[ozmidwifery] Postnatal observations

[cummins]

Dear List   Sorry to go back over old ground (message sent by Mel Dunstan 17/11/04), but I really need your help in a Obs V Midwives battle against doing postnatal observations.  About 4 years ago we ceased doing postnatal observations on all 'normal birth' postnatal women.  Our postnatal unit has run perfectly since this time without incident relating to the postnatal care of wellbeing of the women we care for.  We use a pathway for signing off the education and the wellbeing of mother and child.   Recently we have had a visiting registrar who required postnatal observations on women.  This request has gone to our DON who demanded that our practice be immediately updated and that we do at least one set of obs per day on every woman. In our unit,we do not gain a numerical value from any machine, however, we ask the woman how she is feeling, we observe behaviour, we listen to the woman, we educate and spend time with mother and baby, we are 'with woman'!! and if there is anything deviating from the normal then we investigate further, often by doing observations, however, if there is no indication to do the observations, then I do not believe that they need to be done.  Four years ago, our unit progressed from being task orientated and medicalised, to caring for the individual and empowering the woman to care for herself.  A woman with child is not a medical emergency and removing routine observations is normalising this situation. I have no doubt the woman I cared for last night (day3, engorged breasts, tears, etc) would have an elevated temp, high heart rate and probably an elevated BP but I was already dealing with the problems and a set of obs would have proven NOTHING.    I am so very angry and frustrated that I am now faced with a situation where I need to find some recent evidence based practice to support the fact that we do not do routine observations.  We are having to re-invent a wheel that has been rolling perfectly well for so many years (until it ran over an obstetric nail).   If there is anyone out there who can help, please alert me to web sites, publications, anything!!   Thanks in advance   Felicity