Over the weekend I moved house and was without internet access. I had to stand by and watch the review unfold and only speak with friends and colleagues on the phone until I could by a mobile internet access thingy. Thank god for technology.
For any of you that haven’t read it you can find the whole thing at Maternity Services Review.
Rosemary Bryant (not midwife) in her opening statement says this
Thirdly, there is a lack of unanimity within and between some groups of the medical and midwifery professions on the issue of how to deal with risk and consumer preferences. While it is acknowledged that safety and quality of care is an overarching goal, it would be remiss to always use it as an excuse not to change practice. In maternity services, where most pregnancies follow a normal pattern, we must ensure, frst, that practice is based on evidence and, second, that we are not allowing our safety and quality concerns to prevent us acting on evidence that supports changes to practice. Risk must always be a carefully monitored balance of safety and informed choice.
What a load of bull shit. This woman has no idea about maternity services. Hospitals are not working to best practice or research in many key areas and don’t intend to. The review has mirrored the AMA and RANZCOG almost exactly.
This next snippet shows that even though over half of the submissions were about midwives and homebirth and were written by consumers and midwives, this is what they find important
The Rural Doctors Association of Australia believes that this care is best provided by a collaborative model that involves all members of the core maternity care team—GP obstetricians, midwives and specialist obstetricians—according to the needs and wishes of the woman.
GP Obs are not required unless there is a rural facility and no access to a Specialist for maternity care. a midwife is the specialist in normal midwifery and an Ob is specialist in complications
The further you read the more it is obvious that none of the midwifery/women really has a say, any quote from a submission was fine tuned.
We need to avoid a situation where any proposed reforms impact on the indemnity premiums of the existing medical indemnity premiums (particularly obstetricians and anaesthetists) by increasing the quantity of ‘fre brigade’ or ‘emergency response’ obstetrics in the system. This would arise when doctors are called in at the last minute for an obstetric complication without any prior engagement in assessment or management of the patient.
We can all see that this came from a Doctor, an obstetric complication is the job of an Ob, if they were working correctly then they would see that collaboration means them doing their job properly. Only a Doctor would show this amount of arrogance about their position.
They concluded that lack of indemnity insurance is a problem so they will look at it as long as there is a doctor in charge. What midwife or woman planning to birth with a midwife wants or needs this?
I am not really in favour of insurance as it is always going to lead to this sort of control issue. I also think it doesn’t change risk or practice. Look at the hospital disasters and they are all insured.
It is also obvious that Rosemary has no clue about midwifery when she recommends that further credentialing and competencies are considered for advance midwifery practice.
A Midwife is a Midwife Rosemary! We are not nurses, we don’t need extra training.
To be continued after a day of looking after women in the community.
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You have hit on an issue, Lisa, about a midwife being a midwife. The midwife’s scope of practice is clearly defined. Why do we need extra credentialling? Midwives are different to nurses who can work across a large spectrum of care. This is such a fundamental flaw in the review. We don’t need “advanced” midwifery practice – we just need midwifery practice.