Andrea's Papers

More Articles!: Andrea's Papers Birth Breastfeeding Midwifery Childbirth Education Birth Intervention Parents Articles by Author

Are midwives a dying breed?
by Andrea Robertson
The art of midwifery is being rapidly eroded as the swing towards the medicalisation of birth gathers pace. Midwives are not learning the basics of sensitive and woman centred care in their education because their clinical placements often occur in hospital labour wards where intervention in birth is the norm. Once in practice it is hard to gain confidence when so few normal births (no drips, drugs, monitors etc) are occurring. Midwives need to rediscover how to be really 'with woman' and there are some simple guidelines that can assist this process.

"Just listen to your body ..."
by Andrea Robertson
Many midwives encourage women to 'listen to your body' during labour as a means of tuning in to the demands of labour and finding appropriate self-help measures. This may be a foreign concept for the woman, however, who may have had little encouragement to trust the messages her body sends her during the pregnancy. Including some appropriate messages though the use of practical activities in your prenatal program can increase a woman's confidence of being able to work with her body during labour.

Help - it hurts! ... get me the complementary therapies!
by Andrea Robertson
Why are we so afraid of the pain of labour that we seem compelled to find ways of taking the pain away from women as they give birth? Very few women give birth without the use of medications, even when their primary care giver is a midwife. The increasing use of complementary therapies may indicate a growing awareness of the potential dangers of opiate drugs and epidurals, but relying of another type of pain relievers may still send messages that women can't manage labour without help. Are we unwillingly undermining a woman's confidence and self esteem through 'rescuing' her from her labour?

Watch your language!
by Andrea Robertson
The way we communicate with pregnant women is crucial to their perceptions of themselves as mothers. What we say and how we say it can have a profound effect on their confidence levels and their faith in their own abilities. For the educator, acting as an

Unexpected outcomes - mentioning the unmentionable
by Andrea Robertson
The topic of unexpected outcomes is often dreaded by childbirth educators, who may leave it out of their program altogether. Everything about labour and birth is unexpected, given that we cannot predict the future. The worst case scenarios to need to be tackled as they are issues that all pregnant women will have dwelt on at some point and to avoid talking about them is to devalue women’s feelings on these matters. There are ways the raise these topics that will enable fruitful discussion ...

Prenatal education ... time to lift our game
by Andrea Robertson
For the educator, expectant parents would have to be easiest group to work with: they are motivated, eager to learn and willing to accept anything we say. Yet many preparation for parenthood programs fail to reach their potential because the educator needs to be better trained, resources are limited and administrators fail to recognise and support the potential for life long learning these programs offer.

Working with the young and pregnant
by Andrea Robertson
Working with pregnant teens is a fascinating challenge. Designing an appropriate program will take care as their needs can be very different from those of older women and couples. They may need motivation to attend a group, and appropriate advertising will be essential to attract their interest. For many educators facilitating these groups will provide a welcome change from the more usual preparation for parenthood programs and considerable rewards.

Pregnancy tests - a vital topic for prenatal education
by Andrea Robertson
Including information on the various prenatal diagnostic tests that parents may be offered is vital if informed choices are to be made. The best time to include these topics is in early pregnancy, when expectant parents are being asked to consider their options. There are also a number of basic questions that parents will find useful to ask about any treatments or medications they are offered.

Getting what YOU want from pre-natal education ...
by Andrea Robertson
It is not always easy to present the kind of pre-natal program that you want as an educator. You may be hampered by having to work with larger groups than you would like, not having enough time devoted tot he program to include everything that you, and the participants, want to cover and funding may be tight for resources that will enhance your presentation. Don't just accept these constraints - you need a game plan to overcome these annoying obstacles.

Evaluating your pre-natal programs
by Andrea Robertson
Evaluation is an essential part of any educational program. It is important to know if your efforts are worthwhile and that your goals are being achieved, not only as a measure of your skills as an educator, but also to prevent burn-out. There is nothing more likely to produce frustration and boredom as a feeling that what you are doing is not valued or appreciated.

If your baby is breech
by Andrea Robertson
Most breech babies will turn naturally before labour. You will probably be referred to an obstetrician as these days few midwives will undertake a breech birth, even though in the past most midwives considered this within their scope of practice. There are still some midwives who are happy to assist with this variation of a normal birth, so it may be worthwhile asking around in your local community to see if you can find a willing midwife.

Pregnancy and birth are sexy? You bet!
by Andrea Robertson
Incorporating the subjects of sex and sexuality into pre-natal programs is often a challenge for educators. These topics, while essential and fundamental to the whole process of pregnancy and birth, are sometimes seen as embarrassing and awkward and are therefore shunned as 'too hard'. There are easy and fun ways to work these issues into your program.

Education for Informed Choice
by Andrea Robertson
"Informed Choice" - the buzz words of the moment in maternity care circles! How often are women exhorted to make an "informed decision"? How many times do these words appear in policy documents and procedure manuals? The reality is that this concept, of parents making truly considered decisions about their care, is a mirage. Too many times parents lack the information they need, are asked to make a decision under duress, or are presented with options in such a way that they are gently led to make decisions that fit comfortably with caregiver's and hospital's protocols, rather than the parents expressed needs or desires.

Evaluating your Prenatal Program
by Andrea Robertson
Evaluation is an essential part of any educational program. It is important to know if your efforts are worthwhile and that your goals are being achieved, not only as a measure of your skills as an educator, but also to prevent burnout. There is nothing more likely to produce frustration and boredom as a feeling that what you are doing is not valued or appreciated.

Video Time!
by Andrea Robertson
Using videos to enhance your prenatal education program is popular with parents. They are very comfortable with TV viewing and find it a familiar way to receive information. It is also a useful tool for the educator - it enables you to quickly illustrate points you are making, to include other speakers and viewpoints into your program in a brief yet effective way and it provides welcome variety and a break from other teaching strategies.

Watch your language!
by Andrea Robertson
Pregnant women are some of the most sensitive people you will ever meet. They are highly vulnerable and very suggestive, at a time when they are actively seeking information and support from a wide range of contacts. They listen to everyone and everything, read copiously, ask myriads of questions and are the recipients of mountains of advice.

Breastfeeding Confusion?
by Andrea Robertson
Muddled thinking about the concept of "informed choice" is impacting on effective breastfeeding promotion, especially in prenatal education. Many prenatal educators think that information on bottle feeding must be included in their programs to ensure that women have the opportunity to make a reasoned decision about infant feeding. Thus, details on "how to bottle feed" are explained in the belief that a balanced argument has been presented. This article looks at some of the issues surrounding this issue of breast versus bottle feeding and the role of educators during the prenatal period.

When you've got a problem ...
by Andrea Robertson
In the mid 1980s a Ministerial Review of the Maternity Services in NSW set out to define appropriate care for mothers and babies in this State. Consumers and the various health professionals working in the field formed working groups and hearings were set up all over the State to make sure that parents with different needs were heard.

Unexpected outcomes
by Andrea Robertson
One of the most fascinating aspects of birth is its total unpredictability. No-one knows what will happen and how those involved will fare, and no amount of preparation will ensure a given result. It's this uncertainty that makes giving birth both exciting and frightening!.

Obstetric Interventions Explained
by Andrea Robertson
Muddled thinking about the concept of "informed choice" is impacting on effective breastfeeding promotion, especially in prenatal education. Many prenatal educators think that information on bottle feeding must be included in their programs to ensure that women have the opportunity to make a reasoned decision about infant feeding. Thus, details on "how to bottle feed" are explained in the belief that a balanced argument has been presented. This article looks at some of the issues surrounding this issue of breast versus bottle feeding and the role of educators during the prenatal period.

The power of the group
by Andrea Robertson
For many couples today, having a baby can be a lonely experience. The trend towards smaller families and the isolation stemming from the lack of the extended family (or even a relative that lives nearby) means that many women and their partners find they know few people who are going through the same tumultuous period in their lives, otherwise known as pregnancy.

A new approach to prenatal education
by Andrea Robertson
Nobody can say how the current "accepted" approach to prenatal programs was determined - it seems to have evolved many years ago, and has never been seriously evaluated. This raises some interesting questions: how do we know that the typical model of 6 sessions per series of 2 hours each, starting at around 30 weeks gestation is the most effective format? Would some other format be more attractive or useful for clients? Would other approaches enable us to reach those people who normally avoid pre-natal education?

Get the fathers involved
by Andrea Robertson
Many midwives complain that fathers are "useless" in the labour ward C they sit and read the paper, hang about nervously getting in the way, or get agitated and upset and create anxiety for the labouring woman. Some hospitals still insist on antiquated rules such as "only one support person with the woman at a time" even though the research is clear that good social support makes labours faster and less painful for women. In these hospitals, the woman often has to rely on the father because she cannot have a female friend, and the poor father finds himself thrust into the role of having total responsibility for her comfort and welfare - enough to make even the strongest of men fearful and insecure

The Pain of Labour
by Andrea Robertson
Pain in labour is universal: it hurts to give birth. Since this is such a common experience it could be seen as comforting, a bond among women, a fundamental truth that confirms our special biological role and affirms the importance of our contribution to society. More often, however, it is seen as a blight, an unnecessary imposition, an affliction we must bear as the price for bearing children. This view, bolstered by the perception that pain is a symptom of disease and illness, has enabled medical men to convince us that pain is dispensable during birth, and is of no value, an evil to be cured with modern treatments and technology.