and always under > pressure they may be, but we do have them. We mightn't live up to your > ideals, but there are many midwives trying hard to change the system, > often in the face of considerable apathy and antipathy from the women of > their communities...... > > I think it's time I quit midwifery, really. Too hard, too painful. Trish > > > > > -- > 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.
