Sunday, October 2, 2011

Don't give up!

An opinion
Joy Johnston

I wrote in a recent email to fellow independent midwives, "Don’t give up! Midwifery has survived darker days than this one."
One younger midwife who received that post asked me what I meant. Was I referring to midwives being burnt at the stake, or similar historical atrocities?

Those dark days certainly rate high in the shame file. But, realistically, it's a long way removed from any midwife today.

Midwifery is the one health profession that challenges the medical/legal establishment at its core.  Midwifery enables women to get on with the job of being mothers without interruption, and will only seek treatments or interferences from outside sources (natural or pharmacological; alternative or mainstream) when complications present.

Dark days through which midwifery has survived include days that I and other midwives practising in Australia today have come through. As recently as 1996, the Midwives' Regulations in Victoria required a midwife to practise at all times under the supervision of a doctor. A midwife was not permitted to perform a vaginal examination without a doctor's permission. A midwife was also required to wear clean clothes of a washable material.

Although these arcane rules were put aside ('sunsetted') in 1996 with new policy directions of the State Health Department, the effect of the Midwives' Regulations, medical supervision of midwifery, has been preserved.  Ongoing attempts to reign in and control the midwifery profession, particularly the independent part of it, are offered with the laudable intention of protecting the wellbeing and safety of mothers and babies who may come under the midwife's powerful coercive pressure. Plenty of evidence of this position can be found in submissions to the Maternity Services Review, as previously discussed at this and other sites.

Dark days for the midwife today might include the suspension of her right to practise, or she even be imprisoned for doing no more than is widely considered basic midwifery. Even more likely, a midwife today may spend many months or years facing investigations and hearings by the regulatory authority, following trivial and vexatious complaints by colleagues; often other midwives. That midwife may experience mental and physical symptoms stemming from anxiety and depression. One such midwife wrote after being released from a series of vexatious allegations of professional misconduct: "That is 18 months of my life wasted in worry, stress and on anti depressant medication. Crazy stuff."  She has withdrawn from private practice.

A midwife from South Australia wrote:
When I first was involved in a home birth support group in 1977 the women were helping each other, and sometimes one of two lay midwives may have been available to attend. It was totally underground. I offered midwifery care and listened to the women and developed an approach to care that created education, safety, support for many women. ...

Now with all these changes supposedly to give midwives and women more choice and increase safety, we are back at 1977. Only now the women are even more educated, more autonomous in their decisions and many of them more damaged by the system and the medicalization of birth.

There is little midwifery because most women enter an obstetric model with midwives having to practice obstetric care. Women are traumatized in a way that can not be allowed to keep happening! Coercion scare tactics of "you or your baby could die" or after a women births some one says "if you'd been at home you would have died". This is the lack of truth that pervades maternity care. Women care about their babies more than anyone else. I'm ashamed of the decisions that have been impacted on women in the name of midwifery reform & safety.
(From Rosemary Vaher née Smart, used with permission)

It's not simply 'them' and 'us'.  'Hospital' vs 'home'; 'employed' vs 'private'; 'obstetrics' vs 'midwifery'.

Midwives who have achieved the new standard of being eligible for a Medicare provider number, and whose clients are now able to claim some rebate on their midwife's fees for antenatal and postnatal care have been referred to in a derogatory sense as 'collaborators'.  Midwives who attempt to explain the new regulatory framework that is now in effect, and how this may impact a plan for birth, have been black listed in web-based social networks. Some who read this blog may be aware of other examples.

When a group attacks its own members there is little hope for its continued existence.   We don't need to fear outside forces - self destruction will happen if we don't actively prevent it.  My plea to all who care about authentic midwifery, and who seek to protect natural physiological processes in birth, is that we maintain our support for one another, continue to talk to each other, hear and respect different points of view, and continue 'with woman' through this present dark time.

Don't give up! 

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