Being a private midwife can be a minefield, you never know
what action will set of an explosion. We all know minefields are designed to
destroy or disable. This means you can
have a varying degree of damage from slight, mediocre or catastrophic. Clearing
minefields is a long, slow, time-consuming process, and there is no room for
error, a bit like the life of a private midwife. There is no clear pathway
every woman (case) presents another set of issues often a new battle or the
same one revisited but it is the same minefield, you just pray that you don’t
step on one and get damaged. You have to select your path carefully.
What is so infuriating; the level of bureaucracy that is
required…. let me share a story or two…..you have a so called ‘low risk’ woman
who wants a homebirth, she needs to be booked into hospital as a backup – this
is required by several governing bodies, however the hospitals play ping pong
with you – Hospital ‘A’ says ‘No’ this woman is ‘low risk’ she needs to birth
in hospital ‘B’. Hospital ‘B’ tells you No ‘we don’t have the infrastructure’
to support a homebirth go to hospital ‘A’ and whilst this toing and froing is
going on….. The woman is progressing through her pregnancy…..God help you if
you have a problem…because everyone wants to pass the buck.... And in the meantime
the Director General has resigned; there is a State election so the Minister of
Health does nothing to assist you and no one in the dept. responds to your
urgent requests for help……What is the private midwife to do? However if the
private midwife is found to be lacking in some capacity the hammer falls very
quickly and very hard…... There is just no equity in this at all…it seems that
progress is ever so slow: however I am grateful for the help I do get from some
corners and without that this journey
would not be worth it…. I am also thankful
for the women for without them we would not be midwives and the breaking of new
ground would not be possible.
On the other hand the minefield is the choice some women
make: they choose for whatever reason to go outside any boundary the midwife
has…outside of the scope of practice the midwife has, and each midwife has their
own limits….. now the midwife can choose to accept that woman’s sole choice at
her own personal risk… as there is nothing to protect that midwife when she
works outside the boundary of the so called ‘low risk’, accept her
documentation and sometimes that is not even enough – the woman is only wanting
what she considers is in her best interest. However the midwife ends up having
to defend themselves and this means $$$$$ in legal fees, even if the midwife
did everything within her power. Who looks after the midwives best interest? Not
the regulatory body, not the government and certainly not the AMA - The Midwife
has too….because no one else will…. This is sad reflection of Midwifery
practice in Australia – I for one am not prepared to risk my registration and
pay out $$$$ in legal fees…. until the midwife is afforded protection as her
counterparts in the UK and NZ the Australian private midwife is becoming are
rare commodity and will become extinct.
I will end by saying I have had some wonderful experiences
with women along this journey and every single one has taught me something
about myself and pushed a boundary – I reflect on every experience and say ‘how
can I make the next one better’. The major drawback is the political battle
that each case brings in access to hospital, collaboration and the support
required…. The burden of collaboration is tremendous….it is a one sided affair….every
now and then you step on a landmine and you get damaged….. And you contemplate
when will the damage be catastrophic and you pray it won’t be you and it won’t be
today.
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