Re: [ozmidwifery] News article, woman refused care for being overweight.
While I deplore the fact that any woman would be refused care due to her size, I do understand the issues for clinicians and other staff. I recently had a follow through woman with a booking in weight of 147 kg. She had gest. diabetes + quite bad cellulitis in her right leg. She was cared for by a known midwife in our Midwifery Group Practice and had collaborative obstetric care due to the 'risks' involved. She was booked for IOL with gels at term due to suspected LGA babe, but had uterine hypertony as a result. The consultant Ob. ordered a follow up U/S when he came to review and her little one had a very high head, sitting right over the brim of the symphysis pubis. He recommended elective section for that evening which she agreed to. The experience in theatre was a huge learning experience for me, and very challenging. It took the anaesthetist almost 20 minutes to site an IV (MWs and RMOs had tried without success), then 45 minutes to insert the spinal (her spines were just obscured with fat, and almost impossible to get a nice curve of her back due to abdo size). The theatre table was simply not designed for a woman of her size, it took six of us to manouvere her safely then strap her down. Her abdomen was too pendulous to be held back with retractors so in the end the theatre staff set up an improvised sling and winch system to lift it out of the way. It really opened my eyes to the risks for the woman and OHS issues for staff. I in NO WAY feel any woman should be faced with refusal of care for these issues, rather that on a budget and staffing level they need to be dealt with by the hospital system. As more and more women with high BMIs find it easier to conceive on fertility treatments etc, we will have a real issue in the way we provide safe maternity care services for these women. The outcome for my follow through woman was great, lovely 4.3 kg baby girl and home now day 7 with clean wound and well established BF (Phew!). However, I still believe the situation she faced was potentially dangerous for her, her daughter and the staff involved in her care. Regards, Miriam (2nd Yr Bmid) Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] News article, woman refused care for being overweight.
Maybe, if this woman had 'been allowed' to go into labour she may well have had a nice labour and birth, with no scar on her uterus. I have looked after many overweight women, [and am myself a short, large person.] I remember two extremely overweight women who had beautiful labours and lovely water births. While fat can interfere with descent etc, the psyche plays such an important role that I believe it can overcome just about anything. These women had faith in themselves, they knew their bodies would do the deed, and they had sense not to present in labour until in transition. There can be no general rule. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Miriam Hannay Sent: Monday, 13 June 2005 5:37 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. While I deplore the fact that any woman would be refused care due to her size, I do understand the issues for clinicians and other staff. I recently had a follow through woman with a booking in weight of 147 kg. She had gest. diabetes + quite bad cellulitis in her right leg. She was cared for by a known midwife in our Midwifery Group Practice and had collaborative obstetric care due to the 'risks' involved. She was booked for IOL with gels at term due to suspected LGA babe, but had uterine hypertony as a result. The consultant Ob. ordered a follow up U/S when he came to review and her little one had a very high head, sitting right over the brim of the symphysis pubis. He recommended elective section for that evening which she agreed to. The experience in theatre was a huge learning experience for me, and very challenging. It took the anaesthetist almost 20 minutes to site an IV (MWs and RMOs had tried without success), then 45 minutes to insert the spinal (her spines were just obscured with fat, and almost impossible to get a nice curve of her back due to abdo size). The theatre table was simply not designed for a woman of her size, it took six of us to manouvere her safely then strap her down. Her abdomen was too pendulous to be held back with retractors so in the end the theatre staff set up an improvised sling and winch system to lift it out of the way. It really opened my eyes to the risks for the woman and OHS issues for staff. I in NO WAY feel any woman should be faced with refusal of care for these issues, rather that on a budget and staffing level they need to be dealt with by the hospital system. As more and more women with high BMIs find it easier to conceive on fertility treatments etc, we will have a real issue in the way we provide safe maternity care services for these women. The outcome for my follow through woman was great, lovely 4.3 kg baby girl and home now day 7 with clean wound and well established BF (Phew!). However, I still believe the situation she faced was potentially dangerous for her, her daughter and the staff involved in her care. Regards, Miriam (2nd Yr Bmid) Send instant messages to your online friends http://au.messenger.yahoo.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.
Re: [ozmidwifery] News article, woman refused care for being overweight.
I find this website very helpful for info on larger women and pregnancy. Cheers, J http://www.plus-size-pregnancy.org/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
We too have a BMI cut off of 35. The reason is that the anaesthetists regard this as a risk factor should there be a need to anaesthetise - as Miriam has related the story of one lady quite clearly below. While I find it very hard to refuse a booking on these grounds, we do have to follow protocols laid down for medical reasons. Women who are clinically obese are referred to the tertiary hospital. I agree that women labouring naturally do not usually have problems, whatever their size, but the fact is that smaller units are not equipped to deal with the extra issues that may arise if a large woman does require an emergency anaesthetic. I am very interested to know if high BMI is seen as an issue in homebirth or midwifery led units? Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 13, 2005 3:36 PM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. While I deplore the fact that any woman would be refused care due to her size, I do understand the issues for clinicians and other staff. I recently had a follow through woman with a booking in weight of 147 kg. She had gest. diabetes + quite bad cellulitis in her right leg. She was cared for by a known midwife in our Midwifery Group Practice and had collaborative obstetric care due to the 'risks' involved. She was booked for IOL with gels at term due to suspected LGA babe, but had uterine hypertony as a result. The consultant Ob. ordered a follow up U/S when he came to review and her little one had a very high head, sitting right over the brim of the symphysis pubis. He recommended elective section for that evening which she agreed to. The experience in theatre was a huge learning experience for me, and very challenging. It took the anaesthetist almost 20 minutes to site an IV (MWs and RMOs had tried without success), then 45 minutes to insert the spinal (her spines were just obscured with fat, and almost impossible to get a nice curve of her back due to abdo size). The theatre table was simply not designed for a woman of her size, it took six of us to manouvere her safely then strap her down. Her abdomen was too pendulous to be held back with retractors so in the end the theatre staff set up an improvised sling and winch system to lift it out of the way. It really opened my eyes to the risks for the woman and OHS issues for staff. I in NO WAY feel any woman should be faced with refusal of care for these issues, rather that on a budget and staffing level they need to be dealt with by the hospital system. As more and more women with high BMIs find it easier to conceive on fertility treatments etc, we will have a real issue in the way we provide safe maternity care services for these women. The outcome for my follow through woman was great, lovely 4.3 kg baby girl and home now day 7 with clean wound and well established BF (Phew!). However, I still believe the situation she faced was potentially dangerous for her, her daughter and the staff involved in her care. Regards, Miriam (2nd Yr Bmid) Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.6.9 - Release Date: 11/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] News article, woman refused care for being overweight.
Janet, What a fantastic web site. Thank you as this information will help the very many large ladies that I see in clinic. Their only crime being BMI 35. These women need midwifery care, just don't hand them over please. Cheers Barb -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Monday, 13 June 2005 6:38 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. I find this website very helpful for info on larger women and pregnancy. Cheers, J http://www.plus-size-pregnancy.org/ -- 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] Homebirth Albury/Wodonga
Title: Homebirth Albury/Wodonga Dear All Does anyone know of an independent midwife covering the Albury/Wodonga area?? Many Thanks Justine Justine Caines Secretary Homebirth Australia PO Box 105 Merriwa NSW 2329 Ph: (02) 65482248 E-Mail : [EMAIL PROTECTED] www.homebirthaustralia.org
RE: [ozmidwifery] Problems With new Models
Title: Message Carol, I am wondering how feasiblea caseload is60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary womenand 40 shared women not be a more doable workload? I know this hasfinancial implications but down-sizing the model may increase its longevity.Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basicallytranslates tomidwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carol Van LochemSent: Sunday, June 12, 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
Midwifery led units have a BMI cutoff of 35- I think this is due to anaesthetic difficulties. Sonja - Original Message - From: Susan Cudlipp [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 12:47 AM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. We too have a BMI cut off of 35. The reason is that the anaesthetists regard this as a risk factor should there be a need to anaesthetise - as Miriam has related the story of one lady quite clearly below. While I find it very hard to refuse a booking on these grounds, we do have to follow protocols laid down for medical reasons. Women who are clinically obese are referred to the tertiary hospital. I agree that women labouring naturally do not usually have problems, whatever their size, but the fact is that smaller units are not equipped to deal with the extra issues that may arise if a large woman does require an emergency anaesthetic. I am very interested to know if high BMI is seen as an issue in homebirth or midwifery led units? Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 13, 2005 3:36 PM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. While I deplore the fact that any woman would be refused care due to her size, I do understand the issues for clinicians and other staff. I recently had a follow through woman with a booking in weight of 147 kg. She had gest. diabetes + quite bad cellulitis in her right leg. She was cared for by a known midwife in our Midwifery Group Practice and had collaborative obstetric care due to the 'risks' involved. She was booked for IOL with gels at term due to suspected LGA babe, but had uterine hypertony as a result. The consultant Ob. ordered a follow up U/S when he came to review and her little one had a very high head, sitting right over the brim of the symphysis pubis. He recommended elective section for that evening which she agreed to. The experience in theatre was a huge learning experience for me, and very challenging. It took the anaesthetist almost 20 minutes to site an IV (MWs and RMOs had tried without success), then 45 minutes to insert the spinal (her spines were just obscured with fat, and almost impossible to get a nice curve of her back due to abdo size). The theatre table was simply not designed for a woman of her size, it took six of us to manouvere her safely then strap her down. Her abdomen was too pendulous to be held back with retractors so in the end the theatre staff set up an improvised sling and winch system to lift it out of the way. It really opened my eyes to the risks for the woman and OHS issues for staff. I in NO WAY feel any woman should be faced with refusal of care for these issues, rather that on a budget and staffing level they need to be dealt with by the hospital system. As more and more women with high BMIs find it easier to conceive on fertility treatments etc, we will have a real issue in the way we provide safe maternity care services for these women. The outcome for my follow through woman was great, lovely 4.3 kg baby girl and home now day 7 with clean wound and well established BF (Phew!). However, I still believe the situation she faced was potentially dangerous for her, her daughter and the staff involved in her care. Regards, Miriam (2nd Yr Bmid) Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.6.9 - Release Date: 11/06/2005 -- 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] Problems With new Models
Title: Message The ANF specifies 40-45 woman only for a 'caseload'. Sally - Original Message - From: Jackie Doolan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 10:54 AM Subject: RE: [ozmidwifery] Problems With new Models Carol, I am wondering how feasiblea caseload is60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary womenand 40 shared women not be a more doable workload? I know this hasfinancial implications but down-sizing the model may increase its longevity.Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basicallytranslates tomidwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carol Van LochemSent: Sunday, June 12, 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
[ozmidwifery] Premature babes
Hi everyone Just a question, slightly off topic... Just wondering if premature babies are more at risk for having fragile bones as they grow up?? And if formula impacts on bone density also, they had no breastmilk, only formula Thanks Katrina There are four basic food groups-milk chocolate, dark chocolate, white chocolate, and chocolate truffles. -Anonymous
Re: [ozmidwifery] Problems With new Models
Sorry Sally, I dont know what you mean by this... do you mean that the ANF specify this number as constituting a 'caseload', anything under that is not? cheers jennifairy sally williams wrote: The ANF specifies 40-45 woman only for a 'caseload'. Sally - Original Message - *From:* Jackie Doolan mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Tuesday, June 14, 2005 10:54 AM *Subject:* RE: [ozmidwifery] Problems With new Models Carol, I am wondering how feasible a caseload is 60 women? This seems like a large number and may be one of the reasons why staff are not feeling up to the task. Would 40 primary women and 40 shared women not be a more doable workload? I know this has financial implications but down-sizing the model may increase its longevity. Additionally UK literature states that greater autonomy leads to greater job satisfaction. So I agree with Andrea's posting - which basically translates to midwives having greater control over their practice and time allocation. Warragul model has been a great motivator for many of us watching and planning new model development. I hope this works out for you. Jackie Doolan -Original Message- *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *Carol Van Lochem *Sent:* Sunday, June 12, 2005 5:39 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] Problems With new Models Hi all, I have posted here from time to time, but mostly I'm a lurker. I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do all that on call.They want to have a life. After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives. Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are available for our own women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 high risk women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load. To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions. Any thoughts, suggestions, simmilar experiences? I am truely at my wits end. Sigh :( Thanks for listening Carol -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.1 - Release Date: 13/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Success!!!
CONGRATULATIONS Judy co. in Mareeba. Wishing you all the best. Let us know if we can be of any help. Sue, Rosie and Marion. [EMAIL PROTECTED] 06/11/05 10:52am It is now official as it is in todays Cairns Post and no doubt it will be on the news sometime. MAREEBA MATERNITY IS NOW TO BE A PILOT SITE IN QLD FOR A LOW RISK FREESTANDING BIRTH CENTRE. Thanks to the brilliant work done by the staff, the women, the community and MC, ACMI etc. Apparantly we can start 1 July. Policies are being madly written and all sort of paperwork produced as we will be under a microscope for a long time. Apart from that we have had 3 babies this week, multis who were in too good a labour to risk transferring, 3 very happy mums to birth in their own community. Cheers Judy***This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.Any unauthorised use, alteration, disclosure, distribution or review of this email is prohibited. It may be subject to a statutory duty of confidentiality if it relates to health service matters.If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone or by return email. You should also delete this email and destroy any hard copies produced.***
