Re: [ozmidwifery] Problems With new Models
I trust as well as hoping that each of you who would like to
work caseload one day are also involved with ACMI , or Maternity
Coalition activitiespushing politically to get 1-2-1 midwifery
on a local or state or national level or even at every level??
Denise Hynd
"Let us support one another, not just in philosophy but in
action, for the sake of freedom for all women to choose exactly how and by whom,
if by anyone, our bodies will be handled."
Linda Hes
- Original Message -
From:
Kim Stead
To: ozmidwifery@acegraphics.com.au
Sent: Sunday, June 26, 2005 6:06 PM
Subject: RE: [ozmidwifery] Problems With
new Models
Hi Robyn
If it weren't for the distance - I'd be in boots and all but
Warragul is about 1hr 15 from home - a little too far I think. I
live in hope that one day I'll be able to practice to my full potential
in my own area with support from other midwives and the hospital when
need be! Well done to all of you already living this dream and
those of you who have set up such programs!!!
Kiwi Kim
---Original
Message---
From: ozmidwifery@acegraphics.com.au
Date: 12/06/2005
7:27:38 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: RE:
[ozmidwifery] Problems With new Models
As you would
guess, I am totally supportive of what Robyn says. Cheers,
Mary
Murphy
From:
owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Robyn
ThompsonSent: Sunday,
12 June 2005 4:11 PMTo: 'Kim Stead'Cc: ozmidwifery@acegraphics.com.auSubject: FW: [ozmidwifery] Problems
With new Models
Hi
Kim
We havent
spoken for a while, when I read this message from Carol, I immediately
thought of you. Are you interested?
Carol it really
is sad that midwives see being on-call a problem. Being on-call
is much better than continuous shift work any time. I want to
allay midwives fears of being on-call. Many Australian midwives
like me are on call 24 hours, 7 days a week. We are not called out
all the time, we enjoy our lives and still manage to provide a wonderful
service for women. It wasnt until I took a break for 3 months in
USA, after 18 years of being
readily available for women, that I realised how much I did need a break. My
problem was that I made such a commitment that I forgot to plan regular
breaks. 3 months away gave me time to clear my head and from that
I learnt to reduce my workload and plan some breaks. I am still on-call
and enjoy the challenge of being there for women when they need my
services. Now I have more time to be proactive with midwifery
issues, have some time to travel, spend time with my grandchildren and
enjoy life in general.
For those who
feel concerned about the on-call hours, let me reassure you it is much
better when you are in a team or group practice, you can really
get yourselves well established with on-call work and still manage to
have a full life. A good cohesive team can work wonders together
and women enjoy the warmth of good team spirit.
This note is to
encourage midwives to have a go at being with women in one-to-one or
small team relationships, the personal and professional rewards are
amazing. I am at the far end of my wonderful career now, as I look
back I feel extremely happy and satisfied with the fact that I have been
on-call for hundreds of women over 20 years of service in the home,
and shift work in the hospital system 10 years prior to that. The
world, the planet and the universe is better off by far, for the
personalised care midwives provide women. My professional and life
experience is overwhelmingly wonderful because of these mothers, babies
and families, number 5 and 6 babies in some families, this makes on-call
easy in the big scheme of things.
Warm
regards, Robyn
-Original
Message-From:
owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Carol Van
LochemSent: Sunday, 12
June 2005 5:39 PMTo:
ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems
With new Models
Hi all, I
have posted here from time to time,
Re: [ozmidwifery] Problems with new models
Wellsaid Deborah. ---Original Message--- From: ozmidwifery@acegraphics.com.au Date: 16/06/2005 10:54:58 a.m. To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Problems with new models Hi All, This is my first post, I was drawn toyour discussion about Caseload Midwifery via the BMid Student Collective website.I am a 2nd year B.Mid (direct entry) student at ACU in Melbourne. I amONLY interested in working caseload and I know I can speak for a number of my student colleagues, also. You may have heard of our Follow Through Journey experiences, in which we work one to one with 30 women through their childbearing continuum, with guidance and support from a mentor. This is preparing us inall sorts ofways to work caseload or independently-it proves to all involved the value of continuity of carer to women and midwives.This monthI am on call to support 3 of my wonderful women in their births.I have known them and their partners since their first trimester.I simply take my mobile phone to bed with me and forget about it unless it rings. Antenatal and postnatalmeetings are flexible and in decent hours of the day. I also work part time, have 2 children and am fortunate to have a very supportive partner. I would not be interested in working professionally in any other model of care. In the hospital shift work I have donein placements I have feltfrustrateda lot of the time,I have not felt that I have been able toemploy evidence based practiceand I find constant early shifts unbearably disruptive to my family. I feel so lucky to have been educated in this model of care and hope that by the time many moreBMidders are in the workforce it will become a more commonplace way of working. I don't see suturing or any other clinical issues as a barrier. We are keen to learn and practice these skills in order to work as independent practitioners within a framework of a collaborative health profession. My best wishes to allmidwives and otherscurrently setting up caseload models in their units. Please keep up the great work.Lots ofBMiddersare dying tofill the vacancies as soon as we are able!!! Thanks for the discussion. Deborah Fox
RE: [ozmidwifery] Problems With new Models
Hi Robyn If it weren't for the distance - I'd be in boots and all but Warragul is about 1hr 15 from home - a little too far I think. I live in hope that one day I'll be able to practice to my full potential in my own area with support from other midwives and the hospital when need be! Well done to all of you already living this dream and those of you who have set up such programs!!! Kiwi Kim ---Original Message--- From: ozmidwifery@acegraphics.com.au Date: 12/06/2005 7:27:38 p.m. To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Problems With new Models As you would guess, I am totally supportive of what Robyn says. Cheers, Mary Murphy From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Robyn ThompsonSent: Sunday, 12 June 2005 4:11 PMTo: 'Kim Stead'Cc: ozmidwifery@acegraphics.com.auSubject: FW: [ozmidwifery] Problems With new Models Hi Kim We havent spoken for a while, when I read this message from Carol, I immediately thought of you. Are you interested? Carol it really is sad that midwives see being on-call a problem. Being on-call is much better than continuous shift work any time. I want to allay midwives fears of being on-call. Many Australian midwives like me are on call 24 hours, 7 days a week. We are not called out all the time, we enjoy our lives and still manage to provide a wonderful service for women. It wasnt until I took a break for 3 months in USA, after 18 years of being readily available for women, that I realised how much I did need a break. My problem was that I made such a commitment that I forgot to plan regular breaks. 3 months away gave me time to clear my head and from that I learnt to reduce my workload and plan some breaks. I am still on-call and enjoy the challenge of being there for women when they need my services. Now I have more time to be proactive with midwifery issues, have some time to travel, spend time with my grandchildren and enjoy life in general. For those who feel concerned about the on-call hours, let me reassure you it is much better when you are in a team or group practice, you can really get yourselves well established with on-call work and still manage to have a full life. A good cohesive team can work wonders together and women enjoy the warmth of good team spirit. This note is to encourage midwives to have a go at being with women in one-to-one or small team relationships, the personal and professional rewards are amazing. I am at the far end of my wonderful career now, as I look back I feel extremely happy and satisfied with the fact that I have been on-call for hundreds of women over 20 years of service in the home, and shift work in the hospital system 10 years prior to that. The world, the planet and the universe is better off by far, for the personalised care midwives provide women. My professional and life experience is overwhelmingly wonderful because of these mothers, babies and families, number 5 and 6 babies in some families, this makes on-call easy in the big scheme of things. Warm regards, Robyn -Original Message-From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Carol Van LochemSent: Sunday, 12 June 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caselo
RE: [ozmidwifery] Problems With new Models
Oh Carol That's so dissapointing to read!!! Personally, I'd love to work in your hospital and with your model of care but currently I commute from Maffra to LRH and find that distance plenty enough! It really is a worry like you say, that so much work has been done to lobby for this change, then to find that midwives areunable for whatever reasons.to commit or at least consider all the benefits ofcaseloadmodels and continuity of care! Iam sure it isfear of the unknown and fear that 'we'll have no life'! Coming from NZ, I knowhow rewarding this model of care is!!! Enough rambling! Hoping you find some interest soon! Kiwi Kim ---Original Message--- From: ozmidwifery@acegraphics.com.au Date: 21/06/2005 1:26:32 p.m. To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Problems With new Models Dear Carol, Congratulations on your and your colleagues achievement in offering continuity of care to women in Warragul. I am sorry to hear you're having trouble recruiting a replacement for your colleague.The College has a free section on our website for advertising vacant positions, and we also have an e-bulletin list that goes to more than 1,000 subscribers.I would be happy to advertise your position on both of these if you are still interested. I also wonder if you've considered contacting the universities in Victoria and elsewhere that are offering BMId programs.They may well be able to promote your service to recent graduates.There will also be new graduates emerging from the second intake of BMid students in only another 5 months - I'm sure you would be likely to attract some interest from one or more of such graduates (or students, if you have a capacity to wait). The College is also looking at ways at present that we can help to inform midwives about the benefits of working in the type of model you are providing.There seem to be a lot of fairly negative myths around about the realities of working this way which we are confident of being able to balance out with good information from midwives working this way already. The National Executive meeting in July will be considering some proposals in this area and I'll let you know after that.They won't provide an immediate solution to your problem, but they will at least help to address the bigger picture problem of encouraging and supporting more midwives to give caseload care a try, as you and your colleagues are doing. Kind regards and best wishes for your service, Barb. Dr Barbara Vernon Executive Officer Australian College of Midwives Ph +61 2 6230 7333 Mob 0438 855 529 'Midwifery: Pathways to Healthy Nations' 27th Congress of the International Confederation of Midwives Brisbane Convention Centre, 24-28 July 2005 www.midwives2005.com/index.shtml From: "Carol Van Lochem" [EMAIL PROTECTED] Date: 12 June 2005 5:39:20 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Problems With new Models Reply-To: ozmidwifery@acegraphics.com.au Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences?I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models
Hi Carol I will be free at the end of October and would be available to take up a position with your team if there is atill a vacancy then. If you want to talk further you can email me off list. [EMAIL PROTECTED] Alan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Carol Van LochemSent: Sunday, 12 June 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models
Dear Carol, Congratulations on your and your colleagues achievement in offering continuity of care to women in Warragul. I am sorry to hear you're having trouble recruiting a replacement for your colleague. The College has a free section on our website for advertising vacant positions, and we also have an e-bulletin list that goes to more than 1,000 subscribers. I would be happy to advertise your position on both of these if you are still interested. I also wonder if you've considered contacting the universities in Victoria and elsewhere that are offering BMId programs. They may well be able to promote your service to recent graduates. There will also be new graduates emerging from the second intake of BMid students in only another 5 months - I'm sure you would be likely to attract some interest from one or more of such graduates (or students, if you have a capacity to wait). The College is also looking at ways at present that we can help to inform midwives about the benefits of working in the type of model you are providing. There seem to be a lot of fairly negative myths around about the realities of working this way which we are confident of being able to balance out with good information from midwives working this way already. The National Executive meeting in July will be considering some proposals in this area and I'll let you know after that. They won't provide an immediate solution to your problem, but they will at least help to address the bigger picture problem of encouraging and supporting more midwives to give caseload care a try, as you and your colleagues are doing. Kind regards and best wishes for your service, Barb. Dr Barbara Vernon Executive Officer Australian College of Midwives Ph +61 2 6230 7333 Mob 0438 855 529 'Midwifery: Pathways to Healthy Nations' 27th Congress of the International Confederation of Midwives Brisbane Convention Centre, 24-28 July 2005 www.midwives2005.com/index.shtml From: Carol Van Lochem [EMAIL PROTECTED] Date: 12 June 2005 5:39:20 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Problems With new Models Reply-To: ozmidwifery@acegraphics.com.au Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. attachment: winmail.dat
Re: [ozmidwifery] Problems With new Models
Dear Barb, We are in the Alpine Shire, notheast Victoria. We are very near the snow (which is falling heavily at present) and we have beautiful mountains, trees, and rivers. We also have great cafes, wineries and lots of tourist accomodation etc. We comprise three small rural hospitals as a single organisation. We offer low-risk maternity care with the back up of our GP's, and we share high-risk care with the base hospitals of Wangaratta and Wodonga. Thank you for your offer of support - I will keep the list posted of our progress. Mary Doyle Alpine Health. - Original Message - From: Dr Barbara Vernon [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 16, 2005 4:54 PM Subject: RE: [ozmidwifery] Problems With new Models Dear Mary Congratulations on your funding. Whereabouts is your service? The College of Midwives would be happy to provide any assistance it can. Regards Barb. Dr Barbara Vernon Executive Officer Australian College of Midwives Ph +61 2 6230 7333 Mob 0438 855 529 'Midwifery: Pathways to Healthy Nations' 27th Congress of the International Confederation of Midwives Brisbane Convention Centre, 24-28 July 2005 www.midwives2005.com/index.shtml _ Begin forwarded message: From: Mary Doyle [EMAIL PROTECTED] Date: 15 June 2005 8:49:14 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Problems With new Models Reply-To: ozmidwifery@acegraphics.com.au Dear Andrea and others, We too have received funding for a great continuity of care model, despite small numbers of women. Negativity abounds however and many of our current midwives however are loathe to change their current ' 8 hour shift' status because 1) they have been doing it this way for 10 or 20 years, 2) they are not prepared to give up their lives for being 'on-call' 3) many are nearing retirement age (me included) 4) they are not confident in doing antenatal care5) (most importantly) They have never had the wonderful pleasure of doing true 'continuity of care'!!! We have yet to formally approach the recruitment of midwives for the team, and I see lots of head-bashing in the meantime. I will however continue to try for the sake of the mother and fathers to be, and for the midwives that will follow on in the future. They will learn that this is the only way to go, and 8 hour shifts in caring for women are long gone! Mary Doyle Alpine Health - Original Message - From: Melanie Jane Dunstan To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:59 PM Subject: Re: [ozmidwifery] Problems With new Models HI All Just on the topic of Midwifery Models of Care. Is there any other Hospitals in Victoria having trouble with implementation of the models that have received funding from DHS? Just would be interesting to know Regards Mel - Original Message - From: Andrea Bilcliff To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 9:06 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked both shiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible. And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now, the bulk of my work is 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend, (or anything else for that matter) I just don't schedule appointments for that day. Occasionally I work on weekends or evenings as the need arises. The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month. Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul consider mentoring graduated B Mid postgrad dips in the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you
RE: [ozmidwifery] Problems With new Models
Dear Mary Congratulations on your funding. Whereabouts is your service? The College of Midwives would be happy to provide any assistance it can. Regards Barb. Dr Barbara Vernon Executive Officer Australian College of Midwives Ph +61 2 6230 7333 Mob 0438 855 529 'Midwifery: Pathways to Healthy Nations' 27th Congress of the International Confederation of Midwives Brisbane Convention Centre, 24-28 July 2005 www.midwives2005.com/index.shtml _ Begin forwarded message: From: Mary Doyle [EMAIL PROTECTED] Date: 15 June 2005 8:49:14 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Problems With new Models Reply-To: ozmidwifery@acegraphics.com.au Dear Andrea and others, We too have received funding for a great continuity of care model, despite small numbers of women. Negativity abounds however and many of our current midwives however are loathe to change their current ' 8 hour shift' status because 1) they have been doing it this way for 10 or 20 years, 2) they are not prepared to give up their lives for being 'on-call' 3) many are nearing retirement age (me included) 4) they are not confident in doing antenatal care5) (most importantly) They have never had the wonderful pleasure of doing true 'continuity of care'!!! We have yet to formally approach the recruitment of midwives for the team, and I see lots of head-bashing in the meantime. I will however continue to try for the sake of the mother and fathers to be, and for the midwives that will follow on in the future. They will learn that this is the only way to go, and 8 hour shifts in caring for women are long gone! Mary Doyle Alpine Health - Original Message - From: Melanie Jane Dunstan To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:59 PM Subject: Re: [ozmidwifery] Problems With new Models HI All Just on the topic of Midwifery Models of Care. Is there any other Hospitals in Victoria having trouble with implementation of the models that have received funding from DHS? Just would be interesting to know Regards Mel - Original Message - From: Andrea Bilcliff To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 9:06 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked both shiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible. And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now, the bulk of my work is 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend, (or anything else for that matter) I just don't schedule appointments for that day. Occasionally I work on weekends or evenings as the need arises. The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month. Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul consider mentoring graduated B Mid postgrad dips in the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you Carol, Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own
Re: [ozmidwifery] Problems With new Models
Carol Your description does sound attractive Where have you advertised??Would you be prepared to preceptor new BMid student's I would think they more than most are looking for caseload opportunity Especially in such a location?? Ryde which hasRyde Midwifery Group Practice like the one in Adelaide at the Women's and Children's Hospital is in a capital city Ryde Soldier's Hospital where the MGP is located is a west-North suburb of Sydney near Denistone railway station. As I said I would be comparing notes with manager's of the few other Australian caseload locations (Ryde, WCHS ) to see if you can borrow management, retention/recruitmentideas to solve your difficulty. Have you discussed this situation with the Barb Vernon at ACMI to see if they can help recruit midwives for you through their journal or newsletter?? Denise Hynd "Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled." ? Linda Hes - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 8:46 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Denise, No I haven't spoken to Ryde. Are they in W.A.? Warragul is 1 hour East of Melbourne. It is beautiful dairy country with rolling hills. It is 1 hour from the beach 1 hour from Mount Baw Baw if you're into skiing. Doesn't it just want to make you live here?;)) CarolFrom: "Denise Hynd" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Problems With new ModelsDate: Tue, 14 Jun 2005 17:23:32 +0800Dear CarolHave you compared notes with the managers of RydeAs I spoke to several midwives ther and they have no problems recruiting??Could it be a reflection of your location as I do not know where Warragul isPersonally I want to go back to case load midwifery but I want to stay here in Perth to do it so am working for change here!!If it looks a no goer Imight think of going where I have family in Adelaide Sydney or go to NZ for a complete change ?Denise Hynd"Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled."- Linda Hes-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message.Checked by AVG Anti-Virus.Version: 7.0.323 / Virus Database: 267.7.3/15 - Release Date: 14/06/2005
Re: [ozmidwifery] Problems With new Models - perineal suturing
Like Andrea Q, I have also attended several workshops (and will continue to) but have never had the opportunity to suture. There just hasn't been the need either. I too discuss this with the women antenatally. I explain that if there is a tear that is small sits together well, it will most likely heal well. If there was anything more complicated than that, then I would prefer someone who is suturing on a regular basis and far more skilled than me to do it. The women are generally happy with this. A recent woman who birthed very quickly before I got there sustained a second degree tear. She chose not to be sutured but the next day agreed to a visit with a local friendly GP/Ob because I really wanted a second 'expert' opinion, just to be sure. The GP/Ob said it would heal beautifully if left as it was. Suturing is a skill I really wish I had but I'm not sure how I will get the experience when most of the women I see don't need or choose not to be sutured. Andrea B -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models - perineal suturing
Thanks for your prompt replies Andreas x 2. I agree that not performing perineal suturing shouldn't hamstring provision of midwifery led care. I can however, imagine, some non-supportive doctors trying to say, well if you want to lead the care then you can't expect us to come and 'pick up the pieces' . This of course, isn't fair as doctors refer on to specialists, those things which are outside their skill level and it doesn't cause a problem. But it seems that when it is midwives negotiating with doctors the rules change. Thanks again for your thoughts Helen - Original Message - From: Andrea Bilcliff [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:23 PM Subject: Re: [ozmidwifery] Problems With new Models - perineal suturing Like Andrea Q, I have also attended several workshops (and will continue to) but have never had the opportunity to suture. There just hasn't been the need either. I too discuss this with the women antenatally. I explain that if there is a tear that is small sits together well, it will most likely heal well. If there was anything more complicated than that, then I would prefer someone who is suturing on a regular basis and far more skilled than me to do it. The women are generally happy with this. A recent woman who birthed very quickly before I got there sustained a second degree tear. She chose not to be sutured but the next day agreed to a visit with a local friendly GP/Ob because I really wanted a second 'expert' opinion, just to be sure. The GP/Ob said it would heal beautifully if left as it was. Suturing is a skill I really wish I had but I'm not sure how I will get the experience when most of the women I see don't need or choose not to be sutured. Andrea B -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1140 (20050614) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
HI All Just on the topic of Midwifery Models of Care. Is there any other Hospitals in Victoria having trouble with implementation of the models that have received funding from DHS? Just would be interesting to know Regards Mel - Original Message - From: Andrea Bilcliff To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 9:06 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked bothshiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible.And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now,the bulk of my workis 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend,(or anything else for that matter) I just don't schedule appointments for that day. Occasionally Iwork on weekends or evenings as the need arises.The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month.Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul considermentoringgraduated B Mid postgrad dipsin the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you Carol, Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models - perineal suturing
I do suturing that I feel comfortable with. In the past when I have not felt comfortable then I have asked a friendly GP/obs to help the women and they have. Love Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Dear Andrea and others, We too have received funding for a great continuity of care model, despite small numbers of women. Negativity abounds however and many of our current midwives however are loathe to change their current ' 8 hour shift' status because 1) they have been doing it this wayfor 10or 20 years,2) they are not prepared to give up their lives for being 'on-call' 3) many are nearing retirement age (me included) 4) they are not confident in doing antenatal care 5) (most importantly)They have never had the wonderful pleasure of doing true 'continuity of care'!!! We have yet to formally approach the recruitment of midwives for the team, and I see lots of head-bashing in the meantime. I will however continue to try for the sake of the mother and fathers to be, and for the midwives that will follow on in the future. They will learn that this is the only way to go, and 8 hour shifts in caring for women are long gone! Mary Doyle Alpine Health - Original Message - From: Melanie Jane Dunstan To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:59 PM Subject: Re: [ozmidwifery] Problems With new Models HI All Just on the topic of Midwifery Models of Care. Is there any other Hospitals in Victoria having trouble with implementation of the models that have received funding from DHS? Just would be interesting to know Regards Mel - Original Message - From: Andrea Bilcliff To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 9:06 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked bothshiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible.And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now,the bulk of my workis 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend,(or anything else for that matter) I just don't schedule appointments for that day. Occasionally Iwork on weekends or evenings as the need arises.The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month.Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul considermentoringgraduated B Mid postgrad dipsin the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you Carol, Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared
Re: [ozmidwifery] Problems With new Models - perineal suturing
From my experience doctors will do what they are paid to do and when women are admitted to public hospitals then in most if not all cases they are admitted under the care of a doctor who is paid for this. Therefore they need to be reminded of this and provide the service that needs to be provided whether that be assisting birth when needed or suturing Andrea Q On 15/06/2005, at 5:42 PM, Helen and Graham wrote: Thanks for your prompt replies Andreas x 2. I agree that not performing perineal suturing shouldn't hamstring provision of midwifery led care. I can however, imagine, some non-supportive doctors trying to say, well if you want to lead the care then you can't expect us to come and 'pick up the pieces' . This of course, isn't fair as doctors refer on to specialists, those things which are outside their skill level and it doesn't cause a problem. But it seems that when it is midwives negotiating with doctors the rules change. Thanks again for your thoughts Helen - Original Message - From: Andrea Bilcliff [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:23 PM Subject: Re: [ozmidwifery] Problems With new Models - perineal suturing Like Andrea Q, I have also attended several workshops (and will continue to) but have never had the opportunity to suture. There just hasn't been the need either. I too discuss this with the women antenatally. I explain that if there is a tear that is small sits together well, it will most likely heal well. If there was anything more complicated than that, then I would prefer someone who is suturing on a regular basis and far more skilled than me to do it. The women are generally happy with this. A recent woman who birthed very quickly before I got there sustained a second degree tear. She chose not to be sutured but the next day agreed to a visit with a local friendly GP/Ob because I really wanted a second 'expert' opinion, just to be sure. The GP/Ob said it would heal beautifully if left as it was. Suturing is a skill I really wish I had but I'm not sure how I will get the experience when most of the women I see don't need or choose not to be sutured. Andrea B -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1140 (20050614) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- 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: [ozmidwifery] Problems With new Models
Hi Denise, No I haven't spoken to Ryde. Are they in W.A.? Warragul is 1 hour East of Melbourne. It is beautiful dairy country with rolling hills. It is 1 hour from the beach 1 hour from Mount Baw Baw if you're into skiing. Doesn't it just want to make you live here?;)) CarolFrom: "Denise Hynd" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Problems With new ModelsDate: Tue, 14 Jun 2005 17:23:32 +0800Dear CarolHave you compared notes with the managers of RydeAs I spoke to several midwives ther and they have no problems recruiting??Could it be a reflection of your location as I do not know where Warragul isPersonally I want to go back to case load midwifery but I want to stay here in Perth to do it so am working for change here!!If it looks a no goer Imight think of going where I have family in Adelaide Sydney or go to NZ for a complete change ?Denise Hynd"Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled."- Linda Hes -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Hi Andrea, Thanks for the 'hug' :0 We would not rule out B Mids post grad dips if they were interested. CarolFrom: "Andrea Bilcliff" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Problems With new ModelsDate: Tue, 14 Jun 2005 21:06:16 +1000Hi Carol,I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!)I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked both shiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible. And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now, the bulk of my work is 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend, (or anything else for that matter) I just don't schedule appointments for that day. Occasionally I work on weekends or evenings as the need arises. The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month. Often I don't. My children are getting that bit older now and it's getting even easier.I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!!Would Warragul consider mentoring graduated B Mid postgrad dips in the program? I wonder if it is the location that is a problem too?Sending you some cyberhugs as I can imagine how frustrating this is for you Carol,Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker.I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences?I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Mary can please email me off the list at [EMAIL PROTECTED] Thanks - Original Message - From: Mary Doyle To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 8:49 PM Subject: Re: [ozmidwifery] Problems With new Models Dear Andrea and others, We too have received funding for a great continuity of care model, despite small numbers of women. Negativity abounds however and many of our current midwives however are loathe to change their current ' 8 hour shift' status because 1) they have been doing it this wayfor 10or 20 years,2) they are not prepared to give up their lives for being 'on-call' 3) many are nearing retirement age (me included) 4) they are not confident in doing antenatal care 5) (most importantly)They have never had the wonderful pleasure of doing true 'continuity of care'!!! We have yet to formally approach the recruitment of midwives for the team, and I see lots of head-bashing in the meantime. I will however continue to try for the sake of the mother and fathers to be, and for the midwives that will follow on in the future. They will learn that this is the only way to go, and 8 hour shifts in caring for women are long gone! Mary Doyle Alpine Health - Original Message - From: Melanie Jane Dunstan To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 4:59 PM Subject: Re: [ozmidwifery] Problems With new Models HI All Just on the topic of Midwifery Models of Care. Is there any other Hospitals in Victoria having trouble with implementation of the models that have received funding from DHS? Just would be interesting to know Regards Mel - Original Message - From: Andrea Bilcliff To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 9:06 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked bothshiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible.And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now,the bulk of my workis 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend,(or anything else for that matter) I just don't schedule appointments for that day. Occasionally Iwork on weekends or evenings as the need arises.The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month.Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul considermentoringgraduated B Mid postgrad dipsin the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you Carol, Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". A
[ozmidwifery] Problems with new models
Hi All, This is my first post, I was drawn toyour discussion about Caseload Midwifery via the BMid Student Collective website.I am a 2nd year B.Mid (direct entry) student at ACU in Melbourne. I amONLY interested in working caseload and I know I can speak for a number of my student colleagues, also. You may have heard of our Follow Through Journey experiences, in which we work one to one with 30 women through their childbearing continuum, with guidance and support from a mentor. This is preparing us inall sorts ofways to work caseload or independently-it proves to all involved the value of continuity of carer to women and midwives.This monthI am on call to support 3 of my wonderful women in their births.I have known them and their partners since their first trimester.I simply take my mobile phone to bed with me and forget about it unless it rings. Antenatal and postnatalmeetings are flexible and in decent hours of the day. I also work part time, have 2 children and am fortunate to have a very supportive partner. I would not be interested in working professionally in any other model of care. In the hospital shift work I have donein placements I have feltfrustrateda lot of the time,I have not felt that I have been able toemploy evidence based practiceand I find constant early shifts unbearably disruptive to my family. I feel so lucky to have been educated in this model of care and hope that by the time many moreBMidders are in the workforce it will become a more commonplace way of working. I don't see suturing or any other clinical issues as a barrier. We are keen to learn and practice these skills in order to work as independent practitioners within a framework of a collaborative health profession. My best wishes to allmidwives and otherscurrently setting up caseload models in their units. Please keep up the great work.Lots ofBMiddersare dying tofill the vacancies as soon as we are able!!! Thanks for the discussion. Deborah Fox
Re: [ozmidwifery] Problems With new Models
Hi Andrea, The reason we have this model is because there were only 2 of us willing to do straight case load. I thought that as midwives began to develop a relationship with thier named women that they would be happier with being called in...this is not the case for everyone though it seems. I think the demands of home life add an extra dimension to the directions in which women's lives are pulled. If midwives are met with the comment "Are you going to work again" from thier partner or children it adds a level of guilt which makes it more difficult for them to go out when called. Our model is actually quite flexible, in that we are able to provide one-to-one care to women who require or desire it. However only 2 of us offer this level of care. It is kind of difficult to describe our model, as we've recently made some changes to try to keep the team happy. We may have to tinker with it further if we get no applicants, but we'll see. (How about you Andrea...heehee). I guess having more flexible working arrangements is more difficult for some people to get used to, and it certainly seems to me that it is an individual thing. My main concern is for midwifery generally if we are going to "sell" this type of model to our collegues around the state of Vic. and hopefully the nation itself. These are some of the problems we are experiencing here that I did not expect. Thanks for taking the time to reply Regards Carol From: Andrea Quanchi [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Problems With new ModelsDate: Mon, 13 Jun 2005 09:48:25 +1000Maybe you need to re look at your definition of continuity, It appears to me that what you are trying to sell to people is a type of team midwifery that you have modified to your own needs and as you are finding out team midwifery is not as easy to sell.The best part about true caseloading is that you are on call for women that you know and therefore are prepared to do it because you have developed a relationship with the woman and want to be there. Being on call for an organisation / hospitalis a drag as anyone who had done it knows. You try to carry on your life but in the back of your mind is this thing that looms over you.On the other hand being on call for 'your' women is completely the opposite. They know me. The know what committments I have that are important to me (because I tell them) and together we seem to manage to co ordinate the whole thing without me or my family feeling like it is infringing on our lives.The other big advantage of changing to true caseloading is that you can sell midwives the idea of trying it in a proportion that suits their lives.Somemidwives could take on a smaller number of women that would limit the number of times they will be called in. For example if you only have two women a month and partner with someone else who has two women a month then worse case scenario you will be called in four times in the month(if your partner was unavailable when both her women were in labour) but more likely only twice (for your own women). All you other work will be on days and times you decide to do it.Trying a small number is less scary and the satisfaction is such that they will soon be asking for more women each month.Ask someone who is doing it already to come and have a social interaction with the group and sell it for you.Would be worth the trouble as an situation they can think of will have been encountered and handled before.Andrea Quanchi -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Would love to come and work but the tyranny of distance may prove a problem. My husband and I both work shift work and our kids have never known any different. Every day they ask who is going to be home tonight and I worked out long ago that they were not asking because they were complaining but just sorting out in their minds what today would be. I agree that to some ( who havent tried it) the concept of being on call all the time seems over whelming but the professional satisfaction of being with a woman whom you have got to know (rather than one who has seen someone else and just ends up with you through pot luck) is such that it more than makes up for any inconvenience. When Mum is happy and satisfied then the whole family will benefit in the long run. Andrea On 14/06/2005, at 5:18 PM, Carol Van Lochem wrote: Hi Andrea, The reason we have this model is because there were only 2 of us willing to do straight case load. I thought that as midwives began to develop a relationship with thier named women that they would be happier with being called in...this is not the case for everyone though it seems. I think the demands of home life add an extra dimension to the directions in which women's lives are pulled. If midwives are met with the comment Are you going to work again from thier partner or children it adds a level of guilt which makes it more difficult for them to go out when called. Our model is actually quite flexible, in that we are able to provide one-to-one care to women who require or desire it. However only 2 of us offer this level of care. It is kind of difficult to describe our model, as we've recently made some changes to try to keep the team happy. We may have to tinker with it further if we get no applicants, but we'll see. (How about you Andrea...heehee). I guess having more flexible working arrangements is more difficult for some people to get used to, and it certainly seems to me that it is an individual thing. My main concern is for midwifery generally if we are going to sell this type of model to our collegues around the state of Vic. and hopefully the nation itself. These are some of the problems we are experiencing here that I did not expect. Thanks for taking the time to reply Regards Carol From: Andrea Quanchi [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Problems With new Models Date: Mon, 13 Jun 2005 09:48:25 +1000 Maybe you need to re look at your definition of continuity, It appears to me that what you are trying to sell to people is a type of team midwifery that you have modified to your own needs and as you are finding out team midwifery is not as easy to sell. The best part about true caseloading is that you are on call for women that you know and therefore are prepared to do it because you have developed a relationship with the woman and want to be there. Being on call for an organisation / hospital is a drag as anyone who had done it knows. You try to carry on your life but in the back of your mind is this thing that looms over you. On the other hand being on call for 'your' women is completely the opposite. They know me. The know what committments I have that are important to me (because I tell them) and together we seem to manage to co ordinate the whole thing without me or my family feeling like it is infringing on our lives. The other big advantage of changing to true caseloading is that you can sell midwives the idea of trying it in a proportion that suits their lives. Some midwives could take on a smaller number of women that would limit the number of times they will be called in. For example if you only have two women a month and partner with someone else who has two women a month then worse case scenario you will be called in four times in the month(if your partner was unavailable when both her women were in labour) but more likely only twice (for your own women). All you other work will be on days and times you decide to do it. Trying a small number is less scary and the satisfaction is such that they will soon be asking for more women each month. Ask someone who is doing it already to come and have a social interaction with the group and sell it for you. Would be worth the trouble as an situation they can think of will have been encountered and handled before. Andrea Quanchi -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models
Title: Message 60 women is not feasible at all! As an experienced caseloader that would take an enormous effort and would not be sustainable. A midwife on another list who has also been discussing this theme wrote: Part of the reason for burn out however, is due to hospital managements putting undue institutional requirements on the midwives - making them come in to do shift work when they do not have a birth due, etc. Because of the nature of the work midwives need to be able to schedule their own appointments and take care of their own work in their own time if caseload is to be effective and successful. Therefore it requires full cooperation and support of administration and management. This freedom to work at ones own pace and to schedule work when it suits the midwife is imperative to the success of the model. If one has 4 women per month, then one can only be called out 4 times/month. If one month has 5, then the other month will only have 3. Caroline Flints work is brilliant in explaining this. She advises to schedule all ones own important dates in and then work around that. It works for many of us. Cheers, MM I am wondering how feasiblea caseload is60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary womenand 40 shared women not be a more doable workload? I know this hasfinancial implications but down-sizing the model may increase its longevity.Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basicallytranslates tomidwives having greater control over their practice and time allocation.
Re: [ozmidwifery] Problems With new Models
Dear Carol Have you compared notes with the managers of Ryde As I spoke to several midwives ther and they have no problems recruiting??Could it be a reflection of your location as I do not know where Warragul is PersonallyI want to go back to case load midwifery but I want to stay here in Perth to do it so am working for change here!! If it looks a no goer I might think of going where I have family in Adelaide Sydney or go to NZ for a complete change ? Denise Hynd "Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled." Linda Hes - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 3:18 PM Subject: Re: [ozmidwifery] Problems With new Models Hi Andrea, The reason we have this model is because there were only 2 of us willing to do straight case load. I thought that as midwives began to develop a relationship with thier named women that they would be happier with being called in...this is not the case for everyone though it seems. I think the demands of home life add an extra dimension to the directions in which women's lives are pulled. If midwives are met with the comment "Are you going to work again" from thier partner or children it adds a level of guilt which makes it more difficult for them to go out when called. Our model is actually quite flexible, in that we are able to provide one-to-one care to women who require or desire it. However only 2 of us offer this level of care. It is kind of difficult to describe our model, as we've recently made some changes to try to keep the team happy. We may have to tinker with it further if we get no applicants, but we'll see. (How about you Andrea...heehee). I guess having more flexible working arrangements is more difficult for some people to get used to, and it certainly seems to me that it is an individual thing. My main concern is for midwifery generally if we are going to "sell" this type of model to our collegues around the state of Vic. and hopefully the nation itself. These are some of the problems we are experiencing here that I did not expect. Thanks for taking the time to reply Regards Carol From: Andrea Quanchi [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Problems With new ModelsDate: Mon, 13 Jun 2005 09:48:25 +1000Maybe you need to re look at your definition of continuity, It appears to me that what you are trying to sell to people is a type of team midwifery that you have modified to your own needs and as you are finding out team midwifery is not as easy to sell.The best part about true caseloading is that you are on call for women that you know and therefore are prepared to do it because you have developed a relationship with the woman and want to be there. Being on call for an organisation / hospitalis a drag as anyone who had done it knows. You try to carry on your life but in the back of your mind is this thing that looms over you.On the other hand being on call for 'your' women is completely the opposite. They know me. The know what committments I have that are important to me (because I tell them) and together we seem to manage to co ordinate the whole thing without me or my family feeling like it is infringing on our lives.The other big advantage of changing to true caseloading is that you can sell midwives the idea of trying it in a proportion that suits their lives.Somemidwives could take on a smaller number of women that would limit the number of times they will be called in. For example if you only have two women a month and partner with someone else who has two women a month then worse case scenario you will be called in four times in the month(if your partner was unavailable when both her women were in labour) but more likely only twice (for your own women). All you other work will be on days and times you decide to do it.Trying a small number is less scary and the satisfaction is such that they will soon be asking for more women each month.Ask someone who is doing it already to come and have a social interaction with the group and sell it for you.Would be worth the trouble as an situation they can think of will have been encountered and handled before.Andrea Quanchi-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message.Checked by AVG Anti-Virus.Version: 7.0.323 / Virus Database: 267.6.9 - Release Date: 11/06/2005
Re: [ozmidwifery] Problems With new Models
Hi Carol, I find this very sad too. You are in the unique wonderful position of having both the funding obstetric support. What a pity there's no midwifery interest. One night and one weekend a month is not much to be on call really. (I would love to be in a group practice where I could have one weekend OFF call a month!!!) I understand that not all midwives are able or willing to work in this way but I have to say that as a single mum having worked bothshiftwork and caseload, caseload is by far more family friendly for me. I don't have the back up of a partner/husband for childcare. Trying to work 2 weeks of night duty in every 6 was impossible.And how could I get my children to school if I worked earlies, who would pick them up and feed them after school if I worked lates? A run of late/earlies would leave me exhausted cranky. I often got sick. Now,the bulk of my workis 9am - 3pm, M-F. If a conference or study day is coming up that I want to attend,(or anything else for that matter) I just don't schedule appointments for that day. Occasionally Iwork on weekends or evenings as the need arises.The maximum number of times I would be called out in any month would be 4 if I had a 'full load' for that month.Often I don't. My children are getting that bit older now and it's getting even easier. I get excited when the woman or her partner calls to tell me they are in labour! I used to drag myself into hospital for each shift before. I can't even begin to articulate just how rewarding it is to work with women their families from pregnancy through to 6 weeks. And then when they come back for baby no 2 3...!!! Would Warragul considermentoringgraduated B Mid postgrad dipsin the program? I wonder if it is the location that is a problem too? Sending you some cyberhugs as I can imagine how frustrating this is for you Carol, Andrea Bilcliff - Original Message - From: Carol Van Lochem To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 12, 2005 5:39 PM Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
No, this is the maximum number of women they feel, a midwife doing 'caseload' can effectively care for. Sally - Original Message - From: Jennifairy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 12:38 PM Subject: Re: [ozmidwifery] Problems With new Models Sorry Sally, I dont know what you mean by this... do you mean that the ANF specify this number as constituting a 'caseload', anything under that is not? cheers jennifairy sally williams wrote: The ANF specifies 40-45 woman only for a 'caseload'. Sally - Original Message - *From:* Jackie Doolan mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Tuesday, June 14, 2005 10:54 AM *Subject:* RE: [ozmidwifery] Problems With new Models Carol, I am wondering how feasible a caseload is 60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary women and 40 shared women not be a more doable workload? I know this has financial implications but down-sizing the model may increase its longevity. Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basically translates to midwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message- *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *Carol Van Lochem *Sent:* Sunday, June 12, 2005 5:39 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- 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: [ozmidwifery] Problems With new Models
I agree with Mary that 60 women per month is not feasible as a caseload. I am also experienced working in this model. Here in Manitoba we are expected to carry at least 30 women per year. This lower number was set to compensate for the fact that we are to target women who might most benefit from care. These women often have higher psychosocial needs. I too much prefer knowing women and feel less stressed about being called out for known women who I expect to follow through the whole childbearing experience. However, in our situation as primary care providers, we may be called out more than just for births. We are often paged to respond to decreased fetal movement, bleeding, abdominal pain - the list goes on and on. So it is important to remember that you may not just be called for births but for a myriad of other issues that need to be triaged or dealt with right away. Meaghan in Canada At 04:07 AM 6/14/05, you wrote: 60 women is not feasible at all! As an experienced caseloader that would take an enormous effort and would not be sustainable. A midwife on another list who has also been discussing this theme wrote: Part of the reason for burn out however, is due to hospital managements putting undue institutional requirements on the midwives - making them come in to do shift work when they do not have a birth due, etc. Because of the nature of the work midwives need to be able to schedule their own appointments and take care of their own work in their own time if caseload is to be effective and successful. Therefore it requires full cooperation and support of administration and management. This freedom to work at ones own pace and to schedule work when it suits the midwife is imperative to the success of the model. If one has 4 women per month, then one can only be called out 4 times/month. If one month has 5, then the other month will only have 3. Caroline Flints work is brilliant in explaining this. She advises to schedule all ones own important dates in and then work around that. It works for many of us. Cheers, MM I am wondering how feasible a caseload is 60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary women and 40 shared women not be a more doable workload? I know this has financial implications but down-sizing the model may increase its longevity. Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basically translates to midwives having greater control over their practice and time allocation. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models
I have read that around 40 is reasonable caseload. But if there is a lot of traveling in the particular area then it needs to be less. I think that 30-34 is probably about right for me with a mix of local women and women who may be 30-40 minutes away. I do almost all antenatal visits at the women's homes. If that is the model then certainly a few less than 40 is important. The postnatal daily visits are what really make me busy. If I have several women birthing close together and they are not close by then it can take me half the day every day for a while to visit. Having said this. Generally I work 9-3 m-f with only births and the odd postnatal out of these hours. I like to be home for my children and my clients know this and support me. Love Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models - perineal suturing
I have a more general question about caseload midwifery and midwifery led care. Do all of you who work in team caseload, midwifery led situations, perform the perineal suturing yourselves when it is required? Does this need to be a prerequisite for working in a midwifery led care situation? I have just been discussing this with someone who believes that to provide a midwifery led you all need to be able to suture perineums. This goal is obviously the ideal, but shouldn't, in my opinion, stop midwives providing the majority of antenatal care/assessment in the mean time until everyone is up to speed. Interested in your thoughts on the subject. Helen Cahill - Original Message - From: Sally Westbury [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 9:44 AM Subject: RE: [ozmidwifery] Problems With new Models I have read that around 40 is reasonable caseload. But if there is a lot of traveling in the particular area then it needs to be less. I think that 30-34 is probably about right for me with a mix of local women and women who may be 30-40 minutes away. I do almost all antenatal visits at the women's homes. If that is the model then certainly a few less than 40 is important. The postnatal daily visits are what really make me busy. If I have several women birthing close together and they are not close by then it can take me half the day every day for a while to visit. Having said this. Generally I work 9-3 m-f with only births and the odd postnatal out of these hours. I like to be home for my children and my clients know this and support me. Love Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1140 (20050614) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models - perineal suturing
Surely no one would let the fact that they have never learnt to do perineal suturing stop them from having a caseload. That has to be clutching at straws for an excuse because they dont want to do it. I have never worked in a hospital environment where midwives have performed suturing. I have several times done perineal suturing workshops and spent twenty years watching it done but have never had the opportunity to do it myself. When I went into private practice I obviously needed to consider this and so made arrangements with a GP here that if a woman had a tear at home that I thought was beyond my comfort zone then the woman only needed to come to the hospital and he would come in and see her and she could go home again. I explain this to the women during the antenatal period. To date I still havent sutured a peri. Havent had a tear that needed suturing ( and this seems to be a comfort to the women knowing this?). My last birth the woman had a labial lac that was bleeding enough to be a problem and so put in my first stitch ever. Happy not to be an expert but in no way feel it compromises my ability to have a caseload. Andrea Q On 15/06/2005, at 12:16 PM, Helen and Graham wrote: I have a more general question about caseload midwifery and midwifery led care. Do all of you who work in team caseload, midwifery led situations, perform the perineal suturing yourselves when it is required? Does this need to be a prerequisite for working in a midwifery led care situation? I have just been discussing this with someone who believes that to provide a midwifery led you all need to be able to suture perineums. This goal is obviously the ideal, but shouldn't, in my opinion, stop midwives providing the majority of antenatal care/assessment in the mean time until everyone is up to speed. Interested in your thoughts on the subject. Helen Cahill - Original Message - From: Sally Westbury [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 15, 2005 9:44 AM Subject: RE: [ozmidwifery] Problems With new Models I have read that around 40 is reasonable caseload. But if there is a lot of traveling in the particular area then it needs to be less. I think that 30-34 is probably about right for me with a mix of local women and women who may be 30-40 minutes away. I do almost all antenatal visits at the women's homes. If that is the model then certainly a few less than 40 is important. The postnatal daily visits are what really make me busy. If I have several women birthing close together and they are not close by then it can take me half the day every day for a while to visit. Having said this. Generally I work 9-3 m-f with only births and the odd postnatal out of these hours. I like to be home for my children and my clients know this and support me. Love Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1140 (20050614) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- 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: [ozmidwifery] Problems With new Models
Title: Message Carol, I am wondering how feasiblea caseload is60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary womenand 40 shared women not be a more doable workload? I know this hasfinancial implications but down-sizing the model may increase its longevity.Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basicallytranslates tomidwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carol Van LochemSent: Sunday, June 12, 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Title: Message The ANF specifies 40-45 woman only for a 'caseload'. Sally - Original Message - From: Jackie Doolan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 10:54 AM Subject: RE: [ozmidwifery] Problems With new Models Carol, I am wondering how feasiblea caseload is60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary womenand 40 shared women not be a more doable workload? I know this hasfinancial implications but down-sizing the model may increase its longevity.Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basicallytranslates tomidwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carol Van LochemSent: Sunday, June 12, 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Problems With new Models
Sorry Sally, I dont know what you mean by this... do you mean that the ANF specify this number as constituting a 'caseload', anything under that is not? cheers jennifairy sally williams wrote: The ANF specifies 40-45 woman only for a 'caseload'. Sally - Original Message - *From:* Jackie Doolan mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Tuesday, June 14, 2005 10:54 AM *Subject:* RE: [ozmidwifery] Problems With new Models Carol, I am wondering how feasible a caseload is 60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary women and 40 shared women not be a more doable workload? I know this has financial implications but down-sizing the model may increase its longevity. Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basically translates to midwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message- *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *Carol Van Lochem *Sent:* Sunday, June 12, 2005 5:39 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Problems With new Models
Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
FW: [ozmidwifery] Problems With new Models
Hi Kim We havent spoken for a while, when I read this message from Carol, I immediately thought of you. Are you interested? Carol it really is sad that midwives see being on-call a problem. Being on-call is much better than continuous shift work any time. I want to allay midwives fears of being on-call. Many Australian midwives like me are on call 24 hours, 7 days a week. We are not called out all the time, we enjoy our lives and still manage to provide a wonderful service for women. It wasnt until I took a break for 3 months in USA, after 18 years of being readily available for women, that I realised how much I did need a break. My problem was that I made such a commitment that I forgot to plan regular breaks. 3 months away gave me time to clear my head and from that I learnt to reduce my workload and plan some breaks. I am still on-call and enjoy the challenge of being there for women when they need my services. Now I have more time to be proactive with midwifery issues, have some time to travel, spend time with my grandchildren and enjoy life in general. For those who feel concerned about the on-call hours, let me reassure you it is much better when you are in a team or group practice, you can really get yourselves well established with on-call work and still manage to have a full life. A good cohesive team can work wonders together and women enjoy the warmth of good team spirit. This note is to encourage midwives to have a go at being with women in one-to-one or small team relationships, the personal and professional rewards are amazing. I am at the far end of my wonderful career now, as I look back I feel extremely happy and satisfied with the fact that I have been on-call for hundreds of women over 20 years of service in the home, and shift work in the hospital system 10 years prior to that. The world, the planet and the universe is better off by far, for the personalised care midwives provide women. My professional and life experience is overwhelmingly wonderful because of these mothers, babies and families, number 5 and 6 babies in some families, this makes on-call easy in the big scheme of things. Warm regards, Robyn -Original Message- From: owner-ozmid[EMAIL PROTECTED] [mailto:owner-ozmid[EMAIL PROTECTED]] On Behalf Of Carol Van Lochem Sent: Sunday, 12 June 2005 5:39 PM To: ozmid[EMAIL PROTECTED] Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] Problems With new Models
As you would guess, I am totally supportive of what Robyn says. Cheers, Mary Murphy From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Robyn Thompson Sent: Sunday, 12 June 2005 4:11 PM To: 'Kim Stead' Cc: ozmidwifery@acegraphics.com.au Subject: FW: [ozmidwifery] Problems With new Models Hi Kim We havent spoken for a while, when I read this message from Carol, I immediately thought of you. Are you interested? Carol it really is sad that midwives see being on-call a problem. Being on-call is much better than continuous shift work any time. I want to allay midwives fears of being on-call. Many Australian midwives like me are on call 24 hours, 7 days a week. We are not called out all the time, we enjoy our lives and still manage to provide a wonderful service for women. It wasnt until I took a break for 3 months in USA, after 18 years of being readily available for women, that I realised how much I did need a break. My problem was that I made such a commitment that I forgot to plan regular breaks. 3 months away gave me time to clear my head and from that I learnt to reduce my workload and plan some breaks. I am still on-call and enjoy the challenge of being there for women when they need my services. Now I have more time to be proactive with midwifery issues, have some time to travel, spend time with my grandchildren and enjoy life in general. For those who feel concerned about the on-call hours, let me reassure you it is much better when you are in a team or group practice, you can really get yourselves well established with on-call work and still manage to have a full life. A good cohesive team can work wonders together and women enjoy the warmth of good team spirit. This note is to encourage midwives to have a go at being with women in one-to-one or small team relationships, the personal and professional rewards are amazing. I am at the far end of my wonderful career now, as I look back I feel extremely happy and satisfied with the fact that I have been on-call for hundreds of women over 20 years of service in the home, and shift work in the hospital system 10 years prior to that. The world, the planet and the universe is better off by far, for the personalised care midwives provide women. My professional and life experience is overwhelmingly wonderful because of these mothers, babies and families, number 5 and 6 babies in some families, this makes on-call easy in the big scheme of things. Warm regards, Robyn -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Carol Van Lochem Sent: Sunday, 12 June 2005 5:39 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: FW: [ozmidwifery] Problems With new Models
Hello Robyn Mary, Thanks for your responses. Prior to working on the team I provided one-to-one care for vbac women for a couple of years. I went on-call from 38 weeks until whenever they gave birth. At first I found it hard to relax when I knew someone was due soon. However I was fortunate in having friends who insisted on dragging me out to a movie or dinner regardless.and the phone didn't ring.Many a night's sleep was had without being woken in the wee hours and gradually I got used to it and forgot about it most of the time...until of course you did get called and had to quickly change your plans for THAT day. I learnt to just get on with things and actually expect NOT to get called in, although you know it could happen at any time. Working with a team is less demanding in comparison. Apart from being available during the day Monday-Friday, you have most weekends and evenings free of call.Some of the girls in the team are finding it hard to relax get on with thier time when they are on call and don't sleep well at night waiting for the phone to ring. As a result they are exhuasted even if they haven't been called out. I guess it's like is the glass half empty or half full...it depends on how you look at it. I don't know how you change people's perception though. I thought that given time they would get used to it in the same way that I did. However so far this has not been the case. I feel it is something that needs to be dealt with if we want these models of care to succeed. Regards CarolFrom: "Robyn Thompson" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: "'Kim Stead'" [EMAIL PROTECTED]CC: ozmidwifery@acegraphics.com.auSubject: FW: [ozmidwifery] Problems With new ModelsDate: Sun, 12 Jun 2005 18:11:11 +1000Hi KimWe haven't spoken for a while, when I read this message from Carol, Iimmediately thought of you.Are you interested?Carol it really is sad that midwives see being "on-call" a problem.Beingon-call is much better than continuous shift work any time.I want to allaymidwives fears of being on-call.Many Australian midwives like me are oncall 24 hours, 7 days a week.We are not called out all the time, we enjoyour lives and still manage to provide a wonderful service for women.Itwasn't until I took a break for 3 months in USA, after 18 years of beingreadily available for women, that I realised how much I did need a break.My problem was that I made such a commitment that I forgot to plan regularbreaks.3 months away gave me time to clear my head and from that I learntto reduce my workload and plan some breaks. I am still on-call and enjoy thechallenge of being there for women when they need my services.Now I havemore time to be proactive with midwifery issues, have some time to travel,spend time with my grandchildren and enjoy life in general.For those who feel concerned about the on-call hours, let me reassure you itis much betterwhen you are in a team or group practice, you can really getyourselves well established with on-call work and still manage to have afull life.A good cohesive team can work wonders together and women enjoythe warmth of good team spirit.This note is to encourage midwives to have a go at 'being with women' inone-to-one or small team relationships, the personal and professionalrewards are amazing.I am at the far end of my wonderful career now, as Ilook back I feel extremely happy and satisfied with the fact that I havebeen "on-call" for hundreds of women over 20 years of service in the home,and shift work in the hospital system 10 years prior to that.The world,the planet and the universe is better off by far, for the personalised caremidwives provide women.My professional and life experience isoverwhelmingly wonderful because of these mothers, babies and families,number 5 and 6 babies in some families, this makes on-call easy in the bigscheme of things.Warm regards, Robyn-Original Message-From: [EMAIL PROTECTED][mailto:[EMAIL PROTECTED] On Behalf Of Carol Van LochemSent: Sunday, 12 June 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new ModelsHi all, I have posted here from time to time, but mostly I'm a lurker.I work in a team midwifery model at Warragul, where we have lots ofmidwives who believe in continuity of care, support the women as central tothe whole prossess and have a supportive obstetrician to back us up. Ourproblem is in recruiting midwives to work in our model. Nobody wants to do"all that on call".They "want to have a life". After all these years offighting for this type of thing it seems there are not enough of us aroundto fill this role. Many support the model in principal, but don't see howthey can fit it into their own lives.Our team started just 12 months ago. It is a modified case load, with 1night per week on call, and 1 weekend a month. We are "available" for our"own" women during the day. We provide midwife led care for up to 60 lowrisk women per year, and shared care for up to a further
Re: [ozmidwifery] Problems With new Models
Maybe you need to re look at your definition of continuity, It appears to me that what you are trying to sell to people is a type of team midwifery that you have modified to your own needs and as you are finding out team midwifery is not as easy to sell. The best part about true caseloading is that you are on call for women that you know and therefore are prepared to do it because you have developed a relationship with the woman and want to be there. Being on call for an organisation / hospital is a drag as anyone who had done it knows. You try to carry on your life but in the back of your mind is this thing that looms over you. On the other hand being on call for 'your' women is completely the opposite. They know me. The know what committments I have that are important to me (because I tell them) and together we seem to manage to co ordinate the whole thing without me or my family feeling like it is infringing on our lives. The other big advantage of changing to true caseloading is that you can sell midwives the idea of trying it in a proportion that suits their lives. Some midwives could take on a smaller number of women that would limit the number of times they will be called in. For example if you only have two women a month and partner with someone else who has two women a month then worse case scenario you will be called in four times in the month(if your partner was unavailable when both her women were in labour) but more likely only twice (for your own women). All you other work will be on days and times you decide to do it. Trying a small number is less scary and the satisfaction is such that they will soon be asking for more women each month. Ask someone who is doing it already to come and have a social interaction with the group and sell it for you. Would be worth the trouble as an situation they can think of will have been encountered and handled before. Andrea Quanchi On 12/06/2005, at 5:39 PM, Carol Van Lochem wrote: Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
