Woman and Midwife Exploring the partnership Sally Millar

Woman and Midwife Exploring the partnership Sally Millar Midwife 1

Midwives and women n One of the oldest partnerships in human society Sally Millar Midwife 2

The theory of midwifery as a partnership (Guilliland & Pairman 1994) n n Birth is seen as a normal life event Midwifery is woman centred Midwife provides care during the total childbirth experience Midwifery is a profession in its own right Sally Millar Midwife 3

Practice Standards for Midwives – towards a philosophy of Midwifery n n n Pregnancy is part of the life cycle The focus of midwifery practice is to provide woman-centred care Midwifery practice is holistic in approach The concept of partnership between the woman and the midwife is fundamental to midwifery practice Midwifery practice is based on the best available evidence Sally Millar Midwife 4

The midwife and woman partnership n n A social model of care focussed on the woman and her family Accessible care to a woman and her family preferably in their own community Provides continuity of care The focus of care is on health as a state of complete physical, mental and social well being (WHO) Sally Millar Midwife 5

The partnership develops n n n Trust Confidence Understanding Information giving enabling choice based on best available evidence Support Collaboration Sally Millar Midwife 6

The midwife and woman partnership n n n The partnership empowers the woman and the midwife The partnership enables the woman to make her own choices to fulfill her emotional, physical, spiritual and cultural needs The partnership enables a midwife to practice as an autonomous professional Sally Millar Midwife 7

Centralised hospital care n n n Hierarchy and institutions can inhibit individualised care Systemised care can be easier to provide than individualised care Can make a partnership between women and midwives harder to develop Sally Millar Midwife 8

Changing our maternity care n n n Offering more choice to women: Opportunity to have midwife led care and build a partnership with a known carer(s) Place of care and place of birth Evidence based information Supporting women who want to birth using their own resources rather than intervention Sally Millar Midwife 9

Changing our maternity care n n n Strong, positive support and leadership for midwives to increase confidence in physiological pregnancy and birth Education for midwives in supporting physiological birth process Offer midwives choice in working practice to suit their life situation Sally Millar Midwife 10

Sally Millar Midwife 11

The tapestry of support n n The warp – the strong supports (often invisible) that lie beneath the tapestry The weft – the interwoven threads of our individual experiences and lives Sally Millar Midwife 12

The warp – maternity care in Ireland n n n n Government Policy Health care philosophy System of care Cultural and societal values Financial support – public/private Midwifery care Appropriate Obstetric and neonatal care Sally Millar Midwife 13

The weft n n Our individual and unique stories Each woman and her family and their journey through pregnancy, birth and postnatally Each midwife and her family Each community supporting the partnership including the GPs, Obstetricians and hospitals Sally Millar Midwife 14

Dreams and vision Sally Millar Midwife 15

How did we get here? It was hard work Sally Millar Midwife 16

References n n n n An Bord Altranais (2010) Practice Standards for Midwives ABA: Dublin. Anderson, T. (2002) Out of the laboratory: back to the darkened room. Midirs. 12: 1 65 - 69. Davis-Floyd R (2002). The technocratic, humanistic, and holistic paradigms of childbirth - MIDIRS Midwifery Digest, 12: 4, 500 -506 Guilliland, K & Pairman S. (1994) The Midwifery Partnership - A model for Practice NZ College of Midwives Journal October 5 - 9. Maternity care Working Party (2007) Making normal birth a reality. Consensus statement from the Maternity Care Working Party: our shared views about the need to recognise, facilitate and audit normal birth. NCT, RCM & RCOG. Available from NCT web site. Walsh D & Newburn M (2002 a) Towards a social model of childbirth: part one - British Journal of Midwifery , 10: 8, 476 -481 Walsh D & Newburn M (2002 b) Towards a social model of childbirth: part two - British Journal of Midwifery , 10: 9, 540 -544 Sally Millar Midwife 17