Done something rash this afternoon: I've taken several steps towards signing up to train as an NCT Antenatal teacher. Do I have enough time? Probably not. But I see it as serving two purposes - 1) I can do more of one of the things I enjoy most: teaching prospective parents how to achieve the kind of birth they want and 2) keeping myself up to date - which I have to do for the day job anyway, thus killing two birds with one stone.
As a result I'm thinking of splitting the midwifery/NCT part of this blog off into a new 'baby catching' blog.
Hmm. Babies. My better half reckons they ALL look like Winston Churchill.
I saw this today, on the Net, from the "Musings of Harry":
Dear “medical practitioners”
You are not doctors. You exist because the government can’t afford more doctors. You are the NHS equivalent of Police Community Support Officers.
The fact that your job exists is probably a bad thing. It’s certainly a bad thing when “negligence isn’t really an issue for us” midwives kill their patients with epidurals.
Would this woman have survived if a doctor had administered the injection? Perhaps. Perhaps not. But if you had to choose between a doctor and a midwife to give you your epidural, who would you choose? I wonder who administered Sarah Brown’s medication when she was in labour?
Doctors are trained to diagnose. Doctors are trained to understand how drugs work. Doctors study these things for longer and in much greater depth than any other “medical practitioners”. Doctors should be diagnosing and prescribing, not ancilliary staff — especially not those who are currently unable to obtain insurance because the insurance companies refuse to insure them."
This would be a one off occurrence you're talking about? A midwife killing a patient by administering bupivicaine down the IV line instead of the epidural catheter? I feel so sorry for Marie To and the family of the victim of this dreadful event. It was certainly a terrible, tragic happening and the sort of thing that has to be every midwives' nightmare, but might I remind you of the activities of another doctor: wasn't Harold Shipman a one off occurrence? Though the one was an accident and the other was far more malign as I recall.
As a midwife I do epidural top ups frequently - as do thousands of my colleagues - without mishap. (I must correct your terminology - no midwife 'gives' anyone an epidural - the anaesthetist sites it, we just administer the drugs after the initial 'loading dose' has been given, and look after it - AND I suspect a midwife administered Sarah Brown's medication!). I also do all the antenatal/intrapartum/postnatal care for my clients (who fall within the 'normal' pregnancy remit) without mishap at home and in hospital and have done so for the last 15 years. I don't hesitate to transfer women in from home if I'm at all concerned, or call for a doctor if the pregnancy or labour deviates from the norm.
LET me give you an example of the training I undergo: I can now undertake the 'Examination of the Newborn' - a simple all over check looking for abnormality that takes place 6-48 hours after the birth which includes checking for heart murmurs and congenital hip dislocation. To do this check I had to undertake over 6 months of lectures and tutorials, including the writing of two essays, and the completion of a portfolio with 40 exams documented (8 of which were overseen by a paediatric Consultant or Registrar). This work was marked and verified by the University of Plymouth and was separate and on top of my basic training. My Paediatric Senior House Officer colleagues (who, to be fair, have undergone extensive basic medical training) get shown how to do the examination once then told to get on with it.
I am insured because I work for the NHS. My independent colleagues could also be insured but that the insurance companies want the same rates for that coverage that they ask of obstetricians, and they just can't afford to pay that kind of sum. Which is not quite the same thing as you're saying, Harry. Also, independent midwives work exclusively in the home in the UK - so wouldn't even be administering epidural top ups.
I doubt if many doctors would want to do my job - care for women through the long hours of labour - though they might do what they do in many countries (including USA) where they get 'Obstetric Nurses' to do the hard slog then gallop in at the last moment on their handsome white charger to 'catch the baby', which any old fool could do. Ah, why am I bothering to respond to this garbage?