European Workgroup of Independent Midwives

Aim of European Workgroup.

The aim of the European Workgroup of Independent Midwives is to strengthen the position of independent midwives individually as well as a group. To awaken and strengthen abilities of independent midwives by interchange and acquire knowledge by schooling, taking example and reflecting with colleagues.
Hereby the level of consciousness by independent midwives is raised professionally and socially.
The effect will be more self consciousness by independent midwives, social as well as psychological, who are therefore more able to meet the needs of women.
This effect will strengthen women in their choices and enable them more to give birth their own way.


Mission statement of the workgroup.

The European Workgroup of Independent Midwives is of the opinion that one of the elementary factors contributing to existence of midwives in Europe is the independence and entrepreneurship of midwives over the centuries in Europe.

The independence and freedom of midwives influences the freedom of women in childbirth.

The workgroup likes to stimulate the independence and entrepreneurship of midwives by giving a clear stimulant to individuals for further exchange of ideas, better co-operation, mutual enforcement and schooling.


The workgroup was set up by the following persons:

The workgroup is a new initiative and an action taken by motivated individual midwives in Europe.
The group members each have an individual connection to national and international organisations but like to work at this stage of development as an independent workgroup with various contacts in Europe. The workgroup has temporarily members from various countries.


Background for action and Initiative.

Cultural aspects of the home delivery in Europe.
There is a centuries old European tradition of giving birth at home, guided by educated midwives.
Early this century all children were born at home in European countries, with midwives as the normal and most important birth assistant. This tradition is mostly preserved in The Netherlands.

80% of the midwives in The Netherlands operates as a free entrepreneur and runs their own businesses, 8% of this group, does work as a freelance midwife or is temporarily employed by an independent midwife for replacement.
The number of independently practising midwives has increased in The Netherlands over the last decade by almost 40 %, while the number working in hospitals remained more or less the same.

In the Netherlands the midwife has a pivot function in obstetrics in recognition of her competence and social position in society. The insurance and care giving system of the Netherlands is also helpful for operating as an entrepreneur. Low and medium obstetrical care for midwives and the assistance of aid/attendant at every home birth.

33% of all Dutch women still give birth at home.

The recent "Home or Hospital Birth" study of Wiegers, 1996, in the province of Gelderland, The Netherlands, illustrates for the group she investigated:

"Women at low risk of obstetrical complications, the outcome of planned home births is at least as good as the outcome of planned hospital births for first time mothers, and that for other mothers the outcome of planned home birth is significantly better than that of planned hospital births".

During the last 5 years there is an increasing appreciation of home birth in Europe, especially in Germany and Belgium.

Midwives react positively and constructively to this situation and move from hospitals towards the independent practice and establish practices in cities and the countryside, or birth centres on set up demand. In this new situation the midwife is entrepreneur.

The legal framework for this independent work as midwife in the European Union is included in the Counsel Directive 80/154/EEC, by the European Community legislation in force.

Document 380L0154, Council Directive 80/154/EEC of January 1980 concerning the mutual recognition of diplomas, certificates and other formal qualifications in midwifery and including measures to facilitate the effective exercise of the right of establishment and freedom to provide services.

The education of midwives in the European Union is included in the Counsel Directive 80/155/EEC of 21 January 1980 concerning the co-ordination of provisions laid down by law, regulations or administrative action relating to the taking up and pursuit of activities of midwives. In these documents the minimum standards of midwifery education are laid down.

- Theoretical and technical instruction.
- Practical and clinical training.

The countries of the Union are allowed the greatest possible freedom in organising midwifery training.

Entrepreneurship of midwives is not mentioned in the minimum standard, neither is it a substantial part of the education in the various countries.


Market for the midwife entrepreneur.

In The Netherlands the midwife has 45% of the market in obstetrics.

In Germany 2%-5% and in Belgium about 1%.

In the opinion of the Workgroup it is now time to make midwives aware of the challenges, needs and demands of consumers. Midwives do not always reach the consumer, neither do consumers find their way to highly motivated midwives with their questions and needs.

Education, research and publicity will reinforce everyone (consumers and midwives) to be aware of their challenges and abilities.

Whether it is to give birth (as consumer) or support women giving birth (as a midwife).


Activities.

The European workgroup has long-term goals formulated. Aims for 1999 and 2001 are:



Financial chapter of the workgroup.

The workgroup wants to work at this stage of development independently.
The workgroup is a no profit and not sponsored group.


Literature:



Curricula of the members of the workgroup.

Mrs. Eva - Maria Muller - Markfort
Mrs. Eva - Maria Muller - Markfort finished nursing school training in 1960 in Verviers (Belgium) and attained a midwifery degree from Universite Libre de Bruxelles (Belgium) in 1961.

Practical work as nurse or midwife in Cologne, Paris and Saudi-Arabia.

Back in Europe in 1981. Since 1992 working as independent midwife incl. home births and care for medium and high-risk women in Ahlen, Germany.

Further education and certificates as psychological counsellor and psychotherapist.

Since 1989 active member of BFHD, Association of Liberal Midwives of Germany; representative of BFHD in the ICM, International Confederation of Midwives (Central Europe Region).

Presentations of midwives work at international congresses. Writes articles and translates from English-French news of importance for the journal of BFHD.

Member of AIMS, (Association for Improvement in Maternity Service) and Radical Midwives, Great Britain.

Started further training programme for midwives together with her husband, P.P. Markfort, Psychotherapist.

Focus: The psychological aspect of midwifery care - How to use hypnosis imaginative therapies, NLP Etc. to optimise continuity of care during pregnancy, labour and the post-natal period.

Eva - Maria Muller - Markfort is executive in the European Workgroup of Independent Midwives


Mrs. Anna Rockel - Loenhoff.
Mrs. Anna Rockel - Loenhoff a midwife since 1978 (Bochum, Germany).

Graduated medical doctor (1985, Essen, Germany) and psychologist (1976, Hagen, Germany).

She has three children, 1981, 1985, 1985.

Practised independent for 12 years as midwife and medical doctor in, by her own created midwifery centre "Zentrum Fur Geburt und Elterschaft" Unna, Germany.

Is teaching midwifery at the midwifery school Duisburg, Germany and co-author of the German study book for midwives "Hebammenkunde"(Art and skills in midwifery).

Mrs. Anna Rockel - Loenhoff is since 1984 active in the BFHD, Association of Liberal Midwives of Germany. Was from 1992 - 1998 President of the BFHD.

At the moment is her focus in the organisation on quality assurance and is she initiating European midwifery education.

Anna Rockel - Loenhoff is executive in the European Workgroup of Independent Midwives.


Mrs. Christina Oudshoorn.
Mrs. Tine Oudshoorn is midwife, since 1971(Rotterdam, The Netherlands) and university graduated teacher in midwifery and obstetrics, (1988, Amsterdam, The Netherlands).

She was for 20 years independent midwife in The Netherlands, Zandvoort, Aerdenhout and Heemstede, and several years (1994 - 1996) Director General of one of the direct entry midwifery schools with small maternity hospital, Kerkrade, The Netherlands.

She works for schools, organisations, midwifery groups and hospitals in Europe as consultant.

Designed schooling and information programs like the first re-entry course 1993/1994 for graduated midwives in The Netherlands for the SSOV and the WVS, The Association of Dutch Midwifery Schools and the Ministry of Health.

Recent was Tine Oudshoorn working in Bolivia, as researcher in an interdisciplinary research group investigating maternal death in the Andes.

She studies at the moment Psychology and Business and will finish her study with a research about the midwife as entrepreneur. Tine Oudshoorn is President of the European Workgroup of Independent midwives.


European Workgroup of Independent Midwives
Beatrixweg 14, 6285 NC, Epen, The Netherlands
Tel. +31 43-455 19 47
Fax +31 43-455 27 66
E-mail: europeanindependentmidwives@planet.nl

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