Archive for February 23rd, 2008

Dr C, the conundrum that he is, has had me shouting at my computer screen about one of his pithy entries involving ‘madwives’, and then had me thanking him for alerting me to a wonderful entry by Good enough Mum.

Now he is ranting about ‘polyclinics‘. What do I think? Well, on the face of it, and given the expectations of the public courtesy of this government’s promises, I think that they will be the only way midwives will be able to cover their workload. That is not to say though that they should be way forward in maternity care, they are a centralisation which I fear will lead to a de-personalisation of the care that I am currently striving to provide. Looks like they are the way we will be going though as the definition of a polyclinic states that ‘In terms of the clinical working groups’ recommendations, polyclinics will offer access to antenatal and postnatal care’. So, if the dream (nightmare) comes true it won’t just be pregnant women attending the polyclinic, it will be newly delivered Mums and babies. Combine the 24% caesarian section rate, with the fact that most post-section women are discharged on Day 2 or 3, and then mix in the fact that they will have to access their postnatal care at the polyclinic and I have difficulty seeing anything positive about this proposed reform. It’s not long ago that we would visit all women daily for the first 3 days, twice a day for the first 2, then we would visit at least another 3 times before we discharged Mum and baby, soon the roles will be reversed. I believe that home visits are important, so much can be incorporated. Practical advise, is the room temperature within normal limits? Demonstrating how the baby should be put in it’s crib/cot according to the SID’s recommendations. How is the Mum coping? Easier to judge if she is in her own environment. If a relative is there to help how supportive is s/he being, some can be quite undermining. I am not going to be able to see, sense any of this if I’m not ‘popping’ in for a chat to see how things are going.

I’m going now because I’m just depressing myself. It’s hard being involved with a service which is falling apart around you. 


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