Doctors firm against role of midwives
Here is the latest tosh to come from the Obs in Australia as we wait for the maternity review to get into action.
Adam Cresswell, Health editor January 10, 2009
Article from: The Australian
OBSTETRICIANS have stepped up their counter-attack against a push to give midwives a bigger role, claiming dire consequences will result if a federal review recommends allowing midwives to practise with inadequate medical supervision.
With the federal health minister, Nicola Roxon, already on record as indicating some sympathy for the midwives’ pitch, specialist doctors say the Government should first consider what they claim are the ”harmful effects” experienced in New Zealand, which moved to a midwife-led system in 1990.
Rural NSW obstetrician Pieter Mourik says one of the arguments in support of the midwife-focused model of care is that it would lead to fewer interventions, such as babies being born with the aid of forceps or by caesarean section.”Since 1996 in New Zealand interventions, caesarean rates and post-partum complications have increased to the point where midwives have become concerned,” Mourik said.
These statistics are contested by midwives, who counter that New Zealand officials have publicly disowned these and similar claims made by the Royal Australian and New Zealand College of Obstetricians.
Mourik said midwives had also ”become so stressed, working without immediate medical support, that they are dropping out of maternity care altogether and many have come to Australia to work, including to our local hospital.
”The experiment of midwife-led care in New Zealand has been a dismal failure, with double the maternal deaths and a similar increase in baby deaths and injuries.” Mourik — who now works as a relief obstetric locum in regional Australia to give respite to overworked rural doctors — says a New Zealand coroner had recently ”pleaded” for the country’s GPs to resume providing maternity care, but Mourik says it is ”too late after a generation of exclusion”.
”Government-forced midwife care excluded better qualified and experienced general practitioners from maternity care,” Mourik said. ”Where there were over 1500 GPs in obstetrics in 1996, now there are only six left in the whole of New Zealand.”
This is because they are not necessary
Mourik says the push for a bigger role for midwives is based on ideology rather than evidence. ”This is the group pushing for home births, and we all know home births are more dangerous for the mother and the baby,” he said.
Hannah Dahlen, of the Australian College of Midwives, says the comments represent the latest salvo in a ”scaremongering campaign” by obstetricians determined to stymie efforts to give women greater choice.The head of the New Zealand Government’s Perinatal and Maternal Mortality Review Committee wrote to the president of the RANZCOG in October to protest against the college’s claims that mortality rates in New Zealand had been rising.
Professor Cindy Farquhar said it was ”impossible to compare earlier maternal mortality rates with the current rates because of the completely different way that the data is collected”.
”To suggest that any increase has occurred because of the introduction to midwifery care is unjustified,” Farquhar wrote.
Dahlen says obstetricians are incorrectly claiming or implying that midwives are seeking to be in sole charge of births.
”We are not asking for midwives to be out there on their own — we don’t want that,” Dahlen said.
”What we want, what we have always wanted, is collaborative models of care, where women can have a midwife who cares for her through her pregnancy and postnatal period.
”It’s not about being ‘independent’ — this is about doing what midwives are best at, caring for women, particularly low-risk women, and having support from obstetric colleagues when that’s needed.
”Part of the reason we have such a high intervention rate is because normal, low-risk women are being cared for by highly specialised surgeons trained in surgery.
”We are not saying midwives are not going work with obstetricians — we are asking for more choice, not less.” Dahlen says women are ”marching with their feet” to seek better access to midwifery services, based on the number of women prepared to attend rallies and on the number of submissions from individual women to the federal Government’s review.
In December the Government revealed over 900 submissions to the review had been received, most of them from individual consumers.
Releasing the news at the time, Roxon said in a statement that the women’s ”personal accounts of experiences with maternity care sound a strong note of concern that our maternity system has become too focussed on medical intervention”.
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Bloody hell this makes me mad. Scaremongering at its absolute best! And so far from the actual truth for women in New Zealand. Thanks Lisa for highlighting again the injustices.
Seeing women standing up and testifying to how important this option is in Aus gives me hope maybe we will soon be doing the same here in the U.S.
same ol same ol, things said over and over again. When obstetricians feel threatened, they go on the attack of the midwife. What we want is collabrative care – Midwives looking after low risk women and refering to obstetricians when needed – it’s not difficult.
Waiting with bated breath for the release of Roxon’s report.
What we want is to look after women of all risk and collaborate surrounding women with complex pregnancies. We also want women’s choice to be honoured regardless to risk.
”Government-forced midwife care excluded better qualified and experienced general practitioners from maternity care,” Mourik said. HA, what a joke. Show me one GP who is better qualified and more experienced than Lisa!!
Just want you to know there is hope! In Alberta (Canada) women, their families, and midwives worked for nearly 30 years to get midwifery covered. It finally happens this year! Yeah. Homebirths included. Check out Birth Issues for more info.