Blog Launch – The Integrated Approach

Welcome to the first blog for my website launch.

Let me introduce myself…

Hi! I’m Rachel Di Re.

Now you may be wondering… ‘what kind of surname is that?!’ Well these four little letters, have caused much confusion over my life. (Ha!) It’s pronounced Dee-Ray (or close enough without an Italian accent) and is Italian for “Of the King”. Yep, that’s right, I am a descendant of the King of Artena, a Provence of Rome. Artena is a beautiful ancient village built high on a mountain, about 30 minutes south east of Roma. The saint of Artena is Mary Magdalene and for those of you who know her story, this is powerful symbolism.

There are many “Di Re” businesses and tombstones in Artena and as the story goes… the king had a truck-load (hmmm…. actually more appropriate for the time would be a “horse-cart load”) of children with the queen. Old Kingy had an affair with the young, beautiful house-worker and that broke up the family (insert eyeroll). When he died he left his fortune to his new wife and his children scattered around Italy, and his descendants around the globe. Eventually the Di Re’s moved to the USA and Australia…. hence why I am here!

Now that you have had a history lesson, you might be wondering how I ended up here… after many years of traveling and living around the world, living life to the fullest, running my own massage business, managing health food shops and practicing complementary therapies, I embarked into the world of midwifery in 2007. Today I am an Endorsed Midwife and have my own private practice in Brisbane, Australia.

What is an “Endorsed Midwife”

I usually say: “an endorsed midwife is similar to a GP for pregnancy”. Now obviously I’m not a doctor, but I have postgraduate qualifications which mean that I am able to prescribe medications, write referrals to other medical practitioners, refer for blood tests and ultrasound scans. I can also offer Medicare rebates for my services.

This is how midwifery in Australia has evolved in the past decade: allowing more autonomy to practitioners and providing Women a greater level of personal care.

Home Birth Trends

The world has changed immensely from the days of ancient King rule in Italia (mostly for the better). Childbirth has also seen many changes over the last century.

In Australia, the transition from home to hospital birth occurred as early as the 1920’s, much earlier than the UK. The UK’s transition wasn’t until the 1950’s, although 30% of Women were still allowed to birth at home, until 1967, when the Peel Report (https://nurturingbirth.co.uk/history-of-birth/) stated – with no clinical evidence – that ALL Women were to birth in hospital. Prior to the 1950’s, or thereabouts, births took place in the home with known midwives offering continuity of care. The transition to hospital was due to the belief that home births were unsafe.

During this time, most Women in hospital had their babies whilst under sedation and with the use of chloroform – now known to be unsafe (!!!), toxic to the liver and can induce respiratory failure; therefore, can be fatal.

Now let’s think about this for a moment… there are always risks associated with anything in life, childbirth included. Prior to all of the skills and information we have today, and which we are still discovering, my opinion is that it could have been risky having a baby at home OR in hospital back in those days. I also believe it could have been far less traumatic having a baby at home, rather than hospital, especially if a Woman was sedated and handed her baby afterwards.

Let’s jump forward to the 21st century; we have moved forward in leaps and bounds and deepened our understanding of pretty much everything! Childbirth included!

Specifically relating to childbirth – Women’s rights, modern medicine, complementary therapies, traditional medicine, science, personal choices, true safety, midwifery care, obstetric care, hospital births, home births, emotional wellbeing… you get my gist… and yet there is still a large debate on the best place for Women to birth with many restrictions on that choice, regardless of the location.

Whether health care providers support it or not, it really is up to individual Women to make that informed choice; based on personal preference, access to a supportive team whilst taking into account risk-factors.

I truly believe that a Woman should be supported to birth where she feels most comfortable, with the model of care that aligns with her values. Now, this may be with a private obstetrician in hospital, or an endorsed private midwife at home.

Having said that, the recent Birth Place cohort study (https://www.bmj.com/content/343/bmj.d7400) found that in first time mothers transfer to hospital was quite high (45%), mostly due to pain-relief request. There was also an increase of 4 per 1000 adverse perinatal outcomes. For second and subsequent time mother’s the hospital transfer rate is around 10%, homebirths had no more adverse outcomes than hospitals – therefore equally safe – and a marked decrease in interventions. I share this information with all of my clients to ensure they are making an informed decision, especially for first time mothers.

In my experience, I have seen it can be dangerous and futile to dictate health care to Women without truly hearing their needs. Many clients seek me out due to negative interactions with hospitals, doctors and blanket policies. As a midwife who has worked, in the hospital system, both publicly and privately and also in private practice and continuity of care models, I have found that the integrated approach is best to provide gold-standard care to Women. The blending of wisdom and science is what many Women want.

What I offer

As an Endorsed Private Practicing Midwife (EPPM) I offer a continuity of care model. This includes antenatal care, birth care and postpartum/postnatal care.

I have an integrated approach to all levels of care and I use a blend of natural and pharmaceutical medicines where appropriate and/or required.

For a full range of my services please see my private midwifery services tab on my website.

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