By Caroline Flint

No more midwifery education officers

In a letter dated 11th October 1989 Anthony Smith, `Director - Education Policy Implementation' of the English National Board for Nursing, Midwifery and Health Visiting has written to all senior midwifery tutors to inform them that in future there will be a 'development' in the role of education officers. Each education officer will work with a number of institutions across the entire range of courses for the training of nurses, midwives and health visitors - this `development' to come into operation on 1^st April 1990.

The implications of this `development' are that midwifery training schools will from April 1990 be assessed for approval or reapproval by `generic' educational officers. Thus a midwifery training school may be assessed by a general trained nurse education officer, or a health visitor trained education officer, or a mental handicap nurse trained education officer. Probably no one could fault any of these education officers in their education component, and this might be acceptable if midwifery education was all about education. If the education officers were only approving the educational component of midwifery training having generic education officers might be acceptable, but midwifery training and education has always been service based and herein lies its greatest strength. Student midwives learn most of what they do by example. They learn some of their knowledge in the classroom but a large part of classroom teaching is consolidation of that which has been learnt in the ward or community.

The effects of having `generic' education officers assessing midwifery training schools could have a catastrophic effect on the way women are cared for. Despite assurances that the `generic' education officers will have access to `specialist advice' from education officers who are trained midwives, they will not be going round maternity units with the eye of a midwife. We have said until our throats are dry that midwifery is different from nursing, that when a nurse looks after a patient that patient has to have by very definition `something wrong' with them. In midwifery it is not like that- women we care for have nothing `wrong' with them, they are healthy individuals who need support and empowering, not to be `cared for' even in the kindest fashion.

Ever since the Central Midwives' Board was set up at the beginning of the century we have had midwifery education officers who are trained and previously practising midwives. They have seen what the undercurrents are in a midwifery training school. Many a school has been buoyed up by the words from the education officer `I shall not recommend this school for reapproval unless...'. The unless has varied according to each school, it may be that the school will not be recommended unless they get more secretarial help, or books for the library, but it can also be that the recommendations will be withheld until the obstetricians stop being so interventionist in their management of labouring women and allow the midwives to practise as midwives, or it may be that the labour ward is so unpleasant for women to have a baby in that the school will not be recommended for reapproval until the place has become more appropriate for the accommodation of labouring women, or that untrained personnel are no longer allowed to give advice on breast feeding, or that obstetricians must stop seeing all pregnant women themselves and must allow some of the women to be seen by the midwives.

The effect of education officers with both practical and theoretical midwifery skills has meant a definite improvement in the climate for pregnant women, the gains in both `humanizing' of labour wards and antenatal clinics has been great, and the awareness of the midwife of her skills and role has been increased by the midwifery education officers

The other frightening aspect of this edict from the English National Board is that it has been sprung on us unawares (obviously deliberate). Where has the debate been? Where has the consultation either with the bodies representing midwives, or with the profession? For an elected body to deliberately cut off its electorate , to withhold information from those who voted for them is appalling. The midwife members of the Board have been looking preoccupied for several months; when asked what is the matter they have only replied `I can't tell you, it's confidential'. The English National Board took the decision to do away with midwifery education officers and replace them with generic education officers against the expressly stated opposition of the midwifery committee. This has forced the Chairman of the midwifery

The midwifery committee chairman's statement goes on `The English National Board's Midwifery Committee clearly and unequivocally opposed the concept of Education Officers undertaking a generic role, on the basis that it was a radical movement away from a proven specialist support mechanism for integrated midwifery education and practice'. The midwives we elected to the midwifery committee have been ignored , the discussions have taken place behind closed doors. One wonders how or why our elected members have been so intimidated that they have not been able to share their concerns and anxieties with their electorate.

But most worrying of all is that a principle fundamental to midwifery education has been steamrollered by the very body which has the remit to improve midwifery education. When the UKCC was founded in 1979 midwives expressed their concern that midwives' interests would be lost to the numerically superior nurses. To ally these fears, provision was made in the 1979 Nurses, Midwives and Health Visitors Act `that each board shall consult its midwifery committee on all matters relating to midwifery'. We now have a concrete example of this consultation process being woefully inadequate to safeguard the midwifery profession when the nursing majority holds a different view.

Perhaps it is time to take up the cry `MIDWIVES OUT OF THE STATUTORY BODIES' because we are certainly being destroyed by them.