midwife's muse

Do midwives matter?

There I was, already to chat away about Lotus Birthing, I even had some pictures to go with my ramblings, when the media picked up on the fact that maternity care assistants are taking over the role of the midwife, it has really put any thoughts about placentae and what to do with them following birth on the back-boiler.

Speaking from my own experience, I have no knowledge of MCA's taking over my role. Obviously I would be concerned if I thought that this was really happening, but I don't believe that it is. Well, not in the sensationalist way that some media reports are waxing lyrical about. I am aware, and thankful, that some tasks are now carried out by assistants. I'm thinking here of helping Mothers breastfeed, bathing babies, assisting women in general hygiene, all things that midwives do, if they have the time, but really tasks that trained and experienced MCA's can do well. One of the articles about maternity services wrote 'Three quarters (76%) said they had seen an increase in their birthrate this year and just over half (53%) said the births had become more complex.', and there in lies the key to the problem, the workload has increased, the expectations of women have increased, but midwife numbers haven't. What would people rather, that someone who is able to do a task well carries it out and releases a midwife to care for women in labour and help them to have a healthy baby, or that a midwife tries to do everything and corners are cut resulting in nothing being done properly, and more importantly, safely?

This week The Royal College of Obstetricians and Gynaecologists has issued a statement about the Maternity Services, calling for the department of Health to invest in the service if it really wants to fulfill the aspirations of Maternity Matters, invest they certainly must as to date any investment there has been is invisible to staff on the coal face. I suspect though that government have come up with yet another pipe dream which they hope the goodwill of staff will turn in a reality, of sorts. That's what usually happens, a guidance, edict, command, call it what you will is issued, and more importantly publicised, and we are all supposed to make a silk purse out of a pigs ear. There we are, face to face with the expectant woman who has read all these promises, and we are made to feel duty bound to come up with the goods, but with no extra resources behind us. It's all rather like my recent 'rotation' to another unit, the manager sat there and decided what orientation I needed, she didn't come to me and say 'what would be helpful?' she looked from her perspective, probably thought she was highlighting the right things, and basically wasted three weeks of my life because I was no better off at the end of it. D of H decides that change needs to happen, speaks to a few 'heads up there own backsides' professors, consumer groups, Royal Colleges, doubtless NICE also had something to say, spouted forth to the public about how amazing the service was going to become, patted itself on the back, and is now waiting to see how the phoenix will arise from the ashes.

I know I sound sceptical, jaundiced even, but that is how most midwives now feel. We had our hopes raised back in 1992 with Winterton and Changing Childbirth, and I for one was naive enough to believe that things were going to change for the better, for the women I do think that much has been adapted for the better, but there is still so far to go to improve the maternity services and I, for one, don't think I have enough energy to carry on with this piecemeal way of working.

And, whilst I'm busy griping away, I read in one of the tabloids that midwives earn £60k a year, where? A consultant midwife maybe (according to my manager, who also carries the misleading title 'consultant' she only earns slightly more than me) but as a senior midwife I earn the equivalent of half of the sum quoted in the press.

Gosh. I do feel better for getting that off my chest! 

29.5.07 22:44