Friday, October 29, 2010

Being a student again: a humbling experience:

As a lecturer myself I consider that I am a considerate fair and equitable person when I am dealing with students, in fact it applies to all aspects of my life ; one thing I really don’t appreciate is being taken for a ride.... in other words when students “take the piss” then I come down like a ton of bricks;
As some of you are aware I have commenced another course reaching for new heights..... My aim is still woman and birthing focused..... equality, autonomy and right to refuse treatment; the right for women to choose where to birth and with a midwife.
Being a student in a completely new discipline has been daunting....going from experienced to something completely different, a whole new style and way of really is letting go and learning new ways of being....I still have not mastered this... I guess it will take some time; patience is the lesson I need to master;
As I reach the end of the semester (13 weeks) and start to cram for exams, which incidentally I think is the worst way to learn anything.....I really appreciate the way that I interact with the students whom I have been privileged to teach. Most of the lecturers I have encountered over the past 13 weeks have all been inspiring, articulate and passionate, exactly how it should be; however there is always one.....that is challenging. This one is a male.... he takes a tutorial group... he walked into the class.... or I should say he strutted in and said “hello I am Fred and I Fucking swear.... and if you fucking don’t like, there is the fucking door” well I was flabbergasted my jaw hit the floor.... there were students squirming in their seats...myself included. Here is a man who is presumably highly intelligent.... or so I thought, holds down a very important job and I am sure he would not swear in a court I wonder why he would do so in class.....Our assignment was a case study that we would work on and discuss in a tutorial group, this is nothing new similar way of teaching that I have adopted.... I did notice that I used to say to my students “now this is easy, just follow the model as I go through it” of course it seemed so easy to me, as I teach it week in and week out.... with enthusiasm I might add.....when my tutor went through the case study at 100 miles an hour, telling me how easy it was..... the penny dropped for me.... this is exactly what I said to my students.... “I felt like saying of course its “Fucking” easy you teach it week in and week out and you know it, but alas I did not, I sat quietly and decided I would never tell my students how easy something was.... because it’s not me doing it” lesson learned;
The other valuable lesson I have learned is how vulnerable you can feel as a student: I mean I know that this is possible but as a student you want to pass, so therefore you do not want to be to argumentative as marking is so subjective a terrible way to feel and you don’t want a personality clash; if your tutor does not like you, would it affect your mark, theoretically no.... I felt several times when I questioned the tutor’s methods I was quickly reminded who was the student and who was the could I forget this? I decided it would be best to grin and bear it.... until the unit was over... then I could have my say! Now we are at week 14 he has become nicer....more considerate for the first year students.... even thoughtful.... it must be the semester is nearly over..... and all I can say is thank God for both of us; this experience has made me reflect more on my own teaching methods and I am ensuring that I am always fair and equitable.

Saturday, October 16, 2010

Community Midwifery Program AGM

My day started with some housework.....watching my grandson play his first game of tee-ball, they look so cute and little, wow Dylan at 5 hit the ball quite well and I was impressed; It did remind me of when my children started playing tee ball, the weekends of sport; As for Miss Bella she has just learned to play tag.... so spent my time watching and then playing tag... it was fun; I had enough time to stop and look at a school fete and couldn't’t resist buying a snoring teddy bear... I thought the grandkids would enjoy it when they come and visit....

The afternoon was spent at the CMPWA AGM; it was a delightful meeting, relaxing, it is so good to go a meeting and see mums, babies, (mums breastfeeding) midwives and yes a politician; Rachel Siewert Greens Senator for WA; it was refreshing.... you cannot go to many meetings in the current political climate and not talk about “the determination”; Rachel was a dynamic presenter, she outlined the history of the Maternity Services Review and the enormous progress that has been made in terms of maternity reforms; and the greatest voices are that of women with their babies..the march onto Parliament House the success of the mother of all rallies, in which the government realised what an error was made by not including homebirth in the Maternity Reforms which then lead to a retraction and a two year exemption on homebirth; which I might remind everyone that we have 18mths left and we need to be formulating a plan to include homebirth; one thing was evident for me and that is the power play of the AMA, politicians and midwives; I have said this before that we need to be focusing on the choices of women, the right to choose where and how to birth..The right to refuse treatment... the right to self determination of women.....not just about homebirth; we need this legislated as they do in the UK and NZ: then it is not about the AMA or midwifery, it is about women:

Rachel also discussed the views of many stakeholders, the many varied views on the determination; she gave some detailed background about the process of allowing and disallowing the determination and the possible way forward; she also acknowledged that in the mean time it was important to collate all the evidence of collaboration not working and forward this information to her office; the Australian College of Midwives is also collating this information so you could forward instances of collaboration not being effective to

It was time for a bite to eat a cuppa, mingling & networking..... I was fortunate to meet Dr Ralph Hickling who is a retired Obstetrician; he is launching his new book entitled; “Childbirth today: Too many caesars, not enough joy?” a very interesting man... the book launch will be on Thursday 28th October at 6pm in the Fremantle Town Hall; if you are free come down and buy a book.....I can't wait to read it....

The AGM followed the break; Debbie Slater gave the Chair’s report eloquently and speedily, elections were conducted, no new business and the meeting was done.... the quickest AGM I have been to in a while... fantastic..... Then there was cake and more chatting....every midwives dream.....

It was late afternoon by now, I had enough time to call in to see a friend on the way home before dinner with my sister-in-law and an early night.... ah but the blog needs to be written...... so maybe not so early to bed, but its Sunday tomorrow sleep in day;

Thursday, October 14, 2010

Do we ever learn from history?

I found this pearl:

In 1960 they asked 'Why are most mothers in this country delivered while lying flat on their backs? Traditionally it would seem thatwomen were delivered in a sitting position. Recently it has been re-discovered that this position can reduce pain fromsevere back-ache during labour. The sitting position also reduces by 23% the strain on the heart compared with therecument (sic) position. Many women find that lying on their backs during the second stage of labour is uncomfortable(especially so as they are so often required to do this on a high, hard, narrow "bed") - "like a stranded whale". Surely aproperly designed delivery chair would not be beyond the bounds of 20th Century ingenuity?’Sonia Willington, AIMS Newsletter 2

Why are we asking the same question 50yrs later?

Wednesday, October 13, 2010

Time for Medicare Provider Numbers; it has only taken 24yrs

On the weekend I was in Melbourne and I was fortunate to hear this piece of information which made me sit up and think.... has much changed over 24yrs?..and if we miss this chance will it take another 24yrs?

Submissions concerning midwifery were received from the National Midwives Association the Royal Australian Nursing Federation, the New South Wales Nurses Association, the Launceston North Coast Home Birth Support Group and numerous Private individuals. ......Most of the submissions proposed that midwife be recognised on an equal footing with medical practitioners in respect of the payment of Medicare benefits for certain services associated with uncomplicated birthing........of the many medical and paramedical issues raised with this committee, the question of the payment of registered midwives generated the greatest depth of paramedical submissions addressed 25% were midwifery related......

Has much changed in 24 years..... we are on the brink of change.

Some midwives are confusing the Medicare Provider Number with the requirement of insurance. However the issue of insurance is a requirement of National Registration s129(1)registered health practitioner must not practise the health profession in which the practitioner is registered unless appropriate professional indemnity insurance arrangements are in force in relation to the practitioner's practice of the profession.

In order to have a Medicare Provider Number you need to be an eligible midwife... Have a look on the Australian Nursing and Midwifery Board site to remind you what these requirements are;

The Health Insurance (Midwife and Nurse Practitioner) Determination 2010; for the Medicare Provider Numbers... check out the determination; the Midwifery services and fees range from $31.10 -$724.00 also is included 6 weeks of postnatal care...which is excellent for women and will also help provide greater postnatal care....

This is the beginning of new things, an opportunity of greater access for all women... however we must remember that unfortunately this does not include homebirth...therefore we need to more than ever keep the pressure on the government.. to pass this service fee onto women who choose a homebirth.....

Sad state of affairs for WA homebirth! Give me a break

Currently in Western Australia there are several options for having a baby.... you can check out this website; Having a Baby in WA - birthing options; the website offers information relating to most birthing options; Recently there has been much debate over Homebirth, with the Maternity Services Review and National Registration which now makes it law for midwives to have insurance cover and this is attached to registration; with an exemption to homebirth insurance for two years;

WA has a government run homebirthing program; Community Midwifery WA which provides a homebirthing option; the website carries valuable information for the women of WA including the pros and cons of Homebirth; The AMA has taken it upon themselves to object to this information saying that Homebirth is not a safe option and wants a warning on the website to alert women to this issue;
Today there has been great debate over this point; on the ABC radio show this morning; The health Dept chief medical officer Simon Towler says... that homebirth was a safe option... However the Health Dept says there has now been a warning included to the homebirth site,
now this is a very clever point; there is more than one way to skin a cat.....
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists do not endorse homebirths.
You can read their College Statement here.
The Royal College of Obstetricians and Gynaecologist in the UK do support homebirths – see here for their joint statement with the Royal College of Midwives.

Read the article; "Website promoting homebirths amended";

The AMA's WA president David Mountain said the website information about home births was misleading and did not warn about the dangers involved....

The article also goes on to mention that women should speak to an expert in this area.... well that has to be a midwife an expert in the 'normal process'.
51 WA doctors 'too dangerous' to treat patients without rules
In one case, an obstetrician found guilty of conducting rogue surgery has been allowed to continue practising - but has been banned from using forceps when he delivers babies

Another story over the weekend..... Parents sue over botched forceps birth....."A BABY boy could be left with brain damage after a WA obstetrician's bungled attempt to use forceps during his delivery".

I challenge the AMA Dr David Mountain to please put a "a warning for low risk women having a hospital birth for all iatrogenic injuries caused by a hospital admission for birth". More than 2,500 people die from hospital related injuries.... the Cesarean section rate is higher than ever..and still there are injuries and deaths associated with that....the risks for women having an unnecessary cesarean far outweigh the risks of a homebirth...see the ican website for the facts. .....

Give us a break AMA; Why don't you listen to what women want!

Tuesday, October 5, 2010

Time, Love, Passion and Life: Children:

Time is of the essence; My mother use to say "Pauline there is only time for the quick and the dead" I wish I had Hermione Granger, time watch... that alters time so you can fit it all in...from the Harry Potter movies. There is no doubt that I am a work-a-holic... I have been very well trained for this...again mother use to say "don't sleep your life away, get up and do something".

Over the years I have learned to relax and wind down... I love spending time with Ian on our spontaneous outings...or our occasional golf game.... and the day trips with the Grandchildren are a genuine treat..this is what memories are made of.....even the sitting and watching a Disney cartoon with them is delightful.... Finding the balance with 7 soon to be 8 grandchildren, and a passion for my work can be difficult....but I think the time spent with the children make it more special for both of us....if I was to ask the grandchildren what are their favourite moments with me, it will have something to do with going out on one of Nana's trips...

I have collected a few sayings that really sum up what I think about time.....that relates to family, work and life..... can you guess which one I like most?
Time is making fools of us again. ~J.K. Rowling

Time is the coin of your life. It is the only coin you have, and only you can determine how it will be spent. Be careful lest you let other people spend it for you. ~Carl Sandburg

If you want work well done, select a busy man - the other kind has no time. ~Elbert Hubbard

"Time is a great healer, but a poor beautician." - Lucille S. Harper

"Dost thou love life? Then do not squander time, for that's the stuff that life is made of." - Benjamin Franklin

"The bad news is time flies. The good news is you're the pilot." - Michael Altshuler

"All the flowers of all of the tomorrows are in the seeds of today."- Chinese Proverb

"I am only one, but still I am one. I cannot do everything, but still I can do something. I will not refuse to do the something I can do." - Helen Keller

Love makes the world go round.....I think of love and remember the first movie I saw about love.....yes the classic "Love Story" with Ryan O'Neil & All McGraw:
"Where do I begin (Andy Williams)
To tell the story of how great a love can be
The sweet love story that is older than the sea
The simple truth about the love she brings to me
Where do I start

The other great movie that I watch when i just want to switch off or feeling low...that gives me a lift is the wonderful "Sound of Music" I love the scene when Christopher Plumber kisses Julie Andrews for the first time... on the garden is just such a romantic moment...I know it's sad... but I love it...

love is what makes life worthwhile, I could not be me without my family and friends; the profound love that you have for your children is for some reason multiplied with your grandchildren.... and I think this is because you are wiser, less strict, you can see the error of your ways as you get older.... or you become a soft touch for those beguiling eyes...they are just so beautiful....
It's kind of fun to do the impossible. Walt Disney

If you want to make enemies, try to change something. Woodrow Wilson (1856-1924)

Life is short and we have never too much time for gladdening the hearts of those who are traveling the dark journey with us. Oh, be swift to love, make haste to be kind. Henri Frédéric Amiel

When we are motivated by goals that have deep meaning, by dreams that need completion, by pure love that needs expressing, then we truly live life. Greg Anderson

Teach only love for that is what you are.
A Course In Miracles

I love life, my family and I am passionate about women, midwifery, midwives, law, ethics, fairness & equality and having fun with my children..... but most of all I want to achieve my dreams and vision...and teach the grandchildren about being passionate and following dreams.....for this I need the love and support from my family.....because this is who I am and what is most important next to them.....time is of the essence:

ref for picture;

Sunday, October 3, 2010

Pondering the profession of Midwifery:

I have spent the weekend away from the email and work to try and recuperate from a really bad dose of the flu..... I must be run down, I have taken the opportunity to ponder my future..........The recent months have created much, discussion, passion, excitement, lobbying, stress, anguish, disillusionment, tension and more recently a more pronounced division within the profession of midwifery; even to the point of a midwife reporting the Australian College of Midwives to the ICM (International Confederation of Midwives) which I find extraordinary, I would of thought this would be saved for something so terrible; not here a modern, young progressive country such as ours with excellent maternal and infant outcomes however not so good midwifery services.... I am lost for words at this dissatisfaction within the ranks.....from what I can determine there is a strain of midwives that believe that no matter what the risk factor a midwife can provide the primary care without the necessary collaboration: I am particularly thinking of the twins, footling breach, high blood pressure, more than 1 caesarean at home type births; the homebirth that is not recommend at home. Any high risk category requires an obstetrician, this does not mean that you cannot have midwifery care but you have to collaborate with an obstetrician and birth in hospital.

Tawny Frog Mouth Owl (Male)

This has caused me to reflect on what my own vision is for midwifery within Australia as we are on the cusp of change or no change as it may be. Before I can discuss this it is important to say that I have only practiced midwifery in Australia for 7 years now after completing my midwifery in the United Kingdom and working there for several years, so my basic ideology of midwifery comes from my experiences in the UK. When I first arrived back to Australia as a Midwife it was extremely different and difficult to work as an autonomous midwife to the same level as in the UK, in fact impossible: I even tried the Birth Centre where I was told “no we do not do water births, you have to pull the plug out”, tried independent practice but the thought of no insurance and no support system was too much of a risk, I nearly gave up the profession several times as I felt it was a losing battle.

Nevertheless what kept me strong was the idea of being a change agent and influencing the public perception (namely women and not just the minority of women) of midwifery in Australia so I continued the journey for change and the freedom of midwifery from the medical model which is so prevalent in Australia. So how does one go about change in such a huge way, it seemed only right that you should join the peak professional body for midwives, which is the Australian College of Midwives; whose philosophy is.... “Our vision is to be the leading organisation shaping Australian maternity care for the benefit of women and their families”. The college’s work is to provide a unified voice for the midwifery profession, supporting midwives to reach their full potential and ensuring all childberaring women have access to continuity of care by a known midwife”....The College has grown significantly recently as the profession has gained recognition and respect. The numbers of midwives within Australia has been difficult to quantify.... and so too are the numbers of independent midwives; with nursing and midwifery being lumped together; However due to the new National Registration and separate registers for nurses and midwives, we will finally be able to separate nurses and midwives and determine the numbers of midwives etc;

Tawny Frog Mouth Owl (Female with baby)

Traditionally in Australia midwifery has been seen as a tack on postgraduate course to recent years we have seen the introduction of the Bachelor of Midwifery course which will also improve the profile of midwifery as being separate from nursing; ....... ever since I can remember (20yrs ago) the reputation of midwives is that “they are outspoken/bossy women” “consider themselves better than the rest” “ a bunch of dykes or lesbians” “difficult women” ‘feminists” and I am sure you know more than me, you have to wonder who put these labels upon us? And as I ponder my future.... all these anecdotal comments about midwives are no different now to 20yrs ago..... I have to say I aspire to being a “feminists in the truest sense of the word” I have always valued and wanted equality for women and I firmly believe to be a high-quality midwife one of the qualities is to be a feminist or have feminist ideology.
There are three main facts that I think are imperative to where we currently stand politically: What is a midwife: Medical dominance in obstetrics; Private Health Insurance:

The leaning tree

The role of the Midwife: I was amazed on my return to Australia how very little was known about who a midwife is? What is the role of the midwife? Coming from a system where every woman sees the midwife at 6/8 weeks at the GP surgery to women not seeing a midwife until 19/20wks...... unforgiveable for a woman & midwife. Therefore the first trimester is left to the GP/ wonder they don’t want to give this up now as it is money lost to them......I realise that funding is different here in Australia as compared to the UK, but this just illustrates that there are huge changes required for women and the medical profession in Australia; interestingly if you examine midwifery history you will see that the UK and NZ have gone through several battles similar to the ones we are going through on two fronts, that from outside midwifery (political/medical) and internally from the difference of opinion from the independent sector of midwifery.

The second main point is the medicalisation of childbirth; it seems to me that in Australia generally women take on face value what a doctor says and takes very little responsibility for their own health care or pregnancy.... they seem to have the notion that “Doctor knows best” “just do what you think is right” you are the doctor, however I think this is slowly changing, I am hoping women are changing and taking more control of their bodies and their pregnancy;

Thirdly is private health insurance; here in Australia the uptake of private health is far greater than in the UK, and women seem to think that private health equals better, higher quality health care, which is not the case. Most importantly women think that obstetrician means best possible care whilst pregnant, and this is definitely not the case; private obstetric care means higher caesarean section rates and longer stays in hospital. Yes you need an obstetrician when things go wrong or you have a high risk factor.... but there is no reason why a woman should not be seeing a midwife alongside the obstetrician....but this rarely happens.....

As far as childbirth goes, Australia has a history of being medically led, midwives and midwifery is starting to gain some recognition, up until this point there has been no funding to support the profession of midwifery; the AMA is very strong and with its blanket rule of no support for homebirth this clearly indicates there is no support from that front. The independent midwives feel that the ACM is not supportive enough because they choose to take the safe route which will benefit many women & midwives rather than a few...and this is not to say that the few are unimportant, absolutely not, but small steps of change need to occur in order for greater change to follow; therefore working towards changing a medically dominated system that cannot be changed overnight and made to accept midwifery led care when this is a whole new way of thinking, in this country....... I have always thought it is best to take small careful considered steps to success rather than giant steps trampling on people to get the same result.

My vision is similar to that of the College in that I think that every childbearing woman should have access to continuity of care by a known midwife and that
I would like to see the ACM have its own industrial arm and legal support for its membership
(separated from the ANF)...... however in saying that.....I do despair for the future of midwifery in this country with such fragmentation within the profession........ As for me I am still pondering..... Shall I stay or shall I go? Is there a point to all this?

Isabella 2yrs old, her expression says it all!

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