Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi, I would definitely treat this woman like all others and assume physiological 3rd stage is sufficient. I have never actively managed a 3rd stage, and have given syntometrine 3 times only after placentas were born - all in my early days of homebirth. I always prefer to; a) make sure women are well hydrated going into 2nd stage so they can tolerate volume loss b) if bleeding is serious go into deliver placenta mode I always catch and therefore can measure blood loss at a glance I engage the mother first and tell her she's bleeding and that I need her to focus and deliver her placenta I always give herbs as a first line of attack- shepherd's purse has always been my first choice I would rub up a ctxn, add an ice pack to her uterus if one available Then with her assistance pushing I would apply cord traction and see if the placenta would come Repeat this maybe twice Then contemplate manual removal if necessary (not had to yet...) I have managed 5 large haemorrhages (over 1.5 litres measured) in this manner and have not had to transfer anyone yet.(I have a haemoglobinometer with which I can measure Hbs on the spot over the next few weeks if necessary..) This management regime was taught to me by John Stevenson and always seems to work.Up until very recently, I have always worked alone. Isn't it interesting all the different ways we'd handle this depending on our personal experiences? By the way, late last year I witnessed the worst PPH I'd ever seen - mainly because of the management in the hospital (it was a hospital support not a homebirth), and with all the hands you could ever imagine -I'd say too many - the woman was severley depleted. Drips in etc etc but too much too late. A cord pulling midwife, and then no acknowledgement of when she needed help (irrespective of my pleas) plus she underestimated the blood loss by more than 100% (she thought 600ml, and it was measured by weight (? accuracy) to be more like 1400ml) and then the woman was taken to theatre - more time, more blood, why not a manual removal then and there?? Aaaah. Expect no PPH but stay on your toes ...always my motto. Sue - Original Message - From: leanne wynne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 24, 2005 2:43 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi All, I would be interested to hear from any experienced homebirth midwives how they would care for a woman who is a G10P9 if she chose to birth at home. She has had all normal, quick births so far. Would you use active management of third stage because she is a grand multip or would you still encourage a physiological third stage?? Leanne. From: Marilyn Kleidon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Date: Thu, 24 Feb 2005 16:55:56 -0800 Excellent point. I do think the 500mL definition for PPH is spurious. Having been educated by a homebirth midwifery school I have to say we were not concerned when the blood loss was less than 1000mL as most of our 3rd stages were physiological. Very occassionally we did use oxytocin for management of 3rd stage usually when the woman had a history of PPH greater than 1000mL or retained products etc.. However we were well versed in the Cochrane studies and aware of that evidence so we had a high degree of caution shall I say. We did carry 40 units of pitocin and also ergometrine both vials and tabs to births as well as herbal remedies. Syntometrine does not seem to be available in the USA at least not where I was. That being said from what i have seen here postnatally, active management really decreases the postpartum blood loss in most women. I am currently doing the extended midwifery service and visiting women in their home during the first 1 to 10 days and most seem to have almost finished bleeding by day 5, for most of the homebirth women I visited in the USA just from memory I would say they were almost finished by day 10. Both the American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA) have been collecting stats for 5 to 10 years at least and must have good stats on this topic. I know it isn't Australian data but itmight be helpful. marilyn - Original Message - From: Jenny Cameron To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 23, 2005 3:51 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Good point Michelle. If we used 1000ml as PPH definition the stats would not look so appealing for active mgmt. Also as someone stated women having a physiological 3 stage tend to lose more in the first few hours after birth than those having active mgmt. As far as I am aware no-one has researched total postpartum (say in the first week) blood loss. Hb or Hct estimation is the best way of
Re: [ozmidwifery] epidurals and long term effects
Dear MM As a midwife from the major hospital that you refer to, I am horrified at what you describe. I did not realise that debilitating events such as foot drop and epidural headaches were being ignored. The anaesthetic department of the said hospital prides itself on its superior pain management and followup while in hospital. Have you, as the midwife of these women, put something in writing to the hospital? Services will only improve if wonderful women like you are couragous enough to stand up for the rights of women that have received less than optimal care. I extend my sympathy and regret to the women you refer to. Best wishes Rosemary
[ozmidwifery] Rural Obstetrics!!!!!!!!!
Title: Rural Obstetrics! Dear All Thought you might like to see some more media on the continuing rural saga. I was a little misrepresented I said 70 not 80 and he got the MC representation thing wrong, but perhaps you may like to e-mail Peter at ABC Health report Or better write to Tony Abbott re the Obstetric locum crap! I really have heard it all now. Mr Tony Abbott Minister for Health and Ageing Parliament House CANBERRA ACT 2600 JC xx Obstetric crisis in the bush by Peter Lavelle Published 24/02/2005 If you want to have a baby, don't live in the bush. That's effectively the message for pregnant mums in regional and rural Australia, suffering the gradual closure of obstetric services in country hospitals. And things will probably get worse, not better. Obstetrics is the hard yard of medical practice - the hours are long, and there's a lot of after-hours work (babies come at a time of their own choosing). Insurance premiums are high and the fear of litigation is a constant factor. Many obstetricians - especially young doctors - are leaving the field for the safer and easier areas such as infertility, family planning and gynaecology. Those obstetricians who are left are mainly older men in their fifties and sixties, for whom retirement is not far off. In regional areas, GPs have traditionally done much of the obstetric work done by specialists in the cities. But for the same reasons, GPs too are now abandoning obstetrics - it's just too hard. In New South Wales, for example, the number of GP obstetricians has slumped from nearly 250 in 1996 to 125 last year, according to the Rural Doctors Association of Australia. Women in country areas are increasingly having to travel long distances, often hundreds of miles, to have their babies delivered in metropolitan centres. Dr Andrew Flutzkin, vice president of the Rural Doctors Association of Australia, says that in some instances, women are having their children in cars or by the side of the road. Or they are electing to stay home to have their babies and if something goes wrong, present to the local hospital, which doesn't have obstetrics services and isn't set up to handle emergencies. Under these circumstances the chances of the mother or baby dying are much higher. What makes the problem worse is that in the country, most mothers are admitted as public patients, rather than as private patients. But the trend is towards private obstetrics, thanks to measures like the health insurance rebate and the new Medicare Safety Net legislation (which caps the amount a person has to pay for expensive procedures like childbirth) - measures that make it more attractive for an obstetrician to work in the cities, says Flutzkin. More responsibilities for midwives? How to get obstetric services back to the bush is a question that's concentrating the minds of health bureaucrats at the state and federal levels. But the solutions aren't simple. One idea that's gaining currency at the state government level is to let midwives take over more of the responsibilities that have traditionally been the domain of doctors. Ms Justine Caines is President of a group called the Maternity Coalition, which represents midwives and childbirth educators. She says that in New Zealand about 80 per cent of births are managed by midwives. In Australia it's less than one per cent. She says that midwives are trained to deliver babies with the same expertise as obstetricians and that includes handling emergencies. She's an advocate for the concept of midwives units, in which midwives are responsible for the antenatal care, the delivery, and post natal care. If there's an emergency, women are transferred to a larger hospital by air or road. So far there is one in New South Wales, in the Sydney suburb of Ryde. The unit is just one year old. Two others are planned - for Belmont (in Lake Macquarie) and Camden in Sydney's west. The Victorian Government is also committed to the idea, Ms Caines says. She believes it's the logical solution to the obstetrics crisis in rural and regional Australia. However the concept is facing stiff resistance from sections of the medical profession who resent the threatened loss of income from someone else doing obstetrics services, she argues. Oh for a holiday Increased responsibility for midwives isn't the whole solution, argues Andrew Flutzkin. He believes that when there's an complication in a delivery, specialist services need to be available - with surgeons, obstetricians and anaesthetists on hand at the hospital. He'd prefer to see increased funding and incentives for more obstetricians to train and practice in the bush. In the meantime, obstetricians want a break. Last week, a group met with Federal Health Minister Tony Abbott to ask for funds to cover the cost of obstetric locums (including the costs of the locums' insurance premiums), to give them a holiday
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Thanks Sue! I always appreciate the learning we get from our more superior peers! Keep it coming! It's a reminder to mehow fear can override the way in which we practice! Kim ---Original Message--- From: ozmidwifery@acegraphics.com.au Date: 25/02/2005 7:13:10 p.m. To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi, I would definitely treat this woman like all others and assume physiological 3rd stage is sufficient. I have never actively managed a 3rd stage, and have given syntometrine 3 times only after placentas were born - all in my early days of homebirth. I always prefer to; a) make sure women are well hydrated going into 2nd stage so they can tolerate volume loss b) if bleeding is serious go into "deliver placenta mode" I always catch and therefore can measure blood loss at a glance I engage the mother first and tell her she's bleeding and that I need her to focus and deliver her placenta I always give herbs as a first line of attack- shepherd's purse has always been my first choice I would rub up a ctxn, add an ice pack to her uterus if one available Then with her assistance pushing I would apply cord traction and see if the placenta would come Repeat this maybe twice Then contemplate manual removal if necessary (not had to yet...) I have managed 5 large haemorrhages (over 1.5 litres measured) in this manner and have not had to transfer anyone yet.(I have a haemoglobinometer with which I can measure Hbs on the spot over the next few weeks if necessary..) This management regime was taught to me by John Stevenson and always seems to work.Up until very recently, I have always worked alone. Isn't it interesting all the different ways we'd handle this depending on our personal experiences? By the way, late last year I witnessed the worst PPH I'd ever seen - mainly because of the management in the hospital (it was a hospital support not a homebirth), and with all the hands you could ever imagine -I'd say too many - the woman was severley depleted. Drips in etc etc but too much too late. A cord pulling midwife, and then no acknowledgement of when she needed help (irrespective of my pleas) plus she underestimated the blood loss by more than 100% (she thought 600ml, and it was measured by weight (? accuracy) to be more like 1400ml) and then the woman was taken to theatre - more time, more blood, why not a manual removal then and there?? Aaaah. Expect no PPH but stay on your toes ...always my motto. Sue - Original Message - From: "leanne wynne" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 24, 2005 2:43 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi All, I would be interested to hear from any experienced homebirth midwives how they would care for a woman who is a G10P9 if she chose to birth at home. She has had all normal, quick births so far. Would you use active management of third stage because she is a grand multip or would you still encourage a physiological third stage?? Leanne. From: "Marilyn Kleidon" [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Date: Thu, 24 Feb 2005 16:55:56 -0800 Excellent point. I do think the 500mL definition for PPH is spurious. Having been educated by a homebirth midwifery school I have to say we were not concerned when the blood loss was less than 1000mL as most of our 3rd stages were physiological. Very occassionally we did use oxytocin for management of 3rd stage usually when the woman had a history of PPH greater than 1000mL or retained products etc.. However we were well versed in the Cochrane studies and aware of that evidence so we had a high degree of caution shall I say. We did carry 40 units of pitocin and also ergometrine both vials and tabs to births as well as herbal remedies. Syntometrine does not seem to be available in the USA at least not where I was. That being said from what i have seen here postnatally, active management really decreases the postpartum blood loss in most women. I am currently doing the extended midwifery service and visiting women in their home during the first 1 to 10 days and most seem to have almost finished bleeding by day 5, for most of the homebirth women I visited in the USA just from memory I would say they were almost finished by day 10.Both the American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA) have been collecting stats for 5 to 10 years at least and must have good stats on this topic. I know it isn't Australian data but itmight be helpful. marilyn - Original Message - From: Jenny Cameron To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 23, 2005 3:51 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Good point Michelle. If we used 1000ml as PPH definition the stats would not look so appealing for active mgmt.
[ozmidwifery] Hep B vaccine reaction
Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
[ozmidwifery] Gestational diabetes
Hi, Just wondering if anyone has some good recent research in relation to gestational diabetes. What I'm looking for is data similar to what is found in ''A guide to effective care in pregnancy"... Enkin et al which states all forms of glucose testing should be reviewed due to the 50%-70% false positives and that there is no clear benefit obtained with treating gestational diabetes. This is from the cochrane data base but was printed in 2000. I've just spent a few hours searching the web and I can't find more recent info than this. We're trying to get good evidence so we can continue to keep well controlled gestational diabetic women in our birth centre program (for over 10 years they have been birthing at the birth centre without any problems). Thanks in advance Michelle Find local movie times and trailers on Yahoo! Movies.
Re: [ozmidwifery] Hep B vaccine reaction
Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 7:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
Re: [ozmidwifery] Hep B vaccine reaction
Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not sure how I will be able to give the vaccine to another baby after that experience. Kind regards, Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 11:27 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 7:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
Re: [ozmidwifery] Hep B vaccine reaction
Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not sure how I will be able to give the vaccine to another baby after that experience. Kind regards, Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 11:27 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 7:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
Re: [ozmidwifery] Hep B vaccine reaction
Hi Lisa and Nicole, Like you, I have serious concerns about giving Hep B at such an early age. I believe we areplacing a very heavy insult on a baby's natural immune system. I asked this question of an Immunisation Nurse who was a speaker at a seminar I went to and she said that most cases of Hep B with babies are contracted from staff! I'm also concerned that parents are not given enough information on the pros and cons of this first immunisation as, almost without exception, they sign the permission form. I certainly find that babies are very often upset and crying the night after it is given (I work night shift and often spend many hours walking the baby in a sling when mum is too tired to cope any longer). Certainly, if it is to be given I think it is preferable to give it later in the stay in hospital, not immediately after birth together with the Konakion - another injection that parents never seem to refuse. Joy Joy Cocks RN (Div 1) RM CBE IBCLCemail:[EMAIL PROTECTED] - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 0:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not sure how I will be able to give the vaccine to another baby after that experience. Kind regards, Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 11:27 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does
[ozmidwifery] Protein in Urine?
Hi, A client and I have been discussing protein in urine and how much is too much, when to get worried etc. She was admitted to hospital at 37 weeks with her daughter and induced, apparently due to high blood pressure and protein in her urine. A friend of hers had a similiar symptoms of pre eclampsia but was not admitted to hospital and went on to have a natural birth. So, my question is, can the test measure quantities of protein or just pick up protein in general. If it is in quantities, what level is too much? Thanks Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Has anyone had any experience with women eating a chunk of raw placenta to stop pph? I have read a few things about it and was just wondering if anyone had experience with this. Thanks Love Abby
Re: [ozmidwifery] Hep B vaccine reaction
Hi Nicole and lisa, Are any questions asked re family history of allergies/ vaccine reactions before giving the shots? My own first baby (now 30)had a similar reaction to his first triple antigen (the first vaccine in those days), my mother had a collapse after a tetanus shot requiring an ambulance and adrenalin and my second child as a teenager who had cut his hand on a rusty piece of iron was taken by his bossfor a tetanus shot - the following dayhecollapsed/ stopped breathing and ended up in hospital being resuscitated -this was recorded as a vaccine reaction. My younger children are unvaccinated depite much pressure/ school formsand even a huge dressing down from a GP who called me negligent and ignorant. At a talk last year (at a midwifery conference in SA) by a govt person on the 'logic' of vaccinating, her reasoning was as you mentioned that some babies of carriers - in the US!! she said- had slipped through and not been vaccinated at birth. Apparently "some of these women sued!!" I find this very flimsy and fearfulreasoning to give vaccinations to a pure little newborn - surely this is occasion for parents to take personal responsibility - you would know if you were a carrier and so would your carers as it would be on your records. Why should womenwho aren't carriers be pressured to expose their babies to unnecessary risks? Especially since babies are not going to be engaging in risky behaviour! As I researched after my own children's reactions I became very cynical that much of this pressure is driven by $$$ -ifas you say, if the 2 month vaccination will fully cover a baby (if it is the parent's choice to vaccinate) surely the shot at birth for all babies is overkill? Sounds like that could have been literally, Nicole- it must have been a terrible shock for you and the parents. I really feel for you about being anxious to inject more babies - how do you deal with this in your workplace? So Im wondering - are parents asked about family history of allergies/ reactions to vaccines? Are vaccines given to well babies? when are they given to premmies? Babies who have had any health problems/ respiratorydifficultiesat birth? Or difficult births? What is defined as a reaction severe enough / concerning enough to be referred to the Children's special clinic? Many babies have red limbs, irritability, fever - is this enough to be cautious about subsequent vaccines? Pinky - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 5:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at
[ozmidwifery] Vaccination HepB
Hi all, In SA we have an excellent, well established vaccination support group called VISA (Vaccination Information South Australia) www.visainfo.org.au They have just updated their info booklet, 64 pages, Investigate before you vaccinate: A guide for parents, full of info on all the available vaccinations and fully referenced, easy to read too. It is also vital that all reactions are reported, consumers can ring 1800 007 468 or go to www.tga.gov.au . The law requires that Dr's report adverse events following Immunisation that occur any time following vaccination. Yet the Government admit less than 10% of adverse events are reported, believed to be closer to 2.5%. Wether you choose to vacciante or not, if an adverse event occurs and no one is recording it, it doesn't officailly exist. How can we be making informed choice on lies. Also check out the archives, HepB has come up before with a number of people sharing their expeiences at workplaces. 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.
Re: [ozmidwifery] Hep B vaccine reaction
hi im a 3rd year medical student and as far as i know the hep B vaccine is now routinely given at birth as a public health measure rather than because babies are actually at risk. youre right that infants and children are at low risk of contracting hep b. the only reason it is given at birthis that it is a convenient time to have contact with all hospital born babies, rather than trust in the parents that they would bring the baby back at a suitable time. i have mixed views of different vaccines, but this one and tetanus really take the cake. to subject a newly born baby to a traumatic experience purely for convenience sake (when theyre not even at risk of the disease) is a verypoor policy in my mind, especially because parents are not told this is why it is being given so they assume it is because their baby is at risk. i think if the hep b vaccine is deemed necessary at all, resources should be put in to educating the parents about it and trusting them ! to make the decision if and when to give it rather than the paternalistic view that if they dont vaccinate everyone at birth, noone would have the initiative to bring the baby back when he or she is older and may become at risk. emily lisa chalmers [EMAIL PROTECTED] wrote: Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 7:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver. Do you Yahoo!? Take Yahoo! Mail with you! Get it on your mobile phone.
Re: [ozmidwifery] Protein in Urine?
hi abby urinalysis gives a semi-quantitative level of proteinuria and is usually expressed as trace, +, ++, +++ or . you can also do a 24hour collection of urine to get a fully quanitative measure of the amount of protein. here is an article in mja on whether urinalysis can be discontinued during pregnancy if the initial one is clear.. http://www.mja.com.au/public/issues/177_09_041102/mur10814_fm.html i havent had a good read of it yet but you might be interested :) Benign causes of protein in the urineinclude fever, intense activity or exercise, dehydration, emotional stress and even long days on your feet. More serious causes include glomerulonephritis, multiple myeloma and preeclampsia. If the urine isalkaline, dilute or concentrated, there is gross hematuria (lots of blood in urine)or the presence of mucus, semen or white blood cells, when some meds are used or the dipstick is immersed in the urine for too long,then you can get a false-positive for protein. emily Abby and Toby [EMAIL PROTECTED] wrote: Hi,A client and I have been discussing protein in urine and how much is toomuch, when to get worried etc. She was admitted to hospital at 37 weeks withher daughter and induced, apparently due to high blood pressure and proteinin her urine. A friend of hers had a similiar symptoms of pre eclampsia butwas not admitted to hospital and went on to have a natural birth. So, myquestion is, can the test measure quantities of protein or just pick upprotein in general. If it is in quantities, what level is too much?ThanksLove Abby--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe. Do you Yahoo!? Read only the mail you want - Yahoo! Mail SpamGuard.
Re: [ozmidwifery] Hep B vaccine reaction
Indeed, this has happened to me a couple of times. Once a baby had a full on fit about 5 mins after the injection, then went on to fit more in NBS, and a baby born by elective LUSCS had a respiratory arrest. Both times the docs denied it could possibly have had anything to do with the vaccine! Sally - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 10:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
[ozmidwifery] new baby vaccine
You might debate the necessity of some vaccines, but what about this one (below) I just found on NEWS.com.au , How on earth does this make sense? Cheers Megan Call for anti-junkie baby jab February 26, 2005 From: http://www.theaustralian.news.com.au/?from=ni_story A GROUP of Queensland politicians want the federal Government to investigate giving an anti-junkie vaccination to babies. The vaccination, being considered by British MPs, would render children immune to becoming smokers or drug users. Delegates at this weekend's Queensland Nationals Central Council meeting on the Sunshine Coast will debate a resolution calling for the investigation. Nationals member Ken Wilson, who is taking the issue to the meeting, said he had the backing of his 90-strong western Brisbane suburbs branch. Drugs are a scourge, Mr Wilson said. I feel strongly about this and I'm inviting the federal Government to investigate it and if it proves worthwhile then do a vaccination program. Federal Health Minister Tony Abbott is yet to be approached to investigate, but a spokeswoman said the vaccine was in the very early development stages. Drug addiction is estimated to cost the Government $6 billion a year. 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.
RE: [ozmidwifery] MORE ACTIVE MANGAEMENT
Eating some placenta does work as the placenta is full of oxytocin, therefore contracts the uterus. Taking placenta as medicine also is very helpful for postnatal depression. Recently I have had an amazing result from taking placenta pills to treat a woman who has debilitating paralysing migraines. Within 10 minutes the headache would go, 15 minutes warmth come back to her arm and leg, 30 minutes all paralysis gone. With her first baby she had been in bed with blinding, paralysing migraine for 14 days. This time she was not bed ridden and took placenta pills for about 14 days when she started to feel symptomatic. Sally Westbury Homebirth Midwife It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her. -Judy Slome Cohain
Re: [ozmidwifery] new baby vaccine
And it's not even April Fool's Day!! Is this for real? Joy Joy Cocks RN (Div 1) RM CBE IBCLC BRIGHT Vic 3741 email:[EMAIL PROTECTED] - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 11:47 AM Subject: [ozmidwifery] new baby vaccine You might debate the necessity of some vaccines, but what about this one (below) I just found on NEWS.com.au , How on earth does this make sense? Cheers Megan Call for anti-junkie baby jab February 26, 2005 From: http://www.theaustralian.news.com.au/?from=ni_story A GROUP of Queensland politicians want the federal Government to investigate giving an anti-junkie vaccination to babies. The vaccination, being considered by British MPs, would render children immune to becoming smokers or drug users. Delegates at this weekend's Queensland Nationals Central Council meeting on the Sunshine Coast will debate a resolution calling for the investigation. Nationals member Ken Wilson, who is taking the issue to the meeting, said he had the backing of his 90-strong western Brisbane suburbs branch. Drugs are a scourge, Mr Wilson said. I feel strongly about this and I'm inviting the federal Government to investigate it and if it proves worthwhile then do a vaccination program. Federal Health Minister Tony Abbott is yet to be approached to investigate, but a spokeswoman said the vaccine was in the very early development stages. Drug addiction is estimated to cost the Government $6 billion a year. 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. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Gestational diabetes
Here are a couple that might help http://www.ahrq.gov/clinic/uspstf/uspsgdm.htm http://www.hta.nhsweb.nhs.uk/execsumm/summ611.htm Sally Westbury Homebirth Midwife It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her. -Judy Slome Cohain
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi Abby, You'd have to be quick and really believe this will work in the case of a true and fast PPH. I have seen a woman taste her placental blood whilst having a trickle bleed after the placenta was born and the blood loss stopped , but I can't recall if that was after she got up, in which case she may have dislodged a clot which is the most likely cause for this type of trickle bleeding. More usually, the placenta is sliced up and frozen, in situarions where the woman is scared of/has history of PND. Birthing the placenta is very definitely the mode of action for any PPH, in my poinion. Sue Has anyone had any experience with women eating a chunk of raw placenta to stop pph? I have read a few things about it and was just wondering if anyone had experience with this. Thanks Love Abby Add FUN to your email - CLICK HERE! http://www.incredimail.com/index.asp?id=54475 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hello Leaane Here is a link to an article that may be useful re grand multi's and risk factors; and a link to a reply, just for another view. http://www.mja.com.au/public/issues/179_06_150903/hum10036_fm.html http://www.mja.com.au/public/issues/180_04_160204/letters_160204_fm-3.html Cheers Jenny Jennifer Cameron FRCNA FACM ProMid Professional Midwifery Education Service 0419 528 717 - Original Message - From: leanne wynne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 8:13 AM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi All, I would be interested to hear from any experienced homebirth midwives how they would care for a woman who is a G10P9 if she chose to birth at home. She has had all normal, quick births so far. Would you use active management of third stage because she is a grand multip or would you still encourage a physiological third stage?? Leanne. From: Marilyn Kleidon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Date: Thu, 24 Feb 2005 16:55:56 -0800 Excellent point. I do think the 500mL definition for PPH is spurious. Having been educated by a homebirth midwifery school I have to say we were not concerned when the blood loss was less than 1000mL as most of our 3rd stages were physiological. Very occassionally we did use oxytocin for management of 3rd stage usually when the woman had a history of PPH greater than 1000mL or retained products etc.. However we were well versed in the Cochrane studies and aware of that evidence so we had a high degree of caution shall I say. We did carry 40 units of pitocin and also ergometrine both vials and tabs to births as well as herbal remedies. Syntometrine does not seem to be available in the USA at least not where I was. That being said from what i have seen here postnatally, active management really decreases the postpartum blood loss in most women. I am currently doing the extended midwifery service and visiting women in their home during the first 1 to 10 days and most seem to have almost finished bleeding by day 5, for most of the homebirth women I visited in the USA just from memory I would say they were almost finished by day 10. Both the American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA) have been collecting stats for 5 to 10 years at least and must have good stats on this topic. I know it isn't Australian data but itmight be helpful. marilyn - Original Message - From: Jenny Cameron To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 23, 2005 3:51 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Good point Michelle. If we used 1000ml as PPH definition the stats would not look so appealing for active mgmt. Also as someone stated women having a physiological 3 stage tend to lose more in the first few hours after birth than those having active mgmt. As far as I am aware no-one has researched total postpartum (say in the first week) blood loss. Hb or Hct estimation is the best way of determining blood loss post partum but you need to have a pre-partum Hb/Hct as well. Jenny Jennifer Cameron FRCNA FACM ProMid Professional Midwifery Education Service 0419 528 717 - Original Message - From: Michelle Windsor To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 23, 2005 10:34 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT I haven't heard of a study of this type beingb done. I find it interesting that the NSW policy (similar to many others) of PPH is over 500ml, and yet the WHO states that in healthy populations (ie not anaemic etc) up to 1000ml blood loss may be physiological. It is often said that blood loss at birth is underestimated I wonder how many women have blood loss of over 500ml and are fine due to the increased circulating blood volume in pregnancy. Cheers Michelle Fiona Rumble [EMAIL PROTECTED] wrote: WITH REGARDS TO THE RESEARCH THAT SUBSTANTIATES THE CLAIMS THAT ACTIVE MANAGEMENT IS SAFER THAN PHYSIOLOGICAL MANGAEMENT OF THIRD STAGE, DOES ANYONE KNOW IF THERE HAVE BEEN ANY STUDIES COMPARING PHYSIOLOGICAL WHOLE OF LABOUR AND BIRTH WITH ACTIVE MANAGEMENT OF THIRD STAGE FOLLOWING MANAGED LABOUR AND BIRTH I AM SURE THE RESULTS WOULD BE VERY DIFFERENT. JUST A THOUGHT. CHEERS FIONA Find local movie times and trailers on Yahoo! Movies. 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.
Re: [ozmidwifery] new baby vaccine
Megan, This is frightening, what about spending more money on educating both youth and parents about drugs and their inherent dangers, or better still provide support networks for parents during the various stages of the parenting journey in an attempt to keep parents and their children connected and respecting one another; provide more opportunity for youth at various levels, government, community and family? Surround them with positivity, instill confidence, inherent self worth, respect, ambition - support families to do this, show the way. On and on I could go and sure its not a fool proof way to prevent drug addiction but the effects of such would be far reaching and improve peoples lives and communities generally. I think it is a much better investment than a vaccine. This trend towards a quick fix pill for everything, or worse still, an attempt to prevent something that may not happen with the expectation that everyone could become drug addicts and non contributors within society is very negative. It could become a self fulfilling prophecy. That is, if a child learns that they have been vaccinated against potential drug addiction then this may negatively orientate them towards the very thing we are seeking to prevent! Moreover, who wants to live in a country where the government has this negative focus? - how bloody uninspiring! Some positive leadership would be a great start to addressing the issue of drug addiction. I want to live in a country where parents are given Jean Leidloff's 'Contiuum Concept' or Pinky's 'Parenting by Heart' at the birth of their child and provided with ongoing support. Ideally communities would offer fabulous, all encompassing parenting classes that are so wonderful that they become intrinsic to birth and parenting. If most of us agree that parenting is the most challenging job why is there so little in the way of 'professional development'? Like any vaccine program it is critical that we allow parents to retain a choice as to whether they do or do not vaccinate. This will allow parents to put in the 'hard yards' to prevent drug addiction the old fashioned way - with active parenting filled with love, support and respect rather than this patheitic, one-dimensional method. Cheers Rochelle. - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 8:47 AM Subject: [ozmidwifery] new baby vaccine You might debate the necessity of some vaccines, but what about this one (below) I just found on NEWS.com.au , How on earth does this make sense? Cheers Megan Call for anti-junkie baby jab February 26, 2005 From: http://www.theaustralian.news.com.au/?from=ni_story A GROUP of Queensland politicians want the federal Government to investigate giving an anti-junkie vaccination to babies. The vaccination, being considered by British MPs, would render children immune to becoming smokers or drug users. Delegates at this weekend's Queensland Nationals Central Council meeting on the Sunshine Coast will debate a resolution calling for the investigation. Nationals member Ken Wilson, who is taking the issue to the meeting, said he had the backing of his 90-strong western Brisbane suburbs branch. Drugs are a scourge, Mr Wilson said. I feel strongly about this and I'm inviting the federal Government to investigate it and if it proves worthwhile then do a vaccination program. Federal Health Minister Tony Abbott is yet to be approached to investigate, but a spokeswoman said the vaccine was in the very early development stages. Drug addiction is estimated to cost the Government $6 billion a year. 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. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[no subject]
Hello everyone! I am in need of some help!!! I am 32 weeks pregnant and the baby is in a breech position. I have been doing breech tilts 2-3 times a day for the past week with no success. I am having acupuncture next week. I am particularly interested in some information on the use of pulsatilla. Any ideas will be much appreciated!! Thanks Helen
Re: [ozmidwifery] Hep B vaccine reaction
Dear Joy I am curious to know how a newborn baby can or does get a Hep B infection from staff midwives being the staff with the most contact are almost always Hep B vaccincated and checkedas I think would be paediatricians?? Denise Hynd "Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled." Linda Hes - Original Message - From: Joy Cocks To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 5:13 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa and Nicole, Like you, I have serious concerns about giving Hep B at such an early age. I believe we areplacing a very heavy insult on a baby's natural immune system. I asked this question of an Immunisation Nurse who was a speaker at a seminar I went to and she said that most cases of Hep B with babies are contracted from staff! I'm also concerned that parents are not given enough information on the pros and cons of this first immunisation as, almost without exception, they sign the permission form. I certainly find that babies are very often upset and crying the night after it is given (I work night shift and often spend many hours walking the baby in a sling when mum is too tired to cope any longer). Certainly, if it is to be given I think it is preferable to give it later in the stay in hospital, not immediately after birth together with the Konakion - another injection that parents never seem to refuse. Joy Joy Cocks RN (Div 1) RM CBE IBCLCemail:[EMAIL PROTECTED] - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 0:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not sure how I will be able to give the vaccine to another baby after that experience. Kind regards, Nicole. - Original
Re: [ozmidwifery] Hep B vaccine reaction
Hi Denise, I have no idea, as I think the same as you. I think I was too stunned at the time to even ask that question. Joy Joy Cocks RN (Div 1) RM CBE IBCLCBRIGHT Vic 3741 email:[EMAIL PROTECTED] - Original Message - From: Denise Hynd To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 15:28 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Dear Joy I am curious to know how a newborn baby can or does get a Hep B infection from staff midwives being the staff with the most contact are almost always Hep B vaccincated and checkedas I think would be paediatricians?? Denise Hynd "Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled." Linda Hes - Original Message - From: Joy Cocks To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 5:13 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa and Nicole, Like you, I have serious concerns about giving Hep B at such an early age. I believe we areplacing a very heavy insult on a baby's natural immune system. I asked this question of an Immunisation Nurse who was a speaker at a seminar I went to and she said that most cases of Hep B with babies are contracted from staff! I'm also concerned that parents are not given enough information on the pros and cons of this first immunisation as, almost without exception, they sign the permission form. I certainly find that babies are very often upset and crying the night after it is given (I work night shift and often spend many hours walking the baby in a sling when mum is too tired to cope any longer). Certainly, if it is to be given I think it is preferable to give it later in the stay in hospital, not immediately after birth together with the Konakion - another injection that parents never seem to refuse. Joy Joy Cocks RN (Div 1) RM CBE IBCLCemail:[EMAIL PROTECTED] - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 0:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are
Re: [ozmidwifery] Hep B vaccine reaction
Hi Lisa, I don't believe the baby was at risk of catching Hepatitis B. Which means it will be absolutely tragic if the side effects are long reaching. I don't believe I would be forced to give a vaccine if I didn't want to do it. I would probably be able to ask a colleague to do it if I was unable to do it. However, I have to think about this. I will be seeing the manager on Monday, as I am not happy with the level of information parents receive, and we do know the carrier status of all the mothers. I do know though that the government monitors compliance of maternity units with giving Hep B vac, and it could attract unwelcome attention if the rate of vaccination goes down in our unit. This is not a reason not to do it, but may have implications. There is an adverse reactions register for vaccination, which I have mentioned to the medical staff caring for the baby. Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 12:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not sure how I will be able to give the vaccine to another baby after that experience. Kind regards, Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 11:27 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth
Re: [ozmidwifery] Hep B vaccine reaction
Hi Pinky , I may be able to answer some of your questions. I have studied immunisation, and was an immunisation provider for about ten years. I have become concerned about the willingness of our government to introduce new vaccinations to the schedule, particularly since the introduction of the second MMR prior to the commencement of primary school. This Hep B vaccination at birth seems over the top, and I personally wonder at the relationship between governments and commercial vaccination manufacturers. I may be paranoid. My children are vaccinated. However, I have grown to respect people who make a carefully considered decision not to do so. I think if I had my time over again, I would still vaccinate, but there would be some vaccines that I would refuse eg Sabin. I don't believe parents are asked about previous vaccine reactions in other family members. The health department advice on this one is I believe that other family members are not at any greater risk. The idea of putting a foreign substance into a new baby is also quite a concern to me. I have had someone tell me the birth dose of Hep B is important, because the Mast cells are permanently altered by giving it, so immunity is forever. I was floored by this, and wondered whether I was wrong. But later I thought, why Hep B then, why not measles or some other vaccine? I have found from experience that these nurses usually just repeat the party line. Some can be a bit aggressive when questioned! (Of course I never was!) But it would be a very difficult job to do if you had any doubts in your mind. Vaccines are given to well babies, and premmies, I think just before discharge. I think it is often up to the judgement of the midwife or nurse looking after the baby. The vaccination clinic is mainly for babies or infants with allergic type reactions, or known allergies to egg in the case of MMR. Localised reactions are seen as normal, unless severe. I have only seen two serious reactions in my time, which is now reaching twenty years. Best wishes, Nicole. - Original Message - From: Pinky McKay To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 27, 2005 3:39 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Nicole and lisa, Are any questions asked re family history of allergies/ vaccine reactions before giving the shots? My own first baby (now 30)had a similar reaction to his first triple antigen (the first vaccine in those days), my mother had a collapse after a tetanus shot requiring an ambulance and adrenalin and my second child as a teenager who had cut his hand on a rusty piece of iron was taken by his bossfor a tetanus shot - the following dayhecollapsed/ stopped breathing and ended up in hospital being resuscitated -this was recorded as a vaccine reaction. My younger children are unvaccinated depite much pressure/ school formsand even a huge dressing down from a GP who called me negligent and ignorant. At a talk last year (at a midwifery conference in SA) by a govt person on the 'logic' of vaccinating, her reasoning was as you mentioned that some babies of carriers - in the US!! she said- had slipped through and not been vaccinated at birth. Apparently "some of these women sued!!" I find this very flimsy and fearfulreasoning to give vaccinations to a pure little newborn - surely this is occasion for parents to take personal responsibility - you would know if you were a carrier and so would your carers as it would be on your records. Why should womenwho aren't carriers be pressured to expose their babies to unnecessary risks? Especially since babies are not going to be engaging in risky behaviour! As I researched after my own children's reactions I became very cynical that much of this pressure is driven by $$$ -ifas you say, if the 2 month vaccination will fully cover a baby (if it is the parent's choice to vaccinate) surely the shot at birth for all babies is overkill? Sounds like that could have been literally, Nicole- it must have been a terrible shock for you and the parents. I really feel for you about being anxious to inject more babies - how do you deal with this in your workplace? So Im wondering - are parents asked about family history of allergies/ reactions to vaccines? Are vaccines given to well babies? when are they given to premmies? Babies who have had any health problems/ respiratorydifficultiesat birth? Or difficult births? What is defined as a reaction severe enough / concerning enough to be referred to the Children's special clinic? Many babies have red limbs, irritability, fever - is this enough to be cautious about subsequent vaccines? Pinky - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 5:33 AM
Re: [ozmidwifery] Hep B vaccine reaction
Emily, How refreshing to hear this from a medical person! So often I find medical colleagues unprepared to take the broader view on these issues. You will be treasured by your future patients! I agree entirely, parents will not knowingly put their babies at risk. I have also recently looked after a woman who carries Hep C. Her hygeine is unbelievable. She is incredibly protective of everyone in her family and generally. She also has taken steps to distance her children from people in her past who may be infected. Her baby incidentally, has had the Hep B vaccine. I wish there was a Hep C vaccine, as we have infinitely more mothers with Hep C. Nicole. - Original Message - From: Emily To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 9:44 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction hi im a 3rd year medical student and as far as i know the hep B vaccine is now routinely given at birth as a public health measure rather than because babies are actually at risk. youre right that infants and children are at low risk of contracting hep b. the only reason it is given at birthis that it is a convenient time to have contact with all hospital born babies, rather than trust in the parents that they would bring the baby back at a suitable time. i have mixed views of different vaccines, but this one and tetanus really take the cake. to subject a newly born baby to a traumatic experience purely for convenience sake (when theyre not even at risk of the disease) is a verypoor policy in my mind, especially because parents are not told this is why it is being given so they assume it is because their baby is at risk. i think if the hep b vaccine is deemed necessary at all, resources should be put in to educating the parents about it and trusting them ! to make the decision if and when to give it rather than the paternalistic view that if they dont vaccinate everyone at birth, noone would have the initiative to bring the baby back when he or she is older and may become at risk. emily lisa chalmers [EMAIL PROTECTED] wrote: Hello everyone. I'm fairly new to Australia, (from the Uk) but have been an avid follower of this site for some time now. And, by way of an introduction..and as a first post I feel compelled to ask about this vaccineby my nature, I havnt vaccinated my kids...but as far as this particular vaccine is concernedwhy is it given routinely?? I ask, because I thought that hep B was passed on by blood and sex..(to be crude)...what infant is genuinely at risk of this?? If a baby has a reaction like this...(hope she is ok!!) does that mean she is contraindicated for future vaccines?? Many thanks, lisa Perth - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 7:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver. Do you Yahoo!?Take Yahoo! Mail with you! Get it on your mobile phone.
Re: [ozmidwifery] Hep B vaccine reaction
Thanks Nicole.. How is the baby doing?? I hope the parents are ok too. From my own experiencemuch fussis made of those of us that dont vaccinate...but littleis made of adverse reactions ..or even if vaccinated kids then go on to develop the disease that theyare "protected" from. I was involved in a so called epidemic of measles 2 years ago. All of the kids unvaccinated were reported when they got measles..none of those that were vaccinated were. Its scandelous. Figureswere definately tweaked. It must be really toughfor you hope it goes well with your manager on monday. Could you offer to help rewrite the info given? I had a peek at the site in SA earlier and that looked great! Good luck, lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 2:08 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, I don't believe the baby was at risk of catching Hepatitis B. Which means it will be absolutely tragic if the side effects are long reaching. I don't believe I would be forced to give a vaccine if I didn't want to do it. I would probably be able to ask a colleague to do it if I was unable to do it. However, I have to think about this. I will be seeing the manager on Monday, as I am not happy with the level of information parents receive, and we do know the carrier status of all the mothers. I do know though that the government monitors compliance of maternity units with giving Hep B vac, and it could attract unwelcome attention if the rate of vaccination goes down in our unit. This is not a reason not to do it, but may have implications. There is an adverse reactions register for vaccination, which I have mentioned to the medical staff caring for the baby. Nicole. - Original Message - From: lisa chalmers To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 12:33 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Thats really interesting Nicole, thankyou! Coming from the uk, I know my case,,and can state it..but being here I have found a high uptake off vaccinations amongst babies and children..and have already had to sign all sorts to get my children into school. I do believe in parents making informed decisions..but often found the info available is biased..(in both directions!) As a midwife...if your beliefs were suchcould you refuse to vaccinate babies? And to clarify for me... if a mother is not carrying hep B...how would a baby contact it?Through a blood transfusion? Do you have to report reactions like that? Hope you dont mind me asking,.. lisax - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Friday, February 25, 2005 9:11 PM Subject: Re: [ozmidwifery] Hep B vaccine reaction Hi Lisa, Welcome to Australia! Hepatitis B vaccine has been given routinely at birth now for maybe five years. One of the most common causes of Hepatitis B is contracting it from your mother at birth, if she is a carrier.I believe the practice of Hep B vaccination at birth came aboutbecause there were cases of babies of known Hep B carriers who did not receive immunoglobulin and vaccination at birth, also because the conversion to Hep B carrier status is very high if you contract the disease in infancy. When universal hep B administration came in, most midwives were not happy, but it was still introduced. The doctors order it andthe parents are given an information sheet to read, which I believe does not give the whole picture (including that if the birth dose is not given, the baby still gets a full course by having Hep B vax at 2,4, and 12 months of age). Parents sign a consent form, and then the vaccine is given if they wish to proceed. I like to give the parents the risk factors for contracting Hep B, and the information about the normal immunisation schedule, and let them decide. All the women have their Hep B and Cstatus checked antenatally, and are likely to know if they are a carrier. Many ask what the majority of parents do and are guided by that. Most parents at this stage are going ahead with it. While I can't prove that the incident I experienced tonight was caused by the vaccine, it only occured at the most 10 minutes after the vaccine. I don't know if the baby is contraindicated for further vaccines, but would be very careful. It probably should be done at the Royal Childrens Hospital where they have a specialised clinic for babies who have had vaccine reactions.I am not
Re: [ozmidwifery] Hep B vaccine reaction
Hi Sally, I have decided to put in a report myself to the vaccine reaction register for that very reason. Thanks for sharing your experience, it has motivated me to not wait for the docs to act. Nicole. - Original Message - From: sally To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 11:07 AM Subject: Re: [ozmidwifery] Hep B vaccine reaction Indeed, this has happened to me a couple of times. Once a baby had a full on fit about 5 mins after the injection, then went on to fit more in NBS, and a baby born by elective LUSCS had a respiratory arrest. Both times the docs denied it could possibly have had anything to do with the vaccine! Sally - Original Message - From: Nicole Carver To: ozmid ; Maternity Coalition Sent: Friday, February 25, 2005 10:48 PM Subject: [ozmidwifery] Hep B vaccine reaction Hi All, Have just had a scary experience when a baby became floppy and stopped breathing three timesafter the Hep B vaccine. She is ok, but being observed for 24 hours in special care. It just reinforces my belief that giving all babies Hep B prior to discharge from hospital is unnecessary, and where there are no risk factors present, more dangerous than not giving it. Nicole Carver.
Re: [ozmidwifery] RE: breech
I second that Sally!, Maggie Banks is brilliant and her book is fantastic. Another brilliant NZ midwife Joan Donley, also has a book for pregnancy and childbirth , which covers breech birth, i can scan those pages and send them to you if you like? Kirsten Darwin ~~~start life with a midwife~~~ - Original Message - From: Sally Westbury To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 26, 2005 3:24 PM Subject: [ozmidwifery] RE: breech Hi Helen, If you can get hold of the book Breech Wise by Maggie Banks you will have it all at your fingertips. Maggie is an incredible NZ midwife who has spoken widely about Breech issues. If you cant get a hold of it, let me know and I would be willing to post you my copy Sally Westbury Homebirth Midwife "It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her." -Judy Slome Cohain
RE: [ozmidwifery] RE: breech
Oh.. the other thing that I wanted to say is that at 32 weeks I would not be too worried. Babies are often that way at 32 weeks and then turn. If you were a client of mine I would be saying dont worry until 34-35 weeks. Then do everything!! Sally Westbury Homebirth Midwife It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her. -Judy Slome Cohain
