Christine Henderson

Privilege, poverty and politics

You will have read about or heard on the news of the near tragedy that threatened the life of both the Countess of Wessex and her baby. It has been reported that Sophie had to undergo an emergency caesarean section as a result of placenta abruption. Fortunately, the delay in transfer from home to hospital did not end in tragedy. Midwives, doctors and staff on the central delivery suite were on hand waiting for the police escort and ambulance to arrive. The baby was premature weighing in at 4lbs 9ozs and within minutes a private ambulance was arranged and a medical team escorted her to the regional neonatal unit from Frimley Park Surrey to St. Georges London as a precaution.

A tale of two conferences

From Harrogate: I make no excuses for reporting on the Royal College of Nursing Congress held as usual in Harrogate. There are about 4500 in the RCN Midwifery Society, a membership that is growing. Representatives of the society were very much in evidence among the 10000 attending. The betrayal of experienced nurses by the Government provoked responses of bitterness and anger at the recent pay award, but delegates voted reluctantly to accept the recommendations, making clear that it was at least a starting point for further debate.

Midwives: making a difference

Consider the following: ‘In a trust in England there are clinical guidelines in place last revised a few years ago. Practice has moved on and is different to the guidelines. There are WHO guidelines that support what the practice is and the Baby Friendly Initiative, supported by the trust, is at odds with the existing written guidelines. The midwives want to update them but are prevented from doing so because the consultant doesn’t see the need. The midwives are powerless to take the matter further.’ The power to change is out of the hands of midwives. Sound familiar?

Change and the need for experienced midwifery managers

It seems that almost every week we read or hear about the withdrawal of schemes found to be successful in providing a midwife-led, women-focussed service where choice, continuity and control are key features. To do this requires a workforce that is flexible and empowered, who work in an organization that is flexible, valuing the strengths and limitations of its employees, within an environment that is supportive. There are issues to do with how to provide an equitable service across a trust within the resources available and how to motivate the remaining midwifery staff in changing their way of working (if necessary). Midwives are responsible for the quality of care and therefore are vital to the whole process of change. But successful change also depends upon those in positions to lead and manage the change. The reduction in numbers of experienced midwifery managers is having detrimental effects in some trusts. There is concern that a midwifery view on issues is becoming a rarity and that it is not in th...

Book review supplement

The Pregnancy Book Life will Never be the Same Again. Learning to be a First-time Parent Homebirth and Other Alternatives to Hospital ChildBirth Unmasked Comprehensive Neonatal Nursing: A Physiologic Perspective