Friday, July 4, 2008

Those incompetent midwives are at it again

Here we go again! The hounds have been let loose. It's hunting season again and midwives are the quarry.

Death of a baby
A baby has died in Wellington following a breech (bottom first) birth. I am truly sorry to hear about it and my heart goes out to the parents.

Knee jerk reaction
But I get so fed up with the knee jerk reactions by both politicians and the media. One death compared to more than 50,000 live births in a year and all midwives are incompetent, murdering health professionals according to some. An immediate inquiry has been announced by politicians, ignoring the fact that there are official channels for investigating incidents such as this.

Response from the Midwifery Council of New Zealand
Sally Pairman has released a statement from Midwifery Council which sums things up really well:

There is no evidence to support claims made by public health physician Ate Moala through the media yesterday. This use of anecdote and generalisation is inappropriate and serves only to unnecessarily undermine midwives and public confidence in midwifery and maternity services.

Dr Pairman goes on to say:

There are a number of processes available for proper investigation of complaints about midwives whether these are raised by women, by other practitioners or by DHBs. The interface between the Health and Disability Commissioner’s Office and the Midwifery Council is robust. Where there is evidence gained through a fair and transparent process that a midwife has indeed fallen short of expected standards then that midwife is held to account. Processes that ensure natural justice and transparency for all parties are the appropriate way to deal with concerns about individual practitioners and about the maternity service as a whole.

I am not advocating that midwives should not take responsibility for their mistakes, but just for once I'd love to hear a positive story in the press and midwives actually get thanked for all the long hours and hard work they put into supporting women and their families during childbirth.

A thankless job?
When we get bashed like this in the press without any justification, I must ask is it any wonder midwives are leaving the profession and we cannot attract young women to take their place?

I'm all for letting Ate Moala and her like get on with it and see if she can do better: be on call for 24 hours a day, day in and day out; work for hours on end to ensure women are supported to achieve all that they wish; miss special family events like birthdays and Christmas because she is putting someone else's family before her own; carry the responsibility not just for the time of birth but for years after wards...shall I go on?!

A great maternity service
Again, from the press release from the Midwifery Council of New Zealand:

The public of New Zealand should be justifiably proud of our midwifery and maternity services. The perinatal mortality rate is similar to that of the UK and Australia and the neonatal mortality rate is lower than both. The vast majority of women continue to have safe and positive birth experiences and healthy babies.

How do you feel about health professionals when you see and hear stories of their alleged mistakes in the press?


hbacmama said...

I wish the media would cover the great midwife model of care too. Not only the 'bad stuff'.
I totally 'freaked out' on a general practitioner who insisted that I needed an OB for my pregnancy (I went because I had a terrible asthma attack). I wrote a letter to the governing body of the health authority. They apologized for him. I wonder if he has ever realized how much damage he did to his profession by that attack of midwives...
If I'd been in the hospital for the birth of my third child... she, without a doubt, would not have survived her birth.
Homebirth CAN work... but as with all things in birth... it is uncertain and sometimes bad things happen.
My thoughts are with the parents of the wee babe.

Sarah Stewart said...

Compared to how the parents must be feeling at the moment, I sound like a spoiled, whining brat. So I apologize for that.

I must also point out that midwifery has many, many positive things to offer women as a profession, not least a wonderful degree of autonomy. Of course, with that autonomy comes responsibility. And I would not give up that autonomy for all the tea....

So thank you for that 'good news' comment about your positive experience with midwives.

hbacmama said...

I've been debating commenting again... who can resist? not me obviously!
I am one of those mums who found out after 15 hours of hard labour that there was a foot and buttock trying to make its way out. Two hours later (no anaethetist around at the time) my son was surgically removed from me. It was a terrible recovery. It was a hard road. I hear stories about women who have had perfectly normal outcomes from vaginal breech birth and I ache. The little green monster (jealousy/envy) comes out and takes up residence in my brain.
What you rarely hear is these outcomes... the ones where things do not work out. The ones where the parents may have looked at all the possibilities and chose to go ahead with a vaginal breech. Goodness, seems to me that midwives are the only ones who are 'trained' in this anymore! I had a midwife who still offered to give me a shot at a vaginal breech when our wee girlie freaked us all out with her positioning (she was head down).
Anyway, what I'm trying to say, is. For many women a vaginal breech delivery is almost impossible to get. And yet... sometimes it doesn't work out even when you get it.
*no, you are not wimpering... you are defending the work of the amazing women before you and those who will come after you* and there was no doubt about your sympathies for the family who lost their babe.
I'll shut up now... in a few weeks that breech babe will turn seven... and yet, I still ache for the chance to have pushed him out.

Sheryl Nussbaum-Beach said...

I had home births- 3 of the 4. One child my husband delivered as the midwife did not arrive in time, but we had been prepared and knew what to do. I had a difficult time delivering the placenta and had to be rushed to the hospital because I had lost so much blood. I remember the ambulance driver not being willing to take me as he wanted to make a point about the dangers of using a midwife (there was a political struggle going on much like you describe in my city at the time) and my very passive, sweet 6'2 husband lifted him off the floor with his hand around the collar and persuaded him to change his mind.

The baby stayed home as she had scored very high and was doing fine. I remember when we got to the hospital the nurses saying- "Where is the baby?" to which a responded, "At home where babies should be."

Great memory- that child is a RN now in a busy emergency room and studying to get her Physician's Assistant degree. The battle hasn't been won yet for midwives though I see. :( Keep up the good work.

Sheryl Nussbaum-Beach said...

Oh -- one more story. My friend at the time was also going to have her baby at home via a midwife. Her first had been born in a hospital where it had caught a staff infection and died days after birth. She wanted to have the baby at home as a way of protecting the baby.

Unfortunately, the cord was tightly wound around the second baby's neck and sadly this child died hours before the delivery.

Bottom line- childbirth, no matter where it takes place, has its risks. Midwifery plays an important role in making pregnancy safer for those who choose to deliver at home.

Sarah Stewart said...

Thank you, hbacmamma & Sheryl, for your touching stories. I am very conscious that women appreciate my efforts and it goes without saying that midwives could not do what they do without the support of women.

Childbirth and midwifery is very political - you only have to see what the American Medical Association are saying about women's rights to have home birth after having a previous cesarean section.

It's just that is gets a little demoralizing at times, having to justify our practice despite the fact we have excellent outcomes, high satisfaction levels and stringent processes to follow when things do go wrong.

hbacmama said...

Do NOT get me started on the AMA... despite my residing and being a Canadian. Boils my blood it does!
Happy thoughts, happy thoughts, happy thought.....