WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

whereas now when she responds to calls to rooms the midwife is often asking for her
advice and for a decision to be made. McAra - Couper et al., make the point that within
the secondary environment “less and less is seen of birth itself and more and more is seen
of the management of birth and this is mistakenly thought to be birth. In such a climate
what can result is a version of midwifery that is part medicine and part midwifery – in
other words a hybridized version of midwifery – this does little to protect and nurture the
knowledge which is midwifery” (p.9).
It is up to the experienced midwives to try and pass their knowledge on within an acute
and busy environment. Weil (2008) writes “in one New Zealand urban hospital that
provides secondary/tertiary care the total hours of acuity in the birthing suite increased by
21% from 2005 to 2007” (p.4). It is within such working environments that the
experiences of senior midwives who are confident in their practice and their beliefs in
normal birthing are fundamental in trying to maintain a normal focus and woman focused
care (Earl, 2004).
The belief in women’s ability to birth normally, combined with how ‘normal birth’ is
defined within the secondary/tertiary setting offers senior midwives opportunities to
“push the boundaries of practice and not go completely by the book” (Earl, 2004, p.78).
Earl goes on to emphasize the importance of senior midwives willingness to share their
beliefs and skills in keeping birth normal not only with women but also with fellow
colleagues, inclusive of doctors. The question can be asked is whether this is achievable
with the increasing acuity in the tertiary hospital setting.
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