Reflections from a student midwife:

Student Midwife Reflection six months into her course:

Wow what an experience the past six months has been! I have spent the first half of this year on the maternity ward at Southwest Hospital and work with a fantastic team of midwives. I have loved every day of it and although it has not been easy at times, it has been worth every moment.

I have been extremely lucky in my experiences and have been a part of some awesome births and met some amazing women. I have been a part of three water births, a vaginal twin birth including one breech, hypnobirthing and a baby ‘born in the caul’, just to name a few highlights. My mentor Susan is a great midwife whose knowledge and commitment to women and the midwifery profession astounds me. Although I mostly work with her, I realise it is important to work with other midwives as everyone works differently and has different pieces of knowledge which I know will help me to become the best midwife I can be.

Every Friday we have a Midwives Clinic where women who have shared care with their doctors, come to us for a few visits during their pregnancy. This for me is a real highlight, I enjoy meeting these women antenatally, even if it’s only briefly and building a rapport with them as it is the closest form of continuity of care we have here at the moment.

Everyday is constant learning whether I’m working in labour suites, on the postnatal ward, or in the Midwives Clinic, I usually come home mentally exhausted from everything I have learned that day, I feel like a big sponge absorbing everything! I have become much more confident in CTG analysis and breastfeeding education, although I am not as confident with vaginal examinations as each one is so different, so I am endeavouring to improve on that skill!

The hardest part of becoming a midwife for me is the constant battle for ‘normal birth’. I see midwives everyday advocating for their women to allow for the birth that they want and some doctors just need to interfere. It seems that some of them feel the need to ‘rescue’ these women from that ‘horrible thing’ called labour, they don’t seem to realise that it is the most natural part of life. I’ve seen women coping beautifully with a labour that is progressing and a baby not distressed at all and a doctor walk in and insist on interfering in one way or another, which alters the woman’s ability to trust her body and it appears to be only for the reason of doctor convenience. It is frustrating and on going. The doctors are there for those women, who need assistance in the birth of their baby and in obstetric emergencies, and that’s when midwives then step aside and work with the doctors for the safest option of birth, whether it be an operative vaginal birth or caesarean section. It can be draining being an advocate for these women to get a ‘normal birth’, but worth every bit of it when you get a happy and healthy woman with a happy and healthy baby.

The most important lesson that I have learnt is to always listen to the woman. If she states she feels an urge to push, yet was only 2cm dilated half an hour ago, BELIEVE HER!!

So another six months to go until I am a fully fledged midwife, it is scary, yet exciting. I can’t wait to see what to future holds and look forward to the rest of the year!

Written by Aleisha (Student Midwife)

Capers bookstores presents: Midwifery update workshops

NEW Midwifery Update workshops in Perth April 19-20. We'd appreciate if you could pass this information on to interested colleagues, as bringing these workshops to Perth does incur additional time and expense so we do appreciate help in promoting them.

Student discounts of $25/day are available, for those not working as health professionals at the time. To claim just make a note when ordering, and you will be required to sign a declaration on the day.

Shea Caplice and Sheryl Sidery will present two one-day Midwifery Update workshops: Using Water for Labour and Birth & Essential Midwifery Skills for Challenging Situations in Perth 19-10 April.

Shea Caplice has been a practising midwife for 27 years in a variety of midwifery models. She was Project Coordinator for the first publicly funded Homebirth service in NSW, and is currently the Coordinator of the Royal Hospital for Women Malabar Community Midwifery Link Service, a service with a particular focus on Aboriginal families.Shea produced the film, The Art of Birth: Four Beautiful Births in Water, and has used her experience with waterbirth in training other midwives on many occasions, and co-writing the chapter on waterbirth in Midwifery: Preparation for Practice (Pairman et al). Sheryl Sidery has been practising midwifery for 24 years both in private practice and in the public system. For the past 5 years Sheryl’s work has focused on how we parent and how women’s past and present experiences can shape her mothering. She is currently the Midwifery Consultant for Perinatal Mental Health and combines this with her private homebirth practice.

Kind Regards,
Sarah
CAPERS Bookstore
PO Box 387
Yarraville VIC 3013
Ph 03 9318 0151 Fax 03 9318 0158
office@capersbookstore.com.au

Review of the ACM Conference: The Magic of Midwifery

I will start by saying it was an excellent day the ACM education committee did very well in organising a fantastic program, there was something for everyone. The conference was held at City West a brilliant venue, lots of free parking, the food/refreshments were tantalising and the AV equipment went without a hitch, what more could you ask for.


There are several key components for organising these conference / educational days, initially you do need topics that will attract midwives to attend, and this can often be difficult because the needs and wants of midwives within the State are varied. Secondly it is choosing presenters that will be inspirational, because I think midwives attend these days not only for education but to be inspired and network. Work places can be stressful and the demands on a midwife can be enormous therefore it is imperative from time to time to refocus and remember why you became a midwife and be inspired to be ‘with woman’ with like minded people.


The day started with an inspiring opening by our ACM President....”we are in unprecedented times, there are many changes occurring and we need to get it right”. This was followed by Abby Clemence from the National ACM Office providing us with a synopsis of the Maternity Services Review Recommendations (2009), Federal budget 2009 and National Registration July 2010. To recap the main points for me: 120 million dollars over 4 yrs – Midwives to have Medicare & PBS access from 1 November 2010 for care provided in collaborative teams. Commonwealth to support midwives with access to professional indemnity insurance – unfortunately no support for Homebirth – however Private Practice Midwives do get a reprieve for two years, that means no decision until 2012 and we have to find someone to cover us for indemnity insurance.



It was hard to hear (although I know it is true) that as a workforce midwives are a fragmented profession and do not support the ACM, unlike the medical profession that stick together. This is something that needs to change... do you remember the saying “united we stand, divided we fall” this should be our new motto! I didn’t know that the GP’s have 98% membership to the College of GP’s which makes them very a powerful organisation and as Midwives we have less than 30% membership to the college we need a unified front. You might ask what does this mean or why is this important? Well it shows UNITY especially when attending forums and meetings to change policy etc. And this is part of what the Australian College of Midwives (ACM) does for us whether you are a member or not. I was also surprised to see that Obstetricians make so much money (in one year they can earn 1.5 – 3.5millons dollars) despite having to pay huge indemnity insurance fees and that the safety net assists them in earning or structuring their fees.

If you are currently not a member of the Australian College of Midwives, please join now....
What will be good about having Medicare provider numbers for midwives is that it will raise the profile of Midwifery as a profession in its own right, therefore Midwifery and Midwives will be more valued. This creates an air of excitement as midwives began to think about working within different models of care; private practice and Dominos, Group Midwifery Practice etc. It is very exciting times for a midwife.... for me I think it would be excellent to have my own private practice, (with indemnity insurance for homebirth, however currently not an option) provide women with antenatal care in the home, have the choice for visiting rights to hospitals for the birth allowing me to provide the primary care, for the woman then allowing a 6hr discharge home if all was normal..if a hospital birth was required as opposed to a homebirth. Then provide the follow-up postnatal care in the home..... what a great alternative to care.....

National Registration has been talked about ever since I can remember... and I have been around in the health industry for over 25 years. So it is finally happening... part of me will only believe it when it happens in July 2010 – it is long overdue, Nurses and Midwives will be able to register Nationally and work anywhere in Australia....fantastic.. This will also regulate disciplinary issues preventing State hopping for Nurses and Midwives who have competency or disciplinary issues within their current place of work and resign and go interstate to escape the consequences of their actions.


Nurses and Midwives will be able to register on separate registers; for Midwives there will be four categories: Registered Midwives: Restricted Midwife: student midwife: and non practising midwife... this will enable a true reflection of the numbers of midwives within Australia. This will also cause new problems for employees because some midwives who are currently registered as both a nurse and a midwife may not do so after 2010. What nurse / midwives have to remember is the terms of their current employment..... so there current employment contract, which might be to be registered as both a nurse and midwife...........For more information relating to National Registration please visit National Registration and Accreditation Scheme http://www.nhwt.gov.au/natreg.asp


Read about the first meeting of the new Nursing and Midwifery Board of Australia and who is on the Board. http://www.ahpra.gov.au/documents/First%20Meeting%20of%20the%20Nursing%20and%20Midwifery%20Board%20of%20Australia%20-%2020%20September%202009.pdf

Abby Clemence is passionate about what she does, she has the woman & midwife first and foremost in her sights and presented very well, the audience was captivated by all this knowledge and information.... even though at times there was not enough information, this was due to the fact that the questions asked by the audience, the answers have not been clarified by the government.... so watch this space........................................... Abby finished with MidPLUS - Continuing Professional Development (http://www.midwives.org.au/ ) the importance of midwives showing evidence for the care that we provide and our continuing education processes. So please if you have not joined up for MidPLUS do so now and if you have like me.... get it started....for me this blog will be my reflection, I am sure I can claim some points.............again watch this space; Thank you Abby for your passion and your much appreciated hard work.


The afternoons presentations were more clinically based: they were fascinating and inspiring; several spring to mind; the use of “Language in Midwifery” and the “Follow through Experience”. These two presentations were given by a graduate and a student midwife; they were refreshing, passionate and stimulating. It is great to see forward thinking new midwives to carry us forward.

Intermittent Auscultation – this is always an interesting topic, I have always struggled with the idea of being able to hear variability with a sonicad or pinnard and have had numerous discussions about this topic over the years.... I believe that you can determine the baseline and hear accelerations and decelerations however have been sceptical about the ability of hearing variability.... today I got the answer.... Lesley presented very eloquently and provided a formula of how to hear variability....” Listen for a full minute, in 4 sections of 15 seconds. Count the beats for each 15 seconds separately and multiply each by 4. Compare these four averages to produce a variant amount which should be more than 5 beats”.
We all tried it and I was amazed it worked….. You can teach an old dog new tricks…. Thanks Lesley I now have a new skill together with evidence to back it up….

Midwifery Group Practice… an overview of this model of care… key points for me were: make sure you know what the population wants…. Is this a model of care women want… also do you have the staff who wants to pursue this model of care, very interesting presentation.

The last three sessions, Waterbirth Policy, The Role of the Doula – Australian Doulas (http://www.freewebs.com/australiandoulas/ ) and Antenatal education – a menu approach - that means exactly that...“providing a menu approach to choice about antenatal education” “people like stories, like real life experiences” “ a show and tell experience of learning” -kept the audience riveted to their seats...


WA has been a long time waiting for the Waterbirth Policy... I remember coming to WA 6 years ago after working in the UK within the community & Birth Centre as a midwife and was used to women having the choice of waterbirth... to find that it was not an option here... so I am absolutely thrilled that finally this waterbirth policy was launched today at our conference..Yes it is official you can conduct a waterbirth in the hospital.... make sure you read the policy..Clinical guidelines for women requesting immersion in water for pain management during labour and / or birth. I am sure there are many more midwives equally as happy as I am about this outstanding achievement. Improving Maternity Services (http://www.changechampions.com.au/resource/Janet_Hornbuckle_Mat0209.pdf

It was good to see that we had approx 100 attendees for this annual conference, consumers, midwives and sponsors. There were midwives from Albany to Geraldton, and Kunnunurra and Broome attending, absolutely fantastic.....The day ended with a well deserved Sundowner 1630 – 1730 includes drinks and nibbles ( sponsored by ACM WA Branch), throughout the day there were many opportunities for networking socialising and lots of photos.(watch this space will be posted over the next couple of days)...............it was an excellent conference, I feel inspired and empowered and am excited about the future for midwifery in WA..... thank you to all those who attended..............see you all at the AGM the week before Xmas.

Life members of the ACM Jill Thompson and Janice Butt.