[ozmidwifery] an interesting conclusion
Declining diagnosis of birth asphyxia in california: 1991-2000.Wu YW, Backstrand KH, Zhao S, Fullerton HJ, Johnston SC.Department of Child Neurology, Box 0136, University of California, San Francisco, 500 Parnassus Ave, Room 411, San Francisco, CA 94143-0136. [EMAIL PROTECTED]OBJECTIVE: Birth asphyxia is recognized as an important cause of neonatal morbidity and mortality. Whether advances in perinatal care have altered the incidence of birth asphyxia is unknown. We determined the incidence of birth asphyxia diagnoses made over a 10-year period in California. METHODS: In a population-based retrospective cohort study of 5 364 663 live births, we determined the incidence and case fatality of birth asphyxia between 1991 and 2000. Using a statewide administrative hospital discharge database, we identified all newborn admissions that generated a diagnosis of birth asphyxia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 768.5, 768.6, or 768.9) or a diagnosis that overlaps with birth asphyxia, such as congenital encephalopathy or fetal distress. We determined incidence and in-hospital case fatality rates adjusted for birth weight and demographic characteristics and stratified by associated perinatal complications. RESULTS: The 24 330 newborns who received a diagnosis of birth asphyxia yielded a population incidence of 4.5 per 1000 live births. Black ethnicity (relative risk [RR]: 1.3; 95% confidence interval [CI]: 1.2-1.3), male gender (RR: 1.2; 95% CI: 1.1-1.2), and low socioeconomic status (RR: 1.2; 95% CI: 1.1-1.2) all were associated with increased risk. The diagnosis of birth asphyxia decreased by 91% from 14.8 to 1.3 per 1000 live births during the study years. This decrease could not be explained by an increased diagnosis of overlapping conditions. Overall case fatality was 4%, and the majority of deaths in infants 2000 g occurred in the presence of congenital anomalies, cord abnormalities, or maternal hemorrhage. In newborns 2000 g, case fatality was highest in the presence of chorioamnionitis (48%). CONCLUSION: The diagnosis of birth asphyxia has decreased dramatically in recent years. The factors that are responsible for this decline are unclear and deserve additional investigation.PMID: 15574618 [PubMed - in process]
[ozmidwifery] 2 much fluid
I found this interesting as I once cared for a woman who drank 7Ltrs of reverse osmosis filtered water, in about 10 hrs during labour and SHE had the hyponatraemic seizure. Frightened the life out of me. No complications for either woman or child followed this event. MM J Paediatr Child Health. 2004 Dec;40(12):709-10. Related Articles, Links Maternal water intoxication as a cause of neonatal seizures.West C, Harding J.Newborn Services, National Women's Hospital, Auckland, New Zealand.A term infant was admitted at 6 h of age with seizures related to hyponatraemia. During the last hours of labour the infant's mother had drunk 3 L of water. After delivery the serum sodium was 121 mmol/L in the mother and 126 mmol/L in the infant. Both resolved spontaneously. We discuss this case and the impact of maternal fluid intake during labour on the fetus and neonate. Women should be advised that excessive oral fluid intake during labour could adversely affect both mother and infant.PMID: 15569290 [PubMed - in process]
RE: [ozmidwifery] Midwife in TV drama
Just read your messages about the UK show 'William and Mary' I work at a birth centre in the UK where this was filmed, a couple of us were invited to spend the day to advise how things would really be in these settings to enable the cast to improve the show. It was really interesting, unfortunately we were unable to influence the things that were said as the dialog had been written and decided. I spent the day with them during the filming of the episode about a stillbirth, the actress playing the midwife 'Mary' was actually pregnant herself and was really interested in her role. This episode was quite emotional to film and the 'mother' and 'midwife' were really determined to make it as realistic as possible. 'Mary' asked me what sort of things would be said by the midwife to a mother following a stillbirth and how we would handle this situation. In the episode, the mother didn't want to see or touch her baby. I won't spoil it by saying any more but only that I agree this was a good drama. The actress was really hoping for a homebirth in a pool for herself. Unfortunately I think she went into premature labour at about 36/40 and delivery in a tertiary unit. Wendy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of shaz42 Sent: 05 December 2004 22:20 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Midwife in TV drama hi caught the show on sat nght in adelaide was very good encourge all to watch regards sharon - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, December 06, 2004 7:32 AM Subject: Re: [ozmidwifery] Midwife in TV drama This is a brilliant show - I have seen a number of episodes in the UK. The midwife does home births, water births and even has a still birth at home - all as part of her routine job. Pity it is on commercial TV, but I guess that means a potentially larger audience, so in terms of childbirth education that is also good news! Happy watching. Andrea At 11:18 AM 5/12/2004, you wrote: Earlier in the year someone mentioned a UK show called William and Mary, he's an undertaker and she's a MIDWIFE! Well by accident I watched the end half of it last night (Sat) on ch7 at 8.30pm. I think it was the first one, so tune in next week. Might even be worth dropping ch7 a line to say good on them, so it stays on the air. cheers Megan This message was sent through MyMail http://www.mymail.com.au -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Fwd: [REPRONETWORK] maternal depression
I was wondering if any of you wonderful women out there might be of use for this request. Thank you for your time Take care Alphia ReproNetworkers -- I am looking for some helpful references on maternal depression, especially recent ones that include evaluation of medications commonly given for postpartum depression. My daughter is presently caught in a very bad bout and I am with her and without my books and journals. We've looked at the web sites of Postpartum Support International, Depression After Delivery, and The Postpartum Stress Center - Treatment for Postpartum Depression, and they have been helpful, but I would like to read some medical or med/soc literature if it is out there. Thanks so much -- Janet Alphia Possamai-Inesedy Ba (Hons.) PhD. Candidate School of Applied and Human Sciences Bankstown Campus, University of Western Sydney UWS Locked Bag 1797 South Penrith Distribution Centre NSW 1797 Australia Phone: 02 97726628 Fax: 02 97726584
[ozmidwifery] Incidence of meconium
Hi Leanne, I too, would love to read this article. I work in a major hospital that still does suction on the peri with meconium liquor. If it is not a problem you could fax it to me on 07- 36362323, and just mark it Attention: Joanne Fisher. Thank you very much. Cheers, Joanne. Hi Sue, It really is a terrific article about birthing in the caul. I'm sure I also have an article somewhere about how suctioning the baby on the peri actually stimulates the baby to take a breath and thus meconium is drawn into the lungs whereas if the baby is not touched just the pressure exerted on the baby's chest by maternal contractions will empty the lungs ... I will do some searching ... I can fax articles to you if you wish or send them by snail mail if that is more convenient - let me know. I will now go and hunt through my filing cabinet for those articles before my next client arrives. Leanne. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] re todays Herald Sun
There is a page article re rising caesarean rates in todays Herald Sun (melbourne) - there was a smallish article with lovelycomments about empowerment in an interview with a woman who had a new baby at Mercy birth centre, but a bigger pic of a "superwoman" who had 2 elective caesars as she is a "very organised person" - went home 28 hours after her planned caesar last Christmas Eve and did a load of washing and cleaned the house - nothing mentioned about effects on bonding. Interestingly she works with wild life. Definitely a letter opportunity. Pinky
Re: [ozmidwifery] re todays Herald Sun
I also have just finished rading the same article, adn was just as disappointed with the little story on the lovely birth centre family as opposed to the organized "delivery" of the lady following her two planned caesars. sad that its coming to this..Pauline - Original Message - From: Pinky McKay To: [EMAIL PROTECTED] Sent: Wednesday, December 08, 2004 9:56 AM Subject: [ozmidwifery] re todays Herald Sun There is a page article re rising caesarean rates in todays Herald Sun (melbourne) - there was a smallish article with lovelycomments about empowerment in an interview with a woman who had a new baby at Mercy birth centre, but a bigger pic of a "superwoman" who had 2 elective caesars as she is a "very organised person" - went home 28 hours after her planned caesar last Christmas Eve and did a load of washing and cleaned the house - nothing mentioned about effects on bonding. Interestingly she works with wild life. Definitely a letter opportunity. Pinky
[ozmidwifery] traumatic c-section
Dear listers WA's Today Tonight (7)- last night ran a story of a woman who had a c-section for a breech baby who felt the entire procedure. Apparently she knew the epidural had failed and tried to alert the anaesthetist even asking to be knocked out. The woman likened it to having a limb chopped whilst awake. She is clearly traumatised by this experience and it affected her ability to bond with her baby. (now 5 months) The couple had wanted a third child but she says she would be unable to face this prospect now. She is planning on suing the anaesthetist (who had thegall to send her a bill!) and doing whatever it takes to ensure no-one else endures this pain. The husband spoke about feeling robbed from what should be a precious happy time for his family,where his wife should be overcome with joy at the birth of their second baby. I am not sure what state or hospital this occurred - I missed the beginning. Perhaps anyone watching will think twice about the "pain free" experience of c-sections and epidurals for vaginal birth. Rochelle.
[no subject]
hi i don't know if anyone is interested but one of my continuity ladies husband is making chairs for babies which are made out of wood and sit on the table so baby can join in during meal times also. they are sturdy and well made and would make a great present for anyone who has recently given birth. I have a email address if anyone is interested in purchasing one. regards sharon
RE: [ozmidwifery] Incidence of meconium
It's in the mail!! From: Alan Rooney [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: RE: [ozmidwifery] Incidence of meconium Date: Tue, 7 Dec 2004 16:12:56 +1100 Leanne It will have to be snail-mail Alan Rooney C/- Narrabri Hospital Cammeron St Narrabri 2390 Thanks Alan -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of leanne wynne Sent: 07 December 2004 08:53 To: [EMAIL PROTECTED] Subject: RE: [ozmidwifery] Incidence of meconium Alan, Do you want it faxed or sent via snail-mail? Leanne From: Alan Rooney [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: RE: [ozmidwifery] Incidence of meconium Date: Mon, 6 Dec 2004 22:27:57 +1100 Hi Leanne If you have a copy on suctioning on the peri I would love a copy of it. We have a couple of doctors here who insist on suctioning on the peri.even if there is no mec. Alan -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of leanne wynne Sent: 06 December 2004 14:17 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Incidence of meconium Hi Sue, It really is a terrific article about birthing in the caul. I'm sure I also have an article somewhere about how suctioning the baby on the peri actually stimulates the baby to take a breath and thus meconium is drawn into the lungs whereas if the baby is not touched just the pressure exerted on the baby's chest by maternal contractions will empty the lungs ... I will do some searching ... I can fax articles to you if you wish or send them by snail mail if that is more convenient - let me know. I will now go and hunt through my filing cabinet for those articles before my next client arrives. Leanne. From: Sue Cookson [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Incidence of meconium Date: Mon, 06 Dec 2004 12:33:30 +1100 Thanks Leanne, Is there any way I can access that article or acquire a copy of it - I don't have a membership to MIDIRS. There are certainly lots of articles now that don't support routine suctioning of mec-stained babies at head birth, and yet it is still common practice up here in the Northern Rivers Area hospitals. Any feedback from anyone about changing practices in hospital care? Thanks, Sue Hi Sue, An excellent article in MIDIRS Midwifery Digest 14:1 2004 by a midwife cites Houlihan and Knuppel (1994) as showing that meconium is normally passed by the foetus in 3% of cases @ 36 weeks gestation, 13% @ 36 -39 weeks gestation, 19% @ 40 -41 weeks gestation and 23% @ 41 weeks gestation. This does not cause a problem unless the foetus becomes hypoxic. Leanne. From: Sue Cookson [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: [ozmidwifery] Incidence of meconium Date: Fri, 03 Dec 2004 10:30:36 +1100 Hi everyone, Just wondering if anyone has information on the incidence of meconium during labour? Anecdotally, I would say around 20%, but wonder if other's practices agree with this figure and if there are any statistics showing a reliable figure? Thanks, Sue Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Routine Observations in labour
All these obs in labour. distracting for the woman and annoying for the midwife. We do 15/60 fhr, although I do it 30/60 early labour, and when I can in active labour, 15-30/60 if all has been well. Any concerns I'll listen from cont. to cont. If I'm really worried I'd do a ctg.2nd stage 5/60 until hov then following every cont.I try and slip obs in as I can. Temp 4/60, bp2-4/24conts continuously, pulse 30/60. Ve's I don't tend to do on multis unless they ask. Primips 6/24 from active labour., no real hard and fast rules on ve's. As long as abdom. descent can be detected and mum and bub ok there is no pressure.Observation of iquor, what the woman is saying, how she is managing the conts, fluid intake and output. If all has been well I do not interfere or interrupt the woman, but take my chance as it comes. MS -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Anglodutch NTL AccountSent: Tuesday, 7 December 2004 5:22 PMTo: [EMAIL PROTECTED]Subject: RE: [ozmidwifery] Routine Observations in labour Oops, BP should be hourly of course, not 4 hourly! Claudia -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Anne ClarkeSent: 06 December 2004 23:35To: OZMIDWIFERYSubject: [ozmidwifery] Routine Observations in labour Dear All, Talking about observations. Please take time to reply to this query. What observations - how often, what type of observations e.g. temp, pulse, BP, FHR, PV assessment etc.do you do routinely on a normally progressing singleton labour? With thanks, Anne Clarke
