Monday, February 04, 2008

NEXT GENERATION INDEPENDENT MIDWIVES

Today I experienced an encouraging glimpse into the future of midwifery, as five women sat with me at our kitchen table to plan their transitions from hospital midwifery into autonomous independent practice. This was the first of what I hope will be monthly meetings for the coming six months. Each woman is at a different place in her professional practice journey, and each one will need to find the way from where she is to where she wants to be.

I won't try to record their stories here - they are probably reading this blog, and I know I couldn't do them justice. A couple of these women, both recent graduates, are only a few years younger than I. They have adult children and one has a grandchild and have a wealth of life experience. Two are young - late 20s or early 30s, I'd say, without any children. They are both exceptionally committed to midwifery. Another has an interesting story of studying midwifery by distance education, while living in a remote town in Western Australia. In order to access the practical experience she needed in the course she would drive for five hours to Port Hedland, and work for ten days, before driving home again over roads on which she may not see another vehicle for several hours at a time.

There was a common thread of extra-ordinary lives. As each told her story, I wondered if the next could ‘top’ the previous ones! And they did.

We spent a couple of hours listening to each other, telling birth stories, and getting a feeling for what this group needs to do in order to support each one in her quest. I see myself as a facilitator at present, and I feel privileged to participate.

The plan that we are working on is that each midwife will set out her own plan for professional development, using the Australian College of Midwives MidPlus (2007) program as a guide. Each member will report back to the group on her progress, and any difficulties she is experiencing. These plans will identify specific learning needs, reflective practice, and a sense of accountability to the group. I would like to see each member find a professional mentor from whom she can learn, and to whom she can turn for specific guidance.

I am concerned for midwives who would like to participate, but who are not able to meet face to face with us due to distance and other factors. I would like these people to be able to link in to the dynamics of the group. Although face to face is an ideal way of peer group support, I believe we can use email, Skype, phone, blogs as well as the face to face meetings to achieve our goals. In this way we will create a virtual community that goes way beyond Melbourne’s eastern suburbs. The vision I have is that the ‘remote’ members will be partnered or buddied by one of the members of the face to face group, who will provide a link to the discussion and peer support. The use of webcams with Skype has revolutionised conversations – you can see the person at the other end of the line, and they can see you.

My own interest in this new group has led me to consider the possibility of setting up a course that is offered through a university distance education program. I plan to explore this, and set it as my professional development plan.

One might ask what’s the point of supporting midwives to set up autonomous practice in a society that expects midwives to be obstetric assistants in hospital. That’s a pessimistic outlook.

I have seen a great deal of change and development in midwifery in the past decade, and I believe this form of peer support for professional development and extended practice has a logical place in the profession. I believe there will be increasing numbers of midwives looking for courses which will support their transition from shift work to more woman centred models of midwifery care. I expect that once the ball starts rolling it will gather momentum. This past week has seen the announcement of a large trial at the Royal Women’s Hospital, recording the impact of the introduction of caseloads for midwives. Those midwives will be stepping out of the usual familiar territory of midwifery in this State.

I am optimistic that women are also opening their eyes to protecting and promoting their own healthy natural processes in birth and nurture of the newborn. Women will be increasingly asking for midwives who are expert in working with the natural process, rather than booking into impersonal systems of medical care.

Sure, there’s a lot to be done. But goals will be achieved as we set out taking steps towards them.

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