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Dear all

This is how I see it from outside both systems.

It is unthinkable that he should not think himself the team leader.

 From this context it looks as if he is confusing midwifery with 
obstetric nursing and thinks that all midwives should be obstetric 
nurses. And no doubt he is able to put up a drip and perform arm but I 
doubt he willing and able to put in the time at the 'bedside' giving 
other forms of support - (or indeed getting the mother off the bed). 
Practising obstetric nursing may be like practising midwifery with one 
hand tied behind one's back and an obstetrician, manager and lawyer 
looking over your shoulder.

I would say that problems in the UK maternity services lie in the 
confusion of obstetric nursing and midwifery, it seems to be difficult 
to practise as a midwife in the hospital setting. Presumably it's a 
question of autonomy - midwives practise autonomously  - which includes 
knowing when an obstetric referral is needed. This accounts for good 
outcomes at home and in birth centres (the obstetrician in question 
seems to be against such midwifery led care). If obstetrics is 
omnipresent in the form of protocols and medical presence in the 
building, then there is a blurring of what referral means - it is 
escalation rather than referral.

And of course the very paternalism of hospital care denies autonomy to 
the woman herself, the original problem in Morecombe stemmed from a 
failure to listen to her and her husband.

Midwives are 'with women' and probably see her as the team leader!

Just my 2d.

Margaret Jowitt

On 24/04/2019 22:27, Margaret Dunlea wrote:
> Dear colleagues,
> Thank you for your comments so far. Please see below exact quote and 
> details of the Health Committee submission with regard to the review 
> of the National Maternity Strategy 2016-2026 who took place on the 
> 21st February 2018.
>
>
>   ·"I mentioned in my opening statement the importance of midwives and
>   doctors working together as teams. It is critical we do not lose the
>   tremendous co-operation and teamwork we have had between midwives
>   and doctors in the Irish health service down the years. There is a
>   terrible tendency to look to the UK and say what they are doing is
>   good and, therefore, we will do it. It is not always good. It has
>   had very serious problems in its maternity services. We do not want
>   to repeat the mistakes of separating out midwifery and obstetric
>   care. There are both the same. All obstetricians are midwives and
>   are proud to be midwives but they are also looking after more
>   complicated cases. It is essential they work together and that we do
>   not lose sight of that".
>
>
> For the full transcript go to 
> https://www.oireachtas.ie/en/debates/debate/joint_committee_on_health/2018-02-21/3/
>
> Regards,
> Margaret
>
> **
>
> Margaret Dunlea
> Assistant Professor in Midwifery
> SF, JS and SS Course Coordinator - Midwifery
> School of Nursing and Midwifery
> Trinity College Dublin
> 24 D'Olier Street, Dublin 2
> Ireland
> 0872241798
> 01-8964080
>
> Ollamh Cúnta an Chnáimhseachais
>
> Comhordaitheoir Cúrsaí Chlár Fochéime na Dara Bliana, na Tríú Bliana 
> agus na Ceathrú Bliana
>
> Scoil an Altranais agus an Chnáimhseachais
>
> Coláiste Na Tríonóide, Baile Átha Cliath
>
> 24 Sráid D’Olier
>
> Baile Átha Cliath 2
>
> Éire
>
>
> On Wed, 24 Apr 2019 at 15:26, Margaret Dunlea <[log in to unmask] 
> <mailto:[log in to unmask]>> wrote:
>
>     Dear Colleagues,
>     In a recent submission to the Irish Government's Health Committee
>     on progress regarding implementation of the first National
>     Maternity Strategy in 2016, a senior obstetrician, representing
>     the Irish Institute of Obstetrics and Gynaecology suggested that
>     he was a midwife as well as an obstetrician,  and adding insult to
>     injury, he said that he was proud of it.
>
>     Do you share my outrage with this statement? Do obstetricians
>     elsewhere share this view? What does this mean for working
>     collaboratively?
>
>     I would appreciate your views on tackling this.
>
>     Kind Regards,
>
>     Margaret
>
>     Margaret Dunlea
>     Assistant Professor in Midwifery
>     SF, JS and SS Course Coordinator - Midwifery
>     School of Nursing and Midwifery
>     Trinity College Dublin
>     24 D'Olier Street, Dublin 2
>     Ireland
>     0872241798
>     01-8964080
>
>     Ollamh Cúnta an Chnáimhseachais
>
>     Comhordaitheoir Cúrsaí Chlár Fochéime na Dara Bliana, na Tríú
>     Bliana agus na Ceathrú Bliana
>
>     Scoil an Altranais agus an Chnáimhseachais
>
>     Coláiste Na Tríonóide, Baile Átha Cliath
>
>     24 Sráid D’Olier
>
>     Baile Átha Cliath 2
>
>     Éire
>
>
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