You can tell it is election year in New Zealand. The politicians are getting into stride and of course, the health service is always a target for their pontificating.
Midwives are the cause of all evils
Stephen Franks (National party) believes that midwives are responsible for obstetricians and GPs leaving the health service as well as a rise in mortality rates, staff shortages and decrease in breastfeeding rates. I'm surprised he didn't suggest we were also responsible for global warming.
Grant Robertson (Labour) had a far more balanced post on his blog written by a guest, who is the mother of two babies. She pointed out that the current maternity set up came about because women lobbied for more choice and control over their birthing experiences which they believed they would get from midwives. However, the post ends with the complaint that midwives put too much pressure on women to labour without pharmacological pain relief.
The reality is that GPs and obstetricians were leaving the maternity service before midwives gained parity of autonomy. And the situation in New Zealand is following a global trend, as with the shortages of all health staff. Mortality rates have stayed stable for years and midwifery outcomes are better when there is continuity of care, which is why countries like Australia are looking at midwifery-led care schemes like that in New Zealand. The drop in breastfeeding rates must also be seen in a global context. Women in New Zealand probably get the best post natal care in the world. They are supported by midwives up to six weeks after they have had their babies. In many other developed countries, women get little or no post natal care at all.
No pain, no gain?
As for pressuring women to go without pharmacological pain relief, I feel sure that the majority of midwives encourage choice and informed consent. What worries me about the liberal use of measures such as epidurals is that women are not supported to explore other non-medical alternatives first. Pharmacological pain relief such as pethidine and epidural have side-effects and potential for harm. They can also start a slide into a cascade of intervention that cannot be reversed.
My stance would be that women should have access to all means of preventing pain, including water pools and the opportunity to labour at home with the support of a midwife for as long as they wish before they go to hospital. It is the trend for making epidurals a routine part of care in labour which midwives have grave concerns about.
How much notice do you take of politicians in election year?
Image: 'The beehive' - Parliament, New Zealand