WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

same. This reveals the variance in midwives’ philosophies and how they each ‘view’
normal birth. It is equally important to remember what is ‘normal’ in a midwife’s eyes
may be different to the woman who has birthed her baby.
The midwife in the tertiary setting uses technological interventions if they are required as
well as, but not instead of, utilizing midwifery knowledge and wisdom. The midwife uses
her vision to observe, her eyes will reveal her compassion or at times her fear, and her
olfactory senses will give her clues to the sweet smell of liquor or the rotten smell of
infection. Her hands will detect fever or shock, a breech or vertex presentation and as she
uses her skills, the midwife is communicating, listening, asking, reassuring. She will
provide her midwifery care best in an environment where she feels empowered (Smythe
& Norton, 2007); it is the midwife who is the first “instrument of care” for women rather
than technology (Kennedy, 2002, p.1).
The challenge for coordinator midwives as leaders working within this tertiary hospital
system is the expectation that they work within a culture of medically focused care which
is dominant with no value placed on alternative ways of ‘knowing’. It is the ‘knowing’
which becomes the basis of clinical practice for midwives (Hunter, 2007). Hunter cites
Fullbrook (2004) who describes how midwives utilize their “embodied knowledge to
guide their practice in addition to textbook knowledge” (p.3). She passionately extols the
importance of midwives holding on to this embodied knowledge within the current health
care climate.
58