Hi Jo You have hit on a really interesting point here - what Jocelyn Lawler calls "Minifisms". These are words or statements people use to downplay or minimise something - draw their attention in another direction. Examples are 'I am just going to have a little feel' (where we minimise the discomfort or the procedure of VE), or to use your scenario, Jo...'the baby might have to spend a bit of time on the nursery, because sometimes they need to work a bit hard to breathe, after they have been born by caesarean', or 'it is much better, we use dissolvable stitches - much more comfortable than staples' or (in the case of forceps/ventouse) "we need to give your baby a bit of help to come out"
It's a different story when people talk about vaginal birth after caesarean - no minifisms there! We pack our language with terms that are VERY explicit in their message - trial of scar/trial of labour for example. I don't think there is such a term as "maxifisms", but I am sure we could coin it and come up with some beauties (along with the ones that already exist)! Yet, when discussing a planned caesarean, to get back to minifisms, you might hear "the doctor said the scar would be virtually invisible, and quite small - I imagined it would be much bigger than he said it would be" I was at antenatal class the other week, sitting on the floor in the middle of all the couples, with an epidural set, catheter, and IV set spread out in front of me, going through step by step the procedure of having one inserted, and what having an epidural entails. We also discussed the possible consequences of having an epidural (the anaesthetists at the unit where I work send out an infosheet to women which they have to sign that they have read, discussed with their obstetrician/midwife, and that they understand what is involved before they come to hospital - it lists the adverse outcomes which may be associated with epidurals and the sheet provides a great beginning point for discussions about it). ANYWAY, back to the story, the way that epidurals are discussed in general I think, has to be the greatest example of a minifism EVER! Women and their partners will say - "I never imagined it was so involved" (having an epidural), or "I jst thought I would have one if things got too bad", or - a classic comment here - "I never realised that this was such a big decision to make - that so much could ride on this, or that it could have such an effect on my labour! I thought having an epidural was a simple thing!" Mind you caesarean birth is coming up a close second in the minifsm race.... Just venting..... ----- Original Message ----- From: "Jo & Dean Bainbridge" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, March 29, 2003 6:20 PM Subject: [ozmidwifery] repeat cs candidates > I come across a number of women whom have had more than one cs and when I > talk to them about the risks of repeat cs, the ones who don't go off mad at > me for bringing it up, say that their concerns are for the babies safety > only. I find this incredible that they firmly believe that a cs is safer > for child. When I ask about respiratory disorder and so on, their response > is that they would prefer baby to be in a nursery for a few hours for > monitoring for breathing problems rather than neo-natal intensive care unit > for weeks/ months with brain damage. They seriously believe that an event > like that is common with vaginal births! Mind you, if you look at our > Australian society's attitude towards birth being fraught with danger, it is > easy to understand how these women think that it is true. > When asked about the risks to themselves, they say things such as "I am only > having one/two child/ren anyway" or they would prefer to have a cut on > their tummies rather than a huge tear from their vaginas to their > anus....again skewed view points showing through. (I usually say "well I > can tell you 19 staples in the tummy hurts like hell" "what do you mean > staples???" but now it is a dissolvable stich in many cases so it is even > more trivialised by some care providers) > Not really saying anything you guys haven't already heard but just thought I > would put the anecdotal information that I have come across with CARES. > > How many hospitals have a cs antenatal class? > > How many have VBAC classes? > > I have had a discussion with Marc Keirse (effective care) about introducing > VBAC models of care (in the form of VBAC clinics eg) however his first > thoughts were that it would marginalise VBAC. But my retort was that we are > already marginalised as high risk (no birth centre, continuous monitoring > time restrictions etc) but if we were cared for by educated supportive and > caring care providers who focus on our 99.7% chance of our scar rupturing > and not the 0.3% that it could, then being marginalised would be a good > thing. > Any thoughts on this suggestion? > > 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: "Lois Wattis" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Saturday, March 29, 2003 10:14 AM > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > feeding > > > > Dear Lynne and others on this subject > > I agree this information needs to be given to women antenatally in > whatever > > location they can be accessed. Problem is, women planning C.S. for > whatever > > reason frequently don't attend any antenatal education because they > consider > > they do not need it (not planning labour), so they are missed. Their > total > > exposure to 'education' is what they get from the ob (!!!) usually scant > at > > best. > > > > Another common situation is that they are not 'planning' another pregnancy > > so discount the potential consequences abnormal placental implantation in > a > > subsequent pregnancy. We all know some pregnancies occur - unplanned.... > > Women tend to hear what they want to, and discount the info they feel does > > not apply to them. I also find they (elective C.S. candidates) often know > > NOTHING of the potential risk for endometrial problems related to their > > scarred uterus.... another subject infrequently discussed in the "ob. > > education" process. Unfortunately, so many of the elective C.S. women are > > NOT making truly informed choices. (sigh) Lois > > > > ----- Original Message ----- > > From: "Lynne Staff" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Saturday, March 29, 2003 6:53 AM > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > feeding > > > > > > The potential for placental problems does not seem to be discussed with > > women when they are booking in for repeat caesareans. When I speak with > > women who are having elective repeat caesareans, they seem unaware that > this > > may be a consequence of this choice. As a result of this, this information > > is included in antenatal classes when discussing caesarean birth and also > in > > the VBAC and caesarean class. > > ----- Original Message ----- > > From: "Marilyn Kleidon" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Sunday, March 30, 2003 1:33 AM > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > feeding > > > > > > > Hi Sarah: I just wanted to add a note about the increased risks of > > placenta > > > previa, accreta, and percreta which are real risks to a populatiuon of > > women > > > who have had prior cesarean birth(s). However they really don't tell us > > > anything about this woman's actual risk. If she has had problems with > > > removal of the placenta after her previous cesareans then maybe this can > > be > > > checked out with u/s as this would tell us valuable info. We had a mum > in > > > for an elective repeat caesar the other week who had a known placenta > > > percreta (had been checked by u/s as having not grown through to the > > > bladder). There were extensive precautions taken to avoid an obstetric > > > disaster and they did. I think the risk of women having these placental > > > problems after c/s is a bit like women's risk of developing kelloid > > growths > > > after ear piercings: some of us will never develop them (0% actual risk) > > and > > > others will always develop them (100% actual risk), but we don't know an > > > individuals actual response until after the event, so all we can give is > a > > > population risk. > > > > > > I think an outcome of the increasing number of caesars occuring right > now > > is > > > this increased risk of retained placentas (accretas etc..) due to > uterine > > > scarring. Since we have not done this before I think we simply don't > know > > > what the risks of this particular outcome occuring will be. > > > > > > marilyn > > > ----- Original Message ----- > > > From: "Lynne Staff" <[EMAIL PROTECTED]> > > > To: <[EMAIL PROTECTED]> > > > Sent: Friday, March 28, 2003 1:16 AM > > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > > feeding > > > > > > > > > > Hi Sarah - has she considered labouring and giving birth? > > > > ----- Original Message ----- > > > > From: "sarah.darling" <[EMAIL PROTECTED]> > > > > To: "Ozmidwifery" <[EMAIL PROTECTED]> > > > > Sent: Thursday, March 27, 2003 4:03 PM > > > > Subject: [ozmidwifery] risks of 4th c/s and support for artificial > > feeding > > > > > > > > > > > > > Recent new subscriber here. I'm a community midwife in England and > am > > > > really > > > > > struggling to find research on the risks of a 4th c/s as opposed to > > any > > > > > other number c/s (i.e. what are the increased risks of a 4th c/s, if > > > any, > > > > so > > > > > that one of 'our' women can make a decision whether to try for a 4th > > > baby > > > > as > > > > > she has been told that 4 x c/s is 'too dangerous' - her quote). Also > > > does > > > > > anyone know of any research asking women whether, if they chose to > > > > > artificially feed their baby, they received support/teaching in > making > > > up > > > > > feeds, etc., singly or in groups. This is for a senior student and > her > > > > > dissertation. Really enjoying all the wisdom out there! Best wishes > > > > > Sarah Darling > > > > > [EMAIL PROTECTED] > > > > > Community midwife > > > > > > > > > > > > > > > -- > > > > > This mailing list is sponsored by ACE Graphics. > > > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > > > -- > > > > This mailing list is sponsored by ACE Graphics. > > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > > > > > > > > -- > > > This mailing list is sponsored by ACE Graphics. > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
