WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

Facing the ‘known’ and the ‘unknown’.
In midwifery and obstetrics, practitioners are caring for two lives, one of which is unseen
and whose wellbeing can never be totally guaranteed. The ‘unknowing’ of what is
happening in utero to the unseen baby and the implications for the woman who has been
referred with secondary complications makes for complexity with a need for
multidisciplinary care planning.
Coordinators reveal the teamwork and respect which exists with their medical colleagues
in their united desire for a ‘healthy mother and a healthy baby’. However, they also
reveal their ‘knowing’ of how easy it is for their midwifery and medical colleagues to
veer towards interventionist solutions.
It is the coordinator’s midwifery ‘knowing’, intuition, wisdom and expert tertiary level
clinical midwifery skills which lie at the heart of her practice. This is her foundation on
which she bases her desire for midwifery solutions when she knows it is appropriate.
There is ‘knowing’ that one small intervention such as siting a fetal scalp electrode will
ensure close monitoring of a fetal heart rate and the best potential for a vaginal birth.
There is ‘knowing’ that a woman in advanced labour with an undiagnosed breech baby
and previous uncomplicated normal births can birth her breech baby vaginally. These are
women, with a holistic perspective within a medicalised world of tertiary obstetrics who
are accorded respect from medical, midwifery and nursing staff alike. They know how
life saving obstetric intervention is and how appropriate it is in the tertiary setting. They
also know when to utilize midwifery solutions to best advantage.
172