Not enough or is it too much, according to our JWH? Denise ----- Original Message ----- From: "Marilyn Kleidon" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Sunday, March 30, 2003 11:14 AM Subject: Re: [ozmidwifery] minifisms
> Seems like minifisms have been adopted by large segments of society at the > moment. > > marilyn > ----- Original Message ----- > From: "Lynne Staff" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Saturday, March 29, 2003 4:10 PM > Subject: Re: [ozmidwifery] minifisms > > > > Jocelyn Lawler - "Behind The Screens - Nursing, Somology, and the Problem > of > > the Body" > > Churchill Livingston 1991 > > > > "Minifisms can be verbal and/or behavioural techniques which assist in the > > management of potentially problematic situations by minimising the size, > > significance, or severity of an event involving a patient. They are also > > methods of bringing a situation under control..." p 166 > > > > She discusses minifisms as methods nurses might use to limit distress the > > patient might feel in embarrassing situations (eg 'you've made a little > bit > > of a mess', or 'you've had a bit of a bleed'), > > > > I am looking at them in the larger context of shaping the culture of care, > > by directing the course of events using words. It seems to me sometimes, > > that it's rather like a method of selling something - and the sales > people > > are more often than not very smoothe indeed! > > > > ----- Original Message ----- > > From: "Denise Hynd" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Monday, March 31, 2003 4:41 AM > > Subject: Re: [ozmidwifery] repeat cs candidates > > > > > > > Dear Lynn > > > Do you have a reference in regard to your perception /understanding of > > > manipulative language (? & behoviours) > > > That would help others of us not only become but learn how to tell with > > > thius?? > > > Denise > > > ----- Original Message ----- > > > From: "Lynne Staff" <[EMAIL PROTECTED]> > > > To: <[EMAIL PROTECTED]> > > > Sent: Saturday, March 29, 2003 1:16 PM > > > Subject: Re: [ozmidwifery] repeat cs candidates > > > > > > > > > > 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. > > > > > > > > > -- > > > 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. 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