RE: [ozmidwifery] Post rupture discussion

[Julie Garratt]

Hi Lovely JoJ I was wondering if you were lurking coz I wanted to share a bit of advice I heard a very young doctor give a women in antenatal clinic yesterday, it takes the cake! He said and I quote, “In this hospital we have about a 25% caesarean rate, this means if a women gets pregnant four times she will need an operation to safely deliver at least one of her babies”  Well as you can imagine we had a chat about this in private afterwards. He hadn’t factored in VBAC, repeat sections ect, he just assumed that childbirth was dangerous and I suppose this is why he misinterpreted the statistics. Just a dumb mistake I suppose and it would have been funny if he hadn’t said it to a pregnant woman. Cheers, Julie GarrattJ   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Dean & Jo Sent: 13 October 2004 20:43 To: [EMAIL PROTECTED] Subject: [ozmidwifery] Post rupture discussion   Hi everyone, I was offline kind of when the uterine rupture thing was discussed. So sorry this is a tad old! Lol    As the co-ordinator of CARES here in SA you can imagine how familiar I am with this case and the repercussions of it.  VBAC was allowed in the birth centre at Flinders Medical Centre until July/August of 2001.  The refusal came just 5 weeks after I had my vbac in the BC at Flinders which was an amazing near water birth. I cried for days after hearing it.  We now no longer recommend FMC for VBAC. (Sorry FMC midwives on this list,  but we cant and wont whilst W&CH will accept them with OB approval which they have done and when TQEH was accepting VBACs even after 2cs before their unit closed.)   The ‘arguments’ for removing the right to birth in the BC after cs given to me by the head of OB during correspondence included the outcomes of the case in question. He probably wished he hadn’t brought it up as I made it clear to him that if the woman in question was in the BC then she would not have endured what she did.  He then fell back on the need for continuous monitoring reason for barring birth centre VBAC….don’t they LOVE that one!!  The reality of the new policy was that the vbac pendulum was given a right royal shove back into the negative with the release of the findings regarding this case.  I did read the comment about the complacency of VBAC that had occurred during the last few years with interest…I could see how that could be viewed.  BUT could it be the ever creeping obstetric interventions imposed upon VBACS that led to the increased rupture outcomes?  Do you know what I mean?   It concerns me greatly when outcomes from the management (or mismanagement) of vbac in the labour ward setting, (i.e. the medical model of vbac care), are used to negate the options of birth centre care of vbacs.  Has anyone actually studied the outcomes of VBAC in BC and compared outcomes with the medical model?  Not to my knowledge here in Aust.  There is only one study that was a US study in 1997 and the VBAC rate was 98%.  Lynne Staff has a brilliant VBAC outcomes in her unit also but do these ever get acknowledged when looking at safe vbac management?    Anyway, there’s my 2 cents worth ~ there were a few people wondering why I hadn’t made any comments to date.  Lol! Seriously though, it is a very interesting topic and one in which I relish being apart of!   Cheers Jo --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.775 / Virus Database: 522 - Release Date: 10/8/2004