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The International Conference of Midwives - Asia Pacific Region

By Strid, J
on Monday, 01 Jun 1992 in New Zealand College of Midwives Journal - Volume: 6

Forming a network towards safe motherhood: March 1992, Melbourne, Australia The conference was hosted by the Australian College of Midwives and an impressive number of countries in the region were represented. Karen Guilliland, Bronwyn Pelvin and myself attended the Asia-Pacific meeting the day before the conference began. This was to deal with the business side of the region, and of particular interest to us, was the discussion on consumer representation. Thsi has been a difficult concept for most countries to deal with, although there is already evidence of less resistance, and in Australia increased interest in the prospect of benefits to be gained by actively working with consumers. However, it is necessary to continue highlighting the issue and the value of such a partnership for both women and midwives.

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White spots - what are they?

By Hammond, M, Ryan, K
on Monday, 01 Jun 1992 in New Zealand College of Midwives Journal - Volume: 6

Hammond: "The Mysterious White Spot" is the title of a section in Chapte 6 (Breast infections or mastitis?) in Maureen Minchin's book "Breastfeeding Matters (1985). I am very grateful that I had a copy of her book to refer to when I had the problem outlined below. The 'white spot' problem is something I had never come across or even heard of in my midwifery practice, and speaking to colleagues I find most have not heard of it either. As non-recognition of this problem could easily lead to the giving up of breastfeeding due to a full-blown breast infection I would like to share my experience with other readers of this journal. Ryan: Mary's article raises the opportunity to discuss the existence of white spots and plugged or blocked ducts and their relationship to mastitis in general. Several suggestions have been made to account for the occurrence of this phenomenom. Some women describe the blockage in a milk duct as a fatty plug which is often stringy in nature and may feel gritty when rubbed between the fingers. Others describe a discrete hard granule. To my knowledge no-one has analysed these plugs from women.

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The unseen scars

By Wood, M
on Monday, 01 Jun 1992 in New Zealand College of Midwives Journal - Volume: 6

An unplanned caesarean section is known to have negative implications for the woman and her partner, risking damage to the woman's self esteem and self concept which is widely acknowledged in childbirth literature. My intention in this article is to discuss these implications, and how they can be minimised through appropriate and loving support offered by midwives. As a twenty-two year old primiparous woman, with no previous hospital experience, I underwent an unplanned caesarean section. As a young teenager, I experienced violent sexual abuse. In many respects, the feeling I experienced during and after my caesarean section were the same as those I also experienced as a rape survivor (writing this is also a way for me to let go of some of my "demons".) The shock of an unexpected caesarean section can be overwheliming, and without adequate support or after-care, can precipitate a crisis situation.

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Exercise For Two

By Weatherly, L
on Monday, 01 Jun 1992 in New Zealand College of Midwives Journal - Volume: 6

The risks and benefits of aerobic exercise in pregnancy. In the high tech world of the 1980s and 90s the advantages of regular exercise are being recognised. Fitness and exercise have experienced a boom time - gymnasiums are proliferating in New Zealand, and amongst their clientele are many women of childbearing age - both pregnant and non-pregnant. This paper will examine the relative benefits and dangers of aerobic exercise during pregnancy. It will also outline some practical recommendations for pregnant women who wish to maintain or improve their physical fitness and establish that in doing this they can positively influence their experience of pregnancy.

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Midwife to midwife: Support of the perineum and control of the head

By Hammond, M
on Monday, 01 Jun 1992 in New Zealand College of Midwives Journal - Volume: 6

In the introduction to Michel Odent's book "Entering the World", Dora Henschel, an English midwife, writes about a visit to Pithiviers. She says, "During the birth the nurse-midwife neither supported the perineum nor controlled the emergence of the baby's head". As a student midwife I was taught to do both - support the perineum and control the baby's head. It is only after years of experience and observation that I realised that most of the time this is not necessary. We do it out of habit and it makes us feel that it is this control of the head or support of the perineum (usually with the co-operation of the mother) which has prevented or minimised tearing.

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Editorial: Budget addendum

By Guilliland, K
on Tuesday, 01 Oct 1991 in New Zealand College of Midwives Journal - Volume: 5

The Budget on the 30 July 1991 was a strong statement to New Zealand that this government believes it cannot sustain the Welfare State. The "user pays" principle has now been directed at both health and education sectors and many people are uncertain and apprehensive about the consequences. The one area however where universal access has been retained is in maternity care. I believe the efforts of midwives and women's groups over the last few years to change the law and reinstate midwifery independence has raised politicians' awareness of the importance maternity care plays in the wellbeing of our society.

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Letter to the editor re: spa bath

By Young, L
on Tuesday, 01 Oct 1991 in New Zealand College of Midwives Journal - Volume: 5

In September 1989 a spa bath was fitted into the Delivery Suite at Wanganui Women's Unit. After two years of use, and many gallons of water later, we thought it was about time we evaluated the spa bath. The use of warm water, i.e. bath/spa etc, as a form of comfort/pain relief for labouring women is in my opinion undervalued and very difficult to evaluate. One of the measurable ways to do this was to see if the spa bath had affected the amount of narcotic analgesia used.

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A consumer viewpoint

By Strid, J
on Tuesday, 01 Oct 1991 in New Zealand College of Midwives Journal - Volume: 5

I will speak of some of the areas concerning childbirth which I consider to be of particular concern to women at the present time and some of those which I have observed and learned from sharing experiences with women during my contact with the women's health movement over the past 15 years. Although there is need for a great deal of further change I wish to acknowledge the willingness of midwives as a group, to respect women's wishes and to respond to their needs. It is my belief that the effectiveness of a good midwife lies in her ability to learn from women, gaining an increase in insight and intuitive skills. So the optimum encounter is the two way one where each has something to share and something to learn. This provides the grounds for an empowering partnership. However, we have taken some time to come this far to restore the rifts and to overcome the barriers which have often felt insurmountable.

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Political comment: Midwifery independence?

By Donley, J
on Tuesday, 01 Oct 1991 in New Zealand College of Midwives Journal - Volume: 5

The passage of the Nurses Amendment Act in August 1990, giving NZ midwives independence in practice as well as principle, was a great victory! However, it didn't just "happen". It was part of a protracted struggle over many years as women resisted the medical model of childbirth, of the politicisation and eventual unity of midwives culminating in the formation of the College, of the reclamation of the training of midwives as independent practitioners, of learning lobbying skills, and finally of having a visionary Minister of Health who clearly understood the issues. Now, a year down the track, how many midwives are actually practising independently? Most of the midwives known as "domiciliary midwives" (DMs) are doing so. Although this number is small and growing only slowly, they are recognised as a threat to obstetric control of childbirth. Therefore, a number of tactics are being used in an attempt to undermine midwifery independence.

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Midwifery education without nursing as prerequisite

By Cole, J
on Tuesday, 01 Oct 1991 in New Zealand College of Midwives Journal - Volume: 5

For a number of years, which included the passing of the Nurses Act in 1977, entry to midwifery without nursing as a prerequisite has not been possible. Midwifery has been viewed as an extension of nursing, and for many nurses the additional qualification was needed to advance their career. Since the early 1970s until recently, the number of midwives registering in New Zealand had diminished. Many of the midwives presently in practice have been educated and registered outside New Zealand. Since early 1980s there has been a steadily growing opposition by women to the medicalisation of childbirth in New Zealand which has followed trends in the United Kingdom and the United States of America. There has also been a growing demand for greater choice in childbirth related health care. Women's choice is often a higher profile midwifery care. As well as the demand for a greater midwifery focus, there has been an increasing number of women seeking an education to practice [sic] midwifery, which does not have nursing as a prerequisite. Although attempts have been made to address the problem of providing an adequate education and meeting service needs, all education to prepare midwives has been based upon the premise that mdwifery is a specialism of nursing.

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