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Future Birth Tour 2007

The “Future Birth - exploring new paths to birth” tour has been a huge success. The tour took in six major cities around Australia in eight days - a real travelling circus - and was universally praised on all fronts. The four fabulous speakers provided a wonderful array of ideas, insights and experience that werre appreciated by everyone who attended. Underpinning their presentations was an obvious and deep commitment to women, babies and health and a passion for midwifery that was engaging and inspiring. You can tell that I had a wonderful time, can’t you?

Our tour group: Andrea, Marcos, Polly, Sandy and Sarah

Polly Ferguson opened the day with a clear description of the All Wales Pathway for Normal Birth. This clinical care plan, agreed between all midwives and doctors in Wales, has been responsible for lowering intervention rates, reducing caesarean births and promoting midwifery care through their country. After a long (and exhausting) process of collaboration and discussion, the basic fundamentals of normal birth were agreed and are now applied to all women who want to have a normal birth. In a neat turnaround, midwives assume that a woman who asks to have a normal birth will be offered care described in the pathway, and they will not discuss any alternatives unless there is clearly a medical problem developing in the pregnancy and labour. Recording the woman’s progress is simple - all the midwife needs to do is initial and date each step along the printed Pathway, and make a mark on the partogram during labour - no notes need to be written unless there is a need to explain a deviation. It is a simple strategy that assumes normality from the start, reduces the paperwork during labour and enables the midwife to be much more “with woman”.

Polly will be sending me the evidence underpinning the Pathway that was hammered out during discussion between all stakeholders. Once I receive this, I will upload the Pathway and the evidence onto our website.

In her closing remarks, Polly described how most midwives are “up in the stands” shouting complaints, instructions and sometimes abuse to those playing on the field below. She pointed out that this wasn’t much help and that it was much more fun to be “on the field”, tkaing part in the game. She encouraged everyone to “get their boots on and start playing” - a message that will be taken up by many who will now consider using the Pathway in their own units.

Dr Marcos Dias offered us a rare glimpse into the workings of the maternity health care system in Latin America. He described typical birth outcomes in many of the countries in this region, and what is being done to provide a more humanised experience for women. Marcos is passionate about public health (rare for am obstetrician) and he has committed himself to improving birth outcomes, especially in Brazil. He built the first birth centre in Brazil, in Rio de Janeiro, where midwives are responsible for the care of labouring women. He told us how he had to go to court three times to fight off the doctors (“mothers will die, babies will die”) before it was allowed to open.

Marcos Dias presenting his paper at the Brisbane seminar.

Midwifery as we know it is a very new profession in Brazil, as most women have either obstetric care in the cities, or are assisted by a traditional birth attendant in the poorer rural areas. Marcos is a founding member of REHUNA, the organisation for the humanisation of birth, and was involved in the first two birth conferences on this theme held in Brazil. The first of these was in Fortaleza in 2000 (where I first met him) and then again in 2005 in Rio de Janeiro. There will be a similar event in October 2008, again in Rio, and once more it is expected that around 2,000 people will attend.

Everyone was deeply impressed by this modest man, who is totally committed to women’s health and who is making bold moves to shake up the system through his work as an advisor to the Brazilian Minister of Health. His paper will be on the website very soon.

Dr Sarah Buckley is an Australian GP and mother of four home birthed children who is also a passionate advocate for better birth. Her main concern is the health and well-being of the baby and the emotional, psychological and physical health of the birthing woman. She spends much of her time checking the evidence and scouring the research, assembling an awesome array of scientific data to support her call for undisturbed, ecstatic birth. Her paper was universally acclaimed for its insights and detail, and participants went away with a detailed outline of the impact that birthing practices have on the delicate balance of hormones that are necessary for a successful birth.

Her paper will also be on the website soon, and her book Gentle Birth, Gentle Mothering is a wonderful collection of her writings on this subject, gathered from the many publications to which she contributes regularly.

Sandy Kirkman’s appearance on the program was eagerly anticipated by those who had heard her on the last tour. Sandy is a brilliant speaker, using a hilarious blend of humour and stories to illustrate her message (on this tour) about gender influences on communication. She explained how the different ways that men and women behave and the way they use language can lead to all sorts of misunderstandings, sometimes with unfortunate results.

This can be a particular problem between midwives and obstetricians, who view the world from different gender paradigms. She left us all with some simple instructions that could assist in better collaboration and co-operation, especially in labour ward settings. The first was “never ask an obstetrician for help unless you want him to fix the situation” and “avoid using the word “yes” as a conversation encourager - be direct and simple in your communication with men”. She had some side-splitingly funny stories to illustrate her observations, which left us all uplifted at the end of the day.

Everyone went home laughing, with a broad smile on their face - a rare achievement at a seminar (except ours, of course!).

I am now thinking about the next event, due in two years.....

Posted by andrea at March 31, 2007 04:25 PM