Thursday, November 29, 2007
Midwife shortage in Wellington, New Zealand
Apparently, there is such a midwife shortage in Wellington that women are being 'bribed' to go home straight after birth.
In some ways, that's not such a bad idea. Post natal wards are notorious for providing conflicting advice to new mothers, especially about breastfeeding. And there's the risk of infection, lack of privacy and inconvenience of being away from home and family, which is accentuated if home is some distance away from the birthing facility.
In New Zealand, we have a post natal follow up system of at least five midwifery home visits, up to six weeks post partum - this is set out in the Section 88 Maternity Notice 2007 which is the document that prescribes what services lead maternity carers/midwives must provide . Many midwives carry out far more than five visits.
As a practicing midwife, I am very keen to get women home as soon as possible because I believe it is easier for them to bond with their babies at home. This can require a significant commitment from me, especially if the woman is having breastfeeding problems and needs me to provide frequent home visits to support her feeding.
But in the end the choice must be the woman's. If she has little or no back up at home, or if she has had a difficult birth, she may be better off staying in hospital for a few days. A $100 food voucher is a poor exchange for a woman who is unable to breastfeed due to lack of midwifery support. What do you think - should there be a minimum stay in hospital following the birth of a baby?
Suffice to say, the underpinning problem of the shortage of midwives is concerning. I am convinced that one way to go is to offer free undergraduate education to women to encourage them to become midwives. What would encourage you to become a midwife? If you are a midwife, what do you see as the problems that threaten retention?
Reference: Chapter 45. Mother and Baby: A guide to effective in pregnancy and childbirth. 2000. Murray Enkin, Marc J.N.C. Keirse, James Neilson, Caroline Crowther, Lelia Duley, Ellen Hodnett and Justus Hofmeyr. Oxford University Press.
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