Dear listers,
I am seeking some answers to queries about the
(NSW) Obstetric Data Base Format
Having come from another state (WA) where there
was only a Midwives Birth Notification form and that I was aware midwives can
suggest changes to!.
1) Does any one know who determines what goes
into the Obs Data Base or what questions are asked on these forms which
are filled out after a birth in a NSW Public hospital?
2) Are they only
completed in NSW public hospitals or are other states using them?
3) Are any private hospitals doing
them?
4) Are the same questions asked at every
hospital across the state or only across a health area?
I am concerned as there are implications on the
reflection, thinking and practice of midwives and doctors.
For example asking the practitioner
completing the form not only was there Shoulder Dystocia but to also to
grade SD as either "Mild, moderate or severe."
Similarly is the list of ante natal testing for
each woman going to increase or decrease depending on outcomes or if not
supported by EBP?
For example as we find more "abnormal OGCT" when
evveryone is tested etc or will the test results and costs be reviewed as
recommended in the Cocherane Dat base which now all NSW hospitals can access?
Such that this test becomes routine only for women who have symptoms
or other risk factors?
Mind you the Midwives Birth notification form
also have some implications on the practitioner also, for example the use
of obstetric language re-enforces the obstetric thinking and approach about
practice so most midwives deliver rather than birth women!
Thus I am wondering who reviews the format of the
Obs Database forms?
And what formal use is made of this data, for
example will NSW see a rise in the rates, concerns and looking for
Shoulder Dystocia, GDM such that obs are going to dispute the current low
stats about these problems?
I have always been concerned at the amount
of inservice there is in hospitals, obstetric and midwifery journals and the
like about the statistically rare obstetric emergencies PARTICULARLY WHEN
COMPARED TO THE AMOUNT OF RESOURCES DEDICATED TO education
about SUPPORTING AND ENHANCING NORMAL BIRTH in hospitals etc. Though it
is understandable when every midwife is asked such pointed and dubious
questions and Not asked was the care given evidence based practice
let alone woman centred!?
Denise Hynd
