The Other Side of the World

The other day in class, our Instructor mentioned she’d run into an Honourary midwife at a conference who wished us all the best in our beginning studies and expressed her admiration for our endeavours. That would be the Prime Minister, Helen Clark.
As the story goes, Helen Clark was the Health Minister when the legislation to give Midwives autonomous practice in New Zealand was created. Thanks to her, it was passed through at 2 a.m. when most members of parliment couldn’t be bothered to attend (or oppose) and she managed to slip in some key elements that give us the wonderful scope of independent practice we have today. To be fair, I would probably be livid if I heard that my government was passing bills in the middle of the night when hardly anyone was paying attention (sounds like something out of a Michael Moore movie). However, I can’t help but celebrate her deviance in this case.
In other happy news, we were also informed that the acceptance rate for our program this year was under 16%. Somehow essay-induced-headaches are more palatable when you’ve been especially chosen for them.
And speaking of essays – I’ve written the outline and the intro and it’s only 7:30 p.m. There is still hope in the world yet.

http://www.chelseagreen.com/2006/items/fullmoonfeast
I’m pretty sure there are some days when I spend more time thinking/reading/talking about food than I do eating it. Ah food. Ah books. Ah love . . . .

In honour of my grandfather’s birthday this week, I thought I’d post some photos of him picking figs for me last month. I fervently hope that in 60 or so odd years, I am still climbing trees and leaning out to the tips of the branches to pluck the ripest, most sun-kissed fruit for my grandchildren.

Wednesdays in my life have managed to overcome their usual classification as ‘middle of the week slump’ and become one of my favourite days. Their sudden, dramatic rise was probably due in part to the fact that my school week now starts on a Wednesday – Mondays and Tuesdays being designated for Other Things.

The real reason, however, for loving Wednesdays, is that it’s the day for 177.101 – in other words, 5 delicious hours of sitting around talking endlessly about midwifery, practising midwifery, distracting our instructor off on delicious birth-story tangents, oh and did I mention sitting around drinking tea and talking about midwifery? All in the guise of ‘education’. Ha!
Today in the 3 hour lunch break, one of my friends came over so we could give each other a physical exam (a non-erotic partnered assignment) and we ended up having one of those great long here-are-some-sordid-details-about-me conversations that I was in dire need of having.
Right at the end of class today at five o’clock, we got into a huge, emotional debate about strategies/attitude for dealing with pregnant women (especially teenagers) who engage in abusive habits during their pregnancies(tough love? compassion? how?when?). Up until now, there has been very little vocal disagreement amongst us, and it was actually really wonderful to see the passions rising up and people exposing their deeply felt beliefs. I really believe it’s moments like this that enable us to grow together as a unified, supportive group.
And as if Nature was in agreement with me on the subject of good-coming-from-bad; leaving campus an hour late made me privy to the sun’s only appearance of the day as it nestled cozily back under the long white clouds of Aotearoa.

I know it was long and somewhat . . . political. Not to mention about social issues in a country wherein you do not reside (at least not as far as I know). Anyway, I just wanted to have it here as a marker or reference point. Midwifery is why I’m here, and what I am here to do. It’s a big, scary, important, overwhelming & wonderful thing to take in, and I suppose being attacked is simply par for the course. At least these days they aren’t messing around with those stakes and buckets of tar and flints. . . if you know what I mean . . .

Anyway, in direct contrast, I had a mundane and lovely day today. The weather is holding up nicely in the high 20′s and sitting by the big lead-paneled windows of the city library overlooking the square was delightful. Even more so because I met my friend Karen from school there and got soooo much reading done because I was trying to look impressively studious in order that she think highly of me. Indeed, I only squirmed enough to almost knock the whole table over once!

Then I went home made ridiculously delicious chili and cornbread for the whole house, and lo and behold the weather co-operated and became dark and rainy so we could all snuggle up to the Commonwealth games and comfort food. There was a swimmer from Papua New Guinea who won the 100m butterfly and looked so nervous and choked up as they played the anthem (a first for the country it would seem) – moments of pure, unadultered and shameless sporting-event-throat-lumping. It almost compensates for the botched Olympic coverage (but not quite).

And now, since my readings are all done I am going to reward myself with. . . . reading . . . . a novel . . . . .
. . . . but yes, more reading. Ask my mother, it has been a life-long addiction.

Oh yes, and I arrived home to a postcard featuring a little brown squirrel at my bedroom door (thanks Sarah!). Ah the little buggers, who would have thought I’d miss them?!

Tomorrow at lunch there is the Midwifery students meeting up at Massey (apparently I have to bring food to share, gah! preparing food before noon?!) and I promised myself I would conquer my fear of the journal racks in the library and get some research done for my paper, and then I am going out to a Proper Restaurant for my housemate’s birthday. The likes of which I have not done in New Zealand yet! (working at one doesn’t count). And we have even made a pact to further celebrate her 25th year alive by getting dressed up!. . . .now watch it be freezing cold. . . .
Oh, and the restaurant is called Lone Star. Hahahaha

But anyway, the book, and then a movie-in-bed, and it can only get better after that. . . .

Lately the enviornment for midwives here has been somewhat litigous and hostile due to a couple of well-publicized cases. We are told in class that these periods come and go and are to be expected, weathered even, as the normal rythm of things. One of my lecturers was particularily incensed by the comments an Obstetrician made on the radio last week where he offered to “mentor the midwives” in obstetrics. This is absurd when it’s chasing the anecdote that all my lecturers took the Obstetrical diploma exam one year (for fun) and passed with the highest standards. The following is an editorial published in the Christchurch Press this weekend that I think resoundingly voices the position of midwives in this country.

Many, many years ago my father told me you couldn’t believe a thing you read in the newspaper and we argued vigorously over what I viewed as his deplorable cynicism.
However the last few years have made me rethink.
We are a news hungry society and with the technological advances in the last 20 years, it’s now a 24 hour a day industry. Satellite, Internet, terrestrial – it’s everywhere, all the time. So, deadlines are tight, budgets are tight and demand is greater which may be why it seems to be more and more about sensational reporting rather than in depth informing .
New Zealand midwives provide an internationally respected maternity service for almost 57,000 babies and their mothers every year. They attend women and families of all ages and ethnicities, urban and rural, for 24 hours of the day. Sometimes in rural communities they are the only health professional available. The outcomes for these women are almost without exception better than those of Australian women and babies. This is something to be proud of in a world where it is difficult to achieve health improvements on this scale. More than 2300 midwives make up a workforce of highly educated specialists in pregnancy and childbirth and sadly at the moment, many of our members are feeling their role is being misrepresented by the media.
Recently, a senior reporter told us he had been instructed to “get the dirt on maternity”. An experienced freelance reporter was told her story on midwives was “too positive to print”, and there are those tabloid pleas at the end of a story asking for any other complaints about maternity services to be forwarded to the publication. These have all happened recently but it has not always been like this and I wonder what the agenda is for these media organisations?
Over the last few months, several newspapers have run headlines (some front-page) which I believe are manipulative at worst and incorrect at best. Here’s an example.
Recently the Christchurch Press front page article which stated that the Government was looking at ending midwives so called “monopoly” on maternity. This was the paper’s response to the Ministry of Health’s Health Report following the Coroner’s call for a review of maternity services and midwifery in particular. There was in fact no suggestion that the Government was going to end a midwife’s essential role in maternity. I advised the Press the story was not correct but this advice went unheeded. The use of “monopoly” in itself is unusual when describing a core health service. I am waiting for the reports calling for the end of other monopoly professions such as dentistry!
Health Minister, the Honourable Pete Hodgson, wrote immediately to the Press editor, to say “the quality of maternity care has improved dramatically…and that their story had “misrepresented the Government position… it left the impression the Government wants to weaken the position of midwives…this is inaccurate”. No headlines for the rebuttal were forthcoming.
Even more recently, an advertisement was placed in the Auckland Herald, paid for by the combined DHBs in Auckland who wished to publicly promote their Obstetricians’ support for midwifery and midwives in general. The doctors involved did this because of the difficulty they had with getting their positive comments relating to maternity and midwives published fully in local or national newspapers. The New Zealand College of Midwives welcomed this support.
Midwives are not naïve. They understand that the news media is not there to promote the positive messages of any one organisation. However most of our members feel there just hasn’t been the balance in reporting that one expects from credible media organisations.
The issue the maternity service has of course is that it is such a real part of so many people’s lives that it attracts the same variety of views and divisive opinions as any other life changing event. It is heavily influenced by social, cultural and family experiences and belief systems. It has a huge component of choice and consent expectations and people often go against medical (and midwifery) opinion. It is therefore a highly politicised service.
In maternity, every year, hundreds of babies die. There are less and less babies dying now but there will never be none. Often we do not know why some babies die and sometimes when we do we do not have the technology to save them. However every baby that dies must be reviewed to make sure all of us learn as much as we can about the way we practice. Midwives take this responsibility very seriously.
At any time, the death of a baby is a tragedy; a far reaching, devastating tragedy. It is devastating to the family, the wider community and everyone who knows that family and shares its pain. Every year midwives by the very nature of their work are with women and their families who lose a baby either before birth, at birth or soon afterwards and of course, the midwife also faces her own grief.
Not unexpectedly the death of a baby attracts media attention. There have been three cases of babies tragically dying at birth over the last five years and it has been these cases that the media has gone back to month after month.
The New Zealand College of Midwives is concerned that when it comes to the terribly sad news of a baby dying at birth, it appears that some members of the media are doing their utmost to take a family’s personal tragedy and link the entire New Zealand maternity service in their reporting of the issue.
What seems to be forgotten are the almost 57,000 midwife attended successful, happy, and in most cases wonderful, birthing experiences of New Zealand women, which sadly seem to have no significance. Or the other exceptional work midwives carry out which contributes to the fact that while the numbers of babies that die is the same, more New Zealand babies are born on time and are healthier and heavier than Australian babies despite their NZ mothers being more at the older and younger age range. More NZ mothers have normal vaginal births, less surgical intervention and significantly less trauma to their birth canal. Furthermore breastfeeding rates are increasing, and 94% of babies are receiving their six-week immunisation demonstrating the successful transfer of babies by midwives from maternity to well-child services.
The College believes that what Midwives do in New Zealand is too essential to the wellbeing of women, babies and families to be considered a target to sell more papers or get more people listening or watching.
We are a specialised workforce and a key element of a world class maternity system which tens of thousands of women are a part of every year in New Zealand. Midwives are not part of a criminal fringe yet, in recent times, there appears to be a real attempt by some in the media to make us appear so.
Although it is not perfect and we are all constantly working to improve it wherever we can, New Zealand has one of if not the best maternity systems in the world. Balanced reporting helps us retain appropriate public confidence which in turn ensures the service maintains its ability to improve the health of society.

Karen van der Leden is the BOP representative of NZCOM

Tonight at work I was asked to “hoover” the restaurant floor (I must say, there are times when you really miss working at a hotel with housekeeping staff). When they brought out the vaccum I had a good laugh (to everyone else’s bemusement) because it had little backpack straps. Apparently this is de rigeur here. Has anyone else ever seen one? Admittedly I don’t vaccum that often (especially while travelling). Photo courtesy of my indulgent co-worker, and the kiwi obsession with cell-phone-cameras.

‘Tis official. Two weeks until my first shift at the hospital. Our lecturer told us today they often do waterbirths at the hospital here, so that has heightened the anticipation just that little bit more. If that’s even possible. . . .
Barista: The Espresso Bar http://www.barista.co.nz
Here’s a useful lesson: while in the middle of the second in a series of back-toback shifts, do NOT drink a moccachino on an empty stomach, as carrying very full lattes for the rest of the afternoon will become an exercise in stopping nerve-clanging hand tremors by holding your breath. And no matter what they tell you – breathing is NOT overrated. I do like those frothy drinks though.. . . .perhaps I need to go back to drinking hot steamed milk (my mother’s solution to dragging kiddies along for her cappuchino fix).
Can I just say, however, that it is a *delight* to be able to wear a black t-shirt without collar or buttons or ironing to work? And to serve a nation of congenital non-complainers (a waitress’s dream!). And did I mention the frothy drinks?

Rolled oats, cinnamon, raisins, sliced bananas, ground flax seed, pecans, raw cane sugar. Bliss in bowl form. Also, dinner at 1 a.m.

The fat novel sitting underneath neccessarily completes the meal experience.

What I’m really trying to say here is; I got a waitressing job this weekend and consequently I’m too tired to write coherently about anything. Thank goodness I now have two days off before school to make chicken soup and start my midterm research paper (she writes, in a half-hearted attempt to convince herself it will be so).

Now that I’ve mentioned it, (acknowledging the assignment exists is the first step, right?) I find it incredibly amusing that I’ve written dozens of papers, so far not failed one, and I still dread them like the second plague. It must be a heart-over-head matter. Perhaps one likes trolling through library shelves and late nights and concise, well outlined critical analysis, and the other doesn’t?

Good thing they both agree on the Oatmeal.

A little while ago, someone asked me to do a post on my school supplies – being exciting acquisitions to those of us indentured in our education. And since it was my very first request, and I too am fond of the miscellany that comprises my knapsack contents, I am happily obliging.
Favourites first – how charming is a bright red stethescope? I was slightly concerned it would look bad with all the pink shirts I wear, but I quickly realized how ridiculous that problem was! (and, ahem, I can always wear black, right?).
Pinard Stethescope (for listening to baby’s heart in-utero)
Blood pressure cuff. After reading the extensive instructions on how to take a blood pressure, I was thoroughly confused and convinced I could never piece together the finer points of operating all the bit and pieces (not to mention listening to blood rushing through arteries and watching numbered dials rise and fall). However, I am pleased to announce that once I got everything sorted into the right hand, all the intricacies of it clicked nicely and I can actually figure out a decent blood pressure. The fact I’m doing 4 things simultaneously while doing so still boggles my mind.
Fancy schmancy digital thermometer – like a pearly oyster on a cracked shell
pencils, tape (anyone who gets mail from me will notice the envelope liberally coated with it as my envelopes are terrible!), and 1 cent notebooks (gifted from my cousins).
Already wading in paper . . .
A nice big, fat, terrifyingly comprehensive textbook (recognize the ring, Claire?)
Crocs – the comfiest, washable-est, pink-est, cutest shoes ever owned by me. Maybe I’ll post a picture of them later when they’re splashed in ammniotic fluid? [I bet the boys reading this would love that, eh?].