Hello all, I've sometimes felt a little alienated from many on this list, mainly because the women I work with have such a different focus from what is often described here- they want intervention, they want it now!! Our very competitive VBAC rate and lscs rate (for a tertiary referral hospital) are in defiance of our women's wishes. It is another kind of paternalism- denying women their request for a repeat lscs because our medical heirachy very much believes and pushes VBAC, regardless of previous experiences, regardless of informed requests, based purely on Drs wishes. But that's not actually what I'm wanting feedback on today (though I'd be interested in knowing if this lack of concern with mothers wishes is widespread...) When I went to work on Thursday night, there was a memo there discussing use of Syntocinon infusions and restricting augmented and induced labours to 3-4 contraction in 10 minutes, REGARDLESS OF INTENSITY so they may be 4 tightenings and there you go, can't turn up the synto, failed inductions all over the place, huge increase in c/s for failure to progress. That's one thing but the memo went on to suggest that in the case of spontaneous labour, if the contractions are more than we like, ie more than the 3-4 in 10, we should consider tocolytics. Is this the policy any where else?? We are being asked to interfere, say in a multip's labour who comes in in transition, contracting tumultuously as they sometimes do. For the reason that it doesn't fit our definition of acceptable labour. This is not an OB initiative, it was put out by the CMC with no consultation with Drs or midwives. The CMOs are as taken aback as we are. I'd love to hear if anywhere else does this. That little gift shop is getting closer every day, I swear. 9-5, can't kill or maim anyone, unlikely to be sued- very tempting. Monica
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