Thanks
Judy
--- Alphia Possamai-Inesedy <[EMAIL PROTECTED]> wrote:
> Here is a copy of it.
>
> take care
> Alphia
>
> August 20, 2005 Saturday Travel Edition
>
> SECTION: REVIEW; Health; Pg. 29
>
> LENGTH: 891 words
>
> HEADLINE: Midwifery is safe, and access a right
>
> SOURCE: MATP
>
> BYLINE: KATHLEEN FAHY
>
> BODY:
> ALICIA (not her real name) wanted to give birth in a private
> and safe
> environment attended by a known midwife. She is young and
> healthy. This
> makes her an ideal candidate for one-to-one midwifery care
> where a known
> midwife provides all maternity care for Alicia and her family.
> Midwives are
> qualified and licensed to provide antenatal, labour and
> post-birth care on
> their own responsibility. Normal, healthy women who have
> straightforward
> pregnancies do not need to be under the care of doctors.
>
> But Alicia and her partner, Paul, couldn't find a midwife to
> provide her
> care either at home or in a hospital.
>
> Why not?
>
> Because women who want to claim maternity care as a Medicare
> rebate must
> use a doctor. Thanks to this monopoly, virtually all
> pregnancies are
> managed by doctors, even though this is completely
> unnecessary. Another
> reason that Alicia couldn't hire a midwife is that midwives
> have been
> excluded from the network of taxpayer subsidies and safety
> nets provided by
> the federal Government for doctors' professional indemnity
> cover. The issue
> of Medicare rebates and indemnity insurance cover for midwives
> are matters
> of professional competition.
>
> It can be safely predicted that doctors will resist midwives
> being given
> access to Medicare. Doctors will claim, or imply, that somehow
> midwives are
> unsafe. As a midwifery researcher, however, I know that
> midwifery care is
> safe, and I know doctors cannot produce research evidence from
> randomised
> controlled trials to the contrary.
>
> Why did Alice and Paul want a midwife as their maternity care
> provider?
> According to them, it was because they wanted to feel in
> control of what
> happened to Alicia and the baby. They disagreed with the
> medical model of
> birth that thinks in terms of the bodies of women and babies.
> In the
> medical metaphor, the womb, pelvis and baby are thought of as
> either inert
> or mechanical. For doctors, the body is thought of as able to
> function
> independently of the brains and emotions of women and babies;
> but Alicia
> knows that this is not true.
>
> Alicia and her partner understand that giving birth is a
> deeply private,
> even a sexual function. That is why other primates birth in
> private. The
> medicalised environment is full of strangers who come and go
> and touch the
> woman. The birth environment that medicine creates is
> dominated by
> stainless steel, artificial light, airconditioning, hard
> floors, surgical
> lights and a hospital bed with a rubber-covered mattress.
> Machines are
> frequently attached to the woman to constantly monitor the
> baby's heart.
> This immediately suggests that maybe something is or will go
> wrong in a
> perfectly normal process; thus fear is created. In this
> environment, the
> woman needs to lie still so the machines that are attached to
> her work
> well. Not surprisingly, the woman becomes uncomfortable, is
> fearful of
> strangers and fearful for the baby, she is scared to make a
> noise and
> scared to make trouble.
>
> Women cope by using an epidural anaesthetic to block sensation
> below the
> waist. The outcome of such labours is frequently complications
> for the
> woman and the baby (BMJ 2000;321:137-141). Women who have
> surgical
> interventions and who don't get to actually give birth have
> higher rates of
> depression, guilt, regret, loss of self-esteem, feelings of
> violation, and
> dissatisfaction with care -- sometimes to the point of
> outright hostility.
>
> Midwives pay a lot of attention to creating the right
> environment for
> birth. It is crucial to understand that birthing where the
> woman and
> midwife know each other helps the women feel emotionally safe
> enough to be
> uninhibited in labour. When women choose to birth unaided they
> usually
> experience a great sense of their own strength and
> empowerment.
>
> Labouring without feeling safe is like driving a car with one
> foot on the
> pedal and one on the brake; thus fear leads to prolonged
> labour and
> unnecessary medical interventions. Fear is damaging to labour
> because
> adrenalin is produced and that disrupts the normal hormonal
> regulation of
> the process.
>
> Is midwifery care safe? Should the government allow access to
> Medicare for
> midwifery managed birth?
>
> Yes, absolutely!
>
> All women are entitled to financial support to cover the costs
> of
> childbirth and doctors shouldn't have a government-mandated
> monopoly. In
> terms of safety, the research demonstrates that
> midwifery-managed care, for
> women who are healthy and have straightforward pregnancies,
> there is no
> statistically significant difference in the outcomes for the
> babies.
> Research shows, however, that midwifery-managed birth is safer
> for women
> than birth under the direction of doctors (Cochrane, 2001,
> 2005).
>
> The Australian Medical Association and the Royal Australian
> College of
> Obstetricians and Gynaecologists both oppose independent
> occupational
> status for midwives. Midwives are safe, effective and
> cost-effective
> providers of childbirth care and they should be supported by
> the government
> via Medicare rebates and indemnity insurance.
>
> Women would then be free to choose their maternity care
> providers without
> financial penalty. As adult citizens, women should have the
> right to
> choose. As professionals, midwives should have the right to
> provide
> maternity care to the full legal scope of their practice.
>
> Kathleen Fahy is professor of midwifery at the University of
> Newcastle and
> president of The College of Nursing
>
> LOAD-DATE: August 19, 2005
>
>
>
>
>
> At 07:53 PM 21/08/2005, you wrote:
> >Unfortunately not available electronically, but titled
> "Midwifery is safe,
> >and access a right" what a wonderful comment on women's
> rights and the sad
> >state of affairs here in Australia where most midwives do
> not, and are not
> >allowed to work truly as midwives, encompassing the full
> extent of our
> >legislated practice guidelines. She challenges Doctors to
> provide
> >research evidence from randomized controlled trials to prove
> that
> >midwifery care is not safe, and states that doctors shouldn't
> have a
> >government mandated monopoly on provision of care for
> pregnant women. She
> >goes on to say that women should be free to choose their
> maternity care
> >providers without financial penalty, and that as
> professional, midwives
> >should have the right to provide maternity care to the full
> legal scope of
> >their practice.
> >
> >Three cheers for Kathleen Fahy!
> >
> >Tania
>
> Alphia Possamai-Inesedy Ba (Hons.)
> PhD. Candidate
> School of Applied and Human Sciences
> Bankstown Campus, University of Western Sydney
> UWS Locked Bag 1797
> South Penrith Distribution Centre
> NSW 1797 Australia
>
> Phone: 02 97726628
> Fax: 02 97726584
>
____________________________________________________
Do you Yahoo!?
Yahoo! Photos: Now with unlimited storage
http://au.photos.yahoo.com
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
