Hi Stephen

Just thought I’d make a couple of comments in reply to your post.

1. I am not quite sure why you think the research into midwifery shortages is useless. You haven’t really addressed why you think there is a shortage other than midwives are overstressed. What is the evidence that midwives are overstressed because of a lack of obstetricians? The shortage of midwives and health staff is a global issue and is affected by complex issues such as young people’s attitudes to employment in health eg decisions about life style.

2. NZCOM is not a union but the midwifery professional body. Why do you say it is ‘so-called’?

3. You make a number of sweeping statements like midwives discourage informed consent around medical students – what is your evidence for this?

4. In response to Monty. I was very sorry to read about your personal experiences. There are national statistics on birth outcomes so can I direct you to the maternity reports on the MOH web site. I think you find there has been no national increase in both maternal and neonatal mortality rates.

Thank you, Sarah

[Thanks for commenting directly Sarah. I’ll reciprocate on your site when I get a moment. In answer to your questions
1) Research is likely to be just an excuse for not doing the commonsense things that private employers do all the time, usually intuitively. Because most occupations face shortages and surpluses when the employers and employees are not free to fit the terms of employment around their particular circumstances. “Work-force planning” tries to compensate but fails because people simply leave when the pay and camaraderie and achievement satisfaction and other things we all look for from work are not commensurate (in relative terms) with the effort, risks and frustrations involved. All jobs have all these things in an ever varying mix, but nation wide rigidity tends toward least common denominator terms and conditions and perennial dissatisfaction in the areas where the needs are most testing. “Research” is wasted because the cure in most industries and occupations is local and very personal. Poor employers can’t get staff, or have to pay more (in money or conditions). Good employers are constantly tailoring what they ask and offer to suit their needs and what is available, recognising that satisfying and retaining existing staff is usually the most worthwhile priority. Good employees are usually advantaged.
But in education and healthcare workers face local monopoly employers, worrying always about what their decision on any one person will do in precedent terms to everyone else.
2 I regard its claim to being a “college” as hitchhiking on the brand created by worthier bodies. Because in my long ago dealings with its leader they were far more interested in the status of their members than increasing competence and the interests of the patients. From subsequent reports in their reaction to misadventure they remain more “union’ focussed than “profession” focussed. A true professional body is even more determined to kick out unsuitable members than the employers or other disciplinary bodies, and initiates proceedings, instead of defending members.
3 Direct statement from recent graduates are the source of my comments attributing the lack of obstetric exposure during doctor training (at leat partly) to midwife discouragement of women who might otherwise permit student participation.

Finally – you say on your site that I “dislike midwives”. I dislike what has happened, and especially the loss of choice for women, but your statement has no foundation in anything I’ve said. It is like saying I “dislike rugby players” if I criticise the Hurricanes’ performance, or their coach. In fact when I first gained exposure to these issues I was highly sympathetic to the idea that birthing should be demedicalised and that women should have a choice that included allowing midwives to be the lead carers. I have always found doctors to be difficult (hard to bear) clients. They can be very patronising. But as the contract evolved the more intransigent party was NZCOM. I still kept an open mind on the issues, but it is impossible to overlook the fact that the doctor side warnings have proved to be accurate.