A rare opportunity...

I received an email the other day, informing us as third year students, that we have the opportunity to travel to Malaysia as part of our final semester and last placement to work with locals at the hospitals over there and experience a very different culture and birthing experiences. I had actually learned of this in first year, but at that stage, was really quite nervous about stepping out in the big bad world and making myself known, particularly as a midwife.

Now, having changed immensely due to what I have experienced in the past 2 and half years, I am a lot more confident and trusting in my abilities, not only on a personal level but I guess, professionally and when I got the email was quite excited about the prospect of actually doing something completely unlike me, and grasping the opportunity whilst it was there.

So if all goes to plan, I will be heading to Malaysia at the end of September (on my birthday actually), for 3 weeks as part of my final practicum. I am excited as I have never been anywhere out of Australia but at the same, really anxious and nervous about what I am going to experience and how I will handle being away from my family and more so, about my abilities as a midwife to actually make somewhat of an impact or difference whilst I am there.

I have no idea what I will encounter... especially in regards to their management of labour and birth but I am hoping to look into it and hopefully prepare myself somewhat for it.

I will make updates as I know more and about anything that I learn about the differences between here and there.

Good, Better, Best

Another part of our requirements is following 40 women through their pregnancy and birth which is a great way of building rapport and advocating for women. As well as this, it assists with our birth numbers but unfortunately has resulted in picking and choosing of follow throughs who are more likely to have a normal birth.

In my opinion, any woman that is happy to have me follow her through is a blessing and I would not, not follow them through if their intention was to have a caesarean or there was an increased risk of having one because I believe all women should be supported. It does not mean that I advocate for caesareans that may not be needed or do not attempt to suggest to the woman that a Vaginal Birth After Caesarean (VBAC) is a possibility, but I do not feel that a woman should be denied support and continuity just because there is a 30% chance they may end up in theatre.

It does not teach us anything about 'being with women'; it ignores the true meaning of midwifery. It may seem contradictory to my advocacy of homebirth but where training remains limited to the system and the highly likely result of a caesarean or assisted birth, I don't believe it should be treated as any less significant particularly because it seems that of all women, these are provided with the least choice of all.

A want to practice what they teach...

Despite being of the understanding and opinion that birth is normal and natural and that a woman's physiology was intended for the purpose of supporting and bearing life and being taught this, I am frustrated by the lack of normality that I have witnessed as a student. Our requirements to register include being primary carer of 40 women having a normal vaginal birth... that means no forceps, no ventouse and definitely no caesareans... Here fellow students and myself face a dilemma. Current figures suggest that the caesarean rate is encroaching on 30% or more of births and even higher rates in the private sector, and thats independent of assisted births. Lets for arguments sake say that 50% of all births are either by caesarean or assistance (the current trend suggests this) and that of the 'normal' births include those with intervention such as induction, augmentation, epidural, active third stage ( acascade that increases the risk of caesarean or assistance), what hope is there for us to firstly meet these requirements and secondly, witness anything close to the normality of birth?

The year I began this course, there was not yet any restrictions on us attending homebirths, well not for the university that I am studying at anyways and hence the reason why I was lucky enough to witness and be with a woman who birthed her bubs at home. It was the most amazing experience and having been a part of it, I couldn't think of any other way to have my next baby when the time came. Shortly after I attended this homebirth, we received an email from the university saying that we were no longer allowed to be present at them for insurance reasons... and there went out opportunity to experience a truly physiological birth. Having now had a homebirth and comparing that with the hospital experience I had with my first and that which I have witnessed on the other side of things, I know that I will only ever see a 'normal physiological birth' with a woman birthing at home.

Myself and others have attempted to try and change this but it seems that everyone we approached passed the buck on to someone who would also pass it and so we went round in circles, without getting any answers.

Another reason why I want to bring birth back to what it is in its rawest form and practice what we are taught... and I guess, naming this blog what I have.

Direct-Entry - Blessing or Burden?

Both actually. One of the hardest things about being a direct-entry Mid student is the stereotypical view of nurse-midwives that we are not 'seasoned' to nursing, theoretically or even practically. I have had to deal with this a lot on placement and despite showing my knowledge and ability, I am still treated as inferior and unworthy of being in their presence. Without sounding stereotypical myself, it is this ignorance that is resulting in the next generation of midwives, falling into medicalised ways of thinking and taking away from the normality and simplicity of birth.

One asked me what I would do given an emergency situation if I didn't have nursing skills and another implied that I would never be accepted or taken seriously as JUST a midwife. I was once sensitive to opinion, but starting this course had me learn quickly that sensitivity, as far as taking comments like this to heart, wouldn't get me anywhere, fast.

Given that direct-entry midwifery is fast becoming the new face of midwifery, it would make sense that we would be nutured and welcomed. The reality being that this is true only some of the time. 'The old way' is the only way for some and in that, we are bringing about change that is hard to accept.

On the other hand, in the absence of diagnose/treat basis of nursing and much greater emphasis on woman-centred care and pregnancy as normal physiological process, I feel better able to fulfil what a midwife is in every sense. And I guess, these past couple of years have been a good introduction to what I will face in wanting to change things for the better.

My Frustration...

The following posts will probably reflect over 2 years of frustration and my experiences as a student. A lot of this I have bottled up and rarely expressed as there are many of dissimilar mind and thinking to me and the minority who question why things are like they are and whether there is room for change.

I want to draw attention to a couple of things to start with and I am sure as time goes on, I will continue to voice my opinion about the flaws that I have become aware of and those that will become apparent as I move forward.