A reader has brought to our attention comments made by a NZ medical student on reddit New Zealand discussion thread.
These comments arose during a discussion about an Auckland midwife that arrived late for a flight. When she was refused passage she got her own back by making a bomb threat. During her court appearance she claimed not to know the consequences of her actions. Here’s the link.
The remarks made in the thread appear to confirm many fears about the practices and attitudes of some midwives in New Zealand.
If you’re emigrating to New Zealand to work in midwifery, or are planning to have children, you may find the following of interest.
The UK or Europe (I’ve forgotten which countries in particular) the midwives are essentially specialist nurses with decisions being made primarily in tandem with the doctors, as opposed to here where a doctor cannot have input unless requested to or certain criteria are met. I see the advantages of our system in that you need far fewer doctors but the disadvantage is that there is less oversight and more maverick midwives can get away with pretty much anything until something terrible happens.
From what I understand, their training is essentially some basic anatomy and principles of obstetrics plus assisting in I think 40 births. There is no training in understanding research or interpreting studies which may be why so many are resistant to change. They do what they know and what they were taught.
I’m not sure of the American system at all so can’t compare, but the European/UK SHOs I did obstetrics with were horrified with our system. Their opinions have probably skewed mine a lot.
I definitely agree there needs to be more actual medical/nursing training in their teaching, if not for anything other than mitigating the whole “we are natural and good and medicine is bad” culture that is dangerous and present. The good ones seemed to have that (the best ones I worked with were both ex-nurses) and that’s a system I would fully support. But as it stands currently, I was quite horrified at some of the things I saw…
In my med school OnG run, the first birth I partook in the midwife told the mother not to give baby a Vit K shot. The second one actually changed the time labour started to avoid having to call the obstetrician (result was a nasty 2nd degree tear), there was also a lot of homeopathy/naturopathy, a lot of doctor/medicine bashing, and this was nothing compared to some of the experiences my colleagues had. There were some midwives who were bloody fantastic but far too many who I would have laid complaints against had I the guts to do it. One of my good friends’ kid ended up in PICU because the midwife misinformed them about the pertussis vaccine. I don’t have many good malpractice anecdotes but the ones I do are almost all from obstetrics…
(on the dynamic between doctor and midwife) I wouldn’t necessarily agree it’s a complete partnership. There is still financial incentive to delay calling an obstetrician in the hopes whatever trouble resolves spontaneously. If that trouble doesn’t revolve then the lack of timely intervention is a problem.
Apparently “there is no financial incentive for primary care doctors to get involved, as they get paid less for a delivery than a midwife. Midwives lose out on a lot of money if a doctor ends up delivering.”
“For a home delivery, the midwife had to pay a doctor to attend, ie it comes out of their earnings. In the hospital, if an obstetrician delivers the baby the midwife misses out on about a thousand dollars”
Now, from another poster
What’s the system like in Europe/UK? I’ve only talked to people from the states and I’m somewhat horrified with their system.
In the past, midwifery was a “post-graduate” degree that you did after nursing, I think. Now it’s a standalone course. I don’t actually know what the course entails (anyone here who’s a midwife please feel free to let me know!) but I don’t believe it covers basic human physiology, the importance of observations etc. Most of the midwives I’ve worked with have been “core” midwives (ie working full time in the hospital) so they kind of get that.
I’ve also heard some hilarious/scary stories of things that women have been told by their midwives!
I will try and do GPO – currently there’s no training for it in NZ but we’re planning on going to Aus for 6-12 months in a few years for me to do it there, and I’m 80% of the way through my O&G post-grad diploma. If I wanted to be a city GP I wouldn’t bother, but I want to do rural++ medicine and I think there needs to be someone nearer than 3 hours away that can do assisted deliveries, and knows a fair amount about obstetrics (and also I really like medical gynaecology)
Now for a reply from a student midwife (are you sitting down and ready for this?). According to her Obstetricians are not specialists in the majority of births (i.e. low risk) that happen in New Zealand. However, midwives are, but it is their call to decide when they become high risk and a doctor needs to become involved.
It is interesting to get the story from both sides isn’t it, compare her comments to the statements made above. Is a little knowledge a dangerous thing?
Hey, I’m a student midwife and I feel like I need to clear up several things hear.
Midwives absolutely study human physiology. We have three full years of it. And we definitely study the impact of taking observations and how important they are. Taking and recording observations is learnt in the first few weeks of the degree.
Secondly, midwives are the specialists in low-risk healthy pregnancies and births. Obstetricians are not specialists in low-risk pregnancies and births. Obstetricians are however, specialists in medium or high-risk pregnancies and births.
When the pregnancy or birth has complications, doctors start making the decisions because that is what they specialise in. Doctors are great, but they are not in a position of power over midwives. In the hospital setting when there are complications, doctors and midwives work together for the patients benefit.
The systems in the USA, Europe and the UK are very different to the system in NZ. In NZ midwives are, usually, respected for the qualified professionals that they are. People come from all around the world to study midwifery in NZ because (and I’m not exaggerating here) the midwifery training is better in NZ than any other country.
Yes, SOME midwives are incompetent, but MOST midwives are excellent at their jobs. As with any job, most people are great but a minority are not.
Ooops, there goes that blissful “NZ is better than any other country” incantation. That alone should sound alarm bells.
We’d like to hear from anyone who has experience f obstetrics or midwifery in New Zealand. Tell us your experiences of birthing in the youngest country on earth. This thread will be kept open indefinitely.