May 06, 2004

Midwives needs versus woman's needs

Monday May 3

The Midwifery Intensives event in Adelaide was wonderful. The midwives who attended were a dynamic bunch, delightedly sharing stories and comments that reflected their commitment to women and natural birth. They readily embraced the idea that we make too much of the “complications” of breech, OP labour and vaginal birth after previous caesarean and should regard these as variations rather than dreaded circumstances that spell difficulty and force compromise.

During the workshop session on practical measures to facilitate OP labours, one midwife asked, somewhat cautiously, “but what about ourselves - we must take care not to harm ourselves if we try these measures”. This is a reaction that I have often heard, in workshops in many places, particularly in the UK. These midwives are reflecting the stern warnings that are often dished out by the Occupational Health and Safety Officers who patrol hospitals looking for any actions that might, just might, land administration in a legally difficult position if a nurse/midwife is injured “in the line of duty”. Whilst their concerns are justifiable in some circumstances, often common sense and basic caring are the first casualties when their dictums are applied wholesale.

I understand their concern, and of course no one wants midwives suffering back problems etc. as a result of doing their jobs in labour wards etc. However, potential problems can easily be avoided if staff remember basic back care measures and pay attention to their posture etc. What sometimes happens is that OH &P concerns are used by some midwives to avoid getting involved with women, on the grounds that they “might damage their backs” or “can’t work on the floor”. I have had midwives state bluntly that hot packs, hot towels, warm water baths, even cups of tea for support people, have been outlawed because they present safety hazards and the “policies of the unit” ban them. If this is indeed the situation, then these hospitals should be ashamed of themselves for creating a climate of fear, restricting labouring women’s rights and freedoms and treating adults as children.

If midwives are using these sometimes non-existent “policies” as a means to avoid being “with women” then they should be banned from maternity units on the basis that they are failing to fulfill the most basic requirements of their job. A midwife who is unwilling to touch a woman, hold her, support her and get in tune with her emotions as well as physical needs has no place in labour rooms. If midwives feel uncomfortable performing these basic caring functions, then they might be better deployed to nursing duties where keeping an emotional distance, using instruments and equipment instead of hands to touch people, and not showing feelings is more acceptable (although I think that the power of human touch is often overlooked in nursing as well).

The midwives who are attending our current program are certainly being asked to get in touch with their feelings and attitudes around birth and most are thoroughly revelling in this challenge. The Perth group will have their chance to explore the deeper meanings of birth at their event today.

Posted by andrea at May 06, 2004 10:45 AM

Comments

We have a policy that forbids the use of hot towels and hotpacks in our unit because a woman was burnt once. I remember a few babies being compromised by the use of Pethidine in labour but they haven't banned that yet.

Posted by: Carole on May 13, 2004 09:51 PM