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:
[log in to unmask]">
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".



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

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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]> 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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