Re: [ozmidwifery] How long before synto is used?

[Stephen & Felicity]

"Policies and guidelines are not necessarily 'a load of rubbish' either...Unfortunately, we need these so that we all do the same thing..."   Therein lies the problem with "management" of birth...all women, babies and births are not the same, so if everyone caring for the woman and baby does the same thing, how can this possibly be considered appropriate evidence based care? ----- Original Message ----- From: sally @ home To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 2:13 PM Subject: Re: [ozmidwifery] How long before synto is used? I have to say that, unfortunately, many women are not in tune enough with their bodies to know whether they have ruptured their membranes or not. this is evidenced by what they say on the phone...eg " I'm not sure if I have broken my waters or not".  And we have had incidences of women desperate to be induced tipping a glass of water down their pants to make it look like they have!!   Policies and guidelines are not necessarily 'a load of rubbish' either, they are not just a bunch of words written down at the whim of an individual person. Believe me, having been on a guidelines development committee, with everyone from the Director of Obstetrics to midwives from the birth centre. It has taken over 18 months to review and rewrite only a handful of guidelines. Unfortunately, we need these so that we all do the same thing.There is enough confliciting adveice dished out by midwives as it is. Not all of these guidelines are restrictive and if women know enough to challenge them then I see that as good for the system. I just wish there were more women out there who would challenge the system.   However, whilst I was practicing as an independent midwife...I treated the women I was working with the respect and honour that they deserved and would definately watch and wait in cases like this.   Sally ----- Original Message ----- From: jo To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:26 PM Subject: RE: [ozmidwifery] How long before synto is used? I always find it amazing that what is happening to a woman’s body (i.e SROM) is not believed and that she has to go in for ‘confirmation’. Surely the woman would know and wouldn’t need it confirmed - so the hosp needs evidence because women can’t be trusted to tell the truth. Gggrrrrrr! The more I read about this the more frustrating it gets.   I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldn’t deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days – constant water trickling – 37 +1 labour started – 4 hours, beautiful healthy baby born in lounge room.   Times, clocks, protocols, policies, it’s all a load of rubbish.   Jo   From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ home Sent: Thursday, 15 June 2006 11:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used?   We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion.   Sally ----- Original Message ----- From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used?   How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! It’s a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going!   Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you don’t have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just don’t understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour – wouldn’t the induced labour be more likely to stress baby? And the fact mum couldn’t cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie Slater Sent: Thursday, 15 June 2006 12:05 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used?   The UK’s NICE guidelines inherited from the UK’s Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour – see http://www.nice.org.uk/page.aspx?o=17381     Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used?   For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support   No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.8.3/360 - Release Date: 9/06/2006 No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.8.3/360 - Release Date: 9/06/2006