[ozmidwifery] Horizontal Violence

Thu, 06 Oct 2005 07:18:09 -0700

Dear Sue
your response
 
I would have been shot down in flames for sure!
 
Has remindered me yet again of previous such expereinces of mine that now require me not to work in Mid for my personal health
and thus spurred me further to push for policies on Horizontal violence in midwifery and nursing groups here and nationally
 
I note ANF WA has got the govt backing a campaign of Zero Tolerance of Physical Violence against Nursing staff by patients but I have seen nothing about internal emotional or Horizontal Violence
 
If we are going to bring about meaningful change in services for mothers and babies we need to have policies and practices which name and deal with horizontal Violence
See Caroline Hasties great article for ideas
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, October 06, 2005 3:30 PM
Subject: Re: [ozmidwifery] Induction and third stage labour

As I understand the reasoning - the bigger than physiological contraction caused by the oxytocic bolus can 'squeeze' the placenta and cause blood to be forcibly transfused into the baby.
I agree that it really doesn't make a lot of sense - the cord-clamping website posted by Jenny however, does make a lot of sense, and I only wish hospital procedures allowed some flexibility and common sense to occur!  Especially in Rh-ve women and preterm infants as has been demonstrated to be of benefit.  We had a very prem baby last week, 30 weeks, which as a small unit we are not equipped to deal with.  He was OK and all went well but I was not game to suggest leaving the cord intact at the time,
I would have been shot down in flames for sure!
Sue
 
As for jaundice, none of my 3 had any at all. All very different births, all breast fed without interruption.  I have noted some increase when physiological 3rd stage practised, which begs the question - is it an abnormal event?
"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke
----- Original Message -----
Sent: Thursday, October 06, 2005 7:25 AM
Subject: Re: [ozmidwifery] Induction and third stage labour

I have to admit I've never really understood the reasoning behind the baby supposedly receiving a bolus of blood if the cord is not clamped after synto.  If the placenta is separating from the uterus how does that cause excessive blood to transfuse to the baby? 
 
Cheers
Michelle 

Susan Cudlipp <[EMAIL PROTECTED]> wrote:
The reason given for hasty cord clamping AFTER (not before) administering synto is not to prevent synto entering baby's circulation, but to prevent over tranfusion due to the excessive contraction thus produced 'pushing' too much blood into baby due to squeezing the placenta.  Synto infusions are given all the time for induction and I have never heard of any concerns about it entering baby's circulation.  The synto bolus injection is justified as a means to prevent PPH, the baby's needs are not apparently considered important!
I realise that IPM's only give synto if needed, and when cord has ceased pulsations, but the policies of most hospitals for ACTIVE management of 3rd stage says: 1). give oxytocic with anterior shoulder, 2). clamp and separate cord as soon as baby delivered, 3). commence controlled cord traction as soon as uterus felt to be contracted.
 
I hasten to add that I do not agree with this, but have had reason to research it quite a bit lately and have found, like Karen, that the textbooks and  policies are not crystal clear and many are very much opposed to each other.  Case in point being Obstetric guidelines vs Midwifery guidelines both in circulation in the KEMH policy manuals.
 
Sue 
"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke
----- Original Message -----
Sent: Wednesday, October 05, 2005 11:03 AM
Subject: Re: [ozmidwifery] Induction and third stage labour

I am taken by surprised of this too....i teach the very same as you Karen.  I also believe that the cord should be cut immediately before giving synto, to prevent passage of syntocinon into baby's circulation....if cord is still pulsating, one would think this is possible as synto act quickly.  I am interested to hear everyone elses beleifs and practices too!
Cheers,
Tanya Fleming
----- Original Message -----
Sent: Monday, October 03, 2005 6:21 PM
Subject: [ozmidwifery] Induction and third stage labour

Dear List,

I’m a birth educator and prenatal yoga teacher in Townsville.  I hope these questions are appropriate for this list and would appreciate information from you:

 

  1. Induction.  Andrea’s Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and that’s what I’ve always taught in my Active Birth classes.  However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a women passes her EDD.  Can anyone clear this up for me?

 

  1. Third stage of labour.  I was under the belief that if active management of third stage was chosen, the cord had to be clamped and cut quickly to avoid an over-transfusion of blood from the placenta into the baby.  However, an OB recently told a client of mine that even if she had a Synto injection, the cord could be left until it stopped pulsing.  I’ve checked Myles textbook for midwives but it’s not clear on this. 

 

I appreciate your support.

 

Best wishes,

Karen Shlegeris in Townsville

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