Hi Margaret,
I agree with you about the problems in applying medically based language in
midwifery. I came across this in a practical sense when I was seeking
approval for my own research in Midwifery practice in the 3rd stage of
labour. To access women in labour I had to obtain a signed letter from each
consultant obstetrician within the two units I collected data from. Several
of them objected to the word client being used when referring to women
booked under their care; they wanted me to use the term patient. Conversely
I had a problem with the term patient being used and I am certainly aware
that many midwives do also. Therefore I had to think of a way to bridge the
language barrier between the two professional groups to obtain the access I
needed. I used the term "woman". You are right we do need to develop our
language more in keeping with the holistic and client centred perspective
that is midwifery. At the same time we struggle against the recognition of
those terms within other arenas. 
Tina Harris

		-----Original Message-----
		From:	Margrét I Hallgrímsson [mailto:[log in to unmask]]
		Sent:	22 March 2000 09:22
		To:	[log in to unmask]
		Cc:	[log in to unmask]
		Subject:	Re: Introduction and request

		Hi fellow midwives!
		My name is Margret Hallgrimsson and I have just started to
participate in
		this list. I must say that I could not let it be,not
participating in this
		discussion about "midwifery diagnosis". I am doing my MS in
the University
		in Reykjavik Iceland and I am participating in a course in
Iowa called
		nursing informatics.I have got to know better the nursing
diagnosis in that
		course and at the same time discovered that midwivers have
to start working
		with the midwifery classifications. Here in Iceland we are
bound to use
		ICD-10 medical diagnosis  in labor which is untolerable and
my heart is
		burning when I realise that one day when the hospital get
the idea to count
		the doctors get the credit from our work! but it is also sad
that we
		midwives do not have our own language.  I  would very much
want to be on
		this discussion if you are planning to continue with it.
Warm regards Margret
		At 05:42 PM 3/14/00 -0000, you wrote:
		>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
		>>
		>>
		>
		>
		>
		Margrét I. Hallgrímsson;RN.BSc.RM
		   adr.Reykjavíkurvegur 25 
		       101 Reykjavik
		        hs: 551-5892
		        vs: 560-1186
		   netfang:[log in to unmask]
		


%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%