 |
 |
Dear Tina and Margaret, Tina has made a point which I would like to amplify; that midwifery language is not techno-scientific language but the language of women. Our language has always been undervalued and suppressed. I would hate to see Midwifery developing 'Midwifery Diagnoses' like Nursing did. Nursing did this to parallel medicine in the belief that it would give nursing status and control over the discipline. It has not done that but what it has done is problmatise and quantify a whole area of human experience and in the process most nurses felt disenfranchised. Birthing does not fit within the techno-rational world view. Midwifery does not, in my view, need to match itself to medicine; rather we should be challenging obstetricians to justify, from research, their involvement in normal pregnancies. The research evidence is on our side; my reading of the literature is that midwifery supported, non-interventionist birth is the safest birth for the approximately 85% of women who are well and healthy in pregnancy and whose pregnancies are uncomplicated. I think it is important, as Tina said, to be careful about our language; her example about patient, client, woman is a good one. In being careful let's not mimic medicine because rather than being first rate midwives we could end up being obstetric nurses. Dr. Kathleen Fahy Associate Professor Midwifery Co-ordinator University Southern Queensland 07 46312377 [log in to unmask] -----Original Message----- From: Tina I Harris [mailto:[log in to unmask]] Sent: Wednesday, March 22, 2000 10:47 To: [log in to unmask] Subject: RE: Introduction and request 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] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%