Re: [ozmidwifery] High babies
Dear Megan If it were not such a sad situation you could laugh at the patronising ignorance or is that arrogance and obsurdity of this Obs! Sounds like the next step is C/s for babies who have the nerve to turn around completely as that also stretches the uterus! And of caourse he has not talk of the risks to mother and baby of elective C/s on an arbitary date!! 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: Megan Woodman-Browning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, July 24, 2005 1:28 PM Subject: Re: [ozmidwifery] High babies Dear Sally, I am an independant midwife in Melbourne. could you please contact me [EMAIL PROTECTED] I have a friend of a friend who is in need of a professional further opinion in regards to a transverse baby and apparently a LUSCS is definitely needed (according to her OB) because the uterus has been stretched in an abnormal way and she is at risk of uterine rupture!! Thanks Megan -- 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: 7.0.338 / Virus Database: 267.9.4/57 - Release Date: 22/07/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RH -
Hi wise midwives, Below is a question received through the HAS website. Could anyone please help with an answer. Cheers Jo hunter Hi Hope you could help with another point of view please. I am 28 weeks pregnant I have a 5 year old 2 year old and had a missed miscarriage on the 9th November last year, after each child I have had the RhoGAM injection including with the miscarriage before I had a D C (11week 5 days) although baby had stopped growing at 8 1/2 weeks. I am having a home birth with a reg midwife and went to the doctor to ask for blood form to have the babies cord blood tested at birth to see if I need the RH injection. I am now being told that I have to have the injection again now at 28weeks and 34 weeks regardless ! This did not happen with my 2nd child and there are no antibodies showing at any blood test . Why ? all the doctor will tell me is because that is what is done. I would never put the baby at risk and would like another opinion. Many thanks
Re: [ozmidwifery] RH -
Hi Jo, Directed at your Mothers enquiry: There really isn't another 'point of view', just the facts. The management of Rh Neg women during pregnancy has altered in the past 1-2-years. Possibly this has caused confusionbecauseyour Dr is suggesting a new strategy which he hasn't fully explained.Also we accustomed to antibodies being a good positive thing, in discussing the RH factor it's messy because they are an undesirable thing. Hard to get the head around! The following isroutine management. I wonder if it's clearly understood thatthe idea of Anti-D or Rhogam is to prevent the formation of antibodies. In this regardyou have done all the right things asyou have no antibodies present inyour blood. If you have antibodies to the rhesus factor in your blood you have become "iso-immunised" (i.e. immunised against the RH factor). By giving women who are RH Neg Anti-D or Rhogam during their pregnancy (at 28 34 weeks) any undetected small bleed that may have occurred unbeknownst to the mother will not affect her antibody status. It is designed to prevent her body forming antibodies to the unborn baby's blood(as s/he has an unknown status, i.e. we are unable to determine whether the baby has or doesn't have the RH factor until s/he is born we test the cord blood). The big picture is to wipe-out iso-immunisation from the population the most common time for it to occur is with pregnancy ( it can occur at other times as well i.e. anincorrect blood transfusion). So eventually no women in Aust will be iso-immunised. Of course you would never put you baby at risk, that's why you are checking you are doing the appropriate thing. You are being a responsible mother, checking things out before going ahead because someone said "because that is just what's done". Good on you ! You are in the perfect position to have Anti-D/Rhogam as you are NOT iso-immunised, so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Tech Info at: http://www.transfuse.com.au Hope this helps. Brenda M http://www.themidwife.com.au - Original Message - From: jo To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 10:49 PM Subject: [ozmidwifery] RH - Hi wise midwives, Below is a question received through the HAS website. Could anyone please help with an answer. Cheers Jo hunter Hi Hope you could help with another point of view please. I am 28 weeks pregnant I have a 5 year old 2 year old and had a missed miscarriage on the 9th November last year, after each child I have had the RhoGAM injection including with the miscarriage before I had a D C (11week 5 days) although baby had stopped growing at 8 1/2 weeks. I am having a home birth with a reg midwife and went to the doctor to ask for blood form to have the babies cord blood tested at birth to see if I need the RH injection. I am now being told that I have to have the injection again now at 28weeks and 34 weeks regardless ! This did not happen with my 2nd child and there are no antibodies showing at any blood test . Why ? all the doctor will tell me is because that is what is done. I would never put the baby at risk and would like another opinion. Many thanks
Re: [ozmidwifery] High babies
Surely if this baby is truly stuck in a transverse position at term (and there has been no mention of gestation) a C/S would be necessary? Is she a primip or multi? How long has the baby been transverse and has any attempt been made to encourage it to a more favourable position? sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Denise Hynd [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 7:09 PM Subject: Re: [ozmidwifery] High babies Dear Megan If it were not such a sad situation you could laugh at the patronising ignorance or is that arrogance and obsurdity of this Obs! Sounds like the next step is C/s for babies who have the nerve to turn around completely as that also stretches the uterus! And of caourse he has not talk of the risks to mother and baby of elective C/s on an arbitary date!! 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: Megan Woodman-Browning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, July 24, 2005 1:28 PM Subject: Re: [ozmidwifery] High babies Dear Sally, I am an independant midwife in Melbourne. could you please contact me [EMAIL PROTECTED] I have a friend of a friend who is in need of a professional further opinion in regards to a transverse baby and apparently a LUSCS is definitely needed (according to her OB) because the uterus has been stretched in an abnormal way and she is at risk of uterine rupture!! Thanks Megan -- 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: 7.0.338 / Virus Database: 267.9.4/57 - Release Date: 22/07/2005 -- 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: 7.0.338 / Virus Database: 267.9.4/57 - Release Date: 22/07/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RE:RH - Anti D
Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant track it down. MM
RE: [ozmidwifery] High babies
Sue writes: How long has the baby been transverse and has any attempt been made to encourage it to a more favourable position? I have often wondered why ECV is not offered to women with transverse lie in the same way it is offered to Breech babies. Or is it routinely offered and I don't know about it? Also knowing what parity is the lady and what gestation is this baby? A bit more info is needed before we can comment intelligently. MM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] RE:RH - Anti D
Title: Bericht http://www.withwoman.co.uk/contents/info/anantid.html the booklet 'Anti-D in Midwifery, 2nd editionPanacea or Paradox?' you can purchase at http://www.elsevier-international.com/catalogue/title.cfm?ISBN=0750652322partnerid=474 Lieve Lieve Huybrechts vroedvrouw 0477/740853 -Oorspronkelijk bericht-Van: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Namens Mary MurphyVerzonden: maandag 25 juli 2005 20:42Aan: ozmidwifery@acegraphics.com.auOnderwerp: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women don’t know that it is a blood product and one that often comes from Canada as we don’t have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new “routine” and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be “best”. We really don’t know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant woman’s body also goes into her baby’s. A good book to read is written by Sara Wickham “Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 “ MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I can’t track it down. MM --No virus found in this incoming message.Checked by AVG Anti-Virus.Version: 7.0.338 / Virus Database: 267.9.2/54 - Release Date: 21/07/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.9.2/54 - Release Date: 21/07/2005
Re: [ozmidwifery] High babies
Bicycle shorts! Cheap, simple and hugely effective! J - Original Message - From: Susan Cudlipp [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 12:17 AM Subject: Re: [ozmidwifery] High babies Surely if this baby is truly stuck in a transverse position at term (and there has been no mention of gestation) a C/S would be necessary? Is she a primip or multi? How long has the baby been transverse and has any attempt been made to encourage it to a more favourable position? sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Denise Hynd [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 7:09 PM Subject: Re: [ozmidwifery] High babies Dear Megan If it were not such a sad situation you could laugh at the patronising ignorance or is that arrogance and obsurdity of this Obs! Sounds like the next step is C/s for babies who have the nerve to turn around completely as that also stretches the uterus! And of caourse he has not talk of the risks to mother and baby of elective C/s on an arbitary date!! 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: Megan Woodman-Browning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, July 24, 2005 1:28 PM Subject: Re: [ozmidwifery] High babies Dear Sally, I am an independant midwife in Melbourne. could you please contact me [EMAIL PROTECTED] I have a friend of a friend who is in need of a professional further opinion in regards to a transverse baby and apparently a LUSCS is definitely needed (according to her OB) because the uterus has been stretched in an abnormal way and she is at risk of uterine rupture!! Thanks Megan -- 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: 7.0.338 / Virus Database: 267.9.4/57 - Release Date: 22/07/2005 -- 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: 7.0.338 / Virus Database: 267.9.4/57 - Release Date: 22/07/2005 -- 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] High babies
If I was the woman in question, the very last thing I'd ask for is ECV, Too dangerous and unpredictable. The Spinning Babes website has more information on moving less-then-optimal babies than I have ever seen anywhere else. Gentle Birth archives has a massive amount too along with explanations of using homeopathic pulsatilla. There are many avenues to explore, including, as I wrote earlier, bicycle shorts. Very effective! J - Original Message - From: Mary Murphy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 5:05 AM Subject: RE: [ozmidwifery] High babies Sue writes: How long has the baby been transverse and has any attempt been made to encourage it to a more favourable position? I have often wondered why ECV is not offered to women with transverse lie in the same way it is offered to Breech babies. Or is it routinely offered and I don't know about it? Also knowing what parity is the lady and what gestation is this baby? A bit more info is needed before we can comment intelligently. MM -- 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] fetal heart monitoring.
Ive been looking at patterns of intermittent auscultation for midwifery practice. It seems that little is published outside the NICE guidelines but the ACOG say The American College of Obstetricians and Gynecologists (ACOG) states that with specific intervals, intermittent auscultation of the FHR is equivalent to continuous EFM in detecting fetal compromise.4 ACOG has recommended a 1:1 nurse-patient ratio if intermittent auscultation is used as the primary technique of FHR surveillance.4 The recommended intermittent auscultation protocol calls for auscultation every 30 minutes for low-risk patients in the active phase of labor and every 15 minutes in the second stage of labor.4 Continuous EFM is indicated when abnormalities occur with intermittent auscultation and for use in high-risk patients. Table 1 lists examples of the criteria that have been used to categorize patients as high risk. http://www.aafp.org/afp/990501ap/2487.html Would anyone like to share their guidelines? Sally Westbury
[ozmidwifery] Re: safe hospital births
Dear Jan and all, Seems to me since our GPs have attended ALSO in the last couple of years, they jump in, take over birthing and treat all births as shoulder dystocia! Ending up with horrible dragging out of babies. I probably have over reacted, but 2 recent births I attended ended up this way. Small rural hospital, and I have been a midwife for 33 years. Barbara
Re: [ozmidwifery] RE:RH - Anti D
MM, When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it ! Just providing the basic rationale. Inthe local small Mid unit herewe have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one hereever gave them any grief about declining the Ig, so perhapsinstinctually none of us believe it's the 'right 'thing to do ! On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's 90's who lost baby after baby to hydrops other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant track it down. MM
Re: [ozmidwifery] Irish Mothers Continue to have their Birth Choices Challenged
It's great to see you here, Tracy. I'm so excited about your work. It's always great to be the women turning the first sod, as it were. Brightest blessings and support from Australia! J
Re: [ozmidwifery] RE:RH - Anti D
I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it. I must admit...i haven't done a lot of research on it. What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation? I suppose these sort of studies won't be around for a while, as this is reletively new practise. My personal beliefbeing a negative blood group and having had 2 babies beforeboth negative blood groupsanti-d was not given in pregnancy with these babies.I would probably choose not to have it with future pregancy's either unless positive baby after birth. tanya - Original Message - From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 6:10 PM Subject: Re: [ozmidwifery] RE:RH - Anti D MM, When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it ! Just providing the basic rationale. Inthe local small Mid unit herewe have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one hereever gave them any grief about declining the Ig, so perhapsinstinctually none of us believe it's the 'right 'thing to do ! On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's 90's who lost baby after baby to hydrops other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant track it down. MM
Re: [ozmidwifery] fetal heart monitoring.
We are now using the RANZCOG guidelines, which cite the NICE guidelines as one of the reference sources(just personally I find these guidelines incredibly restrictive for the labouring woman). A update on the guidelines is due out early August. Current version is available online although I cant seem to find it at the moment. Cheers Alesa Alesa KoziolClinical Midwifery EducatorMelbourne - Original Message - From: Sally Westbury To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 9:13 AM Subject: [ozmidwifery] fetal heart monitoring. Ive been looking at patterns of intermittent auscultation for midwifery practice. It seems that little is published outside the NICE guidelines but the ACOG say The American College of Obstetricians and Gynecologists (ACOG) states that with specific intervals, intermittent auscultation of the FHR is equivalent to continuous EFM in detecting fetal compromise.4 ACOG has recommended a 1:1 nurse-patient ratio if intermittent auscultation is used as the primary technique of FHR surveillance.4 The recommended intermittent auscultation protocol calls for auscultation every 30 minutes for low-risk patients in the active phase of labor and every 15 minutes in the second stage of labor.4 Continuous EFM is indicated when abnormalities occur with intermittent auscultation and for use in high-risk patients. Table 1 lists examples of the criteria that have been used to categorize patients as high risk. http://www.aafp.org/afp/990501ap/2487.html Would anyone like to share their guidelines? Sally Westbury
RE: [ozmidwifery] RE:RH - Anti D
Coming from New Zealand the whole deal of giving anti d routinely at 28 34 weeks is very different to what guidelines NZ have. The red cross blood service in NZ have guidelines http://www.nzblood.co.nz/?t=25 scroll down to use of anti d during pregnancy and post partum. I am rhesus iso immunized due to a mixing somewhere between 36 weeks and birth, without a visible bleed, but I was told I was a tiny percentage, something like 1 in 1000 woman who become iso immunized, most have a visible bleed and can be given the anti-d. Sara Wickhams book is fantastic and I too believe the pharmaceutical companies get more out of the prophlatic use of anti-d than woman do. Kirsten From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Tanya Fleming Sent: Wednesday, July 27, 2005 6:55 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] RE:RH - Anti D I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it. I must admit...i haven't done a lot of research on it. What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation? I suppose these sort of studies won't be around for a while, as this is reletively new practise. My personal beliefbeing a negative blood group and having had 2 babies beforeboth negative blood groupsanti-d was not given in pregnancy with these babies.I would probably choose not to have it with future pregancy's either unless positive baby after birth. tanya - Original Message - From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 6:10 PM Subject: Re: [ozmidwifery] RE:RH - Anti D MM, When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it ! Just providing the basic rationale. Inthe local small Mid unit herewe have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one hereever gave them any grief about declining the Ig, so perhapsinstinctually none of us believe it's the 'right 'thing to do ! On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's 90's who lost baby after baby to hydrops other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant track it down. MM
Re: [ozmidwifery] RE:RH - Anti D
I thought I'd just put my 2cents worth in as a pregnant Rh negative mum. I don't know much about the science behind it but I was told with my first one (only 2 yrs ago) that I would only need Anti-D if I had a bleed or after birth and not routinely because it was difficult to get. This time around a GPtold me that I need it at 28/36 weeks, after birth and if I have any bleeding. I am thinking that the availability of Anti-D must have picked up so there is an opportunity of $$ for someone. Joh - Original Message - From: Tanya Fleming To: ozmidwifery@acegraphics.com.au Sent: Wednesday, July 27, 2005 7:25 AM Subject: Re: [ozmidwifery] RE:RH - Anti D I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it. I must admit...i haven't done a lot of research on it. What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation? I suppose these sort of studies won't be around for a while, as this is reletively new practise. My personal beliefbeing a negative blood group and having had 2 babies beforeboth negative blood groupsanti-d was not given in pregnancy with these babies.I would probably choose not to have it with future pregancy's either unless positive baby after birth. tanya - Original Message - From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 6:10 PM Subject: Re: [ozmidwifery] RE:RH - Anti D MM, When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it ! Just providing the basic rationale. Inthe local small Mid unit herewe have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one hereever gave them any grief about declining the Ig, so perhapsinstinctually none of us believe it's the 'right 'thing to do ! On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's 90's who lost baby after baby to hydrops other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant
Re: [ozmidwifery] RH - Anti D
Having done a bit of research on it recently for our birth centre women it seems that only 1.5% of negative women will become isoimmunized during pregnancy. And that figure includes a large proportion who are mismanaged and not given Anti-D when potential sensitizing events occur eg. bleeding, ectopics, abdominal trauma. So the real figure would be much less. It seems total overkill to treat all women for a problem that 98.5% of them won't encounter. The other thing is that Anti-D does cross the placenta and there are no studies on the long term effects on the baby. In Ireland in the 80's (before complete blood screening) there were women who ended up with Hep C through Anti-D. It makes me wonder if in the future they will detect other blood borne diseases which were transmitted via Anti D. Just my thoughts Cheers MichelleTanya Fleming [EMAIL PROTECTED] wrote: I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it. I must admit...i haven't done a lot of research on it. What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation? I suppose these sort of studies won't be around for a while, as this is reletively new practise. My personal beliefbeing a negative blood group and having had 2 babies beforeboth negative blood groupsanti-d was not given in pregnancy with these babies.I would probably choose not to have it with future pregancy's either unless positive baby after birth. tanya - Original Message - From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 6:10 PM Subject: Re: [ozmidwifery] RE:RH - Anti D MM, When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it ! Just providing the basic rationale. Inthe local small Mid unit herewe have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one hereever gave them any grief about declining the Ig, so perhapsinstinctually none of us believe it's the 'right 'thing to do ! On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's 90's who lost baby after baby to hydrops other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women dont know that it is a blood product and one that often comes from Canada as we dont have enough from Australia. It is really big business. I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators. There is nothing mandatory about the new routine and many women do not follow it for the above reasons. It really is a big experiment that women are expected to follow because it is seen to be best. We really dont know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group. What goes into a pregnant womans body also goes into her babys. A good book to read is written by Sara Wickham Over the last 30 years, anti-D,! or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England2001 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency) Maybe someone has this book? I know I read an article by Sara with much the same title, but I cant track it down. MM Do you Yahoo!? Messenger beta: Free worldwide PC to PC calls and a special headset offer!
