|
Hi Jan,
thanks so much for your
post. I too would love to work outside the hospital system however being a
recent graduate and having no-one to "apprentice" me, I lack the confidence to
do so. I feel my only option is to work overseas for a while (an expensive
option with 3 children and partner in tow). In the meantime I embrace the
wise-woman knowledge I encounter on this list. I have another question too. The
docs where I work have the fear that the cervix will close before the placenta
can birth. I think this is their reasoning for manual removals if they are not
out in the specified time frame. Is this because of the syntocinon given for
medically managed third stage, or is this a realistic possibility also for
physiological third stage? Once again, forgive my ignorance.
blessings,
Liz.
----- Original Message -----
Sent: Sunday, July 11, 2004 6:42 AM
Subject: Re: [ozmidwifery] Birth summary
forms
Hi Liz
I'm lucky that I work outside the hospital system so
the guidelines used are safety and the mother's wishes. While ever there is no
bleeding I leave well enough alone. It is not good to meddle when conducting a
physiologic third stage. Although emergency drugs are in the family fridge
they are not used unless excessive bleeding necessitates it.
In this
particular case the woman had been vomiting towards the end of a very long
first labour so she was exhausted after giving birth. After warm herbal tea
for fluid replacement (and some home-made chocolate brownie to restore her
blood sugar levels) she put her newborn son to the breast but after that she
just wanted to close her eyes and sleep.
As it was well past midnight,
that was what I wanted as well,
I tucked my client into her bed where she
promptly fell asleep. I slept (very lightly) on the floor beside her. When she
awoke in the early hours of the morning she emptied her bladder. I thought the
placenta would come away then, but it didn't, so as the baby was still asleep,
tucked in with his father, we had a cup of tea and went for a walk.
It was
some walk, along the northern end of Bondi Beach, climbed up Ben Buckler and
walked another two blocks over the top of the hill. She was ready to come home
then as she felt she wanted to empty her bowels. So we headed home and sat on
the toilet again and with a mighty push the placenta was expelled.
On
reflection, there was no obvious oedema in the lower birth canal, so I assumed
this was simply a case of a very fit woman, with very strong abdominal and
pelvic floor muscles that trapped the placenta temporarily.
We still look
back on this experience and have a laugh at the memory of the neighbours (also
super-fit early morning walkers) out on Bondi Beach congratulating my client
on having the baby - not knowing that his placenta was still in situ as we
were talking!
I always get satisfaction when completing the Perinatal
Data forms for the Dept of Health.
Although there are not a great number of
homebirths recorded, the long third stages that often occur at home must
affect the state's records of the average time
taken.
Cheers
Jan
Jan
Robinson Independent Midwife Practitioner
National Coordinator Australian
Society of Independent Midwives
8 Robin Crescent South Hurstville NSW 2221
Phone/Fax: 02 9546 4350
e-mail address: <[EMAIL PROTECTED]>
website: www.midwiferyeducation.com.au
On
10/07/2004, at 8:30 PM, Liz Newnham wrote:
Dear
Jan,
what
did you do in the situation about the placenta? Where I work at present the
doctors get twitchy if a placenta hasn't birthed within an hour, let alone
eight (mind you - labour ward - tertiary hospital, policy of
CCT). Forgive my ignorance.
Liz.
-----
Original Message -----
From:
Jan Robinson
To:
[EMAIL PROTECTED]
Sent:Friday,
July 09, 2004 6:59 AM
Subject:Re:
[ozmidwifery] Birth summary forms
Hi
Sue
Not sure what birth summary forms are, but my Birth Register is
simply an excel spreadsheet with all the details .. name address age etc.
all the demographics. then time membranes ruptured (if less than an hour
before birth ... etc..) number of vaginal examinations (i love entering
zeros!) , length of each stage position for each stage ... time of birth ,
date of birth lots of stuff plus comments for anything interesting like
placentas in situ for eight hours , what we did about it , what type of
sutures were used, etc. The reason for it all being on a spreadsheet is so
that I can statistically analyse it to get the average age of my clients,
average duration of labour, first stage etc. It might be handy one day. I
would have to get m y daughter to help me with the analysis as I am not
brilliant using Excel, ... one of my clients set it up for me many years ago
... It's easy enough to do if you understand Excel. I think Robyn THompson
sets hers up on some similiar type of spreadsheet.. she was going to market
it at one stage. Hilda Bastian also had a brilliant one set up to go underd
the HBA banner. It was the best idea I had ever seen as it also had the
facillity for anylisising social data as well. She was going to get hers to
a marketable stage too but then the homebirth movement seemed to crumble
temporarily and it has been lost to us. It would be a great project for HBA
to tackle, but we could also get the NSWPD people to provide us with a
template for their data sheet with add ons. The USA midwives have one that
Maralyn Kleidon would know about but she is in the states at the moment.
Perhaps we could put pressure on the College to produce a workable one for
all homebirth midwives that could be used to collect research data for their
IPM Accreditation program that they are getting set up. Lots of
possibilities
Did you get the papers I sent you? We need to get the
new forms from Centre Link now.
Haven't got mine yet, they tell me they
don't have anymore as they had a printing mishap so I will have to go up to
my local office to get then.
Hope you and Arthur are both well. Give
my love to Penny.
Jan
Jan Robinson Independent Midwife
Practitioner
National Coordinator Australian Society of Independent
Midwives
8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546
4350
e-mail address: <[EMAIL PROTECTED]> website:
www.midwiferyeducation.com.au
On 07/07/2004, at 5:12 PM, Sue Cookson
wrote:
Hi all,
Can anyone email me copies of their birth
summary forms please?
Am looking to rewrite my own, but would love some
of your inspiations and insights.
Many thanks,
Sue and
Penny
--
This mailing list is sponsored by ACE Graphics.
Visit
<http://www.acegraphics.com.au> to subscribe or
unsubscribe.
|
