Saturday, August 27, 2011

Where is the woman?

Today's SMH and Age newspapers carry reports around the insurance debacle that has been unfolding this past week. I have written about it here and at the other blogs - you can click on the links at the right hand side of this page if you haven't already read them.

Where is the woman?
... the pregnant-labouring-childbearing woman in this whole dog's breakfast of red tape?

Midwives today face a choice between a very clear duty of care to the woman, the essence of midwifery, or an equally clear direction by our government which prohibits practice that is not covered by professional indemnity insurance.

If the midwife's primary commitment is to the woman, and she accompanies a woman for whom she has provided antenatal care to hospital, the midwife may be the subject of a notification to the regulatory authority, which may lead to restrictions to her practice.

If the midwife does not see the woman at the centre of the care, or is too fearful of the prospect of 'notification', her only realistic option is to give a handover to the hospital midwife and go home.

Isn't regulation of the health professions supposed to be in the interests of the person(s) receiving professional care?

Midwives are unique in the spectrum of regulated health professionals for several reasons.
  1. We are not treating illness: we are working in harmony with wellness and strength as a woman prepares to welcome a child into her family.  Only if/when complications arise is there a requirement for the midwife to offer referral to medical services.  Without complications, the expectation is that the woman will proceed through the childbearing process under her own steam.
  2. We are 'with woman':  when working privately, we choose to provide professional care that is focused on the individual woman, rather than focus on the service or the condition. 
  3. We work with each woman, in a decision-making process that always seeks to achieve the best outcomes for both mother and baby.
  4. There are important personal and social aspects to childbearing that can be easily overlooked in the impersonal and often emotionally sterile world of hospital care.  Women who have access to a known and trusted midwife when giving birth are able to be confident that they are making well-informed decisions. 
These four essential aspects of midwifery practice are consistent with, and driven by, serious research evidence as well as common sense.  They are written into our definition, our competencies, codes of professional practice, ethics, education ... (linked here), and our agreements with the women who ask us to be their private midwife.

Midwifery simply does not fit into the regulatory/bureaucratic pidgeon hole that has been made to match the other 11 regulated health professions.

If any women reading this are feeling insecure, or in need of someone to talk to, please call me on 0411190448.


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