teebrown

Hi, I am currently studying my Pre-Health Certificate to be able to qualify for a Midwifery Course in Christchurch. I am currently filling out my application and I am stuck on one of the questions, I have no idea how to answer it (I have to write a 2000 word essay).

The question is:

B. Describe where you see midwifery in the wider context of women’s health and what you consider the significant issues are for midwifery practice in NZ today.

I sort of answered the first part of the question but I have no idea how to answer the second half, I have only been in NZ 4 months.

Any help and advice would be much apappreciated

CarolineSwan

i cant help apart from to say look at that post you were talking on a few weeks back and someone who used to be a midwife was saying stuff aboout how bad it is, i cant remember who it was now, but you could perhaps just copy and paste that and tweak it around lol, no really it might give you some ideas

Am Loolah

Pretty sure it was Vitalstatistix?

scrubbedexpat094

OMG this is such a crappy question, well the first half is!!!

Something on the lines of a midwife's role being to empower women & acting as their advocate which will have a positive effect on a woman's mental well-being etc. Midwife's role in health education/promotion. So able to look at wider issues eg. breast health, sexual health, alcohol, smoking & drug issues etc. Women are extremely receptive to health education during pregnancy & with a newborn, also a good time to educate men on health issues.

That's a start on the first part, will probably think of more over a glass of wine!

Significant issues for midwifery practice in NZ today - dear god, where to start
1. Shortage of midwives impacts on the health & quality of service provided to women & whanau.
2. Use of nurses on hospital maternity wards is detrimental to the care received. Midwives are autonomous practitioners, specially trained to care for mother & baby. Nurses are trained to look after sick people. Whilst midwives require some nursing skills they are mostly caring for healthy women going through a normal life event.
3. Lack of midwifery supervision. All UK midwives have a Supervisor of Midwives & have an annual review to discuss any areas for improvement, development or concerns. This system does not exist in NZ. The system that does exist of re-certification is expensive & ineffective.
4. Hierarchy within the maternity service ie. doctors top of the heap, followed by independent midwives then hospital midwives & the discrepancy reay especially between the latter two.
5. Hours worked by LMC's. Practice becomes unsafe due to the 'greed factor' ie. she who catches the baby gets the money from the Govt. So many midwives will carry on without any sleep for 24hrs+ so that they get the money, rather than handing over to a fresh colleague.

There are more but something to be going on with. HTH

scrubbedexpat094

Twas moi!

teebrown

Thank you Vital that gives me something to go on - do you have anything on the positive side, I wouldn't want my application to P*ss too many people off before I get my foot in the door.

luvwelly

How about the choice aganda for women to have the type of birth they desire? We don't all want a natural childbirth with no pain relief (like in the Netherlands)..some of us very much want epidurals up front and if this can't be guaranteed because of unreliable availability of anaethetists out of hours for instance, many (older) women will opt for elective c-section instead. Being in pain is very undignified.

The old favourite of the midwife having the time to be there emotionally for the woman in labour (is that the reality in NZ I have no idea?) .....in UK NHS my experience was that the midwife popped in and out from time to time....the emotional support was provided by my OH...and multiple midwives were involved.....but that is probably preferable to a 'tired midwife' as mentioned above...surely every person in attendence should be paid sth...not just the one who actually delivers?

Logisitics of handover to the medics when complications arise?
Glad this stuff is all behind me tbh

PamDH

Hi,
I am a midwife here in New Zealand have been here 5yrs and practiced 4 yrs as self employed LMC.

1. Midwives in lead maternity carer role is unique here in comparison with other parts of the world. Gained autonomy 1993 then midwifery council formed 5years ago and became responsible for their own profession. This came about from the then Health minister.
LMC stands for Lead Maternity Carer, as a qualified midwife here in New Zealand and following the Health Practioners Assurance Act in 2003 the Midwifery Council was formed independently of the Nursing Council and we were able to practice independently.
We are responsible for coordinating a woman`s maternity care from the time that they choose to book with us until 6wks postnatally. We are soley responsible for providing care for our caseload of women 24hrs a day 7days a week. Many of us work within a midwifery partnership or as a group providing back up care for holidays and days off. Many of us are highly skilled individuals working within remote rural areas or working within areas where only consultant obstetrician services are provided in which case many of our skills go beyond the role of 'normal' birth and we can act to support the Obstetrician as a Senior House Officer would do.
This means that any care which is provided to the woman which involves her maternity experience the LMC should be informed.
2. this provides continuity of care for the woman and whanau.
3. You have to mention the Treaty of Waitangi, and the 3 'P' s Protection, Participation and Partnership.
4. Partnership is the founding principle we have a 'professional friendship' with the woman and her whanau.
I recommend the textbook Midwifery preparation for practice. Pairman, Pincombe, Thorogood and Tracy
There is also a blog http://nzmidwiferypractisingreflection.blogspot.com
My blog also has some of my reflections on it

http://midwifeblogger.blogspot.com
I am also on twitter as @PamDH

teebrown

Pam, Thank you so much, that is a great direction for my essay, i'm to get the books out now and get down to it. I thought I was going mad, I just kept repeating the question but no answer was jumping out. I love this site for help, oh and welcome, I notice you're new.
Thank you once again, a very big help.

scrubbedexpat094

On the positive side, higher rates of breastfeeding in NZ. It was refreshing not to keep asking a woman how she was going to feed her baby as is normal in the UK. Midwife's role is fundamental in helping/supporting women to establish breastfeeding & to continue breastfeeding. Getting all hospitals to be accredited to the Baby Friendly Hospital Initiative (BFHI) is another challenge.

Sorry I can't add more but very busy at present, I would normally be hunting for references but have put my madwifery stuff away! Thankfully Pam has turned up with a more positive view of NZ midwifery. Wish that had been my experience.

teebrown

Thank you once again Ladies, it's much appreciated x

PamDH

No problem anytime

I actually probably don't have that much of a positive view! I now am doing a post grad masters with Otago taking some time out from LMC work because I suffered 'burn out" I often whinge on my blog!