Articles by Month: February 2003

Dr Lennart Righardt

This morning I was able to talk on the phone to Lennart Righardt, the Swedish paediatrician who has been promoting breastfeeding and normal birth for many years. Lennart was in Sydney, as part of a 5 month long round-the-world holiday he is enjoying now that he has retired.

I first met Lennart many years ago when he attended an Active Birth workshop in London, and we discovered we had many beliefs and concerns in common. Later, when he visited Sydney to see his daughter who lives here with her family, we also had time together discussing mutual concerns and sharing ideas.

Lennart has produced a CD with music and spoken word that is designed for expectant parents to listen to as they prepare for the birth of their baby. He has also made a video on delivery self attachment that shows how a baby can crawl to the breast and latch by itself (if necessary) and the way that drugs given to women during birth block this natural instinct and may therefore delay the initiation of breastfeeding. All very interesting. The video Breastfeeding: The Baby’s Choice also from Sweden, is very similar.

Lennart has always been a champion for natural birth and now that he has retired, his input will be missed. I wish him well for a peaceful life (and feel envious of the ability to take a 5 month holiday in interesting parts of the world!)

Posted by andrea at 09:41 AM | Comments (2)

Birth in a corporate world

A busy day today - finalising a submission for a big project we are hoping to undertake later in the year (more on this later) and also tying up loose ends before setting off for the UK in two days.

A colleague in Queensland contacted me about the horrible time she is having trying to practice midwifery in her local public hospital. It seems that the concept of “corporatisation” has taken hold and the hospital is trying to emulate big business by badging their products and services rather than focusing on health care.

This has resulted in more attention being paid to the image and indoctrination of the staff than the needs of the patients. In the maternity unit the caesarean section hovers between 30 - 60% depending on the day of the week and inductions are the way most labours start.

What is the point of all this? Why would a hospital try to look like a big business? People who are sick just want to get better and receive good care from someone whois more interested in helping them than how their uniform stands up to scrutiny. I can see the need to have staff training sessions on public relations - how to make people feel welcome, how to communicate well, learning how to smile under pressure etc, but this is surely just common sense and basic good manners.

Private hospitals are all about marketing a name and business-like functioning. They are also the places where the most important people are the doctors (who bring in the money, sorry, clients) and where the patient is the lowest one on the totem pole. This approach is especially inappropriate for pregnant women, who are not sick and should not have to be there in the first place. However, many of them come from the corporate world themselves and I guess they feel right at home! The dazzling image must also be clouding their judgement - why else would they accept the unjustifiable rates of interventions in their births that occur in these money making shrines?

Posted by andrea at 03:47 PM | Comments (2)

A great event for childbirth educators

Well, the National Association of Childbirth Educators Conference (NACE)is over for another 18 months - three days of listening, debating, enlightenment, networking and catching up with colleagues. Lots of highlights, but a few stand out in particular:

Sheila Kitzinger, on what will probably be her last visit to Australia. She has been unwell and looked very frail, but her passion, her ability to command attention with her voice and the overwhelming relevance of her message are as strong as ever. Her keynote address looked at the history of childbirth and its intrinsic centrality to women’s lives, illustrated by a wonderful collection of pictures from all over the world. Much of what she spoke about is contained in her lovely book Rediscovering Birth, a must on your bookshelf for those days when you are feeling a bit low and demoralised.

Today she presented a smaller workshop session on the theme of birth as rape, again illustrated with women’s words and Sheila’s own compassionate insights. Real stop-you- in- your- tracks stuff.

Yesterday’s program featured fathers, with wonderful presentations by Paul Pritchard and Richard Fletcher, both of whom are facilitating men’s groups on parenting, in different parts of the country. As most childbirth educators are women it can be difficult to try and put ourselves in men’s shoes so their needs can be met in our pre-natal programs. Paul and Richard had a very simple answer to this dilemma - give the men space an let them explore these issues for themselves. An obvious solution but one that is not offered nearly enough.

The Hypothetical facilitated by comedienne, radio personality and all-round good gal Julie McCrossin was a hoot. A panel of speakers addressed various aspects of the question that women should be allowed to choose an elective caesarean section. A popular topic for debate, perhaps made more popular as a choice by debates such as these!

As usual there were a multitude of smaller workshops and seminars available, requiring difficult decisions to be made. I didn’t get to any of these because I was staffing the Birth International display, but at least I can catch the summaries in the proceedings.

Only one quibble from me - everyone kept talking about “antenatal” programs, classes etc. This language really grates every time I hear it because of its unintentional negative overtones. I much prefer to use the word pre-natal, which seems logical to me as a natural precursor for the post-natal period.

The next event will be in Tasmania in October 2004. Not sure that I will be there as I am always in the UK in October, but I certainly enjoyed being part of this event as I feel sure that everyone else who attended had a fine t ime. Congratulations to NACE on an event that was well organised and very professional.

Posted by andrea at 04:38 PM | Comments (2)

What is happening in our Birth Centres?

I was shocked to hear today about the state of affairs ion one of Sydney’s best known Birth Centres. Apparently the midwife shortage is so acute that many are having to work double shifts. In order to get some sanity into their lives by not working too many nights, the midwives are routinely rupturing membranes at around 8 cms, announcing that there is meconium in the liquor and then transferring women to he labour ward for the birth. This is now so common that there have been no births in the Birth Centre in the last month.

Can this really be true? I heard it from a reliable source who is a regular supporter of women (doula) giving birth in that hospital. I have no reason to doubt her word and I know that the Birth Centre manager has left and has not been replaced as yet.

Can midwives really be behaving like this? What are they doing about it, apart from taking out their frustrations on the women? Staff shortages should not be the reason for rupturing membranes! This is an outrageous situation, and one that needs direct and effective action. It is enough to make you weep..... where are we heading, indeed?

If I was a cynical person, I would say that the doctors are being kept happy with enough midwives to manage their private clients, and that the Birth Centre is being seen as expendable and starved of midwives when shortages occur. Years ago women marched to protest the proposed closure of this Birth Centre - maybe another march is needed now.

Posted by andrea at 05:24 PM | Comments (3)

The National Association of Childbirth Educators Conference

Today, I will be setting up the Trade Display for Birth International at the National Association of Childbirth Educators (NACE) Conference in Sydney. These events have been held every two years for a long time (15 years?) and are rotated around the various capital cities in Australia - we are back to Sydney at last!

I am not always involved very much - by now, with 30 years of experience in this field, I don’t feel it is appropriate for me to be submitting abstracts and asking to be included, so I usually wait to see if I am invited to participate. This year I will be giving a 15 minute presentation (!) as part of a panel discussion, and I have chosen the topic of “The Future of Childbirth Education - educating for choice or compliance?” I will only be able to give this important topic a very cursory outline in the time available, but hope to at least raise some issues.

There are a number of interesting speakers on the 3 day program, headed by Sheila Kitzinger, who last visited us in 1992. This may be her last visit to our country, so I am sure everyone will be keen to hear her. Susan Maushart is the other major speaker, on the topic of “Motherhood as a subversive activity” - should be stirring and popular!

There are lots of concurrent workshops and seminars from which to choose, making for very difficult decisions because all of them sound relevant and engaging. I’ll feed back useful information through Diary entries over the coming days.

Posted by andrea at 07:50 AM | Comments (2)

Are we overdoing pregnancy care?

For the last 10 years, Michel Odent has been publishing his excellent “Primal Health Research Newsletter”. It comes out quarterly, and each issue explores an aspect of pregnancy and birth care that has implications for the future health of babies and mothers.

The latest issue, Volume 10, No. 3 examines the advisability of routine pregnancy care for the majority of women and comments on the many studies and randomised controlled trials that have proven that routine ultrasound scans, haemoglobin testing, glucose tolerance tests and even the taking of blood pressure do nothing to improve the outcome of the pregnancy. As always, Michel raises interesting questions and propositions, and in this newsletter he suggests that the emphasis should be on preconception care rather than pregnancy care. The references that back up his assertions are included and will be useful for students and midwives interesting in providing more cost effective and beneficial pregnancy programs for women.

You can obtain the newsletter by emailing Michel Odent at Modent@aol.com. The research papers can be found on the Birthworks website, where all the data accumulated by the Primal Health Research Centre can be located.

Posted by andrea at 03:27 PM | Comments (2)

War and peace

This weekend has seen huge numbers of people massing to protest the war that seems to be inevitable. As I write this, hundreds of thousands of Sydneysiders are massing in the city to vent their anger and frustration with our Prime Minister who seems to be hell bent of supporting the American President, ahead of his own people. Australia is a peaceful and peace loving place, with tolerance and the concept of “a fair go” firmly embedded in our national psyche. The idea of fighting someone else’s war, on the other side of the world, at the behest of a deeply suspicious, belligerent, right-wing cowboy is anathema to me and millions of my compatriots. There are other ways to deal with tyrants apart from dropping bombs on them. Perhaps the American President will find himself subjected to some of these measures in the end, because people perceive his bellicose and posturing behaviour as tyrannical as well.

The NSW Midwives Association is marching in today’s protest and had I been in better health, I would have joined them. My heart is with these women, who, as midwives, know that the way one begins life can have a profound impact on the mental and emotional (as well as physical) health of people. We must humanise birth if we are to produce reasonable human beings.

I wonder how George W Bush was born? Was he “untimely ripped” from his mother’s womb, or dosed with drugs that have impacted on his capacity for love and respect? I have always believed that the babies born today will be making the decisions that affect us all in the future and that we should therefore recognise the impact of our actions on these sensitive beings in the precious and important hours around birth. We need our children imprinted with love and sensitivity, not aggression or survival anxieties.

It may be too late to save the American President. However, there are good and rational people in the world and with luck they will prevail over the war mongers and blinkered egomaniacs that seem to be leading us at present.

We may feel helpless and sometimes hopeless when viewing the antics that are leading us down self-destructive paths. Even if we can’t do much to impact the bigger picture, we can influence the smaller picture, in the hope that the future will provide a safer and more respectful, tolerant home for us all. The next time you are journeying towards birth with a labouring woman, remember that her child may hold your future in his/her hands. Be gentle, be kind, be patient and loving. These are lessons we can pass on to the next generations through our direct action and heartfelt example.

Peace be with us.......

Posted by andrea at 11:56 AM | Comments (2)

Getting the message through to maternity managers

You may recall the fun and games I had when attending a birth at a hospital near where I live in Sydney (Diary entry for January 6). I followed up with a letter to the Unit Manager in which I detailed the problems we had encountered and our impressions of the Unit and its staff. This letter was not about the woman whose birth I was attending, but about the bigger picture of Unit policies, staff attitudes and skills and their willingness to be “with women” rather than “with the institution”. Their inflexibility, rudeness and lack of care for the woman’s needs during labour were also of concern.

There was quite a bit of discussion on the ozmidwifery list about this Diary entry, the main thrust of which was “shooting the messenger” because I had the temerity to point up some deficiencies, as I saw them, in this Unit. There was also the inference that I was really just touting for business (that is, running a workshop for their staff). Of course, their staff should be having a series of on-going in service sessions on how to be “with women” and the midwives we met early on certainly had no idea how to use a CTG or do a vaginal examination with the woman off the bed! It doesn’t matter who facilitates this practical skills training as long as they receive it and I certainly am busy enough not to be actively seeking work!

Finally, a letter of response has arrived today. It details the training that the staff have now received on the use of water during labour and birth, especially as it relates to the needs of the midwife. It says that my concerns “have been discussed at both ward and departmental level”. That’s all. I’ll bet they were discussed, and also the incident report that was generated on the night in question! The interesting thing is that the letter does not state that any action has been taken or is planned, or even that they have any comments on the issues that I raise and nowhere in the letter are the labouring women who might use this Unit mentioned.

The way this matter has been treated indicted to me that this unit does not have a woman-centred philosophy of care, that they are not listening to women (users of the service or their support team) and that they are unwilling to address any comments or suggestions that might improve the care they offer women. Given that this unit holds itself out as a “showpiece” in Sydney, I find this kind of arrogance very sad. What a missed opportunity for great public relations and positive publicity!

I will be closely following the experiences that several of my younger friends have when they give birth there in a few months time.

Posted by andrea at 06:45 AM | Comments (2)

NSW Birth Statistics - obtaining a copy

For those of you who have been following my Diary entries about the NSW Birth Statistics, you may want to know more - these statistics are very useful to show to parents in prenatal programs, for example. The information is contained in the

NSW Public Health Bulletin Supplement

Volume 13, Number S - 4 December 2002

ISSN 1034 7674

“New South Wales Mothers and Babies 2001"

It is a free publication and can be ordered from

Centre for Epidemiology and Research

Public Health Division

NSW Department of Health

Locked Bag 961

North Sydney NSW 2059

For those of you in other States who are looking for similar information on birth outcomes in your area, you will not be so lucky. The NSW Department of Health has been producing these reports for years, but is the only State to do so. The others have much smaller reports, often just no more than a few tables (Victoria, for example) or make nothing available in print at all (Queensland). This is a very unsatisfactory state of affairs: as taxpayers propping up our health care system we have a right to know how our money is being spent; as expectant parents and families we have a right to know what is going on in our hospitals and how they are performing; as caregivers we need to know how our hospital compares with others in the region and across the State as a whole.

It would be worthwhile calling your local Department of Health and requesting the information they have. Mention the NSW Report and ask for similar information to be made available where you live. If we don’t ask for this, we will never get it!

Posted by andrea at 03:20 PM | Comments (2)

Birth outcome statistics for NSW - Part 3

We all know that more women today are requesting epidurals for labour pain than ever before. Therefore it has been interesting to review the percentage of women at various hospitals in NSW (for the year 2001) who are given epidurals. As expected, women choosing to use a private hospital for the birth have every likelihood of ending up with a bill from the anaesthetist for your epidural.

The highest reported rate of epidural use was at Kareena Private Hospital - 76.4%, just pipping Prince of Wales Private Hospital in Sydney which had a rate of 76%. The Mater Mothers Hospital in North Sydney had a rate of 62.7% and Hurstville Community 65.2%.

At the other end of the scale were Wyong (see my previous Diary entry) whose rate was 0.0%, Inverell Hospital with 0.8% Mudgee 2.3%, Broken Hill Base Hospital 9.6% and Armidale Hospital 4.5%. Of course, these are all country units and there is probably not an anaesthetist available to offer epidural for anything other than caesareans. Where epidurals are not on offer, pethidine or nitrous is used instead, and this is reflected in the figures: Wyong for example has a whopping number of 44% of women using nitrous and 21.9% using pethidine and only 1.6% of women giving birth in that midwifery unit escaped with no pain medication at all. Makes me wonder what has happened to the skills of those midwives working in Wyong!!

Reviewing the figures for “Nil” use of pain relieving drugs makes sorry reading. Again, the private hospitals have dismal outcomes: Kareena Private with 2.6%, The Mater Mothers in North Sydney, just 1.8%, Hurstville Community 7.25%, St George Private 4.0% and Prince of Wales Hospital 2.8%.

The hospital with the lowest rate of women labouring without drugs was Gosford (in the same area as Wyong), with a pathetic outcome of just 0.9%!. 50.2% of women there get nitrous oxide, 38.9% have pethidine and 25.3% have an epidural. They seem to have lost the plot completely.

The best hospitals could only manage rates of 28.3% (Muswellbrook), 24.7% at Inverell, 25.6% at Moree and 29.8% at Queanbeyan. Much better than most but still falling a long way short of ideal.

We have a lot of work ahead if we are to turn this around. Almost all babies born in NSW will be exposed to one or more drugs during labour and birth and will have on-going effects from this exposure for days and perhaps much longer. The work of Jacobsen suggests that it may be many years before the insidious effects show up, perhaps as drug addictions or other antisocial behaviours.

Midwives have got to ger their acts together over this. They are the ones who are offering the pethidine and nitrous oxide instead of using their skills to enable women to manage in other ways. Perhaps midwives could be counted amongst the biggest drug pushers in our State!

Posted by andrea at 03:37 PM | Comments (2)

Birth outcome statistics for NSW - Part 2

In reviewing the outcomes for births in NSW, it is worthwhile looking at the rates for induction, as this is a well known starting point for the cascade of intervention that often leads to either an instrumental or caesarean birth.

The rate of spontaneous onset of labour with no further intervention varies between 18.4% at Kareena Private Hospital to 66.6% at Broken Hill Base Hospital (where they have caseload midwifery). Amongst the big city teaching hospitals, the rates are 51.5% at King George V (now the Royal Prince Alfred Women and Babies Unit), 44.7% at Royal North Shore, 45.1% at The Royal Hospital for Women and 50.5% at Westmead.

Once labour starts, many women are then augmented with either ARM or oxytocics, but again there are wide variations: 13.5% augmented at King George V, 17.1% at Royal North Shore, 21% at Royal Hospital for Women and 18.7% at Westmead. Kareena Private augments 17.1% and Broken Hill Base 11.6%.

Inductions tell another story: 21% at King George V; 27.3% at Royal North Shore, 20.9% at The Royal Hospital for Women and 19.3% at Westmead. Kareena Private induces a whopping 37.8% and Broken Hill induces 14.9%.

Wyong Hospital (another with midwifery programs in place) also has interesting figures: 62.6% of women begin labour spontaneously, however 34.6% go on to be augmented. Their rate of induction is only 2.5%! It seems you won’t be prodded into labour artificially in Wyong, but once you start you’ll be expected to get on with it!

Perhaps the moderate approach found at Bankstown Hospital in Sydney is the way to go: 62.4% spontaneous labour rate, 8.9% augmentation and 19.3% inductions.

In case you are adding up these figures and are wondering why they don’t add up to 100% for each hospital - there are a percentage of women who have no labour (i.e. they have an elective caesarean) and this ranges from 13.9% at King George V, 15% at Royal North Shore, 12.9% at The Royal Hospital for Women, and 11.5% at Westmead. Kareena Private Hospital’s obstetricians are busy with 26.4% elective caesareans, and Broken Hill’s midwives have 7% of women with elective caesareans. Wyong Hospital has 0.5% elective caesarean rate!

Why I am I giving you all this detail? First, NSW is the only state that makes these statistics freely available to anyone who wants them, a proper state of affairs for taxpayers and customers (patients) alike. Second, to illustrate the fact that it is worth shopping around for maternity care as it varies considerably. Knowledge is power and we need to use these figures to argue the case for a more rational approach to maternity services, and by that I mean midwifery care not obstetric over servicing.

Next, let’s look at use of pain medication......

Posted by andrea at 08:03 AM | Comments (2)

Birth outcome statistics in NSW: Part 1

The NSW Mothers and Babies 2001 report has arrived on my desk. It makes fascinating, if alarming, reading as it details the birth outcomes, neonatal intensive care statistics and perinatal and maternal death statistics for the whole population of the State and for subgroups that live in out community. There is such a wealth of information here that it deserves several Diary entries which I will spread over the coming days.

The figures are compiled from the Midwives Data Collection form that is completed following every birth in the country. In 2001, there were 85,858 babies born to mothers with an average age of 29.9 years. About one in four mothers were born overseas. Over the preceding five years the number of women giving birth in birth centres fell from 4.6% to 3.4% and the number of planned home births decreased from 202 to 182 ( the number of unplanned home births was 297 in 2001).

The changing pattern of type of birth was clearly evident: in 1997 the normal vaginal birth rate was 70.4% and in 2001 it was 65.4%. Over this five year period the caesarean birth rate rose from 18.2% to 23.6% - the rate of vacuum and forceps births remained the same. For privately insured mothers the figures were worse: the normal birth rate decreased from 61% to 55.5% and the rate of caesarean birth rose from 22.2% to 28.2%. For women using the public health system the rate of normal birth fell from 75.4% to 71.8% and caesareans rose from 15.4% to 18.6%.

This increase in caesarean births is alarming. It has been climbing steadily at about .05% per year from some time but in these figures we see a sudden jump to a level that rivals the US and UK. The rate of prematurity increased as well - from 6.8% in 1997 to 7.2% and there was a slight decrease in babies born at 42 weeks or more. Only 44.4% of women in 2001 began labour spontaneously and 24.8% were induced, the remainder were either augmented (17.7%) or had elective caesareans (13%).

The disparity between private and public is also apparent when comparing other birth outcomes for the year 2000: forceps births accounted 3.6% for public patients and 6.8% for private patients; vacuum extraction was used for 5.1% of public patients and 8.9% of private patients; elective caesarean was used for 9.3% of public patients and 16.9% of private patients. Even emergency caesareans showed significant differences: 9.3% of public patients and 11.3% of private patients.

It is clear that maternity care is in chaos, starkly illustrated by these rapidly worsening outcomes for women and babies. These figures relate to the years before the Federal Government decided to encourage more Australians to use the private health system by subsidising the cost of private health insurance by 30%. It is already known that more pregnant women now use private health insurance to pay for their health care and that private hospitals are so heavily booked that some are only guaranteeing a bed if a woman is prepared to give birth on a chosen day (i.e. be induced). When the outcomes for these years are collated in the future, the writing will be very clearly on the wall: women and children are paying for the madness of the private obstetric system with its over-servicing and preference for scheduled, managed births.

As a taxpayer, I object to my taxes being used to underwrite this appalling apology for a health care system. I don’t want my money going to subsidise the rich who can afford health insurance and the private hospitals who are also allowed to dip into the public purse.

Pregnancy is the only health condition that a woman is encouraged to choose expensive specialist care as a first option. For all other health concerns, a primary care giver (GP) must be chosen first and a specialist will only be consulted if the primary care giver is unable to fix the problem. Midwives should be caring for pregnant women, as they are the appropriate primary care givers in this instance. Until this happens we will have birth outcomes that cannot be justified in any way, especially in a healthy, well fed, wealthy population such as Australia’s.

More on these statistics tomorrow.

Posted by andrea at 04:22 PM | Comments (2)

Midwifery revolution in the private health care sector

Midwifery is at last being recognised as being every bit as viable for private hospitals as obstetrics has traditionally been. In Australia, Mayne Health, who operate 29 maternity units across the country, have announced that they will trial midwifery care alongside obstetric care as options for women choosing to give birth at Selangor Private Hospital in Nambour, Queensland.

This is a major breakthrough - the first time that midwives will be able to work in the private sector as independent practitioners in the same way as their obstetric colleagues. The obstetricians at this innovative unit are supportive of this plan, which already has a strong midwifery philosophy underpinning its excellent outcomes.

The program is not yet ready to roll as the details of funding and patient payments etc has yet to be finalised. The potential for midwifery is enormous and the outlook for women choosing to use the private sector (and their health insurance) will be improved.

I’ve been reviewing the birth outcome statistics in NSW over the past few days (more in the next Diary entry) and I can only say that I am appalled. Women who choose private medical care and private hospitals in this State have a very small chance of achieving a normal birth and every likelihood they will have an instrumental birth or caesarean section.

Let’s hope that Mayne Health can lead the way and offer real competition to the obstetricians who have dominated birth practices in the private sector. There seems to be an attitude amongst obstetricians generally that once a patient is safely locked in to their list (that is, once she’s paid her booking fee) they can manage her as they wish. Over servicing, scare-mongering as a means of coercion and the use of non evidence based practices are rife. The figures for outcomes tell the story very vividly.

New ways of doing things are desperately needed and it is wonderful that there is glimmer of light at the end of the private health care tunnel.

Posted by andrea at 03:47 PM | Comments (3)

Campaign for maternity reform tastes success

I have just heard that things are hotting up in NSW regarding the reform of maternity services. Having ti face the electorate in 7 weeks focuses the Government and its Ministers very clearly and Craig Knowles has had some shocking experiences with irate women demanding better maternity care in recent rallies in Bulli and Camden. He seems to be developing a phobia about strollers containing babies!

I am told that NSW Health will implement the NMAP in the Hunter and Illawarra Area Health Services as the starting point. This will mean that women in those areas will be able to access midwifery care and give birth where they choose - hospital or home and funded directly by the Health Service. Central Sydney Area Health Service (Royal Prince Alfred Hospital is its flagship maternity hospital) was to be included but was dropped when they excluded home births from their proposed service.

This is a major breakthrough and one that has come about through intense and clever lobbying by the consumers and midwives involved in The Maternity Coalition. They have put together such a strong case for reform that to ignore it would be foolhardy, as the political parties are beginning to discover.

There will be more news soon, but the revolution is certainly underway. It is just like the “olden days” when we were struggling to get rooming in and father at births - it has taken a long time to get consumers on the march again but they are falling into step right now!

Posted by andrea at 03:56 PM | Comments (2)

Midwifery programs at St George Hospital

Today has been spent with a group of 23 midwives from St George Hospital in Sydney. Some were new students, others new graduates, we had representatives from the Labour Ward, the Birth Centre and the community midwifery program. There was a great collegiate atmosphere in the group and a genuine passion for normal births - we had a great day exploring Active Birth together.

This hospital is an outstanding example of what can be achieved in a big city teaching hospital within a diverse community. They are affiliated with the University of Technology and have a very active midwifery research program. Their new graduates program enables recently qualified midwives to consolidate their experience in a birth centre program rather than the main labour ward, thus further developing skills in normal birth rather than technological management of labour. Their community based midwifery and caseload practices are excellent examples of this type of service. The intervention rates in the labour ward are better than average for Sydney.

The maternity leadership in this unit is outstanding, and the supportive workplace that emphasises innovation, woman-centred care and midwifery values is able to attract team leaders and midwifery managers of high calibre. The obstetric team is led by Professor Chapman who has a genuine respect for midwifery and is encouraging a move towards a home birth service as the next logical step for the hospital. Jo Wills, a passionate midwife, is the Patient Services Manager and Pat Brodie and Caroline Homer (who authored the best selling manual on implementing midwifery models of care) are also on staff.

I have offered this workshop to the hospital in return for their support of my video project, in which I hope to develop and produce a series of educational videos for midwives. I have started filming births in the hospital and hope to capture many more on video over the coming months. Later this year I plan to film in their labour ward, looking at the midwife’s role in facilitating normal birth and another program for childbirth educators. I really enjoy working with these like minded colleagues and I feel we are really in tune with many of the issues that underpin good births for women and babies.

Meanwhile, I am learning my way around the hospital campus - not getting lost is always a priority on these sprawling sites!

Posted by andrea at 05:09 PM | Comments (2)

De-bunking pregnancy myths

Old wives tales and other urban myths are commonly passed along to pregnant women - in fact, being on the receiving end of so called “advice” can be one of the banes of being pregnant.

This site has an interesting collection of such yarns and myths. Check it out for a laugh and some insight into the silly stories that are floating around .....

Posted by andrea at 04:03 PM | Comments (5)

New standards for the accreditation of midwifery education

The new Standards for the Accreditation of Three Year Bachelor of Midwifery Programs has been released by the Australian College of Midwives. All the current, and future courses will be required to meet these standards, which have resulted from three years of wide consultation amongst key stakeholders.

The aim of these Standards is to ensure that midwives will have a similar level of education and experience regardless of the State or institution where they have studied. For the first time, midwives will have readily identifiable competencies that they can use for registration portability across not only Australia, but the world. Graduates will meet the minimum skills required for practising independently and autonomously, an essential if midwives are to be available for the proposed caseloading practices it is hoped will evolve soon from legislative changes.

The philosophies embodied in the Standards are those of: woman centred care; primary health care; cultural safety; “following through” women to gain well-rounded experience, and the goal of graduates capable of undertaking the full role and sphere of midwifery practice according to the International Definition of a Midwife.

Some of the specific key Standards that B Mid programs must meet are:

• A course of a minimum of 3000 hours (3 years) of which theory constitutes no less than 1500 hours and midwifery practice constitutes no less than 1500 hours.
• The involvement of at least 10% consumer representatives on all program related committees.
• Practical experience for students that enables: a minimum of 30 follow-through experiences, 40 births as primary care giver for birth and immediately afterwards, 100 antenatal visits and 100 postnatal visits, with placements in all areas of maternity care provision in the community and hospitals.

These Standards will ensure high quality midwives graduate from our Universities, fully equipped to undertake the broad sweep of midwifery practice in whatever setting they wish.

I am impressed by the efforts of those involved in identifying and establishing these criteria and the collaborative approach that been used to ensure agreement. It is not uncommon for Universities to jealously guard their course requirements and curricula in ways that ultimately lead to uneven abilities of graduates across a range of institutions. That a unifying, collaborative approach has been achieved in this instance, to ensure quality across all institutions for the benefit of the country, employers, students and the community deserves recognition and applause. A fantastic effort!

Posted by andrea at 04:28 PM | Comments (4)