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In the "olden days", there used to be a guideline
for FTP that worked very well. . . .
"Never let the sun set twice on a woman
in active labour". So, from 4 cms there should not be two sunsets on that
woman. That's a good way to know that you're not dealing with an exhausted
woman whose uterus is bagged out. Of course, 99.9% of women will give
birth in this time. One of the cautions that I believe we should be
telling more women is not to wake up their husbands and to stay dark, quiet and
resting if the birth begins in the night. I think that coming into a birth
after working a "graveyard shift" means that the woman's endocrine system is out
of sync. It is very foolish to make a big dramatic deal out of early birth
sensations. Gloria
----- Original Message -----
Sent: Wednesday, February 01, 2006 3:09
PM
Subject: Re: [ozmidwifery] Resounding
failure of "active labour management"
I hear you, Helen! I know a
woman who dilated fully in 4 hours (yes, 4!) then had a rest and be thankful
stage of an hour during which it was decided she had "FTP" and she had a
repeat surgery. I spoke to another woman recently whose surgeon had just
told her that owing to her fairly short labour with her first child, she only
had 10 hours in which to birth the second or face surgery. Talk about
arbitrary! Marsden Wagner is right when he describes how much the timeline for
labour has shrunk over the last 20 years. I have a section on FTP, or as I
prefer to call it, Failure to Wait on my forums which provokes lively
conversation from many of the members who have scars on their bodies from this
particular myth. I have a great link to a hospy protocol on dxing FTP which
relies solely on machines to decide the appropriate strength of cx and then on
the clock to check for dilatation - woman stationary in the bed, of course, so
the machines can work. In the absence of "good enough" cx and time factors,
the woman is taken to theatre with absolutely no mention of how she or the
baby are going. Utter madness. We'll be like the US soon and our maternal
death rates will start to rise with the upping of initial unnecessary surgery
and then the refusal of VBAC.
J
----- Original Message -----
Sent: Thursday, February 02, 2006 9:49
AM
Subject: Re: [ozmidwifery] Resounding
failure of "active labour management"
I totally agree with all of your comments
Janet. My original bone of contention in this case however, is the
"time line" approach where if the cervical dilatation is slower than
everyone thinks is "normal" then the woman is whisked off for a
caesar. This seems to happen far too much still despite both mother
and baby coping just fine. I know what revelation it was to me 17
years ago when my friend went to Boothville in Brisbane to have her first
baby and was FULLY DILATED FOR 12 HOURS. I had not long done mid in
Darwin and couldn't imagine anyone being "allowed" to go that long with a
good outcome. Her daughter is very healthy! 17 years
later, I still can't imagine that happening in any mainstream
setting.
Tragic
Helen Cahill
----- Original Message -----
Sent: Wednesday, February 01, 2006
1:26 PM
Subject: Re: [ozmidwifery] Resounding
failure of "active labour management"
Rachel,
I only hear this from
health professionals. I don't hear it from women, not even the most
mainstream hospy birthing mamas with whom I deal. It's a very small
percentage of women who embrace this technology, and an even smaller
number who knowingly embrace it. If you read mainstream birth stories they
usually start with "My baby was 10 days overdue so my hospital/surgeon
said I had to be induced." The women are generally scared, although normal
physiological birth scares them too, but have no idea of the massive risks
involved. When it all goes pearshaped, as it so often does, the
hospital/surgeon and those around them tell the woman she is defective and
can't birth "properly". It sometimes leads to ERC solely for fear as
women are so shocked by the assault of active management that they seek to
control the process in future by choosing surgery without the horror of
labour under these circumstances. Of course, the profiting surgeon is only
too happy to oblige.
Apart from women
transferred from BCs to labour wards, the most traumatised women I see are
those who have had active management foisted on them by hospital policies
and the belief that you can't say no. Not that saying no helps women in
most hospitals anyway, you only need to read those same birth stories to
hear that also. Whatever MWs in hospitals are being asked about induction
and active management, women are really not understanding what it is and I
almost never hear of a woman who *wants* to be induced, they just don't
know they don't have to be. Most women now believe that
without interventions like induction and ARM that babies won't come and
that women don't know how to go into labour.
Tragic but something I
see all the time. Try some mainstream birth forums to read the same story
over and over and over again.
J
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