[ozmidwifery] fractured pelvis
What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out? -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] fractured pelvis
No, a vaginal birth is very possible. It all depends on where the fractures occurred, if they actually involved the in/outlets. They rarely do. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 5:54 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] fractured pelvis
Kristin, No never rule a VBAC out, always consider the individual circumstances. It cost nothing to try ! You can always opt out if there are any signs of problems. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 5:53 PM Subject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] fractured pelvis
How could she confirm this? From: "Ken Ward" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:29:39 +1000 No, a vaginal birth is very possible. It all depends on where the fractures occurred, if they actually involved the in/outlets. They rarely do. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 5:54 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] fractured pelvis
X-rays taken at the time would show the breaks, and would now show the healed bone. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 7:00 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] fractured pelvis How could she confirm this? From: "Ken Ward" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:29:39 +1000 No, a vaginal birth is very possible. It all depends on where the fractures occurred, if they actually involved the in/outlets. They rarely do. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 5:54 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] need some references
Hi Debbie, Have you thought about caseloading. Its more cost effective and woman centredthan team models. I dont have references but Im sure some of the otherwonderful women on the list can help. regards Diane - Original Message - From: Debbie To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 3:28 PM Subject: [ozmidwifery] need some references Hi all, Am in the midst of an assignment which entails developing a proposal for team midwifery in my rural unit here at Orange. I need some more references to support this alternative model of care from a traditional medical model. In anticipation, Debbie
Re: [ozmidwifery] fractured pelvis
Yes! My thoughts exactly Brenda! :) From: "brendamanning" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:50:43 +1000 Kristin, No never rule a VBAC out, always consider the individual circumstances. It cost nothing to try ! You can always opt out if there are any signs of problems. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 5:53 PM Subject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] premature urge to push
Miriam, To another Carolyn, from the mail below. Sorry if I confused you. Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of safetsleep international Sent: Tuesday, April 18, 2006 7:40 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] premature urge to push vedrana did you intend to send this to me or another carolyn somewhere else? rgds miriam - Original Message - From: Vedrana Valčić [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, April 12, 2006 6:50 PM Subject: RE: [ozmidwifery] premature urge to push Dear Carolyn, I'd like to copy your mail to one web forum (mainly about pregnancy, birth, childhood) in Croatia. Its address is www.roda.hr/rodaphpBB2. Would that be OK? Warm regards, Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of safetsleep international Sent: Wednesday, April 12, 2006 8:12 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] premature urge to push wow...'special lady'in my humble experience there are not many who have grown to grasp this level of intellectual and experiential awareness and intelligence ...i will be saving this email and reading it and the references for some time...thankyou warm regards miram - Original Message - From: Heartlogic [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, April 12, 2006 4:44 PM Subject: Re: [ozmidwifery] premature urge to push Hello Kristen, From the literature, uncontrollable urges to push before full dilatation of the woman's cervix and descent of the baby's head are certainly associated with babies who are in a posterior position, that is back of the baby's head, the bone called the occiput, pressing against the woman's sacrum and putting pressure on her bowel 'prematurely'. That is the accepted, physical version of events. Physical interventions to change the baby's position include, but are not limited to: *position changes of all kinds mostly during labour surges, *such as leaning forward, *leaning backward, *opening the ischial spines with various strategies such *as assisting with inwards pressure on the alae of the sacrum; * lifting the trochanters when the woman is squatting (that takes some doing but is a wonderful opener) *lunges with one leg raised on a chair, squatting etc; *the flapping fish (yoga) position which is lying down on the side the baby's back is on, with leg and arm behind, so the person is more on their abdomen - also called the recovery position; lunging as before, but with the woman's body leaning posteriorally into the side the baby is on to reduce space and encourage baby to rotate to the front. *Another excellent strategy is (the midwife or doctor) using the fingers of one hand in the woman's vagina to construct an artificial pelvic floor to help the baby rotate to the front. This is most useful with a greater degree of dilatation as the person needs to have their hand directly on the baby's head to put the counter pressure on (gently and firmly) for increased flexion and rotation of the baby's head. Of course, the woman needs to be informed and agree and be in a position (birth stool is great for this) to enable the midwife/doctor to do this. As we know, we are not merely physical, a bit of material, like a brick or plank of timber, we are a breathing, feeling, moving, social entity. We are more, much more than that which can be cut or fashioned into an article of usefulness. From another point of view, examining our human self, we are an amazing brain and nervous system network, whose function is predominately based on a lifetime collection of learned patterns, concepts and expressions overlaying a genetic intelligence of predetermined processes and capabilites, such as giving birth. Neuroscience. neuropsychology and endocrinology now tells us that emotions (chemicals) are what fires the feeling/vibratory/electrical brain/nervous system into action (which affects/is expressed in the muscular etc reactions/behaviour of the whole body) and the conscious (spiritual) self, that bit of us that thinks in the moment and is untouchable and invisible, is the thinking director of the whole brain/body mind and action, This director is located in the prefrontal cortex of the brain. From my observation and experiences, an uncontrolled urge to push is often associated with thought patterns such as 'wanting it over' and the associated emotional response (through the amygdala) is a release of a chemical flooding, that matchs that pattern of thought. The brain and nervous system gets the chemical and electrical message, for example 'to get it over' and the body starts the pressure before it is really ready to do so. Doing physical things can help move the woman's focus and attention from what is wrong to what she wants to happen. In this instance, moving from
Re: [ozmidwifery] need some references
I can supply you with some for a "caseload" model if you are interested. We have just started with caseload at Camden and is so far going well. More flexible for midwives and women enjoy having their own midwife. Sonja - Original Message - From: Debbie To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 3:28 PM Subject: [ozmidwifery] need some references Hi all, Am in the midst of an assignment which entails developing a proposal for team midwifery in my rural unit here at Orange. I need some more references to support this alternative model of care from a traditional medical model. In anticipation, Debbie
[ozmidwifery] article FYI
Fetuses Called Impervious to Sensation of Pain By Neil Osterweil, MedPage Today Staff Writer Reviewed by Rubeen K. Israni, M.D., Fellow, Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine April 14, 2006 Explain to interested patients that the author asserts that fetal neural circuitry determining pain perception is not fully developed until about 26 weeks of gestation, and that fetuses do not have the developmental capacity to experience pain, which requires development of conscious understanding. Be aware that three states -- Arkansas, Georgia, and Minnesota -- mandate that health care providers tell women that fetuses may be able to feel pain by 20 weeks of gestational age, an assertion that according to the author is not supported by medical evidence. Review BIRMINGHAM, England, April 14 - Fetuses are physically incapable of feeling pain until the end of the second trimester, and unlike newborn children have not developed the processes that would allow them to recognize pain as a signal of a harmful encounter, a researcher here asserted. An absence of pain in the fetus does not resolve the question of whether abortion is morally acceptable or should be legal, wrote Stuart W.G. Derbyshire, Ph.D., a senior psychologist at the University of Birmingham, in the April 15 issue of the BMJ, formerly the British Medical Journal. Nevertheless, proposals to inform women seeking abortions of the potential for pain in fetuses are not supported by evidence. The states of Arkansas, Georgia, and Minnesota have all enacted legislation requiring that women seeking an abortion be told that fetuses may feel pain after 20 weeks of gestation; and 22 other states have similar legislation pending. A comparable federal law has been proposed. Yet such laws are based on information of dubious merit, Dr. Derbyshire asserted. Legal or clinical mandates for interventions to prevent such pain are scientifically unsound and may expose women to inappropriate interventions, risks, and distress, he wrote. Avoiding a discussion of fetal pain with women requesting abortions is not misguided paternalism, but a sound policy based on good evidence that fetuses cannot experience pain, he added. The crux of his argument is that both from a physiologic and developmental standpoint, fetuses cannot experience pain - in part because the neural circuitry is not fully connected before 26 weeks' gestation, and in part because fetuses don't have the developmental capacity to understand that a provocative stimulus is painful. Important neurobiological developments occur at seven, 18, and 26 weeks' gestation and are the proposed periods for when a fetus can feel pain, he noted. Although the developmental changes during these periods are remarkable, they do not tell us whether the fetus can experience pain. The subjective experience of pain cannot be inferred from anatomical developments because these developments do not account for subjectivity and the conscious contents of pain. Dr. Derbyshire likened the pain perception system in the developing fetus to an alarm system in which the wiring is gradually laid down, but the final connections are not made until 26 weeks gestation, when neuronal projections from the thalamus to the cortex have been completed. The minimum gestational age at which a pain signal may be transmitted from the periphery is seven weeks, the point at which neural projections from the spinal cord can reach the thalamus, he said. Yet the wiring from the thalamus to the cortex is not laid down until about 12 to 16 weeks, and thalamic projections into the cortical plate are not completed until about 23 weeks. Another two to three weeks are needed before peripheral free nerve endings and their projection sites in the spinal cord are fully mature. By 26 weeks' gestation, the characteristic layers of the thalamus and cortex are visible, with obvious similarities to the adult brain, and it has recently been shown that noxious stimulation can evoke hemodynamic changes in the somatosensory cortex of premature babies from a gestational age of 25 weeks, he wrote. Although the system is clearly immature and much development is still to occur, good evidence exists that the biological system necessary for pain is intact and functional from around 26 weeks' gestation. But even with a fully intact and functional system in place, he argued further, fetuses have not developed the conscious capacity to understand, process, or experience pain. He pointed out that the International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, and that pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. By this definition
Re: [ozmidwifery] need some references
diane wrote: Hi Debbie, Have you thought about caseloading. Its more cost effective and woman centred than team models. I dont have references but Im sure some of the other wonderful women on the list can help. regards Diane - Original Message - *From:* Debbie mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Tuesday, April 18, 2006 3:28 PM *Subject:* [ozmidwifery] need some references Hi all, Am in the midst of an assignment which entails developing a proposal for team midwifery in my rural unit here at Orange. I need some more references to support this alternative model of care from a traditional medical model. In anticipation, Debbie Apologies for the formatting, its a cut'n'paste jobbie Im sure there are more but this is off the top of my head... Re the team mid thing, I refer you to the Sandall 1999 article - not the only report to show that team midwifery is not as sustainable (for the midwives) as caseload or continuity of carer. cheers jfairy Benjamin, Y., Walsh, D. Taub, N., 2001, ‘A comparison of partnership caseload midwifery care with conventional team midwifery care: labour and birth outcomes’, /Midwifery/, vol. 17, p. 234-240. Brown, S. Lumley, J., 1994, ‘Satisfaction with care in labour and birth: a survey of 790 Australian women’, /Birth/, vol.21, no. 1, pp. 4-13 Cornwall, C., 2001 /Proposal for Midwifery Caseload Practice (MCP) at WCH,/ Women’s and Children’s Hospital, Adelaide Cornwall, C., 2004, ‘Midwifery Group Practice is born at WCH in Adelaide’, /Australian Midwifery News,/ Australian College of Midwives, Toorak, Victoria Donnellan – Fernandez, R., 2000, ‘Autonomous Private Midwifery Practice: A Retrospective 1994-2000’, /Promaco Conventions: Childbirth in Isolation, Proceedings for the ACMI Goldfields Sub-branch Conference/, Kalgoorlie, 3-4 October. Fenwick, N., 1998, ‘Continuity of carer: the experiences of midwives’, in /Psychological/ /Perspectives on Pregnancy Childbirth/, ed. S. Clement, Churchill Livingstone, Edinburgh, UK. Flint, C. 1994, ‘Getting to Know Your Client’, /Modern Midwife, /April 1994, Vol. 4 Garcia, J., 1995, ‘Continuity of carer in context: what matters to women?’ in /Effective/ /Group Practice in Midwifery: Working with Women/, ed. L. Page, Blackwell Science, Oxford, UK. Green, JM., Coupland, VA. Kitzinger, J.V., 1990, Expectations, experiences, and psychological outcomes of childbirth: a prospective study of 825 women’, /Birth/, vol.17, no. 1, pp 15-23 Green JM., Renfrew, MJ. Curtis, PA., 2000, ‘Continuity of carer: what matters to women? A Review of the evidence’, /Midwifery/, vol. 16, pp 186-196. Hodnett E., 2001, ‘Caregiver support for women during childbirth’ /Cochrane Review in the Cochrane Library/, Issue 2, Update Software, Oxford. Homer, C., Brodie P. Leap, N., 2001, ‘/Establishing models of continuity of midwifery care in Australia: A resource for midwives and managers’/, Centre for Family Health and Midwifery, Faculty of Nursing, Midwifery and Health at the University of Technology Sydney. Homer, C., Davis, G., Brodie, P., Sheehan, A., Barclay, L., Wills, J. Chapman, M., 2001b, ‘Collaboration in maternity care: a randomised controlled trial comparing community-based continuity of care with standard hospital care’, /British Journal of/ /Obstetrics and Gynaecology/, vol.108, pp.16-22 Homer, C.S., Matha, D.V., Jordan, L., Wills, J. Davis, G.K., 2001c, ‘Community-based continuity of midwifery care versus standard hospital care: a cost analysis’, Australian Health Review, vol.24, no. 1, pp. 85-93. Hundley, V., Cruiksank, F., Milne, J., Glazener, C., Lang, G., Turner, M., Blyth, D. Mollison, J., 1995, ‘Satisfaction and continuity of care: staff views of care in a midwifery-managed delivery unit’, /Midwifery,/ vol. 11. pp 163-173 Leap, N. 1997, ‘Caseload Practice that works’, /MIDIRS Midwifery Digest,/ vol. 7, no. 4, pp. 416-418 Magerey, A., 2004, ‘Evaluation in primary health care’, lecture notes distributed in the topic Managing Midwifery Practice 2, (MIDW 3005) at Flinders University of South Australia, Bedford Park on 25 March Maternity Coalition, Australian Society of Independent Midwives and Community Midwifery WA Inc., 2002, ‘National Maternity Action Plan, /Birth Matters/, vol. 6 no. 3 Sept, p. 18-19, also avail. at _www.maternitycoalition.org.au/nmap.html_ Mc Court, A., Page, L., Hewison, J. Vail, A., 1998, ‘Evaluation of one-to-one midwifery: Women’s responses to care’, /Birth/, vol. 25, no. 2, June, pp. 73-80 NHMRC 1996, /National Health Medical Research Council Options for Effective Care in Childbirth/, Australian Government Printing Service, Canberra NHMRC 1998, /Review of Services Offered by Midwives/, Australian Government Printing Service,
[ozmidwifery] yep send on your caseload refs please
Thanks for the replies, invitation (will get back to you soon on that Barb) and the references. It is for an assignment and it probably is best to get some good caseload references to compare against team midwifery and disscuss in the proposal what would best suit Orange. Thanks all Debbie
Re: [ozmidwifery] fractured pelvis
Kristin, I can't reply off-list to you re the Doula query because I don't have your email address. Would you like to send it or are you over the 'query stage' now ??? With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 9:09 PM Subject: Re: [ozmidwifery] fractured pelvis Yes! My thoughts exactly Brenda! :) From: "brendamanning" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:50:43 +1000 Kristin, No never rule a VBAC out, always consider the individual circumstances. It cost nothing to try ! You can always opt out if there are any signs of problems. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 5:53 PM Subject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] fractured pelvis
Why are we worrying about a vbac? Has this woman already had a previous c/s? -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 9:10 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvis Yes! My thoughts exactly Brenda! :) From: "brendamanning" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:50:43 +1000 Kristin, No never rule a VBAC out, always consider the individual circumstances. It cost nothing to try ! You can always opt out if there are any signs of problems. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 5:53 PM Subject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] fractured pelvis
Doh ! I think I just threw in a red herring !!! Speed reading not always so accurate huh ? With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Ken Ward To: ozmidwifery@acegraphics.com.au Sent: Wednesday, April 19, 2006 1:20 PM Subject: RE: [ozmidwifery] fractured pelvis Why are we worrying about a vbac? Has this woman already had a previous c/s? -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristin BeckedahlSent: Tuesday, 18 April 2006 9:10 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvis Yes! My thoughts exactly Brenda! :) From: "brendamanning" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] fractured pelvisDate: Tue, 18 Apr 2006 18:50:43 +1000 Kristin, No never rule a VBAC out, always consider the individual circumstances. It cost nothing to try ! You can always opt out if there are any signs of problems. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 18, 2006 5:53 PM Subject: [ozmidwifery] fractured pelvis What is the likelihood of CS with a woman whose 22 and has a Hx of fracturing her pelvis in 3 places in a car accident? Would a vaginal birth be totally ruled out?-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
