Wednesday, January 16, 2008

"Midwifery" standing independently in WA

The profile of Midwifery has been given a great boost, in Western Australia (WA). This has been a long time coming and a dream come true for many midwives. As you will be aware in 2006 WA introduced the new Nurses and Midwives Act & the Regulations. Also the Nurses Board has changed its name to the Nurses and Midwives Board of WA (NMBWA). You might say so what? but this had made an enormous difference to the Midwifery Profession in Australia particularly in WA and world wide. This is because now you can be a midwife in WA without having to be a nurse first. You might of heard the terms Direct Entry Midwifery? what is this? this is the term predominately used in the UK, NZ or Eastern States. This is a midwife who is not a nurse first, a midwife who has completed 3 or 4 years education / preparation in the art of midwifery. The education for this midwife is as comprehensive as that of nursing but specialising in women, midwifery. We must remember that women who are pregnant are predominately healthy and pregnancy is not an illness. Now Direct Entry Midwives from the UK, NZ, and Canada can register directly in WA and work as a midwife, whereas before they had to register through the Mutual Recognition Act.
In WA we are fortunate to be conducting one of the first Bachelor of Science Midwifery courses at Curtin University starting in February 2008. This course is for people who want to be midwives not nurses. All student midwives will receive a wide range of clinical experience in both the hospital and community setting, together with and intergration of evidence based theory units. The course will be 3 years full time comprising of 50% theory and 50% clinical. The course has been designed to meet the NMBWA & the Australian College of Midwives regulations and standards. At the completion of the Bachelor of Science Midwifery, the student will demonstrate competency at a begininning level in accordance with the ANMC national competency Standard for the Midwife (2006).
I am very excited about this program commencing and being a great success. This is the way forward for midwifery, to be "with woman" and empower women about their "birth choices".

My Experience of Direct Entry Midwifery:

I am a nurse and a midwife, however when I completed my midwifery in the UK and I soon learned what the difference was between the to professions. Midwifery is a force to be reckoned with in the UK, it is emensely powerful. I guess here in WA I never really understood that there was a difference, because the culture here was / is? that you did your nursing first and then you added midwifery, for some, if you wanted to climb up the corporate ladder it was an essential. There really was never a real distinction between the two professions. I must admit when I was a student midwife (postgraduate degree Midwifery) in the UK, I was very negative about Direct Entry Midwives for the first 6 months because of my ideals or perceptions. I was ingnorant about what their course entailed, when I took the time to find out I found that it was more than adequate. It was only when I stopped being so high and mighty about being a A&E nurse, I really began to see the benifits of the Direct Entry Midwives and learn from them. I began to see that their out look on their women was from a normal healthy perspective as opposed to mine that was 'sick' 'high risk intervention', always looking for the abnormal rather than starting from the normal then progressing to the abnormal. I had to learn to be 'with woman' to ask before 'I did' to be still and 'listen to what the woman wanted' as opposed to jumping in and taking over, being paternalist, doing what we think is right, disempowering women. Once I learned this I knew, what it is to be a midwife providing a safe environement for women to be!
I respect and value both professions of nursing and midwifery, I am proud to be both, there is more than enough room for mutual collaboation, respect and embrace the change.
We need to embrace change, because change is good - ïf you always do what you've always done how can things be different"

Be daring embrace life! do something different!


Carolyn McIntosh said...

Good news about the DE program in WA. I had not caught up with that information. Good luck with the program. I teach in Otago and I know that the program here is continually changing and evolving in response to feedback and community needs. I am hoping that blogging adds a new dimension to my teaching. Life must be pretty busy for you at the moment. All the best.

Sarah Stewart said...

I'm a colleague of Carolyn's so I second what she says. We're looking at making our program delivery more flexible so we can reach women who want to be midwives but cannot move to Dunedin to be 'on campus'.

Carolyn said...

Congratulations on your mention in MIDIRS midwifery essence online newsletter. This will raise the profile of your course and also this blog.

Anonymous said...

Hi Im a DE midwife working in Sydney. There arent many of us about in Australia. I was the only one when I worked in Cairns. I must say there are some excellent nurse-trained-first midwives here, and in this country I felt the lack of a nurse background when I considered working in the outback. However I do also notice a very strong shift toward obsetric view of womens health : so much so I feel a real drainging away of hope for normal birth here. Maybe coz i work in private hospitals mostly! Midwives lack a strong identlity and will to fight for normal birth. THe hierachy modely in hopsitals means that midwives never stand up to the doctors and question thier motives or decisions. I feel if DE midwifery would raise a stronger sense of identity for midwives, there would be a greater chance for normal birth to be preserved. Trouble id theres no MONEY in normal birth and theres heaps in obstetric - so that's the way the tide moves.

infomidwife said...

Dear Anonymous,
Thank you for your valued comments. It is great to see direct midwifery alive and well. I think it is important to remember that sometimes health systems in different countries contribute to how women perceive the sort of options avaliable to them. Australia has a high percentage of people with priviate health care cover and therefore sometimes the perception is that if you are paying for a private service you are getting better quality - hence the disparity between midwifery led care and obstetric care. Also the profession of Midwifery is not as well known here in Australia as it might be in the UK and New Zealand (NZ), this could also be attributed to the fact that Australians are still quite medically led. We need to raise the profile of midwifery, that is more midwifery led care - so that pregnant women see a midwife as early as 12 weeks like in the UK & NZ. We are working very hard to raise the profile of midwives and certainly courses such as the Bachelor of Science (Midwifery) will be helping to do this as there are many people wanting to be midwives and not nurses.
The ANMC National Competency Standards for the Midwife 2006 provide a framework for which the midwife is expected to work within, to provide woman centered care. It also recognises the woman's right to self determination in terms of choice, control, and continuity of care, this care is provided in both the public and private sectors of health care.
In terms of the money issue, we need to educate, inform, guide and empower women to make the their own personal choices regarding the birth and care they desire.

infomidwife said...

Hello Carolyn,
thanks for the support, I expect like your course it will continually grow and change dependant on the needs of the community. Watch this space, I am not directly teaching in this course my friend and colleague Jenny Wood is doing that. I am watching and supporting her.
Thanks for letting me know about the MIDIRS mention that was great. Keep up the good work - taking Midwifery & Midwives forward.

siti said...

Hi. I am Siti from Brunei. I am also a nurse and a midwife.Hope we can share our experiences.Cheers.

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