Wednesday, September 23, 2009

High Tech Midwifery I wrote for Midwifery Today I think in their first year

For you youngsters:  This contains some "dated" terminology.  We started in 1981 as Apprentice Academics.  This opinion piece was written several years after we started but long before we became Ancient Art Midwifery Institute.  You can see I have been concerned about ultrasound for a long time.  I have become even MORE hands-off in my philosophy since then.

High Tech Midwifery 
by Carla Hartley

My work with Apprentice Academics brings me in touch with hundreds of midwives every year.  I am in a unique position to notice trends among midwives.  Over the past year I have observed a trend that is scaring me – more and more midwives are becoming “HIGH TECH”.  In the last few months I have talked with three beginning midwives who had never used a fetoscope in their training – only Dopplers.  I  know midwives who are “ordering” sonograms on a somewhat regular basis.  
Are midwives embracing technology out of a lack of knowledge of intrinsic dangers and potential risks?  Maybe it is a desire to do more in less time (which we can all identify with) but it should set off a warning bell somewhere in our subconscious that we have gotten off track.  There  is also the possibility that midwives lack confidence in their own diagnostic ability.  I am afraid, however, that the underlying reason could have a great deal to do with our desire to work with, and to be accepted by, the medical community.  In our attempts to seem less radical, less judgmental, and more cooperative, are midwives being seduced by technology?  It is not a desire to learn technical and medical information, or a wide variety of skills and services offered that makes a midwife a “Jr. OB” – it is a reliance on technology.  

I asked a large number of parents why they had chosen home birth with a midwife rather than a physician attended hospital birth.  The most frequent answers were: level of caring, amount of time spent together, lack of gadgets and machines.  I like those distinctions.  Rather than three unrelated comments, I see a definite relationship between them  I would like to see all three distinction preserved; compromising one may eventually compromise all.  Any unwarranted use of technology carries with it the risk of detachment from the client… and ultimately from the art.  The French doctor who invented the first stethoscope, Rene Laennec, is credited by the authors of Medicine on Trial, with the simultaneous creation of a separation of doctor and client – a symbolic act of distancing one’s self from the client that has become woven into medicine.  Midwives, on the other hand, have practiced in the opposite manner.  We attempt to draw closer to our clients during the relationship because we know it enhances the safety and because it is our way.  My fear is that as we use our hands and ears less, we will also use our hearts and minds less.  We will create a separation and will be at risk of losing something that is uniquely ours… that which defines a midwife as    
“with woman”.

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