Just for 2 seconds can we focus on the big breakthrough in womens maternity care

[Julie Doula]

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.

[SammyRo]

Prob a bit off topic, but I had this model in the public system with DD. I didn't get to choose my mw, but that didn't matter, as she was lovely and there was a great continuity of care - I had many of my appointments at home, and once my waters broke, she was happy to leave me for 4 days as long as she came over 2x a day, plus i montiored my temp (not that I needed it), I then gave birth to DD in the birth centre and was totally supported in our choices.

So its great that this model is going to be wider available...although, what i can't understand is, that if there is a fantastic option like this already available in the public system, why more women don't choose it. I obviously only know about my experience, but I felt that my mw whilst probably acting in line with policy, she was also acting in line with what we wanted - I know other hospitals will only let you go 24hrs after waters break, or only push for an hour before they intervene - my mw just let me go because whilst dd was taking her time, everything was fine (she finally appeared after 2 1/2 hours of pushing)

[Julie Doula]

it is normal for first time mothers to push for longer than an hour - up to 6 hours even. I though most hospitals allowed at least two hours? One hour for a first time mama is really draconian. She hardly gets a chance. 2 and a half hours sounds about average for a first timer. (Nice work, SammyRo!)

[Janie]

I know a midwife who now works here in Oz, but trained in Europe, and worked there for most of her career. She finds it difficult that she has less autonomy, and authority, in her work here. She has been known to sometimes go her own way, to give mothers a better chance of unhurried vaginal delivery . I think she is wonderful to do that, but it is sad that she has to do it underhandedly.

[SammyRo]

it is normal for first time mothers to push for longer than an hour - up to 6 hours even. I though most hospitals allowed at least two hours? One hour for a first time mama is really draconian. She hardly gets a chance. 2 and a half hours sounds about average for a first timer. (Nice work, SammyRo!)

THanks I was pretty chuffed! I'm just sad that this time we have moved and aren't in the catchment for the same hospital.

I've only heard this stuff from mothers groups and stuff, and I remember one mum at a diff hosp who was moved from the birthing centre to the labour ward after an hour. Although I could be mistaken. And another friend who went private who was only given about 4-6 hours once her waters broke before they induced her, and then about the same 4 hours after the induction before they took her off for a c-sect. But that was prob because the ob wanted to go play golf or something


I know the HB thing is still a huge issue, but for me, I am really happy that this type of mw care is being opened up to more people - having built that relationship with our lovely mw meant that we got the birth we wanted. But, as you say, it will probably come down to how much freedom they have to do they're job. And that will probably come down to how much respect they are afforded from the obs. doctors.