Reflections of March

Wow this month has flown by and what a month, I feel I have been plane hopping all month: as I look back it has been action packed and some of it I will reflect in more detail, a quick synopsis of the month will give you some idea of the places I have been and what I have been up to.

The new semester started at the end of February, I was on the back foot as I was still marking tri-semester work from Singapore (Dec – Feb), which in effect creates a greater work load. The beginning of semester is always hectic and exciting, having revamped your course work and set new assessments it’s always a challenge then seeing the student’s progress through their course gives me a great sense of satisfaction.

Singapore was the first trip of the year, again exciting, challenging and rewarding we start the first session with what are the students expectations of me over the three day teaching period…… if I do not do this I feel that there could be a danger of just vomiting the course information to the all students – my style of teaching is quite animated and I use a lot of case examples to illustrate the use of legal and ethical points and the students seem to respond to this format of teaching…….. I really love it….. And the feedback is always good. Each time I visit Singapore I have my favorite places I like to visit such as Borders & Kinokuniya Bookshops.


I also like to visit somewhere different. This time I went to Sentosa Island to see the new casino and Universal Studios…. However the studio will not be opened until after I leave so I will have to return. Never the less I did manage to find a new bookshop called Page One and I bought Ian a book about his beloved Leeds. I never mind travelling alone, as I can please myself as to where and what I see and if you have a vivid imagination you would be surprised as to how you never feel alone…….but I do miss sharing those special moments with my husband….. “like when I finished teaching and feel on cloud nine because it went really well”. Next trip to Singapore will be August….. so watch this space….


On a personal level we took a weekend out and went to a family friends wedding which was held at Rivendell Winery Yallingup. I worked on the Friday night and enabled a woman to have a wonderful normal birth of a healthy beautiful little girl, so we left early Saturday morning and drove down …….. It was a brilliant wedding……Kate looked enchanting and deliriously happy everyone had a wonderful time……the company, weather, food and wine was divine, what more could you ask for…… but Monday came around all too fast and the working week began again….

The following week was the ACM Board and Strategic meeting…. In Canberra………leaving on Wednesday evening and returning on Sunday night…. It has been three days of intensive meetings, brain storming, networking and sharing with some incredible, talented, wonderful people…. I am so inspired this will have to be another blog…


Beyond Q Books, Curtin ACT

However today we that being Tracy and I did get into a bit of bother with the Federal Police at Capital Hill… We decided to visit Parliament House so we could take the obligatory photo out the front…… however not realizing we had parked at the back entrance….. Which I did think this looks different to the last time I visited…… however we continued…. Walked up the path and took as usual a multitude of pictures….. What would we do without out digital cameras……. We were laughing joking and admiring the building and the beautiful fauna….. Walked around the building and into an alcove which had a very tall gate…. Behind the gate were the most beautiful climbing wisteria bushes I had seen….. And so proceeded to take the pictures beyond the gate….. We then walked back to the car…… as we reached the stairs…. I noticed several police officers and did wonder why all of a sudden there were three of them….two of which were on bicycles and the other had come in a car….. The one on the stairs approached us and said “good morning, nice day” I responded and said “yes’’….. Carefully looking at his uniform making sure they were Police and not security….. The officer then asked me if I had been taking photos of the building……. I did think carefully before answering as I did consider saying ‘no’ however I decided that honesty was the best policy in this instance…..as we live In Australia and it’s a free country in terms of taking photos….. And I needed to be at the airport within the next 2hrs so now was not them time to be difficult. The officer then informed us that we had set of the silent alarm when we entered the alcove and took photos beyond the gate….. This was illegal. I then informed the officer that I had not seen any notices to let me know that 1 – I could not enter the alcove and 2 – I could not take any photos…..to which he responded…. “No there isn’t”….. “we have bought this up before and the powers to be think that the signs would spoil the image or ascetics of the building”. He then asked to examine our cameras and proceeded to delete three photos that were illegal…. From both our cameras…. The officers were very polite and friendly and said it was an honest mistake on our part…… which of course it was…. However I do feel that there should be warnings for the general public not to take photos or enter the restricted area….. To prevent this from happening……I not appreciate my photos being examined and deleted….. However the alternative was not good either…..missing my flight…. On a positive note it is good to see that security is at a premium and that our Parliament House is well protected…. My estimate was that the officers were there within 5 mins of us taking the photos….. So a job well done by the diligent Federal Police and I am grateful to know they are doing their job.



Flying home from Canberra can be tiresome, three hours time difference and several airports to navigate…… I managed to do some shopping at the Melbourne airport during my stopover and of course now I have my 6 hour battery for my Acer laptop I can get some blogs, emailing and work done…… I am looking forward to being home…… have missed everyone…. I am hoping to have a quieter time for Apri, to catch up on some work, blogging etc…. As I have not had a weekend at home for the whole of March…….I just want to sit and chill………………….

Watch for the next blogs. ACM Strategic meeting summary, Group Midwifery Practice plans..... I am so inspired...... its time to move and make it happen......

Clinical question for you?

A client presents: 37+3: G2 P1: Group strep B positive for IV antibiotics in labour..... history of Spontaneous rupture of membranes (SROM)at 0200hrs.... presented to hospital at 12noon, fetal movements felt and clear liquor noted...team decision for IOL...dept busy so client to walk around until staff available to commence IOL, the woman may go into labour on her own...still no contractions... now 1300 hrs staff available.. CTG for 20mins reactive no contractions, clear liquor noted..... IV syntoncion commenced as per regime.....Would you do a baseline vaginal examination at this point or would you wait until the woman commenced contracting? is there a need to do this vaginal examination at this point? What do you think?

A historic day today for Midwives in Australia

Today's legislation gives midwives the right to a Medicare number come the 1st November 2010, whether you are a supporter or not of the new legislation this is a monumental day… never in Australian history has such recognition be afforded to the profession of Midwifery.

It was good to listen to the proceedings in Parliament and hear the words 'midwife' 'midwifery' continuity of care' spoken so many times and in such a positive light and for the first time to hear the AMA take a bit of heat...it was truly exciting and it will be worth reading the transcript.......for prosperity...

The Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009

The Midwife Professional Indemnity (Commonwealth Contributions) Bill 2009

I have thought long and hard about this legislation and despite its short falls I still think it is a good place to start. Recently I had the pleasure of meeting an esteemed midwifery blogger who introduced me to a new way of contemplating this legislation, that being: it is a ploy by the AMA to manipulate midwives and midwifery through the process of collaboration, that this is what the government had planned all along and we as midwives were lambs to the slaughter…….. Although I am open to this suggestion ….. I like to believe other wise that the Health Minister had the best interest of women and midwives in creating this step towards the emancipation of midwifery and midwives to provide woman centred informed choice…. the freedom of choice, place of birth for women and access to a named midwife.

The fight must go on to define the terms’ collaboration’ and also defining ‘eligibility’ what is the ‘eligible midwife’. Midwives have the right to work autonomously and not be controlled by doctors or obstetricians…… Midwives are the expert in the ‘normal’ process of birth…… Homebirth is not illegal it is a reliable choice for women, for which they should be given the option….. And not controlled by the medical model. Someone recently said to me “rules are meant to be questioned, we should not follow blindly” and our cause is one such case…… we need to stand up and be counted…..we as midwives have the right to birth women at home if it is the woman’s choice and it is safe for her to do so…… We must remain vigilant, posed ready for battle to defend this right…… and make sure that the government, doctors and anyone else that may wish to deter us from being able to provide women with the freedom to choose what health care want.

It is an exciting time of the year..... the new semester

Sorry I have not blogged for a few weeks....
I had a mini break.... it was a girlie weekend in Sydney for one of our friends 50th birthday, it was planned early last year... just brilliant...just what the doctor ordered... I spent on night in Sydney it was fantastic, it has a bitter sweet place for me, I spent the last few years of high school there, the first few years of my working career, my first love and the birth of my son.... and heartache about my mother and family life...walking around Martin Place and the city bought back many memories both good and bad... it feels like going home, even though its not.


I met up with an old nursing buddy from 30 yrs or more ago....it was interesting sharing dinner and reminiscing....its good to do that from time to time. I then caught the train with the gang and spent the next few days in Brooklyn.

Brooklyn on the Hawkesbury: NSW



Life is grand as you sit and contemplate it on the edge of a pier, the sun is rising, chorus of the birds in the background and in the distance a reminder of city life with the constant drum of traffic catching your eye… this is a little piece of heaven…. A secluded secret part of the world… as I sit and write this blog I am watching the birds on a tin roof preen each other chatting away and I think how privileged I am to be witness to such a life…. Now the waft of bacon and eggs drift across my nostrils and remind my stomach of how much alcohol I consumed last night…… it was wonderful to see Jen again and be with such lovely people….there is something special about a group of women sharing, drinking, laughing… there is no stone unturned… we are a force to be reckoned with… and as much as I think it’s a mans world there is nothing more forceful than strong women……maybe money….. These birds can be noisy buggers……. It’s time to get some breakfast……




I met up with some of our Eastern States midwifery colleagues who are for me truly inspirational... and gives me the reason to continue the journey for the recognition of the "midwife" in Australia, I like to use the analogy of the Suffragettes fighting for the equality of women....in trying to get the vote....when describing the political battle midwives are having to be heard, seen, given the right to provide women with continuity of midwifery care, informed choice, the right for women to choose where they want to birth....and for midwives to work autonomously, and not be subjected to being signed off or controlled by an obstetrician..the medical model..... Collaborative care is a two way street....
It was fab talking to other midwives and gaining a broader perspective of the issues midwives and midwifery are facing in these challenging times.....



Back to reality with a thud...it is the beginning of the semester... new students.....it is always so exciting to see them...the enthusiasm is palpable and as for me I just love the thrill....I love the first lecture.... this is when you have the most students and you can have them eating out of the palm of your hand.... sharing the knowledge its just brilliant... however my workload is exceptionally high.... I know, I can hear every academic saying "yes whats new".... I tried going into work on Monday with a new philosophy...."I have enough time in the day to get everything I need to get done...completed"... well that was a complete farce...it got from bad to worse and I am just chasing my tail.... the email inbox still needs to be emptied...on second thoughts maybe it was a bad time to go to Sydney... better planning next time..but alas you really cant choose when you are going to be 50... it was a brilliant time and I am thankful for the wonderful time I had...ah well there is another day tomorrow.....and the work will still be there.....

PhD or not? is it worth it?

Does this hat suite me? there is a lovely maroon gown that goes with it....is it worth up to 5 yrs of my life???? I was recently part of the academic procession at the university graduation.... and I was really inspired and enthusiastic about doing my PhD....as I watched others receive their awards... some of them looked so young...I took this picture to place on my vision board....in an attempt to see the end result.... but then when all is said and done... reality bites ....

The burning question in my busy lifestyle is whether or not to do my PhD? I am at candidate stage and have been for over a year...but have been too busy to pick it up... I need to now make a decision.... I initially was going to do something on nursing and midwifery documentation but have since changed my focus and would do something surrounding women's choices, birth, midwifery etc....I would also like to leave a legacy... something significant that changes practice for the best...but I am not sure if it is worth it....it will take three years full time or five years part-time...

I am now 53 and wonder the value of continuing along this road....Once I commence the journey I want to complete it...but something will have to give in order for me to do it... the subject matter is something I am passionate about but the financial reward is minuscule....My current workload does not permit me to pick up this study, there are just not enough hours in the day.... as for my private life.... we have seven grandchildren and still counting...whom I adore and love to spend time with as they are young for such a short time...this would mean less time for everyone.... then there is my husband, I am sure he would support anything I choose to do even if it was standing for the opposing political party to him......Working is a must... but I can reduce the number of hours I work....


I do enjoy studying and challenging myself.... the other option is not to do my PhD and continue doing what I am currently doing and get more involved in the college.... I am not sure how I will go with that...as I don't have a challenge.....
I follow Sarah Stewarts blog and she also had this decision to make..read her PhD Dropout... it is not an easy decision.... if you wish to remain in education.....I am no closer at making this decision... it will also mean I will have to change the way I study in order to complete the PhD which is usually evening study, it will take up some of my weekend if I am to complete it in the required time frame.....

What do you think? what is the answer?

Allowing women to make their own decisions......

Here is the follow up to the Empowering women - not as easy as you think scenario

....the woman is GBS positive with query ruptured membranes....she has commenced IV antibiotics, the advice given to her by the doctor is to be induced immediately 1700hrs....as the doctor feels she will not go into labour on her own...she is currently contracting 1:10 mildly. After being given all her options by the midwife....

The woman chooses not to be induced until the morning and goes against the medical advice given (this is all clearly documented).... she does choose to stay in hospital and wait until the morning.... her hope is to go into normal labour.... the outcome of this scenario is that the woman continued to walk around, eat, drink and no monitoring, until in established labour.... she progressed into normal labour and birthed at 0739hrs that morning....an assisted birth....

This was a good outcome by a woman who knew what she wanted and was willing to standby that decision despite the advice given by the doctor....she determined the risks and made her mind up with the information given... together with what she had anticipated for her birth (her birth plan was a natural normal birth) and an induction of labour was not in that plan (as it meant, restrictive movement, monitoring) however she made the best compromise she knew how..... to achieve what she wanted..... well done... congratulations......

Anger due to cuts in private obstetricans fees

This is an interesting debate the cutting of costs for rebates in private health insurance. Previously women could claim 80 per cent of out-of-pocket obstetrics fees after reaching the safety-net threshold.
It is also interesting to see that low risk women are asked to attend local hospitals as opposed to mainstream high risk hospitals where the intervention rate is much higher. This is where we would benefit from having more birth centers, or midwives working out of hospitals within the community.
The question is will this push women to seek midwifery led care in low risk cases, as opposed to paying more to see a private obstetrician and risk the cascade of intervention..... and higher costs.
The recent newspaper article Anger over cut to obstetrics rebate discusses these issues, stating that in the current boom will we run out of beds in our hospitals.

What the article fails to mention is that midwifery led care in low risk women is a more affordable option and saves the tax payer millions of dollars.....