November 12, 2002

Reflections on this UK visit

Today is my last day in the UK for this tour. It has been hectic, to say the least, and I am looking forward to 24 hours on a plane, far away from people, phones, faxes and emails!

The overwhelming impression I have formed from my contact with some hundreds of midwives and educators at workshops and conferences during this visit is that midwifery is steaming ahead in some areas and in the doldrums in others. Midwives are stretched everywhere and morale is low, except in those pockets where home birth rates are high or midwives are working in successful team/caseload practices. I’ve met midwives who do many home births, and others who are setting up birth centres with woman centred philosophies. I’ve met innovative educators and heard about wonderful prenatal programs tailored to meet the needs of parents rather than those of the system.

I have also come across a few midwives who still want to retain power over women, think nitrous oxide is akin to “having no drugs” in labour, are convinced that TENS increases endorphin levels in labouring women (despite no evidence for this statement) and that diamorphine is God’s gift to womankind. There have been eductors who only do the classes because they are forced to and others struggling under impossible conditions to provide any kind of half-way decent service. I guess this kind of mix is to be expected in a country with a population of 60 million and a health system groaning under its own weight.

Tonight, as I set out for home, I wonder what awaits...... bush fires, heat, dust and a parched landscape. There is also the energy of the NMAP team, the hustle and bustle of various election campaigns (and opportunities for pushing birth reforms) and exciting developments with our own Birth International workshops and Grad Dip program. It is going to be a long, hot summer and I am looking forward to the challenge. Next stop - Sydney!

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