Re: [ozmidwifery] caseload

[Helen and Graham]

Title: Re: [ozmidwifery] question

I also meant to say that as I currently work caseload I agree without a doubt, that the flexibility and family frendliness of working with a small team of midwives is far higher than in working shifts.  Not to mention the increased work satisfaction in getting to know fewer women and being able to provide better care!!!   It was actually this list that helped me decide that caseload was worth a try so there's one success story.   Helen     ----- Original Message ----- From: Helen and Graham To: ozmidwifery@acegraphics.com.au Sent: Saturday, November 19, 2005 7:43 AM Subject: Re: [ozmidwifery] question Your sense of frustration is palpable Justine.  I totally agree with you but when you have worked that hard to get your qualifications, you have a livelihood at stake, and you also have "the Bolam test" that you mentioned the risks of non conformance or stepping outside the boundaries in a hospital system are too high for most.    This conversation reminds me of my frustration with many women who don't want to breastfeed or if they do, they soon give up despite all the evidence suggesting that it is best.  Sure there are reasons like sore nipples, "not enough milk", "bad advice" but many times it is just because they don't want to.  That is when I think family pressures comes into it.  Cultural expectations, peergroup and family pressures, financial pressures to return to work, unrealistic expectations about the personal commitment required to successfully breastfeed etc.  Of course, none of these things were a problem to me but I can't place my own values/feelings on others.   We all react differently and the wheel turns slowly.....   Helen Cahill     ----- Original Message ----- From: Justine Caines To: OzMid List Sent: Friday, November 18, 2005 11:45 AM Subject: Re: [ozmidwifery] question Hi Mary and all I am responding to a few on this thread! Medical Boards seem to only be used in extreme cases as there is such a closed system of protectionism. One of our Premiers told me once he totally believed what I was saying in relation to a broken maternity system as he knew of the huge protection offered by the 4 walls of a hospital (well for Drs, not midwives!).  But was he game enough to take it on?  No way. The most tragic part is the lies women are told so they not only believe what happened was necessary but that the Dr saved them.  I don’t have an answer to that one. The other insidious fact is that even when families sue the new civil liability laws now require what is called the “Bolam Test” and this means if an Ob can determine what they did was custom and practice as evidenced by other practitioners (not proven by best practice evidence) then that’s fine.  So to me we are stuffed on that count. Few people know this. But yes caseload practice and a real scope of midwifery that determines a boundary that is not interferred with by medicos until a woman or babies condition is outside of it is the answer. What can midwives do?  Say they want to work this way!!! UNITE. Despite all our hard work I see so many midwives clutching to the rostered fragmented way of work.  I am sick of hearing family responsibilities as the reason.  This is fear of change and a resistance to even try.  I am sure that caseloading on a part-time basis (with good back-up which is essential) is MORE family friendly.  And hey lobbying politicians and meeting the demands of journalists and travelling hundreds of Kms as a consumer advocate ain’t too family friendly!! We are on the cusp and I reckon we can advance or slide at the moment. Anyway I am going to shut up and try and have a baby or 2! Justine 37 +5 __________ NOD32 1.1290 (20051117) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com