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Liz
As a mid student, I have also wondered about the
cervix closing before the placenta is birthed. With the birth of my third child
(at home) we opted for a physiological third stage and have since done some
research on the timing of cord clamping. It seems there is a lot of supportive
literature for delayed cord clamping with one of the few factors against it
being the fear of the cervix closing before birth of the placenta.
Tania
----- Original Message -----
Sent: Wednesday, July 14, 2004 6:59
PM
Subject: Re: [ozmidwifery] Birth summary
forms
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
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