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Dear Liz
Once the elections are out of the way (one in WA
also coming up) I also am thinking of a year or 2 in either NZ or the UK to
keep my skills and energy up!!
I did my mid there many moons ago and have a friend
marrying there next year.
Meanwhile I cannot emotionally or morally
support our medicalised birthing environment and I wish that the majority
of Australian midwives would acknowledge that whilst they support it and
also do not work to change it, it will continue for those reasons not because it
can not be changed !!
I feel positve that change will increase and
occur not only becuase of the efforts of Maternity Coalition but finally by
efforts being made by Barb Vernon and others at the ACMI who are working for
real change and inspire others to act in concert with them and MC.
NZ shows us that in concert political action by
women and midwives can effect real change..
Denise Hynd
"Never believe that a few caring people can't change the world. For,
indeed, they are the only ones who ever have."
Margaret Mead
----- Original Message -----
Sent: Friday, July 16, 2004 7:09 PM
Subject: Re: [ozmidwifery] Birth summary
forms
Thanks Tania, Lois and
Marilyn,
it all helps. Andrea, I
would love to come to Sydney for Maggie's workshop (I've heard her talk at two
futurebirth conferences, and she's wonderful). I just feel that I would like
someone around for a while while I'm starting out. It's not only that I've
been trained in the system, it's also because of my relative
inexperience. That's why I'm thinking that a year in a caseload practice
(not many in my area - none in fact) in NZ or UK wpuld give me the grounding I
need.
Denise, I totally
sympathise. I too am working on NMAP and MC stuff, and really don't know
what to do next. Oh for a (big) fairy godmother.
blessings to you
all,
Liz
----- Original Message -----
Sent: Saturday, July 17, 2004 5:30
AM
Subject: Re: [ozmidwifery] Birth
summary forms
Hi Tania:
I don't think there is any research that
indicates an increased risk of the cervix closing during a physiological
third stage or expectant management of third stage. The risk of the cervix
closing before the birth of the placenta is associated with active
management of third stage that is it (the risk) increases after the oxytocic
has been administered, hence the often or apparently aggressive
delivery of the placenta in active management. There is increased risk of
PPH with expectant mangement of third stage (note not true physiological
management) as evidenced in the trials on the Cochrane data base. I have
read discussions that argue that this increased risk of PPH may
be due to provider/care giver error in how they manage expectant management
ie how aggressive are they with placental delivery are they prepared to
watvh and wait as jan has indicated?
marilyn
----- Original Message -----
Sent: Wednesday, July 14, 2004 5:02
PM
Subject: Re: [ozmidwifery] Birth
summary forms
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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