I feel I need to reply to this mail, to say that in no way have I ever
intended to aim criticism at midwives who choose to work in the 'system'
which is where yes, I'm quite aware, that the vast majority of women birth.
I have only the utmost respect for those who are able to provide a quality
service, that is evidence based and woman centred, despite what I see as a
system that predominantly doesn't support that.  I could not do it, and I
have several friends who can, and for that, on behalf of my women friends
who birth in hospital I am thankful.  I am also the first one to admit that
I simply don't have the skills to work effectively in a high risk area, or
any hospital unit, and that I would indeed need some further education or at
least a refresher to attend women in this situation, and so I chose to work
in the community instead.   

I have always afforded hospital based midwives the utmost respect, when
circumstances have led me to require their assistance with a birthing woman.
Unfortunately, I can't say the same has been returned.  No tarring with a
brush going on here, just a reality, that many of us out there putting our
homes and families on the line every day, are unable to gain any form of
respectful treatment from anyone, be they medical or midwifery staff, when
we step foot in a hospital, even for the most appropriate reasons.  

I too wish for that unity you talk about, but I fear that until the woman,
and her choices, no matter how safe or unsafe, well or ill advised, or
absolutely for or against what we believe in, is the focus, we have a long
way to go...

With respect

Tania

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of gch midwife
Sent: Wednesday, 2 November 2005 6:25 PM
To: [email protected]
Subject: Re: [ozmidwifery] The Advertiser today...

I have been a keen reader of the ozmidwifery site for some time, and have 
always admired and respected the dedication, knowledge, and passion for 
achieving a normal birth, that is continually portrayed on the site by 
homebirth midwives.

It was therefore, with great disappointment that I watched the criticism 
unfold recently regarding the skills/practice of hospital based midwives (or

supposed lack there of!!). Comments like this appear arrogant and serve only

to cause division within a profession striving to provide optimal outcomes 
regardless of where a woman chooses to birth.

Time for a reality check. We are living in a 21st century society, not 
Utopia. There will always be women who are unable, for many reasons, to 
birth safely in the familiar environment of home, or supported in a birth 
centre model. For these women, thankfully, there are a dedicated group of 
midwives willing to care for them in a hospital environment. We do not need 
the care we provide undermined and devalued by midwives who consider 
themselves elitists in the area of childbirth. Instead, what is required is 
a unity within the profession and mutual respect for the work we each do.

At what point in the evolution of midwifery practice was there a 
hierarchical system introduced which relegated hospital based midwives to 
the bottom of the pyramid, and elevated home birth midwives to the top of 
the pyramid????

I find comments such as "deskilled and desensitised to the realities of 
birth" and "often lack confidence in their own midwifery skills" extremely 
offensive and unprofessional. Criticism was also aimed at emphasis for 
hospital based midwives being on education in CTG interpretation, 
resuscitation and emergencies. As a hospital based midwife caring for high 
risk women with pregnancy complications (as well as uncomplicated pregnancy 
and childbirth), it would be grossly negligent of the midwife to not be 
competent in skills such as CTG interpretation, resuscitation and obstetric 
emergencies. If I was a woman birthing in a hospital environment, I would 
expect this level of education and expertise from my midwife.

Regardless of your area of practice, be proud of where you work and the care

you provide, but appreciate the unique skills and knowledge of other 
midwives who choose a different practice setting than your own.

Hospital Based Midwife.



>From: Belinda <[EMAIL PROTECTED]>
>Reply-To: [email protected]
>To: [email protected]
>Subject: Re: [ozmidwifery] The Advertiser today...
>Date: Sun, 30 Oct 2005 18:00:33 -0800
>
>not all midwives are oppressed or socialized unwillingly, they are often 
>active participants in the way birth is medicalised and deemed as risk. 
>they can be intelligent, educated women who believe in the way they manage 
>birth. many only see it as work, something they do rather somethign that 
>they are... to be proud of and cherished. unfortunately the lack of 
>experience or knowledge about unmedicalsed ways of managing birth and the 
>power of medicine and technology encourages and enforces their beliefs and 
>practices. in saying this however once again I must encourage us all not to

>pity or dismiss hospital based midwives because firstly that is where most 
>women birth and secondly many struggle day to day circumventing, 
>manipulating or challenging the system, doctors other midwives,  policies 
>or procedures so they can care for women well (as i am sure Rachel is 
>experiencing). it is often a lonely position to be in where you can be 
>actively discriminated against and  harrased . I do not lack confidence in 
>my skills as a homebirth or hospital based midiwfe, the reality is there 
>are significant differences in being able to use them.
>Belinda
>
>
>wump fish wrote:
>
>>I think any midwife who has spent their career in a hospital setting would

>>need 're-wiring' to attend homebirths. Hospital birth is so different to 
>>homebirth, and the danger is that midwives bring the hospital and it's 
>>guidelines to the home. I don't think it is a case of 'upskilling', just a

>>totally different way of working and hospital midwives have been oppressed

>>and socialised into a particular way of practising. They often lack 
>>confidence in their own midwifery skills and women's ability to birth.
>>
>>Rachel - trapped in a hospital with pinging machines and missing homebirth

>>and midwifery.
>>
>>
>>>From: "Tania Smallwood" <[EMAIL PROTECTED]>
>>>Reply-To: [email protected]
>>>To: <[email protected]>
>>>Subject: RE: [ozmidwifery] The Advertiser today...
>>>Date: Sat, 29 Oct 2005 21:06:12 +0930
>>>
>>>Love that term, Macdonaldisation!  I also get concerned when I hear of
>>>midwives needing to be "upskilled" to attend 'normal' births, or to give
>>>women care in water, etc.  I think as a midwife we should all be able to
>>>handle the 'normal'.  I personally would need upskilling to work in a
>>>tertiary institution with all those machines that go 'ping'!
>>>
>>>
>>>Tania
>>>
>>>
>>>-----Original Message-----
>>>From: [EMAIL PROTECTED]
>>>[mailto:[EMAIL PROTECTED] On Behalf Of Belinda
>>>Sent: Sunday, 30 October 2005 1:57 PM
>>>To: [email protected]
>>>Subject: Re: [ozmidwifery] The Advertiser today...
>>>
>>>a big part of it is the multi skilling crap which is just a way of
>>>getting constant work out an individual which i think is why so many
>>>places are against direct mid entry midwives, they cant be used like
>>>slaves to work everywhere anywhere anytime. it is an evolving problem
>>>and much to do with globalisation and utilising the human resources to
>>>the best benefit of corporation which hospitals are fast becoming. The
>>>macdonaldisation of society!!! It really worries me....
>>>Belinda
>>>
>>>Tania Smallwood wrote:
>>>
>>> > Not just a question for Barb, but anyone who knows about it, I'm
>>> > curious to know about the Midwife/nurse practitioner that you refer to
>>> > in Qld. What exactly do they do? How is this different to working
>>> > within the scope of a registered midwife? I'm aware that the college
>>> > is not supportive of the notion of midwives becoming NP's, but I'm
>>> > actually interested in what role they play in maternity care over and
>>> > above the general run of the mill midwife?
>>> >
>>> > Cheers,
>>> >
>>> > Tania
>>> >
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>>>
>>>
>>>
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>>
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