Re: [ozmidwifery] No Contractions

[diane]

Title: Message

Thanks All, for your thoughts, Not so sure it was rest and be thankful stage as she had already had involuntary pushing happening for a while with the first bit of second stage contractions that were only very short, and she had brought baby down to on view at that stage, it was then they dropped right off and when bub was almost crowning that they stopped. I didnt feel comfortable to have her sit there with low FH and head 1/4 out!   Dont think there was a psychological block as she had even stated earlier " i cant wait to feel that burning, stretching then I know it is almost here"   We dont have on site doctors but have strict criteria for transfer or to call in the consultant. We dont put up synto, that would require transfer. I even thought about yelling BOO to scare her and get a fetus ejection reflex!! : )   She had been self regulating her fluid intake, but it could have been helpful to get some carbs, and usually I would do this but she had been vomiting a reasonable amount and felt it best to stick with fluids, perhaps some cordial could have helped.   Would love some good references on the Ketones too, we get hounded badly about hydration. Cheers, Di ----- Original Message ----- From: Lisa Gierke To: ozmidwifery@acegraphics.com.au Sent: Friday, October 06, 2006 4:15 PM Subject: RE: [ozmidwifery] No Contractions No Mary wasn't directing this at you or anyone in general really...just feel for Di...as think she did a great job as some hospital midwives would have thrown it in the too hard basket and called the doc for the vaccumm waay before; what with the fetal distress and all (tongue in cheek)..... And yep beating up on ourselves is  a real midwife trait isn't it! Especially when you have rotton doctors and others putting their 2 cents worth in about you decsions! Can anyone think of the reference for the ketone thingy?.. LisaX -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary Murphy Sent: Friday, 6 October 2006 3:52 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] No Contractions Hi Lisa, there was definitely no intent of implied criticism when I said “no should haves”.  Just a reminder that we beat up on ourselves all the time .  “OH maybe I should have, shouldn’t have”. etc.  We each have to respond to the best of our clinical judgment, in the way we see it, at the time.  It is hard to say “I would do this when” because there is no hard and fast rule, just that rush of adrenalin and a sense of alarm that makes us act.    Sorry I can’t elaborate further. I agree about the fluids.  In fact quite a while ago I read some articles about the presence of keytones being normal in labour.  sorry can’t remember where. MM   From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Lisa Barrett Sent: Friday, 6 October 2006 1:19 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] No Contractions   Sorry Mary If my language inferred "should have" but when would you get a woman to push without a contraction?. Exception maybe breech out to nape of neck with worries about the baby's condition.   IV fluids doesn't constitute any part of normal physiological labour unless I've missed something vital.   When asked for opinion in future I will refrain from giving any unless my language is less confrontational. Lisa Barrett ----- Original Message ----- From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Friday, October 06, 2006 8:17 AM Subject: RE: [ozmidwifery] No Contractions   Di, It sounds as tho you managed a difficult situation in the best way you knew, and that is all one can do.  You are now seeking to learn from it and we will obviously give you tips based on our experiences.  Don’t feel that you “should have “etc.  Many midwifery authors in all kinds of natural birthing magazines like Midwifery Today etc, have spoken about the “rest and recovery stage” where the body needs to gather its strength for the final stage.  It usually happens at the end of a demanding first stage and the woman showing signs of tiredness. I am old enough to remember doctors saying “turn her on her side and give her a rest, Sis”, in a time when IV fluids, synto drip and epidurals were available but not used so aggressively.  At the transition between the first and second stage in a primip, the  urge to push with each contraction needs to be resisted for a little while and breathed through, so that there is no pushing on a cervix that is not completely out of the way. We often can’t reach that little bit at the back, but it is still there. We talk of an anterior lip, but there can be a posterior one too.   The urge to push is triggered by the baby putting pressure on the nerves, even tho there is still a lip etc.  Pushing without contractions is not usually the most productive thing, but as I said, you handled it the best way you knew how.remeber the discussion on”undirected pushing”?  I am sure you will get lots of tips which will help us all in our practice no matter where we are. Cheers, MM