Wednesday, October 06, 2010

Looking at the big picture

A lovely young woman in my care came for a prenatal checkup, beaming. After the usual hello she told me of her sister's birth a few days ago. Her sister gave birth to her first baby at a big public hospital, without any assistance, without any drugs! The wonder of physiological birth - the miracle of birth - has left its mark on this woman's mind. I was pleased to hear the story. Normal birth is worth protecting.

We know that birth is not an illness, yet a normal birth is often something that is a surprise rather than the expected pathway.

Medical dominance in birth has, for many people, extinguished this amazing knowledge. Midwives and doctors often see birth as a minefield, expecting disaster at any moment. Then they proceed to interfere, interrupt, intervene ... and hey presto ... they were right!

Years ago we midwives who were budding activists for promoting normal birth used the Fortelesa Declaration (WHO 1985) to get the message out that ‘Birth is not an illness’.

In the early 1990s we used the Innocenti Declaration (UNICEF and WHO) on the rights of the newborn to put pressure on maternity services in relation to breastfeeding and bonding.

In the mid-90s we promoted the ICM Definition of the Midwife, which is now incorporated into national codes of midwifery practice and educational standards.

We still have a long way to go. We need to constantly go back to this ‘big picture’ stuff, and hold it up as our standard.


The current state of play in the government's efforts at legislative reform (see another blog) is simply unacceptable to midwives under international and national midwifery standards.

Midwives have to just say NO! It’s not good enough to say we will take baby steps to Medicare funding. Compromise that is wrong is simply wrong, and will be regretted in the long run.

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