A response to the recent antics of the AMA.

fullsizeoutput_1864A few months ago the AMA (Australian Medical Association) dealt a low blow to midwives and they have recently rehashed this. Here’s the lowdown….

Recently there have not been so many women booking in with private obstetricians. There are many reasons for this. The gap for a private obstetrician is big. Its not unusual to pay $10000 or more to have their care.  The benefits for women are that they have the same person providing their care throughout pregnancy and they get a single room and a longer stay. Along with this they are often (not always) more likely to have more interventions like instrumental births and caesarean sections.

The Midwife provides the same care. They can’t do a caesarean section or an instrumental delivery, although some midwives do instrumental deliveries in various parts of the world. They look after you antenatally, at birth and postnatally. They suture perineums, they cannulate for drips, take blood and provide a care package for the whole period. Midwives problem solve, they order ultrasounds and tests and have excellent clinical skills. They are highly trained professionals who provide safe evidence based care.

They work as a team with doctors to refer anything that is not normal. Midwives deal with normal birth but work in collaboration with Doctors when pregnancy and birth is not normal. They still provide all of that care, they just work more closely with the multi disciplinary team at those times. There are programmes available that provide you with a named midwife through the whole of your pregnancy, birth and postnatal period. Publicly they are free of charge. Publicly you might have to share a room and get a shorter stay.

I’m not against Doctors. I want to make that clear. I am practically married to one and a large portion of my friends are Doctors so this isn’t a Doctor bashing session. But it is a bit of an AMA bashing session. #notevensorry

Public Midwives have a good relationship with public Doctors generally. This is usually a very respectful relationship. Some of the more senior midwives will have known that Doctor since they were an intern. They will have taught them many skills and had their back many times in tricky situations. Many public Doctors are appalled by this recent AMA stance.

The AMA put out a report yesterday responding to the health ministers recent statement about conducting a statewide review of staffing levels in midwifery. I actually agree with the Dick here. We do need to look at staffing. It is essential to safe midwifery care. The staffing levels in Queensland generally are appalling and it is unsafe. Midwives do an extraordinary job with the staffing resources they have. Women are incredibly lucky to have these midwives caring for them.

The AMAs response to this was to twist it to suit private obstetricians agendas. They said that the core issue was  ‘Midwives working without obstetrician supervision or input’.

This is not true.

This is how it works…

Public midwife looks after pregnant women through pregnancy, birth and postnatally. If at any time there is a variance from normal, the woman is referred to an obstetrician team. They may then have some adjustments to their care but continue to be cared for by a midwife. Pregnant women also sees doctor for at least 2 appointments during her pregnancy because in public hospitals we have multi disciplinary care. They may also have a GP who is providing shared care. This is how it has always worked in public midwifery. Its a shared multi disciplinary model.

They also stated that the governments commitment to a midwife only approach is questionable and that Australian and overseas research shows that it is not the best model of care. This is also completely untrue. As I mentioned, a midwife will always refer to a doctor if there is a variance from normal. There have also been many studies to confirm that midwifery led care with the correct referrals is safe. Midwives who work privately and independently will also refer to a Doctor if there is a variance from normal.

They then state that the private hospital system has a truly multi disciplinary care model with midwives and obstetricians working together.

HALLO, SO DOES PUBLIC! It’s barefaced lies to suggest otherwise.

You could in fact question the safety of mothers and babies in some private hospitals. There is often no paediatrician, theatre team or back up except at certain times. When the shit hits the fan as it sometimes does in obstetrics then you would fare far better in a public hospital with all of those professionals present 24 hours a day. This is why some private obstetricians feel far more comfortable working in a private unit attached to a public unit. Back up.

Midwives are part of a regulated profession. They have Bachelor degrees, Masters and Doctorates. They are required to refer to Doctors when additional care is required as Liz Wilkes wrote in her excellent response this morning. You can read that … HERE.

There is a dodgy agenda going on here and unfortunately members of the public often have no idea of the truth. We need to speak up, for women and for midwives. The nursing and midwifery profession has been bashed so appallingly for so many years. I hope that they will recognise their exceptional clinical skills, knowledge and value and rise up to challenge this.

I’m barracking for them.

Shame on you AMA.

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