We try so hard where I work to give woman centered care which is
great when all goes according to plan. But if it doesn't: why no
IV (she was drinking well), why no catheter (she was voiding
well), why no CTG (frequent intermittant asucultation showed no
abnormalities) etc etc. This was a transfer for obstructed
labour. Even with all these things they could not manage a
vaginal birth but the criticism is there.
 cheers,
Judy

--- Sue Cookson <[EMAIL PROTECTED]> wrote:

> 
> Hi,
> I'm still getting only the odd email so apologies if I repeat
> what 
> anyone else has said.
> Justine really has her finger on the pulse in terms of
> consumer 
> apathy/lack of knowledge. One thing that really struck me as I
> was 
> completing my midwifery degree though and doing my clinical
> placements, 
> was how scared most midwives working in the hospitals are of
> being sued. 
> They practice defensive midwifery/obstetrics becuase they are
> constantly 
> covering their arses.
> 
> The same story of course with all the doctors. And that's how
> we are all 
> taught, as such. And as a student, when I dared to stand up
> for the 
> women to stay off the CTG or refuse a c/section just because
> it was 8pm 
> what did I get - abuse and fear thrown at me by 'senior'
> midwives - 'it 
> will be on your head if that baby dies' stuff. And I'm not
> kidding or 
> making this up. This is how we as students are taught - be it
> within a 
> BMid degree or as a post grad nurse... and we work besdie all
> the fear 
> based doctors...
> 
> Of course I discussed CTG vs intermittent auscultation, etc
> etc and 
> placed the documents on the desk the next morning, but if I
> hadn't had 
> my 20 odd years of normal birth prior to doing my placements
> then I 
> would be learning to behave and think like others who work in
> and for 
> the system. I was even challenged fully for delaying cord
> clamping ..by 
> a young doctor ..who of course was taught that cutting the
> cord 
> stimulates the baby to breathe... and when I presented a PP
> presentation 
> to other midwives in the unit about delayed cord clamping -
> one 
> response? None of us cut the cord early here anyway. Duh - I
> nearly fell 
> over. This is why there is so little change....
> 
> And don't bite my head off either - I know there are also
> midwives 
> working in the system who are doing fantastic work to enact
> change - to 
> policies and attitudes, to empower the women ... bu in my
> mind, the 
> change will have to occur as a total change - like midwifery
> led units 
> with little doctor input, where midwives are happy to truly
> advocate for 
> the women and be prepared to continue to learn - like taking
> women past 
> 41 weeks or even 42 weeks if all is well, taking on care of
> normal birth 
> with all its facets .... birthing happier and healthier babies
> with 
> mothers intact about their birth process and should I say it
> .. maybe 
> even empowered as mothers and parents.
> 
> Sue
> 
> 
> 
> >Nah, not throwing it out the window at all, I see it as
> having great
> >potential and a great opportunity to learn and develop for
> Australia. It's
> >great for everyone to know what you've just said Justine, as
> no-one really
> >knows anything about what's going on, and all the work
> occurring behind the
> >scenes. The more we know about progress, the more we can work
> together and
> >understand the whys and hows and get excited. Also good for
> morale I think,
> >seeing and hearing progress... but with that you also need to
> talk
> >challenges, goals and improvements to be made. 
> >
> >Perhaps you might like to speak at the conference and let us
> know what you
> >have been doing, what you are hoping to do and how you are
> working with NZ
> >to help our case here? I would be more than happy, I am sure
> everyone would
> >love to know and also ways they can help women have more
> options in
> >Australia. Lyn Allison is going to be listening - its an
> opportunity to be
> >heard which we can't miss, no matter how many times we have
> to say it.
> >
> >Best Regards,
> >
> >Kelly Zantey
> >Creator, BellyBelly.com.au
> >Conception, Pregnancy, Birth and Baby
> >BellyBelly Birth Support
> >
> >-----Original Message-----
> >From: [EMAIL PROTECTED]
> >[mailto:[EMAIL PROTECTED] On Behalf Of
> Justine Caines
> >Sent: Monday, January 08, 2007 1:47 PM
> >To: OzMid List
> >Subject: Re: [ozmidwifery] where has this list gone?
> >
> >Dear Kelly and all
> >
> >Some additional information may assist you before you totally
> throw the NZ
> >model out the window.
> >
> >For those of us who have lobbied at high levels, and been
> involved with
> >writing (and selling!) NMAP etc we needed to totally
> understand the good and
> >the bad of NZ.
> >
> >Kelly your statements re intervention in NZ on a broad brush
> are not totally
> >true.
> >
> >One of the major down falls of the stats (ie c/s) is the
> midwifery
> >interaction with obstetrics (ie large metro units that have
> the greatest
> >birth numbers).  To prove this look at the NZ rural units
> stats where
> >midwives are providing a total care package without an
> obstetric unit and
> >epidural service at the door.  These stats are stunning.
> >
> >The funding arrangement is NZ is wonderful.  It gives parity
> to each
> >maternity health professional undertaking the same work.  It
> has been
> >legislated (s88). It also places the woman at the centre to
> choose her carer
> >and direct payment accordingly. The consumer focus re dispute
> resolution is
> >stunning. (Are you aware of this Kelly) Compare all of this
> with Australia.
> >Women are mostly treated as a piece of meat that will make
> them money.  Last
> >week I heard a GP/Ob respond to 6 complaints with "Well I'm
> trying to run a
> >business".
> >
> >Australian women have no real choice. Choice of a private
> Hosp and private
> >Ob is NOT choice. 1% access to midwifery is NOT CHOICE.
> >
> >So one of the major solutions for them (NZ) and us is a total
> midwifery
> >scope of practice that does not place a woman within an
> obstetric dominated
> >setting unless there is clinical need.  This means home birth
> and stand
> >alone midwifery units, this means women labouring at home for
> as long as
> >possible (with their midwife).  You only need to look at
> Australian
> >co-located birth centres to get a similar picture.  Yes it is
> the best we
> >have but the 50% transfer rate is not representative of
> women's incapacity
> >or midwifery care (on the whole).  It is as a result of
> obstetric domination
> >and protocols that have no basis of evidence.  This is how we
> set midwifery
> >and women up to fail.  Why can't a woman with PROM labour in
> a BC?  What
> >difference is the transfer to a theatre from delivery suite
> to BC? This is a
> >total furphy.  So are many other's that exist.
> >
> >The answer in Australia is firstly a funding stream. 
> Medicare for midwives
> >(without restriction).  Then women actually have a funded
> choice.  From
> >there many hurdles (no doubt). I agree women are the key, but
> it is nearly
> >impossible to get women to fight for or even explore
> something they have no
> >experience of.  So a funded choice would get the cultural
> change happening.
> >To do this we need midwives that are with women so I believe
> it is a
> >partnership of change.  Women will lead but midwives will be
> there right
> >beside them.
> >
> >In solidarity
> >
> >Justine
> >
> >
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