Dear all,I have been following this debate for several weeks and feel very inspired. I think midwifery is alive and well in the UK and I also feel there are many to want to see the profession flourish.
We have had many policies and guideline. Many countries have led from the front re startegies to promote normality.The WHO's work is so important but I feel it needs to be disseminated more effectively.
Personally I am not sure about the applicability of a baby friendly type strategy to the promotion of normal birth. Birth is a complex process. We need more work locally to promote normality and approaches that are used may differ from one provider to the next.
An assessment of the local context by individuals leading on promoting normality must form the basis of solutions to address problems that interefere with promotion. It must present a action plan as to how problems specific to their context is going to be addressed, how it will be evaluated and what progress if any has been made and if not why not and what cn be done to address this.This focus must be sustained.
Assessment of midwifery students with regards to birth physiology and factors that can disrupt this process needs to be more comprehensive. A viva type approach with a range of assessments re their understanding of physiology is crucial to be assessed as fit for practice. My observations of practice shows that this knowledege is still lacking.
Preceptorship: We are really need to enforce this. Newly qualified midwives absolutely need this and it must form an important part of any strategy. This must also be applied to junior obstetricians who must be held equally accountable when they employ practices that harm women.
I am currently doing a observational study on a labour ward and as part of this testing a observational Tool of practices to support physiological labour and birth. I complete my PhD in Oct next year and will be able to share my findings. The Tool can be used in a number of ways to structure support of midwifery practice. Soo, Denis, Mary Ross-Davie. Christine McCourt and several women from the MLC were involved in its development. I have written two articles on the Tool and feel quite strongly that structured approaches can be more effective in developing expertise.
Revalidation processes needs to be tougher. Midwives must present evidence of peer review of practice related to promoting normal physiological birth whether women are low risk or high risk. This can be done by PMAs. It is not enough to present just a reflective accounts.
We need to improve ways in which evidence is communicated to women. Presenting induction as a way of reducing c-section rates is not going to help reduce interventions.
Last but least we need to frame midwife-led care more strongly as evidence-based care as opposed to midwife-led care versus obstetric -led care. This is creating divisions that can only do harm. Women should be able to walk into any birth environment and receive care that supports physiology by all heathcare professionals. Nothing beats colloborative care.
Thank you, Florence Darling
----Original Message----
From: [log in to unmask]
Date: 09/11/2018 10:31
To: <[log in to unmask]>
Subj: Re: MIDWIFERY-RESEARCH Digest - 6 Nov 2018 to 7 Nov 2018 (#2018-197)
Discuss possible ways forward with Jacqueline Dunkley-Bent, Gates Foundation, WHO ...
On Fri, 9 Nov 2018 at 09:49, Soo Downe <[log in to unmask]> wrote:
Its great to see all this enthusiasm! Is anyone thinking about practical ways forward?
All the best
Soo
From: A forum for discussion on midwifery and reproductive health research.
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