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The Domino Birthing Option

Abstract:

It is enormously rewarding to support a woman you know throughout her birthing experience. Domiciliary Midwives throughout New Zealand are addicted to the rewards of this way of working despite the lower financial return. The basis for practice is a pride in maintaining one's standards of practice, and a commitment to each woman, to provide her with a professional service. This direct, highly visible, contractual arrangement between a woman and a midwife, requires that a midwife be flexible, knowledgeable and always open to new challenges of learning and relating to women. My commitment is to meet the individual needs of each woman. Last year the Domino option was started at Northland Base Hospital on trial for one year. Dom-in-o means 'dom'iciliary midwife 'in' and 'o'ut. It is a borrowed English term. The domiciliary midwife ses a woman antenatally and in early labour at home. The active part of labour, the birth, and up to 8 hours after the birth happens in the hospital labour room. Sometimes the postnatal stay is overnight if the birth occurs late in the afternoon or evening. Some women are keen to get home as soon as possible and others do not want to take a new baby out in the night termperatures. If a woman or baby requires further in-hospital care, they are transferred into the hospital system and the domiciliary midwife takes up their care on discharge. This option became possible due to: a) The pressure of society to improve women's health. b) The reduction of postnatal beds in Northland Base Hospital following bed occupancy review. c) The innovative attitudes of hospital management and nursing staff. d) The pressure from consumers and the obligation of the Auckland Hospital Board to meet community needs at the recommendation of the Women's Service Developmental Group.

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domino midwives, independent autonomous practice, women's choice of birth options