Hi Marilyn, Thanks for the clarification, pleased to hear that 2nd stage is the only time FHR would be listened to after every contraction. jo ----- Original Message ----- From: "Marilyn Kleidon" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, December 08, 2003 3:39 AM Subject: Re: [ozmidwifery] Fwd: response from Pat and Nicky and fetal hearts
> HI Jo: > > Listening in second stage is the only time one would listen after every > contraction which is often written "after every contraction or every 5 > minutes", if I typed every 2 it was a typo. And that would be active 2nd > stage. Should not be done so it interfers with any position the mother wants > to be in, which of course is the advantage of dopplers. > > marilyn > > > ----- Original Message ----- > From: "jo hunter" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Friday, December 05, 2003 8:44 PM > Subject: Re: [ozmidwifery] Fwd: response from Pat and Nicky and fetal hearts > > > > Hi Marilyn, > > I personally don't and didn't have a problem with my fetal hearts being > > listened to at my own homebirths where there was a midwife present. > > I think the argument is, correct me if I'm wrong, how often to listen in. > > Thinking of my own labours I would consider after ever contraction to be a > > bit over the top and I could imagine getting annoyed should someone be > > trying to do that to me. I'm not a trained midwife so have no idea what > the > > standard of practice is regarding this - but every 2 minutes??? > > I agree that hearing the heart when in labour is reassuring and reminds us > > of why we are doing the whole labour thing and yes, mothers should most > > definately not fear the midwife listening in. > > All the best > > Jo > > ----- Original Message ----- > > From: "Marilyn Kleidon" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Sunday, December 07, 2003 1:35 AM > > Subject: Re: [ozmidwifery] Fwd: response from Pat and Nicky and fetal > hearts > > > > > > > Hi Jo and all: > > > > > > This timing of listening to fetal hearts keeps coming up and I find it > > > concerning. Having worked and studied in the USA in homebirths and been > to > > > workshops with Ina May Gaskin et al., I do not recall any of my mentors > > > there even debating whether to listen to the FH or not during labour and > > > birth. I want to make it clear I am talking about studying in the > > heartland > > > of homebirth in the USA not some obstetric hospital there. Now we have > all > > > been to births where the last thing you have time for is getting an > > > obligatory fetal heart before the baby is born but that is a no-brainer > > and > > > a quite different situation from a midwife in attendance at a birth not > > > listening to the baby to avoid disturbing the ambience/mood of the > mother. > > > On our very first interview with our mothers to be we discussed how > mother > > > and baby would be monitored in labour the frequency etc., our transfer > > > policies, there were no surprises in store for the women. Our women were > > > happy to have their BP, pulse and temp monitored in labour and > understood > > > why and how often we would do this, they were also happy for us to > listen > > to > > > the baby at 30 min, 15 min, and between ctx intervals we would discuss > > doing > > > this with headphones if using a doppler, or using a pinards or a > fetoscope > > > if they didn't want the u/s technology used. As I think Lesley said, > there > > > are many births that the neighbour lady could have popped in to catch in > > > which these monitorings are nothing more than reassuring and they could > > lull > > > you into believing they aren't necessary, what we are there for is to > > catch > > > the anomolous birth where things aren't quite right and decisions need > to > > be > > > made. Also as has been said things can appear normal if you aren't > > > monitoring when in fact they aren't, sometimes mothers become aware that > > > something is amiss and other times they don't. Particularly when you > have > > > prolonged first or second stage I believe you need to be listening for > > fetal > > > well being. > > > > > > In the practices I worked in our transfer rate was low (between 10 to 20 > % > > > depending on the proportion of primips in the practice at any point in > > time) > > > as was the c/s rate (5%). I have to say that I have never been present > at > > a > > > homebirth where the monitoring appeared to have a negative effect by > > > increasing fear/angst, adrenaline etc, though theoretically I can see > and > > > understand the argument. Quite honestly I had never even heard > > intermittent > > > auscultation as being a problem until I read it on this list. I know > that > > > studies have linked efm and ctg's with increased intervention and so we > do > > > need to be aware of the misuse and misunderstanding of technology (it is > > my > > > understanding that it is not the trace so often that is wrong as the > > > interpretation of the trace as could be the interpretation of decels > heard > > > by doppler). I do think we need to be cautious about what we discard or > > want > > > discarded and I don't think mothers or fathers need to fear their > midwife > > > listening to the fetal heart: it should be reassuring. > > > > > > marilyn > > > ----- Original Message ----- > > > From: "jo hunter" <[EMAIL PROTECTED]> > > > To: <[EMAIL PROTECTED]> > > > Sent: Friday, December 05, 2003 12:23 AM > > > Subject: Re: [ozmidwifery] Fwd: response from Pat and Nicky > > > > > > > > > > Hi Nicole, > > > > Great to see you the other day - even though brief. > > > > About the hospital run homebirth service, I think that alot of the > > > comments > > > > that are seen as negative are a reflection of the lack of faith > > consumers > > > as > > > > well as midwives have in the hospital system. I think we all agree > that > > > Pat > > > > and Nicky are wonderful women centred midwives with alot of > experience. > > > The > > > > 'negative' comments, although may appear to be directed at them, > > actually > > > > are not, they are directed at the 'system'. > > > > We have a hospital system in this country that can't even serve the > > women > > > > who want to use them, with the majority of women (unless really strong > > and > > > > educated and well supported) suffering unnecessary intervention at the > > > hands > > > > of overzealous obstetricians. Midwives hands are tied because of the > > > > hospital protocols under which they must operate or they fear losing > > their > > > > jobs. This has been described by some midwives on this list as a > > reality. > > > > I was ignorant to this for some time, having had homebirths myself and > > > only > > > > knowing what other women had told me of their experience and treatment > > in > > > > the 'system'. Now as I support more and more women as their doula in > > > > hospitals I am appalled at what goes on. It must be the most > > > > incredibly frustrating job working as a hospital midwife and I applaud > > all > > > > who soldier on regardless. > > > > The reason a hospital run homebirth service concerns me is for the > very > > > > reason that it is hospital run. I don't doubt that the midwives > > operating > > > > and working in the service all have the very best intentions and all > > > > advocate women centred care, however I have to question whether, to > some > > > > extent their hands will also be tied with the fear of losing their > jobs > > > > should a situation arise that an Independent midwife may see as within > > the > > > > normal realm but the protocols and guidelines of the hospital system > see > > > as > > > > abnormal. There are many many > > > > 'situations' during labour and birth where this is evident (even down > to > > > how > > > > often a midwife should > > > > listen to a baby's heart during labour, whether this is necessary > after > > > > every contraction so the midwife has an idea of how the baby is coping > > or > > > > whether it is yet another unnecessary intervention the women is > > subjected > > > to > > > > that may > > > > interrupt the rhythm of her labour) > > > > Of course we are all striving to achieve the same goal, real choices > for > > > > women, publicly funded homebirth and one to one midwifery care. It is > > > > imperative that we get it right the first time round (for NSW) as this > > is > > > > most likely our only chance. > > > > So pleased you've joined the list Nicole - will catch you soon. > > > > Jo Hunter > > > > > > > > ----- Original Message ----- > > > > From: "Ron & Nicole Christensen" <[EMAIL PROTECTED]> > > > > To: <[EMAIL PROTECTED]> > > > > Sent: Thursday, December 04, 2003 4:37 PM > > > > Subject: Re: [ozmidwifery] Fwd: response from Pat and Nicky > > > > > > > > > > > > > Hi everyone, > > > > > As a newcomer to this mailing list, I haven't had the time to go > > through > > > > all > > > > > of the responses to the 'models of midwifery care' debate - but just > > > > merely > > > > > browsing through some of the e-mails - it perplexes me that there > > would > > > be > > > > > so much negativity - even more so - when we have two VERY > experienced, > > > > VERY > > > > > wise, VERY respected; VERY intuitive; VERY woman centred and VERY > > > > homebirth > > > > > orientated midwives who are at the forefront of developing such a > > model > > > > > inclusive of homebirth ..... that in itself will hold my faith, > > > confidence > > > > > and belief in this model. > > > > > I would also have faith in the midwives who would be part of such a > > > > model - > > > > > to be woman/family centred and have a strong belief and love of > birth > > as > > > > a > > > > > natural and normal family event ... I just cannot envisage a > > medically > > > > > minded midwife (which is contradictory in itself!) to be interested > in > > > > being > > > > > a part of this - nor do I see Pat or Nicky allowing such a midwife > on > > > the > > > > > team. I do not believe that a homebirth midwife attached to a > > midwifery > > > > > model at a hospital would be any less passionate and loving as an > > > > > independent midwife - and yes, I too can see interest from > independent > > > > > midwives who haven't practised since the indemnity crisis or from > > those > > > > who > > > > > need a bit more security - great!!! > > > > > Especially in the light of this ever increasing caesarean epidemic - > I > > > > > embrace and praise this attempt to provide homebirths as part of a > new > > > > > midwifery model. I know that it is something that I would absolutely > > > use - > > > > > especially when the cost of an independant midwife rules our little > > one > > > > > income family out of that league (our recent homebirth was a loving > > > gift). > > > > > I see it as a positive and exciting step forward in what is a very > > bleak > > > > and > > > > > dismal maternity service that currently exists. > > > > > I just hope that Pat and Nicky do not get so disheartened by the > lack > > of > > > > > support, that they would consider forgetting about setting up the > > > > proposed > > > > > model. > > > > > We should all be saying Go Pat and Nicky!!! (I know I am!!!). > > > > > > > > > > kindest regards, > > > > > Nicole > > > > > > > > > > > > > > > > > > > > ----- Original Message ----- > > > > > From: Andrea Robertson <[EMAIL PROTECTED]> > > > > > To: <[EMAIL PROTECTED]> > > > > > Sent: Thursday, December 04, 2003 3:03 PM > > > > > Subject: [ozmidwifery] Fwd: response from Pat and Nicky > > > > > > > > > > > > > > > > > > > > > > >Subject: response from Pat and Nicky > > > > > > >Date: Thu, 4 Dec 2003 13:59:40 +1100 > > > > > > > > > > > > > >Dear Andrea > > > > > > > > > > > > > >Thank you for sending us the emails that have been circulating > > about > > > > the > > > > > > >proposed homebirth model at St George.We find much of the content > > > > > > >insulting and grossly ill informed. > > > > > > > > > > > > > >It is hard to imagine where the information has been collected > from > > > and > > > > > we > > > > > > >find it very sad that so much can be said about what is not yet > > > formed > > > > in > > > > > > >any way. > > > > > > > > > > > > > >There is a meeting in a few weeks time and these views will be > well > > > > > > >represented and discussed in a respectful and honourable manner. > > > > > > > > > > > > > >Please do not forward us any more emails. > > > > > > > > > > > > > >You may post this onto ozmidwifery > > > > > > > > > > > > > >Many thanks > > > > > > > > > > > > > >Pat Brodie & Nicky Leap > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > -------------------------------------------------------------------------- > > > > -- > > > > > ---- > > > > > > > > > > > > > > > > > > > > > > ----- > > > > > > Andrea Robertson > > > > > > Birth International * ACE Graphics * Associates in Childbirth > > > Education > > > > > > > > > > > > e-mail: [EMAIL PROTECTED] > > > > > > web: www.birthinternational.com > > > > > > > > > > > > > > > > -- > > > > > 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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