Title: Re: [ozmidwifery] research @ uni
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Dear Jan
Please phone me I have misplaced my diary and do
not have a sydney phone book now!
Denise
----- Original Message -----
Sent: Saturday, March 15, 2003 1:30
PM
Subject: Re: [ozmidwifery] research @
uni
Dear Jen
Start by obtaining the two
references in the Myles Textbook for Midwives. They are listed on pages
463 and 464 in the thirteenth edition. You may have a later edition
than this.
Duration of the second stage (Sleep et al 1989)
Sleep
suggests there is no good evidence that the imposition of an upper time
limit for duration of second stage improves the outcome for mother or
baby.
Benyon 1957 suggested that active pushing during the latent
phase of the second stage achieves little more than exhausting and
discouraging the mother.
Benyon 1957 also demonstrated that
spontaneous delivery was not speeded by maternal effort at this stage. Passive
descent of the fetus should be allowed to continue until the head is visible
at the vulva.
While I can�t provide you with evidence other than
empirical, I agree with Alesa; Midwives who have been around labouring women
on a continuum never perform a VE whilever labour progresses and the fetal
heart sounds remain normal.
You could interview some homebirth
midwives about the number of internal examinations they perform and perhaps
review the partograms of a small group of hospital patients and compare them
with a matched group of IPMs clients who birthed at home. This would probably
demonstrate that continuous care leads to less vaginal examinations in labour.
Jan Robinson
__________________________________________________________________________
Jan
Robinson
Phone/fax:
011+ 61+ 2+ 9546 4350
Independent Midwife Practitioner
e-mail:
<[EMAIL PROTECTED]>
8 Robin Crescent
www:
midwiferyeducation.com.au
South Hurstville NSW
2221
National
Coordinator,
ASIM
__________________________________________________________________________
On 16/3/03 12:28 AM, "Alesa Koziol"
<[EMAIL PROTECTED]> wrote:
Valid research questions, although
the first one is better worded (IMHO) however, the practice of VE to confirm
full dilatation is not universal although if this is the practise that you
have witnessed ...............................
As you state there are so
many other signs that a Midwife who is astute will note that confirm full
dilation has occured- especially if she has been accompanying the woman for
some time along her birth journey
Alesa
Alesa Koziol
Clinical Midwifery
Educator
Melbourne
----- Original Message -----
From: Jen Semple
<mailto:[EMAIL PROTECTED]>
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
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