Re: [ozmidwifery] Re: uterine rupture 1998

[Belinda Maier]

I will throw a flame - what is a traditional midwife and why is this person always without faults and seemingly all knowledgeable and sanctified. Why should I as a midwife capable of managing women with induction's, ctgs, multiple iv lines and drugs, catheters, monitors, ventilated babies, suction, uvcs uacs etc etc be classed as something other (therefore subtextually less than)  this traditional midwife - where is she for sick women and babies who deserve a midwife. We have some crappy midwives in Australia, some fantastic doctors, some brilliant midwives and a whole lot of interventionist medicos. we all agree that medicalisation of childbirth is not good when so prevalently applied to all well women. Please do not separate midwives, it maintains the divide and conquer problem which means we can do less than if we accept diversity and stand together. This traditional midwife vs obstetric nurse stuff is a huge bug bear of mine. I attend homebirth as well and am quite confident and comfortable independently, but my ability to work in labour wards and NICU settings does not mean I work as an obstetric nurse - ever. I also work very hard with students and know full well the dilemmas they endure in their training and can understand their frustration Midwives cannot instigate a vbac induction alone - it is a medical decision   Inductions for vbacs is incredibly dangerous and stupid in my own opinion, I have seen two uterine ruptures in women attempting a vbac induction and invariably the epidural they also have does not help . However it stems from the problem of medical dominance in the perception of risk and management of childbirth and risk; and the limitations on midwives  (and lack of value accorded to midwifery ) - agency to practice and influence practice and management decisions in their own right  - and to develop and train in the wide gamet of midiwfery knowledge and practice. A continuing and complex debate/problem we are all trying very hard to change Belinda ----- Original Message ----- From: Abby and Toby To: [EMAIL PROTECTED] Sent: Monday, October 04, 2004 2:25 PM Subject: Re: [ozmidwifery] Re: uterine rupture 1998 >>While I do not support the notion that women desiring vbac are considered high risk or obstetric care, I do believe that once a decision is made to augment and/or induce a labour then the obstetrician needs to be consulted referred to and obstetric protocols need to be followed if the decision is made to augment/induce, even though midwives are providing the one-to-one care, it is now obstetric care.   I think the way midwives are trained now, they can still be the carer if induction etc was chosen because they are trained basically as obstetric nurses, not really in the traditional sense of a midwife. (Throw the flames if you want, but this idea comes from student midwives themselves.) Though, I would question any midwife that agreed or suggested medical induction for any woman having a vbac, it hikes the risk factor up by heaps. A scarred uterus is usually only at a higher risk of rupture than an unscarred uterus when unnecessary interventions are performed ie induction. I haven't heard or read of any woman having a vbac that had a uterine rupture that was labouring completely naturally, with absolutely no interventions eg. natural or medical inductions, ve's, ARM etc. I have met one woman that ruptured, not after a c-section, but her second son was born so quickly and ferociously she ruptured.   Love Abby