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.
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.
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.
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????
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.
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.
you provide, but appreciate the unique skills and knowledge of other
midwives who choose a different practice setting than your own.
Hospital Based Midwife.
I wanted to respond to this because it touches
something I've felt for a while. I've been a lurker on this list for ages but
not a contributor because, despite many years as a midwife (and I use the term
advisedly, I don't consider myself an obstetric nurse) I've had the impression
from the language used on this forum that the work I do and even the
women I look after is somehow not as valuable or important as community based
midwifery or birth centre care. I don't for a moment think that this is the
stated position of most of the contributors to this list. But to a hospital
based midwife it certainly can come across that way. I've never been accused of
being a shrinking violet but I haven't cared to expose myself here, to
dismissive comments about the place I choose to work or the people I work
with. Not all hospital midwives do their 8 or 10 hour shift and ignore it for
the rest of the day.
People are people. I have had atrocious handovers
of care from the midwife on the shift before me. I have also had atrocious
handovers of care, or refusal to share antenatal findings, from homebirth
midwives bringing women into hospital.
Women who come to the place where I work come from
a wide cross section of the community. Many come from countries where English is
not the first language. Some are highly educated, some are illiterate.
There are early attenders and women having their fourth child in
succession without booking in or having any antenatal care. Not to put too
fine a point on it, not all families are committed to providing the best
start for their babies. As midwives we give care to all these women, the best we
can.
I joined this list in the hope of learning more and
gaining support for some of the difficult times and knotty questions that arise.
I've learned heaps and am so glad I joined; getting different viewpoints from the ones I encounter every day has
been so valuable and opened my mind to many new things.
But I can't say I've been confident that I
would receive support, I came to the conclusion long ago that my place of
work would overshadow what I had to say and I do not feel inclined to
apologise for the fact that not only do I work in a hospital Delivery Suite, I
even feel satisfactin and joy in much of what I do.
Another hospital midwife
