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Antenatal education: Whose purposes does it serve?

By Gilkison, A.
on Wednesday, 01 May 1991 in New Zealand College of Midwives Journal - Volume: 4

Teaching is an integral part of a midwife's practice, and as a midwife I have always believed that the midwife is the best health professional to provide antenatal education. I have looked on in despair as yet another area of midwifery practice has been gradually eroded, with physiotherapists and childbirth educators 'taking over' what was once the domain of the midwife. However, taking a closer look at the way politics, society and institutions control women borh as consumers of a health systerm, and as health care workers, has led me to a more in-depth examinatin of what women learn from antenatal classes, who controls these classes, and the place of the midwife as childbirth educator.

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"A midwife's gift - love, skill and knowledge": The theme for the International Confederation of Midwives 22nd International Conference

By Crombie, B.
on Wednesday, 01 May 1991 in New Zealand College of Midwives Journal - Volume: 4

Kobe is a small city in Japanese terms, bordered by the calm inland sea of Osaka Bay and the Rokko mountain range behind. It is a hard city to get lost in, as long as one remained above ground that is, and didn't venture into the vast subterranean shopping centre which connects the four rail stations... The Conference began with the opening ceremony on Sunday 7th October. There were 6,000 enrolments from 43 nations...All 12 New Zealanders present gathered together under the NZ flag for photographs.

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Lactation consultancy in New Zealand

By Ryan, K.
on Wednesday, 01 May 1991 in New Zealand College of Midwives Journal - Volume: 4

Why lactation consultants? The promotion of breastfeeding is a success story with breastfeeding numbers generally continuing to rise until they reached a plateau in the early 1980s. Along with the increase in the number of women initiating lactation goes an increase in both the number experiencing difficulties and the complexity of the nature of those problems. The percentage of women who start out breastfeeding is good but, alas, the statistics show a rapid fall off in the breastfeed rate in the first three months. Clearly, these women are not receiving the support they require when problems arise. Many of them discontinue lactation because of a lack of information at a crucial time. Generally, standard advice is all that is required, but increasingly more skill is needed in diagnosis of problems and management of the mother and baby.

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Editorial: Women in partnership

By Pairman, S., Cameron, D.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

Two years seemed a long time, when back in 1988 in Auckland some 'rash' Otago midwives volunteered the Otago Region to host the first New Zealand College of Midwives conference. We had no idaea what this would mean. Once of the things it did do, was bring together a group of five midwives and two consumers, to form the conference committee. Over the months this group developed and grew, delivered three babies and became a close knit, supportive group of women. We learned to work collectively, to value each othes' strengths, whilst we certainly put much energy into the conference organisation, our meetings became a precious time to be together, to give us time out from children, partners and work and to enjoy each other. When we looked back on the conference and our enjoyment of it, we recognised that what made it so special was the fact that women were together, learning and enjoying each other - just as we had done in our smaller group. At the conference there was a diverse group of 170 women from all over New Zealand, from all kinds of midwifery settings and with all kinds of difference experiences, beliefs, expectations and values. It seems amazing that this group could, so quickly, become a cohesive group of women who at the end of the conference could stand, arms about each other, and sing.

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Letter to the editor re: Mini-pill

By Pot, M.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

First of all congratulations on the publication of your new newsletter. I was however disappointed to see an advertisement for the mini-pill in your newsletter. Considering that midwives promote breastfeeding it is inappropriate for this advertisement to appear. (includes a reply from Schering)

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Letter to the editor re: lay midwives

By Donley, J.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

It would appear from their letter in the last Journal that the 'lay' midwives are confused about responsibility and power. While women having home births are expected to take responsibility for their pregnancies and births, every midwife has to take responsibility for her practice. Any midwife - registered or lay - who is not prepared to accept this responsibility is leaving the woman she cares for in the lurch. Similarly with power. The power belongs to the woman giving birth. Therefore it surprises me that the lay midwives say that they "share their power with the woman". In fact, it is the birthing woman who 'shares power' with the midwife. No midwife should get into the power trip - either in contention with the birthing woman or with other midwives. We should be working together in the best interest of the woman giving birth. (this is the letter in its entirety)

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Midwife to midwife: induction via acupuncture

By Morgan, Y.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

I recently found, during my first pregnancy, that being 'overdue' is a most tedious state to be in. The days seemed to stretch into weeks and I began to feel that my baby would never be born. My doctor started muttering about induction when I reached 42 weeks, and I found my self-confidence and faith in 'nature' fading fast. When a midwife colleague suggested that I seek advice from a local practitioner in acupuncture and Chinese medicine, I decided to try it as I felt I had nothing to lose and that it seemed less invasive than standard induction methods and more scientific than castor oil and hot baths. The action of 'taking charge' of the situation made for a big improvement in my mental state.

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Physiological separation of the placenta

By Hammonds, M.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

Physiological separation of the placenta is something that most doctors and midwives have never seen. The mere thought of it fills them with fear and anxiety. Frequently the birth attendant in hospital is in far too much of a hurry to wait for the placenta to separate on its own, or is fearful of what will happen if an ecbolic is not given. Clearly most women do not need a 'routine' ecbolic. There are potential dangers in receiving syntometrine when it is not needed, for example, in the case of undiagnosed twins, or the rise in blood pressure that is sometimes caused by the ergometrine in syntometrine. Surely it makes more sense to assess the needs of individual women. An ecbolic (IV oxytocin or IM syntometrine) can be given with good effect, if needed, either before or after the placenta has been expelled. In my experience when no ecbolic is given, the placenta usually appears within 20-30 minutes of the baby being born, although often it is much sooner than that. Usually the woman feels some backache or a contraction and may have a small amount of bleeding and pushes the placenta out. Often the placenta is expelled before the cord is cut, while the mother is holding the baby. This was part of a paper 'Study of 100 planned home births' presented at the 1990 Midwives Conference. (This is the full version of what was published in the Journal.)

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Political comment: Autonomy for midwives

By Donley, J.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

The Nurses Amendment Act 1990 Date of conception - 9 Nov 1989 Date of birth - 22 Aug 1990 Gestation - 41 weeks The passage of the Nurses Amendment Act just two days after the first National Conference of the NZCOMI will have far-reaching effects on New Zealand maternity services. NZ midwives and women must be extremely indebted to the Honorable Helen Clark for her determination to 'midwife' this Bill through its various stages of labour despite opposition from a strong medical lobby, the National Council of Women which wanted to retain the doctor as 'gatekeeper', and even senior nurses and midwives in the Waikato AHB. In a letter to the Minister of Health the latter expressed "anxiety about the lack of preparedness of many midwives for the expanded role associated with independent midwifery practice... lack of professional oversight... and of any formal auditing standards of midwifery care". Conceived on 9 November 1989 as a two-clause Bill amending section 42 of the Nurses Act 1977, it was introduced to Parliament by Helen Clark. During its pregnancy in the Select committee, 99 submissions were received.

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Women in partnership: Report from the 1990 Midwives Conference

By Guilliland, K., Hassen, J.
on Thursday, 01 Nov 1990 in New Zealand College of Midwives Journal - Volume: 3

What a remarkable year for midwifery! This has been achieved by a remarkable collection of women and midwives working together for social change. The Conference had an air of celebration, warmth and an overwhelming sense of the'power of partnership'. Karen Guilliland welcomed participants, reflected on the beginnings of the College, and stated that the foundation of this was built on the fundamental belief that the relationship between midwife and woman is one of partnership. The College is the first professional group to include the people for whom we provide the service in policy and decision making at all levels. Keynote speaker, Dr Marsden Wagner gave his first paper titled: "Medical reactions to midwife autonomy". He outlilned the enormous world-wide struggle over freedom, power, and control of health care, in particular, in the maternity services. He identified two models in conflict, that of the medical model prompted by the medical profession and the social model promoted by a disparate group of people including midwives, social scientist, epidemiologists and women's organisations.

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