Re: [ozmidwifery] ctg stuff
Title: Re: [ozmidwifery] ctg stuff Dear Sue and all What an amazing thread!! Choice is the key. The choices that are respected and funded are those that prop up the medical monopoly of the big business of birth. So all you wonderful midwives out there, start/keep saying it. There are no rules or protocols for women, there is evidence and advice and a duty of care for midwives but at the end of the day a woman must be making the decision. It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice. Now it is choice within a vacuum of medical dominance. I heard an interesting thing re ADHD on the radio the other day. The researcher said if we only ask Drs we will only ever get a medical response. Nothing new but nicely put. By continuing to defer to medicos when the majority of us have no medical condition we will never make lasting change. I believe some midwifery stars were recently at a conference espousing the benefits of managed 3rd stage and justified by saying physiological could only ever be considered when things were totally natural so there was no real point etc. Whilst I understand the pragmatics of that comment and the reality of the current system. I find this a real sell-out and on par with the CTG argument and many others. Just because something is the majority does not mean it is right. Sometimes all the fools are simply on the same side, rich and very powerful ones I know. Recently I was told midwives greeted my news of twins at home with reasonable upset saying it was one thing to do it but I should have done it quietly!! Oh dear. It would have been so much nicer to have prem babies with respiratory distress (saved by Obstetrics) or a vaginal birth in lithotomy with a forceps for twin 2. Lets get real. Innocent until proven guilty and Healthy until proven sick!! They key to change is in the unity. If enough midwives and women said No more it would change very quickly. When we disagree and are challenged lets ask ourselves where the womans rights are in our anger, upset et etc and lets continue to shout it loudly to Obs cause they have no argument. JC
Re: [ozmidwifery] How long before synto is used?
Hi, As you say it will always depend on the hospital policy.However, Iimagine the best way to gain an independent answer might be to review the evidence - A guide to effective evidence in pregnancy childbirth (Enkin et al) may be helpful, though it may also be slightly outdated. Alternatively, go to the Cochrane database on-line.Then at least you've got the evidence to change the hospital policy (you've got to have goals!!) Best wishes. On 6/14/06, Kelly @ BellyBelly [EMAIL PROTECTED] wrote: For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: Re: [ozmidwifery] ctg stuff
"if we trulysupport choice then surely even 'bad' choices should be respected?" Why? Solely in the name of blindly supporting "choice" as a concept? How does this benefit Mothers and babes?We also have the choice to beat our children, men have the choice to rape women, and we can also choose to be cruel to helpless animals if we like. Should we respect these "choices" so as to indiscriminately uphold the paradigm of choice? Of course not. Why are innately harmful birthing choices (that affect not only the birthing woman but also her child) any different? If a Mother has made the decision to bring her child to birth, then shouldn't the Mother and babe be able to do so as optimally and safelyas possible - why is the "choice" to do so by mutilation and trauma even available, where it is not optimal practice? Besides which, do women birthing truly have "choice"? Or are the options they are TOLD they have presented to them by a patriarchal system directed at pacifying and controlling them in order to maintain the status quo and secure the balance of power; rewarding "good" (compliant) behaviour and brutally punishing "bad" (well-informed and assertive) behaviour? Women aren't making their "choices" in a vacuum and the incredible external pressures and aggressive campaign of misinformation they face strongly influences any directions they may take. We're far too focused on the choice and not focused enough on the Mothers and babes at the mercy of those choices. We need to stop singing about "choice" and focus on the facts; change the system, squash the misinformation,advocate for safety of Mother and baby, place the power back in their hands, and not be afraid to get REAL. Political correctness has no place in birth and nor does beauracracy. - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 2:20 PM Subject: Re: Re: [ozmidwifery] ctg stuff Choice is an interesting concept: if we trulysupport choice then surely even 'bad' choices should be respected? One of our obs has joked about having a sign made for the ANC saying 'please do not ask for an induction as a refusal often offends' because the request comes so often. However, the other obs will often agree to a woman's request without too much argument. I have seen instances where the Ob has told the woman - you are not ready to birth, there is no reason to induce and if we try you will have a lengthy and horrible labour. The reply was "I DONT CARE- I WANT TO BE INDUCED" How can the ob refuse in this instance? The reverse is not true - if a woman reaches T+10 she is booked for IOL - there is little 'choice' within our policy for anyone who wishes to wait longer - despite the evidence or the individual circumstances. Occasionally requests for'social' induction can be for very valid personal reasons and such instances should also be respected. I have discussed with some of our obsthe mentality of agreeing to elective C/S for no other reason than maternal request, given that we are a public hospital -should we bewasting taxpayers money on non-essential surgery etc etc. Again the question of choice. If a woman demands an elective C/S despite discussion of the pros and cons, the usual route is to go with her wishes - presumably for fear of litigation if the birth does not go well. I did challenge one ob who agreed without hesitation to a woman's request for repeat C/S and asked him what his attitude would have been if she had asked for VBAC - did not get much in the way of response! Not saying that I agree with this you understand but it does cause some tricky moral dilemmas. I feel the key issue is one of respect and honest discussion - ah but that is all too often missing within the medical model of care. That and education - women don't know that they have choices to challenge the usual practice of whoever their care provider happens to be, sadly those who do challenge are often seen as 'troublesome radicals' if their challenge is against 'routine' interventions. (Of course they are not seen the same way if their challenge is to request unecessary interventions! :-)) Sue - Original Message - From: Emily To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 8:49 AM Subject: Re: Re: [ozmidwifery] ctg stuff hi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only
RE: [ozmidwifery] ctg stuff
Title: Re: [ozmidwifery] ctg stuff From: Susan Cudlipp "The reply was 'I DONT CARE- I WANT TO BE INDUCED' How can the ob refuse in this instance?" In my experience, many women don't understand that being induced can result in a very different birthing experience for themselves and their babies. Perhaps rather than simply being told yes or no, a woman would change her mind about wanting to be induced (or the way she is induced)if she hadall the facts. I also think "due dates" (particularly the dates calculated at early ultrasounds) can have a hugely negative psychological effect on a woman's willingness to wait for labour to start spontaneously. From: Justine Canes "It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice." And that women are fully informedwhen making those choices.
RE: Re: [ozmidwifery] ctg stuff
Hi Emily, Good on you! As far as induction and c/s on demand the rule of weighing up the benefits vs risks still applies. Some women's emotional state may make it sensible although regrettable, to concur with their wishes. However, if you have been caring for a woman throughout her pregnancy, and have build up a good trusting relationship, I think this situation would be rare. Women don't feel safe in our disjointed system, where they can see up to 25 health professionals in one childbearing experience. Warm regards,Nicole Carver. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of EmilySent: Saturday, June 17, 2006 10:49 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: Re: [ozmidwifery] ctg stuffhi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only collective inertia and fear that has led to everyone still using it. the fact that it has sneakily become the best practice standard. in the big cochrane review on the subject the only benefit seen was a reduction in neonatal seizures seen in the CTG group. this was used as evidence that it may reduce the incidence of cerebral palsy in this group also. actually, there was follow up studies done on all the studies included in the review some years later and it actually showed no difference in cerebral palsy rates in most studies. one study amazingly actually showed a higher rate of cerebral palsy in the CTG group !! this has been conveniently forgotten. CTGs are still sold to women as being a safety net to prevent cerebral palsy despite the fact that there is absolutely no evidence whatesoever of this being the caseall that remains to be the benefit of CTGs is for care providers. it makes many people feel safe to have a neat little print off documenting what has been happening. the other thing is that apparently in the court system, parents can only be 'compensated' if a no fault verdict is made and that requires a CTG. anyway i wrote a huge article about this titled 'the irony of obstetric risk analysis' and handed it in with my end of term work. i am waiting with bated breath to hear the feedback and whether i will fail for being so blatently anti-obstetrics to my obstetric supervisors!!! but i figured theres less harm saying it all now, on my way out :)the reason im writing this is that the (good) obstetrician wants me to put together my views on social inductions and social elective caesars and how we should respond to women who sometimes demand these things and whether it is ethical to refuse. im really struggling with it because if we all always say inform and then follow the mothers wishes, what right do we have to refuse this? it is often for what i see as ridiculous reasons (ie the woman recently who demanded an induction so she wouldnt birth on 6/6/06 and threatened to kill herself if we didnt) but who am i to judge women's choices like others judge non-interventionalist choices?id love to know everyones thoughts on this one love emily Do you Yahoo!?Everyone is raving about the all-new Yahoo! Mail Beta.
Re: [ozmidwifery] ctg stuff
Susan Cudlipp wrote: Choice is an interesting concept: if we truly support choice then surely even 'bad' choices should be respected? Yeah see this is where a persons rights as a medical consumer gets tricky. How do we define 'bad' choices whilst being culturally/theologically/spiritually/ etc sensitive? Look I think that the woman who wanted to be induced before the 6/6/06 has just seen too many Exorcist movies, but who are we to deny her the right to hold a totally different world view? Yes we could argue that her choices can potentially cause harm to herself her baby, we can attempt to 'inform' her of her rights and responsibilities as we see them, but at the end of the day if she is willing to make that decision then it is hers to make. If we are going to be 'real' about supporting womens rights to choose, then we also have to be real about where the responsibility ultimately lies, until this is sorted in a cultural, political legal sense, its going to keep going around in these same circles. The bottom line is that we are arguing about the choices human beings have in our culture around birthing, when we cant even choose the way we die, that also is a choice that is proscribed (by law even). In the situation of dying, one has to consider that you can do it yourself quietly (or not) at home (ie 'commit' suicide - notice the allusion to a criminal activity in that statement), but you cant expect the help of the medical establishment to do so (ie euthanasia). That is one very obvious 'boundary' to what medical science can 'ethically' provide. Maybe if more women understood that the same boundaries exist in the birthing scene, we may see some changes take place! Because of the fear of litigation (ie, where the ultimate responsibility lies), you cannot expect the medical establishment to sanction or support any behaviour that it defines as 'life-threatening'. The fact that the information the establishments use to create those definitions is not always evidence based just adds to the frustration! With all due respect to those who work in hospitals, please can we all just admit that as soon as you become a 'patient', your choices (and therefore your responsibilities) are potentially (depending on what you want) over-ridden by hospital policy (ie, there are boundaries to the support you can expect)? We can argue that 'it is her body, her baby', but if she cant (is not allowed or supported to) make choices that the institution sees as inherently 'dangerous' (by thier definition) to herself or her baby, then its all just bullshit. Call me naive (go on, I dont mind), but - What we want as consumers is to be able to access medical help *on our terms*. What we want as midwives is to know we are working with people (women mostly but not only women) that are willing able to take responsibility for their choices decisions. -- Jennifairy Gillett RM Midwife in Private Practice Women’s Health Teaching Associate ITShare volunteer – Santos Project Co-ordinator ITShare SA Inc - http://itshare.org.au/ ITShare SA provides computer systems to individuals groups, created from donated hardware and opensource software -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: Re: [ozmidwifery] How long before synto is used?
Sally, It is up to wonderful women midwives like you to keep women's chances alive - don't give up! What hope will we have if the best chance we have at choice no longer wish to work in the system? We need to infiltrate the system to get anywhere. Don't underestimate the power and ability you have to change things, along with all of us sticking together. Power in numbers, power in beliefs. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of sally @ home Sent: Saturday, 17 June 2006 1:56 PM To: ozmidwifery@acegraphics.com.au Subject: Re: Re: [ozmidwifery] How long before synto is used? You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- 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] VBAC'er in Narre Warren (VIC)
A mum on my forums is after a VBAC after a traumatic birth and lives in Narre Warren. She is going public, so I was wondering if anyone could suggest a good woman centred option for her, I dont think she is comfortable with a homebirth just yet, but I have suggested she read The Thinking Womans Guide to A Better Birth which she is getting this week so who knows ;) Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: Re: [ozmidwifery] ctg stuff
By 'bad' I meant -choices that I or most midwives would disagree with - such as social (non-medically indicated) induction or elective C/S. They might be 'bad' choices in my view but there are plenty of intelligent women out there whose views are opposite to mine. I may disagree, I may attempt to inform (and I do, often), I may even avoid caring for them, but I cannot ultimately make their choice for them. They are making choices regarding what happens to their own bodies, not anyone else's, so it cannot be put in the same context as rape or child beating- I know that these choicesaffectbabies too, but because they are so commonplace it is hard to convince women that their choice to intervene unecessarily might also impact negatively on the baby. An example was on front of me recently: a mum had a child with Leukaemia, was due to birth the second one. Life was getting very hard with the care of sick child and increasing pregnancy, she asked to be induced early to make this time easier, for all sorts of personal reasons as well as medical ones. This was not the best option for babe-to-come, not the best birthing option for mum-to-be but it was the best option for the family unit as a whole. Who would deny this woman's choice in this situation? Have you ever tried to talk a smoker into quitting? The evidence is undisputably in their face but the choice to continue or not is theirs to make. Yes, misinformation must be fought. Yes, women must have good support and advocacy. Yes, to all those things but do we want to be accused of forcing 'our' beliefs on women?Because our truth is not necessarily their truth. Love this stimulating discussion - and please know that I am in no way trying to offendanyone, just playing Devil's advocate :-) Sue - Original Message - From: Stephen Felicity To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 3:21 PM Subject: Re: Re: [ozmidwifery] ctg stuff "if we trulysupport choice then surely even 'bad' choices should be respected?" Why? Solely in the name of blindly supporting "choice" as a concept? How does this benefit Mothers and babes?We also have the choice to beat our children, men have the choice to rape women, and we can also choose to be cruel to helpless animals if we like. Should we respect these "choices" so as to indiscriminately uphold the paradigm of choice? Of course not. Why are innately harmful birthing choices (that affect not only the birthing woman but also her child) any different? If a Mother has made the decision to bring her child to birth, then shouldn't the Mother and babe be able to do so as optimally and safelyas possible - why is the "choice" to do so by mutilation and trauma even available, where it is not optimal practice? Besides which, do women birthing truly have "choice"? Or are the options they are TOLD they have presented to them by a patriarchal system directed at pacifying and controlling them in order to maintain the status quo and secure the balance of power; rewarding "good" (compliant) behaviour and brutally punishing "bad" (well-informed and assertive) behaviour? Women aren't making their "choices" in a vacuum and the incredible external pressures and aggressive campaign of misinformation they face strongly influences any directions they may take. We're far too focused on the choice and not focused enough on the Mothers and babes at the mercy of those choices. We need to stop singing about "choice" and focus on the facts; change the system, squash the misinformation,advocate for safety of Mother and baby, place the power back in their hands, and not be afraid to get REAL. Political correctness has no place in birth and nor does beauracracy. - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 2:20 PM Subject: Re: Re: [ozmidwifery] ctg stuff Choice is an interesting concept: if we trulysupport choice then surely even 'bad' choices should be respected? One of our obs has joked about having a sign made for the ANC saying 'please do not ask for an induction as a refusal often offends' because the request comes so often. However, the other obs will often agree to a woman's request without too much argument. I have seen instances where the Ob has told the woman - you are not ready to birth, there is no reason to induce and if we try you will have a lengthy and horrible labour. The reply was "I DONT CARE- I WANT TO BE INDUCED" How can the ob refuse in this instance? The reverse is not true - if a woman reaches T+10 she is booked for IOL - there is little 'choice' within our policy for anyone who wishes to wait longer - despite the evidence or the individual
Re: Re: [ozmidwifery] How long before synto is used?
time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. I so relate to what you have said Sally. It is hard to work in the system and maintain your integrity as a midwife. Considering the vast majority of midwives do work 'in the system' most of us do our best to provide the best we can within whatever restrictions we have to toe the line to. The system needs midwives like you who know how to challenge, and how to help your sisters challenge, so that in time we can change it. Please don't give it up. Sue - Original Message - From: sally @ home [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 11:56 AM Subject: Re: Re: [ozmidwifery] How long before synto is used? You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- 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 Free Edition. Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] ctg stuff
Title: Re: [ozmidwifery] ctg stuff My point here was that this woman DID have this explained very carefully by a patient ob who did not want to induce her, and still she wanted it done. And we see so often those who come in time and time again trying very hard to get induced - some women will resort to all kinds of subterfuge, truly, and I have no idea why they are so keen to put themselves through the induction process, but they just want the pregnancy OVER. Sad Sue - Original Message - From: Roberta Quinn To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 4:24 PM Subject: RE: [ozmidwifery] ctg stuff From: Susan Cudlipp "The reply was 'I DONT CARE- I WANT TO BE INDUCED' How can the ob refuse in this instance?" In my experience, many women don't understand that being induced can result in a very different birthing experience for themselves and their babies. Perhaps rather than simply being told yes or no, a woman would change her mind about wanting to be induced (or the way she is induced)if she hadall the facts. I also think "due dates" (particularly the dates calculated at early ultrasounds) can have a hugely negative psychological effect on a woman's willingness to wait for labour to start spontaneously. From: Justine Canes "It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice." And that women are fully informedwhen making those choices. No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006
[ozmidwifery] Kath's story
I was 'with' a woman on thursday night when she birthed that left me on a real high Kath has been seeing me for her whole pregnancy and we had discussed birthing at home many times but she had decided that she wanted to go to the hospital to birth. perhaps if it was my second baby I might have it at home' she said. Despite this I kept picturing her birthing at home and was puzzled why because I don't try and change women's minds or convince them of one way or the other but point out the advantages and disadvantages. She let me know wednesday night that she had had a few niggles and on thursday morning that she was leaking. I visited after lunch and then left her to it. She rang at 7pm to say that the liquor was pink but that they were OK for now, At 9pm they rang and asked me to come. I arrived at 9:15 pm to find her leaning over her bed having strong contractions but she was able to chat to me easily between them. She did tell me they were pretty strong but she felt she had ages to go yet! We chatted, checked her BP FHR etc and I watched her to try and assess where she was up to. She went to the loo at 9:45 and as I listened to her she made a noise that got my attention. I asked her about it but she denied any urge to push and then told me she just needed to open her bowels! I asked her to have a feel in her vagina and she said she could feel something hard! because she had been so adament that she wanted to birth at the hospital I donned a glove and had a quick feel. I said well there's two choices we can have the baby here or you can have it in the car because there's no way your making it to the hospital. She looked at me with a grin and said well I'd rather stay here than do that. So we did and ten minutes and three pushes later James arrived much to his parents amazement and his midwives amusement. The whole thing was great, she sat up in bed an hour later and said well I'd do that again as she put her baby to the breast without any fuss. Three days later they are all loving every minute of their whole experience and I feel truely blessed to have been part of it. Andrea Q -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Kath's story
Hip Hip Hooray! I, and I'm sure everyone else on this list, enjoyed hearing about your wonderful experience with Kath. It's stories like that that keep us all going. Thankyou. Nicole Carver. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Andrea Quanchi Sent: Sunday, June 18, 2006 12:11 AM To: ozmidwifery; Maternity Coalition Subject: [ozmidwifery] Kath's story I was 'with' a woman on thursday night when she birthed that left me on a real high Kath has been seeing me for her whole pregnancy and we had discussed birthing at home many times but she had decided that she wanted to go to the hospital to birth. perhaps if it was my second baby I might have it at home' she said. Despite this I kept picturing her birthing at home and was puzzled why because I don't try and change women's minds or convince them of one way or the other but point out the advantages and disadvantages. She let me know wednesday night that she had had a few niggles and on thursday morning that she was leaking. I visited after lunch and then left her to it. She rang at 7pm to say that the liquor was pink but that they were OK for now, At 9pm they rang and asked me to come. I arrived at 9:15 pm to find her leaning over her bed having strong contractions but she was able to chat to me easily between them. She did tell me they were pretty strong but she felt she had ages to go yet! We chatted, checked her BP FHR etc and I watched her to try and assess where she was up to. She went to the loo at 9:45 and as I listened to her she made a noise that got my attention. I asked her about it but she denied any urge to push and then told me she just needed to open her bowels! I asked her to have a feel in her vagina and she said she could feel something hard! because she had been so adament that she wanted to birth at the hospital I donned a glove and had a quick feel. I said well there's two choices we can have the baby here or you can have it in the car because there's no way your making it to the hospital. She looked at me with a grin and said well I'd rather stay here than do that. So we did and ten minutes and three pushes later James arrived much to his parents amazement and his midwives amusement. The whole thing was great, she sat up in bed an hour later and said well I'd do that again as she put her baby to the breast without any fuss. Three days later they are all loving every minute of their whole experience and I feel truely blessed to have been part of it. Andrea Q -- 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] quote of the week
There is not a single report in the scientific literature that shows obstetricians to be safer than midwives for low risk or normal pregnancy and birth. So if you are among the over75 percent of all women with a normal pregnancy, the safest birth attendant for you is not a doctor but a midwife. Loved this quote from this web page http://www.mercola.com/2006/jun/17/the_midwife_a_steadily_growing_and_natural_childbirth_option.htm This is from the USA as well! Jane -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 6/16/2006
Re: [ozmidwifery] ctg stuff
One aspect of choice that needs to be considered is that even when all the pros and cons are weighted carefully and a very informed choice is made, there is no guarantee that the option chosen will prove to be the best in the final analysis. Mistakes can still be made and decisions thought to be the best can turn out to be the worst. This may result in an unexpected outcomes, but is part of life and often leads to rapid and useful learning. However, often when a poor choice leads to a bad outcome, the blame starts flying and scapegoats are sought (part of the grieving process). It can often be the mother who is blamed (for example in a home birth) or the doctor, if the birth takes place in hospital. For example, if a woman decided, after being told all the advantages and disadvantages of an induction and is counselled on likely outcomes, then still choose this option then I belive she must be supported in her decision. It still may turn out OK (Sally Tracy's work showed that if a perfectly healthy mother chooses an induction for no medical reason she has a 40% chance of coming through without further intervention). If things do turn out unexpectedly and complications arise, then this women needs support postnatally so that she learns from the event. However, she may be blamed or left feeling guilty or depressed without supportive counselling with no opportunity to learn how her decision, even though taken carefully, was in the event not the best one she could have made. I am all for choice and better options being made available. I also believe that women will try and make the best decisions they can given a chance, and even though they may decide to do things differently than we would, they have a right to make those choices. Circumstances change too, and these may affect the decision making process - labour can be much harder than anticipated and help may be sought. This is where the options are really needed so that an epidural is not the only option available, but baths, showers etc etc are also at hand (and a lot of this will come down to midwifery attitudes and skills). This is a tricky area - informed choice is really a myth, as so many vested interests come into play, but we must support women once they have made a considered decision. To do less would be to undermine her further and to miss the opportunity for learning, even of some of those lessons are unpalatable at the time. Not really expressing this well this morning. Regards Andrea At 03:29 PM 17/06/2006, you wrote: Dear Sue and all What an amazing thread!! Choice is the key. The choices that are respected and funded are those that prop up the medical monopoly of the big business of birth. So all you wonderful midwives out there, start/keep saying it. There are no rules or protocols for women, there is evidence and advice and a duty of care for midwives but at the end of the day a woman must be making the decision. It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice. Now it is choice within a vacuum of medical dominance. I heard an interesting thing re ADHD on the radio the other day. The researcher said if we only ask Drs we will only ever get a medical response. Nothing new but nicely put. By continuing to defer to medicos when the majority of us have no medical condition we will never make lasting change. I believe some midwifery stars were recently at a conference espousing the benefits of managed 3rd stage and justified by saying physiological could only ever be considered when things were totally natural so there was no real point etc. Whilst I understand the pragmatics of that comment and the reality of the current system. I find this a real sell-out and on par with the CTG argument and many others. Just because something is the majority does not mean it is right. Sometimes all the fools are simply on the same side, rich and very powerful ones I know. Recently I was told midwives greeted my news of twins at home with reasonable upset saying it was one thing to do it but I should have done it quietly!! Oh dear. It would have been so much nicer to have prem babies with respiratory distress (saved by Obstetrics) or a vaginal birth in lithotomy with a forceps for twin 2. Lets get real. Innocent until proven guilty and Healthy until proven sick!! They key to change is in the unity. If enough midwives and women said No more it would change very quickly. When we disagree and are challenged let's ask ourselves where the woman's rights are in our anger, upset et etc and let's continue to shout it loudly to Obs 'cause they have no argument. JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] ctg stuff
Hi Emily, Could you please email me off list? Re your supervisor's request. Regards, Lynne - Original Message - From: Emily To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 10:49 AM Subject: Re: Re: [ozmidwifery] ctg stuff hi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only collective inertia and fear that has led to everyone still using it. the fact that it has sneakily become the best practice standard. in the big cochrane review on the subject the only benefit seen was a reduction in neonatal seizures seen in the CTG group. this was used as evidence that it may reduce the incidence of cerebral palsy in this group also. actually, there was follow up studies done on all the studies included in the review some years later and it actually showed no difference in cerebral palsy rates in most studies. one study amazingly actually showed a higher rate of cerebral palsy in the CTG group !! this has been conveniently forgotten. CTGs are still sold to women as being a safety net to prevent cerebral palsy despite the fact that there is absolutely no evidence whatesoever of this being the caseall that remains to be the benefit of CTGs is for care providers. it makes many people feel safe to have a neat little print off documenting what has been happening. the other thing is that apparently in the court system, parents can only be 'compensated' if a no fault verdict is made and that requires a CTG. anyway i wrote a huge article about this titled 'the irony of obstetric risk analysis' and handed it in with my end of term work. i am waiting with bated breath to hear the feedback and whether i will fail for being so blatently anti-obstetrics to my obstetric supervisors!!! but i figured theres less harm saying it all now, on my way out :)the reason im writing this is that the (good) obstetrician wants me to put together my views on social inductions and social elective caesars and how we should respond to women who sometimes demand these things and whether it is ethical to refuse. im really struggling with it because if we all always say inform and then follow the mothers wishes, what right do we have to refuse this? it is often for what i see as ridiculous reasons (ie the woman recently who demanded an induction so she wouldnt birth on 6/6/06 and threatened to kill herself if we didnt) but who am i to judge women's choices like others judge non-interventionalist choices?id love to know everyones thoughts on this one love emily Do you Yahoo!?Everyone is raving about the all-new Yahoo! Mail Beta.
RE: [ozmidwifery] ctg stuff
On the contrary, very well said. -Original Message- From: Andrea Robertson This is a tricky area - informed choice is really a myth, as so many vested interests come into play, but we must support women once they have made a considered decision. To do less would be to undermine her further and to miss the opportunity for learning, even of some of those lessons are unpalatable at the time. Not really expressing this well this morning. Regards Andrea -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] ctg stuff
I agree... so often women in early labour present over and over, demanding intervention. The reasons for non intervention are explained very clearly, there is no ambiguity of information from midwives or medical staff... the risks of undesirable outcomes- forceps, c/s, fetal distress etc, being hooked up to drips and monitors (yes, policy for Syntocinon use at our place) but women still want it in the majority of cases. Once they make sure they can have an EDB and so 'won't feel' whatever intervention happens... bring it on. Very dispiriting. And if you try to hold out, the next thing that happens is that you're answering a complaint from the PAtient Representative as to why you cruelly withheld legitimate treatment. No wonder midwives and doctors get worn down. Monica - Original Message - From: Susan Cudlipp [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 11:46 PM Subject: Re: [ozmidwifery] ctg stuff Re: [ozmidwifery] ctg stuffMy point here was that this woman DID have this explained very carefully by a patient ob who did not want to induce her, and still she wanted it done. And we see so often those who come in time and time again trying very hard to get induced - some women will resort to all kinds of subterfuge, truly, and I have no idea why they are so keen to put themselves through the induction process, but they just want the pregnancy OVER. Sad Sue - Original Message - From: Roberta Quinn To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 4:24 PM Subject: RE: [ozmidwifery] ctg stuff From: Susan Cudlipp The reply was 'I DONT CARE- I WANT TO BE INDUCED' How can the ob refuse in this instance? In my experience, many women don't understand that being induced can result in a very different birthing experience for themselves and their babies. Perhaps rather than simply being told yes or no, a woman would change her mind about wanting to be induced (or the way she is induced) if she had all the facts. I also think due dates (particularly the dates calculated at early ultrasounds) can have a hugely negative psychological effect on a woman's willingness to wait for labour to start spontaneously. From: Justine Canes It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice. And that women are fully informed when making those choices. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Kath's story
I just love hearing stories like that Andrea. Congratulations to you both. Cheers Judy --- Andrea Quanchi [EMAIL PROTECTED] wrote: I was 'with' a woman on thursday night when she birthed that left me on a real high Kath has been seeing me for her whole pregnancy and we had discussed birthing at home many times but she had decided that she wanted to go to the hospital to birth. perhaps if it was my second baby I might have it at home' she said. Despite this I kept picturing her birthing at home and was puzzled why because I don't try and change women's minds or convince them of one way or the other but point out the advantages and disadvantages. She let me know wednesday night that she had had a few niggles and on thursday morning that she was leaking. I visited after lunch and then left her to it. She rang at 7pm to say that the liquor was pink but that they were OK for now, At 9pm they rang and asked me to come. I arrived at 9:15 pm to find her leaning over her bed having strong contractions but she was able to chat to me easily between them. She did tell me they were pretty strong but she felt she had ages to go yet! We chatted, checked her BP FHR etc and I watched her to try and assess where she was up to. She went to the loo at 9:45 and as I listened to her she made a noise that got my attention. I asked her about it but she denied any urge to push and then told me she just needed to open her bowels! I asked her to have a feel in her vagina and she said she could feel something hard! because she had been so adament that she wanted to birth at the hospital I donned a glove and had a quick feel. I said well there's two choices we can have the baby here or you can have it in the car because there's no way your making it to the hospital. She looked at me with a grin and said well I'd rather stay here than do that. So we did and ten minutes and three pushes later James arrived much to his parents amazement and his midwives amusement. The whole thing was great, she sat up in bed an hour later and said well I'd do that again as she put her baby to the breast without any fuss. Three days later they are all loving every minute of their whole experience and I feel truely blessed to have been part of it. Andrea Q -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. The LOST Ninja blog: Exclusive clues, clips and gossip. http://au.blogs.yahoo.com/lostninja -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] ctg stuff
So true Andrea. Many years ago a woman consented to be admitted with a transverse lie at term but rejected any treatment. She was a mulipara. Many times over the next week the dangers were explained (such explanation was well documented) and she declined CS. Finally she consented and it was scheduled for the next day. That evening SROM and thick mec. Emergency CS and a beautiful boy around 9 lbs was born. Died next day of Mec aspiration pneumonia. She blamed the hospital. That left us feeling bad but eventually she came to realise just what happened and when she came an gave us a potted plant for the ward we knew she had done a lot of work with her grief and was starting to come out the other side. Cheers Judy --- Andrea Robertson [EMAIL PROTECTED] wrote: One aspect of choice that needs to be considered is that even when all the pros and cons are weighted carefully and a very informed choice is made, there is no guarantee that the option chosen will prove to be the best in the final analysis. Mistakes can still be made and decisions thought to be the best can turn out to be the worst. This may result in an unexpected outcomes, but is part of life and often leads to rapid and useful learning. However, often when a poor choice leads to a bad outcome, the blame starts flying and scapegoats are sought (part of the grieving process). It can often be the mother who is blamed (for example in a home birth) or the doctor, if the birth takes place in hospital. For example, if a woman decided, after being told all the advantages and disadvantages of an induction and is counselled on likely outcomes, then still choose this option then I belive she must be supported in her decision. It still may turn out OK (Sally Tracy's work showed that if a perfectly healthy mother chooses an induction for no medical reason she has a 40% chance of coming through without further intervention). If things do turn out unexpectedly and complications arise, then this women needs support postnatally so that she learns from the event. However, she may be blamed or left feeling guilty or depressed without supportive counselling with no opportunity to learn how her decision, even though taken carefully, was in the event not the best one she could have made. I am all for choice and better options being made available. I also believe that women will try and make the best decisions they can given a chance, and even though they may decide to do things differently than we would, they have a right to make those choices. Circumstances change too, and these may affect the decision making process - labour can be much harder than anticipated and help may be sought. This is where the options are really needed so that an epidural is not the only option available, but baths, showers etc etc are also at hand (and a lot of this will come down to midwifery attitudes and skills). This is a tricky area - informed choice is really a myth, as so many vested interests come into play, but we must support women once they have made a considered decision. To do less would be to undermine her further and to miss the opportunity for learning, even of some of those lessons are unpalatable at the time. Not really expressing this well this morning. Regards Andrea At 03:29 PM 17/06/2006, you wrote: Dear Sue and all What an amazing thread!! Choice is the key. The choices that are respected and funded are those that prop up the medical monopoly of the big business of birth. So all you wonderful midwives out there, start/keep saying it. There are no rules or protocols for women, there is evidence and advice and a duty of care for midwives but at the end of the day a woman must be making the decision. It is not until we have a full complement of choice from homebirth to elec c/s can we say that women are really making a choice. Now it is choice within a vacuum of medical dominance. I heard an interesting thing re ADHD on the radio the other day. The researcher said if we only ask Drs we will only ever get a medical response. Nothing new but nicely put. By continuing to defer to medicos when the majority of us have no medical condition we will never make lasting change. I believe some midwifery stars were recently at a conference espousing the benefits of managed 3rd stage and justified by saying physiological could only ever be considered when things were totally natural so there was no real point etc. Whilst I understand the pragmatics of that comment and the reality of the current system. I find this a real sell-out and on par with the CTG argument and many others. Just because something is the majority does not mean it is right. Sometimes all the fools are simply on the same side, rich and very powerful ones I know. Recently I was told midwives greeted my
[ozmidwifery] Consent, information and outcomes (reply to Judy's story - long)
Judy said: .admitted with a transverse lie at term but rejected any treatment. She was a mulipara. Many times over the next week the dangers were explained (such explanation was well documented) and she declined CS. Finally she consented and it was scheduled for the next day. That evening SROM and thick mec. Emergency CS and a beautiful boy around 9 lbs was born. Died next day of Mec aspiration pneumonia.. What if there is another way of processing this story? How about looking at it from a neurobiophysiological point of view? We now know that the biobody suit is an interweaving multisystem communication centre with messenger molecules interacting at unbelievable numbers of encounters per millisecond. We now know that emotions (one form (with many parts/aspects) of messenger molecules) are the central organising process of the nervous system (both central and peripheral) We know that much that goes on both internally and externally bypasses the conscious mind (awareness) We now know that the conscious mind (that is awareness) hangs around in the prefrontal cortex and a bit of the left side of the brain It is focus and intent, coupled with perception (beliefs underpin perception) that shapes so much of what we experience We now know that the pictures we see over and over again have a strong tendency to come true - that is the role of the right side (hemisphere) of the brain - it is our creative link. Even when we are not consciously thinking them. They form a pattern in the neurology/nervous system. we now know that neural net profiles (that is the way the neurons fire together in patterns, plus the way that message is passed through the nervous system/unconscious mind aka body) create 'states' or emodied patterns of movement, behaviour, feelings (which is when the part of the brain associated with movement/place in space/kinaesthetics, plus that part associated with emotions, motivation, sex, stress, etc plus the left and right side of the brain AND the prefrontal cortex and all its meaning making connections all work together for a common purpose) and all of this is transmitted from one part of the biobody suit to another in nano/milliseconds via the four main messenger molecule communication pathways that messages from people in authority are hypnotic, that is they go straight into the imaginative part of the brain/neurology bypassing the conscious mind and that if there is resistence to the message it is even more powerfully encoded in the neurology. so that everything is affected, including the prenate of a mother. so I wonder how that woman was responding on a deep, emotional and imaginative level to the constant bombardment of negative messages? hmmm Babies who are sideways in the uterus have a message, the neural net profile of the mother is being fired about something which causes her neurology (which includes her nervous system) to go into patterns - these patterns cause the pelvic muscles, plus the muscles of the uterus to adopt different tensions, which therefore play out as different baby positions - often a malposition. Sideways babies usually are indicating that something is sideways in the woman's life and you need to ask the woman what that is, rather than frighten (with all the nervous system electrics and messenger molecule cascades that come with fear in all his guises - well meaning or not) her into submission. What if... as a result of the constant shroud waving *the mother was fearful and resistent *she thought that couldn't happen to me as she pictured it happening as it was being replayed over and over again *fear and resistence sends electrical messages everywhere, floods of messenger molecules through her and the baby's bodies - totally switching into high alert the sympathetic pathway of the autonomic system DANGER was the ongoing message for a week... cortisol in chronic (and more than a few minutes of DANGER is chronic) washes away brain cells and connections and is toxic to cells and babies hmmm babies pickled in stress juices don't grow well, they don't feel loved and welcomed and they feel fear sometimes what we do as health professionals can be like pointing the bone (which is very easy to understand why that works when we understand the role of expectation, belief and how the brain works) is this one of them? I don't know of course, no one can know for sure. It depends on so many variables, such as what was she thinking about minute by minute day after day? How did she feel after being informed of the dangers and risks? What was her reaction? What did she think about when no one was there? What was going on for her at home and in life? That's worth thinking about. Carolyn -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Kath's story
thanks for sharing Andrea. I love hearing stories like this one. :-) Katrina (who is 40/40 today) On 18/06/2006, at 12:10 AM, Andrea Quanchi wrote: I was 'with' a woman on thursday night when she birthed that left me on a real high Kath has been seeing me for her whole pregnancy and we had discussed birthing at home many times but she had decided that she wanted to go to the hospital to birth. perhaps if it was my second baby I might have it at home' she said. Despite this I kept picturing her birthing at home and was puzzled why because I don't try and change women's minds or convince them of one way or the other but point out the advantages and disadvantages. She let me know wednesday night that she had had a few niggles and on thursday morning that she was leaking. I visited after lunch and then left her to it. She rang at 7pm to say that the liquor was pink but that they were OK for now, At 9pm they rang and asked me to come. I arrived at 9:15 pm to find her leaning over her bed having strong contractions but she was able to chat to me easily between them. She did tell me they were pretty strong but she felt she had ages to go yet! We chatted, checked her BP FHR etc and I watched her to try and assess where she was up to. She went to the loo at 9:45 and as I listened to her she made a noise that got my attention. I asked her about it but she denied any urge to push and then told me she just needed to open her bowels! I asked her to have a feel in her vagina and she said she could feel something hard! because she had been so adament that she wanted to birth at the hospital I donned a glove and had a quick feel. I said well there's two choices we can have the baby here or you can have it in the car because there's no way your making it to the hospital. She looked at me with a grin and said well I'd rather stay here than do that. So we did and ten minutes and three pushes later James arrived much to his parents amazement and his midwives amusement. The whole thing was great, she sat up in bed an hour later and said well I'd do that again as she put her baby to the breast without any fuss. Three days later they are all loving every minute of their whole experience and I feel truely blessed to have been part of it. Andrea Q -- 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] How long before synto is used?
We talk about choices, but look what we will do for free cash ??? Megan (whose 4th was bornon histiming2 weeks before the magic date) Baby bonus creates hospital havoc18jun06 THE introduction of the baby bonus on July 1, 2004, caused more than 1000 scheduled births to be delayed, a new study shows.In its May 2004 Budget, the Federal Government announced a maternity payment $3,000 for every baby born on or after July 1. Research by Melbourne Business School economist Professor Joshua Gans and Australian National University economist Dr Andrew Leigh has shown there were more births on July 1, 2004, than on any other single date in the past 30 years. "We estimate that around 700 births were shifted from the last week of June 2004 into the first week of July 2004," Dr Leigh said. "But more troublingly, we found that around 300 births were moved by more than two weeks." The researchers also found that the share of births that were induced or delivered by caesarean section was high in July 2004. Dr Leigh said hospitals needed to plan for July 1 this year, when the bonus rises from $3,000 to $4,000. "Maternity hospitals should expect fewer babies in the last week of June and more in the first week of July," Dr Leigh said.
