I wrote the following for another list I am on for doulas. This is my "Gold Standard":
What I would like to see, and aim for having established, in all institutions and practices that support pregnant and labouring women and new parents. The following is my gold standard. Perhaps yours is different. perhaps we should each have our own if we have any hope of effecting change. The Gold Standard for All Birthing Women: Antenatally: No routine testing for fetal abnormality: full explanations given of the false positive & negative rates, the benefits and risks, the decisions that need to be considered when there is a positive outcome to a test. No routine ultrasound scanning except by maternal request Full information provided on self help and dietary considerations for women diagnosed with GBS, gestational diabetes, pre eclampsia, anaemia and high blood pressure Quality antenatal education available for all Exercises taught to all women for encouraging a breech or posterior baby to turn ECV & moxibustion suggested and practiced wherever possible for breech babies All doctors taught the techniques & skills necessary for vaginal births of breech babies Consent forms for caesarean and epidural made available antenatally for women to read, ask questions about and understand Hospital policies and routines published and made available antenatally Labour & Birth The following not to occur unless there is a medical indication, which is explained ot the mother with the benefits, risks, alternatives and possible outcomes if nothing is done provided for her: IV's & heplocks episiotomy electronic fetal monitoring suctioning eye drops induction pain relief lying on the bed stirrups time limits AROM Vaginal examinations restrictions on eating and drinking stitching for first degree tears cord traction fo rnatural third stage drapes enemas The following made available in every birthing environment: massage oil mattress on the floor dimmed lighting adjustable temperature water in the form of bath or shower low lighting heat packs variety of seating (rocking chair, bean bag, birth ball etc) perineal compresses music All babies to be with mother immeidately after delivery, unless there is a medical need for baby to be separated Baby to be weighed and measured in labour room and returned straight to mother No baby to be washed or cleaned except by maternal request All mothers to be able to be upright and mobile if they wish to be, encouraged by the staff to do this Privacy available for all women, with all staff and attendants knocking before entering her room No pain relief to be offered by anyone in attendance, but available for any woman who would like it No limit on number of attendants that mother wishes to have around her Vaginal examinations only by maternal request unless there is a complication during labour Postnatally All mothers to be supported and encouraged to offer breastfeeding to baby within one hour of delivery No routine jaundice testing No baby's in nursery unless requested by mother No pacifiers or water to be offered No artificial milk to be offered to breastfed babies unless there is a medical indication Full information on the risks and benefits of vaccination Full information on the risks and benefits of circumcision A room set aside in the special care baby unit for intensive care babies for the parents to stay while their baby is in special care Breastpump to be available to all women with babies in special care All postnatal staff to be fully trained in breastfeeding techniques and possible problems All postnatal staff to be fully trained in recognising postnatal depression Support groups available, and contacts given to all women, of groups to support mothers with any problems or just to have support of other women postnatally That is what I am working towards. How do I do it? Empowerment of my clients. Education of the doctors I work with. Speaking up if I see something that I know is not supported by evidence and research. Don't sit back and expect things to change. They won't unless we make it happen. Don't blame doctors for being thoughtless, insensitive and not offering choice. If we, and our clients, don't ask for it to be any different it never will be. People do not change because everyone else is muttering to themselves about how awful they are. They change because of pressure. Because they start to hear of another way. Nikki Macfarlane ----- Original Message ----- From: "Johnston" <[EMAIL PROTECTED]> To: "ozmidwifery list (E-mail)" <[EMAIL PROTECTED]> Cc: "Robin Payne (E-mail)" <[EMAIL PROTECTED]> Sent: Sunday, April 14, 2002 5:07 PM Subject: FW: consumer representation > This message is from Robin Payne, who is a consumer activist > extraordinaire, and runs the Choices for Childbirth work in Melbourne. > > Dear friends > > I have become the consumer rep. on the Royal Australian & New Zealand > College of Obstetricians and Gynaecologist's (RANZCOG) curriculum > development committee. Next Thursday (18th April) I will participate in a > full day workshop on the curriculum with 15 other committee members (all > members of RANZCOG). I am keen to represent as broad a view as possible > although feel there are some fundamental commonalities that all women would > expect from the obstetrician as her carer. I would value any feedback and > comments from anyone who wishes to comment as I have been asked to make a > 10 minute presentation at the study day on "A Consumer View of What the > Obstetrician and Gynaecologist Needs to be Like in 2020". As this is coming > up fairly soon your comments would be appreciated asap. Even if you just > jot down key points, I can then incorporate them into what I'm saying. I > will also be providing feedback via the Maternity Coalition journal Birth > Matters on my presentation for the day. > Please feel free to contact via email or on (03) 9380 2863 if you would > like more info. > thanks, Robin Payne > --- > Outgoing mail is certified Virus Free. > Checked by AVG anti-virus system (http://www.grisoft.com). > Version: 6.0.286 / Virus Database: 152 - Release Date: 9/10/01 > > > -- > 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. 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