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Continuity Of Care Undervalued

Here is a good article by Barb Vernon. I am not always a fan of the CEO of the college not being a midwife herself and being somewhat controlling but this is a good article.

Continuity of midwifery care undervalued

By Ged Kearney and Barbara Vernon

Midwifery models of care are about women being cared for by a health professional they get to know and trust.

Midwifery models of care are about women being cared for by a health professional they get to know and trust.

When a woman arrives at hospital in labour, who do you think will do an assessment, care for the woman and deliver her baby? If you ask most women they will tell you this person was a midwife, because in most cases the birthing experience is normal despite the rising rate of Caesarean sections. This story is repeated over and over in our hospitals every day. There are about 280,000 births every year in Australia.

The World Health Organisation (WHO) recognises midwives as the most appropriate and cost effective health care professionals to manage a normal pregnancy and birth. Australia continues to ignore recommendations of the WHO and doesn’t fully recognise the extensive professional skills and education of midwives; skills that allow hospitals and birth centres to leave the birthing of most of the nation’s babies in their capable hands.

The Federal Government’s impending Maternity Services Review Report is an opportunity to recognise and develop the contribution of Australia’s excellent midwifery workforce. The Australian Nursing Federation and Australian College of Midwives agree the review must reflect the findings and recommendations of evidence based research and reports.

In 2008 the Cochrane review found the available international studies support the notion that all pregnant women should be offered midwifery models of care. But let’s be clear about what this means. It does not mean, as some critics would have us believe, that women are cared for by midwives instead of doctors. Midwives collaborate with doctors every day. Given that a midwife is at virtually every birth and Australia is one of the safest countries in which to have a baby is testimony to midwives skills in providing safe care to women experiencing normal labour, and in recognising if and when a doctor might be needed if complications arise.

Midwifery models of care are about women being cared for by a health professional they get to know and trust. Most women today meet as many as 20 or more strangers during their maternity care. In the model being proposed, each woman is teamed up with a small number of known midwives, who care for them throughout and visit the doctor with them to discuss any medical needs or risk factors they may have. The woman and midwife get to know each other well.

The government’s discussion paper on Primary Maternity Services recognised that continuity of midwifery care through pregnancy, birth and in the post-natal period is as safe as traditional fragmented hospital care. The report also found midwifery care brings a range of tangible benefits including: greater preparation for birth; shorter labours, a reduction in interventions during labour; reduced need for caesarean section; lower rates of admission to special care nurseries, reduced health care costs; and better support for early parenting. Overall women report increased satisfaction with their care, greater self confidence after the birth of their child, and reduced vulnerability to post natal depression.

So why is it still so hard for Australia to accept that this is the best way for the majority of babies to be born? Why are we so far behind other developed countries with our Caesarean section rates at 10 per cent higher than the OECD and 20 per cent higher than those recommended by the WHO? Why are fewer than 5 per cent of Australian families able to access continuity of midwifery care? Why doesn’t Australia recognise and value the highly qualified and professional midwives that are already delivering the majority of the nation’s children?

Australia has a workforce shortage in maternity services; the skills and professionalism of the workforce are not appropriately used. We do not make enough use of the skills of midwives in providing primary care. And we are tying up the time and expertise of specialist obstetricians in providing routine care to healthy women.

The Maternity Services Review is an excellent opportunity to improve access to quality maternity care in Australia and to bring us up to the standard of care available to women in many other OECD countries.

Commonsense and evidence must lead this debate, rather than unsupported opinion from vested interests. Misinformation does nothing to reassure the public that the maternity system is in safe hands. Let’s bring balance to the debate and deal with the facts and find a way of improving maternity services for all Australian women and their families.

Ged Kearney is the federal secretary of the Australian Nursing Federation and Barbara Vernon is executive officer of the Australian Council of Midwives

One response to “Continuity Of Care Undervalued”

  1. ries

    a start would be for this to be published in it’s entirety in EVERY paper in this nation, so that WOMEN could respond vocally, and those contemplating their birth attendant in the future would know what to ask and fight for, in the care they want. (amongst other things)….. it’s a start, and quite conservative….but a start?