Safeguard the autonomy of midwifery practice

Earlier this year our colleague Deborah Purdue was struck off by the NMC. Details of the case and decision can be found on the NMC website under Fitness to Practise Decisions for March 2009. Three of the charges found to be proven relate to her not carrying out an internal examination until she had been in the home for 4 hours (Charges 1b, 2b and 4c). For many of us this is normal practice, particularly in the home setting. This decision by the panel seriously threatens the autonomy of midwives since it seeks to dictate the detail of how we practise. Guidelines are just that (local and NICE) and should not dictate our practice under individual circumstances. Looking at the detail of the case, with hindsight you may feel you would have done differently, but this petition is about the issue of when a midwife may choose to carry out this procedure in the course of caring for a woman in labour. Please sign this petition if you agree with the statement below. The idea behind this petition is to point out to the NMC that not performing internal examinations routinely is widespread practice amongst midives and therefore not a valid reason for striking a midwife off the register. Statement: Whilst we recognise that Vaginal Examinations are a useful tool to give information to include in the picture of the overall progress of labour and the wellbeing of mother and baby, as midwives we have many skills at our disposal to diagnose the beginning of labour and assess the progress of a labour, without routinely performing what is a physically and emotionally invasive procedure that is not in itself without risk*. It is our understanding there is no evidence that performing routine regular vaginal examinations safeguards the wellbeing of the foetus*, nor that it is an infallible diagnostic tool, since labour is a progressive state with many changing factors involved at any one time. We the undersigned would therefore not auomatically and routinely perform a vaginal examination on immediate arrival at labour and would use our clinical judgment, during any individual labour as to when and whether such an examination is necessary. Some women we care for have no vaginal examinations at all during their labours. * references supplied

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