Naomi
Where do they get these theories?!?! They need to revisit their teachings on mechanisms of labour and the passage of the baby through the pelvis. Descent and rotation of head, then shoulders has nothing to do with the most "powerful" contraction, but with the movement of the baby as it negotiates the pelvic floor. Any good textbook explains this clearly, it is essential to wait for the shoulders to rotate before attempting to deliver them. No wonder you are getting a spate of "dystocias" One wonders why this is not self-evident to those practising this theory.
My latest bone of contention is that the obstertric guidelines for 3rd stage (KEMH) states that CCT should be commenced immediately, and that to wait for (quote) "so called signs of separation" will risk a retained placenta. This staement is 5 lines long and accredited to only one doctor - no references or justifications. Whereas the same hospital guidelines, but the Midwifery ones, go into great detail about waiting for signs of separation, and are referenced and justified accordingly.
I only became aware of this when I challenged a doctor about his management of 3rd stage. He waved the obstetric guidelines at me and I was flabbergasted as I had the midwifery ones in MY hand. When there are two such totally opposing directions being followed it is very hard to reach any sort of agreement.
To check this out - those employed in WA can access the guidelines via the Intranet site. i just tried to access from home but was denied. It takes a bit of looking to find both but those of you at KEMH should have hard copies of the guidlines at you workplace. I feel that I should bring this to someone's attention but do not know where to go with it - and my suspicious nature warns me that they might just decide to adopt the obs guidelines totally and leave us with no back up for normal midwifery practice!
Sue
"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke
- ----- Original Message -----
- From: Carol Van Lochem
- To: [email protected]
- Sent: Sunday, June 26, 2005 5:55 PM
- Subject: Re: [ozmidwifery] broken collar bone & subsequent birth
- We have had a few here lately & I think it's to do with the practitioners. Docs are beeing taught to try to have the whole baby born with just one push. The theory behind this is the push that gives birth to the baby's head is the strongest and if the shoulders follow rapidly they won't have time to get stuck!!(Go figure). As a result we are getting an increased number of shoulder dystocias, and with in that group a number of fractured clavicles, where as I'd rarely ever seen them before. They appear to occur for the 2 docs that don't wait for restitution, but this is just anecdotal.
- Carol
- >From: "Susan Cudlipp" <[EMAIL PROTECTED]>
- >Reply-To: [email protected]
- >To: <[email protected]>
- >Subject: Re: [ozmidwifery] broken collar bone & subsequent birth
- >Date: Sun, 26 Jun 2005 14:26:36 +0800
- >
- >Quite possibly.
- >I do remember one very nasty shoulder dystocia waaaay back, resulting in a very depressed large baby with # clavicles. It was not a nice birth at all, but I was not really involved in it having come into the room on the emergency call bell.
- >I like what Gloria has written - makes a lot of sense. Unfortunately I can imagine that 'panic mode' would set in within a hospital birth and very few (drs) would be prepared to wait in such a situation.
- >Sue
- >"The only thing necessary for the triumph of evil is for good men to do nothing"
- >Edmund Burke
- > ----- Original Message -----
- > From: Mary Murphy
- > To: [email protected]
- > Sent: Saturday, June 25, 2005 8:31 PM
- > Subject: RE: [ozmidwifery] broken collar bone & subsequent birth
- >
- >
- > What is going on here do you think? Could position have anything to do with it? Eg. "bed dystocia"?
- >
- >
- >
- >
- >------------------------------------------------------------------------------
- >
- > Sue wrote: I have seen several, not always from shoulder dystocia, sometimes from that though, sometimes just a 'difficult' birth, one not so long ago was from a straight forward birth with no apparent reason.
- >
- > I agree that it is not a hugely serious situation and that the bubs do not suffer long-term damage, although obviously not the best!
- >
- > Gloria wrote: . I've never had one in my work either
- >
- > Mary wrote: I have NEVER seen a #clavicle in 26 yrs of both hospital & home midwifery,
- >
- >
- >
- >
- >
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