Re: [ozmidwifery] physiological 3rd stage

Mon, 20 Jun 2005 13:06:03 -0700

Thank you so much, Mary.  You've got to love Dr. John.  I have a story from the early days of Canada's settlement about 3rd stage management.  One of our First Nations women was taken to a "settlement" because the placenta seemed to be adhered to her body.  When the dr and nurses inspected, they couldn't believe that the placenta, uterus, bladder and bowel were all pulled out.  After that horrifying case, a public health nurse was sent in to the native settlement to find out what was going on with the mw because they'd never seen such a thing before---usually the mws handled things very well.  Sure enough, the nurse witnessed the mw jumping right away to pull on the placenta.  She had an overwhelming fear of the placenta being inside and, for some reason, thought it had to come away quickly.  The nurse grabbed her and prevented her from interfering.  The mw was beside herself but prevented from acting.  After 1/2 hr, the placenta came in a healthy way and the mw was amazed.  The nurse gave her an alarm clock and told her "If I'm not here, you wait 30 mins before touching the woman or I'll come back and hit you with a frying pan".  That became her rule and they never again had any transports to the settlement for p.p. problems.
 
After I read that story, I started having that policy too.  It works.  I think it's very important to tell the parents beforehand that the birth is not complete until the placenta comes out.  They must plan to continue with the dark, quiet and privacy of the birth until the placenta is birthed.  This discussion with both parents prevents the father from grabbing his cell phone and making announcement calls in that precious newborn time period.  The mw "guarding the normal" extends well past the moment of birth into the placenta and nursing time.
Gloria Lemay, Vancouver, BC Canada
 
----- Original Message -----
Sent: Monday, June 20, 2005 5:35 AM
Subject: RE: [ozmidwifery] physiological 3rd stage

http://www.midwiferytoday.com/articles/bristol.asp        Try this link Sue. Cheers, MM

Thanks Mary - I'd like to see it - would you post or fax to me?  Fax no is 94545953 - if you don't have it on file.

Sue

 

Sue I have an article By Dr John Stevenson critiquing the Prendiville third stage trial.  The doctors wouldn’t take any notice as they deregistered him for supporting homebirth practices etc. I’m sure I have it somewhere if you want it for yourself,  cheers, MM

 

Hi Denise

I wanted some info that I could use in promoting physiological 3rd stage to doctors.  I am aware of recent studies which say that oxtocin should be routine for 3rd stage, and this seems to have been adopted almost completely in hospitals.  Where a woman chooses otherwise there is little to help support her choice within an obstetrically managed model of care.  If there are any studies out there that could present this arguement I would like to read them.

The post script to this birth was that she had an induction yesterday at T+ 4 for raised BP, had a quick labour and normal delivery, standing, oxytocin third stage, but with a sympathetic midwife who did not 'rush' this bit.  All is well and home today, quite happy with events.  I just think it's such a shame that her opinion was opposed, fairly aggressively,  I wish we saw more women take the trouble to inform themselves as this young lady did.

Thanks,Sue

"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke

----- Original Message -----

From: Denise Hynd

Sent: Friday, June 17, 2005 6:47 AM

Subject: Re: [ozmidwifery] physiological 3rd stage

 

Dear Sue

Who is it you want the evidence for woman or the Ob?

The women has accept the dr's scaremongering

 

I think  both need information on what is informed consent

And she needs to be reminded to trust her own god given body's ability to give birth which if she were in many other "undeveloped" countries would not be questioned

 

see the Health Consumer's Council pages and leaflets

 

and as you sad on the cascade of Intervention

 

I can hear it in operation from here!!

Denise Hynd

 

"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."

 

— Linda Hes

----- Original Message -----

Sent: Thursday, June 16, 2005 10:03 PM

Subject: [ozmidwifery] physiological 3rd stage

 

Dear list-wives

Have just had a frustrating 'discussion' with one of our obs. A woman has written a very clear birth plan stating that she wants no interventions unless absolutely necessary.  The 'problem' being that she is a JW and will not accept a transfusion under any circumstances.  The said obs was of the opinion that she should not be 'allowed' the choice of physiological 3rd stage in this case so as to prevent the risk of haemorrhage.

I wonder if any of you know of any studies into physiological 3rd stage that I can use here?  There is plenty of 'evidence' about the 'wisdom' of prophelactic use of oxytocics, but naturally the doctors, and sadly very few midwives, have any experience of expectant management of third stage. 

I am quite upset about the attitude displayed here that the woman's informed wishes are not being respected, but of course got no-where in trying to discuss this.  This girl is no more likely to bleed than any other person, but she has now been 'persuaded' to alter her birth plan. The trouble is she now has a raised BP at term and has been admitted. I can almost hear the 'cascade' starting! 

Any good evidence gratefully recieved.

Regards, Sue

"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke

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