If you read what I wrote, I was refering to Americas CPM's simply because Thepees asked me for more information. I completley agree that USA's DEM's and Australias DEM's should not be compared, due to a completely different syllabus of education (USA's DEM's learn to worship the 'birth goddess', light candles, are taught the Salem witch hunt was about men suppressing women so they could take over birth, and the main DEM college over there even teach incorrect CPR and that monitoring the mothers heartbeat is the same as monitoring the babies- meaning the midwives are taught to monitor mothers heartbeat and mark it down as the babies). So yes, it is very different. However that hasn't stopped the hospitals from looking at statistics between their DEM's (CPM's) and their CNM (nurse-midwives) and feeling that the same results will be reflected here. Yes, that is unfair, but it's happening Don't hate the person that tells you this. It's not my fault they do this
That being said, the govt ARE trying to change hospital views. Such as this extract for rural area health providers:
"The relatively recent introduction of Direct Entry Midwifery (DEM)courses in Australia offers health services the opportunity the
move away from staffing structures that use nurses with midwifery
qualifications for both general nursing and midwifery duties. This
generalist approach restricts the opportunities for midwives to
work in their chosen field, often to the point where they leave
It is true that DEM graduates cannot be rostered for general
duties for which they are not trained, but hospital authorities that
do not develop ways to utilise Direct Entry Midwives will soon
find the pool from which their midwifery workforce can be drawn has all but dried up"
I wasn't able to find the article I was talking about previously, as it was Aussie so I dismissed it as unimportant for the factsheet over in USA, but I have a OBGYN trying to find a way to get me a study from the aussie Journal of Clinical Nursing so that I can pass it onto you ladies to relieve any doubts you have- to link, you would have to pay to read it after subscribing to the journal.
And NZ ladies, you aren't off the hook either lol. A close friend of mine is in charge of an organisation she created- Action to Improve Maternity. They work with families who have had negelgent midwives in NZ that caused a disabillity or death. As there are more and more happening, they want to create databases and update your training. Because of this organisation, the founder was a finalist for NZ's 2011 woman of the year, and has regular meetings with the health minister over there who has jumped on their cause, about ways to improve midwifery and how to go about implementing the database they want. In the 1960's, NZ was in the 10 ten for lowest perinatal deaths. Now, it's in the bottom 10- there is a reason for NZ being one of the worst 10 places to have a baby.
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21-01-2012 16:28 #31
21-01-2012 16:50 #32
PP -that organization is well known here in midwifery fields. Yes perinatal mortality and morbidity happens and as I said earlier this is by no means just in nz, just with dem's etc. This is across the board. If u look at those midwives and the errors that led to those babies deaths/disabilities (I'm hot on this subject) it's a range of poor ctg training skills from all different fields of training and experience, dem's and nurse/midwives as lmc, overseas trained and nz trained midwives, obstetricians not coming or stepping in when called into transfer care, and more importantly this is not at all a reflection of dem training in nz.
Tragedies happen and don't we know it. But as this post discusses the merits of dem vs dual I do not at all think that dem causes these issues. I think poor practitioners cause these issues. No matter how, what or where u train.
In response to your comment on our training we have a four year degree. Containing over 2400 hours of clinical practice. This has been implemented in the last three years and is to ensure we hit the ground running with inside knowledge of physiology, pathophysiology and know clinical mgmt for pregnancy related issues, norms and changes. I find our training amazingly intense and deep and can not fault what we are trained but can fault individual students practices themselves and thus maybe following thru when they graduate. Which in every instance will be where the issues lie. In all disciplines.
Eeeeek sorry for the rant haha
21-01-2012 16:56 #33
Ps: the purpose of my previous post was to say (in a long heated up way lol) that when it comes to training, u will learn what u need to know to be a midwife with the dem course. Don't worry about that
21-01-2012 16:58 #34
Don't be sorry for the rant! It's good to get it out, and also express yourself M/W is one field I will never touch, simply for the fact that it's such a heated field in regards to peoples opinions. I wouldn't be able to keep my mouth shut if I had parents-to-be come in and talk about a few things that I am very passionate about. It's the same reason I plan on never working in peds.
21-01-2012 17:27 #35
21-01-2012 19:02 #36Junior Member
- Join Date
- Jan 2012
Eugh it's posts like this that make me mad. I'm 5 months off finishing my direct entry program. The hospital that I've done the majority of my placement at is in a regional area and ever since the program started graduating midwives 4 years ago, every single grad midwife who applied has been offered a job. I don't know if anyone has actually looked at their program details lately, but within all of my subjects I have learnt about the impact that cardio disease, resp disease, diabetes, mental illness, thyroid problems, multiple, kidney disease, liver disease etc has on pregnancy or the impact that pregnancy can have on those diseases plus how the medications could affect pregnancy. Anyone suffering from a disease that you seem to think you need to know 'nursing' knowledge for would be seen in a high risk clinic by obstetricians and obstetric physicians antenatally, and when they were in labour there be would considerable input from the doctors into their care, plus copious notes about their condition. If you were still a bit unsure, you'd go Hey Dr X, I saw in her notes that she has this condition is there any extra observations/tests/things I should keep an eye for that I should know about because of that condition. It's that simple. Midwives are the experts in normal pregnancy and birth, you seem to be forgetting that. Additionally in your nursing degree when your learning about all these diseases that you seem to think every woman is going to walk through the door with, your learning about them in the non-pregnant setting, 99% of the time there are additional complications/changes that would occur in the pregnant setting. As previously said the UK and NZ have had direct entry midwives for years and years without any problem.
I'm currently doing my placement in a Birth Centre, and the midwives are there have been nothing but supportive and very appreciative of the fact that I'm doing the direct entry program. In fact in their minds, they think the dual students do not qualify with enough midwifery experience to practice safely in birth suite because they only have done half the clinical time in midwifery as the bmids have. Some day people will wake up and realise that nurses and midwives are two very different professions.
21-01-2012 19:24 #37
21-01-2012 20:20 #38Junior Member
- Join Date
- Jan 2012
My program structure
First year - normal pregnancy, normal birth with 250 clinical hours
Second year - abnormal pregnancy, abnormal birth (so preterm, multiples, any one with pre-existing medical history) with 250 clinical hours + 25 hours in a mental health facility
Third year - full time clinical placement
And as it was said before, dual degree programs are shutting down and so are the post grad programs. I remember being told late last year that a PG student would have to do the delivery because she still hadn't gotten her 10 catches. 10 catches is apparently all they need to get there midwifery qualification and they think the direct entry midwifes are the under qualified people!!!
For me being almost halfway through third year, I personally have birthed 20 babies (standing, all fours, squatting, lithotomy, birth stool, vaccum - you name I've done it!), been second midwife at 5 water births, been second midwife at another 10 or so births and been the midwife at about 10 caesareans. I still have another 3 weeks left of this semester and another semester left. How is this 'not qualified enough'??
21-01-2012 20:29 #39
UK; Maternal mortality is high in the UK, especially compared to Australia who until recently didn't have DEM's. In the UK, it's just under double our rate (NZ is even higher than the UK). But that has changed since the Lancet released those details. As of the middle of last year, over a 18 month period, there were 42 maternal deaths in London alone. British Medical Journal (BMJ) states that indirect and direct maternal deaths have risen (These 'indirect factors' should have been picked up and are what I have been refering to) over the last 20 years, when it should have reduced; Lancet have put out figures that maternal death rates should decrease by 1.4% per year, due to new technology, diagnostics, treament and knowledge). Thankfully their perinatal rate has remaind static.
I'm all for DEM's and those that see that yes, this is still a new degree that has come bugs to work out. Nothing is perfect when it first starts. It needs working on, it needs perfecting, it needs reviewing and addressing. UK and NZ are discovering now, with retirement of a lot of the Nurse/midwives, that yes, they do need to look more into it. In the next 5 years, according to a public health survey sent out by a univerty in WA, australia will see 44% of the nurse/midwives over 55 reitre- so we will see if our statistics reflect NZ and UK with the nose dive when that happens.
21-01-2012 20:46 #40Junior Member
- Join Date
- Jan 2012
Why do you think we monitor temperatures in labour? Increase in maternal temp = increase in baby temp = tachycardiac baby
The midwives that I am working with in the birth centre (90% whom are all Midwives not midwife/nurses) are the most careful practitioners I know because they know if something goes wrong because of their actions, its goodbye Birth Centre
I would say this incident is more to do with the fact that this was a pretty useless midwife not the fact that she wasn't a nurse. I would also counter propose the situation involving a friend of mine, where a doctor (You'd think they'd be qualified) and a nurse/midwife were ready to send a lady home because they didn't think she was in PTL. My friend who's a bmid student, found that she was contracting and she delivered 30 mins after arrival at the tertiary hospital.
I hope you've been follow the current new media stories about lack of informed consent for caesareans and inductions at the moment, midwives and continuity of care needs support more than ever now, and people like you are not helping!!
Also off topic but would the creator of this thread learn how to spell midwifery properly!!!
Last edited by cupcake91; 21-01-2012 at 20:52.
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