October 23, 2002

The state of midwifery in Britain

I have just been catching up on my September MIDIRS Digest - breakfast reading when I am eating in Hotels during my travels. It contains the usual array of research articles but there are also several original pieces focussing on the state of midwifery in the UK.

These comment on various aspects of midwifery practice and lament the fact that it is being completely dominated by medicine and is in a gradual process of decline, with extinction on the horizon. Many people in other countries look to the UK as an example of midwifery at its best, yet the reality is completely different. The profession is supported by Government laws (for example, a midwife must stay with a woman if she decides not to go to hospital for the birth, even if it is against the midwife’s advice), regulation (the Nursing and Midwifery Council oversees many regulations that strengthen the midwife’s personal practice and protect her standing), Government enquiries such as the Winterton and Cumberlidge Reports, and enjoys a high profile in the community. Yet each year the number of births in the sole charge of a midwife is falling (now around 68%, down from 75% five years ago), the caesarean section and interventions rates are rising rapidly, midwives are in chronic shortage (some units are 30% down on the numbers they need) and many students fail to complete their education, dropping out in despair.

Lots has been written about this - books, in fact. It does concern me though, that if this si the state of affairs in a country that has such a strong midwifery culture, how will other countries, where there are no supportive laws and regulations fare? In Australia we are fighting to get a new style of maternity care (NMAP) adopted as policy in a country where we have 7 Governments to negotiate/fight with, no legislation that support or protects midwives and no overall regulations that govern and shape midwifery practice. I hope that this lack of regulation will prove a strength rather than a downfall. In New Zealand, midwives managed to get themselves well positioned from a similar base as Australia, so I will remain optimistic.

Britain is a country that is often described as a “nanny state” and there is no doubt that life here is closely monitored, controlled, organised, regulated and dictated. Everything is covered by some rule or another and people are often treated as incapable - signs warn of potential disasters (“beware uneven surfaces”, “mind the gap”) apologies abound (“we apologise for the delay of 3 minutes in the later running of this train”, “we regret any inconvenience caused by this alteration to your .......” etc) and there is an air that the taking of personal responsibility is a thing of the past as “someone” will take care and provide for you. Apologising for the lack of services now replaces the actual service itself.

Perhaps this is partly why the health care system is in such crisis and that midwives are falling behind. By over regulating and offering to “take care” of people from cradle to grave, the State has effectively stifled initiative and produced a population is prepared to be cowed in return for not having to think for themselves. This is no doubt a harsh and simplistic view, but I despair when I see the lack of action by midwives and their inability to get themselves organised on a national level to address issues of primary importance to their existence. There is a lot of talk about these issues, such as the excellent articles in MIDIRS, but where is the fervour, passion and collective action to change things?

Perhaps it will take a major crisis ( the current situation does not yet seem to be bad enough) to precipitate collective action amongst midwives. Yet I fear that the culture amongst women here, the vision of themselves as “poor things” that need to be looked after, the prevailing view that “someone else” will fix it and their lack of personal backbone will spell disaster and that midwifery may yet be lost. I feel like shaking the lot of them and telling them to wake up before it is too late!

After few weeks in the UK, I always seem to feel like this - frustrated and amazed. You don’t realise how different the Australian culture and way of thinking is until you stand it beside the British way of life!

Posted by andrea at October 23, 2002 07:48 PM

Comments

You may find it interesting to visit the sites about poker card, casino no deposit, online casino casions, gambling cash, blackjack sites, roulette casions, gamble tip, internet casino web, slot machine odds, online casino bonus deposit, online gamble game, casino gambling strategies, casino game strategies, las vegas table, video poker casinos, roulette online card, slot rule, blackjack online deposit, blackjack betting 3d, poker 888, gambling 8888, blackjack tip, poker on net, casino casions, casino gaming, gambling no deposit. .

Posted by: blackjack on January 19, 2004 08:22 AM

Comments

You may find it interesting to check the pages in the field of phentermine effect, zyban tablet, viagra cream, propecia for woman, online pharmacy prescriptions, tramadol mens, ultram 400mg, wellbutrin resistance, paxil overnight, meridia comparing, zyrtec online, xenical cheap, vioxx 12 5mg, vaniqa dosage, retin a canada pharmacy, prozac on line, generic viagra 10 pills, celexa woman, buy phentermine addiction, xenical capsules, ambien substitute, dilenyoung about, hopforyou pills, kip980 perscription medication, mng765 what is, pol_uri facts, piter_gordon mail order, miss20092000 2 month supply, robert_zed2003 fasten, fp292003 men, diagodream supplements, jacglen2003 can i, lisa_plamer products, gill_bern review, gtrgtr45 100mg, poklop2000 men`s, nolzer12 men`s, rtopopi mail order pharmacy, oklokol for woman, racertroy2003 information on, viagra information about, phentermine alternative. .

Posted by: fp292003 on January 21, 2004 02:12 PM