New Zealand College of Midwives (INC)

Appropriate technology for birth

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

(Marsden Wagner is the World Health Organisation's Director of Perinatal Health Care Services: European region. There is probably no better indicator of the approach that is taken to birth than the way in which technology is used at the time of birth. Consequently, as might be expected, supporters of the medical model of birth and supporters of the social model of birth hold widely different views of birth technology. In the medical model, a reliance on technology is the natural outgrowth of the mechanistic view of the body. The body is a complex, rather imperfect machine whose efficiency can be improved by other machinery. It is important to react to signals from, or information about the body, but those reported by the patient are subjective and qualitative. Machines, which relay quantitative and objective information directly from the body, are more reliable. The social model presents a contrasting set of beliefs. According to the social model, a crucial ethical and practical dilemma at present is an uncertainty about the nature of technology, its real benefits and hazards, and the extent to which perople are able to make informed choices about how and where technology may influence and dominate the structure of everyday life.

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The Domino Birthing Option

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

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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Ultrasound use in New Zealand

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

Ultrasound is sonic radiation (as opposed to isotopic radiation of X-ray). A product of warfare, it was developed during World War I to detect submarines. Developed for obstetrics by Professor Ian Donald of Glasgow in the 1950s, by 1968 it was becoming a popular method of determining the growth of the fetus hiding in the amniotic fluid like a submarine skulking on the ocean floor (Oakley). Ultrasound is sound waves at frequencies over 20,000 per second - above the range of human hearing. The higher the frequency, the greater the power. Diagnostic ultrasound is done at a frequency range of 1-10 mega hertz (MHz). The irradiation (exposure) may be continuous (Doppler) or pulsed (imaging). A pulse generator passes a high voltage alternating current through a piezo-electric crystal, causing it to vibrate and emit ultrasound pulses. These are formed into a beam which penetrates the area interface. In New Zealand diagnostic ultrasound in pregnancy was in use from 1973. Radiologist J.H. Steward reported 20 to 30 scans per day at National Women's Hospital (NWH) with the number rising. However, the Maternity Services Committee Report 1976, "Maternity Services in New Zealand" (Bonham and Mackay) expressed some uncertainty about "the final place of ultrasound scanning as an alternative to radiology, particularly for the diagnosis of twins, placenta praevia and fetal head growth" (15.4). By 1980 NZ doctors were recommending that all pregnant women should be routinely scanned at 20 weeks "as a matter of course". Dr Florence Fraser, an obstetrician at NWH specialising in ultrasound took issue with this.

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Editorial: Editorial committee; Nurses Amendment Bill

By Hedwig, J., Manoharan, H.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

Welcome to the second issue of New Zealand College of Midwives Journal. Firstly, we would like to introduce and thank the editorial committee for their support, encouragement and guidance in selecting, writing and proof reading articles for this issue.

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Letter to the editor: Congratulations

By Goreing, M., Lecky-Thompson, M., Barbier, C., Pairman, S.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

Various letters offering congratulations to the College following publication of Issue 1 of the Journal

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Letter to the editor re: midwifery professionalism

By Judd, K., Gordan, A., Waata, M.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

We were pleased to read an article by Joan Donley on Professionalism in your first issue of this journal, and would like to address the issues of autonomy for midwives and power.

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Letter to the editor re: childbirth educators

By Drew, J.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

Your first issue of the Journal made exciting reading. The growth, in a few short years, from 'near extinction' of midwives, through to the establishment of the NZ College of Midwives, separate midwifery education, strong progress towards autonomy, (and now a proposal for a Direct Entry course), is nothing short of phenomenal.

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Letter to the editor re: Obstetrician's comment [plus Editor's apology]

By Baird, M.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

In the first issue of your College Journal, September 1989, [p.6] there is a comment which is wrongly attributed to me. It is alleged by Joan Donley that I told the Wellington O & G Society that the three greatest threats to modern obstetrics are: 1. consumerism 2. feminism 3. midwives In fact I said no such thing and such a view is contrary to my beliefs. I was addressing a private meeting on the future of obstetrics, particularly on moves the Government might make.

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The Nurses Amendment Bill: The implications for midwifery

By Pelvin, B.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives Journal - Volume: 2

"...or registered midwife..." three words are poised to change the face of midwifery practice in New Zealand as most midwives have known it. Inserted after "general practitioner" in Sections 54.1 and 54.2 of the Nurses Act, these words return to midwives our status, our professionalism and our independence. Helen Clark, Minister of Health, introducing the Nurses Amendment Bill to the House of Representatives said "Having a baby is not an illness. It is a normal physiological process that for generations was viewed as such. With the advent of medical technology, there has been a trend towards treating pregnancy and labour as an illness. This has resulted in an increasing amount of medical intervention in the management of normal pregnancy which has led to the erosion of the midwives role. This has proved both costly and in many cases, inappropriate.

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Introduction of the Nurses Amendment Bill in Parliament

By Clark, H.
on Thursday, 01 Mar 1990 in New Zealand College of Midwives - Volume: 2

Mr Speaker, I move that the Nurses Amendment Bill be introduced. Although the Bill has only two clauses, it will have a significant impact on the delivery of childbirth services, and the practice of midwifery. This bill will enable a midwife to take responsibility for the care of a woman throughout her pregnancy, childbirth, and post natal period. At present Section 54 of the Nurses Act 1977 makes it an offence for a midwife to provide a service unless a medical practitioner has undertaken responsibility for the care of the client. At present, subsections (1) and (2) of Section 54 of the principal Act have the effect of prohibiting a person from carrying out obstetric nursing if responsibility for the care is undertaken solely by a registered midwife. Such responsibility may be undertaken only by a medical practitioner. The effect of the clause is to allow a registered midwife to undertake sole responsibility for the care of the patient in such cases. This places a registered midwife in the same position as a medical practitioner for the purposes of Section 54.

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Search the New Zealand College of Midwives Journal

Appropriate technology for birth

The Domino Birthing Option

Ultrasound use in New Zealand

Editorial: Editorial committee; Nurses Amendment Bill

Letter to the editor: Congratulations

Letter to the editor re: midwifery professionalism

Letter to the editor re: childbirth educators

Letter to the editor re: Obstetrician's comment [plus Editor's apology]

The Nurses Amendment Bill: The implications for midwifery

Introduction of the Nurses Amendment Bill in Parliament

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