RE: Fundal Pressure
Hi Genevieve This is interesting. I assume it is in response to the discussion on the ozmid chat line, so I will send it on there. I don't remember the discussion getting into shoulder dystocia. Joy Johnston -Original Message- From: Genevieve Lilley [mailto:[EMAIL PROTECTED]] Sent: Friday, 10 September 1999 23:28 To: Johnston Subject:RE: Fundal Pressure Try having a look at Coates, T. Manoeuvres for the relief of shoulder dystocia, Modern Midwife, 7(5), September 1997, which is cited in an article in Open Line, which reads: "A five year review conducted in Totonto found that fundal pressure, when used without other manoeuvres, was associated with a high rate of neurological and orthopaedic damage. In addition, it has been suggested that fundal pressure is associated with uterine rupture and premature separation of the placenta." -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Homebirth conference
Just a quick message:- A huge thank you to all the organisers of the home birth conference. I' ve juat arrived home from the most amazing, wonderful, energising weekend. Thanks too to all those people who went, and made it such a wonderful conference. And thanks to Mari-Carmen Povoda for her foresight in faxing Germaine Greer. I will write more when I've had some sleep and am more sensible - I just had to let everyone know what a wonderful time I had, and how great it is to now be able to put faces (and bodies) to many of the names from this list. Love and blessings Elisabeth -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Fundal Pressure + more
Dear All Yes it looks as though at some stage (in the US may be other countries too??) fundal pressure was being used to manage shoulder dystocia and with the poor outcomes that you have mentioned. It apparently further impacts the shoulders and is a big no no. I was taught as a student way back then never to use fundal pressure for impacted shoulders but to use Supra Pubic pressure with woman's knees on her chest or the all fours position. Was able to be with a mother at a very special homebirth this morning. Mothers first child was a trisomy 18 stillbirth at home, second baby was diagnosed Downs by amino and she opted for a birth centre birth, The baby turned out to be fine. She came to Indonesia and discovered she was pregnant a few days after arriving here. Lots and Lots of tears, baby wanted but felt she could not go through everything again. She recently opted for a homebirth instead of a birth centre as she felt she "wanted to come full circle". Refused all tests including U/S. Now would you believe we started labour in a hotel last night. They had to move out of their house urgently last week due to pest control problems- were scheduled to move back in tomorrow. The road outside their hotel was blocked off last night - military road block and searches, don't know why. Anyway at first light this morning I moved her to her home which she very desperately wanted to do. She birthed a beautiful healthy little girl 1 and 1/2 hours later. Just had to share this. Kind Regards Mandy O'Reilly Johnston wrote: Hi Genevieve This is interesting. I assume it is in response to the discussion on the ozmid chat line, so I will send it on there. I don't remember the discussion getting into shoulder dystocia. Joy Johnston -Original Message- From: Genevieve Lilley [mailto:[EMAIL PROTECTED]] Sent: Friday, 10 September 1999 23:28 To: Johnston Subject:RE: Fundal Pressure Try having a look at Coates, T. Manoeuvres for the relief of shoulder dystocia, Modern Midwife, 7(5), September 1997, which is cited in an article in Open Line, which reads: "A five year review conducted in Totonto found that fundal pressure, when used without other manoeuvres, was associated with a high rate of neurological and orthopaedic damage. In addition, it has been suggested that fundal pressure is associated with uterine rupture and premature separation of the placenta." -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
unions and midwifery
Dear Jen and others interested. If we midwives were to withdraw from ANF en masse and join another union, making a clear and loud statement that ANF did not represent midwives, then we would have stymied their attempts to silence us and keep us under the nursing umbrella. HACSU in Tasmania already has about a third of nurses (some of whom are midwives) in their union and ANF is forced to collaborate with them. Surely we could find another Australia wide health services union to take us in, especially since we have 72,000 registered midwives Australia wide. If only one quarter of these decided to make that statement, then ANF would be stuffed as far as making policy statements about midwives is concerned. Just a thought. Trish -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: anf and direct entry
Dear all, Just back from the Homebirth Conference so stand back and watch me roar Why are midwives affiliated with any nursing groups at all, We have to add a conference note shed that snake skin and emerged as a pheonix from the ashes of our birthing flame. Midwives let us unite and dispell the ties to nursing.. If nurse you be as well as a midwife because of your community role then let you join or affiliate to two seperate groups. DOWN WITH THE anf (I think that must be Austalian Nurse Federation ??), down with the QNC, and all nursing councils. Unite let midwives who are MIDWIVES govern our own actions and not hang on to the preverbial cancer that constricts our very existance. Suggestion a collection of names from all midwives who want a MIDWIFERY COUNCIL and for us to force them to respect our difference and demand indivdual identity. nigel Ps there is more!! --- Johnston [EMAIL PROTECTED] wrote: Dear Jen Thanks for this. I have forwarded your message on to Anne Marie Scully at ANF, who is a member of the Bachelor of Midwifery Taskforce which prepared the 'Reforming Midwifery' discussion paper. Also to Diane Cutts who chaired the taskforce. Let's all remember that it is the responsibility of the midwifery profession to define midwifery. Joy Johnston -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Jen Byrne Sent: Friday, 10 September 1999 15:48 To: [EMAIL PROTECTED] Subject: anf and direct entry Dear list. As most of you may be aware the University of SA and Flinders University are collaboratively developing a three year undergraduate midwifery degree (Direct Entry) to be offered in 2001. We have appointed a project officer. One of our aims is to coordinate a national collaboration. We would be pleased to hear from any interested universities. This letter has been sent to the University of SA and Flinders University from the ANF SA Branch following a number of letters sent to them asking them to review their policy on direct entry when they had their annual state delegates conference in August. I QUOTE(I had great difficulty in writing this even though it is a quote - referring to midwifery as nursing!! ) "...delegates voted overwhelmingly to maintain ANF's curent policy position regarding midwifery including opposition to direct entry programs. The ANF has a national policy which oppose direct entry education programs for specialist areas of practice such as midwifery and mental health nursing. The basis for this is that we believe that it is necessary for nurses to undertake a broard-based undergraduate program and to specialise at postgraduate level. This is particularly relevent in the contemporary environment where clients' needs are so diverse and nurses must be able, more than ever before, to respond to the full range of needs. Further more, there continue to be chronic shortages of specialist nurses in rural and remote areas particularly of midwives and mental health nurses. Employers in these areas continue to assert that direct entry courses will not address these shortages. Consequently we wish to reiterate our concerns about the university's plans to introduce a direct entry midwifery program, as we do not believe it is in the best interests of the community or the nursing profession." END OF QUOTE There was some debate at the ACMI conference in Tassie around the issue of should we just ignore ANF. As ACMI does not have an industrial arm we have nowhere to go for industrial issues execpt ANF. In SA the professional officer is supportive of Direct Entry and understands midwifery is a separate profession, however we are up against a national policy. What does the list think about this issue? -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. === From Cathy Bock and Nigel Duncan. at BIRTHING HANDS (Homebirth, ante/post natal care and hospital support) [EMAIL PROTECTED] 0414 886827 or 0414 554840 OR VISIT OUR WEBSITE ENTER FOLLOWING OR SEARCH FOR BIRTHING HANDS. http://www.homestead.com/birthinghands/BIRTHINGHANDS1.html __ Do You Yahoo!? Bid and sell for free at http://auctions.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Go for Direct Entry(Read the bottom)
Dear Andrea Thanks for your comments regarding DE and the issues with ANF. I have tried previously to get members of the list to lobby their state ANF on this issue and was told we should be concentrating on ACMI and not expending energy on ANF (sorry Denise). However I do see them as a problem as the organisations will not employ the DE midwives without industrial backing. We also need to change or deregulate the hours (ie. anualised salaries) so midwives can undertake their role in the mainstream system. ANF is being quite difficult on these two issues. Anyway, regarding my background. I undertook my Midwifery at the Royal Hosptial for Women. Carol Thorogood and I shared a flat for the year. What at team!! For the past 12 years I have been in academia mostly at Flinders Uni but also Uni SA teaching nursing students regarding life span and the maternity modules though on occasions I have had to teach in the acute care area( ghastly - but until 3 years ago midwifery was not in the tertiary sector in SA). I also, during this time took 2 years out and was appointed the Midwifery Fellow at the QVH in Adelaide where I undertook a Randomised Controlled Trial on the Birthing Centre. I have also conducted my own practice as a childbirth educator and lactation consultant since 1986. I am a director of Australasian Lactation courses. I teach in the Master of Midwifery and also the Bachelor of Midwifery and coordinate the midwifery programs. Hope this is enough. I would be happy to be in your study if you are still looking for participants. At 07:46 PM 9/11/99 +1000, you wrote: Dear Jen, You have to remember that all new ideas are threatening to a large majority. As a midwife has this broad based training I wish I didn't. Far from seeing it as an advantage it is simply an excuse for employers to abuse my chosen area of work at the expense of the group of clients that I have chosen to work with. The only way I could train as a midwife was to do my general training first. Then I chose to do mid and to continue to work as a midwife. BUT as I have chosen to live outside an area that has enough births for a full time mid ward they fill the ward up with ANYTHING because I am trained to look after them. If I wasn't they would have to look at other ways of utilising my skills to 'their' best financial gain by expanding the role of the midwife. In a general ward it is always the mid women who miss out because they are not sick (dependent physically). Now before all the idealists jump in I agree OK that the women would be better off with a completely differnt system but maybe this will force 'them' to look at it not today because they can still get general trained midwives but as midwives train as direct entry the shortages will force the establishments to employ them. The first ones though had better be prepared to be in it for the long haul as employment opportunities may be limited for a while. Although there are already rural areas that say they can't get enough midwives so if they are prepared to live in the country ( and its a great life ) they may be OK. Graduate programmes are another area that you will need to look at. As a midwife in a rural setting (I can't tell you where in case big brother is watching) we currently have mid students and they get great experience with us because they are supernumary(?) but we are unable to take them as grads because we only have two on each shift. If they are allocated to a labouring woman there will not always be someone to assist them as much as they may need in the begining as the other sucker is caring for the ward full of medical/surgical/paediatric patients. For grads who have already been in unpaid education for three years to have to take an unpaid grad year is asking alot but that is what they may have to consider. Especially the first few years unless you can find some sympathetic employers. As for the ANF it belongs to the members and all those midwives who are members may like to have a say about this issue. The union was not happy about PCAs when they were first introduced but they can now become members of the ANF. So don't be discouraged by the fact that they, as representatives of all those nurses who don't see midwifery as a seperate entity from nursing, aren't celebrating the introduction of direct entity. (You know those bloody midwives have always been up themselves sort of thing that nurses have been saying about midwives as long as I've been a midwife) I think this is an important move for midwifery and would like to see you go ahead with it, Isn't it amazing that prior to this week I've never heard your name before and now we have e.mailed each other twice in two days about two seperate issues. Are you directly involved in the masters course and if so could you give my an insight into your background. I'm interviewing potential lecturers and if your introducing direct entry you just got
Re: anf and direct entry
Dear Andrea, How right you are! As long as midwives have to register as nurses in Australia then their unique services will be abused and their skills lessened. Plumbers are not electricians and whagg we all no how dangerous it is to mix electricity and water!!! LOve Nigel I move that the Ineffectual ACMI actually demands individual recognition for the midwifery profession and art. We have more in common with our clients than we do the nursing profession. I move all midwives in the ACMI evaluate their own understanding of midwifery and the role of the midwife, Please let consumers in heaven knows we need a positive direction. Love MIDWIFE nigel --- [EMAIL PROTECTED] wrote: Dear Jen, You have to remember that all new ideas are threatening to a large majority. As a midwife has this broad based training I wish I didn't. Far from seeing it as an advantage it is simply an excuse for employers to abuse my chosen area of work at the expense of the group of clients that I have chosen to work with. The only way I could train as a midwife was to do my general training first. Then I chose to do mid and to continue to work as a midwife. BUT as I have chosen to live outside an area that has enough births for a full time mid ward they fill the ward up with ANYTHING because I am trained to look after them. If I wasn't they would have to look at other ways of utilising my skills to 'their' best financial gain by expanding the role of the midwife. In a general ward it is always the mid women who miss out because they are not sick (dependent physically). Now before all the idealists jump in I agree OK that the women would be better off with a completely differnt system but maybe this will force 'them' to look at it not today because they can still get general trained midwives but as midwives train as direct entry the shortages will force the establishments to employ them. The first ones though had better be prepared to be in it for the long haul as employment opportunities may be limited for a while. Although there are already rural areas that say they can't get enough midwives so if they are prepared to live in the country ( and its a great life ) they may be OK. Graduate programmes are another area that you will need to look at. As a midwife in a rural setting (I can't tell you where in case big brother is watching) we currently have mid students and they get great experience with us because they are supernumary(?) but we are unable to take them as grads because we only have two on each shift. If they are allocated to a labouring woman there will not always be someone to assist them as much as they may need in the begining as the other sucker is caring for the ward full of medical/surgical/paediatric patients. For grads who have already been in unpaid education for three years to have to take an unpaid grad year is asking alot but that is what they may have to consider. Especially the first few years unless you can find some sympathetic employers. As for the ANF it belongs to the members and all those midwives who are members may like to have a say about this issue. The union was not happy about PCAs when they were first introduced but they can now become members of the ANF. So don't be discouraged by the fact that they, as representatives of all those nurses who don't see midwifery as a seperate entity from nursing, aren't celebrating the introduction of direct entity. (You know those bloody midwives have always been up themselves sort of thing that nurses have been saying about midwives as long as I've been a midwife) I think this is an important move for midwifery and would like to see you go ahead with it, Andrea Quanchi -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. === From Cathy Bock and Nigel Duncan. at BIRTHING HANDS (Homebirth, ante/post natal care and hospital support) [EMAIL PROTECTED] 0414 886827 or 0414 554840 OR VISIT OUR WEBSITE ENTER FOLLOWING OR SEARCH FOR BIRTHING HANDS. http://www.homestead.com/birthinghands/BIRTHINGHANDS1.html __ Do You Yahoo!? Bid and sell for free at http://auctions.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
BEAUTIFUL BEAUTIFUL, WONDEROUS SOULS. HOMEBIRTH 1999.
=== From Cathy Bock and Nigel Duncan. at BIRTHING HANDS (Homebirth, ante/post natal care and hospital support) [EMAIL PROTECTED] 0414 886827 or 0414 554840 OR VISIT OUR WEBSITE ENTER FOLLOWING OR SEARCH FOR BIRTHING HANDS. http://www.homestead.com/birthinghands/BIRTHINGHANDS1.html __ Do You Yahoo!? Bid and sell for free at http://auctions.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
nigel and ineffectual ACMI
Dear Nigel, If you look at ACMI position statements, press releases, letters to politicians, etc, in fact any correspondence (action) it has engaged in at State and National level you will see that it does promote recognition of midwifery as distinct from nursing and distinct from medicine. As to ineffectual, prove it. Just because certain changes have not occurred, doesnt mean something is ineffectual. It just means the resistance is too strong. If all midwives were active members of ACMI, and if ALL WOMEN really did feel passionate and want what we say they want, and were willing and able to act, there would be no resistance at all. Now, are you a member of ACMI? Are you active at a local level? If not, become so. If you feel passionately, let your local rep/branch know and be prepared to act with them. A non-member cannot move anything. Now, as to having things in common...many issues we share with women have no relevance to nursing, but eschewing an alliance that has been productive, and that many, many midwives still cherish, even though it is not without its disadvantages would be foolhardy. Why cut our noses off to spite our faces??? (And see Nicky Leap's paper from the recent ACMI Conference for a rational and lively critique of the definition of a midwife in relation to nursing, so that rhetoric and rubric can be idnetified where it exists.) I say, make strategic alliances, whilst maintaining an identity, where and when they serve our best interests as a woman centred profession. After all most nurses (96%) are women and will need our services at some time. That doesn't mean we are to be nurses, just as electricians are not plumbers. But the electricians and plumbers will band together for the benefit of both trades. Interestingly, you have chosen for your metaphor the two trades within the building area that have achieved a high degree of occupational closure (separate identity enshrined in law)!!! And yet this is precisely what many criticise midwifery (through ACMI) of trying to perpetuate. That's all for now. Trish -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
BEAUTIFUL BEAUTIFUL, WONDEROUS SOULS. HOMEBIRTH 1999.
Dear all, Cathy and I want to thank everyone involved in the birth of such a wonderful conference. But it as more of a conference it was more than our dreams. To unite and yet respect diversity!! I began to believe there was no passion in midwifery, that the art had died at the hands of science and the monster of Frankenstein as pitiful as it was, was allowed to reign. Thank you for re-igniting a passion a belief in the spirituality, in the understanding of the existance of more than flesh and blood. For re-juvenating and life enriching. I thank everyone there. I thank the people I wept with, laughed with and held. I give honour and respect to our shared lives and souls. I respect the honesty and opennesss of everyone. Thank you for realising there is a woman in every man and a man in every woman and it is this harmony that the truth lies. A POEM Cathedral window, shattered fragments to the ground, through centuries and years that have gone, no sound. each fragment giving a beautiful light each fragment shining so far and bright. Yet alone, a piece of glass, that told little tale. Discovered as hurtful, blinded eyes, so frail. The time is here to open voice, re-frame and unite. realise our heritage through enableing true sight. For no longer does then cathedral frame the window as before, but the window is the church every timber, foundation, and door. Sorry will send many more please visit us at our web pagtry typing birthinghands in your search engine or... http://homestead.com/birthinghands/BIRTHINGHANDS1.html we are currently adding our review of the conference pages.. love and love and love til it over flows... blessed be. nigel === From Cathy Bock and Nigel Duncan. at BIRTHING HANDS (Homebirth, ante/post natal care and hospital support) [EMAIL PROTECTED] 0414 886827 or 0414 554840 OR VISIT OUR WEBSITE ENTER FOLLOWING OR SEARCH FOR BIRTHING HANDS. http://www.homestead.com/birthinghands/BIRTHINGHANDS1.html __ Do You Yahoo!? Bid and sell for free at http://auctions.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
GST independent midwives
Some info on the GST for any midwives who have 'fee for service' clients. After speaking to a number of people at the Australian Tax Department (ATO), I have been told that we do not have to apply a GST to midwifery services as we are exempt under subsection 38B Health . However we can claim a credit on the items purchased or aquired for use in our business. These input tax credits can be claimed back on our business activity statement, a new form , which is lodged with the ATO monthly or quaterly. To do this we have to register and receive an A B N (australian business number). You can register for an ABN even if you do not have to register for GST because we are carrying on an enterprise. There is more info available at website taxreform.ato.gov.au under health, 38-10, other health services, 38-50 section 195-1 Annie Sprague RN RM MCH Independent Midwife 34 Shiers St. Alphington 3078 Melbourne Aust. Ph. (03) 94973625 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Thank you!
Hi Rebecca, thank you for your lovely comments. I am afraid we sometimes create heated debate but it is so nice to see you on the chat line, Before commencing in practice get in touch with your hopes and fears. Address your fears and embrace your hopes. If your fears revolve around anything physically or spiritually lacking correct this first. Network with local midwives and womens groups and send e-mails to the chat line. Willwrite more soon but have to go. Write through the chat line with specific questions / comments. And just know you are doing the right thing also get in touch with HOMEBIRTH Australia and JOIN!! Tell your Friends etc!! nigel --- [EMAIL PROTECTED] wrote: > Hi guys > > Just wanted to say that I really enjoy reading what > you have to say on > ozmid. I am a midwife in Canberra who has just left > the hospital system > because I felt like I was selling my soul - just > couldn't do it there > anymore. At the moment I am looking in to > commencing an indipendant > practice, just not sure where to begin. Any helpful > suggestions would be > gratefully received! > > Keep up the good work, and may I say it is nice to > see some independant > midwives out there who aren't forty plus and have > had at least 5 of their > own birth experiences (something that seems to be a > battle for me with my > [older] colleagues) > > Rebecca Davey > > > From Cathy Bock and Nigel Duncan.atBIRTHING HANDS (Homebirth, ante/post natal care and hospital support)[EMAIL PROTECTED]0414 886827 or 0414 554840OR VISIT OUR WEBSITE ENTER FOLLOWING OR SEARCH FOR BIRTHING HANDS.http://www.homestead.com/birthinghands/BIRTHINGHANDS1.html Do You Yahoo!?Bid and sell for free at Yahoo! Auctions. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: unions and midwifery
Hi Trish, re ANF and midwifery membership. We need to be aware that ANF has many midwives as members, this number is much greater number than the 3000 or so that are members of ACMI. ANF could assert representation of midwifery practitioners in Australia that would challange ACMI in that role. Can we sit at the table and work something out with ANF?? I would hesitate to be adversial. Also I would not cherish the thought of midwifery practitioners not being covered by an industrial body without clout in the health industry. Just some thoughts Irene Coonan Corporate Services Manager - Original Message - From: Trish David [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, September 13, 1999 9:10 AM Subject: unions and midwifery Dear Jen and others interested. If we midwives were to withdraw from ANF en masse and join another union, making a clear and loud statement that ANF did not represent midwives, then we would have stymied their attempts to silence us and keep us under the nursing umbrella. HACSU in Tasmania already has about a third of nurses (some of whom are midwives) in their union and ANF is forced to collaborate with them. Surely we could find another Australia wide health services union to take us in, especially since we have 72,000 registered midwives Australia wide. If only one quarter of these decided to make that statement, then ANF would be stuffed as far as making policy statements about midwives is concerned. Just a thought. Trish -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Unions, DE, defining midwifery
We are all passionate about midwifery or we would not be on this list. However, there is a place for some pragmatic approaches in negotiations - around developing woman-centred midwifery services and 'direct entry' midwifery education - and that's about being political. There are good political (and humane) reasons also to define midwifery in a way that does not alienate others, in particular nurses, who are also defining their profession in terms of holistic, wellness centred care and autonomous practice - and my paper in Hobart was all about defining midwifery as separate from nursing so I won't go on about it here. Lack of respect for colleagues (and I include midwifery colleagues on this list here) can be offensive and hurtful. We need to be aware of the language we use when expressing our passion for midwifery - the language of combat 'back fires'. In South Australia there is no union representing midwifery other than the ANF. As a non-nurse I have joined the ANF because I recognise that they are the only body at present who are in a position of power in terms of negotiating wages and conditions that will enable midwives to work in the public service providing continuity of care/carer. Clearly there needs to be new awards such as an annualised salary and the ANF are the only body that are in a position to do this on our behalf at the moment. People (myself included) use the term 'industrial' rather loosely. Perhaps we need to separate out from workplace agreements the industrial benefits of a professional body that provides free professional and legal advice and representation at meetings with management, Nurses Boards or law courts - particularly where there is a potential claim of professional misconduct. This aspect of the industrial arm of the Royal College of Midwives in the UK is what motivates the members (30,000) to join and pay considerable subscriptions (same story in NZ I think). Perhaps we (ACMI) should consider investing in a team of employed people to set up and run an industrial arm of the College, raise the fees and promote understanding of what is on offer - and then maybe we would get a membership that would pay for the infrastructure and personnel required to run a midwifery professional body with 'clout'. Cheers Nicky Nicky Leap, Senior Research Fellow, Midwifery The Flinders University of South Australia, GPO Box 2100, Adelaide, SA 5001 Tel: (08) 8201 3442 Fax: (08) 8201 3410 Home: 'Cennednyss', Summertown, SA 5141 Tel/Fax: (08) 8390 1069 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Unions, DE, defining midwifery
Great idea. Lets do it Irene This aspect of the industrial arm of the Royal College of Midwives in the UK is what motivates the members (30,000) to join and pay considerable subscriptions (same story in NZ I think). Perhaps we (ACMI) should consider investing in a team of employed people to set up and run an industrial arm of the College, raise the fees and promote understanding of what is on offer - and then maybe we would get a membership that would pay for the infrastructure and personnel required to run a midwifery professional body with 'clout'. Cheers Nicky Nicky Leap, Senior Research Fellow, Midwifery The Flinders University of South Australia, GPO Box 2100, Adelaide, SA 5001 Tel: (08) 8201 3442 Fax: (08) 8201 3410 Home: 'Cennednyss', Summertown, SA 5141 Tel/Fax: (08) 8390 1069 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
mainstream midwifery services
Dear Joy, Jan et al I think that everything would change very rapidly (as it did in NZ and Ontario) if there were a system that enabled midwives to have guarranteed health service per capita funding for being 'Lead Maternity Carers' (NZ term). I would favour some national maternity payment (if as Carol suggests we're going to have to wait as long as it would take to get a sorry out of Johnnie Howard to get provider numbers!) as in NZ and Ontario. A system where self employed midwives contract with individual health services on an annual basis is a vulnerable system. In the SE London Midwifery group practice the annual negotiations were a nightmare - each year they tried to stop our funding, as in Newcastle, not because they disapproved of our service (on the contrary), but because it was a convenient, discreet pool of money that could get axed - because ultimately it wasn't mainstream enough. The midwives are now 'The Albany Midwives' in new community premises sub-contracted to a hospital (Kings) working as part of the mainstream services on offer, alongside other midwifery group practices formed by employed midwives. I believe they have just negotiated the next 3 year contract for per capita payments for an agreed number of women. This model works well for this group of self employed midwives and it's a managers dream - no oncosts, overtime, penalties, sickness/maternity cover to worry about. However - it is not being replicated anywhere else in the UK as far as I know. It seems it's too big a leap to go self employed and negotiate sub contracts/contracts. So I end up thinking that here it has to be some radical overall national payment as in NZ to give many midwives the incentive to switch from employed to self-employed status. The New Zealanders describe this opportunity as being crucial to the development of 'autonomy' in terms of how midwives see themselves as practitioners and how they are able to engage in woman-centred practice. I believe we need to be making a clear proposal to Canberra for a committee to explore and develop a national maternity payment so that women can access free midwifery care (caseload practice). We should think BIG on this issue - a 10 year Vision - and 'seize the moment' in light of the Senate Inquiry. This might open up a debate - is true autonomy ever going to be possible within models where midwives are employed? I wonder what people out there think? Would Australian midwives embrace self employment if they could be guarranteed per capita government funding? Cheers Nicky Nicky Leap, Senior Research Fellow, Midwifery The Flinders University of South Australia, GPO Box 2100, Adelaide, SA 5001 Tel: (08) 8201 3442 Fax: (08) 8201 3410 Home: 'Cennednyss', Summertown, SA 5141 Tel/Fax: (08) 8390 1069 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Unions, DE, defining midwifery
Hi Nicky Just a word about the industrial situation in New Zealand. Currently the New Zealand College of Midwives does not have an industrial arm to argue for awards and conditions for hospital employed midwives. It does however have a large part to play in the negotiations at the Health funding agency and ministry of health levels on the fee structure for maternity care and all issues to do with self employed midwives who are half the midwives in the country. Therefore they do in effect have an 'industrial' role but not what Australians would view as 'industrial'. The college also offers free legal advice on all matters midwifery for both self employed and hospital employed midwives and student midwives who are members...which is something that ACMI could look at for a start. Most hospital employed midwives in New Zealand also belong to the New Zealand Nurses Organisation for industrial clout in negotiations with hospitals for wages and conditions. There is no reason why NZCOM could not be the negotiating body other than there are very few people employed at the national office and they would be run off their feet. They do however have a huge amount of skill in negotiating salary issues. ACMI would need to have the ability to employ skilled people to do this kind of work and that would mean paying higher fees for membership. Hospital employed midwives (in NZ) may also be employed on a salary without hours of work being stipulated (a variation to the collective nurses contract) and this was negotiated on their behalf by the Nurses Organisation. This is potentially open to abuse by employers however as the caseload is not attached to the salary and I am aware that the caseload varies around the country for hospital employed midwives working in continuity of care models...as does the salary. The Australian situation is very different to that of New Zealand and therefore unique strategies/solutions need to be developed. regards Maralyn At 01:22 PM 9/13/99 +0900, you wrote: We are all passionate about midwifery or we would not be on this list. However, there is a place for some pragmatic approaches in negotiations - around developing woman-centred midwifery services and 'direct entry' midwifery education - and that's about being political. There are good political (and humane) reasons also to define midwifery in a way that does not alienate others, in particular nurses, who are also defining their profession in terms of holistic, wellness centred care and autonomous practice - and my paper in Hobart was all about defining midwifery as separate from nursing so I won't go on about it here. Lack of respect for colleagues (and I include midwifery colleagues on this list here) can be offensive and hurtful. We need to be aware of the language we use when expressing our passion for midwifery - the language of combat 'back fires'. In South Australia there is no union representing midwifery other than the ANF. As a non-nurse I have joined the ANF because I recognise that they are the only body at present who are in a position of power in terms of negotiating wages and conditions that will enable midwives to work in the public service providing continuity of care/carer. Clearly there needs to be new awards such as an annualised salary and the ANF are the only body that are in a position to do this on our behalf at the moment. People (myself included) use the term 'industrial' rather loosely. Perhaps we need to separate out from workplace agreements the industrial benefits of a professional body that provides free professional and legal advice and representation at meetings with management, Nurses Boards or law courts - particularly where there is a potential claim of professional misconduct. This aspect of the industrial arm of the Royal College of Midwives in the UK is what motivates the members (30,000) to join and pay considerable subscriptions (same story in NZ I think). Perhaps we (ACMI) should consider investing in a team of employed people to set up and run an industrial arm of the College, raise the fees and promote understanding of what is on offer - and then maybe we would get a membership that would pay for the infrastructure and personnel required to run a midwifery professional body with 'clout'. Cheers Nicky Nicky Leap, Senior Research Fellow, Midwifery The Flinders University of South Australia, GPO Box 2100, Adelaide, SA 5001 Tel: (08) 8201 3442 Fax: (08) 8201 3410 Home: 'Cennednyss', Summertown, SA 5141 Tel/Fax: (08) 8390 1069 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: mainstream midwifery services
This might open up a debate - is true autonomy ever going to be possible within models where midwives are employed? I wonder what people out there think? Would Australian midwives embrace self employment if they could be guarranteed per capita government funding? Hi Nicky and all I agree that true autonomy is difficult within an employed midwife model if midwives believe the hospital has the authority to dictate their practice. But is true autonomy what midwives want There are many examples even in New Zealand where midwives are funded to be self employed autonomous midwives and still choose to work in shared care arrangments with general practitioners whom they call in to 'catch the baby'. I cannot understand why unless it is a transitional period where women are learning the value of the autonomous midwife and will eventually stop asking for both her midwife and doctor to be present...or whether midwives are finding their own feet and will eventually believe they have the skills to work autonomously and will stop asking for the doctor to be present. What do midwives truly want and believe? Do midwives want autonomy of practice? Do midwives believe they are capable of autonomous practice? What is so valuable about autonomy? Legally, midwives in Australia already have the ability to be autonomous practitioners. Where are you autonomous midwives??? autonomy/interdependent/collaborative/independent what does it all mean??? I'm enjoying the debate and ideas!! Cheers Maralyn -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
