Sally @ home wrote:
Exactly, Shelley.
In practice I do very few VE's as well, relying on all the external
signs we, as midwives, use everyday. However, having one's knowledge
and experienced completely disregarded is extremely disheartening.
We are organising a forum to try and alter the policy/guideline, but
have very little time to prepare...hence the plea for help :o)
Thanks
Sally
The thing about being tuned in to the subtle signals and processes that
women invariably go through during labour and birth, is that you have to
actually *be there*, spend the time (& I include antenatal 'time' in
this too) watching, listening, feeling, smelling, hearing - not
something you can do by watching the ctg at the mid station, or by
walking into a room to observe a woman for 3 minutes to make decisions
about what is happening for her & her further care.
Prolonged observation beats textbook definitions of 'normality' any day.
I get really pissed off when I consider that these obstetric definitions
( & hence protocols) have been created largely by people who have
*never* provided labour and birth care for women who they have a
pregnancy-long relationship with, and who attend for the *whole labour*
- if that was the case we may have much broader definitions of what is
'normal'.
I personally think its a huge violation of women to even have a protocol
which legitimises time-based (ie 4 hourly) vaginal examinations, purely
because it is 'quicker and easier' to determine progress of labour.
Sally I would be asking your obstetricians - if they had a choice
between assessing labour progress by observation alone, or assessing
labour progress by inserting their fingers into a womans vagina, what
would they choose? I would also be inviting them to 'witness' an entire
labour where VE's were not routine, & were not done at all unless there
was some valid evidence-based reason to do so. Its not good enough for
the 'medical establishment' (of which we as midwives are a part) to
dismiss knowledge that comes from experiences they will not put
themselves in the way of.
cheers
--
Jennifairy Gillett RM
Midwife in Private Practice
Women’s Health Teaching Associate
ITShare volunteer – Santos Project Co-ordinator
ITShare SA Inc - http://itshare.org.au/
ITShare SA provides computer systems to individuals & groups, created
from donated hardware and opensource software
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