Wednesday, July 21, 2010

Cascade of normal, birthing on country and social media activism

The "Breathing new life into maternity services" earlier in July was one of the best conferences I have been to for a while. The conference aimed to bring midwives and obstetricians together to look at how they can improve communication and collaboration in Australia. The conference ended on a very optimistic note with the presidents of the Australian College of Midwives and RANZCOG committing to work closer together. I'll be very interested to see how long that resolution lasts.

I gave two presentations about Second Life and using social media for inter-professional collaboration which I think were well received.

Two main themes emerged for me from the conference: supporting indigenous women to birth on country and the use of social media for consumer-led activism in maternity services.

Birthing on country
A large number of indigenous women who live in rural and remote locations in Australia are moved to urban centres to have their babies. This has devastating effects on the family and their culture identity. The argument for doing this is that it is much safer to birth in an urban compared to the back blocks. However, this is being looked at closely especially in the light of the work that is being carried out with the Inuit people in Canada.

Birthing in remote Canada

A/Professor Vicki Van Wagner, Mina and Harry Tuguluk gave a very moving presentation about a project that has brought birthing back to the remote community of Nunavik with amazing clinical outcomes. Vicki talked about the 'cascade of normal' which I think is an attitude of mind as much as anything - thinking about birth as normal leads to a normal birth - a wonderful alternative to the cascade of medical intervention.

I was very touched by the comment made by an elder who talked about birthing away from country as more harmful than birthing in a remote community. It has got me reflecting on Maori women and birth. Whilst we do not have the same remote communities as Australia and Canada, I wonder how much harm we have done by bringing Maori women to European hospitals to birth in New Zealand?

Social media: the new political activism?
The other theme for me was the use of social media by consumers. It was really a throw away comment by Professor Eugene Declercq in his talk "Improving Policy, Practice and Outcomes". He confirmed what I have been saying for some time: midwives cannot ignore consumers' use of social media to campaign for better maternity services. Consumers are media savvy and not afraid to put forward their opinions on Facebook, Twitter etc. Midwives ignore this activism to our peril.

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