August 02, 2002

Rural midwives under threat

Last week I was presenting an Active Birth workshop for midwives in Wagga Wagga at the invitation of the Community Health Service in that region. There were representatives from all the maternity units in the area and it was clear that many were feeling very stressed, due to pressure caused by staff shortages and, in some cases, heavy handed demands of obstetricians.

One of the issues that arose was that of the threatened closure of several small maternity units. Midwives were unhappy about referring women to other units where they might get more choice in their care because that would reduce their own client numbers, perhaps tipping the balance towards closure. I heard that the obstetrician in one town was being allowed to lay down the law (e.g. “all women must deliver on the bed regardless of their wishes”) because he was threatening to leave if he was thwarted.

I pointed out that given the shortage of midwives, they were in a great bargaining position to lobby for the midwives clinics that they wanted and also for other midwifery models of care, which would reduce the need for obstetrics and cost less for both the hospital and the community. I described the National Maternity Action Plan (NMAP) and gave out some copies of the summary document, encouraging them to download the full document from our website (se button on t he home page). It has all the research, costings, logistics and practical implementation ideas that they need to instigate a community based midwifery service.

At the end of the day, the threatened closure of small units and the shortage of staff can be seen either as an inevitability or an opportunity. Looked at positively, this crisis provides the best chance for midwives to get the services they want to provide, which will not only improve their working conditions ( a major factor in retaining staff) but also give women more choice in rural areas.

I just hope that the midwives can find the necessary extra strength to take on this struggle, knowing that the end result will be worth it. In the meantime, I will be back In Wagga Wagga to do a Teaching Skills workshop next month and I hope to keep their spirits up with another Active Birth workshop early next year.

Posted by andrea at August 02, 2002 04:48 PM

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