RE: [ozmidwifery] Re: Midwifery Educators

[Nicole Carver]

Hi Barbara, Do your parents have any say in the cord clamping? Perhaps they need more information such as at their education sessions? We also do active management, but Dad's are still able to cut the cord. Not many of our Mum's do physiological third stage. However, we had a lotus birth recently which went well. I believe that although midwives do not have a lot of power in hospitals, parents requests are often listened to. There is an opportunity to harness this to bring about a cultural change, and if parents continue to request certain practices they will break down the resistance to change. I have not given pethidine through an epidural before. We have infusions though. They are Fentanyl/Marcain and we do obs 5 minutely for 30 minutes, then full set of obs with pain score, sedation score, dermatomes and motor function, then pulse, BP, resps and sedation score hourly, with dermatomes and motor function 4 hourly. I think it is good to keep your obs consistent to save confusion, particularly with new or inexperienced staff. Cheers, Nicole.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Barbara Stokes Sent: Tuesday, October 25, 2005 10:15 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Re: Midwifery Educators Dear Midwives, I have just returned from our small hospital “midwives and doctors breakfast meeting”.  This is to encourage communication.  We have 4 GP/Obs and 9 midwivies. On discussion was a new policy for epidural-top ups: both pethidine only and marcain/fenytal . Policy is now insistent on bp obs 5minutely for 30 minutes for both top-ups. Other hospitals have had the pethidine only top-ups:  prior giving top-up bp, in 5 minutes and then in 15 minutes.   Does anyone have an email address for me to contact?   Also does anyone have policy or guidelines re allowing dads to cut cord?  This meeting has decided that no cord clamps (plastic) will be put on set up so the forceps are used, Dad can do a token cutting later (?how later) when cord clamp (plastic) is to be put on. I was hailed down when I suggested that a well baby could be put onto mum and continue with the cord clamp/ dad cutting cord when ready.  If the baby needed active resuscitation then quick transfer to resus. trolley would be normal procedure.   As you will have noticed our GP’s only do active 3rd stage, mothers have never heard of physiological 3rd stage even though same discussed at ante-natal classes.   Thanks from a disappointed midwife, Barbara