----- Original Message -----
From: Audrey Eustance <[log in to unmask]>
To: <[log in to unmask]>; A.R M <[log in to unmask]>
Sent: 31 July 1999 18:14
Subject: Re: Midwife Shortages?


I would like to reply to the Midwifery shortages discussion.

I retired in 1995 when it became apparent that the way in which I had worked
for 20 years as a completely satisfied and fullfilled midwifery was no
longer respected. All my mothers could not have had more continuity of care.
as I was a GP attached community midwife and not only did I care for them
during that pregnancy but for all the subsequent babies. I believe that all
these
patients at my surgeries were part of my caseload and I was responsible for
their care. I ran two sessions a week and they always knew I would be there
available if they were anxious, they very rarely abused the fact that they
could call me on these afternoons. If I was not there my partner would stand
in for me and me for her. Therefore it was rare that they could not be in
touch with one of us.

Fortunately we had a GP unit which we were very committed to and over the
years it became more difficult to keep control of it. The mothers loved it
but due to many things it became more
difficult to keep. Opposition from obstetricians, from management and GPs
whose commitment left a lot to be desired. We had to fight to keep it many
times, eventually it became a Midwives Unit but it was in name only. The
staff who were totally committed to it were constantly removed and
uncommitted staff were rotated through it and the whole ethos of the unit
was lost.

All the mothers knew that if we were looking after them at our surgery
sessions (and giving them the parentcraft classes which were such happy
occasions) it would not be possible to always be there in the labour ward
for them. It was also very important that we cared for them in the
postnatal period which seems to have little imput these days.  They were
still our responsibility until 28 days postnatally. This was not daily
visits, unless they needed them, but they knew we were there if they were
worried - sometimes only on the end of the telephone or late visits if
needed, not always in on-duty hours. If they were booked for the GP unit the
greater number were delivered by their own midwife or her partner.  Those
who were attached to the consultant unit were not.  However there was, until
several years before, a board on the labour unit which had the names on of
all the patients and we would often pass through and if one of my mothers'
names were on, then we would see and support them and occasionally deliver.

Job satisfaction for me was total and all my mothers were happy with their
care.  However one day it became politically incorrect to have these
patients' names on the board in the labour ward any more and I began to feel
unwelcome there. Changing childbirth was the fashion now and I could not see
that I was not giving that type of care.  We were no longer respected by
management, we were out of date, etc. etc . etc.  By this time I had an
enlarging family which I felt needed me more than the profession, so one day
I decided that this was the time to finish.

For me what Jane Sandall has said summed it all up. One last thing - I
believe we lost it when teaching came out of the maternity unit and into the
colleges and degrees came in.  This does not attract clinicians.

Audrey Eustance





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