While so many have and continue to struggle for political change in maternity care, let’s look at a country that achieved every single desired goal … New Zealand.
We can speak from authority because we’re a New Zealand based charitable Trust even though The Pink Kit skills evolved in the US in the early 1970s. We have an advantage. We know what happened in the US in the 1960s/70s when there was a Skills-based childbirth trend (didn’t happen in New Zealand), what happened in the US when this shifted to a Choice-based childbirth trend by the 1980s and what happens when midwives run the maternity system.
Let’s look together at what New Zealand put in place in 1990 … a Midwifery Model of Care. Here’s a list from the midwifery viewpoint and from the expectant parents view.
MIDWIVES:
- Direct Entry trained in a 4 year program.
- Mentoring after training (still being improved)
- Can work in hospital as secondary staff … wages, shift, no personal clients
- Can work in hospital as Domino midwife … wages, shift, in a team with personal clients, can do home birth and hospital birth.
- Can work independently … work in pairs, paid for each client, can do home births and hospital and can continue care in hospital.
- Domino and Independent midwives offer continuity of care and primary care to all their clients.
- There is no shared care. The midwife continues continuity of care and primary care and is responsible for the client even if she needs obstetrical care.
- Midwives have a Partnership with women … and secondarily with the man/partner/family.
- Midwives have their own professional organization that’s independent from the nursing board.
- The midwifery professional organization (NZCOM) sees the profession of midwifery as ‘protecting and promoting physiological birth’.
- Midwives support ‘choice’ and ‘informed consent’.
- In 1990 there were GPs who also did births. Presently there are less than 50.
- Approximately 87-95% of pregnant families have their own midwife or team.
PREGNANT WOMAN:
- Maternity care is free. New Zealand has a Direct Health Care system with slightly higher taxes, choice of provider, referral to specialist when necessary, small co-pay for some visits and prescriptions.
- Most book with a midwife at 12-20 weeks, are seen monthly, then bi-monthly, then weekly until birth.
- The midwife attends the woman during birth when the woman needs her.
- The midwife continues care for 6 weeks after the birth … up to 12 visits.
- Women are expected to take responsibility to create a Birth Plan.
- New Zealand women love having a continuity of care/primary care midwife
New Zealand has the best maternity system in the world. It’s basically two tiered with primary and secondary care working through how to work together.
SO WHAT COULD GO WRONG?
- The C/S rate has almost tripled from 12.9% to 30%+
- The use of ‘interventions’ has risen.
- More women are ‘choosing’ epidurals and elective Caesareans.
- Midwives are exhausted and fewer are remaining as Independent midwives because they work 24/7
- New Zealand has NO societal expectation that families become skilled. ‘Taking responsibility’ is all about gathering information, learning the pros/cons of interventions, making ‘informed decisions’ and creating a Birth Plan.
- The New Zealand Ministry of Health is considering changing the system. That would be horrible.
NEW ZEALAND IS NOT THE USA OR OTHER COUNTRY
- The US had a Skills-based childbirth trend in the 1960s/70s. There is still Lamaze, Bradley and Active Birth. Birthing Better with The Pink Kit Method® evolved in the early 1970s but became publicly available in 2000. Hypnobirthing and babies is now available. But midwives were no longer integrated into the maternity system.
- In other countries, including New Zealand midwives were well integrated into the maternity system but rarely was there continuity of care. And no other country except the US had a Skills-based Childbirth Trend.
- Growing a Skills-based Childbirth Trend is entirely independent of the type of maternity system.
- A Skills-based approach to all pregnancies and every birth focuses on what expectant families can do for themselves.
- There are three roles in every birth: The skilled birth provider/s; the woman doing the birth, the father/other helping her. Each role requires skills. Presently only the birth provider’s skills are considered essential. Women have been told skills aren’t essential because birth is natural. Men/others have been told their role is to support a woman not to coach her.
- Every family needs to choose one or more skills-based resource, learn how to prepare the pregnant body to become a birthing body then learn and practice birth and coaching skills and write a Skills-based Birth Plan (what skills they will use). Then families need to use their birth and coaching skills in whatever birth unfolds.
STRENGTHENING THE MIDWIFERY MODEL OF CARE:
- New Zealand already has a wonderful two tier maternity system but it’s not working because the Partnership Model does not require families to become skilled.
- The NZ Ministry of Health could supply multiple copies of the three best known skills-based resources to midwives. NZCOM could then include in their standards of practice that every family choose one or more skills-based resource as part of their Partnership’s responsibility.
- Midwives could help families create the conventional Birth Plan (what they want and don’t want … all about delivery of service) and a Skills-based Birth Plan (what skills the family will use) and then encourage the family to use their skills as their birth unfolds.
EVOLVING A SKILLS-BASED BIRTH PLAN
- It’s simple … if you’re pregnant get a skills-based resource, learn, practice and use your birth skills
- if you know someone who is pregnant give them a skills-based resource as a baby shower gift
- if you’re an independent birth provider then supply your clients with skills-based resources and EXPECT them to become skilled and ENCOURAGE them to use birth and coaching skills
- if you work with pregnant families as a doula or childbirth educator or other provide your clients with skills-based resources and EDUCATE them as to the benefits of having their own set of skills … let’s do it now.
Here’s a link. This link will be put on all the posts. Kristen has 6 kids, the last 3 are PK babies. She KNOWS about birth and is one of our affiliates. That means if you purchase The Pink Kit through her she gets a commission. Her husband Scott’s first baby was her first Pink Kit experience. He’ll explain how The Pink Kit made certain he was able to become a skilled birth coach to a woman who had previously had three great births! You can find their interviews on our YouTube channel.
Kristen’s written a time-line calendar for use of The Pink Kit. You just need to sign up to her mail list (we don’t keep a mail list) and she’ll send you the Time Line. She’s worked through both Edition #2 and #3 of The PInk Kit so she knows all it’s imperfections and la-dee-dahs past them to the skills she wants to improve for each birth. Can women and men have better births each time? Sure can! The more skilled, the more we master the experience.
http://blog.naturalbirthandbabycare.com/pink-kit-timeline-from-natural-birth-and-baby-care-com/
Please join the Movement to grow a Skills-based childbirth trend. Don’t’ let another birth go by without that family being skilled.
NEXT POST: SKILLS-BASED BIRTH STORY #6