I seriously considered if it was 'worth' coming to the Review this year, seeing as I had only one client last year. However, I am just as committed to providing quality care to one client as I was to 60 women. Also, I remain committed to the ideal of Review and wanted to show my continuing support to the process, as well as model practice for student midwives. Finally, if I ever go back to full time midwifery practice, I will be able to show evidence of my keeping up to date, as well as being able to claim a competency-based practice certificate.

Having a caseload of one woman in conjunction with my full time work as lecturer has been rewarding and challenging. It re-emphasised that my heart is in midwifery practice and that is where my talents lie. Thus, it was a real joy to be a 'real' midwife and get out of the office on a regular basis. I am very grateful to the midwifery team at Otago Polytechnic, in particular Sally Pairman, who has enabled me to do this with material and psychological support. I am also very grateful to my client "Anne" for allowing me to be her midwife.

I did not feel that I could take on more than one or two clients because of my commitments to teaching, family and my studies. Thankfully, everything slotted in extremely well and there were no problems around making decisions about priorities. I obsessed all the time and 'gave' Anne whatever condition I was teaching that week. It became clear that whilst my knowledge stays current, my confidence had dropped, which makes it all the more important to continue with practice. Having only one client as opposed to a larger caseload makes it easy to blow things out of proportion. So I needed to keep telling myself to 'calm down' and remember what I would do if I were in full time practice, and put everything into perspective. Having said that, I was able to spend far more time with Anne than if I was a full time midwife, and I believe she appreciated that.

The one aspect I am particularly pleased with is my management of the third stage, although I also have to acknowledge Anne's absolute faith belief in the workings of her body. My big challenge was Anne's problems with breast-feeding. I am not sure that there was anything else I could have done, and I wonder what was going on for Anne that I never picked up on.

My aims for this year are to have another client, if it can be arranged. I am completing my final year of my Masters' studies. I am carrying out a research thesis into how midwives use the Internet. I am also a member of the 2002 NZCOM conference committee in Dunedin.

I have put together an information folder that I can give my clients to keep as they materialise. I have joined the Dunedin Homebirth Association but am not an active member. I will probably let this membership slide as I do not have the time to attend meetings, although I continue my philosophical support. I had planned to offer myself up to join the Review committee but the conference committee has replaced that.


Professional development plan