Thank you to Marie and others who have responded to my query me. I welcome
the references and any further info you may have.
I am interested in women being "happy to be induced" earlier rather than
later.
Consumer satisfaction is difficult to accurately measure.
I was aware from Swedish studies that infection wasn't a major concern,
even when women with term PROM used hot tubs. However, I wonder if these
women were happy to be induced because they feared
infection/morbidity/mortality, or were anxious about delayed onset of
contractions after ROM; or were influenced by the common ("normal")
obstetric practice of inducing labour within a few hours of ROM, or was it
the physical discomfort?
It seems from my current research that women with the least knowledge and
lowest expectations of "natural", spontaneous labour (as opposed to
interventionist) & birth, are the most easily satisfied. Women who had
term PROM felt under obstetric pressure to "do something" ie.go into
labour, or else.
Your thoughts?
Felicity
At 07:42 PM 8/8/99 +1000, you wrote:
>Felicity
>
>The quote was from the 'Term PROM' study, the largest mullticentre trial of
>care for women with pre-labour rupture of membranes (PROM) at term. RWH
>Brisbane was one of the participating Australian Hospitals. It was
>published early in 1996 I think, and I dont have the reference here at
>home, but will locate it for you.
>
>And yes, it did find that the majority of women were happy to have labour
>induced (syntocinon or Prostin - 2 armsof the trial) than wait for 3 days
>to see if labour occured spontaneously (After 3 days those not in labour
>were induced by the methods previously mentioned - groups 3 and 4).
>However, there was NO STATISTICALLY SIGNIFICANT difference in outcomes, eg
>infection, perinatal morbidity/ mortality etc between the early
>intervention and wait up to 3 days, groups.
>
>The conclusions were that provided there were no signs of
>infection/impending infection it was fine for women to choose either
>immediate induction or waiting for a few days, though the women who were
>induced early were more happy with their treatment than those randomised to
>the delay groups. I feel using the quoted statement as information for
>women who MAY experience term PROM some time in the future, is misleading
>in that it gives only one selective view of the study and is a subtle form
>of coersion, to ensure that women follow the preferred course of action of
>a particular hospital should they be unfortunate enough to have PROM at
>term. While it may be true that most woment prefer induction to delay (and
>that's fine), these women are not being provided with the information to
>enable informed choice.
>
>Some women may feel strongly about waiting, providing mother and baby
>remain healthy, and that is their right. If they choose this option they
>should not be made to feel guilty, nor should they be pressured with scare
>tactics. Informed choice means that all the possibilities are presented..
>
>Marie Barton
>
> <[EMAIL PROTECTED]>
>> To: [EMAIL PROTECTED]
>> Subject: Re: Evidence based info
>> Date: Sunday, 8 August 1999 10:37
>>
>> Hi all,
>>
>> I am most intrigued by this statement:
>> "...in a large recent study more women were satisfied with their care
>when
>> labour was induced with intravenous oxytocin compared to a wait and see
>> approach."
>> Could somebody please direct me to the source/research?
>>
>> Many thanks,
>> Felicity
>>
>>
>>
>>
>>
>> >> Heather we are also reviewing policies at the BC as a result of a
>NHMRC
>> >Evidence Based Clinical Practice Research Program . The Mater Mothers'
>> >Hospital are overseeing this program they would be more than happy to
>give
>> >you some flow charts, guidelines and information sheets for Women to
>read
>> >I'm sure.
>> >>
>> >> We like to provide Families with research based, accurate information
>- if
>> >it does not become a compulsory addition to your policy manual you might
>> >like to have a look at the information from the MMH independently. For
>an
>> >example some quotes from the Families information sheet include
>> >> One in every 10 women giving birth will have TermPROM.
>> >> Research has shown that women with TermPROM who have labour induced
>are
>> >less likely to develop infection because they have shorter labours and
>fewer
>> >vaginal examinations during labour.
>> >> ., in a large recent study more women were satisfied with their care
>when
>> >labour was induced with intravenous oxytocin compared to a wait and see
>> >approach..
>> >>
>> >> mmmmmmmm if "one third of Women are GBS+", "1 in 1000 babies are
>> >affected ", 'usual' SROM is whilst labouring and "Approximately 20% of
>men
>> >and nonpregnant women with GBS disease die of the
>> >disease"...............................mmmmmmmmmm
>> >>
>> >> Heather in response to your request Anne Eaton the Womens Health Unit
>CNC
>> >has this week competed the new policy for prophylaxis prevention of GBS
>> >infection I am sure she would be available to discuss your requests if
>you
>> >wanted to contact her. If you would like a copy I could send it to you.
>> >And lastly, when we as a team complete our policy for the BC I could
>also
>> >send you a copy.
>> >>
>> >> Some recommendations from the WHU policy
>> >> No routine A/N screening
>> >> Recommended I/P A/B <k35
>> >> ROM >18hrs
>> >> M temp _>
>> >> GBS colonisation ever detected
>> >> GBS bacteriuria " "
>> >> Previous infant GBS+
>> >> Rx M
>> >> IV penicillin 1.2g 4h for duration of labour or
>> >> Erythromycin if allergy 500mg 6h for duration of labour
>> >> *Aim at least one dose of A/B 4h prior to birth, however 2h will give
>baby
>> >adequate cover. Neonatal staff to be informed of m temp_> 38 in first
>24 h
>> >> Maternal Anaphylaxis Rx...........
>> >> Rx B
>> >> Urine spec
>> >> Gast asp
>> >> 1h obs for 4h then 4hrly until 24h old (cease if urine neg)
>> >> *If rec A/B not given or A/B <2h Rx penicillin imi 50mg/kg single if
>> >infection thought likely cont until culture results avail
>> >>
>> >>
>> >> Cheers
>> >> Katrina
>> >>
>> >> --
>> >> This mailing list is sponsored by ACE Graphics.
>> >> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>> >>
>> >
>> >--
>> >This mailing list is sponsored by ACE Graphics.
>> >Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>> >
>> >
>> ______________________________________________________________
>> "Never doubt that a small group of thoughtful, committed citizens can
>> change the world. Indeed it is the only thing that ever has"
>> Margaret Mead
>>
>>
>> _--_|\,-- From Townsville ** Felicity Croker
>> / \ in sunny ** Psychology & Sociology &
>> \_.--._/ North Queensland ** Centre for Women's Studies
>> v ** James Cook University
>> ** TOWNSVILLE, QUEENSLAND 4811
>> AUSTRALIA
>>
>> PH: (07) 4781 4909
>> INTERNATIONAL: 61747814909
>> FAX: 61 7 4781 5117
>>
>>
>>
>> --
>> This mailing list is sponsored by ACE Graphics.
>> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>--
>This mailing list is sponsored by ACE Graphics.
>Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>
>
______________________________________________________________
"Never doubt that a small group of thoughtful, committed citizens can
change the world. Indeed it is the only thing that ever has"
Margaret Mead
_--_|\,-- From Townsville ** Felicity Croker
/ \ in sunny ** Psychology & Sociology &
\_.--._/ North Queensland ** Centre for Women's Studies
v ** James Cook University
** TOWNSVILLE, QUEENSLAND 4811
AUSTRALIA
PH: (07) 4781 4909
INTERNATIONAL: 61747814909
FAX: 61 7 4781 5117
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
