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Just a couple of comments in this very interesting set of e-mails.
The Community Midwifery Program in Western Australia used to have a budget for
preceptoring midwives for a period of 8 months to prepare them for ACMI
accreditation, which requires a minimum of 10 homebirths per year. (I don't
know how many births per year for other work places. eg birth centres.
???) During this time the midwife was on a minimal rate of pay (sorry,
don't know the rate) and worked with the CMP midwife on call, in a caseloading
model. For the first 2 months the "apprentice" shadowed the midwife every
where, working the same hours, on call 24hrs/day and familiarising herself with
the life of a homebirth midwife. She also attended some of our prenatal
classes and our postnatal support groups. The next three months she took
on her own caseload and the CMP midwife shadowed her for much of the time (not
all). The final 3 months, the "Apprentice" worked mostly on her own except
for the births, when the CMP midwife acted as 2nd midwife. This was a very
intense time, for both the Preceptor midwife and the Apprentice. It was
great preparation for the role, and 6 midwives were preceptored in
this way. I did say we used to have a budget, because we no longer have it
and will have to fight to get it back. We also have had many
midwives who used their own long service leaveand joined the CMP without pay in
a "shadow" role as above. As well as these, we have student midwives from
the U.K. and other states who do their placement with us, mostly carrying their
own costs.
Re the "difficulties" of caseloading. My own story is a good
illustration of how it CAN be done. (I'm not blowing my own trumpet, just
telling my story.) At the age of 40, with 5 kids ranging from 5-17 and a very
supportive but mystified husband, I embarked on the journey of a rural homebirth
midwife. For 12 months I was preceptored without pay, by a midwife
who was working in the SW of W.A. At the time there was some discussion of
me paying her as occurred in other places. Homebirth was legal
but "underground" at the time and the hospitals, medical profession and many
midwives were very hostile. During the next 7 years I travelled up to 120
Kms each way to births and antenatal & postnatal visits, teaching A/N
classes and staging seminars for midwives. (great networking) I Had to be
very creative with my time. I attended about 3 births a month, on my own,
as I was the only midwife in the upper South -West region. There were no
pagers or mobile phones in the area, as no mobile towers and there were "phone
trees" to track me down if needed. During this time I also did my B.Nsg
part time. My family thought I was a bit strange at first, but the kids
thought it better than having a grumpy shift-working mum. After 7 yrs, the
family (&I) moved to the city & I continued on as a MIPP and then a CMP
midwife. I am 63 this year and I just love being a caseloading
midwife. I have so much free time as I can mostly arrange things around my
client visits. Being "on call" is not a burden as mobile phones make it so
easy. I follow the Caroline Flint philosophy, but neither have as many
holidays nor get the same rate of pay. Caseloading is great fun and for me, a
non-stressful way of life. cheers, MM
As long as the newly graduated BMId is are
working with another experienced midwife and can be adequately supervised for at
least twelve months. Definitely it is the best way to go but you need
supervision. In the UK they have designated supervisors for all
midwives.
Once a
student has completed the Bmid, is it feasible to go straight into Independant
Practice without working in a hospital?
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