Cate!
I am presently working with clinical pathways for mother and child before
and after normal delivery. I would agree with Christine that clinical
pathways work is really not about our patients but rather about re-thinking
our organisation, indeed in some circles this work is called "process
re-engineering".
I do however think that the work is very valuable from a health-economics
viewpoint, making sure that the care we provide is appropriate for a
particular group of patients and that resourses are being used where best
needed. It is therefore vital that midwives are included in clinical
pathways work. If nothing else is acheived at least we make ourselves aware
of how our organisations work and where the money goes!! Without that
knowledge it is difficult to be true advocates for the women in our care.
As far as what is to be considered normal birth, WHO has produced a very
succinct and interesting paper on this subject. I can't just remember the
name but if you visit the website (www.who.ch) you will be able to locate
it. It may save you a great deal of precious and expensive time.
Good luck. Linda Kvist, Helsingborg, Sweden.
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