Re: [ozmidwifery] back on the list

[Sandra J. Eales]

Marilyn I saw a documentary on this hospital on SBS a year or two ago and remember that the reason for the high incidence of fistulas from obstructed labours was because of the extreme youth of the women when they became pregnant.  Most of them were "child-brides" often married before they started menstruation.  Mostly muslim population felt that girls needed to be married whilst still "pure".  Their bodies and hips are not fully developed when they become pregnant at the very beginning of adolescence and so the high incidence of obstructed labour.  Campaign to convince religious leaders to encourage delay of marraige was a total failure.  Heartbreaking to see these little giggling 10 and 11 yr old girls playing with dolls being sold off in marraige with promise from the groom and his family that he would wait until after menarche to consumate the marraige and when TV crew returned to village a short time (weeks or months) later the "child-bride" is withdrawn and unsmiling and no longer a virgin despite the fact that she still has not had her first period.   Sandra Eales ----- Original Message ----- From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Sunday, August 25, 2002 11:45 PM Subject: Re: [ozmidwifery] back on the list Sounds like an obstructed labour to me. On that note, could any of you who have read "A hospital by the river"  fill me in on why so many obstructed labours were/are occuring in Ethiopia. I had imagined, before I read the book, that it was because of adhesions as a result of female circumcision, however, the author never once even hints at this practice. Her explanation is lack of medical care, women birthing first babies alone at a young age miles from hospital. The discriptions of such births are similar to Rhonda's description below with the exception that the woman is alone and c/s is not a possibility so she remains undelivered until the baby dies and passes macerated. Again, the description of the fistulas occurence is bladders bursting and tearing of the vaginal wall etc.. Is it just that with a population as large as in sub Saharan Africa, even a small percentage of women having this problem is a large number of women, is it malnutrition causing women to have deformed pelves, or was a political decision made not to mention the practice of female circumcision? Or is it some combination of all of these? The author says that such fistulas occured in Europe and America before the advent of successful obstetrical intervention (c/s, forceps). I am not trying to cast an doubt on the authors work, I think what she and her husband did for these women and what the hospital continues to do is invaluable, but I am really curious as to the origins of the fistulas. marilyn ----- Original Message ----- From: Rhonda To: [EMAIL PROTECTED] Sent: Saturday, August 24, 2002 5:07 AM Subject: Re: [ozmidwifery] back on the list To explain this I can only say what she has relayed to me -  they thought the head was on show and she had been pushing and pushing when a second membrane burst and what 'they' had thought was the babies head was a huge bulb of fluid.  The head was still right up there and not on show at all.  This was when the GP id the internal and said - "It wont fit!"  She was at this stage saying "shoot me NOW!  i just want to die."  She was in labour for 26 hours before the c/s and was totally exhausted - couldn't move for days, she was so bruised.  Couldn't pass urine for 2 days or use her bowels for over a week.    It was her last baby!  Hmm.   Rhonda.   -------Original Message-------   From: [EMAIL PROTECTED] Date: Saturday, August 24, 2002 21:12:06 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] back on the list   I have never heard of any one pushing for 8 or 10hours! Comments please. Love Lina Davern. >From: "Rhonda" &lt;[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: &lt;[EMAIL PROTECTED]> >Subject: Re: [ozmidwifery] back on the list >Date: Sat, 24 Aug 2002 00:40:40 +1000 (AUS Eastern Standard Time) > >Whoops - in this case she had been pushing hard for at least 8 to 10hours >and the head had still not moulded. She had C/S and his poor little head >was brused and baby was unable to straighten his head for months his neck >was sort of cricked. He was 9lb 8oz which was big for her. >Her second baby's head was 37cm - 8lb baby and she had a lot of trouble >ending in forceps and large episiotomy (Ob saying - this should have been a >c/s.) >The first and third were small babies 5lb and 6lb and she had no problems. >I guess after that length of time pushing and her history it was accurate. > >But, you are right moulding makes a big difference. > >Rhonda. > >-------Original Message------- > >From: [EMAIL PROTECTED] >Date: Friday, August 23, 2002 11:56:47 >To: [EMAIL PROTECTED] >Subject: Re: [ozmidwifery] back on the list > >It was only when he felt the head and the pelvis after full dilation that >he >could acurately say - "It wont fit." >I still think this is a dubious way to decide if the Head will fit through >as the second stage of labour (after full dilation of the cervix) moulds >the baby's head and allows the suture lines to overlap.. that is why a >baby's head is so soft. I t is amazing what time and patience will do >after full dilation. MM _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. . ____________________________________________________   IncrediMail - Email has finally evolved - Click Here