Direct-entry Midwives in England

I am a direct-entry midwife practising in England. I cannot understand the attitude of those in the U.S. who have decreed it a felony to be one! I presume there are many OBGYN doctors who do not want to lose the financial benefit.

Here in England direct-entry midwives are beginning to outnumber those who have trained as nurses. After 3 (or sometimes 4) years of training we gain either a diploma or degree status depending on the course chosen at university.

Following qualification I have now been in practice in a large teaching hospital for 18 months. I look after women during normal labour and delivery and providing things are proceeding well, also am the sole person attending the delivery. Only if things do not go according to plan do I need to ask the assistance of the medical team. Even then I could still be the only person at the delivery if there is no need for instrumental or c-section birth. Similarly I will work with the docs when caring for women with problems. If the birth itself is predicted to proceed to a normal vaginal delivery I will be the person there.

There are other aspects to my job where I also practice autonomously, but that is the situation as far as delivery in hospital is concerned.

The powers that be in the U.S. could do well to look at the practice of midwifery in other countries; they will see that despite some problems it works well to the benefit of women. However, until the U.S. healthcare system is no longer dominated by men and money, I think it will be a long struggle for the midwives there to change things. You all have my wholehearted support and best wishes.
-Coreen

Reprinted from Midwifery Today E-News (Vol 2 Issue 5, Feb 4, 2000)
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在英國我是一個直接參與助產實務者，我不了解在美國對有這樣被裁定有重罪的人態度。我推測有很多婦產科醫師，不想失去這些經濟上的利益。
    這是英國直接參與助產實務者正開始一項超過數量的人接受過像護理人員那樣的訓練，在三年（有時候是四年）的訓練。我們同樣的也得到一張由大學依照選擇課程發給的文憑或是有學位的程度。依照下面的資格，我也曾在一所大的教學醫院從事實務有18個月，我照顧正常待產生產的婦女，提供各項持續事宜進展順利，並且也是一個人參與生產。假如事情進行的不如計劃時，我需要詢問醫療團隊的協助者，甚至我有可能是唯一在生產方面的人，假使他們沒有需要器械或是要剖腹產時。同樣的當關心有問題的婦女時，我的工作和醫師一起。假使這個生產不如預期成為正常自然生產順利進行時，我將是那個在那裡的人。
    我的工作在其他層面上，我的工作在實務上是有自主性的，但是這情況在醫院就是要被關注的。這種力量在美國可能做很好，視為在其他的國家助產實務。他們將看到儘管有一些問題，但是它在婦女的福利上做得很好。然而，直到美國的健康照護系統不再受到男性和金錢控制，我想對於助產是要改變很多事情，它可能是一項長久的掙扎，你們全部有我全心全意的支持和最好的祝福--Coreen。