Dear Ishbel,

Thank God, we have people like you. It is very right for you to show
your concern. Remember when I sent an EMail asking what value
we put on ourselves. What is our worth? Since 1988, Midwifery
profession, in UK, seems to be deliberately marginalised. It
seems to me that many midwives are so frustrated with what is
going on, as it seems that no matter what we try to do, HIGHER
STUDIES, RESEARCH & EVIDENCE BASED PRACTICES, no
one is prepared to take note of us!, form A - Zee!

We h
ave been labled "madwives",. This is not a joke, those who
say it mean it. Any time I complained of our eminent danger of
"disappearing", I have been told that," Nursing is a generic name.
Everyone knows that midwifery is included".

When ever the Government gives anything to Nursing, the nurses
take it to themselves without asking, what about the midwives. We
need a strategy for making midwifery heared and known in good
achievements not only in bad practices.

I have nothing against combined stud
ies. What I hate is watering
down the quality of academic delivery in the name multi-
professional education. Infact I do not think that nurses and
midwives should study together because we care for well people.
We are autonomous in many ways in our professional practices
and supervision. To me, the ideal multi-disciplinary education for
the midwives is combined studies with the obsteric medical
students, social workers, school nurses, biologists, police, health
visitors, business students and al
ternative medicine students.


I hope and pray that one day the society will take note of us. I wish
the Government will audit the resources in midwifery education and
practice. This will show them where we are at, having travelled a
very long way indeed. I sincerely wish that Midwifery institutions
will consider introducing enterprenueral mentality into our education
and practices. I hope this will make midwives better negotiators for
themselves and their profession.

We are very frightened to
take risks and so any and every one that
comes along decides to treat us as they like. When shall we start
to love ourselves and our profession very dearly?. We work so hard
that we are so tired to focus and think for our selves.

Please God help our profession globally!

All the best, Ishbel,

Go ahead, I support you.

Love


Bridget I.Okereke

On 6 Dec 00, at 9:33, Ishbel Kargar wrote:

> ----- Original Message -----
> From: "oppera" <[log in to unmask]>
> To: <[log in to unmask]
>
> Sent: 19 October 2000 01:12
>
>
> I would like to write to the N.H.S. executive protesting at the possibility
> of amalgamating midwifery and nursing. Do you think this would be helpful.
>
> I am sending you information about our organisation OPPERA
> here is some information for you on oppera I hope it is not too much!
> Babies OPPERA
> An Outline of Oppera Services.
>
> The following services are either currently offered by OPPERA or are in
> some level of preparation. This is a blu
e print of a plan of work which may
> take ten years to implement. I have indicated in italics how these
> activities appear to me to fit with the Tudor Trust's areas of focus. Most
> of these services have a strong element of "advice services delivered
> locally" so this is not specifically mentioned. We currently have a small
> counselling centre for work with families.
>
>
> 1) The Preconceptive Parent Programme.
>
> (a) Schools Programme: Sex and Relationships.
> (Education in citizenship
, supplementary to curriculum on health, sex and
> emotion education)
>
> (b) Physical and Psychological Preparation for Parenthood. (Education in
> citizenship)
>
> (c) Infertility Programme (marriage counselling)
>
> (d) Deconstructing primal experiences, releasing primal pain. (Accredited
> counselling work)
>
> 2) The "Real First Year" Programme: From Conception to 3 Months post
> birth.
>
> (a) Working with music and movement (parenting skills)
>
> (b) Understanding prenat
al development processes.
>
> (c) Inner and outer touch: feeling relatedness for parents and baby
> (Parenting skills)
>
> 3) The perinatal period; the birth process from start to finish.
> (Parenting skills)
>
>
> 4) The Birth Refacilitation Programme. (Parenting skills)
> (Preventative work with families on the edge of crisis.)
>
> (a) Introduction and explanation of birth refacilitation
>
> (b) Preparation for the parents
>
> (c) Cathartic work with parents and children

>
> (d) Somatic repatterning and relaxing baby massage.
>
>
> 5) The Intensive Course for adults and Professionals (marriage
> counselling training.)
>
> 6) Trauma work with older children and adult survivors of birth trauma.
> (Accredited counselling)
>
> 7) The Public Awareness Programme.
>
> (a) What is a person? Seminar.
> (b) Further seminars with Oxford University
>
> 8) The Action Research Programme.
>
> 9) Adoption Work
>
> (a) For adoptors
> (b) For child
ren
> (c) For adult adoptees
>
> 10) The Professional Training Programme.
>
>
> PROGRESS REVIEW.
> THE END OF FIRST YEAR OF OPERATIONS.
>
>
> The fundamental aims of OPPERA in its first year have been to lay down
> solid foundations to build a long term programme of work. In this respect
> establishment of the trust as a holding structure has been an important step
> following nearly a year's preliminary groundwork by Nick Owen, building on
> the conceptual base set out in the 12 Congress
 of the International Society
> for Prenatal Psychology and Medicine in 1998. The Trustees themselves
> represent a broad spectrum of relevant interests in society. They include
> both mothers and fathers of young children, ethnic minorities, academic
> psychology, philosophy, genetics and law. Trustees are also grounded in
> local politics and business. The chair's acclaimed new book, "Dear Mr
> Darwin" is one of the key elements in the challenge to the current fashion
> of evolutionary or genetic
 psychology, which discounts the value of early
> learning.
> The professional advisory group has been steadily expanded through the
> year. David Wasdell is perhaps the world's leading expert in prenatal and
> perinatal psychology. Roy Ridgeway's "International Integrated Health
> association" is attempting to do similar preconceptual work to OPPERA in
> Russia and Ukraine, where preconceptual care is minimal. Roy has written a
> classic book on the subject "The unborn Child, a New Concept of Care"
.
> William Emerson is another world leader in the field, whose collected works
> have just been published, providing 20 year's research reports, backing up
> the rationale of OPPERA with evidenced based data. They are available now
> as "Collected works, Vols 1 and 2."
> We briefly had a local teacher of midwifery involved, but she withdrew
> through pressure of work. We have not so far replaced her with a member of
> the local health services. This urgently needs remedy.
> We have broadened ou
r scope with people from different fields. Maria de
> Leon is a world leader in the development of prenatal music stimulation
> education. Shirley Ward is a leading figure in primal psychotherapy in
> Europe, based in Ireland. Deirdre Haslam completes the current team. She is
> a university counselling and psychotherapy teacher with special interest in
> this field.
>
>
>
>
> FINANCES
>
> The trust has been able to raise resources to the value of £29,500 in its
> first year.
> The main contri
bution has been the donation of professional time and
> expertise by Nick Owen, the acting Director of the Trust, to the value of
> £15000. Further professional time has been donated by Manches, Solicitors,
> in seeking Charitable Registration, to the value of £2000. The lottery has
> given £5000. The Oxford City Council has given £500. The Oxfordshire
> Community Association £1000. There has been one private donation of £1000.
> The Oxford School of Psychotherapy and Counselling has provided
> accom
modation and other logistic support to the value of £5000.
>
> The trust will need to be able to take over the tenancy of the current
> premises in East Oxford in September if it is to stay with a physical base.
> Mr Owen will only be able to continue his current level of involvement,
> unpaid for another 6 months.
> The need for new and increased resources is therefore acute. The Tudor Trust
> has been identified for us by the Oxford Council for Voluntary Action as
> the single most relevant trust
 fund to approach. A bid has been submitted
> to the Lottery for funding work on Poverty and Disadvantage but the more
> central lottery focus of Health will not be accessible till the end of next
> year. There is a possible private donation of £5000 in the pipeline. The
> trust has also bid for funds to provide counselling services to the local
> Sure Start programme. However, it has agreed to waive fees, on the basis of
> its commitment to working with seriously disadvantaged families. "Children

> In Need" did not give a grant last year, but their Director has encouraged
> the trust to make a smaller bid in November.
>
> The next trustee's meeting has fund raising as its key agenda item. While,
> the first year must be considered a relative financial success, since the
> trust has been successful in three out of four of its funding applications
> and has attained the valuable endorsement of the Oxford City Council, no
> substantial funding has been achieved and the total picture has to be v
iewed
> as precarious going into the second year. A working relationship with the
> Tudor Trust may be crucial to the future success of our work.
>
>
>
>
>
> Registration with the Charity Commission.
>
> This has been a slow and tortuous process, which just may be near to
> completion.
> The Trust deed has had to be completely redrawn and the Objects rewritten to
> comply with archaic legislation.
>
> The Commission has chosen to be sceptical of the educational value of the
> subject matter
: this, inspite of our recruiting no less a figure than
> Professor Susan Greenfield to our Public Awareness Programme aswell as three
> other eminent Oxford Professors.
> However, one member of the commission staff has already stated that he has
> no doubt that the trust is Charitable under the Act. The trust is fortunate
> in obtaining the pro-bono services of the eminent Manches solicitors to
> carry the matter through to a successful conclusion. The long delays have
> held back the trust from f
eeling confident to raise funds.
>
>
>
> FIRST YEAR EDUCATION PROGRAMMES
>
> 1) INTRODUCTORY
> 2) INTENSIVE
>
> 1) The Introduction to OPPERA Programme.
>
> The strategy here was to inform as many health care professionals as
> possible about the existence of OPPERA and its services.
>
> An information pack was put together to include:
>
> 1) Promoting Positive Parenting: a leaflet outlining the services
> available to parents and prospective parents.
>
> 2) An invitation to the I
ntroduction to OPPERA seminar presentation, either
> to staff in their own work place, or at the trust's centre.
>
> 3) An invitation to join an Action Research Group, exploring prenatal and
> perinatal phenomena at work or in private life.
>
> This was sent out to selected health centres and all counselling centres
> across the county of Oxfordshire and Oxford City. The letters were followed
> up with telephone calls to doctors and practice managers, but without much
> positive response. We ha
d hoped for 2 sessions a week, but achieved only
> one or two per month in the first 6 months of work.
>
> Professions responding included a doctor, a number of cranial osteopaths,
> chiropractors, counsellors and psychotherapists, a groupwork consultant, a
> reflexologist, a mental health resource centre worker, and one social
> worker from the Children's Society.
>
> Connecting with Doctors.
> The most promising connection established through the programme was with
> Paul Johnson, a senior hosp
ital doctor working in the neonatal field. We are
> hoping this will develop into a presentation at the John Radcliffe and
> shared working in the Autumn. We have established contact and received a
> letter of support from the Consultant at the Foetal Research Centre in
> Newcastle. The Professor in Oxford has so far responded negatively, however.
> We have been invited to give a presentation to the foetal and neonatal
> stress research centre at Queen Charlottes in September.
>
> Connecting with Ps
ychologists.
> We are giving a presentation to the Winnicott Research Unit at Reading
> University in September. We have not yet had a response from psychologists
> in Oxford, however.
>
> Connecting with nurses.
> The main target groups, Health Visitors and Midwives have failed to
> respond, despite meetings with the C.E.O. of Oxford City PCG, who offered to
> facilitate this process. We briefly managed to recruit a senior midwifery
> tutor to our advisory panel, but she withdrew through pressur
e of work,
> having just started a new job. Feedback from nurse managers is that
> resources are currently being withdrawn from "normal families" to
> concentrate on those with severe problems. The midwifery shortage in the
> county is such that there is great pressure on women not to have home
> births.
>
> Action Research Group.
>
> Several members of the groups introduced to OPPERA have agreed to join the
> proposed Action Research Group which will start work this Autumn, so this
> objective h
as been achieved.
>
>
>
> Professionals and the public.
>
> The goal of persuading clinics to accept leaflets has not yet been met, but
> the Charity Mind has agreed to put leaflets into its centres throughout the
> county.
>
> An article about OPPERA was printed in the Oxford N. C. T. journal, which
> led to an important professional connection with a local complementary
> health clinic.
>
> A North Oxford clinic has also taken an interest in the work, which we hope
> will lead to collabo
rative work this autumn.
>
> National Childbirth Trust
>
> We have not yet shown the intro to OPPERA material to an N.C. T. Group, but
> a contact with 2 teachers has been established and we hope to do so in the
> autumn.
>
> Oxford Parenting Forum.
>
> Connecting with educators
> Oxford is perhaps the country's leading county in parent education. OPPERA
> has joined this as a way to introduce more people to our work. Information
> was displayed at their annual conference. However, our work was
 marginalised
> there. It was displayed in the most peripheral area and torn down at the
> start of the day by someone who felt it had defiled their space!
> One of the management committee was persuaded to propose a presentation of
> our work, but has not done so yet. We expect this to happen in the course of
> the next year.
>
> East Oxford Healthy Living Initiative.
>
> OPPERA joined in partnership with other groups seeking money for a
> co-ordinated set of services through the New Opportuniti
es Fund. This gave a
> brief opportunity to explain the work of OPPERA to quite large groups of
> community activists from their voluntary sector. Sadly the bid was
> unsuccessful, but the group still exists with long term objectives not tied
> to the N.O. F. The group is preparing for a new phase of work. OPPERA will
> be considering a possible partnership with them in this next phase
>
> Sheila Kitzinger
>
> Nick Owen has met and corresponded with Sheila Kitzinger who has provided
> helpful con
tacts and advice. We hope to develop this link with such a key
> theorist and authority in the birth field who lives locally. It is hoped
> that Sheila will be able to help more when her curent television series is
> completed.
>
>
> Parent-child 2000
>
> Nick Owen attended this national conference on parenting. It was too late
> for OPPERA to be included in the formal presentations of the conference, but
> it was a significant opportunity to communicate with individuals and groups
> from all par
ts of the country, and to begin to network. OPPERA comes in on
> the back of 30 years of research into the primal field, but it is still at
> the cutting edge of early parent education in this country at the present
> time. Only the PIPPIN Charity offers prenatal parent education. No one is
> yet grasping the nettle of perinatal experience. It may be several years
> before the mainstream can take on our insights.
>
> OCHRE Practitioners Group.
>
> OPPERA shares counselling premises with this group
of counsellors and
> psychotherapists. OPPERA has presented its work to members of this group,
> and has received a positive response, with several members going on to take
> the Intensive Course. Some members are also joining the research group.
>
> Politicians.
>
> We have introduced the work to several local politicians including a meeting
> and correspondence with the local M.P. One local politician has become a
> trustee. We have proposed a presentation to one of the parties education
> commi
ttee.
>
>
>
>
>
> Sure Start
>
> We have attended stakeholder meetings of this important Government National
> Initiative which has a local project very close to our centre. We offered
> enthusiastic support to the project. Nick Owen met with the Director, who
> explained that the key value of her enterprise was user involvement, and
> that OPPERA was very unlikely to have any appeal to her client group. Our
> experience to date suggests that there is strong emotional resistance to our
> new p
aradigm of work, which is evident in the management of this group. Our
> view is that choices made without adequate information are not real choices,
> and we very much regret that we have have so far been denied the
> opportunity to share our "Intro to OPPERA material" with staff or parents
> at the project, something that has been afforded to other groups. We have
> put in a bid to provide counselling services to this project which have been
> turned down "at this point in time".
>
>
> 2) The In
tensive Programme.
>
> As Part of "The Millennium Festival" the National Lottery funded our first
> Intensive Training Course Programme, entitled "From Preconceptions to Post
> Birth", a four day intensive residential course aimed at helping people
> explore the experiential roots of pre and perinatal psychology. Attendance
> at this course, or an equivalent, is an essential element in preparing
> professionals to be able to work with OPPERA .
>
> The course was widely publicised locally and Nati
onally. It was full, with
> a maximum of 11 students and facilitator attending.
>
> All but one completed the course. The man who left a day early did so to
> support a friend in distress. The enthusiasm of the group was such that 2
> follow up days have been arranged, with the majority offering to become
> members of the Action Research Group. Several members have also
> volunteered to help with the development of OPPERA services. One has set up
> our web site. 2 members have submitted extensi
ve notes on their learning as
> part of OPPERA's research agenda. More are promised.
>
> This was also the first primal training group in an extended residential
> format that
> the facilitator had led, previous work having been with psychotherapy
> students over non-residential week ends. Feedback from all participants
> indicates that the work was done well. Members have reported significant
> improvements in their personal development and important changes in their
> level of work with clients.
All members have expressed an interest in
> continuing the primal learning process.
>
> All members showed high levels of commitment to the learning process, at the
> time, working at a deeper level than any group the facilitator has
> previously experienced.
>
> The course structure invited participation and shared leadership, on the
> basis that there is a need for sharing knowledge and skills in a new
> multi-disciplinary field of inquiry. In this respect, a significant
> contribution was made
 by Julia Gresty, an experienced psychotherapist, who
> has also taken on a co-ordinating role, on behalf of OPPERA, for the follow
> up days. Clare Pollak, David Colbourne and Elizabeth Winder also brought
> group and individual facilitator skills, while Tracy Aird was able to
> contribute theory from the cranio-sacral perspective.
>
>
> Research Presentations. Meridian 2000 Congress.
>
> Nick Owen studied data from video, verbal and written reports from the
> course for a presentation at the Me
ridian Congress on prenatal and perinatal
> psychology at the summer solstice in London this year. The presentation was
> focussed on the experience of twin loss in early gestation recapitulated at
> birth, a phenomenon that affects something between 10% and 70% of embryos,
> depending on which research study you follow!
> It was entitled "the Ghost in the Machine". More than half the congress
> delegates attended the presentation, which was well received, inspite of
> technical problems which preven
ted replay of the video material. The
> presentation was itself recorded and will become part of the developmental
> learning process for OPPERA. The material will also become available to the
> wider community both Nationally and Internationally through the congress
> archive.
>
> Feedback from the report has already been fed back into the OPPERA follow up
> first meeting to stimulate a meta-learning process. A copy of the report
> will be available on the website.
>
> Nick Owen also contributed
 to a Symposium on Primal Learning Processes in
> the Training Group, at the same Congress.
>
>
> RESEARCH WORK
>
>
>
> Research from the intensive course.
>
> The OPPERA approach to all its work has to this date had an Action Research
> methodology. Course members were encouraged to reflect upon, study and
> record their personal experiences during the training and to write them up
> afterwards. Three written reports from members have been received to date.
>
> The facilitator has made hi
s notes available to group members.
>
> A considerable number of the course sessions have been recorded on
> video-tape, the camera often being directed by group members, adding a
> participative element to the research process.
>
> July saw the first follow up day to the course, the second will be in
> September. The first formal meeting of the Research Group will follow that
> in October.
>
> ACTION RESEARCH
>
> Humanistic psychologists, perhaps most notably John Rowan and Peter Reason
> have
 developed an approach to research that is not merely founded on human
> values but is humanistic in its modus operandi. It is a qualitative method
> generating qualitative data. It is now well established academically in this
> country and internationally, with regular international conferences. There
> are post graduate degree courses in it offered at several universities.
>
>
> OBJECTIVE OR QUANTITATIVE RESEARCH
>
> OPPERA is also interested in the possibility of objective data research,
> part
icularly along the lines explored by William Emerson, where babies
> treated for birth trauma are matched with similar untreated babies and
> followed up over a long period. This will only become possible when adequate
> staff and financial resources become available. We have established a
> dialogue with the Director of the Oxford University Department of Public
> Health, Health Services Research Unit, and have been offered support in
> terms of attendance by one of their staff at steering group meet
ings, which
> is extremely welcome. We are not yet in a position to pick up on this.
>
>
>
> REVIEW OF
> DIRECT WORK WITH CLIENTS
>
> Individual, family and group work.
>
> OPPERA has a very wide and demanding brief, to provide education, advice and
> counselling to the public and professionals, both locally and Nationally.
>
> At the current time there is just one part time member of staff and no admin
> support. A decision has been taken to prioritise the educative role of
> OPPERA in
 relation to key National organisations. However, it is essential
> for OPPERA to provide evidence for the effectiveness of its concepts and
> methods in practice at local level.
>
> Work has therefore begun and will be continuing to grow with a range of
> client groups. The list of possible programmes offered by OPPERA is long,
> and in practice only a few of them are likely to be taken up within the next
> year. It is very much a matter of finding which parts of the local community
> are open to
our work.
> Current work is summarised below under the headings in the introduction.
>
> 1) Preconceptive.
> Infertility.
>
> Face to face Client advice work has begun locally. Some interest in this has
> also been expressed by professionals in London, which will be picked up
> soon.
>
> 2) The "real first year".
> Prenatal and Perinatal work/Teenage Pregnancy
>
> We have explored OPPERA involvement with 2 local groups for teenage mothers.
> We have supported one family through the process of
teenage pregnancy which
> had involved a very traumatic birth, the direct result of medical
> intervention. This work is on going.
>
> 4) Birth Refacilitation.
> We are just at the beginning of this work with babies. (Nick Owen has
> significant experience in working with babies and children prior to the
> start of OPPERA.)
>
> 5) Intensive course.
> One complete, the next in preparation. We have been working at great depth
> with this group of experienced professionals. Through interviewing,
>
groupwork on the intensive course, and follow up work with participants, we
> have been able to make significant improvements in the competence of
> professional practitioners, to enable them to begin to work at greater depth
> with their clients.
>
>
>
> 6) Trauma work with older children and adult survivors.
>
> Pregnancy and mental health: We are in dialogue with the Oxford Survivors
> mental health group at an organisational level. One client with a history of
> severe mental illness and con
comitant physical problems has been
> successfully helped through to a happy delivery in very stressful
> circumstances.
> Twins work; In dialogue with staff and a patron of the Multiple Birth
> Foundation, we have been exploring the psychological problems surrounding
> monozygotic twins, with special reference to the not infrequent incidence of
> anorexia in later development. We have contributed to a seminar discussion
> at Queen Charlottes in West London on this theme. A research report will be

> made within the next six months.
>
> 9) Adoption
> Nick Owen has worked extensively with adoptees prior to the establishment of
> OPPERA. No work has been started since the start of the charity, but an
> adoptee has been approached to join the advisory panel.
>
>
> PUBLIC AWARENESS
>
>
> The trust has been fortunate in having the help of one of its prenatal
> therapy students, a senior member of Somerville College Oxford. She has
> enabled us to start a series of day seminars in conjunction
 with Oxford
> University.
>
> The first seminar theme was "What is a person?" . It attracted some of the
> country's most distinguished speakers, led by Professor Susan Greenfield,
> Director of the Royal Institution, and the country's leading public
> communicator in the field of neuroscience. Responding to her, Professor Dan
> Robinson is both a neuroscientist and philospher, with major contributions
> to the fields of early human development and personal identity. Professor
> Bill Fulford is a
forensic psychiatrist and philosopher and editor of a
> journal linking psychiatry, philosophy and psychotherapy. The team was
> completed by Felicity deZulueta, consultant psychotherapist and
> psychiatrist, author of "From Pain to violence," a book on the importance of
> poor early parenting in later violent behaviour.
>
> 2 of the more memorable inputs were the fact that a rat pup has more legal
> protection and rights than an unborn human being in this country,
> (Greenfield) and that the unborn
 child had no legal personhood at all until
> 1995 (Robinson).
>
> The main aim of the seminar was to stimulate the debate between philosophers
> psychologists and neuroscientists about the origins and fundamental nature
> of the human person, in the light of the advances in neuroscience during the
> decade of the brain.
>
> The aim was met with the proviso that there were too few neuroscientists
> among the attenders, so that the afternoon was slightly unbalanced by
> contributions from philosoph
ers.
>
> OPPERA is keen to promote its next seminar on the theme of embryology,
> psychology and society, the major theme of the moment now that stem cell
> research has been given the go ahead.
>
> OPPERA WEB SITE
>
> The Lottery has funded our computer and web equipment. A web presence has
> existed for some time, but it has now taken on a professional shape. In time
> we expect the site to develop a great deal so that it becomes our key
> contribution to public awareness on prenatal and pe
rinatal experience and
> parenting.
> The web Address is: www.oppera.org.uk
>
> There is a great deal of work to do to make it an effective communication
> vehicle, however.
>
> OPPERA very much supports your aims.
>
> Best wishes
>
> Nick Owen
>





Bridget.I.Okereke,
Midwifery Education Department,(Sen.Lecturer).
Middlesex University,
10 Highgate Hill,
London N19 5NF
0181 362 6020
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