Re: [ozmidwifery] Epidural top-up Policy and breast feeding

[Susan Cudlipp]

Title: Re: [ozmidwifery] Epidural top-up Policy

Justine, you wrote:   As to who should do it, yes let the Drs go for it, it's their domain!  If midwives determined what was and wasn't midwifery then we would have real change in this country NOW. That is an interesting point, and raises some very amusing mental imagery!  Maybe I'll try that next time :-) But seriously, epidurals have become a very entrenched part of the whole 'having a baby' package, and we as midwives are charged with the minute-by-minute care of our women, therefore it does need to be within our scope of practice.  Epidural anaesthesia DOES have a place in SOME births.  Until women are better informed and realise that they are being hoodwinked into believing that birth is a serious medical condition, change will not happen.  Until women have a real choice to opt for midwifery led care, the obstetric model will continue to dominate.   The thread on breast feeding is bringing up much angst as it always does.  From my own experience, I fed my 3 children with much joy and varying degrees of sucess.  Being a midwife did not actually help me a great deal!  The first 2 latched on with ease and I rather smugly thought "what's all the fuss about?" but I did not manage to feed them for long ( 12 weeks and 6 months respectively) The third one was completely different, which taught me that a great part of feeding came from the baby, she seemed to have such a different 'suck' from her brothers and made me very sore in the beginning. It was not on my agenda at all to bottle feed and fortunately I was able to work through the many problems. In the end I fed her until she made the decision to stop at 15 months. As a midwife I support my clients in whatever their choice is.  I will naturally promote breast feeding and do all in my power to help it be successful but I respect a woman's choice, if that is not what she wants to do, it is not my place to make her feel guilty or a failure. I do not believe in women suffering for an ideal (particularly if it is not their own) and I have seen many women struggling with guilt as well as sore nipples when they truly do not want to continue breast feeding.  The "Nipple Nazis" are real - even though I am sure none of them realise that is how they come across.(can think of many examples of this) For a great many reasons some women just do not feed successfully or with pleasure.  Probably 1-1 mid care would help many sort out their feelings prior to the birth, but it would not be a cure for all.  Just my thoughts on this Sue "The only thing necessary for the triumph of evil is for good men to do nothing" Edmund Burke ----- Original Message ----- From: Justine Caines To: OzMid List Sent: Thursday, May 19, 2005 8:07 PM Subject: Re: [ozmidwifery] Epidural top-up Policy Dear Lisa and All You seem to have missed my point.  I did not advocate against women choosing an epidural, I said the use of epidurals should not be within a midwifery scope of practice and I stand by that.  I find it insane when a fraction of midwives actually work as midwives and yet we yell and scram to keep supporting all the obstetric who ha.  Don't worry all that stuff is very safe.  I agree every woman needs a midwife, regardless (but topping up the epidural is not being a midwife) As to who should do it, yes let the Drs go for it, it's their domain!  If midwives determined what was and wasn't midwifery then we would have real change in this country NOW. We will never see midwifery practiced fully while there is such support for an obstetric model with all its trappings.  The balance is so severely skewed it is time to get realand establish what is midwifery and the right of healthy women to access it exclusively. With less than .2 of 1% of women being able to be cared for by a known midwife and yet women being able to demand epidurals, social inductions, and elec c/s I  know where the work needs to be done. As a woman I have paid $14,000 for homebirths, with not a cent in return.  Yet I  pay for the 30% rebate for privately insured women to have the works.   Something has to give. I really believe midwifery on the whole to be with well women with only an emotional and supportive role for women accessing medical care and intervention. Just because 80% of women currently receive intervention and many blindly ask for  it doesn�t mean it�s right, or that they are informed.  Most women are told an epidural can�t harm the baby!!   How can we say women really want/need an epidural when 99% of them are forced to share their most intimate moment with a stranger and nearly as many of them can�t even use warm water immersion and they are in a system that sets them up for failure (pelvis too small, big baby, unreal labour time frames etc etc!). What we know is that where midwives form a relationship with women the use of drugs is slashed.  In our local unit Epidurals are hard to obtain and consequently 2 are done each year, what makes these women different to the city women where it is peddled?? Hope this clarifies Justine Internal Virus Database is out-of-date. Checked by AVG Anti-Virus. Version: 7.0.308 / Virus Database: 266.11.9 - Release Date: 12/05/2005