I am expressing a level of frustration; how are people to make decisions when you put out information and you get no responses; what does it take for people to respond? i know you read the blogs, but never a comment; this is so important; does this mean you accept the staus quo, you don't give a toss, you have no opinion, or really doesn't matter what you say nothing will change? I have no idea what to think....because it's one way communication here....
I liken the position of the Australian College of Midwives to the recent federal election: everyone you speak to is voting for the person you want.... or not voting for that person....the numbers are close all the polls predicated 50 - 50 or thereabout.....Now with the Determination; I have to say the polarity is almost the same, although I think that because the majority of midwives are not commenting.... the minority who believe that the determination should be squashed have a louder voice. Therefore this is the common view because the rest aren't speaking..... we have 500 members in WA.... and i have heard from less than a quarter.....it is time to be vocal.....
The facts are that the Determination was passed in July...when it comes up in the Senate next week it is to allow or disallow..... there is no discussion about the determination....the time for talking is over... Any debate that would be had, would then be as to whether, or not, the disallowance motion should be passed.
... the bottom line is if it is not allowed... we then lose everything, because the Government of the day will not reintroduce it. I have to add why would they?
The argument I have been given is that the determination will create a two tier midwifery service.... I believe this happened when we created 'the eligible midwife' not the medicare provider number.... and rebate.... in fact i could argue there has always been a two level midwifery service...those midwives who believe their scope of practice is the experts in normal childbirth.... then to collaborate when things move outside that scope with an Obstetrician.... however there are those midwives who will accept and care for a woman from any risk category because it is the woman's choice..... there we have a dichotomy: my solution is if you had that , trusting, supportive arrangement with your women it wouldn't matter if you had to seek collaborative advice from an Obstetrician..... it is all about the relationship you build with the woman.....
is this a topic to which we will get no agreement or have things just got to a point where the passionate people from both sides are at logger head... and the majority of midwives are just not engaged.....?
I am a Curtin Postgraduate Midwifery student and have indeed been reading a number of blogs regarding the new Government Determination and not leaving a comment! I personally feel that I am not aware of enough of the political history of midwifery to comment, but I shall just mention that I feel that the Determination should be given a chance. I believe relationships, communication and positive approach to any issue can have a truly beneficial effect on any new idea/proposal and midwives should form informal support groups or be supportive to each other in a positive proactive way to work through this new Determination.
ReplyDeleteIt is so good to see that Midwifery Students are taking an interest in this discussion as it is your future; may I say that it is sometimes wise to be mindful which blogs and how you respond to blogs, a bit of caution is always best; thank you for responding and best wishes for the rest of your course.....
ReplyDeletePauline
While I agree with you that there are two tiers of midwifery I do not believe it is the split between those willing to refer and those not.
ReplyDeleteHaving worked as an independent midwife and with independent midwives I can state categorically that those I worked with referred in an appropriate and timely manner when the situation required and according to the ACMI Guidelines for Consultation and Referral. Women would then be presented with the direction advised by the obstetrician, with contemporary reliable research such as the Greentop Guidelines by RCOG, and would discuss in depth with their midwife their hopes and fears, their own personal assessment of risk based on their own values and beliefs and interpretation of the research, and then the woman and her family would make their choice.
Often her choice would be different to the recommendation of the ob...and yes the midwife would support her with this...
About two and half years ago this all changed and when ever an independent midwife referred a woman in for obstetric consultation she was reported to the Nurses and Midwifes Board if the woman was not considered low risk. This then meant that by supporting a woman to birth at home, if this was what she chose, the midwife would then face retribution from those who did not agree that women have the right to self determination over their birth choices or midwifery support to enable them to do this as safely as they could ....from this time on consultation and referral in a supportive environment was made extremely difficult for independent midwives.
It seemed to become more about a witch hunt, even amongst our own, than about the woman and her baby.
For me Midwifery is not about professional status or jostling for position or control with obstetricians...it is about family, woman and birth and all that this encompasses.
As Barbara Katz Rothman states "Birth is not only about making babies. It's about making
mothers -strong, competent, capable mothers who trust themselves and believe
in their inner strength."
Abbey
I don't need this to be anonymous I just don't know how to post it differently.