"Let us support one another, not just in philosophy but in action, for the
sake of freedom for all women to choose exactly how and by whom, if by anyone,
our bodies will be handled."
----- Original Message -----
Sent: Wednesday, December 08, 2004 3:09
PM
Subject: Re: [ozmidwifery] Routine
Observations in labour
I am finding this whole thread really interesting, and quite
horrifying all at once! If I were a labouring woman, I'd be blowed if
I'd be standing still to let someone monitor my pulse and resps every 1/2 an
hour! And for what? I can't believe that all of us don't
truthfully expect a pulse rate to be higher than normal when in active labour,
or that a woman labouring well in a warm pool might have a slightly raised
temp.
The way I see it, there are plenty of women having babies
who manage to stay at home until labour is well established, before they enter
a hospital or birth centre, or call their midwife to attend them at home, and
these women are not having any of that damaging neo-cortex stimulation from
someone wanting to observe and document their vital signs. Whilst I know
a baseline is important, should we not be assuming that in the absence of any
other signs, a healthy woman in labour is just that? Is it just the fear
of litigation that drives us to do half hourly obs? Or is it truly
justified from a research based perspective? I like to think that as a
midwife, I approach the whole idea of pregnancy and birth from a wellness
perspective, that a woman is healthy and well, and has the ability to gestate
and birth under her own steam until I'm proven otherwise. This
philosophy carries on in labour too, so why are so many of us suddenly
treating women like they are an accident waiting to happen when they are in
labour? Maybe there's that thought that a birth is safe and successful
only in retrospect, I dunno...
Working independently with normal healthy women, who expect
to be treated as such, we do a baseline bp in labour when we arrive, or when
the opportunity arises, (feeling their skin to do the bp gives you a good
indication of whether they are hot or not, and pulse is heard through the
steth during the bp reading) and if all's well, and their pregnancy has been
uneventful from that point of view (no hx of raised bp for example) then it
doesn't factor into it again, unless labour becomes prolonged, or we're
thinking about transfer into hospital. I don't feel that I'm
taking any chances in not doing these obs constantly, and the vast majority of
the women we birth with get on with it and birth, undisturbed by us clanking
around with a sphygmo etc. We check the water temp regularly, but this
is non invasive, and also listen to baby quite frequently, depending on what
the mum is comfortable with. Those who don't want any doppler are always
most obliging to let us know that baby is moving frequently. Stretches
the comfort level a bit I know, but when it all comes down to it, it's their
birth.
Anyway, just my 2 bob's worth...
Tania
----- Original Message -----
Sent: Wednesday, December 08, 2004 5:53
PM
Subject: RE: [ozmidwifery] Routine
Observations in labour
All these obs in labour. distracting
for the woman and annoying for the midwife. We do 15/60 fhr, although I do
it 30/60 early labour, and when I can in active labour, 15-30/60 if all has
been well. Any concerns I'll listen from cont. to cont. If I'm really
worried I'd do a ctg. 2nd stage 5/60 until hov then following every
cont. I try and slip obs in as I can. Temp 4/60,
bp2-4/24conts continuously, pulse 30/60. Ve's I don't
tend to do on multis unless they ask. Primips 6/24 from active
labour., no real hard and fast rules on ve's. As long as abdom.
descent can be detected and mum and bub ok there is no pressure.Observation
of iquor, what the woman is saying, how she is managing the conts, fluid
intake and output. If all has been well I do not interfere or
interrupt the woman, but take my chance as it comes.
MS
-----Original Message-----
From:
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[mailto:[EMAIL PROTECTED]On Behalf Of Anglodutch
NTL Account
Sent: Tuesday, 7 December 2004 5:22 PM
To:
[EMAIL PROTECTED]
Subject: RE: [ozmidwifery] Routine
Observations in labour
Oops, BP should be hourly of course, not 4
hourly!
Claudia
Dear All,
Talking about observations. Please take time to reply to this query.
What observations - how often, what type of
observations e.g. temp, pulse, BP, FHR, PV assessment etc. do you
do routinely on a normally progressing singleton labour?
With thanks,
Anne Clarke
