I am very sorry if you have taken the recent discussion as a personal attack
on hospital based midwives. I have been a hospital based midwife for most of
my career (and still am), therefore have great respect for the work they do.
I think the main points being made were that it is a very different job than
an out of hospital midwife. Working outside of the hospital makes being
'with woman' easier because there are not as many obstacles such as polcies,
guidelines, drs etc. It promotes different skills and ways of working.
No-one is suggesting that training in obstetric emergencies, ctg
interpretation, high risk care etc are not essential. I personally completed
the Advanced Life Support in Obstetrics course because I believed these
knowledge and skills were necessary in modern midwifery (in or out of the
hospital). However, the point I was trying to make was these skills are
often perceived as MORE important than the skills involved in facilitating a
physiological birth and avoiding problems. There is plenty of research to
demonstrate that women want caring and supportive midwives who respect them
and their birth choices AS WELL as being able to manage an emergency. Most
complaints result from communication break-downs and lack of information.
How much training do we get on supporting women's birth choices and
providing adequate information?
I think the opposite of what you propose is true. Hospital based midwives
specialising in high risk are considered more highly skilled than
community-based midwives. I gained more respect for my high risk
hospital-based midwifery than I did for implementing waterbirth, or my
community based midwifery. I was even asked why I wanted to specialise in
low risk stuff because my career would go no-where.
Anyhow, I am very sorry if I offended you. I have just finished a
nightshift, so I hope this email comes across as intended. Sometimes it is
difficult to see the water you are swimming in.
Apologies
Rachel
From: "gch midwife" <[EMAIL PROTECTED]>
Reply-To: [email protected]
To: [email protected]
Subject: Re: [ozmidwifery] The Advertiser today...
Date: Wed, 02 Nov 2005 17:54:47 +1000
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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