A feeling of being in two different worlds

Midwifery

M2dm/ely (1994) 10, 129-124 0 L ongman Group Ltd 1994

EDITORIAL

In the last few months I have attended two confer-

France

ences which made me feel that I was living in two

and have a normal baby if the maximum

entirely

of technology

different

the message

worlds. At the first conference

given was that women

achieve a successful outcome they submitted technology.

themselves

However,

could

to pregnancy

not

unless

to the latest medical

at the second

conference

the message was that for women to achieve a successful outcome has to reach

to pregnancy

their environment

a basic level, and this basic level

that women

can only survive childbirth

is used during pregnancy

birth was a stark contrast. In particular as a significant proportion

of the proposed

even be disadvantageous In my discussions

(Chalmbers

with the French

The problem

the European in

Paris

in

Conference April

International Conference

and

Primary in London

Newsp174). Eight hundred

of the Sages Femmes the

second

Health in June

was

Care

the confer-

ence in Paris and it was a disappointment sion over midwifery.

the

(PHC)

(see International

midwives attended

see the heavy dominance

was

of the medical

was that the programme

was difficult thinking.

to respond

Unfortunately

to changes

the facilities in the audi-

isfied

conference

with this.

My advice

to the

organisers would be that they should consult with potential

conference

speakers

and

speak some

participants

should

also consider

care in childbirth. conference

about possible inviting

of those who have questioned

need for medical dominance

of speakers there was no

in the provision

participants

proportion

ogy in care in childbirth

Primary

Health

Care

at

(PHC)

the

International

conference

those who provide the greater proportion

were of PHC

throughout the world, nurses and midwives, and they represented 32 countries. At the PHC conference

the discussion

was on

how people could be empowered to obtain for themselves those facilities which have been shown

of

would be met and hope-

fully the debate on the use of upjmpiatr

speakers

to the

In that way the needs of the

discussion after the sessions. By contrast the greater of

the

were dissat-

didactic doctors.

ties for asking questions

it

in current

speakers and the midwife participants

profes-

of the very poor facili-

was organ-

torium meant that it was difficult to challenge

were given by midwives and most were given by Because

of child-

at the conference.

ised at least one year in advance and therefore

to me to

Few of the presentations

midwives

dissatisfied with the medical dominance

freedom

to need. The first conference

or may

et al, 1989).

over snack and meal breaks I found that they are birth that was being promoted

from stress, with the provision of health

interventions

have not been shown to be advantageous

included clean water, adequate food, housing and care according

amount

and child-

in developed

technolcountries

would continue. In this issue of Midwivq presenting

information

there are two articles

on women’s views of the

care that midwives provide. The areas investigated are

labour

and

childbirth

(Bluff

& Holloway,

1994) and postnatal care (Stamp & Crowther, 1994). It is encouraging to see midwives evaluating the quality of care they provide and it is com-

to improve health. Discussions centred around assisting peoples to improve their social circumstances and in particular the provision of educa-

forting to see that women still have the abiding trust in midwives (Bluff & Holloway, 1994) that

tion for women

was demonstrated

and helping

women

to obtain

gainful emloyment so that they are in charge their own financies. The views expressed

of in

in the 1980s (Drayton & Rees,

1989). However, it is a cause for concern that women are still receiving conflicting advice 12.7

124

MIDWIFERY

(Stamp

& Crowther,

1994).

Conflicting

advice

occurs in all walks of life. I lost count of the number of different recent

explanations

car breakdown.

within the legal profession ent ways are there

of the cause of my

Differing

to make

cake? However, the childbirth vulnerable

views are rife

and how many differa Victoria

sponge

continuum

is a very

time for women and their families and

this can only be made worse by conflicting It is obvious research

that there

is a need

into the nature of conflicting

advice.

for further advice and

how it might be reduced. ANN THOMSON

References Bluff R, Holloway I 1994 ‘They know best’: women’s perceptions of midwifely care during labour and childbirth. Midwifery 10 (3): 157-164 Chalmers I, Enkin M, Keirse M J N C 1989 Effective care in pregnancy and childbirth. Oxford University Press, Oxford Drayton S, Rees C 1989 Is anyone out there still giving enemas? In: RobinSon S, Thomson AM (eds) Midwives, research and childbirth, Vol 1. Chapman & Hall, London Stamp G, Crowther CA 1994 Women’s views of their postnatal care by midwives at an Adelaide Women’s Hospital. Midwifery IO (3): 148-156