- Email: [email protected]
Women and birth
Women and Birth (2007) 20, 39—40
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
journal homepage: www.elsevier.com/locate/wombi
EDITORIAL
Women and birth As I write this Editorial, my last as Deputy Editor for Women and Birth: The Journal of the Australian College of Midwives, I am reflecting on what an exciting time it is to be a midwife in Australia. It has been an honour and a privilege to serve as the Deputy Editor as we steered this challenging course to being a journal with a new name, new publisher and on line. Congratulations to the new Deputy Editor, Associate Professor Jenny Fenwick. Jenny is a highly respected researcher, writer and educator and will also bring her many years of experience in independent practice to this role. I wish her well in his new role. Recently, the Australian College of Midwives held a national forum to discuss the future of midwifery education. Seventy midwives from all over the country met together in Melbourne and resolved to work towards national standards for all programs that prepare midwives for entry to practice. In a country of eight states and territories, where there is little national consistency, this was a significant decision. Education underpins everything in our profession. If we do not get our midwifery education right, it is difficult to see how the rest will fall into place. This initiative is also being driven by a wider agenda led by the Australian Government. In April 2007, the Council of Australian Governments (COAG) agreed on the arrangements for a new national system for the registration of health professionals and the accreditation of their training and education programs for implementation by July 2008. The new system will initially cover nine health professions including medical practitioners, nurses and midwives, pharmacists, physiotherapists, psychologists, osteopaths, chiropractors, optometrists and dentists.1 The National Education Forum, led by the Australian College of Midwives, was an important strategy in the process to ensure that midwifery education will be ready when the new national approach to accreditation of training and education programs is implemented. In recognition of the significance of midwifery education, Women and Birth will be publishing a Special Issue titled Midwifery Education. This edition will be published in June 2008 and edited by Professor Nicky Leap. We are therefore calling for papers for this special issue. These can be based on primary research, literature reviews, discussions or opinion pieces. The deadline for papers is 30 September 2007.
There are other reasons why it is an exciting time to be a midwife. One is that the recognition that normal birth should be promoted seems to be gaining momentum. Midwives have been talking about the need to reduce unnecessary caesarean section and promote normal birth for decades. Recognition that this should be widely promoted is becoming more and more obvious in government policy documents both here and internationally. I would like to share two examples of this policy shift. In March 2007, the New South Wales Health Department released a policy directive titled Maternity — Timing of Elective or Pre-Labour Caesarean Section.2 Compliance with policy directives is mandatory in the NSW public health sector and is a condition of subsidy for public health organisations. The policy directive has three main points that I would like to raise here. Firstly, and I quote, ‘‘elective or pre-labour caesarean section must not routinely be carried out before 39 completed weeks.’’ Secondly, ‘‘women must be provided evidence-based information and support to enable them to make informed decisions about childbirth (taking into account the information and cultural needs of culturally and linguistically diverse communities). Addressing women’s views and concerns must be recognised as being integral to the decision making process.’’ Part of this also states that ‘‘when considering a caesarean section, there must be discussion (and documentation) on the benefits and risks of caesarean section compared with vaginal birth specific to the woman and her pregnancy. Maternal request on its own is not an indication for elective caesarean section and specific reasons for the request must be explored, discussed and recorded.’’ The third point is that ‘‘skin-to-skin contact between the woman and her baby must be encouraged and facilitated within one hour of birth’’ and ‘‘women who have had a caesarean section must be offered additional support to help them to start breastfeeding within the first hour of birth of their baby.’’ The other policy initiative has been from the United Kingdom with the release, again in April 2007, of the document: Maternity Matters: Choice, access and continuity of care in a safe service.3 This document states that by the end of 2009, four national choice guarantees will be available to all women and their partners including choice of how to access maternity care; choice of type of antenatal care;
1871-5192/$ — see front matter # 2007 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
doi:10.1016/j.wombi.2007.04.004
40 choice of place of birth (depending on their circumstances this includes at home birth, in a local facility under the care of a midwife or in a hospital supported by a local maternity care team including midwives, anaesthetists and consultant obstetricians); and, choice of place of postnatal care. Continuity of midwifery care is a pivotal guiding principle of Maternity Matters with acknowledgement of the need for a known midwife for each woman. The document states that ‘‘all women will need a midwife and some need doctors too’’ and recognises that ‘‘midwives are the experts in normal pregnancy and birth and have the skills to refer to and coordinate between any specialist services that may be required.’’ It is also understood that if the role of the midwife encompasses midwifery continuity of care, ‘‘it is likely that they will have a higher level of job satisfaction too.’’ Both these policy documents are significant for midwifery, both in Australia and internationally. These place women firmly in the centre of any maternity service and ensure that midwives are at the forefront of providing that care. We must seize the moment and capitalize on the momentum that these documents provide for midwifery-led services and for a stronger maternity service that is woman centred. As I said, it is an exciting time to be a midwife. I am confident that Women and Birth will continue to be a primary site for publishing research and scholarship that informs the future of maternity care for woman and their families.
Editorial
References 1. COAG. Council of Australian Governments’ meeting: 13 April 2007. Canberra. Accessed 17 April 2007. Available from: http://www.coag.gov.au/meetings/130407/index.htm#top. 2. NSW Health. Maternity–—timing of elective or pre-labour caesarean section (PD2007_024). Sydney: NSW Health Department, Accessed 17 April 2007. Available from: http://www.health.nsw.gov.au/policies/. 3. Department of Health/Partnerships for Children Families and Maternity. Maternity matters: choice, access and continuity of care in a safe service. London: UK Department and Health, Accessed 17 April 2007. Available from: http://www.dh.gov.uk/ en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073312.
Caroline Homer* Centre for Midwifery, Child and Family Health, Faculty of Nursing, Midwifery and Health, University of Technology Sydney, P.O. Box 123, Broadway NSW 2007, Australia *Tel.: +612 9514 2977; fax: +612 9514 1678 E-mail address: [email protected]
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
journal homepage: www.elsevier.com/locate/wombi
EDITORIAL
Women and birth As I write this Editorial, my last as Deputy Editor for Women and Birth: The Journal of the Australian College of Midwives, I am reflecting on what an exciting time it is to be a midwife in Australia. It has been an honour and a privilege to serve as the Deputy Editor as we steered this challenging course to being a journal with a new name, new publisher and on line. Congratulations to the new Deputy Editor, Associate Professor Jenny Fenwick. Jenny is a highly respected researcher, writer and educator and will also bring her many years of experience in independent practice to this role. I wish her well in his new role. Recently, the Australian College of Midwives held a national forum to discuss the future of midwifery education. Seventy midwives from all over the country met together in Melbourne and resolved to work towards national standards for all programs that prepare midwives for entry to practice. In a country of eight states and territories, where there is little national consistency, this was a significant decision. Education underpins everything in our profession. If we do not get our midwifery education right, it is difficult to see how the rest will fall into place. This initiative is also being driven by a wider agenda led by the Australian Government. In April 2007, the Council of Australian Governments (COAG) agreed on the arrangements for a new national system for the registration of health professionals and the accreditation of their training and education programs for implementation by July 2008. The new system will initially cover nine health professions including medical practitioners, nurses and midwives, pharmacists, physiotherapists, psychologists, osteopaths, chiropractors, optometrists and dentists.1 The National Education Forum, led by the Australian College of Midwives, was an important strategy in the process to ensure that midwifery education will be ready when the new national approach to accreditation of training and education programs is implemented. In recognition of the significance of midwifery education, Women and Birth will be publishing a Special Issue titled Midwifery Education. This edition will be published in June 2008 and edited by Professor Nicky Leap. We are therefore calling for papers for this special issue. These can be based on primary research, literature reviews, discussions or opinion pieces. The deadline for papers is 30 September 2007.
There are other reasons why it is an exciting time to be a midwife. One is that the recognition that normal birth should be promoted seems to be gaining momentum. Midwives have been talking about the need to reduce unnecessary caesarean section and promote normal birth for decades. Recognition that this should be widely promoted is becoming more and more obvious in government policy documents both here and internationally. I would like to share two examples of this policy shift. In March 2007, the New South Wales Health Department released a policy directive titled Maternity — Timing of Elective or Pre-Labour Caesarean Section.2 Compliance with policy directives is mandatory in the NSW public health sector and is a condition of subsidy for public health organisations. The policy directive has three main points that I would like to raise here. Firstly, and I quote, ‘‘elective or pre-labour caesarean section must not routinely be carried out before 39 completed weeks.’’ Secondly, ‘‘women must be provided evidence-based information and support to enable them to make informed decisions about childbirth (taking into account the information and cultural needs of culturally and linguistically diverse communities). Addressing women’s views and concerns must be recognised as being integral to the decision making process.’’ Part of this also states that ‘‘when considering a caesarean section, there must be discussion (and documentation) on the benefits and risks of caesarean section compared with vaginal birth specific to the woman and her pregnancy. Maternal request on its own is not an indication for elective caesarean section and specific reasons for the request must be explored, discussed and recorded.’’ The third point is that ‘‘skin-to-skin contact between the woman and her baby must be encouraged and facilitated within one hour of birth’’ and ‘‘women who have had a caesarean section must be offered additional support to help them to start breastfeeding within the first hour of birth of their baby.’’ The other policy initiative has been from the United Kingdom with the release, again in April 2007, of the document: Maternity Matters: Choice, access and continuity of care in a safe service.3 This document states that by the end of 2009, four national choice guarantees will be available to all women and their partners including choice of how to access maternity care; choice of type of antenatal care;
1871-5192/$ — see front matter # 2007 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
doi:10.1016/j.wombi.2007.04.004
40 choice of place of birth (depending on their circumstances this includes at home birth, in a local facility under the care of a midwife or in a hospital supported by a local maternity care team including midwives, anaesthetists and consultant obstetricians); and, choice of place of postnatal care. Continuity of midwifery care is a pivotal guiding principle of Maternity Matters with acknowledgement of the need for a known midwife for each woman. The document states that ‘‘all women will need a midwife and some need doctors too’’ and recognises that ‘‘midwives are the experts in normal pregnancy and birth and have the skills to refer to and coordinate between any specialist services that may be required.’’ It is also understood that if the role of the midwife encompasses midwifery continuity of care, ‘‘it is likely that they will have a higher level of job satisfaction too.’’ Both these policy documents are significant for midwifery, both in Australia and internationally. These place women firmly in the centre of any maternity service and ensure that midwives are at the forefront of providing that care. We must seize the moment and capitalize on the momentum that these documents provide for midwifery-led services and for a stronger maternity service that is woman centred. As I said, it is an exciting time to be a midwife. I am confident that Women and Birth will continue to be a primary site for publishing research and scholarship that informs the future of maternity care for woman and their families.
Editorial
References 1. COAG. Council of Australian Governments’ meeting: 13 April 2007. Canberra. Accessed 17 April 2007. Available from: http://www.coag.gov.au/meetings/130407/index.htm#top. 2. NSW Health. Maternity–—timing of elective or pre-labour caesarean section (PD2007_024). Sydney: NSW Health Department, Accessed 17 April 2007. Available from: http://www.health.nsw.gov.au/policies/. 3. Department of Health/Partnerships for Children Families and Maternity. Maternity matters: choice, access and continuity of care in a safe service. London: UK Department and Health, Accessed 17 April 2007. Available from: http://www.dh.gov.uk/ en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073312.
Caroline Homer* Centre for Midwifery, Child and Family Health, Faculty of Nursing, Midwifery and Health, University of Technology Sydney, P.O. Box 123, Broadway NSW 2007, Australia *Tel.: +612 9514 2977; fax: +612 9514 1678 E-mail address: [email protected]