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Reconsidering breastfeeding management: One breast or both breasts at a feed?

By Jackson, H
on Friday, 01 Oct 1993 in New Zealand College of Midwives Journal - Volume: 9

Following the recent UNICEF breastfeeding awareness initiative and the recognition of breast milk as the best form of nutrition for infants, there has been an upsurge by health professionals, especially midwives, in developing strategies that promote, protect and support women to breastfeed. However, not all of these have met with the success that had been anticipated. Many units have introduced guidelines and policies in an attempt to ensure that breastfeeding management has some consistency and mothers are given correct information to enable them to make informed decisions about the breastfeeding experience - a highly desirable development that has the potential to help both professional and mothers. However, what appears to be happening is that these guidelines are becoming inflexible rules to be carried out to the point of extreme insistence. As a midwife and lactation consultatnt I have become increasingly alarmed at the insistence of many on one-sided feeding or using both breasts at each feed, and at the increasing number of women who have developed breastfeeding problems as a direct result of this. This discussion will consider these issues in light of recent research that emphasises the role which the baby plays in controlling its own rate of nutrition.

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Editorial:The Maternity Benefit Tribunal

By Pairman, S
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

...Two years on from the introduction of the Nurses Amendment Act, we still face many challenges in trying to provide a midwifery service which meets women's needs, and of which the midwifery profession can be proud. The Maternity Benefit Tribunal was clearly a challenge from the medical profession responding to competition for increasing numbers of women choosing the services of independent midwives. The New Zealand Medical Association put a case for a general increase in the maternity benefit but also argued that midwives should be on a separate schedule because their service was different to that of doctors - the doctors being more highly trained and able to deal with all the problems!

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Letter to the editor re: Continuity of care

By Henderson, M
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

In response to B. Pelvin's article "Current Ethical Considerations" in your December 1992 Journal, I must protest... How dare B. Pelvin presume to choose in which way midwifery should be practised for me, the consumer, by stating that continuity of care should be THE midwifery model. She belittles the vast majority of her midwifery peers by damning fragmented care.

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A half day in the life of Angela Kearney, currently working in Mozambique

By Kearney, A
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

...Leaving the house by 5.10am the guard gives me a rather one eyed look wondering where I could be going in the dark and alone... I'm off to do a visit to the small town of Murrua in the district of Ile, Zambezia Province... I'm especially interested in the role of the Traditional Birth Attendant within the society and hope to meet with some of these women in Murrua to talk with them, to learn a little of their customs, attitudes and practices to birth...This fits into the job I do as co-ordinator for the training of TBAs in Zambezia. The Ministry of Health in Mozambique has a policy on training these women in basic hygiene and care of a mother giving birth and her newborn baby with the objective of reducing the very high infant mortality rate.

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Political comment: Contracting for midwifery services under the health reforms

By Guilliland, K, Pairman, S
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

The intent of the health reforms is to separate the funder (that is the governmnet) from the provider (e.g. midwives). This process will commence on the 1st July where funding responsibility will be taken over by four Regional Health Authorities (RHAs). All of the money currently spent on health including the Maternity Benefit, AHB funding, pharmaceuticals benefit and General Medical Services Benefit (GMS) will be distributed to the RHAs on a population based funding mechanism. The RHAs then buy the services needed by their communities from the providers. The Maternity Services seem to be viewed separately by the RHAs when considering contracting. They do not automatically assume they will be part of the services offered by GPs.

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Innovative organisation

By Tully, E
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

An important theme within contemporary sociological writing is the need for new ideas and approaches to the understanding of emerging forms of social organisation. This work challenges taken-for-granted perceptions about the organisation of social phenomena such as the family, economy and policy by revealing how complex and diverse the relations within these institutions are. Such an analysis focuses on the actual patterns or networks of social relations in which actors are located. It seeks to explain how creative, responsive peiople, who are both enabled and constrained by the contexts in which they are located, establish networks of relations which make new social forms possible. This theoretical approach is therefore concerned with the way in which relationships between people shape their interests, strategies, resources and outcomes. I would like to draw on the idea of organisations as social constructions, whose structure reflects the nature/type of social relations from which they emerge, to explain the formation of the New Zealand College of Midwives. My objective was to examine the establishment of this professional organisation as a means of exploring how organisations are shaped. I spoke to Karen Guilliland, the inaugural president to hear her account of the process. To this account I have added some theoretical ideas about the development of professions.

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Te Koha

By Russo, J
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

2pm, Friday 6th September 1991, a feeling from deep within, intuitively I knew my time of growing and carrying Te Koha within my body was drawing to an end. Instinct told me that I had felt my first contraction. Excitement welled within, I had been waiting to meet her for nine months. As my first experience with childbirth 15 years ago had been a 'far from joyous' occasion, I tentatively awaited the arriving of Te Koha. At that time a 16-year-old, I prayed that the act of birthing would be kinder to me at 31.

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Placenta: A User's Guide

By Wheeler, K
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

What's the big deal about your placenta? Well, your baby's placenta is as important to your baby's growth and development as your baby's genetic make-up. Instead of saying 'You are what you eat', maybe we'll all be saying in the future 'you are what your placenta makes you'. In this guide I would like to introduce you to some of the interesting things about the placenta, its range of functions, and to a 'user's guide' of terms you might hear about the placenta.

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A study of student midwives' beliefs, expectations and aspirations

By White, G
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

During 1990, the year of passage of the Amendment to Nurses' Act 1977, a comparative study was made of current midwifery education on New Zealand, and of student midwives expectations of their ability to practise as autonomous, professional midwives (White, 1991). All student midwives undertaking a full-time midwifery course within the five New Zealand Polytechnics were invited to participate. They were sent a series of three self administered questionnaires (precourse, midpoint, and end of course). Because the Southern Region (Southland) had a different academic year, only the first questionnaire was given to students completing the course (1989-90), and students commencing (1990-91). This prvided a unique sample and results were analysed separately.

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Early discharge: the effects of early discharge from hospital on the attachment and nurturing processes of mothers and their babies

By Brice, D
on Thursday, 01 Apr 1993 in New Zealand College of Midwives Journal - Volume: 8

Following overseas trends, the concept of shorter stays in hospital after childbirth (early discharge) has become the subject of study as to its popularity, workability, advantages and disadvantages. Kilgour 91990) defines early discharge as a planned event, occurring from six hours after normal childbirth. Overseas studies reveal that the advantages of planned early discharge far outweigh the disadvantages but to date, very little local research has been done.

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