July 01, 2003

Lessons learned in Europe on this trip

Today I start my trek home, after 5 weeks of touring around the UK and Spain. It has been an interesting trip, taking in England, Scotland and Wales and the program included the “Essential Midwifery” Program with Lynne Staff and the usual mix of Active Birth and Teaching Skills workshops. As I prepare to leave, I am thinking about what I have learned from this visit:

Scotland has more midwives than it needs and some can’t get jobs, while in England there is an acute shortage.
Wales is forging ahead with midwifery targets and initiatives that will give midwives there a higher profile and better working conditions. Their new Clinical Pathway tool will reduce the paperwork involved in caring for a labouring woman and hopefully enable births to be classified as “normal” more often.
Many of the larger teaching hospitals in England have abandoned the CTG trace on admission but have instituted 15 minute FHR readings throughout first stage instead. This seems a sure way to disrupt normal labours and create more work for midwives and potential anxieties for labouring women.
Midwives in Spain happily work 24 hour shifts, as they have always done, while midwives in the UK are being told they cannot work a minute past 12 hours maximum because of European Union Working Time directives. Both countries are members of the EU.
Spain has the lowest birthrate in Europe (1.2 births per woman) and some of the most antiquated maternity care practices. It is a staunchly Catholic country.
There is a need for midwives in England to gain skills in team building if they are going to be successful in creating the many birth centres (born again midwifery-led units) they need to create genuine options. Bullying is rife and counterproductive behaviours abound in midwifery circles.
The National Childbirth Trust is still stuck in its very middle-class attitudes, and while it does an excellent job with parents in this demographic, their teachers and leaders have no idea what it is really like at the coal-face for the majority of educators in the UK, who work within the NHS. The NCT have little chance of expanding further into the community without better leadership and closer working relationships with midwives and parents on a broader scale.
Prenatal education programs are being cut back within the NHS in many areas and there are still hospitals in the UK that have no programs for expectant parents at all.

There is much more to think about and I will expand on further thoughts in future Diary entries. It will be a couple of days before my next entry - the trip home will take 24 hours of travel time. Back to you soon after!

Posted by andrea at July 01, 2003 05:38 PM

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I am really not sure who all will read this, i hoping that it is some one that can help me. i would love to volunteer some where in europe, with a midwife and see all that goes on. i want to become a midwife when i finish nursing school in a year and i would love to see what it is like. i would be grateful if someone could help me out.

missy

i am sorry if i am not supposed to post things like this here but i really had no idea what else to do

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