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Legal Responsibilities Related to Fetal Deaths

By Pelvin, B
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

The New Zealand College of Midwives has been made aware that there have been two instances of Registered Midwives signing Medical Certificates of Death in circumstances where a baby has been born alive and then subsequently died. It seems that this has occurred following the lowering of the gestational age (from 28 weeks to 21 weeks) at which a baby is considered viable.

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User Views of Maternity Care

By Lawrence Beech, B
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

I am honoured and delighted to be invited to present the Inaugural Address to this NZ College of Midwives Fifth National Conference. Having travelled around the world presenting users' views of maternity care, I have found that every country, without exception, is vigorously developing and enhancing maternity care under the control and influence of medical men. While midwifery has been described as the oldest profession in the world, it has been on the slippery slope since the Middle Ages, when thousands of midwives, or wise women, were burned to death. I do not suggest for one moment that prior to the 20th century midwives worked in an Arcadian world where all was sweetness and light. On the contrary, midwives have always struggled either in conditions of poverty, or battling to maintain the profession in the face of male domination, medicalisation of birth or trying to give care to far too many women at the same time. As research has shown into community midwifery in the 1930s, some midwives committed suicide because of the pressures of the work. One should not forget the recent sad case of the Australian midwife who committed suicide allegedly because of the tensions of trying to provide real midwifery care in a hostile technological environment.

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A Fresh Approach to Pain in Labour

By Leap, N
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

Pain is never the sole creation of our anatomy and physiology. It emerges only at the intersection of bodies, minds and cultures (Morris, 1991-1). Being with women in pain is one of the few experiences that all midwives share. Working with our own discomfort at being with women in pain and not offering to dull or take it away is understood by midwives the world over. However, we live in a society that sees the relief of pain as a major benefit of modern living. Many people see the role of the midwife as someone who is trained to produce what I call 'the menu' of what is on offer in order to facilitate informed choice for women. Any midwife who does not subscribe to this approach is swimming against the tide and is at risk of being called 'cruel'. I wanted to develop a clear rationale to respond to accusations such as: "Why should women suffer pain in childbirth in the 1990s?" and "Why on earth would you not offer pain relief?"

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"What does the New Zealand College of Midwives do for me?" A response to the New Zealand Nurses Organisation

By Donley, J
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

The NZ College of Midwives (NZCOM) has been accused by some NZNO members of failing to meet their needs. If we are to understand the complexity of the current issues, we need a comprehensive overview of the connections between these problems and past events. The interaction between midwives and nurses in New Zealand has a long history. The Midwives Act 1904 established state control of maternity care in St Helens Hospitals for the 'deserving poor' and the training and registration of midwives. Being few in numbers, New Zealand midwives never formed an independent organisation to represent their interests. Nurses, registered in 1901, formed the New Zealand Trained Nurses Association in 1903. Not many nurses had a midwifery qualification, but midwives with a nursing training were entitled to join the Nurses Association. Later, the direct entry midwives were encouraged to join.

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Informed Consent - Issues for Midwives

By Pearse, J
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

When the organising committee started planning this conference, they were very aware that 1998 represents ten years from the release of Judge Cartwright's Report on the Cervical Cancer Inquiry (committee of Inquiry into the Treatment of Cervical Cancer at National Women's Hospital and other related issues - the Cartwright Inquiry). In preparing this paper it seemed fitting to go back and read that Report once again. Much of my time is spent defending midwives and I constantly see the grief, the guilt, the worry, the self-doubt and general feeling of devastation that consumer complaints cause to the midwife and her family. A number of the complaints seem unjustified and the motivation is not for understanding, reasonable recompense or a just outcome, but is to exact punishment or revenge. It is not uncommon for the complaints to go through multiple forums and take up the time and energy of years of the life of the woman, of her family and of her midwife and of her family as well. At the end of it all there is often no resolution, no peace and no sense of satisfaction for either side; indeed the nature of these conflicts seems to leave the parties indelibly changed. Women lose their trust in midwives and in their own ability to birth, midwives lose their trust in women and their joy in birth. The win/win situation is seldom achieved.

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Informed Choice in Maternity Care

By Viccars, A
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

The term may have been around for some time, but the question is, do we just pay lip service to it or do we give it the credence it deserves? This article sets out to briefly explore what is meant by informed choice. It will explain how the Informed Choice Initiative is working in the UK and how we can evaluate whether we are offering women informed choice about the care they receive during pregnancy and childbirth.

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Commonwealth Nursing and Midwifery. Action Plan: New Zealand Progress Report, 1998

By Editor
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

The following report is an outline of the midwifery profession's progress on meeting the International Commonwealth goals for strengthening midwifery in New Zealand. The goals were set out as an Action Plan by the Commonwealth Nurses Federation in Vancouver during 1997. They also recommended ongoing feedback, monitoring and evaluation of these goals. The Chief Nurse Advisor, Frances Hughes, is to present this report to the 11th Commonwealth Ministers of Health meeting in November 1998. In addition, it provides useful synopsis for midwives who have not been involved in the evolution and achievements of the NZCOM and the midwifery profession.

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Notice of Publication: Mary Jean O'Neil

By Nursing Council of New Zealand
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

On 11 February 1997, the Nursing Council of New Zealand ("the Council") referred a complaint concerning Ms Mary Jean O'Neil to the Health and Disability Commissioner as required by law. Subsequently, on 25 August 1997, the council received an opinion from the Health and Disability Commissioner that Ms O'Neil had breached the Health and Disability Services Code of Consumers Rights and a Notice of Charge was referred by the Director of Proceedings to the Council on 30 October 1997 and a disciplinary hearing convened by the Council in January and March 1998. The Council's findings in respect of professional misconduct and penalty were confirmed in writing on 24 March 1998 and 21 May 1998 respectively.

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New Zealand College of Midwives National Conference, Auckland, 1998: Reflections on a Decade of Change

By Rowley, M
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

Midwifery in New Zealand has now had nearly a decade of rapid growth and development so it is time to reflect on what has happened, what shape we are in today and where we might be in another decade. Recalling the state of midwifery prior to 1990 and the passionate and hard won battle to achieve midwifery autonomy is something we all need to reflect on from time to time... I would like to explore two issues with you in this paper. The first is to describe my view of the state of midwifery in New Zealand today. The second will explore a vision for the future as the profession continues to develop and mature.

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Community Birth Services: Great Home Births in the Manawatu

By Griffin, H, Walsh-Tapiata, W
on Sunday, 01 Nov 1998 in New Zealand College of Midwives Journal - Volume: 19

The early 1990s saw rapid health reforms in Aotearoa/New Zealand. In the Manawatu, the Manawatu Home Birth Association (MHBA) was both active and well supported by consumers and midwives. Concern regarding the impact of these health reforms on home birth resulted in a decision to proactively pursue a contract with the Central Regional Health Authority (CRHA) to ensure that home birth remained a viable, safe and appropriate option for all concerned. This article will look at the development of Community Birth Services Trust (CBS), an umbrella organisation for the delivery of home birth services. This will be followed by an outline of the current operation and provision of CBS services, highlighting some of the critical factors to the success of this service to date. This success is best measured by those who use the service and therefore the last words are comments from both consumers and midwives.

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