Yeh, I don't like how they've appeared to give on one hand - but taken with the other.

I fear that even with the new continuity of care arrangements (which I think will be a great improvement - for mothers and midwives), if midwives are still controlled by rigid obstetric policy, they will still not be able to offer the true midwifery model as an alternative to the medical model. They'll end up functioning as obstetric nurses collaborating with a medicalised system. it will be very hard for them to really offer the midwifery model. I think they will not have much autonomy to function as professionals in their own right - just like most birth centre midwives are prevented by obstetric policy from offering women real midwifery care.

I think we need independent midwifery and independent birth centres so women can choose between the midwifey model and the medical model, and so midwives can choose to work within the obstetric framework or practice the midwifery model.

Continuity of care, although an improvement, won't help much if the midwives have their wings clipped by a hierarchy of medical control.

I know I'm saying this badly, but I do know midwives in NZ and UK have much more professional autonomy than here, and that midwives in USA are totally under the control of the medical hierarchy and are reduced to being obstetric nurses.