Ina May Awarded Honorary Doctorate « Ina May Gaskin

Ina May Awarded Honorary Doctorate « Ina May Gaskin

Ina May's blog tells us that:

"LONDON—Ina May Gaskin, of Summertown, Tennessee, was awarded the title “Honorary Doctor” by the Thames Valley University, London, England, on November 24, 2009. The award was presented by the faculty of the Health and Human Sciences division of the University in recognition of her work in demonstrating through midwifery and natural childbirth that women’s bodies still work as they were designed. Gaskin accepted the award in the Grand Auditorium of Wembley Stadium before an audience of 600.

Gaskin, who will turn 70 in March, thanked her mother for not scaring her about childbirth; Dr. Grantly Dick-Read (author of the classic Childbirth Without Fear); her high school biology teacher for teaching her to keep an open mind; her husband, Stephen Gaskin, for allowing 270 young people to accompany him on a lecture tour in the winter of 1970-71; and several physicians for mentoring her during the early years of her career as midwife.

Gaskin also thanked “the little Capuchin monkey who, in 1970, held my hand with an electrifying touch, thereby teaching me in an instant that I could also have touch that powerful if I lived as much in the moment as she did.”

I came across Spiritual Midwifery when it was released in the 70's. I can't remember how I found out about the book. But I do remember how much the book affected me and my practice. I adored the book and was radicalised by the ideas in it. I carried it everywhere. In the early 80's, I was working on night duty as the relief night manager in a maternity unit. I left the book on the labour ward desk when I did a 'round' of the wards. One of the older obstetricians, known for his difficult and pedantic manner, passed me with his nose deliberately 'up in the air' and said, glancing at me with a twinkle in his eyes "I'm off to do a spiritual caesarean!". I knew he'd been reading my book in the labour ward. I thought to myself that could only be a good thing.

I loved Ina May's gentle loving approach to women and birth. I loved the common sense, practical way she worked with women and incorporated men into the birthing process. Ina May has been the shining light for keeping birth normal and helping midwives to reclaim their place with women. The stories of the Farm midwives and the women's experiences of birth fueled my desire to work one on one with women. I credit Ina May with being a big reason why I finally took the plunge into private midwifery practice with Maralyn Fourer (ex Rowley), together gaining visiting rights in public hospitals at a time when midwives didn't do such a thing. Ina May's Guide to Childbirth is another classic and I find that women today really value this book for the calm, sensible, affirmative approach it takes.

Sincere congratulations to Ina May for her forward thinking, beautifully expressed, deeply held trust in women and their birthing process. You are a legend and you deserve this honour. Thanks for being my mentor (even though you don't know you were/are).

Consensus, collaboration and power imbalances - words from the Senate Hearing on Women's choice of birthplace and midwife's role

From the Senate hearing

Senator SIEWERT—The issue around consensus is about somebody who has spent years of her life in a
consensus system—a consensus decision-making process. One of the things I clearly know is that, if there is a power imbalance, consensus tends not to work, because at the end of the day the people holding the power can say, ‘I don’t care what you think; we’re the ones that sign on the dotted line at the end of this process.’ That seems to me to be one of the keys here. You can say that the medical practitioners will collaborate and want a consensus approach, but at the end of the day it is the medical profession and obstetricians who will be responsible for signing off on collaborative care arrangements under the current process, and that is what
people are concerned about. It seems to me that it is clear that there is a power imbalance when you are happy with this amendment but patients, midwives and nurse practitioners are not happy with it. So that says to me that fundamentally there is an issue here.

Dr Pesce—All right. We have lots of very happy patients that do not seem to be unhappy with the power
balance. But in trying to address—

Senator SIEWERT—We have 2,000 emails from people saying that they do not like the current
amendment.


Dr Pesce—And there are 280,000 births a year. But we do not have to get stuck on that. In terms of the
power imbalance, if there is a power imbalance, I suspect that it emerges from the fact that we have different
competencies and that, at the end of the day, when something goes wrong—in an abnormal or high-risk
pregnancy—it is an obstetrician that is required to perform an instrumental delivery or a caesarean section,
which is not within the competency of a midwife. If there is an imbalance, I suspect that it emerges from the
fact that midwives can care for a patient to a certain point and then, if something goes beyond that, they need
to enlist the services of a collaborating obstetrician. But that obstetrician obviously is hesitant to just become a
technician and say, ‘I will just step in when I am asked to.’ They would like to step in at the right time. So, if
there is a power imbalance, it arises from the different competencies of the people who work in the team,

Community Affairs Legislation S12666.pdf (application/pdf Object)

Proof Committee Hansard

SENATE

COMMUNITY AFFAIRS LEGISLATION COMMITTEE

Reference: Health Legislation Amendment (Midwives and Nurse Practitioners) Bill

2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill

2009; Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009

THURSDAY, 17 DECEMBER 2009

CANBERRA

CONDITIONS OF DISTRIBUTION

This is an uncorrected proof of evidence taken before the committee.

It is made available under the condition that it is recognised

as such.

BY AUTHORITY OF THE SENATE

[PROOF COPY]

TO EXPEDITE DELIVERY, THIS TRANSCRIPT HAS NOT BEEN SUBEDITED

Great work by everyone at the Senate Committee hearing yesterday! Rachel Siewart (Green's senator) asked insightful questions.

Some comments below, from members of Maternity Coalition around the subject of safety - dynamic Dr 3am's catchcry - where was he when The Butcher of Bega was out and about?

"Mrs McIntosh —The way we see it is that the woman should be at the centre of that—her choices be
respected; all the information given; and safety looked at, not only physical safety for her and the baby but
also emotional and psychological safety. They are paramount not only to a woman’s experience through
pregnancy, labour and birth but also to breastfeeding, postnatal depression, relationships, bonding and ongoing
issues with siblings. They are all so intertwined that, if a woman is not right at the centre of the collaboration,
it is probably not going to be all that effective.

Ms Catchlove—Nobody has more interest in the safety of a baby than the mother of that baby. I make a
decision for my baby and myself, and I am absolutely 100 per cent motivated by safety. And I am the only
person who can weigh up what is a safe choice for me and my family.

Mr Teakle—Safety is about being comfortable with the risks. There is no way of defining something as
being safe or unsafe. We have a bunch of different people here who are going to have different feelings about
what risks they are comfortable with. Some doctors might be comfortable with the risks of a caesarean,
because that is something they are familiar with and they feel in control of it; a midwife might feel
comfortable with something else. Once we get into an argument about other people deciding what is safe for
the woman, then we have lost focus. The woman needs to decide what she feels safe with, on the advice that is
provided to her by experts who can give her really good advice about that. That is why in other countries
informed choice has been understood as the way of getting out of these arguments.
It is terrible to have arguments going on in the media about what choices women should make. That is not
about safety; that is about control".


S12666.pdf (application/pdf Object)

GOVERNMENT BACKFLIP ON MIDWIVES

Family First Leader Senator Steve Fielding has welcomed the decision by the Health Minister to back down on its controversial plan to drive homebirths underground.

...now the government says it won’t force midwives to work in formal collaborative arrangements with doctors as a condition of insurance.

"The Rudd Government's backflip proves they clearly underestimated how important this issue was to Australian women,” Senator Fielding said.

“Women should have the right to choose whether they want to have a birth in a hospital or at home, and midwives that assist in either case should be able to access affordable indemnity cover.

How I love intelligent, thinking men! Senator Fielding, not only believes women have the right to be self determining, he even reads the research and understands it. (wonder if dynamic Dr 3am has read this report?)

“Numerous studies have shown that for low-risk women with appropriate transfer-to-hospital options available, homebirths are at least as safe as births in hospitals or birth centres.”


GOVERNMENT BACKFLIP ON MIDWIVES

Planned-Home-Births.pdf (application/pdf Object)

Amidst all the predictable power based rhetoric about birth place and care provider from the Australian doctors' union, led by the self appointed arbiter on women's choice and midwives' freedom to practice, Dr Andrew Pesce, there is a beacon of light on the subject from British Columbia

The College of Physicians and Surgeons of British Columbia have just released their position statement, which says:

The College’s Position

The College supports a woman’s right to personal autonomy and decision making in obstetrical care.

Planned-Home-Births.pdf (application/pdf Object)

Updated November 2009
Board Approved December 2009

Although this statement does not go as far as saying that homebirth is safe and that homebirth is a wise choice, as the evidence from around the world clearly demontrates it is, the statement does provide an indication that at last (some) doctors are officially recognising that women are autonomous and have rights. This recognition of women's rights is a step in the right direction for a profession which has traditionally, well, at least for the last couple of hundred years or so, positioned itself as the powerful elite.

This statement is refreshing news and makes Dr Andrew Pesce's posturing on his ability to influence The Australian Minister of Health, the Honourable Nicola Roxon to remove and restrict choice in both birth place and practitioner for childbearing women and limit the practice of midwives, appear as sad, pathetic and out of step with evidence informed practice as it is.

Not only has Dr Pesce got his sights on controlling midwives and birthing women, he and his other unionists are also seeking to deprive the Australian public of another group of excellent health professionals, the Nurse Practitioners. Australia has seen the 'turf wars' raging for several decades now, as doctors use power tactics to keep control of the health system and ensure nurses, midwives, patients and childbearing women remain subservient.

However, the winds of change are blowing.

The disgraceful thing is that while some Australian doctors seek to live in a time warp and glorify the days when doctors were gods, nurses and midwives were handmaidens and patients and childbearing women were subservient by undermining initiatives to improve choice and access to optimal health care, they will unnecessarily hamper true progress in health and health care provision.

Meet Mr 3am: the nation's dynamic top doctor

Known for his candour and willingness to speak his mind, the 49-year-old has made his presence felt at the negotiating table as the Federal Government attempts to push through health reforms.

He successfully lobbied Health Minister Nicola Roxon to make amendments to home birth legislation, ensuring that midwives would be denied Medicare payments unless they could prove they were working collaboratively with doctors.

The home birth lobby claimed the changes curtail a woman's right to choose how she gives birth, but Dr Pesce cites it as his greatest achievement so far as AMA president.

Meet Mr 3am: the nation's dynamic top doctor

AMA welcomes amendment to the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 | Australian Medical Association

The Medical Union crows victory over the right of women to choose where to birth and who with! Roxon and Rudd pawns in the AMA's game of control and domination

5 November 2009 - 3:05pm

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Government’s decision to amend the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 to specify a formal requirement that midwives and nurse practitioners must work in collaboration with medical practitioners.

Dr Pesce said the AMA has been negotiating with the Government for this vital change to the legislation for some time, and the AMA had received recent support from other medical groups, most notably the Royal Australian College of General Practitioners.

“We made it clear to the Government that without a requirement in law that there be collaborative arrangements between midwives, nurse practitioners and doctors then the legislation did not have any safeguards to ensure continuity of patient care, nor did it have any protections against the fragmentation of patient care services,” Dr Pesce said.

“I repeat – the amendments impose a legal requirement for collaborative arrangements between medical practitioners and midwives or between medical practitioners and nurse practitioners.

“The AMA has worked cooperatively with the Government on these amendments to the legislation.

“These changes create a framework of quality primary care delivery that supports team-based care and ensures that the role of medical practitioners, particularly the patient’s usual General Practitioner, is not undermined.

“Evidence shows that patients enjoy better health outcomes when they are treated in a model of care that provides coordinated, continuous, and comprehensive patient-centred care that is delivered by appropriately trained health professionals.

“The AMA commends the Government for recognising and accepting amendments that are in the interests of patient care.

The AMA will continue to work with the Government as further regulations and guidelines are developed to ensure that collaborative arrangements are based on best practice standards of medical care,” Dr Pesce said.

The AMA’s position was part of its submission to the Senate Community Affairs Committee on 22 July 2009. AMA President, Dr Andrew Pesce, appeared before the Committee on 6 August 2009.

5 November 2009

CONTACT:

John Flannery 02 6270 5477 / 0419 494 761

Peter Jean 02 6270 5464 / 0427 209 753

AMA welcomes amendment to the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 | Australian Medical Association

Julia Gillard's 2005 speech about the importance of choice for childbearing women

In 2005, Julia Gillard was the Shadow Minister of Health, Manager of Opposition business in the House of Representatives. Ms Gillard spoke at the following conference: 

Midwifery By The Sea - Riding The Waves Of Change

Speech - ANNUAL CONFERENCE OF NSWMA

20th October 2005 
Following are excerpts from Ms Gillard's speech

"Thank you very much for your invitation to join you here today at your annual state conference by the sea.

The best start in life

It will not surprise this audience - I'm sure you will all agree - if I now say that I see the pregnant woman as the best focus for early intervention.

Between us we could draw up an impressive list of perinatal programs that would boost the health of the mother and her baby, and improve outcomes, and give all our kids the best start in life. 

Obstetric services and workforce shortages

In the middle of this is the big event - the birth.

I know that midwives - as a group and individually - have strong ideas about what should be provided in terms of birthing services. 

But shockingly, it is increasingly the case that for some women the idea of having a choice of birthing services and having continuity of care throughout their pregnancy, the birth and in the post-natal period is an impossible luxury - not just unaffordable, but unobtainable in their local area.

The shortage of midwives is also a problem. The Australian Health Workforce Advisory Committee estimates a current national shortage of 1850 midwives, and this is expected to increase over the remainder of the decade.

Midwives face additional concerns about the lack of professional recognition as well as limited opportunities to practise as primary carers and provide continuity of care to women. 

The need for a concerted approach 

Clearly this is no time for turf warfare between doctors and midwives, but it is time for all health care professionals involved in delivering obstetrics care to mount a combined attack on the Howard Government to force them into action to address this situation.

Unless and until the Government is shocked and shamed into realising that Australian women are now scrambling to find the birthing centre of their choice, and in some cases scrambling to find any professional who will deliver their child, the situation will not improve. 

It seems to me that we need a variety of solutions to fit all the circumstances that arise.  There is no 'one size fits all' way to solve the problems that present so differently in metropolitan Sydney, the isolated community of Wilcannia, the growing town of Byron Bay and the multicultural suburbs of Western Sydney.  The one common factor is the pregnant woman and her child - they must be at the centre of the solution.

… I believe that midwives … are key heath care professionals whose role in the care of women and their babies has yet to be fully realised in the Australian health care system.

We need to realise that potential so that mothers have real choice in their birthing experience, and their babies have the best start in life".  

Beautiful and true words. However, now we are finding that it is no longer the Howard government standing in the way of women's choice, it is now the Labor Government.  Right now, Nicola Roxon  is seeking to abort women's choice in birth place and birth attendant.  Ms Gillard, you need to ensure that your words in 2005 were not empty rhetoric and politically driven spin to win brownie points in opposition. 

The time for action on your words is now. 

1. Ensure the needs and choices of all childbearing women are at the centre of any  goverrnment, health /maternity  service or policy action. 

2. Ensure that midwives are able to work unhampered by politics in the way that the World Health Organisation recommends.  

3. Provide a level playing field for health care providers (midwives , lactation consultants (IBCLC) and doctors) who work with childbearing women (access to Medicare, insurance and PBS)

4. Remove professional silos and institute true dialogic conversations and interactions for those situations when childbearing women require a multidisciplinary approach for their situation).

 

Facebook | RALLY FOR BIRTH CHOICES - SYDNEY

The proposed amendment to the nurses and midwives legislation is contained in the Federal Minister of Health's press release below.

As Jo Hunter, convenor of Homebirth Australia explains:

"The point that will redefine the fundamental nature of midwifery and certainly homebirth midwifery in Australia is that “collaborative arrangements with medical practitioners will be required to access the new arrangements”. In short this amendment will require midwives to work with GP obstetricians and private obstetricians and have a “collaborative arrangement” in place at all times.

This is NOT acceptable. How will it be possible for a midwife who attends homebirths and for women wishing to birth at home to gain the support of a GP ob or private obstetrician when their own college statement does not support homebirth?

RANZCOG statement reads -

“The College does not support Home Birth or ‘Free-standing’ Birth Centres

(without adjacent obstetric and neonatal facilities) as appropriate Health Care

Settings. The College acknowledges that a very small minority of women will

choose to birth in these centres, even if appropriately informed of the

consequences”

In solidarity with our northern and southern sisters (who will be rallying outside Kevin Rudd’s Brisbane office and Julia Gaillard’s Vic office) please come and rally outside the Minister for the status of women, Tanya Plibersek’s office in Sydney".

Facebook | RALLY FOR BIRTH CHOICES - SYDNEY

THE HON NICOLA ROXON MP
MINISTER FOR HEALTH AND AGEING

MEDIA STATEMENT – 5 NOVEMBER 2009

Midwives/ Nurse Practitioner Amendment

The Minister for Health and Ageing, Nicola Roxon has today circulated an amendment the Government intends to introduce into the Health Legislation (Midwives and Nurse Practitioners) Bill and the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill.

This amendment makes clear in the legislation something that was articulated both on introduction of the Bill to parliament and in the explanatory material tabled at that time.

Following requests for clarification, this amendment will simply clarify in legislation that collaborative arrangements with medical practitioners will be required to access the new arrangements.

The details of these requirements will be specified in subordinate legislation following the ongoing consultation with the professional groups.

These bills are a key plank of the Government’s 2009/10 Budget commitments which recognises for the first time the role of appropriately qualified and experienced midwives and nurse practitioners in our health system.

The Minister for Health and Ageing said today “I thank the doctors, nurses and midwives for their constructive engagement to date to ensure these new opportunities for nurses and midwives are implemented in an integrated fashion for the benefit of patients.”

For more information contact the Minister’s office on 02 6277 7220

Outcomes for Caseload Midwifery at St Mary's UK

 This poster was presented at the June 2009 Normal Birth conference in the UK. The poster reports on a prospective cohort study on all live births at St Mary's Hospital in the Imperial College Healthcare Trust NHS. The study evaluated the caseload model in that health service.

Women who had caseload, or one to one relationship based midwifery care were found to have fewer interventions in labour and birth. These women were found to have a higher rate of births at home, higher rate of normal births, a reduced rate of both analgesia and epidural anaesthesia, higher breastfeeding rates and more normal births.  The rates of caesarean section and babies admitted to the nursery were the same for both groups of women.

caseload09.jpg (image)

Science & Sensibility » Beyond Due Dates: How Late is Too Late?

The following is a quote on the Science and Sensibility blog by Rosie:

"Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele. There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average."

The comment above is so important to think about. How do we right this crazy wrong?

The way that that the normal, physiological span for when labour begins has been contracted to the due date is unacceptable and wrong. The 'due date' was always an estimation, not a set in concrete date.

The feverishness with which the medical model approach to childbearing seeks to control women with babies on the inside is simply astonishing and, when you really think about it, deplorable.

We menstruate at different ages, we go through menopause at different ages. Children learn to speak, to crawl and to walk within wildly varying time frames. These time frames are normal. Everyone is different.

Can you imagine what it would be like if we suddenly imposed restrictions and curtailments on what was considered normal and acceptable in those domains of human development?

Such restriction would lead to inhuman and cruel procedures.

The medical control of birthing women's processes is often inhumane and cruel, although it positions itself as 'lifesaving', heroic and really, the only field which really cares about the baby. The medical model view has positioned mother and baby as competing entities and medicine is the advocate of the baby. Barbara Duden is a German historian who has written a great book called Disembodying Women. Barbara talks about how women have been depicted as a faulty ecosystem and the baby is depicted as an endangered species in modern medical discourse.

The rise in the rate of surgical birth, maternal depression and admissions of babies to neonatal intensive care units is the fallout from this crazy making 'emperor has no clothes' medical model approach to try to control women and childbearing.

The childbearing process has to be worked with, not worked on.

Science & Sensibility: Beyond Due Dates: How Late is Too Late?

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Facebook | 26th Homebirth Australia Conference 2010

Facebook | 26th Homebirth Australia Conference 2010

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South West Alliance of Rural Health (SWARH)

˜To know your midwife and be able to have as natural a birth as possible with minimal intervention is certainly something this hospital can brag about'

South West Alliance of Rural Health (SWARH)

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Review into male circumcision legality - Yahoo!7 News

Laws protect girls from genital surgery but parents wanting to circumcise boys can "go around willy-nilly chopping up bits of their sons", a state children's commissioner says.
Tasmania's commissioner for children Paul Mason and the Tasmanian Law Reform Institute have embarked on what they say is the largest review into the legalities of male circumcision in Australia's history.
Mr Mason said a critical issue for any non-therapeutic circumcision is whether parental consent is sufficient to protect a surgeon from legal action if the child's genital autonomy is thought to have been infringed.
"The only thing that protects a doctor from an action for assault or a civil prosecution is the valid consent of the patient," he said.
"The law is getting pretty hazy about whether a parent can give a valid consent for a child's non-medical procedure."
Mr Mason said about 90 per cent of Australian male babies were circumcised in the 1970s, dropping to about two per cent these days.
Its infrequency nowadays only heightens the chance of a circumcised boy feeling aggrieved as an adult that his rights were ignored as a child, he said.
But High Court rulings and United Nations conventions on the rights of parents and children and legal consent in terms of bodily integrity argue against parental-consent circumcision, he said.
Read more:

Review into male circumcision legality - Yahoo!7 News

Senate Committee Meeting update

This is the message from Lisa Metcalfe from Maternity Coalition following the Senate Committee hearing yesterday on the midwives and nurse practitioner bills before the Senate.

The transcript from the Senate committee hearing will be available on
this link in the next 24 hours or so
http://www.aph.gov.au/Senate/committee/clac_ctte/health_leg_midwives_nurse_practitioners_09/hearings/index.htm

MC, HBA, HAS and ACMI all presented to the committee
some terrific advocacy by the consumers
Thanks to those who represented MC (Bruce Teakle and Makayla Macintosh)

Media monitoring from Heidi this morning

Great to see this in the Age!
http://www.theage.com.au/travel/mothers-irate-at-qantas-baby-bungle-20090805-ea45.html

Lisa

--
Lisa Metcalfe
NSW President
Maternity Coalition
29 Oceana Pde
Austinmer NSW 2515
Ph: 02 4268 1675
Mob: 0437 577 576
Em: nsw@maternitycoalition.org.au
Web: www.maternitycoalition.org.au

Melbourne Homebirth Rally Video

Melbourne Homebirth Rally Video Aug 4 2009

This message has been sent to everyone by Justine Caines, Birth activist extraordinaire!

"Forwarding on the excellent work of homebirth mum, journalist and editor extraordinaire Libby Chow and sending her enormous thanks for documenting this awesome community effort. In the name of choice, freedom and human rights - homebirth.

http://www.youtube.com/user/redmango1975

A fabulous heart warming day for us all. BRING ON CANBERRA!"

Australian Private Midwives Association - Home

Australian Private Midwives Association - Home

Homebirth is back on the agenda for Labor

The political arena is hotting up regarding women's choice to birth at home with the midwife of her choice

http://www.theaustralian.news.com.au/story/0,25197,25865135-23289,00.html

If you haven't written a letter yet, now's the time - you can google any of the politicians and send a letter to that person.

All very exciting. Great for women, great for babies, great for families, great for midwifery, great for the future of our society.

This is where Nicola Roxon was clear about not funding women's choice to birth at home with a private midwife

parlinfo.aph.gov.au

Nicola Roxon's bill to outlaw a woman's rights to choose to birth at home with the midwife of her choice

Can everyone please write to Nicola Roxon and tell her (politely, but strongly) what her bill has meant to you?
The Hon Nicola Roxon MP
Minister for Health and Ageing
Australian Government
PO Box 6022
House of Representatives
Parliament House
Canberra ACT 2600
Email: nicola.roxon.mp@aph.gov.au

and write to your local federal politician. Google his/her name and you will get their contact details.