|Beautiful Brisbane, the city of my birth|
continuing from yesterday's post, ...
[I have posted these comments on a social media site that might not be accessed by many of my readers, so have copied and expanded it here.]
A blog post by UK midwife-author-teacher Sarah Wickham, questioning the Australian regulation of midwives, provides comment on the UK model of supervision of midwives.
I share Sarah Wickham's concern, when midwives are subjected to "vexatious reporting and persecution in a number of ways, simply for supporting women’s choices."
Without pointing the finger at any person, and I wasn't at the recent homebirth conference in Brisbane, I think it's likely that Sarah has heard only a fraction of the story. In my opinion there have been too many cases recently, some on public record, in which midwives have hidden behind a notion of the woman's choice, when in fact there was no discussion of escalation of care and appropriate intervention. Midwifery partnership can only be achieved when the conversation between the midwife and the woman is ongoing, and informed *decisions* are made rather than choices.
An effective program of professional supervision of midwives could, theoretically at least, support the midwife in real time whose client is making an informed decision that does not follow usual professional advice. This would apply whether the midwife was in private practice or employed in a hospital or other birthing facility. The UK model of supervision of midwives is for all midwives.
A midwife can't afford to be a true believer, or to 'trust birth' in any idealistic way, even though we act to promote, protect and support normal birth and the physiological adaptation of the newborn to life out of the womb.
The setting/place of birth (home/hospital) has become an obstacle in this country to good midwifery practice, because privately practising midwives are restricted to homebirth. The exclusion of PP midwives from mainstream hospital is not in the interests of wellbeing and safety of mother and baby, and probably contributes in complex (and unaccountable) ways to some adverse outcomes. The midwife's duty of care includes what we do in emergencies, and accessing medical (ie hospital) help in a timely manner.
The introduction of the wonderful www, and social media, and digital communication ... has had a profound impact on some women's access to information about birth, and their choices. Anyone who remembers 20 years ago, when homes didn't have internet access, and mobile phones were great big clunky devices, will know what I mean. Now women tell me they have 'researched' their choices, as though it's done and dusted. The rise and rise of freebirthing is very much an internet phenomenon.
Please keep the conversation happening.