Re: [ozmidwifery] pelvic exams

[Marilyn Kleidon]

AS others have said we learn by asking permission of the women. At Seattle Midwifery School all the women were given a letter of informed consent by the senoir midwife who was our preceptor. At the very beginning of their relationship with the midwife they could choose to have a student involved in their care or not, they could also chose the degree of involvement and defer making the decision about our involvement until meeting us. All of us experienced 2 or three refusals in the process, it teaches you humility. So, they got to know us throughout their care and as the time for birth approached we discussed vaginal exams, our lack of frequency of performing them ( many women didn't have even one ve, most had one, usually at their request, and some had 2 ve's, if it became clear that labour was stalling and multiple ve's would be likely to hasppen over time we didn't compound the matter by adding extra exams) and who should perform them. Mostly it probably involved some degree of how comfortable they felt with us at this stage and how competent they thought we were. We took their blood and did many other exams along the way so they had some means of evaluating us. if we had just met the woman then we were the 2nd attendant at the birth not the primary.   About 2 yrs ago while i was living in the uSA, it was reported on public radio that medical students learned many of their procedures not only ve's but cannulation, urinary catheterisation, and more complicated vascular catheterisations on anethetised or even near dead or recently dead patients without any prior consent. It was quite an issue. One by one the medical schools were stopping the practice. We (as midwifery students) had to successfully cannulate, inject, pap smear, draw blood from, (read any procedure we performed on women) each other several times before attempting the procedure on clients. Of course we didn't get to do this with labour ve's, but we did learn the importance of explaining the procedure, talking the woman through it. The only procedure I declined having done to me at school, was catheterisation, as I have never had a uti, I just couldn't stand the thought of possibly getting one at 50. I offered my veins more often and my cervix. Medical schools were adopting the practice of paying women and men to be clients/patients for their students when they learnt to do pap smears etc, some of the younger women in my class did this for the University of Washington Medical School. They would get $50 an exam. Some made $600 in a night. It was really the logistics of doing a speculum exam not  actual paps. And, it was really teaching the students to be respectful and talk to the women.   marilyn ----- Original Message ----- From: Jo & Dean Bainbridge To: [EMAIL PROTECTED] Sent: Monday, March 17, 2003 2:28 PM Subject: Re: [ozmidwifery] pelvic exams How do midwives learn how to preform pelvic exams? Jo Bainbridge founding member CARES SA www.cares-sa.org.au [EMAIL PROTECTED] phone: 08 8388 6918 birth with trust, faith & love... ----- Original Message ----- From: Carole Claxton To: CMOB Sent: Monday, March 17, 2003 10:48 PM Subject: [ozmidwifery] pelvic exams I was flabbergasted when I read this,  but don't know how true it is!?! What a dreadful thing to do to women without their knowledge!! Carole Medical schools alter pelvic exam policies Some of the nation's leading medical schools have abandoned a little-known, decades-old practice of letting students perform pelvic exams on women without their consent while they are under anesthesia. http://www.msnbc.com/news/883838.asp