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Lack of cooperation

Legally forcing midwives into compulsory collaborative arrangements won’t work, says a midwifery academic.

Writing in a recent issue of Women and Birth, Karen Lane, a lecturer at Deakin University criticised what she called the new “militarised” arrangements for midwives. She argued rather than encouraging a collaborative culture, it would instead “crush it”.

“Militarized collaboration and thus negates all that genuine collaboration stands for –equality, mutual trust and reciprocal respect,” she said.

She also said the AMA-negotiated determination for collaboration wrongly assumed midwives would be unwilling to work together with doctors, unless legally required to do so.

Rather, she said, it is often the doctors who are unwilling to collaborate.

“The assumption that midwives don’t voluntarily collaborate is wrong,” she said.

This she said was shown in a qualitative inquiry conducted into select caseload maternity units in South Australia, Victoria and New South Wales during 2009–2010. In many instances midwives and obstetric staff worked together successfully – without it being a legal requirement.

“The radiant success of many dedicated caseload units in achieving organic collaboration makes a mockery of the idea that midwives must be commanded to collaborate and that obstetricians are models of collaborative virtue.”

“The evidence shows that genuine collaboration is possible without legislative force but it requires a coalition of the willing among senior midwives and obstetricians to institute regular interdisciplinary meetings and clinical reviews and to model respectful behaviour to new entrants.

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