October 23, 2003

Maternity care in Guernsey

Guernsey is proving interesting, especially the health services, which are run by the local Health Board. People pay to visit the GP (£25.00 per visit) and a flat rate of £2.50 per prescription. Services provided at the hospital are free and the Health Board contracts the doctors to provide the in-patient care. Maternity services are in the hands of the four obstetricians on the Island, although there is a midwives clinic and midwives do catch some of the babies.

The group members today claimed that they had high rates of normals births, but I understand that the caesarean rate is 27% and epidural use is also high. Many women have OP positioned babies, probably a result of the affluent (and sedentary) lifestyle that is associated with the main industries here - banking and tourism. Diamorphine (heroin) is the drug of choice and lots of women receive it, along with Entonox. One midwife claimed that it was quite possible to have a normal birth using diamorphine!

Today’s program was a special one-day event, that I will never offer again, after this experience in Guernsey. There were so many issues that we had to leave out and time for practising skills was very limited. Tomorrow’s group will be different and I will try and include some of the topics we omitted today, as they too will only get one day. It feels very unsatisfactory to have only given them half of the program in effect and I feel very unhappy with the result. Of course, the group didn’t know what they missed out on, but I do and it feels very incomplete. The valuations that I received were fine, although I am sure some decided not to offer feedback as they were feeling very defensive and negative after my presentation.

Tomorrow will be interesting and will be yet another challenge.....

Posted by andrea at October 23, 2003 04:20 AM

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Posted by: blackjack on January 19, 2004 10:25 AM

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As a Midwife who has recently taken up post in Guernsey, the practice is one of strict consultant led care with midwives acting the role of an obstetric nurse. A situation which is not highlighted at interview; Quite the opposite.

The manager, at interview led me to believe that Guernsey is keen to embrace the practice of midwife-led care, the consultants would just not let that happen unfortunately.

Clinical practice as a Midwife in Guernsey is impossible, it really is no wonder that Midwives feel dispondent and moral is at an all time low.

As a Midwife who has been qualified some 15years, I can not advocate Guernsey as a place of sound practice.

Please withhold name and address with thanks

Posted by: A Midwife on April 19, 2004 12:52 AM

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As a group of Midwives presently working in Guernsey we would like to respond to the letter dated 19th April, 2004.
This is not a true representation of midwives feelings and practice. Although at present it is a Consultant Led Unit, Midwives are working towards offering a Midwifery Led Care Service. Midwives feel they practice autonomously and are highly trained to deal with all obstetric emergencies.
In Guernsey we are in an ideal position to practice midwifery using all skills from booking to discharge in the community.
We feel disappointed the midwife making the comments felt unable to discuss this with her manager and identify herself.
Anyone wishing a true picture of midwifery in Guernsey, please contact the Midwifery department direct.

Posted by: Midwives on June 19, 2004 07:27 PM

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I worked in Guernsey for two years and found the whole experience quite refreshing after working in the NHS with low morale and Midwives leaving the practice. Pregnant women in Guernsey have a unique provision of care and all round experienced gained with rotating from hospital to community and seeing some women through the whole process from booking to discharge.Maybe if you experienced having a baby in Germany you may change your mind ! May be you should audit the clients themselves before making sweeping statements of the care provided.After all if a woman wants to have diamorphine for pain relief or no pain relief then surely its her own choice as we are all striving to promote woman centred care.
May be Midwives should have more respect and support for each other in the profession without internal politics and put women first!
From a happy ex midwife from Loveridge ward

Posted by: Sarah Pettit-Mee on July 1, 2004 03:14 AM