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And so does Canada. Wow Denise, I empathise, I
really do.
marilyn
----- Original Message -----
Sent: Friday, July 16, 2004 9:58 PM
Subject: Re: [ozmidwifery] Birth summary
forms
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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