Speaking from experience
Midwives magazine: Issue 6 :: 2011
The 2009 cohort of the BSc midwifery programme at the Highland Campus of the University of Stirling respond to Laura Cox’s article in Midwives Issue 2 :: 2011, which highlighted the need to promote normal birth.
In Let’s get back to normality (Cox, 2011) Laura Cox identified the theory-practice divide in the promotion of normality. She acknowledged that a large part of her clinical experience was spent caring for high-risk women with the support of the multidisciplinary team.
Contrary to Laura’s experience we feel very privileged to have had unique opportunities to care for low-risk women and to promote normality in our placement areas. We have observed and participated in midwifery practice in a wide variety of settings including many remote and rural areas within a large geographical region. This has demonstrated to us very tangibly the differences between consultant-led care, such as that available in the maternity unit at Raigmore Hospital, and midwife-led care both in the community and in midwife-led units where, in our experience, normality is much more likely to be promoted.
In addition to having time to spend with women, both antenatally and postnatally, we have had opportunities to observe first-hand the decision-making skills of midwives working in often isolated situations, and to observe how they deal with obstetric emergencies. It is also a tremendous honour to be involved in home births when the opportunity arises.
In the consultant-led maternity unit at Raigmore, we participated in one-to-one midwifery care where women are never left unattended during labour.
Although the care of high-risk women and the accompanying interventions inevitably feature more noticeably in a consultant-led unit, the promotion of normality remains a priority. We have all had experience of supporting women in upright positions in labour and attending women giving birth on all fours. In addition, almost half of our cohort has been involved in the care of women labouring and/or giving birth in water, and the uptake of this option is closely monitored through audit. It is also rewarding to be part of the care continuum when we care for intrapartum and postpartum women in hospital whom we have cared for antenatally in the community.
We would encourage future Scottish midwifery students to seek out placements in the Highlands and Western Isles as they offer such excellent learning experiences. However, with the demise of the University of Stirling’s midwifery programme on completion of the September 2010 cohort, it is sad that these clinical opportunities may no longer be fully utilised.
Laura’s article warned about the effects of staff shortages and midwives over-medicalising birth. Given the excellent maternity services provision in the Highlands and Western Isles it would be sad if in the future, with reduced numbers of students, midwives’ ever-increasing workload and the current financial constraints, the drive to promote normality and provide quality support for new mothers were to be compromised.
Our mentors have given us a wonderful example of how to support women throughout the childbearing continuum and how to promote normality. We hope to emulate their practice when we qualify as midwives.
The 2009 cohort includes Hayley Duff, Sharon Fitzpatrick, Lisa Hawkins, Louise Loudon, Angela Mapplebeck, Lucy Moyes, Fran Stephen, Sarah Tuach and Jillian Wilson.
Cox L. (2011) On Course: Let’s get back to normality. Midwives 14(2): 41.