Re: [ozmidwifery] research @ uni

[Nola Aicken]

Jen, I have to agree with Mary's comments. I believe it is very 'institutional' to not 'allow' a woman to push before we do a VE to ascertain if she is fully dilated. Gosh, who are we!   Not only are we setting the woman up for intervention, because many women can be fully and then move into that resting phase before pushing, but we are taking away completely their confidence in their own ability to birth. In units like mine where some of the obstetricians set the time clock for second stage ie one hour for primi, half hour for multi, then I am certainly averse to jumping in and doing a VE. Surely as midwives we can observe the body language and hear the change in the woman's sounds. After bumper to bumper contractions, transition stuff and you hear those wonderful 'pushing' noises. Whoa, to me we are on a roll. Why would I want to do a VE!   As Mary so aptly states there are times that progress does indicate that we need to do a VE, but let's identify the normal and leave well alone. Sometimes yes, primis can be tricky, but time will tell. My unit is very obstetrical, but I rarely do a VE to establish second stage. Women who are regarded as high risk, have induction of labour, epidurals and other interventions are in a different category of course. You can't always rely on their innate ability to labour and birth because of the interventions and therefore cannot recognise the signs of normal progress so easily.   Tew (Safer childbirth) may be of help and the WHO guide to normal birth (1996). A great topic to explore and I wish you luck.   Nola  ----- Original Message ----- From: Jen Semple To: [EMAIL PROTECTED] Sent: Saturday, March 15, 2003 7:32 PM Subject: [ozmidwifery] research @ uni This semester @ uni we're doing a subject called Research in Healthcare (we share it w/ nursing & bioscience students).  For 1/2 of our mark for the subject, we have to write a research proposal w/ 2 other students.  At this stage, we've thought of a question & have begun to do a literature review & have hit a brick wall! Basically, we haven't found any existing research on our topic.  I know that doesn't neccesarily mean our topic is crap, but I don't know if that means if our topic is feasible or not! Just wondering what you all think... whether the topic's feasible, any article suggestions, or anything else that comes to mind.  Here's our question: "Do women need a routine VE to confirm they're fully dialated before they are 'allowed' to begin pushing?"  or alternatively "Does performing a routine VE to confirm a women's fully dialated before she's 'allowed' to begin pushing reduce maternal &/or fetal outcome?" All of the midwives did a routine VE to confirm a women's fully dialated before she's 'allowed' to begin pushing @ the hospital we did our clinicals in.  & w/ increasing the risk of ascending infection, discomfort for the woman, the need to validate what the woman's body is telling her, etc... it just seemed really unnecessary. Anyway, it's early days, so if this question won't work, we have plenty of time to do something else. Jen Yahoo! Mobile - Check & compose your email via SMS on your Telstra or Vodafone mobile.