Dear Susan,
I see the word diagnosis as part of the scientific, techno-rational paradigm
of assess, diagnose, plan, implement and evaluate. This paradigm works well
if you have a problem or if you want to treat everything as a potential
problem. Such a paradigm guides thinking and perception. The midwifery
paradigm, I think, is quite different. I have written on this for the
Australian College of Midwives Journal; Being a Midwife and Doing Midwifery.
You may find it interesting so I am attaching a copy of that article from my
files.
Dr. Kathleen Fahy
Associate Professor
Midwifery Co-ordinator
University Southern Queensland
07 46312377
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-----Original Message-----
From: Susan Burvill [mailto:[log in to unmask]]
Sent: Wednesday, March 15, 2000 3:43
To: [log in to unmask]
Subject: Re: Introduction and request
Dear Kathreen
Thank you for your input. I read with interest your comments. I do agree
with you that diagnosis is a biomedical slant but I am interested in the
'midwifery diagnosis' not the medical diagnosis. It may become more apparent
when I start to do my indepth interviews that the paradigm of 'diagnosis'
does not apply to midwifery, which is part of what I wish to establish or
not establish. I have observed that midwives make diagnosis although not
termed diagnosis. For example, 'a woman is in 2nd stage of labour' - is
surely a diagnosis? Not wanting to get too involved in the semantics at this
stage, I find midwifery decision making fascinating and a foundation to
understanding how our approach differs to our obstetric colleagues.
Kind regards
Susan
----- Original Message -----
From: Kathleen Fahy <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, March 11, 2000 6:11 AM
Subject: RE: Introduction and request
> Dear Susan,
>
> I don't have much to specifically add to your topic but I do have a
> suggestion for changing your words.
>
> If your aim is to move away from biomedical discourse then a word like
> 'diagnosis' keeps you locked in. Maybe there isn't a 'start' to labour.
> Maybe it creeps up slowly. Maybe that is one of the big differences
between
> midwifery and obstetrics; midwives don't have to put things in tight
boxes.
> We can accept the continuity of branxton hicks, early labour, established
> labour etc. Why do you want to answer this question?
>
>
> Dr. Kathleen Fahy
> Associate Professor
> Midwifery Co-ordinator
> University Southern Queensland
> 07 46312377
> [log in to unmask]
>
> -----Original Message-----
> From: Susan Burvill [mailto:[log in to unmask]]
> Sent: Saturday, March 11, 2000 8:23
> To: [log in to unmask]
> Subject: Introduction and request
>
>
> Dear Colleagues
> I have been on the list for many months but not actually introduced myself
> I am Susan Burvill, I practice as an Independent midwife in South London
and
> at present I am doing an MSc at Surrey University in Advanced Clinical
> Practice (Midwifery).
> My particular interests surround the re-discovery and develpment of a
clear
> midwifery discourse which is distinctly separate from the biomedical
> discourse now so ubiquitous in women's health and childbirth. For my final
> MSc dissertation I am focussing on the midwifery diagnosis of labour
onset.
> In order to tease out and explore the 'midwifery expertise' I will conduct
> serial indepth interviews with two experienced midwives along the lines of
> Firlej and Hellens 'Knowledge Elicitation' process.
> Has anyone read or heard of this approach used to explore midwifery
> knowledge? I have found none so far.
> I would also be interested on any refs pertaining to labour onset
diagnosis,
> there appears surprisingly little in the data bases and journals that I
have
> reviewed.
> I look forward to any leads
> Thanks in advance
> Susan
>
>
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