August 21, 2003

Sally Tracy and midwifery reforms

Yesterday I spent a wonderful couple of hours with my colleague Sally Tracy. She has just completed her doctorate in midwifery (Australia’s first) and in the process produced some magnificent research papers that have been enormously useful in pushing the case for autonomous midwifery care in Australia.

Sally has been appointed as Associate Professor of Midwifery Practice Development for the Northern Area Health Service and the University of Technology, Sydney, and in that role she is overseeing the development (at last) of innovative midwifery programs in the northern suburbs of Sydney.

This geographical area has always been the affluent part of Sydney, and consequently it has had a plethora of privately practising obstetricians and private hospitals. It is the only health region that has steadfastly refused to modernise by building birth centres or establishing midwifery services, and a year ago there was an attempt to close three smaller maternity units in the name of developing a “centre of excellence” at Royal North Shore Hospital. This would have meant that women would have had to travel some distance in labour, something that the planners has decided women would tolerate (but they didn’t actually ask them, they just made this assumption). When the blueprint was revealed, amid much fanfare and in the lead up to a State election, there was an outcry and this part of the plan was dropped.

Sally has been appointed to get things moving and she is off to a running start. After a few months in the post she has already flagged that things will be changing and the doctors, used to making decisions without consultation or citing any evidence, are being challenged - an unfamiliar process, but one they will have to adjust too quickly.

One of the smaller units in the area, Ryde hospital, has indicated they are willing to explore setting up an autonomous midwifery model of care. As the operational and staffing details are being finalised, it is possible that women in Ryde will have access to the first truly autonomous midwifery service in Sydney. Once this is in place, it will serve as a model for others and it is expected that other hospitals will follow suit.

One advantage that Sally brings to the task of establishing these types of services is her experience of working in New Zealand, where she regularly lectures and works as an occasional locum (her “sanity time”, as she would say). She know these systems work well, for midwives and women and she is just the person to push reform through the maze of bureaucracy and professional obfuscation that the health system specialises in.

We are lucky to have her working in the field and I, of one, hope that she will stay in a practice setting rather than submerging herself in academia and research.

Posted by andrea at August 21, 2003 09:19 AM

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