Saturday, March 15, 2008
Thinking about midwives in second life
I have just returned from a walk up the river with my dog. He is a Clumber Spaniel just in case you are wondering and he is called Buster.
As Buster and i were walking along I was pondering the meeting I had in Second Life this morning with a couple of midwifery educators, one from Canada and the other from America. We had a really nice time, just the three of us. We went dancing on Koru Island. We listened to music, communicated through text and watched our avatars dance. We were all amazed at how good it felt and from my perspective it increased our connection and comfort with one another enabling us to communicate more freely.
Sudbury, Lisachris and I cavorted across the dance floor and did some amazing maneuvers. We spoke about possibilities of meeting with students in this sort of environment. We also discussed how we had been searching for places in second life where our students might be able to learn some midwifery skills. We had been looking for clinical spaces for students to learn some of these midwifery skills. This was a preoccupation of mine when I first came into second life and is something that has concerned me since then. My thoughts on this are changing and this was one of the things that preoccupied me on my walk with Buster.
Internationally there is a great deal of concern about rising intervention in birth In Australia in Florida and here is another from Australia, with some good discussion about the problems of caesarean, and this from my friend Sarah . There is lots and lots more on this and easy to find.
So we are concerned about this and many of these posts suggest that midwives are the answer. Midwives are the guardians of normal birth. Midwives can support women to avoid caesarean section. I believe the problem is that many midwives, who are receiving their midwifery education in this time of increasing intervention and rising rates of caesarean section, never get a chance to see women outside the clinical environment of a hospital, or perhaps an clinic type birthing centre. Those who have been fortunate enough to care for women in their own homes, even if they do not birth there, will know that there is a whole world of difference. This virtual environment, of Second Life, provides us with the opportunity to give our midwifery students a totally different environment. I believe many midwives are frightened of stepping outside the walls of the medical establishment. They are worried and concerned about how they might cope without the security they perceive within these walls.
I think the ideal birthing centre in Second Life already exists and I believe it is called Arwenna's Secret Garden. (I am not sure if Arwenna would agree though), somewhere very like this anyway. Imagine working with a woman who is labouring in this environment. Supporting her as the intensity of the contractions increase. Affirming her ability to do this job. When she feels the birth is near there are several places to go. There is a small hut with mats on the floor or there is the lovely rock pool. If there are problems we can talk with our colleagues in the medical establishments if we need to. If the labour was not going so well we could liaise as we would in the real world and transfer the woman to the hospital with all the bells and whistles. This would be great learning for our students. Supporting normal and helping the woman to birth in a lovely peaceful setting observing in case intervention is required. Talking with medical colleagues and supporting the woman as she transfers to a medical establishment and maybe continuing the care in this environment.
When I first came to New Zealand and for about 10 years I worked in Rangiora Rural Maternity Hospital. while I was there we created a small, peaceful, private garden for labouring women. More recently I have worked in Balcutha and Lumsden. All of these have private outside spaces where women can labour in a peaceful garden setting. This is not so unusual in rural maternity units in New Zealand.
Why should we recreate the medical environment that we know increases intervention in birth? Is it not more appropriate for us, as midwifery educators to try to give our students a sense of how it is to care for women outside this clinical environment?
I am not suggesting that this type of scenario based learning is just around the corner. I think as educators we have a lot more to think about and learn before we are ready to start supporting student learning in this environment. But we do need to think about what we want for our students when we are ready to do this and I do think this will happen. We could also be talking with our medical colleagues about how they see this working and the learning opportunities involved in inter-collegial communication. I do not believe that the profession of Obstetrics is happy about the rising caesarean section rates either, but normal birth is not their specialty it is ours. It is for us to support the normal and consult appropriately. This is the real way forward I feel. Mutual support and respect for the place and skills of the other, while keeping the woman and her choices at the center and as the focus of care.
I look forward to your thoughts and comments on this.