Dear Barb

Health administrators are scared and they have only a very scant
understanding of law.

Oh Barb, this is very sad.  I understand the law (I read the act) and I am a
Mum at home in her PJ's most of the time!  NO EXCUSE, if they are making
decisions about practice and citing litigation they don't understand as a
reason then that is even more dangerous! The fact is outside of catastrophic
injury their is little any one can claim any more (In NSW and the ACT
especially).  To get anything you need to claim at least 10% permanent
injury (and that's considerable)
 
 
How does one respond to that mothers loss? How can one say "evidence
shows ....' to a woman dealing with a loss. Part of the problem is we
have a generation of consumers who do not understand adverse outcomes
can occur no matter how diligent one is. They look for blame and
financial gain. Another we have non-clinicians and I include some
consumer groups here, making rules and decisions without understanding
how the system works nor how toxic the working environment is for
midwives. 

Naturally it is very difficult, when dealing with such loss to imply well
hey it sometimes happen, but again it is the truth.  Loss like this will
always be devastating but when a woman has a trusting relationship with a
midwife she knows then it has to help.

As for consumers making rules.  Consumers are advocating for choice and from
your e-mail it and the many thousands of other anecdotes we hear it is
ABSOLUTELY NECESSARY.  Barb you are doing your best (like so many more).
Please don't fall into the trap of thinking that when we criticise the
'system' we are criticising you as an individual.  We will continue to fail
if midwives respond 'personally' to our criticisms of the system.

 Unfortunately 95% of midwifery staff are part-time that come to WORK for 8
hours will not challenge this directive, they are not interested. A general
comment and I apologise in advance to those who are not like this "they have
a good balance in their life/work arrangement".

Yet another reason for major change, that acknowledges what midwifery is and
enables a scope of midwifery practice.  Then you wouldn't have to fight
continuously! Also why can't midwives work caseload practice part-time? In a
group practice of 3 (with back-up for on-call etc) but with a designated
caseload women would have much better care and midwives would work as they
were trained through the continuum.  With this model it would also be
necessary to assert the scope of practice so you would not need to tango
with the CTG etc etc.

I remember what struck me most about labour for the first time it is from
Janet Balaskas.  She says birth is like the ocean, if you fight the current
(rip) you may be pulled under and drown.  If you go with it, you will go
further than you have ever before, but later you will be able to swim back
to the safety of the shore!

Perhaps we all need to apply this to the urgent need for maternity services
reform.  Change can be scary but when we look at what we have, it can't be
much worse!

In solidarity

JC
xx

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