[ozmidwifery] Breastfeeding The Natural State
Hi, Not long to go until the Australian Breastfeeding Association's International Conference. Already we have more than 500 registrants, but there's roon for plenty more. We also have some space available for trade displays. The prices are extremely reasonable The sponsorship prospectus can be downloaded from www.cdesign.com.au/aba2005.The 3 day Conference program includes many well known and world renownedspeakers - Dr James McKenna, Dr Brian Palmer, Prof Peter Hartmann, Sue Coxand Prof Heather Jeffery, Nancy MoorbacherDay 1 - Natural State - focuses on how babies and breasts are meant to be,their unique anatomical and physiological qualities, and the role we play inensuring they get together for their mutual benefit.Day 2 - Stormy Weather - has the scientification of breastfeeding made itmore difficult than what it is? Have we created conflict between instinctand expert?Day 3 -Cultural Perspectives - explores how cultural variations influencebreastfeeding knowledge and practice.The provisional program has now been uploaded on the website and can beaccessed at www.cdesign.com.au/aba2005.
[ozmidwifery] Human Milk Bank
This was on the list earlier this year. Helen Cahill http://www.theage.com.au/articles/2004/08/12/1092102573402.html Australia's first milk bankAugust 12, 2004 - 1:06PMAustralia's first milk bank is to start offering breast milk to newmothers in Victoria from the beginning of next year.Melbourne-based lactation consultant Margaret Callaghan plans to openthe private service which will pasteurise milk donations and offer themto mothers who cannot produce enough for their own babies.The proposal has raised questions about how the new service would beregulated.Ms Callaghan said the private company setting up the Victorian milk bankplanned to set up in NSW next and then to establish clinics nationwide.She said new mothers who wanted to donate would be screened for diseaseand would then express the milk at home."It wouldn't be like a cow shed," she said.The milk would be pasteurised and given to premature babies whosemothers for some reason could not provide enough milk.Premature babies would be targeted initially as they were the mostlikely to suffer necrotising enterocolitis (NEC), or bowel blockages,after being fed formula, she said.Mothers milk also aided neurological development and reduced the risksof infections, Ms Callaghan said.Hospitals used to provide excess milk from new mothers to babies whoneeded it until the rise of the spectre of AIDS in the 80s.Ms Callaghan said that as the average age of mothers increased, so hadthe demand for breast milk."I have people ringing me saying 'Where can I get some human milkfrom'," she said.The president of paediatrics and child health of the Royal AustralasianCollege of Physicians, Professor Don Roberton today said any move tomake breast milk more available was positive as long as the milk wasproperly screened for disease.Professor Roberton said human milk had advantages over formula,especially for premature babies."But we also have to be very aware of any potential risks that mightoccur with human milk," he said.Breast milk would need to be carefully screened in the same way donatedblood was, he said.Breast milk banks operate in the UK, the USA and parts of Europe but theprospect of them opening in Australia has raised the question of who isresponsible for their regulation.A Therapeutic Goods Administration spokesman said a breast milk bankwould be a state rather than a federal responsibility.A spokesman for the Victorian Department of Human Services said a breastmilk bank would come under the State food act.The operators would have to show their product was "free of infectionand fit for human consumption" and convince the government that they hadstrict screening processes in place, he said.- AAP No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.300 / Virus Database: 266.5.2 - Release Date: 28/02/2005__ NOD32 1.1017 (20050302) Information __This message was checked by NOD32 antivirus system.http://www.nod32.com
Re: [ozmidwifery] Human Milk Bank
Hmmm. Well I haven't heard anything about it and I'm in contact with many lactavists who'd love this. I shall do some investigating! Anyone know the LC in the article? J - Original Message - From: Helen and Graham To: ozmidwifery Sent: Sunday, August 21, 2005 6:02 PM Subject: [ozmidwifery] Human Milk Bank This was on the list earlier this year. Helen Cahill http://www.theage.com.au/articles/2004/08/12/1092102573402.html Australia's first milk bankAugust 12, 2004 - 1:06PMAustralia's first milk bank is to start offering breast milk to newmothers in Victoria from the beginning of next year.Melbourne-based lactation consultant Margaret Callaghan plans to openthe private service which will pasteurise milk donations and offer themto mothers who cannot produce enough for their own babies.The proposal has raised questions about how the new service would beregulated.Ms Callaghan said the private company setting up the Victorian milk bankplanned to set up in NSW next and then to establish clinics nationwide.She said new mothers who wanted to donate would be screened for diseaseand would then express the milk at home."It wouldn't be like a cow shed," she said.The milk would be pasteurised and given to premature babies whosemothers for some reason could not provide enough milk.Premature babies would be targeted initially as they were the mostlikely to suffer necrotising enterocolitis (NEC), or bowel blockages,after being fed formula, she said.Mothers milk also aided neurological development and reduced the risksof infections, Ms Callaghan said.Hospitals used to provide excess milk from new mothers to babies whoneeded it until the rise of the spectre of AIDS in the 80s.Ms Callaghan said that as the average age of mothers increased, so hadthe demand for breast milk."I have people ringing me saying 'Where can I get some human milkfrom'," she said.The president of paediatrics and child health of the Royal AustralasianCollege of Physicians, Professor Don Roberton today said any move tomake breast milk more available was positive as long as the milk wasproperly screened for disease.Professor Roberton said human milk had advantages over formula,especially for premature babies."But we also have to be very aware of any potential risks that mightoccur with human milk," he said.Breast milk would need to be carefully screened in the same way donatedblood was, he said.Breast milk banks operate in the UK, the USA and parts of Europe but theprospect of them opening in Australia has raised the question of who isresponsible for their regulation.A Therapeutic Goods Administration spokesman said a breast milk bankwould be a state rather than a federal responsibility.A spokesman for the Victorian Department of Human Services said a breastmilk bank would come under the State food act.The operators would have to show their product was "free of infectionand fit for human consumption" and convince the government that they hadstrict screening processes in place, he said.- AAP No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.300 / Virus Database: 266.5.2 - Release Date: 28/02/2005__ NOD32 1.1017 (20050302) Information __This message was checked by NOD32 antivirus system.http://www.nod32.com
[ozmidwifery] when to cut an episiotomy
A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
Re: [ozmidwifery] when to cut an episiotomy
I'm not one of the professionals in here, Paivi but hi anyway. : )I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide.Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible. Just my 2c ; ) Janet - Original Message - From: Päivi To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 6:31 PM Subject: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
[ozmidwifery] Liability ruling in Weekend Australian
http://www.theaustralian.news.com.au/common/story_page/0,5744,16318814%255E23289,00.html Liability ruling delivers fuel to midwife debate Adam Cresswell, health editor August 20, 2005 DOCTORS and midwives are at loggerheads over their legal liabilities from new-style birthing units after a hospital sued an obstetrician to recover a share of the $7.5million it was ordered to pay for a birth mishap involving a midwife. Obstetricians say the case vindicates their fears they will be held responsible for the work of midwives, who are pushing for expanded roles and recently started a second midwife-led birthing unit in NSW at Belmont near Newcastle. But midwives such as Robyn Rudner, who works at the Ryde midwifery group practice in Sydney, the state's first public midwife-led birthing centre, said doctors' fears were overblown. She said while the Ryde and Belmont units had good safety records, midwives would remain legally responsible for any mistakes they made. We are fully responsible for women under our care as midwives, and when we transfer women to a hospital we remain responsible (for their own actions), she said. The legal case, adjourned this week in the NSW Supreme Court, was mounted by the Greater Southern Area Health Service in NSW. The doctor being sued was an on-call obstetrician when the baby was born in September 1995. While the delivery was handled by a midwife in the obstetrician's absence, the health service claims the doctor failed to adequately supervise the case. It was ordered to pay the mother $7.5million in April 2003, and is now seeking a contribution from the obstetrician. Pieter Mourik, a retired obstetrician from Albury, NSW, claimed the case bore out fears doctors would continue to carry the responsibility for mishaps in a midwife's delivery. Dr Mourik said the case was dynamite and it was unheard of for a hospital to sue a doctor for a procedure carried out by another health worker. However, Andrew Bisits, director of obstetrics at John Hunter Hospital, who has helped develop the Belmont unit, said while the whole atmosphere around pregnancy and childbirth ... has degenerated into this very negative and fearful experience, units such as Ryde and Belmont were an antidote to such fears.
[ozmidwifery] Kathleen Fahy article in Weekend Australian...
Unfortunately not available electronically, but titled Midwifery is safe, and access a right what a wonderful comment on womens rights and the sad state of affairs here in Australia where most midwives do not, and are not allowed to work truly as midwives, encompassing the full extent of our legislated practice guidelines. She challenges Doctors to provide research evidence from randomized controlled trials to prove that midwifery care is not safe, and states that doctors shouldnt have a government mandated monopoly on provision of care for pregnant women. She goes on to say that women should be free to choose their maternity care providers without financial penalty, and that as professional, midwives should have the right to provide maternity care to the full legal scope of their practice. Three cheers for Kathleen Fahy! Tania
Re: [ozmidwifery] Human Milk Bank
I have forwarded this to Margaret Callaghan ( in the article)- she is a fabulous LC -a past pres of ALCAafew years ago. Haven't heard anything recently re milk bank proposal. I think Marg is in NZat present so we may not hear for a while. Pinky - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 6:08 PM Subject: Re: [ozmidwifery] Human Milk Bank Hmmm. Well I haven't heard anything about it and I'm in contact with many lactavists who'd love this. I shall do some investigating! Anyone know the LC in the article? J - Original Message - From: Helen and Graham To: ozmidwifery Sent: Sunday, August 21, 2005 6:02 PM Subject: [ozmidwifery] Human Milk Bank This was on the list earlier this year. Helen Cahill http://www.theage.com.au/articles/2004/08/12/1092102573402.html Australia's first milk bankAugust 12, 2004 - 1:06PMAustralia's first milk bank is to start offering breast milk to newmothers in Victoria from the beginning of next year.Melbourne-based lactation consultant Margaret Callaghan plans to openthe private service which will pasteurise milk donations and offer themto mothers who cannot produce enough for their own babies.The proposal has raised questions about how the new service would beregulated.Ms Callaghan said the private company setting up the Victorian milk bankplanned to set up in NSW next and then to establish clinics nationwide.She said new mothers who wanted to donate would be screened for diseaseand would then express the milk at home."It wouldn't be like a cow shed," she said.The milk would be pasteurised and given to premature babies whosemothers for some reason could not provide enough milk.Premature babies would be targeted initially as they were the mostlikely to suffer necrotising enterocolitis (NEC), or bowel blockages,after being fed formula, she said.Mothers milk also aided neurological development and reduced the risksof infections, Ms Callaghan said.Hospitals used to provide excess milk from new mothers to babies whoneeded it until the rise of the spectre of AIDS in the 80s.Ms Callaghan said that as the average age of mothers increased, so hadthe demand for breast milk."I have people ringing me saying 'Where can I get some human milkfrom'," she said.The president of paediatrics and child health of the Royal AustralasianCollege of Physicians, Professor Don Roberton today said any move tomake breast milk more available was positive as long as the milk wasproperly screened for disease.Professor Roberton said human milk had advantages over formula,especially for premature babies."But we also have to be very aware of any potential risks that mightoccur with human milk," he said.Breast milk would need to be carefully screened in the same way donatedblood was, he said.Breast milk banks operate in the UK, the USA and parts of Europe but theprospect of them opening in Australia has raised the question of who isresponsible for their regulation.A Therapeutic Goods Administration spokesman said a breast milk bankwould be a state rather than a federal responsibility.A spokesman for the Victorian Department of Human Services said a breastmilk bank would come under the State food act.The operators would have to show their product was "free of infectionand fit for human consumption" and convince the government that they hadstrict screening processes in place, he said.- AAP No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.300 / Virus Database: 266.5.2 - Release Date: 28/02/2005__ NOD32 1.1017 (20050302) Information __This message was checked by NOD32 antivirus system.http://www.nod32.com
RE: [ozmidwifery] when to cut an episiotomy
Title: Bericht Hoi Païvi, This was on the list a while ago. greetings Lieve Routine episiotomy shows no benefits, only harmSource:Journal of the American Medical Association 2005; 293: 2141-8 Comparing maternal outcomes with routine versus restrictive use of episiotomy in a systematic review of the literature. Routine episiotomy does not appear to provide the benefits traditionally credited to it, and, in some cases, is more damaging than a spontaneous tear, say researchers. Episiotomy was initially introduced on the assumption that a deliberate incision would heal more quickly and with fewer complications than a spontaneous tear, and that it would lead to less pelvic floor problems, such as fecal or urinary incontinence or impaired sexual function, later on. To determine whether this is actually the case, researchers led by Katherine Hartmann, from the University of North Carolina at Chapel Hill in the USA, conducted a systematic review of the best quality trials available comparing routine with restrictive use of the procedure. The 26 articles selected for detailed study were consistent in finding that routine episiotomy did not reduce the severity of laceration, pain, or pain medication use, compared with restricted surgery. There was also no evidence to support the longer-term outcomes ascribed to episiotomy, including prevention of fecal or urinary incontinence or reduced impaired sexual function. In fact, pain during intercourse was more common in women who underwent the procedure. Study co-author John Thorp Jr. summarized: "In most cases, episiotomy doesn't do any good, and it can harm women. Why would one want a surgical procedure that's worthless Lieve Huybrechts vroedvrouw 0477/740853 -Oorspronkelijk bericht-Van: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Namens PäiviVerzonden: zondag 21 augustus 2005 10:31Aan: ozmidwifery@acegraphics.com.auOnderwerp: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi --No virus found in this incoming message.Checked by AVG Anti-Virus.Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005
RE: [ozmidwifery] when to cut an episiotomy
I will only do an episiotomy if I am really concerned about getting the baby out quickly. I have done one on a peri that was really tight, and didn't stretch up. I think I have done three in my career, Nicole C. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Janet FraserSent: Sunday, August 21, 2005 6:57 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] when to cut an episiotomy I'm not one of the professionals in here, Paivi but hi anyway. : )I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide.Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible. Just my 2c ; ) Janet - Original Message - From: Päivi To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 6:31 PM Subject: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
Re: [ozmidwifery] when to cut an episiotomy
Hi Nicole, That is so awasome, how many births have you done in your career? I read about a midwife, who had performed 6 episiotomies in 650 births. Two of these were when she was taught how to make them as a student. Paivi - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 12:55 PM Subject: RE: [ozmidwifery] when to cut an episiotomy I will only do an episiotomy if I am really concerned about getting the baby out quickly. I have done one on a peri that was really tight, and didn't stretch up. I think I have done three in my career, Nicole C. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Janet FraserSent: Sunday, August 21, 2005 6:57 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] when to cut an episiotomy I'm not one of the professionals in here, Paivi but hi anyway. : )I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide.Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible. Just my 2c ; ) Janet - Original Message - From: Päivi To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 6:31 PM Subject: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
RE: [ozmidwifery] when to cut an episiotomy
Hi Paivi, Not as many births as some of my colleagues. However, I have been to a Dennis Walsh workshop called something like Evidence Based Care in Normal Labour. He stated that the ONLY evidence based reason for episiotomy is in severe fetal distress. They are sometimes required for manoevres to get a baby out with severe shoulder dystocia, but in most cases not. Certainly, I have had a couple of tears personally, and I didn't find them a problem. However, the thought of someone taking scissors to my perineum fills me with terror! Kind regards, Nicole. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of PäiviSent: Sunday, August 21, 2005 9:53 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] when to cut an episiotomy Hi Nicole, That is so awasome, how many births have you done in your career? I read about a midwife, who had performed 6 episiotomies in 650 births. Two of these were when she was taught how to make them as a student. Paivi - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 12:55 PM Subject: RE: [ozmidwifery] when to cut an episiotomy I will only do an episiotomy if I am really concerned about getting the baby out quickly. I have done one on a peri that was really tight, and didn't stretch up. I think I have done three in my career, Nicole C. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Janet FraserSent: Sunday, August 21, 2005 6:57 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] when to cut an episiotomy I'm not one of the professionals in here, Paivi but hi anyway. : )I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide.Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible. Just my 2c ; ) Janet - Original Message - From: Päivi To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 21, 2005 6:31 PM Subject: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
RE: [ozmidwifery] when to cut an episiotomy
I have never cut an episiotomy since I have been registered as a midwife. I did as a student midwife in 1988. Sally Westbury Homebirth Midwife Learn from mothers and babies; every one of them has a unique story to tell. Look for wisdom in the humblest places - that's usually where you'll find it. Lois Wilson
Re: [ozmidwifery] Liability ruling in Weekend Australian
Thanks for this link Tania, re thecase - two thoughts ONE - this is exactly why all midwives need to be aware that they should have their own PI Insurance - because of the reality that vicarious liability alone does not cover a midwife. Sadly - many midwives still make the assumption that the PI Insurance issue is to beput in the basket for IPM's to deal with, in the belief it is only their issue (how sad our colleagues are not supported anyway! ) - but the truth is PI is an issue thataffects all midwives ! good to see Bisits calling it as it is and not buying into the primary care stuff as RANZCOG recently did (it would be delightful to be a fly on the wall right now). Of course Mourik's claim that Ob's be responsible for the work of midwives is the response we would expect when the issue not been faced is the OB been responisble for their own work..which leads into point two. TWO - We all knowobstetric beds are the highest number of hospitalbeds used currentlyapprox 250,000 per year. And despite theOB'slargely turningbirthing into big 'business' - with overservicing of well womenand less time available for the women who do need hrs of intensiveobstetric care - govts still provide the funds to keep it happenning, Women donot actually receive the care they think they will when they choose an obstetrician for their care in both the private and public health sector.we know the OB'sdo not providethe care for a woman experiencing labour and birth- it isthemidwives who provide this care with theOB glorified for catching the baby (if they actually make it in time -and only if the woman hasprivate health cover).Whilst different OB's do have different practices, in the public health arena a woman does not realise that even in an obstetric emergency -caesarean section or emergency medical care - the Obstetrician does notprovide this.- women do not realise it isprovided by theteamof midwives and drs/ob's in training (residents and registrars) while theobstetricianswho may have seen the women for one or two brief periods in pregnancy and birth (15-30 mins ?) are drumming up big business (scans and genetic tests),often imposed on healthy well young women at whim - who again do not need to be overserviced with costly and unnessary tests. and we all know only a small proportion of women receiving this care actually need it - and the costs to women and the system are exorbitant. Yet how do the govts address this ? -when the insurance crisis hit thefed government bailed the OB's outto the tune of $600 million and libs senator helen coonan secured coverage with Llyods(London)...the govt also providesaccess to thehigh costs claim scheme (where if the Ob's PI insurance fee is more than 7.5% of their income the govt pays the rest 80% ANDwill payout any claim over $300,000 !) - not to mentionthe coveragebymedicareetc. so why do govts continue to pay unnessary medicalised birth costs and the 'patch up the damage funds' for other health costs resulting from women recovering from traumatic birth experiences, postnatal depression etc ? why do they keep plugging up the holesand support a service that is essentiallyunnessary and expensive medical sub standard carefor the majority of women (80% WHO)? Why do govts deny women the right to experience the safest and most cost effective pregnancy and birth care ensuring the health system'dam' wall burstswhilemidwives do not have equity to accessmedicare provider numbers or insurance ? ...yes abbott has stated he is now finally considering medicare for midwives but only if a woman has been serviced by the public health budget of a medicare swiped visit to the GP for a referral first ! despite all the evidence, unnessa'scary costs are continuing to be paid outbig time - for sub-standard care of healthy well women experiencingpregnancy and birth. one does not need to look much further than the individual and organisationaldonations at election time and the politics of the obstetric alliance to work out why. Sally-Anne - Original Message - From: Tania Smallwood To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 7:00 PM Subject: [ozmidwifery] Liability ruling in Weekend Australian http://www.theaustralian.news.com.au/common/story_page/0,5744,16318814%255E23289,00.html Liability ruling delivers fuel to midwife debateAdam Cresswell, health editorAugust 20, 2005 DOCTORS and midwives are at loggerheads over their legal liabilities from new-style birthing units after a hospital sued an obstetrician to recover a share of the $7.5million it was ordered to pay for a birth mishap involving a midwife.Obstetricians say the case vindicates their fears they will be held responsible for the work of midwives, who are pushing for expanded roles and recently started a second midwife-led birthing unit in NSW at
Re: [ozmidwifery] when to cut an episiotomy
I think many midwives can claim very good episiotomy rates. Mine over twenty years in 0. My virginal scissors get taken to each birth but have never been out of the packet except to be put in a new packet and re sterilised. Who else would like to celebrate their lack of desire or interest in cutting a woman's perineum. Andrea Quanchi On 21/08/2005, at 6:57 PM, Janet Fraser wrote: I'm not one of the professionals in here, Paivi but hi anyway. : ) I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide. Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible. Just my 2c ; ) Janet x-tad-bigger- Original Message -/x-tad-bigger x-tad-biggerFrom:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-biggerPäivi/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerTo:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-bigger[EMAIL PROTECTED]/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerSent:/x-tad-biggerx-tad-bigger Sunday, August 21, 2005 6:31 PM/x-tad-bigger x-tad-biggerSubject:/x-tad-biggerx-tad-bigger [ozmidwifery] when to cut an episiotomy/x-tad-bigger A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that They will try to avoid episiotomy, but will cut just in case, if not sure. In Finland the episiotomy rates are from 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases). I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how often have you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
RE: [ozmidwifery] Liability ruling in Weekend Australian
You said it all Sally_Anne Tania xx From: owner-[EMAIL PROTECTED] [mailto:owner-[EMAIL PROTECTED]] On Behalf Of Sally-Anne Brown Sent: Monday, 22 August 2005 5:19 AM To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Liability ruling in Weekend Australian Thanks for this link Tania, re thecase - two thoughts ONE - this is exactly why all midwives need to be aware that they should have their own PI Insurance - because of the reality that vicarious liability alone does not cover a midwife. Sadly - many midwives still make the assumption that the PI Insurance issue is to beput in the basket for IPM's to deal with, in the belief it is only their issue (how sad our colleagues are not supported anyway! ) - but the truth is PI is an issue thataffects all midwives ! good to see Bisits calling it as it is and not buying into the primary care stuff as RANZCOG recently did (it would be delightful to be a fly on the wall right now). Of course Mourik's claim that Ob's be responsible for the work of midwives is the response we would expect when the issue not been faced is the OB been responisble for their own work..which leads into point two. TWO - We all knowobstetric beds are the highest number of hospitalbeds used currentlyapprox 250,000 per year. And despite theOB'slargely turningbirthing into big 'business' - with overservicing of well womenand less time available for the women who do need hrs of intensiveobstetric care - govts still provide the funds to keep it happenning, Women donot actually receive the care they think they will when they choose an obstetrician for their care in both the private and public health sector.we know the OB'sdo not providethe care for a woman experiencing labour and birth- it isthemidwives who provide this care with theOB glorified for catching the baby (if they actually make it in time -and only if the woman hasprivate health cover).Whilst different OB's do have different practices, in the public health arena a woman does not realise that even in an obstetric emergency -caesarean section or emergency medical care - the Obstetrician does notprovide this.- women do not realise it isprovided by theteamof midwives and drs/ob's in training (residents and registrars) while theobstetricianswho may have seen the women for one or two brief periods in pregnancy and birth (15-30 mins ?) are drumming up big business (scans and genetic tests),often imposed on healthy well young women at whim - who again do not need to be overserviced with costly and unnessary tests. and we all know only a small proportion of women receiving this care actually need it - and the costs to women and the system are exorbitant. Yet how do the govts address this ? -when the insurance crisis hit thefed government bailed the OB's outto the tune of $600 million and libs senator helen coonan secured coverage with Llyods(London)...the govt also providesaccess to thehigh costs claim scheme (where if the Ob's PI insurance fee is more than 7.5% of their income the govt pays the rest 80% ANDwill payout any claim over $300,000 !) - not to mentionthe coveragebymedicareetc. so why do govts continue to pay unnessary medicalised birth costs and the 'patch up the damage funds' for other health costs resulting from women recovering from traumatic birth experiences, postnatal depression etc ? why do they keep plugging up the holesand support a service that is essentiallyunnessary and expensive medical sub standard carefor the majority of women (80% WHO)? Why do govts deny women the right to experience the safest and most cost effective pregnancy and birth care ensuring the health system'dam' wall burstswhilemidwives do not have equity to accessmedicare provider numbers or insurance ? ...yes abbott has stated he is now finally considering medicare for midwives but only if a woman has been serviced by the public health budget of a medicare swiped visit to the GP for a referral first ! despite all the evidence, unnessa'scary costs are continuing to be paid outbig time - for sub-standard care of healthy well women experiencingpregnancy and birth. one does not need to look much further than the individual and organisationaldonations at election time and the politics of the obstetric alliance to work out why. Sally-Anne - Original Message - From: Tania Smallwood To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 7:00 PM Subject: [ozmidwifery] Liability ruling in Weekend Australian http://www.theaustralian.news.com.au/common/story_page/0,5744,16318814%255E23289,00.html Liability ruling delivers fuel to midwife debate Adam Cresswell, health editor August 20, 2005 DOCTORS and midwives are at loggerheads over their legal liabilities from new-style birthing units after a hospital sued an obstetrician to
Re: [ozmidwifery] Kathleen Fahy article in Weekend Australian...
Here is a copy of it. take care Alphia August 20, 2005 Saturday Travel Edition SECTION: REVIEW; Health; Pg. 29 LENGTH: 891 words HEADLINE: Midwifery is safe, and access a right SOURCE: MATP BYLINE: KATHLEEN FAHY BODY: ALICIA (not her real name) wanted to give birth in a private and safe environment attended by a known midwife. She is young and healthy. This makes her an ideal candidate for one-to-one midwifery care where a known midwife provides all maternity care for Alicia and her family. Midwives are qualified and licensed to provide antenatal, labour and post-birth care on their own responsibility. Normal, healthy women who have straightforward pregnancies do not need to be under the care of doctors. But Alicia and her partner, Paul, couldn't find a midwife to provide her care either at home or in a hospital. Why not? Because women who want to claim maternity care as a Medicare rebate must use a doctor. Thanks to this monopoly, virtually all pregnancies are managed by doctors, even though this is completely unnecessary. Another reason that Alicia couldn't hire a midwife is that midwives have been excluded from the network of taxpayer subsidies and safety nets provided by the federal Government for doctors' professional indemnity cover. The issue of Medicare rebates and indemnity insurance cover for midwives are matters of professional competition. It can be safely predicted that doctors will resist midwives being given access to Medicare. Doctors will claim, or imply, that somehow midwives are unsafe. As a midwifery researcher, however, I know that midwifery care is safe, and I know doctors cannot produce research evidence from randomised controlled trials to the contrary. Why did Alice and Paul want a midwife as their maternity care provider? According to them, it was because they wanted to feel in control of what happened to Alicia and the baby. They disagreed with the medical model of birth that thinks in terms of the bodies of women and babies. In the medical metaphor, the womb, pelvis and baby are thought of as either inert or mechanical. For doctors, the body is thought of as able to function independently of the brains and emotions of women and babies; but Alicia knows that this is not true. Alicia and her partner understand that giving birth is a deeply private, even a sexual function. That is why other primates birth in private. The medicalised environment is full of strangers who come and go and touch the woman. The birth environment that medicine creates is dominated by stainless steel, artificial light, airconditioning, hard floors, surgical lights and a hospital bed with a rubber-covered mattress. Machines are frequently attached to the woman to constantly monitor the baby's heart. This immediately suggests that maybe something is or will go wrong in a perfectly normal process; thus fear is created. In this environment, the woman needs to lie still so the machines that are attached to her work well. Not surprisingly, the woman becomes uncomfortable, is fearful of strangers and fearful for the baby, she is scared to make a noise and scared to make trouble. Women cope by using an epidural anaesthetic to block sensation below the waist. The outcome of such labours is frequently complications for the woman and the baby (BMJ 2000;321:137-141). Women who have surgical interventions and who don't get to actually give birth have higher rates of depression, guilt, regret, loss of self-esteem, feelings of violation, and dissatisfaction with care -- sometimes to the point of outright hostility. Midwives pay a lot of attention to creating the right environment for birth. It is crucial to understand that birthing where the woman and midwife know each other helps the women feel emotionally safe enough to be uninhibited in labour. When women choose to birth unaided they usually experience a great sense of their own strength and empowerment. Labouring without feeling safe is like driving a car with one foot on the pedal and one on the brake; thus fear leads to prolonged labour and unnecessary medical interventions. Fear is damaging to labour because adrenalin is produced and that disrupts the normal hormonal regulation of the process. Is midwifery care safe? Should the government allow access to Medicare for midwifery managed birth? Yes, absolutely! All women are entitled to financial support to cover the costs of childbirth and doctors shouldn't have a government-mandated monopoly. In terms of safety, the research demonstrates that midwifery-managed care, for women who are healthy and have straightforward pregnancies, there is no statistically significant difference in the outcomes for the babies. Research shows, however, that midwifery-managed birth is safer for women than birth under the direction of doctors (Cochrane, 2001, 2005). The Australian Medical Association and the Royal Australian College of Obstetricians and Gynaecologists both oppose independent occupational status for midwives.
RE: [ozmidwifery] when to cut an episiotomy
Also to consider, a sentence in Episiotomy and the Second Stage of Labor edited by Sheila Kitzinger that has always stood out for me as it makes so much sense. Whenever you put the scissors in and cut you ALWAYS have second degree perineal trauma. If you work to birth the baby with an intact peri then more than half of the time you will have it. Why do we cause so much pain to women unnecessarily?? In the last few years I have done a first degree nick for a tight peri and another time for a tight hymenal ring but neither needed sutures. Where I work we only have the cord scissors on our tray. Cheers Judy --- Lieve Huybrechts [EMAIL PROTECTED] wrote: Hoi Païvi, This was on the list a while ago. greetings Lieve Routine episiotomy shows no benefits, only harm Source: Journal of the American Medical Association 2005; 293: 2141-8 Comparing maternal outcomes with routine versus restrictive use of episiotomy in a systematic review of the literature. Routine episiotomy does not appear to provide the benefits traditionally credited to it, and, in some cases, is more damaging than a spontaneous tear, say researchers. Episiotomy was initially introduced on the assumption that a deliberate incision would heal more quickly and with fewer complications than a spontaneous tear, and that it would lead to less pelvic floor problems, such as fecal or urinary incontinence or impaired sexual function, later on. To determine whether this is actually the case, researchers led by Katherine Hartmann, from the University of North Carolina at Chapel Hill in the USA, conducted a systematic review of the best quality trials available comparing routine with restrictive use of the procedure. The 26 articles selected for detailed study were consistent in finding that routine episiotomy did not reduce the severity of laceration, pain, or pain medication use, compared with restricted surgery. There was also no evidence to support the longer-term outcomes ascribed to episiotomy, including prevention of fecal or urinary incontinence or reduced impaired sexual function. In fact, pain during intercourse was more common in women who underwent the procedure. Study co-author John Thorp Jr. summarized: In most cases, episiotomy doesn't do any good, and it can harm women. Why would one want a surgical procedure that's worthless Lieve Huybrechts vroedvrouw 0477/740853 -Oorspronkelijk bericht- Van: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Namens Päivi Verzonden: zondag 21 augustus 2005 10:31 Aan: [EMAIL PROTECTED] Onderwerp: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that They will try to avoid episiotomy, but will cut just in case, if not sure. In Finland the episiotomy rates are from 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases). I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how often have you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005 Do you Yahoo!? Try Yahoo! Photomail Beta: Send up to 300 photos in one email! http://au.photomail.mail.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Kathleen Fahy article in Weekend Australian...
Thanks Judy --- Alphia Possamai-Inesedy [EMAIL PROTECTED] wrote: Here is a copy of it. take care Alphia August 20, 2005 Saturday Travel Edition SECTION: REVIEW; Health; Pg. 29 LENGTH: 891 words HEADLINE: Midwifery is safe, and access a right SOURCE: MATP BYLINE: KATHLEEN FAHY BODY: ALICIA (not her real name) wanted to give birth in a private and safe environment attended by a known midwife. She is young and healthy. This makes her an ideal candidate for one-to-one midwifery care where a known midwife provides all maternity care for Alicia and her family. Midwives are qualified and licensed to provide antenatal, labour and post-birth care on their own responsibility. Normal, healthy women who have straightforward pregnancies do not need to be under the care of doctors. But Alicia and her partner, Paul, couldn't find a midwife to provide her care either at home or in a hospital. Why not? Because women who want to claim maternity care as a Medicare rebate must use a doctor. Thanks to this monopoly, virtually all pregnancies are managed by doctors, even though this is completely unnecessary. Another reason that Alicia couldn't hire a midwife is that midwives have been excluded from the network of taxpayer subsidies and safety nets provided by the federal Government for doctors' professional indemnity cover. The issue of Medicare rebates and indemnity insurance cover for midwives are matters of professional competition. It can be safely predicted that doctors will resist midwives being given access to Medicare. Doctors will claim, or imply, that somehow midwives are unsafe. As a midwifery researcher, however, I know that midwifery care is safe, and I know doctors cannot produce research evidence from randomised controlled trials to the contrary. Why did Alice and Paul want a midwife as their maternity care provider? According to them, it was because they wanted to feel in control of what happened to Alicia and the baby. They disagreed with the medical model of birth that thinks in terms of the bodies of women and babies. In the medical metaphor, the womb, pelvis and baby are thought of as either inert or mechanical. For doctors, the body is thought of as able to function independently of the brains and emotions of women and babies; but Alicia knows that this is not true. Alicia and her partner understand that giving birth is a deeply private, even a sexual function. That is why other primates birth in private. The medicalised environment is full of strangers who come and go and touch the woman. The birth environment that medicine creates is dominated by stainless steel, artificial light, airconditioning, hard floors, surgical lights and a hospital bed with a rubber-covered mattress. Machines are frequently attached to the woman to constantly monitor the baby's heart. This immediately suggests that maybe something is or will go wrong in a perfectly normal process; thus fear is created. In this environment, the woman needs to lie still so the machines that are attached to her work well. Not surprisingly, the woman becomes uncomfortable, is fearful of strangers and fearful for the baby, she is scared to make a noise and scared to make trouble. Women cope by using an epidural anaesthetic to block sensation below the waist. The outcome of such labours is frequently complications for the woman and the baby (BMJ 2000;321:137-141). Women who have surgical interventions and who don't get to actually give birth have higher rates of depression, guilt, regret, loss of self-esteem, feelings of violation, and dissatisfaction with care -- sometimes to the point of outright hostility. Midwives pay a lot of attention to creating the right environment for birth. It is crucial to understand that birthing where the woman and midwife know each other helps the women feel emotionally safe enough to be uninhibited in labour. When women choose to birth unaided they usually experience a great sense of their own strength and empowerment. Labouring without feeling safe is like driving a car with one foot on the pedal and one on the brake; thus fear leads to prolonged labour and unnecessary medical interventions. Fear is damaging to labour because adrenalin is produced and that disrupts the normal hormonal regulation of the process. Is midwifery care safe? Should the government allow access to Medicare for midwifery managed birth? Yes, absolutely! All women are entitled to financial support to cover the costs of childbirth and doctors shouldn't have a government-mandated monopoly. In terms of safety, the research demonstrates that midwifery-managed care, for women who are healthy and have straightforward pregnancies, there is no statistically significant difference in the outcomes for the babies. Research
RE: [ozmidwifery] when to cut an episiotomy
Because you asked: I have cut 3 in 22 yrs as a homebirth midwife. 1 for foetal distress, 1 for buttonholing the other I cant remember. It was all so long ago. Working with a group of 7 other midwives, I have never heard of them cutting episiotomies either. MM Who else would like to celebrate their lack of desire or interest in cutting a woman's perineum.
Re: [ozmidwifery] when to cut an episiotomy
In more than 25 years and over 1200 births, I am ashamed to tell you I've cut 3. One for an unyielding primip perineum which would not budge after hour of crowning. Next birth, it stretched nicely and didn't need an epis. Two, as a last ditch effort in a fatal shoulder dystocia--didn't help anything. Third for a distressed babe with bad scalp colour, born with a non pulsing cord and am glad I did it because I think there was a real problem there that MAY have compromised the baby. Gloria Lemay, Vancouver BC - Original Message - From: Andrea Quanchi To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 3:06 PM Subject: Re: [ozmidwifery] when to cut an episiotomy I think many midwives can claim very good episiotomy rates. Mine over twenty years in "0". My virginal scissors get taken to each birth but have never been out of the packet except to be put in a new packet and re sterilised. Who else would like to celebrate their lack of desire or interest in cutting a woman's perineum.Andrea QuanchiOn 21/08/2005, at 6:57 PM, Janet Fraser wrote: I'm not one of the professionals in here, Paivi but hi anyway. : )I've read in a few places about how episiotomy rates suddenly drop when studies into them begin. A hb MW I know does less than one a year so I figure that's a good guide.Mostly in hospitals they're performed for no reason at all but the damage they do to women's bodies and psyches horrifies me. It's sanctioned genital mutilation. In birth planning meetings I run I suggest to women that they never put their bodies in a position that can be easily reached by someone with scissors. Our rates are very high in Australia. Well IMO, any rate of episiotomy is too high unless it's negligible.Just my 2c ; )Janet - Original Message -From: Päivi To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 6:31 PMSubject: [ozmidwifery] when to cut an episiotomyA mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals?Paivi
Re: [ozmidwifery] As if messing with humans isn't enough..
This is the same nightmare scenario we have here in lovely Vancouver, BC Canada with our beluga and killer whales in captivity at the Vancouver Aquarium. It would curl your hair. The sea mammals are ultrasounded for "science" ---what does that do to their delicate sonar?? If not for the fact that the sea mammals are large and in water, I'm sure there would be cesareans. As it is, the babies are born spontaneously (at least vaginally although being contained in a small pool as opposed to an ocean has to cramp the mother's style) but then the fun begins. The public is allowed to come into the viewing area and great throngs show up to see the cute baby and new mom trying to get together to breastfeed. Needless to say, the breast feeding does not go well. They used to gavage feed the baby whalebut they always died of infection, so the scientists "discovered" that colostrum is essential to baby whale survival. Now, the question arises, how to get that precious colostrum into the baby's gut while still selling tickets to the public H. . . . they invented a whale breast pump. So, the poor mother was lured into a "holding" pool, the water drained out of the pool once she was captive, and the pump attached to her mammaries. The colostrum was thus obtained and force fed to baby. Baby died anywaythere's more to breastfeeding and colostrum than just the substance, obviously. Peace, quiet, privacyand love seem to matter to whales, too. I have it all on tape---videotaped the evening news every night. All I could think was the words of Christ on the cross "Father, forgive them for they know not what they do." Gloria Lemay - Original Message - From: Andrea Quanchi To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 2:59 PM Subject: Re: [ozmidwifery] As if messing with humans isn't enough.. It might be interesting for who ever wrote this to send a letter to the orang u tan keeper at the zoo, When the Melbourne zoo gorilla had a LUSCS a few years a go I ended up in quite a series of emails with the gorilla keeper who was in fact keen to talk about what had happened and why and to explore ways they could have handled it better next time. She in fact very much led the dialogue asking questions about what she had observed and what it might have meant. Asking the PR department at the zoo would be equivilant to asking the PR department at a big hospital to describe why things happen in labour ward. But ask the midwife and you'll get a very different answer.Andrea QuanchiOn 20/08/2005, at 3:34 PM, Carolyn Hastie wrote: FYICarolyn Hastielogo_h.gifICAN E-News Line International Cesarean Awareness Network Volume 31August 17 , 2005Focus: Eve and Araca enewshorse.gif1. Essay: Eve and AracaEarly May in Utah usually brings a few warm days and this year was no exception. We enjoyed a day trip to the zoo during this warm respite. Hogle Zoo isn’t my favorite zoo, but the kids enjoy seeing the animals.Two weeks later – on Mother’s Day- Eve, a female Orangutan, had a cesarean to deliver her baby, Araca. When I first heard the news, I thought, “What else would you expect to happen? You have an animal on the endangered species list, pregnant. What zoo keeper is going to ‘risk’ that pregnancy and baby by sitting on her hands and not doing anything? And ‘anything’ is enough to slow an animal’s labor progress.” There were many articles in the following weeks about the baby’s arrival. Strangely enough, I wasn’t upset by any of them, until I happened to hear a radio ‘interview’ with one of the zoo staff. The zoo keeper described the baby’s day, being cared for by the staff, fed formula from a bottle and being held by staff in furry vests. The radio host joked with her about the care of the baby, asking how the staff avoided ‘getting messed on’. The zoo employee said, “We don’t diaper the baby, we want to do everything natural with this little orangutan.” Suddenly, I was so angry I couldn’t see straight. Here is Eve, whose birth was denied her by staff, who now rejects her own baby. Here is a baby, whose mother doesn’t recognize or claim her, being fed formula from humans, being held by humans in furry vests and being shown off between the hours of 10 a.m. until 11 a.m. and again at 2 p.m. until 3 p.m. daily, and they have the nerve to claim they are doing everything natural because the baby doesn’t have a diaper on!I don’t know the details of Eve’s birth of her daughter. When called, the Zoo will not give out any details. When asked questions like, “How did staff know Eve was in labor? How long was she in labor? Was baby in distress at birth?”- no answer is given. You and I most likely will never get the answers to these questions or to the ultimate one they
RE: [ozmidwifery] when to cut an episiotomy
Here is a quick story about my personal experience. When I was birthing my beautiful 4560 gram baby (now 16 months old) my midwife was concerned that my peri had stretched as far as it was going to (i.e. not far enough) and was about to perform an episiotomy. She was only able to make a very slight nic as the scissors were blunt and I had one almighty contraction at just the right time! Bubs head was out and she was then very quickly born with my peri basically intact except for some slight grazing. How lucky was I? I am just so thankful for this outcome. So I tell everyone who is remotely interested in birth that I was saved by a pair of blunt scissor and one contraction. Of course I KNEW (after giving birth to 2 other babies 4440 and 4320 grams without episiotomy) that I did NOT NEED one of these things anyway! Cheers, Julia V. (Aspiring Midwife) -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nicole Carver Sent: Sunday, 21 August 2005 7:56 PM To: [EMAIL PROTECTED] Subject: RE: [ozmidwifery] when to cut an episiotomy I will only do an episiotomy if I am really concerned about getting the baby out quickly. I have done one on a peri that was really tight, and didn't stretch up. I think I have done three in my career, Nicole C.
Fw: [ozmidwifery] when to cut an episiotomy
- Original Message - From: brendamanning To: [EMAIL PROTECTED] Sent: Monday, August 22, 2005 8:52 AM Subject: Re: [ozmidwifery] when to cut an episiotomy Paivi This article was in a Melbourne newspaper 12 months ago, probably quite current stats. It can be seen in it's entirety on: www.theage.com.au I have been working in Mid since 1979 cut the required5 episiotomies in my training, since then have cut 2 in the last 20 years, both for fetal distress. BM To cut or not: debate on childbirth procedure By Amanda DunnHealth ReporterAugust 13, 2004 A surgical cut to make room for the baby's head in a vaginal birth is too commonly performed in private Victorian hospitals, an obstetric expert has warned. Obstetric epidemiologist James King also told The Age that, conversely, severe vaginal tears during childbirth are more prevalent in public hospitals, which may indicate the need for better supervision of inexperienced doctors. "Sometimes it (cutting) is absolutely necessary, but it's probably overused," he said. His comments followed a report commissioned by the Department of Human Services, which found that between 1999 and 2002, an episiotomy - in which an incision is made through the perineum at the entrance to the vagina - was given to one in every three private patients, compared with one in five public patients. Professor King, who led the review, said the difference between public and private rates may be because vaginal deliveries were more likely to be supervised by midwives in the public system, who supported lower episiotomy rates. Euan Wallace, an obstetrician at Monash Medical Centre, said it was once the orthodox view that episiotomy was preferable to allowing a vaginal tear because it preserved pelvic floor muscles. But evidence since has challenged that view. - Original Message - From: Päivi To: [EMAIL PROTECTED] Sent: Sunday, August 21, 2005 6:31 PM Subject: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomyrates arefrom 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases).I already know, that you have a different opinion on when it is needed, but it would be interesting to know from you, who work as midwifes, how oftenhave you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals? Paivi
RE: [ozmidwifery] when to cut an episiotomy
Hi I am usually quite a silent participant but felt an urge to comment on this topic. I have been a midwife for 15years and still am working in hospital settings with high risk women and women that choose to birth in a hospital. The rate of episiotomy can be high in hospital settings but I have had to perform 8 in all this time and all for severe fetal distress and I feel that if all of my pregnant women that I cared for were low risk pregnancy and natural healthy labour then this would yield a different result. Sometimes I keep a closer eye on previous history of 3rd 4th degree tears who have done no perineal massageantenatally. hope this helps Jenni *** 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. ***
