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An anonymous group has started an online petition to extend midwifery training following the death of a baby during a delivery involving an inexperienced midwife.
The group, which appears to include a senior Waikato midwife, is collecting signatures to support a change to New Zealand's maternity training guidelines.
The group wants the guidelines changed so that newly graduated midwives have to complete a two-year internship in a base hospital before they can become independent lead maternity carers.
Addressed to health minister Tony Ryall, the petition has collected 528 signatures so far.
Baby's death triggers petition
The first signatory on the petition, Linda Depledge-Brooker, had previously written a letter to the Waikato Times commenting on the inexperience of the midwife involved in a highly publicised delivery that left a baby dead and nearly killed the mother.
Adam Barlow died in October last year after a 15-hour labour that is being investigated by the coroner. An obstetrician's report for ACC found "entirely preventable" and "serious" errors were made.
In her letter, dated 1 July, Ms Depledge-Brooker wrote: "I was distressed to learn the midwife involved became a lead maternity carer with a hefty case-load straight after she graduated.
"Maybe a two-year stint in a hospital [after graduation] wouldensure random preventable tragedies such as what happened to the Barlow family, are avoided."
Ms Depledge-Brooker did not return New Zealand Doctor's call in time to meet today's deadline.
Midwifery Council defends status quo
The Midwifery Council has not discussed the petition, but chair Sally Pairman says there is no evidence to suggest a need for new midwifery graduates to undertake a hospital internship.
The council has received only two complaints about new graduates since 2003, and a recent audit by the College of Midwives found new graduates actually tend to perform better than their more experienced counterparts.
"I don't think there's any evidence at all that there's an issue with our new graduates," Dr Pairman says.
Moreover, she says, a hospital internship would not give new graduates much beneficial experience since most hospital midwives play a supportive role to independent midwives who are the lead maternity carers (LMCs) for around 85 per cent of births.
Midwifery training recently overhauled
Dr Pairman points out that maternity training has recently been intensified so that midwives gain the equivalent of a four-year degree before they graduate.
Over the last year and a half, New Zealand's four midwifery training centres have begun teaching the new programme that requires students to complete, within three years, a minimum of 2400 hours of clinical training before they graduate, compared with the previous minimum of 1500 hours.
During their training, students have placements with hospital-employed midwives, LMC midwives, Plunket nurses, and in neonatal intensive care units.
Their final year is effectively an internship year because they spend 80 per cent of it practising under supervision, she says.
After graduation, new midwives can then join a first year of practice mentoring programme, which has been in place for three years.
Dr Pairman says maternity training, which was last reviewed in 1992, was intensified because new graduates lacked confidence rather than competence.
The first intake of students into the new programme will graduate at the end of 2011.
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Comments
Could someone please explain
Could someone please explain why it is that the midwifery profession is always,yes always being severely criticised by all and sundry, including the media. It doesn't seem to matter that they are not at fault, simply that they have been at some time involved in the care of a women during her pregnancy and a problem occurs.
If we were still in the middle ages, we could burn midwives publicy at the stake. No doubt many sad Neanderthal like individuals would applaud this. Is it because as men we perceive that women should not have a profession and should be beholden to men? Have we not gone past this? Are male medical practitioners furious that midwives are looking after women through pregnancy AND doing a better job with probably improved results? Are we truly a society that respects others regardless of gender, ethicity, race, religion, sexual preference? Or do we simply go with the flow, wherever that they lead us?
If individual's, whose forceful opinion overshadows true events and puts a negative spin on something that doesn't exist. That these individual's have perhaps their own agenda. Could we please get some balanced and accurate media reporting. Perhaps verifiying the exactitude of is published would go a long way to remedying this. Unless however, the media themselves have a total lack of ethics and bad news for them is good and sells advertising slots and publicty.
I am quite frankly appalled at reporting of event as the media seems to be a complete circus. There was a time as a young man, I would listen to the media and read newspapers and believe that the information portrayed was accurate. Unfortunately, those heady days of truthful reporting have long since disappeared.
Are we perhaps more interested in other people misery...........
Well said.
Well said.
Surely the media have to be
Surely the media have to be accountable for their reporting? if not, why on earth not? and what can we do?!
My ex wife is a midwife who
My ex wife is a midwife who has practiced independently since the end of 2005(after her 3 year degree). I saw the extent of her training(both theoretical and practical) and agree with the latter point in the article that new graduates are actually much less likely to have problems. Even with the last reforms, it will continue to take a while for the benefits of reform to come through. Personally, I was quite impressed with the number of births she attended and completed (under supervision) from very early in her training. She was also lucky to be supervised by some really capable midwives during that time (and her training was before the even more recent additions to the programme). The theoretical / medical elements of the course were also well beyond what is often implied in the media.
As an aside, she started with a low caseload and built it up as her confidence grew (There were, of course, other new grads who overloaded themselves, which I guess can lead to problems...). She supplemented her income and sought extra experience by working in a hospital as well. From what I remember, this was useful from a relationships perspectives (hospitals can be quite political & dysfunctional at times) but as suggested in the article, the practical benefit was more limited.
I find it really sad that midwives have some high profile failures but there always seems to be a disproprtionate level of criticism for it. I acknowledge that sometimes it is due to poor LMC decisions, but we need to remember that even western medicine can't prevent all deaths / injuries during childbirth.
I work as an LMC. I fully
I work as an LMC. I fully agree that students intending to work as LMC's should work on a two year internship at a hospital base before independently practicing.
More and more new grads are leaving LMC work due to their lack of confidence and level of responsibility they have working as an LMC. Its too much, too soon. Every new grad (hospital or LMC based) needs to gain a level of confidence and support, thereby making a natural progression over time. This bears no reflection on the competence of the midwife.
A new grad can be 'text book ready' but when your in a womans home and she's starts having a secondary haemorrhage in front of you - does every new grad have the confidence to know what to do by themselves initially? There's no red button on the wall for people to come running in to assist. In rural areas, you could be waiting up to 30+mins just for an ambulance to arrive.
Perhaps, if new grads worked in this internship, it would also help to bridge the gap between 'hospital and LMC' care and a better understanding of 'walking in each others shoes'.
And finally, yes - the media is despicable for their portrayal of midwives. But thats for a different petition, to the Government.
I cannot believe that you
I cannot believe that you are adding to this erroneous, totally unbalanced and to be frank, factually incorrect rubbish we keep hearing about in the media regarding midwifery graduates.
Let's deal with some facts for a change, shall we? You state,"More and more new grads are leaving LMC work due to their lack of confidence and level of responsibility". Really? And where do you get that from because I know (yes I have seen the verified figures) that more graduates are in fact staying in the profession as a result of the training providing them with confidence (which is only ever undermined by comments like yours and the media having a go at the midwifery profession as a whole) and the suppoprt provided by the First Year in Practice Programme which is just outstanding.
As for your comment about there not being a red button in the wall for when something goes wrong - based on that, you would want every woman to have their baby in a hospital, "in case". Do you know what the research and stats say about the increased number of negative outcomes for normal, healthy woman giving birth in a main hospital?
Stop helping to add to the perpetuation of this rubbish about the poor education of midwifery graduates and get up to speed with the facts. Then and only then can you speak from a position of knowledge and credibility.
1. From a regional NZCOM
1. From a regional NZCOM meeting recently held and a MFYP meeting.
2. Your right, the MFYP is outstanding. It recognizes that new grads have long faced challenges that can undermine their confidence within their early years as midwives; for many different reason's. The MFYP therefore aims to offer them maximum support; to build and maintain their confidence throughout their career. What a shame midwives could not benefit from this before :-)
3. I am fully aware of hospital birth stats, hence why i have worked very happily as a homebirth midwife to women for 16 years. if you read my comment correctly, i address the 'confidence of the midwife dealing with an adverse situation so soon after her training. I have known too many good midwives leave the professional based on this.
4. I made no reference at all of the midwifery education being poor?
5. i am entitled to my own opinion, as are you.
Anonymous - I thnak you for
Anonymous - I thnak you for your reply as it has at least made clear for me where some of this misinformation is coming from. I admire anyone who speaks up on any matter, that takes an effort and dedication. However, all this campaign against midwifery grads is doing, is undermining the maternity system and scarmongering, making women feel unsafe and unsure about a maternity system that is world quality.
You say (and thanks for answering my queries)and I have put your responses first with mine after:
1. From a regional NZCOM meeting recently held and a MFYP meeting.
I am sorry but you have been given incorrect information and that's a real shame.
2. Your right, the MFYP is outstanding. It recognizes that new grads have long faced challenges that can undermine their confidence within their early years as midwives; for many different reason's. The MFYP therefore aims to offer them maximum support; to build and maintain their confidence throughout their career. What a shame midwives could not benefit from this before :-)
I do not follow your point here. The petition this Voxy story is about, is specifically focused on wanting a 2 year internship for grads and you state that you think that is needed in part because of the MFYP - which you agree is outstanding. Is your point that there are midwives who were were educated before the MFYP was in place and it is a shame for them? If that's the case, the petition does not address that - the petition is all about a 2 yr internship, which you have said grads need and yet you feel the MFYP is outstanding - I am confused about what are trying to say?
3. I am fully aware of hospital birth stats, hence why i have worked very happily as a homebirth midwife to women for 16 years. if you read my comment correctly, i address the 'confidence of the midwife dealing with an adverse situation so soon after her training. I have known too many good midwives leave the professional based on this.
No, you say grads are leaving. Grads are midwives who are a year out of their degree. These qualified midwifery grads are in fact not leaving the profession as you have suggested by using the word Grad. Are you meaning LMC's who qualified quite some time ago? Again unsure of what you are getting at. One thing I do know is the "confidence" of new grads (and NZ women actually) in recent years has been severely undermined by strategic campaigns (media based) aiming to return NZ to a medicallised / GP led maternity system. And man, there are some agendas in that I can tell you.
4. I made no reference at all of the midwifery education being poor?
Of course you did - you support a 2 year internship in hospitals for midwifery grads. The people behind the petition want this because they believe (by direct assertion and by implication) that the education is not up to scratch.
5. i am entitled to my own opinion, as are you
Of course you are - I despise apathy and admire anyone who makes the effort to state their opinion and back it. However, your "opinion" is based on misinformation and is, I am sorry to say, wrong in so many ways it is dangerous when such opinions are expressed, gaining media coverage (they love the sensational!) and seriously undermining the confidence women have in what is (I can back this with facts, not opinion) a fantastic maternity system AND education programme for midwives (I can back that with facts as well, not opinion).
With the "right" to express an opinion comes a "responsibility" - all I ask is that you think about that each time you state your opinion.
The angle i am coming from -
The angle i am coming from - is why is an internship seen as a bad thing? and what does it have to do with 'poor' education?
I choose to be hospital based for 3 years following my graduation. Whilst i didn't enjoy the environment and medical approach to a normal pregnancy, not all pregnancies of course are uncomplicated.
For that reason, i knew i needed as much 'hands on experience' of emergency events whilst having the benefits of colleagues around me to assist and guide. This enabled me to gain my own confidence and expand upon my clinical skills and judgements.
When i made my long awaited for change to working independently, i did so with more confidence and assertiveness and trust in my enhanced skills. I also felt i could be a better advocate to women to challenge medical intervention, as i had experienced it intensely. I don't feel in anyway that my training, or my new grad skills were sub standard, i saw it as a way of expanding upon my secondary care skills and gaining a full time insight of the hospital system.
In other countries, midwives / doctors / nurses are often required to work in a hospital for a period of time before going into the community, so why is the notion viewed so negatively here?
In the last 7 months, 2 new grad lmc's here have left their practice to work in a hospital as they feel the responsibility is too much for them holding a caseload 24/7. One of them felt a 'failure' by doing this, which is terrible. Why should she feel a failure for working in a hospital? Shouldn't we all work together as a profession? It's the maternity system that puts too much pressure on lmc's by working 24/7 with full accountability.
The media is despicable in its portrayal of midwives (as per my first comment). Quite what can be done, i just don't know. Midwifery in new zealand has come a long way in a short time, and for that reason i strongly believe the profession can pull through this.
Unfortunately I missed the
Unfortunately I missed the call that asked for my comment for the above article.
In response to the comments above:
I represent the consumer group SOMS (Save Our Maternity System)
We are a group of consumers who feel that the training system is inadequate for midwives at the moment in NZ. We are not attacking midwives but the SYSTEM. We feel so strongly for the families, like the Barlows and others, who are suffering so terribly after preventable tragedies that they have had to endure, and that is what motivates us to put time and energy into this.
We feel worried about further tragedies occuring, the integrity and
reputation of the midwifery community and the future of the maternity system in this country. We also feel that it is unfair on newly graduated midwives to put them in situations which they may not be qualified for.
Even one baby dying should be enough to prompt a change, but despite recommendations being made in the past, the system continues to let consumers down. Recommendations were made to put the internship in place within a 2005 coroner's report, and in an evaluation of the mentorship program, 2008.
For us, this is an issue of urgency. It is difficult to sit back and watch grieving families without taking action in their honour.
We want to acknowledge that a majority of babies are delivered safely by experienced and knowledgeable midwives, and this is what consumers in this country should be able to rely on now and in the future.
I was just wondering if you
I was just wondering if you can tell me if LMC's are still paid differently depending if they are the actual person to deliver the baby or not. I understand from the past that if a woman has gone through labour with their midwife and then has to have an assisted birth, the funding they receive is less than had they delivered the baby? If this is still the case, is this something SOMS represents or is it purely about training of midwives?
LMCs receive a package deal
LMCs receive a package deal for labour and birth. So whether the labour is 2 hours long or 16 hours long the midwife receives the same amount of money. If the birth happens using assistance, then the money is unchanged - so, no, there is no penalty financially to the LMC. If it is a multiple pregnancy, or the women needs more ante-natal visits, then the money remains the same - the only difference is if the woman needs more than 12 post-natal visits (the minimum required is 7) there is an extra fee paid.
If the woman requests/requires an elective Caesarean section (planned) then the LMC does not receive the birth fee. In some instances the LMC will receive an 'exceptional circumstances' fee for attending the planned CS - if not there, no fee.
All of the info regarding roles and responsibilities and renumeration is available by looking at section 88 of the Public Health and Disability Act online.
SOMS represents consumers
SOMS represents consumers who want to make sure that future midwifery care is of a quality standard, whether a mother chooses to deliver at a hospital, at a birth centre or at home. We should be able to trust that we will have the very best care that we all deserve. If an internship at a base hospital will help to receive this then how could it possible be a bad idea? Builders do internships,Olive, and they CERTAINLY learn on the job!!
What midwives get paid is not part of our petition, or our interest. We are focussed on making sure that preventable tragedies are prevented!
Cheers
It could be a bad idea if
It could be a bad idea if midwives have to work as interns in a hospital, as then, as I mentioned, the sickest women in our secondary and tertiary centres may be cared for by the most inexperienced midwives.
I thought builders did an apprenticeship - which is actually akin to the midwifery education.
The midwifery degree update(which has been in force since 2009 for some areas, and began in 2010 for others) needs time to take effect.
This change has meant a large increase to both clinical and theory hours,and is the equivalent of 4 years in 3. Midwives can then apply for the MFYP programme, at present not compulsory - but certainly around 98% of graduates join - which supports practice and development for the first year. After that midwives still have competency based practising certificates, which means every year there are compulsory and elective educational and review requirements. Perhaps the new degree needs a chance to prove itself before any more changes.
I did notice in the paper recently that over 600 people suffered injuries at their GP surgeries last year and claimed ACC. All health professionals get it wrong sometimes- with tragic results at times - but that doesn't mean revamping everything at every turn.
One question Linda - what
One question Linda - what makes you think two years in a base hospital will improve whatever you seem to think the current problems are? I am very curious as to where this has come from. Apart from the huge logistical issue of putting more then 200 graduates into base hospital maternity suites, many experienced, older midwives see some of the cases that end up in the paper and say in their 20 or 30 years of practice, they have never seen such a combination of circumstance or situation like the one in the news. So, at what stage would you think a "graduate" is in possession of all they need to know to head out into the big world, as they do now, better equppied to manage what is often a totally exceptional situation? And do you have evidence to show the problem is definitely with midwives and not in the DHB's or elsewhere? Do you know for sure that it is not an issue where problems occur AFTER the handover from LMC Midwife to hospital registrar, obstetrician or DHB maternity services? We have to know where the problems are occuring (if indeed there are problems) before we look at solutions and I am wondering if you know this and if you do, how? Cheers.
Thank you for all that
Thank you for all that robust commentary that this petition has generated. Obviously 'anonymous' is speaking the language of SOMS. It would be a shame if the only outcome of preventable tragedies is that the midwifery profession is criticised.
That is the exact reason that this petition's aim is important. The more issues that arise when inexperience and/or a lack of knowledge is to blame, the more media attention will be focussed on midwives, and so it becomes a bitter cycle.
Especially when considering the number of newly graduated midwives going into the community, and the fact that the more experienced midwives will eventually move on or retire.
Thank you for all that
Thank you for all that robust commentary that this petition has generated. Obviously 'anonymous' is speaking the language of SOMS. It would be a shame if the only outcome of preventable tragedies is that the midwifery profession is criticised.
That is the exact reason that this petition's aim is important. The more issues that arise when inexperience and/or a lack of knowledge is to blame, the more media attention will be focussed on midwives, and so it becomes a bitter cycle.
Especially when considering the number of newly graduated midwives going into the community, and the fact that the more experienced midwives will eventually move on or retire.
Working in a hospital does
Working in a hospital does not necessarily mean one gains the confidence to work 'independently' (a misnomer if ever there was one).
If all new graduates worked in a DHB facility (secondary? tertiary?) then some of the illest women would be cared for by some of the most inexperienced midwives. As well, who would be LMC for the women in the community? Support for midwives is not always consistent within DHBs, which is why some graduates will not consider applying.
Of course the death of a baby is a tragedy for all concerned, including health professionals, but systems cannot be changed each time a baby dies. No matter what care is given and by whom sadly babies do sometimes die.The mentoring review in 2008 recommended that MFYP programme be compulsory for all graduates; a stance midwives strongly support.The government has not supported this move and in fact the funding for the programme may be cut.
I am a 3rd year student
I am a 3rd year student midwife who graduates in December this year. I have considered being an independant midwife but am terrifed as this prospect, not becuase of the responsibility because I have had good clinical experiences, a experienced mentor, and am in the MFYP programme, but due to public opinion about new grad midwives. There is a need for us to work in this area yet recent publicity totally undermines our confidence to take this step. As a student I have been involved in several emergencies within a hospital clinical setting and I must comment that often the emergency was handled vey well by the midwives both new grad and experienced. I still have a choice to make about where I choose to work but at the moment my confidence is crushed given this recent media article.
I'm not a midwife and i'm
I'm not a midwife and i'm confused this all this!
- If 80% of midwives in NZ work as LMC's - is there good support and supervision for them? I read online that they have yearly supervision and attend study days, but what about their caseload and the way care is provided?
- If that new gad was too busy, shouldn't there be a limit to woman they can care for by themselves?
- Why don't other countries work this way if NZ system is so safe / good?
- What's so 'wrong' with a new graduate working in a hospital? isn't a midwife a midwife where ever she works?
i'm not against lmc at all, but i'm trying to understand why there is such a big division!
thanks
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I'm not a midwife and i'm
I'm not a midwife and i'm confused this all this!
- If 80% of midwives in NZ work as LMC's - is there good support and supervision for them? I read online that they have yearly supervision and attend study days, but what about their caseload and the way care is provided?
- If that new gad was too busy, shouldn't there be a limit to woman they can care for by themselves?
- Why don't other countries work this way if NZ system is so safe / good?
- What's so 'wrong' with a new graduate working in a hospital? isn't a midwife a midwife where ever she works?
i'm not against lmc at all, but i'm trying to understand why there is such a big division!
thanks
About 60% of midwives work
About 60% of midwives work in hospitals or primary birthing units (as 'core' midwives) and the others work as primary caring midwives providing LMC roles. One is not better than the other - we all need each role - but one cannot survive without each other. LMCs cannot provide 24 hour care e.g. for women who want to remain in hospital after birth, or sick women who need to be admitted because of complications
LMCs are on call, and earn a better rate of pay - but they have no sick leave, annual leave (paid) etc - they are a small business. GST and tax etc.
Core midwives work rostered shifts, usually are not on call, and have the protection of the employed situation. Each has pros and cons.
Midwives often choose where they work due to family circumstances; for many, the model of midwifery in NZ being continuity of care is the reason they are attracted to the career. Working in fragmented care situations in hospital is not so satisfying for some.
Please bring back the
Please bring back the doctors to this whole labour and birth process. From my experience I believe that I now have less choice than before about who attends me and my bnaby during delivery and the immediate post birth period .I would not trust a midwife with the my life or that of my child. I am beggered that the midwifery council have effectively disenfranchised the medical profession in the birth process and more beggered that doctors have let them. I would choose to have a specialist doctor overseeing my birth process, it is all to awful when it goes wrong with just a midwife in charge.
Simple answer!!!!!! Get rid
Simple answer!!!!!! Get rid of the biggest problem.........the direct entry midwifery training which it would appear is a big fat gravy train for all concerned........if a new LMC new grad has her confidence crushed by the media reports re midwives.......you are shaky in your experience for a start.
We need to go back to the old system of being trained nurse first that would certainly solve a lot of problems students at the hospital looking after what one blogger said was 'the sickest women' in the hospital setting, well it wouldn't be such a dangerous or scary situation for the student midwife would it..........if she had some basic nursing under her belt.........it's just plain common sense isn't it? Seems to me the only ones that don't want a system change are the ones well aboard the 'gravy train' already and couldn't care a less about the loss of a baby..........unless of course it's happening to their own family.......and then it becomes a very different matter!
This system will go full circle just watch it's just a matter of how many more tragedies we have to read about before somebody with the power to change things wakes up end says enough is enough, and yes there are often bad out comes when a woman is delivered at a dhb hospital why........not brain surgery is it..........she is often there because she has problems to begin with.....or the LMC often new grad.......has left it too late to transfer a patient in and they are In Deep trouble when they arrive.... And btw then the poor lady is deemed secondary care and the midwife if not experienced enough dumps the woman in the hands of her more experienced midwifery colleuges and goes home to bed and may get called back to the delivery......and yes it's called 'handing over to secondary care...as this lady is now beyond my scope of practice.......what a crock!! And yes the lmc still gets paid if she leaves the woman, bet they will stay if the dollars are taken off them if they leave and don't even bother to stay in a support role.....how uncaring is that eh!!!!
Whatever happened to the flash partnership model that this system is supposed to offer women in their care,time for a commission of enquiry into this whole training system and the unreliable stats that accompany it's
Introduction........ What is it going to take??? If you agree sign the petition for change midwifery training in nz it's online just google. And yes the media do report a lot and how many sides do you want to hear re a dead baby........there is only one side.........ask the parents what they went through and have to live with for the rest of their lives, or the parents with the braindamaged children who don't even make the stats......we are seeing more and more, and because of all this the new training is costing this country and it's childbearing population way too much !! In more ways than one and it is simply tragic and the rest of the word are laughing at the stupidity of what is going on in this country and are shaking their heads in disbelief, great system but nurses first then start your midwifery training........bring the tried and true back!
I starting reading your
I starting reading your comment thinking, okay, there's a few good valid points made here, then i got too -
"dumps the woman in the hands of her more experienced midwifery colleuges and goes home to bed and may get called back to the delivery......and yes it's called 'handing over to secondary care...as this lady is now beyond my scope of practice.......what a crock!! And yes the lmc still gets paid if she leaves the woman, bet they will stay if the dollars are taken off them if they leave and don't even bother to stay in a support role.....how uncaring is that eh!!!!
Several things, firstly 'dumps a woman in hands of her more experienced colleagues and goes home to bed'
I can only speak for myself as a rural LMC who works in a high demand area, and am available day and night, 7 days a week for all the needs of a woman (clinics, visits, emergencies, late night phone calls/texts/visits etc) that i am not infact superwoman. To work safely 24/7 i do need sleep and rest and therefore cannot take on the whole spectrum of care. I feel it would unsafe for me, and the woman, if did work as a primary and secondary care provider (even with the cover i have). As a Unit midwife I worked shifts set by the hospital - so i was not over extended in my hours and therefore able to provide safe care.
Having also worked in secondary care for over 10 years previously, i have the same skills as my midwifery colleagues there, which in a rural practice i feel i need just as much and if not more than them - i'm more isolated here and need to act and respond immediately and am accountable for that.
You might also wish to check through section 88 regarding payments as lmc's are only paid under certain criteria. I have lost over a third of my expected income annually when events happen which are not covered for payment. S88 is very basic, and makes little allowance for individual situations of midwifery care.
For example, my client was 39 weeks, in 'early' labour, i have visited her several times during the night and day for the support she wanted, her clinical risk changed and i needed to transfer her. I phone consulted, then wrote referrals, made phone calls to del suite, faxed notes and fully discussed with woman and her family (all at 4am)
Yet I was not able to claim a single dollar as she was not in est labour, and exceptional circumstances payment is only for clients not in labour. I wonder how many other people would go to work at night (or day) and not expect to get paid for it? yet i do.
"how uncaring is that?". Hmm, please don't judge us all the same. You have no idea how i work or the care i provide :-)
Well Anonymous "simple
Well Anonymous "simple answer!!! get rid.
It is funny how people with strong views are, shall we say ..... reluctant to post their name. If you have an opinion, at least have the courage to post your name.
On the subject of going back to the old days, where midwives had to be nurses first...... it was my understanding that there is a huge difference between the professions. Hence the move to direct entry midwivery training.
The only "what a crock" in your statement is that you deemed yourself an expert with the audacity to portay such a biased and bigoted opinion.
I feel it unnecessary to respond to your other awful comments on the basis that you apppear to be lacking in knowledge in this sphere and wish only to "slam" a profession. Unfortunately, you are not alone as do many others and in particular the media, whose sole aim to to sell papers and advertising with little or no regard to the truth.
As for Lolly, who "beggars" belief, doctors may still be LMC's, most have chosen not to due to the small financial gain for looking after a women for the three trimestres. You may choose an obstetrician to serve as your LMC but would be required to make additional payments.
All in all what should be said, is that the NZ model of care is the best in the world. Yes, I know you will be surprised to hear this, but that is the case and we as NZers should be proud of that fact.