Delivering happy memories
Interview with Croatian midwife Iva Podhorsky Storek

   
”There’s a lot to be done when it comes to the role of us midwives, and after this workshop I feel I’ve got an idea of where to start,” says Croatian midwife Iva Podhorsky. Over a quick cup of coffee in one of the breaks during the Workshop on Clinical Guidelines Development, she reflects on her insights from three productive days in Split.

She has worked at the "Sestre milosrdnice" Hospital in Zagreb since 1993, the first ten years in the delivery ward and the last three as head nurse in the gynaecological/obstetric operation ward. A qualified position with considerable responsibility one might think, but not so if you ask Iva Podhorsky Storek.

“The problem here in Croatia, as in many ex-communist countries, is that midwives are not given any individual responsibility, we just follow doctor’s orders,” she says. Croatian midwifery students graduate at the age of 18 after two years of study and have no possibilities for further education in the field. In order to advance her knowledge and skills, Iva Podhorsky Storek has therefore chosen to study three additional years of nursing. The limited role of her midwifery colleagues continue to concern her, however.

“We function more or less like obstetrical nurses. We are responsible for the equipment and for looking after the delivering women, but all the decisions are taken by the doctors.” She had no great expectations when coming to the WHO workshop in Split, but says she has been positively surprised.

“I didn’t know what to expect, really, but just the fact that for the first time in my life I’ve come to a meeting together with doctors, makes it quite special.” The discussions with colleagues from the other countries in the Stability Pact has given her hopes that different professional groups can indeed cooperate and change things for the better. There is a lot of work to be done, not least regarding guidelines on midwifery care, she feels.

“In Croatia we have to start more or less from scratch by developing guidelines for normal, physiological deliveries. We still practice active management in many cases.” There is also the whole question of changing the attitude towards the women in delivery that needs to be addressed.

“We have to work on a more human and holistic approach, where the women are allowed to choose which position they want to give birth in for example. Today, there is a standard procedure for all, which doesn’t allow much catering for individual preferences.” Iva Podhorsky Storek’s conclusion on the Split workshop is that the aim of a midwife, and of all staff in perinatal care, should be to give the delivering women a happy memory to take home with them.

“Ideally they should want to come back and give birth again. As things are now, they usually have no desire to return at all.”
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