----- Original Message -----
Sent: Monday, August 02, 2004 4:21
PM
Subject: [ozmidwifery] Request for
information on current models of midwiferyled care
Seeking a bit of information
please...
In the process of MOs arguing
against midwives working as primary carers in normal healthy low risk
pregnancies, I have known them to come out with comments such
as:
"What if they (the midwives) don't act on
a problem and the doctor only becomes involved when the s...t hits the
fan........then who's fault is it???"
"Midwives aren't qualified to make the decision
about when things are outside the normal"
"Medical indemnity insurers will stop insuring
hospitals if a doctor is not in charge"
"The perinatal mortality rates would
increase!"
I know that midwives act as primary carers in
NZ, Holland and even in WA. They are also primary care givers in
various midwifery models throughout Australia. But I don't
have knowledge of the intricacies about truly midwifery-led models
to use as ammunition.
I do know that midwives are quite able to
distinguish between the normal and abnormal and if they don't refer
someone on as necessary, they should be and are held responsible as
part of their registration requirements/code of ethical
behaviour.
When responding to such criticisms against
midwives, I also like to make comparisons between GPs and Specialists.
Just because a GP misses something or behaves negligently, we don't say
"that's it" everyone has to go straight to see a specialist as GPs can't be
trusted!!!!! But this seems to be the case when comparing midwives to
doctors/specialists.
For my own knowledge and to assist me in
my future responses to such criticisms, can anyone tell me the
following:
1. Medical indemnity status of midwives
working in New Zealand - my understanding of it is that they work under the
control of the health department and
2. If anyone gets sued it is the
hospital/health service. Is this correct?
3. If the hospital is successfully sued,
where does the money come from if a huge payout is granted. My
understanding is that taxpayers all contribute somehow to a government fund
for such purposes.
4. Do all the women see a doctor at the
beginning of pregnancy to be screened as low or high risk or does the
midwife screen them and refer them on if needed.
5. Do all women see a doctor in labour on
admission or do the midwives totally provide the support/care with medicos
only being called if there is a problem.
6. What are the comparisons between
perinatal mortality and caesarian rates between countries with midwifery led
care and Australia - I've heard they are lower but don't have any research
to back my claims.
I know I could search the net all day to find
out the above answers but as we have so much combined knowledge on this list
I decided to try here first.
Thanks in advance
Helen Cahill
