Midwifery matters: May 5 is International Day of the Midwife and the theme this year is Midwives and women--a partnership for health.

The theme for this year's International Day of the Midwife (IDM), celebrated on May 5, is "Midwives and women--a partnership for health". The International Confederation of Midwives, in its announcement of the theme for this year's IDM, said the midwife's relationship with the woman she cared for was unique among health practitioners because the woman was not suffering illness or injury and because, at the end of the childbearing experience, the woman did not return to the same circumstances of life.

"Many women's interest in health services and health education is stimulated by their experience in childbirth and their input--in partnership with midwives--to the planning and shaping of services is a powerful force," the confederation said.

The confederation represents national midwives' associations from more than 75 countries. Its 27th triennial congress is being held in Brisbane from July 24-28 this year. The overall theme is Midwifery: Diverse Pathways to Healthy Nations, with each day having a separate theme. Bay one looks at history; day two at professionalisation; day three at current ways of knowing; and the last day is devoted to future pathways.

Projects manager with the New Zealand College of Midwives Lesley McLennan said the college did not officially mark IDM but left it to regions to mark it in appropriate ways.

NZNO to launch web pages for midwives

NZNO hopes to mark the day with the launch of web pages dedicated to midwives and midwifery issues. Professional nursing adviser with responsibility for liaison and co-ordination with midwifery members, Susanne Trim, said the web pages would include the support services NZNO offers to midwife members; key contact people within the organisation; NZNO's relationship with the College of Midwives; NZNO's midwifery reference network; library resources; and NZNO position statements and policies.

There are a number of midwifery issues under discussion at present. Under the terms of the nurses' and midwives' multi-employer collective agreement (MECA), a professional development and recognition programmes (PDRP) working party has been established. This will have two strands, one looking at a PDRP for nurses and one looking at a PDRP for midwives employed by district health boards.

The safe staffing inquiry arising from the MECA negotiations will have midwifery input. Trim said the guidelines NZNO developed last year for safe staffing levels for maternity units, after extensive consultation with midwifery members, will be submitted to the inquiry. The committee of inquiry will also travel throughout the country to hear submissions from members on patient safety and safe staffing.

Scope of practice issues

NZNO is also working with some individual midwives on scope of practice issues. There has been some debate on whether midwives working in some areas, eg abortion and family planning clinics, are working within the Midwifery Council's scope of practice for midwives.

Midwifery Council registrar Susan Yorke said the Council's view was that the activities of midwives working in those areas did not necessarily fit the scope of practice but that did not preclude midwives doing them. "Midwives have to maintain competence across the whole scope. Midwives working in these areas need to find ways to keep their hand in, to be involved in all aspects of the scope of practice."

The Council's re-certification programme was revised fast month. It includes compulsory and elective continuing education requirements and professional development requirements. Yorke said the Council did not consider the re-certification programme too onerous and those working in areas such as abortion and family planning clinics, would have to find ways of meeting the requirements.

She said the Health Practitioners' Competence Assurance Act, under which the Council operated, was predicated on protecting public safety. "The Council is of the view that if somebody calls herself a midwife, regardless of the area in which she works, the public expects that midwife to be competent in all aspects of midwives' scope of practice. We are concerned with protecting the public safety."

A nurse/midwife member of the MECA negotiating team, Janet Black, agrees that the Midwifery Council's requirements to maintain competency across the whole scope of practice are not too onerous. "Most midwives would be able to meet the requirements." Black, who works half time in Waikato Hospital's neonatal unit as a nurse specialist and half time as a midwife, is orientating to ante- and post-natal areas and delivery suite to maintain competence across the scope. "It is really important to have a midwifery body of knowledge in neonatal units. You can't really run a neonatal unit without that knowledge. A midwife has a broader knowledge of the dynamics of the birthing family."

Black is maintaining both her midwifery and nursing annual practising certificates and believes many other nurse/midwives will do so too.

She believes midwives working in abortion or family planning clinics will be able to meet the Council's requirements. "They could ask a midwife colleague to mentor them through a case and the compulsory education requirements, including cardiopulmonary resuscitation and infant resuscitation, can easily be achieved. There are ways for those midwives to maintain competence at an entry level across the whole scope."

MECA a draw for independent midwives

Black said there was some anecdotal evidence in the Waikato that the MECA may draw independent midwives back to hospital-based employment. "Many independent midwives are very tired and many are burning out faster than hospital staff. The pay increase, combined with fixed working hours could well tempt some independent midwives back to hospitals."