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Dear Jill
It is interesting that you are reviewing your
policy as I am currently doing the same! The sad fact of the matter is that for
many reasons women will choose to terminate a pregnancy. Sometimes
timing of genetic testing, awaiting results and decision making will bring
this closer to 20 weeks than is desirable for all concerned however, these women
are still deserving of the best available physical and emotional
care. Birthing rooms are perhaps not the most preferable venue
but they it is certainly better than a sterile surgical room. We have had
experience with cervagem and Alpha F2 in the past, but over the past 18 months
Dr's where I practise have been using misoprostil. This seems to be as effective
in producing cervical dilation as previous agents, but by observation it seems
to be a somewhat gentler agent. Dilation leading to delivery will take
longer than the previous agents and may need repeated doses over a 24 hour time
frame with contractions being their most severe in the first two hours following
application. The greatest difficulty that has occurred with this method is that
because this is a gentler agent sometimes these very small extremely premature
fetus' will be born alive despite gestation and birth weight. This of course is
extremely distressing for all concerned and parents do need to be made aware of
this possibility prior to the pregnancy termination process commencing as (in
Victoria at least) if this occurs this babe is legally required to be registered
as a live birth and then when death occurs a neonatal death. In this case the
parents are then required to make burial decisions. If you are interested in
sharing policies Jill I would be happy to post via mail
regards
Alesa
Alesa
Koziol
Clinical Midwifery Educator Melbourne |
