Re: [ozmidwifery] independent midwifery/national standards

[Sue Cookson]

I was just wondering if there had been any responses to the discussion 
of national standards etc?? I haven't received anything at all,


Sue


An interesting discussion.
Brings me to the assignment I've just completed on the variation in 
education, regulation and registration of midwives and competency 
assessments that occur across our wide brown land.
And these will be the things that bring us to be either supportive or 
not of hospital birthing. South Australia maternity system is 
definitely much better organised and funded than the New South Wales 
one. Can't speak for any other. I've done clinical placements in both 
states and working in environments with new equipment, standard spa 
baths, and midwives who collectively practice evidence-based midwifery 
with supportive services is delightful compared with the other - 
outdated equipment, tired midwives and outdated policies and protocols.
I've also attended many years of homebirth and as Tania says, there is 
simply no comparison in experience or outcome when working with 
families you know and trust. I am still and alwys will be in awe of 
what midwives can do when working with women they don't know.
I always believe however that even when entering an institution that 
may be outdated and tired with the odds of normal birth against us, 
that my presence can always make a difference to a woman who has 
invited me to assist her. So I also offer hospital 'supports' because 
I believe and do make a difference.


The NSW area where I live and work has limited midwife antenatal 
clinics even, and midwifery group practices just don't exist. Birth 
practices are disjointed and outdated but they are changing and the 
last five births I attended in the capacity of a final year student 
were simply great within the limited scope of practice that exists in 
this neck of the woods.


I guess we can all try and see the good that each area/service/midwife 
can bring to the women we all serve and help to create change where 
needed.
Perhaps standardisation of education, registration and competency 
assessments through nationalising maternity service (like in NZ and 
other OECD countries) would be for the best for women and midwives - 
may create a more predictable, evidence based active group of 
committed midwives.

???

Sue




Absolutely agree Jo that it is the women who are perhaps at higher 
"risk"
that would most benefit from the continuity of care from a known 
midwife,
the outcomes at the Women's and Children's in Adelaide have clearly 
shown
that the women who are in high risk groups going through the MGP are 
having
better outcomes, less intervention and more normal births, than the 
low risk

women going through the medical model of care. Definitely food for
thought...goes to show that the research is indeed right.

I feel that it's the right place here to put in my 2c worth too, 
about IPM's
and homebirth. Please remember that IPM's, while at times appearing 
to be
superhuman - and I say that from my experience as a consumer of IPM 
care,
they are also human. Building up a rapport with a woman over the 
space of a
shift is indeed an art, and something I am amazed that my colleagues 
can do,
day in day out. Really knowing a woman, having a relationship with 
her and
her whole family that spans months, and sometimes years, having an 
emotional
investment in helping her to achieve the best birth possible, is 
something

that simply can't be compared with working on a shift by shift basis.
If you have never stood by, and watched a woman be lied to, or 
coerced with

untruths, or half truths, if you have never been treated appallingly by
those who are your equals, but feel you are beneath them, if you have 
never
seen the look of defeat in a woman's face as all the positive energy 
leaves
the room and someone calls her stupid and naïve for trying to have 
her baby
without intervention, then you have no idea about the pain that is 
felt, and
the helplessness, and even the feeling of betrayal you feel because 
you can
no longer protect or hold the space, for that woman. I have been in 
these

situations, and I can really understand why some midwives prefer not to
provide care to women choosing to birth in the hospital system. There 
is an

element of self preservation about it too, let's not forget that.
Sometimes, it's just too painful to go willingly and knowingly into a
situation that you know is not going to go the way the woman wants.
Transferring in for an obstetric need is of course, something completely
different...
And that's not to say that the care you provide Sharon, in the 
hospital in
which you work, is not the best you can do, with the circumstances 
you have.

What we all know is that it is not the best thing for all women, and
according to the research, it's actually not the best thing for most
women...just because it's all that's on offer doesn't mean we 
shouldn’t be

looking to improve it, and one midwife one woman care is just the
begi

[ozmidwifery] independent midwifery/national standards

[Sue Cookson]

An interesting discussion.
Brings me to the assignment I've just completed on the variation in 
education, regulation and registration of midwives and competency 
assessments that occur across our wide brown land.
And these will be the things that bring us to be either supportive or 
not of hospital birthing. South Australia maternity system is definitely 
much better organised and funded than the New South Wales one. Can't 
speak for any other. I've done clinical placements in both states and 
working in environments with new equipment, standard spa baths, and 
midwives who collectively practice evidence-based midwifery with 
supportive services is delightful compared with the other - outdated 
equipment, tired midwives and outdated policies and protocols.
I've also attended many years of homebirth and as Tania says, there is 
simply no comparison in experience or outcome when working with families 
you know and trust. I am still and alwys will be in awe of what midwives 
can do when working with women they don't know.
I always believe however that even when entering an institution that may 
be outdated and tired with the odds of normal birth against us, that my 
presence can always make a difference to a woman who has invited me to 
assist her. So I also offer hospital 'supports' because I believe and do 
make a difference.


The NSW area where I live and work has limited midwife antenatal clinics 
even, and midwifery group practices just don't exist. Birth practices 
are disjointed and outdated but they are changing and the last five 
births I attended in the capacity of a final year student were simply 
great within the limited scope of practice that exists in this neck of 
the woods.


I guess we can all try and see the good that each area/service/midwife 
can bring to the women we all serve and help to create change where needed.
Perhaps standardisation of education, registration and competency 
assessments through nationalising maternity service (like in NZ and 
other OECD countries) would be for the best for women and midwives - may 
create a more predictable, evidence based active group of committed 
midwives.

???

Sue





Absolutely agree Jo that it is the women who are perhaps at higher "risk"
that would most benefit from the continuity of care from a known midwife,
the outcomes at the Women's and Children's in Adelaide have clearly shown
that the women who are in high risk groups going through the MGP are 
having
better outcomes, less intervention and more normal births, than the 
low risk

women going through the medical model of care. Definitely food for
thought...goes to show that the research is indeed right.

I feel that it's the right place here to put in my 2c worth too, about 
IPM's

and homebirth. Please remember that IPM's, while at times appearing to be
superhuman - and I say that from my experience as a consumer of IPM care,
they are also human. Building up a rapport with a woman over the space 
of a
shift is indeed an art, and something I am amazed that my colleagues 
can do,
day in day out. Really knowing a woman, having a relationship with her 
and
her whole family that spans months, and sometimes years, having an 
emotional
investment in helping her to achieve the best birth possible, is 
something

that simply can't be compared with working on a shift by shift basis.
If you have never stood by, and watched a woman be lied to, or coerced 
with

untruths, or half truths, if you have never been treated appallingly by
those who are your equals, but feel you are beneath them, if you have 
never
seen the look of defeat in a woman's face as all the positive energy 
leaves
the room and someone calls her stupid and naïve for trying to have her 
baby
without intervention, then you have no idea about the pain that is 
felt, and
the helplessness, and even the feeling of betrayal you feel because 
you can

no longer protect or hold the space, for that woman. I have been in these
situations, and I can really understand why some midwives prefer not to
provide care to women choosing to birth in the hospital system. There 
is an

element of self preservation about it too, let's not forget that.
Sometimes, it's just too painful to go willingly and knowingly into a
situation that you know is not going to go the way the woman wants.
Transferring in for an obstetric need is of course, something completely
different...
And that's not to say that the care you provide Sharon, in the 
hospital in
which you work, is not the best you can do, with the circumstances you 
have.

What we all know is that it is not the best thing for all women, and
according to the research, it's actually not the best thing for most
women...just because it's all that's on offer doesn't mean we 
shouldn’t be

looking to improve it, and one midwife one woman care is just the
beginning...

Tania







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