What our students say
BSc Midwifery student Michelle Baker, 26, on her experiences of a two week exchange programme in New York...
“In the final year of the BSc course, students have the opportunity to go abroad and compare different models of midwifery education and practice. The Faculty has an established exchange programme with New York’s Suny Downstate Medical Center
, with places available each year for a two week visit. You can also organise your own exchange to another country if you wish.
“Suny Downstate is a large academic medical centre with around 30 sites across New York. As part of the exchange programme, I attended midwifery lectures, was placed in hospitals and visited a range of birthing centers around New York.
“This was my first visit to the USA so I did quite a lot of sightseeing too. All the usual things – the Empire State Building, Statue of Liberty, a Broadway show... The lecturers at the Center gave us plenty of advice about things like which restaurants to go to!
“I found it really useful to see how midwives work in a different country”
“Midwifery in the USA was originally based on the British model, but there are aspects of it that have been implemented very differently. I found it really useful to see how midwives work and what their scope of practice is in a different country and culture. We often don’t think of the USA as being a very different culture to the UK, but in some ways it can be. It was interesting to see just how different things can be, and also to notice what we might learn from each other’s approaches to midwifery practice.
“The Suny Center is one of only a few places in the USA that offers a direct entry midwifery course, so it was a really good place to make direct comparisons with what we do here in the UK. Usually midwives in the USA have to be nurses first, then they do a masters programme in midwifery.
“In US hospitals, the care of pregnant women is very obstetrics-led. Babies are delivered by a doctor and a woman’s general care is given by an obstetric nurse. So midwives don’t have a very big role to play in hospital births. They tend to assess the progress of labour and report back to the doctors, and will give directions to the nurses, such as drugs to be given. They do quite a lot of ante-natal work such as family planning and reproductive health. So the midwifery courses in the USA have a much broader scope than in the UK and include things like pharmacology, gynaecology, family planning and sexual health.
“I found the lectures in the USA very different to those in the UK. Lots of them include information about the American insurance system, which is really quite complex. There are so many different kinds of insurance and certain types will pay for some things and not others, which can limit the healthcare choices available to people.
“On the positive side, in the US medical centers they offer a system of ‘continuous care’ where a woman is treated by the same team from childhood through puberty and into adulthood, menopause and beyond, so the care team get to know women and their histories really well. I can see how that could work really well in this country, if we had more staff and resources.
“We met some amazing and inspiring people”
“I really loved enjoyed the whole experience. The people were so friendly. I think the midwives at the Center do an incredible job in sometimes challenging circumstances. We met some amazing people, including Dorothea Lang, the first midwife to be registered in New York! Dorothea, who’s now in her eighties, has done a huge amount of work with the International Confederation of Midwives (ICM) campaigning for the midwifery profession in the USA, for example in pushing for direct entry courses in midwifery and for midwife-led rather than doctor-led care for normal low risk births. I hope they will achieve that, but it would take a big change in their healthcare and insurance systems, which are geared towards doctor-led care.
“I would definitely urge anyone considering the exchange programme to go for it. It was a wonderful experience, and so interesting to see how the same job can be approached so differently in another country and culture.”