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Visiting Scotland

I’ve spent my last few days in Inverness in the north of Scotland. I won’t be posting any blogs from here though, because the standard of internet service in British hotels has once again let me down and getting any access to email or the internet is next to impossible (and expensive). I’ll put these messages up as a block as soon as I can find a workable connection.

The group in Inverness was a mix of local midwives and a large group of students. Raigmore Hospital in Inverness has about 2800 - 3000 births each year and a caesarean section rate of around 30% - typical of many hospitals in the UK. We ranged across the usual spread of topics in this program, and I was particularly asked to address how to avoid intervention when labour was progressing slowly (midwives are often under pressure to conform to pre-determined birth plans typified by partograms), building midwives’ confidence in facilitating normal birth and the management of third stage.

The students in the group also voiced their concerns that although they are being taught from a woman-centred care perspective, they are often frustrated by the requirement to adhere to caregiver and hospital system based protocols (often not evidence based) when they undertake their practical placements.

Once again I heard of silly health and safety, and infection control measures that are stifling any kind of lateral thinking or common sense approaches to providing comfort for labouring women. The lack of floor mats (condemned as hotbeds of infection in this area!), restrictions on the use of hot packs for easing labour pain (deemed as unsafe) and the requirement to have women give birth on beds because anywhere else may place a strain n the midwives’ backs, were all examples quoted by the midwives here.

As ever, I provided examples from other units where these issues have been successfully addressed through lateral thinking and co-operative effort, for everyone’s benefit. I find it frustrating that midwives in the UK don’t bother to look beyond their own hospitals for examples of best practice and innovation that are not only more professionally appropriate, but more importantly, benefit the women they are supposed to be serving. There are many good stories to be told in the UK, but a general lack of curiosity and an almost rigid need to maintain the status quo is affecting forward thinking and innovation in many places. Midwifery is going backwards at the moment in the UK, and is at great risk of being subsumed by medicine into a maternity service staffed by obstetric nurses.

I am hoping for more positive news from my next group in Aylesbury (England). In the meantime, I am hoping that I have been able to give the midwives in this area a glimpse of other ways of doing things and perhaps a vision of how they can achieve more personal satisfaction with their work.

Posted by andrea at September 15, 2006 11:45 PM