This article for RANZCOG is typical of the attitude of doctors in this country. It complains bitterly about the lack of opportunity of student doctors to “catch babies”. How they are in competition with midwives (who of course really should be secondary to them) and they should be taught about the wonderful birthing process and how things go wrong all the time.
They feel that they have the right to attend births and “deliver babies” .
If they want to learn about normal birth then they should be attached to a home birth midwife so they can really find out about normal birth.
All schools face these problems, regardless of whether students are located in large tertiary centres or rotated to smaller metropolitan or rural maternity units for their birth suite experience. One reason is the increasing caesarean section rate, approaching 30 per cent and rising, in most of our teaching institutions, which means that a student may spend hours getting to know a woman and her partner, and observing the progress of labor (or the lack thereof) and then not ‘catch’ the baby when birth finally occurs by the abdominal route. A second reason is the large number of women who will not consent to a medical student performing the delivery of their baby, even though the hands of that student will be firmly guided by those of an experienced midwife or doctor.
Are women pieces of meat to be guinea pigs? How sad for Student Dr’s that the inconvenient raise of the section rate is interfering in their training. Shame on those inconsiderate woman.
Why are midwives always after thoughts when the recommendations are that the best outcomes for women comes with midwifery attendants?
Evaluations from medical students in 1999 showed distinct problems with gaining experience in the delivery suite. Medical students frequently met resistance to their approaches to be included in the care of laboring women and, although it is every woman’s right to refuse a student, evaluations reflected some degree of hostility coming from midwives who were aiming to protect women’s birth experience by discouraging medical student involvement
How dare midwives protect women’s experience when a very important medical student need “delivery experience”. When will these people understand that a woman’s birthing experience is not a public free for all. Maybe student Doctors should follow a women through her pregnancy and birth if that’s the experience they require instead of pushing their way into the most important event in a womans life.
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I couldn’t agree with you any more Lisa. Surgeons and student surgeons have no right in attending normal birth what so ever, it is their job to see to complicated women. It is the midwives role to attend births, afterall is it their speciality.
I agree – at least where there is competition – it should always be the midwife who is given preference. If midwives can’t access normal birth experience then the consequence is that they don’t get crucial experience – and then we really are in trouble as more women will need obstetric help.
Why do these med students need this experience at all?
I have been reading and loving your blog, but I do take a bit of issue with this post. I’m 39 weeks pregnant, under care of two wonderful midwives.
Personally, I see having students around as a way to expose these students to what a normal birth can be! I’ve had a couple of my appointments observed by a med student (not midwifery student) and I thought it was wonderful that this student was getting exposure to normal birth and care and informed consent.
And besides, these people do need to learn somehow. Isn’t it better to catch one’s first baby as a student rather than as a fully licensed, legally liable physician?
Otherwise though, I really LOVE your blog!!!!!!
Thanks for a great point Leslie. My personal stance is that fully licenced Physicians should not be catching babies. Normal birth is for women and midwives, Obs are the specialists in complications and in surgery. Should student midwives get to cut a woman open? No because it’s not their role.
In the current climate of birth however I can understand why you feel that Med students should be involved in normal birth.
This is an interesting discussion. In my previous life as a public health student I wrote an essay lamenting the medicalisation of childbirth, most of which I still agree with. Interestingly, I’m now a graduate medical student myself. I’m also a mum, so I have several points of view.
During my own birthing experience, I was attended to by marvellous midwives in a hospital birthing suite, and would consider home birth for my next. I did need to be induced in the end, and once handed over to the “medical” ward, was attended to by a cold and rough doctor (OBS trainee I believe) and unfortunately a similar midwife. I learnt much from this experience (about what not to do!), and think it is very important that all medical students do get some exposure to both “normal” and more complex births. But I totally agree, they shouldn’t just be able to barge in and feel like they have the right to be there when the pushing starts.
I did an elective last year (as a 2nd year student) and was lucky enough to follow a woman through 24 hours including a pre-eclampsia presentation and then being induced. I actually missed the “grand finale”, as I had to go back home to Melbourne to my son, but the experience I shared with the woman and her family was moving. I think it’s important that all medical students get to understand childbirth not just from the clinical point of view but especially the emotional. rollercoaster that is labour and childbirth. If the student is supportive and helpful through the labour process, I’m sure there are many women who would not mind them sticking around.
As an intern in a rural location, junior doctors may be the only person present when a woman comes to hospital in labour. Once intern year is completed, junior doctors are registered to work anywhere in the country, as a locum, travel overseas etc. While midwives are specialists in this field, it’s also vital that doctors know how to care for both normal and complex births if the need arises. I’d rather not see such a divide – there are actually some of us medical students/doctors out there who want to take a more holistic approach to birth!