Re: [ozmidwifery] Episiotomy
Please send to the list as I am also interested : ) Päivi - Original Message - From: Alice Morgan [EMAIL PROTECTED] To: [EMAIL PROTECTED] Cc: ozmidwifery@acegraphics.com.au Sent: Monday, June 19, 2006 8:38 AM Subject: RE: [ozmidwifery] Episiotomy Hi Suzi, I have several studies that show thiscan't think of them all off the top of my head, but will find them for you and send you the info. I'll have to dig out my thesis (I've been somewhat pretending it doesn't exist at the moment). As a start, I think the recent (2005) JAMA published study talks about it, as do Thacker and Banta (1983) and Woolley (1995). There's also one that compares mediolateral and midline episiotomies (Thacker, 2000 from the British Medical Journal). Hope this helps as a start...I'll try to see what else I can find and send to you. Alice From: suzi and brett [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Episiotomy Date: Mon, 19 Jun 2006 09:28:24 +1000 Can anyone point me in the right direction for good evidence that episiotomys have an increased risk of extending to 3 or 4 th degree? or am i remembering - interpreting incorrectly and the best evidence that we have only conclude generally that restrictive epis. has lowered morbidity because the women mostly doesnt end up with as much truama as anticipated. Little discussion i am having with one of our doctors - who says mediolateral cut is not at an increased risk of extending, only midline. My arguement was that only fetal distress with no time to wait for streaching ( or well informed maternal request?) is the only reasons for episiotomy. Im sure if it was a slice down the eye of a penis and the posibility of the man having painful sex and other morbidity for the next year - some doctors may think twice. Love Suz x _ New year, new job - there's more than 100,00 jobs at SEEK http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t=752315885_r=Jan05_tagline_m=EXT -- 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] Ineresting article
Title: Evaluation of the Edinburgh Post Natal Depression Scale using Rasch analysis Research article . Evaluation of the Edinburgh Post Natal Depression Scale using Rasch analysis Julie F Pallant , Renee L Miller and Alan Tennant BMC Psychiatry 2006, 6:28doi:10.1186/1471-244X-6-28 Published 12June2006 Abstract (provisional) Background The Edinburgh Postnatal Depression Scale (EPDS) is a 10 item self-rating post-natal depression scale which has seen widespread use in epidemiological and clinical studies. Concern has been raised over the validity of the EPDS as a single summed scale, with suggestions that it measures two separate aspects, one of depressive feelings, the other of anxiety. Methods As part of a larger cross-sectional study conducted in Melbourne, Australia, a community sample (324 women, ranging in age from 18 to 44 years: mean=32yrs, SD=4.6), was obtained by inviting primiparous women to participate voluntarily in this study. Data from the EPDS were fitted to the Rasch measurement model and tested for appropriate category ordering, for item bias through Differential Item Functioning (DIF) analysis, and for unidimensionality through tests of the assumption of local independence. Results Rasch analysis of the data from the ten item scale initially demonstrated a lack of fit to the model with a significant Item-Trait Interaction total chi-square (chi Square=82.8, df =40; p.001). Removal of two items (items 7 and 8) resulted in a non-significant Item-Trait Interaction total chi-square with a residual mean value for items of -0.467 with a standard deviation of 0.850, showing fit to the model. No DIF existed in the final 8-item scale (EPDS-8) and all items showed fit to model expectations. Principal Components Analysis of the residuals supported the local independence assumption, and unidimensionality of the revised EPDS-8 scale. Revised cut points were identified for EPDS-8 to maintain the case identification of the original scale. Conclusions The results of this study suggest that EPDS, in its original 10 item form, is not a viable scale for the unidimensional measurement of depression. Rasch analysis suggests that a revised eight item version (EPDS-8) would provide a more psychometrically robust scale. The revised cut points of 7/8 and 9/10 for the EPDS-8 show high levels of agreement with the original case identification for the EPDS-10.
Re: [ozmidwifery] How long before synto is used?
Women aren't doing their own Inductions and Caesareans... Very true, but they are all too frequently choosing them Alesa Alesa KoziolClinical Midwifery EducatorMelbourne - Original Message - From: Stephen Felicity To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 18, 2006 5:36 PM Subject: Re: [ozmidwifery] How long before synto is used? Interesting, Megan. The thing that is alarming to mein this scenario is not thepossiblecash motivation, but the fact that "scheduling" and "delaying" birth is considered to be something we as human beings have a right to do as a normal part of our birthing processes. Also the "tsk tsk for shame" in this article seems to be solely directed at the birthing women, and not the professionals willing to intervene in the birth process to suit a timetable. Women aren't doing their own Inductions and Caesareans. - Original Message - From: Megan Larry To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 18, 2006 3:31 PM Subject: 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.
[ozmidwifery] Article: New Mums Run Off Their Feet
Something we already knew, but passing it on, it was on Today Tonight: REPORTER: Sophie Hull BROADCAST DATE: June 15, 2006 New mums are working 75 hours a week. No-one said new mums had it easy, but it seems dads might be the last people to realise just how much is involved in coping with a newborn. The Australian National University's Julie Smith surveyed 188 Australian women during the first year of their baby's life. She asked them to record the time they spent on child care, sleeping and cleaning with an electronic tracking device. The results were staggering. Mums are spending around 75 hours a week working - 60 of those on childcare. In comparison, fathers were spending just six hours a week on childcare. I think any normal person would take a look at a 75 hour week and say that person is over worked, Julie said. What surprised me was little time they got to themselves. They are literally on call and in that first nine months of the baby's life they are on call 23 hours a day. Julie said mothers got on average one hour a day when they did not have the main responsibility for the baby. It's very clear that these are very long hours creating a lot of stresses for mothers and it's also very clear that those mothers who's partners were absent from the home were losing a lot of sleep which is a basic measure of the stresses they're under, Julie said. She said the study results provided a clear message for dads: Be there, Julie said. And do as much of the housework as you can. The figures are showing that if the father has less time at work in that first nine months the mother gets more sleep and that's got to be good for every body. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
[ozmidwifery] Consumer demand for inductions and caesareans
This is a very interesting area of debate. The thing that strikes me about obstetrics is that it seems to be one of the few areas of medical 'science' (other than plastic surgery) where the woman is allowed to 'choose' a particular procedure, and in most cases the taxpayer will foot the bill. Is it ethical for obstetricians to do caesareans because women 'demand them'? Is it ethical to provide inductions because they are 'demanded?'. I cannot demand morphine from the medical system because it makes me feel good, and yet our system allows women to demand certain obstetric procedures because they think it is good for them...We need to respect women's requests and expectations, but are their requests and expectations absolute?I'm not a midwife and I thankfully don't have to struggle with these daily dilemmas. But consumers aren't always right and they certainly aren't always wrong.What test can be used to determine whether a request is met or not?David _David Vernon, Editor and WriterHaving a Great Birth in Australia, Men at Birth, With Women - Shiftwork to Group Practice and The Hunt for MarasmusGPO Box 2314, Canberra ACT 2601, AustraliaEm: Click here to email meMy other websites: Beryl's Hansard | A Busy Dad's Guide to Cooking | Kitty Maus _ On 19/06/2006, at 9:10 PM, Alesa Koziol wrote:Women aren't doing their own Inductions and Caesareans... Very true, but they are all too frequently choosing them AlesaAlesa KoziolClinical Midwifery EducatorMelbourne- Original Message -From: Stephen FelicityTo: ozmidwifery@acegraphics.com.auSent: Sunday, June 18, 2006 5:36 PMSubject: Re: [ozmidwifery] How long before synto is used?Interesting, Megan. The thing that is alarming to me in this scenario is not the possible cash motivation, but the fact that "scheduling" and "delaying" birth is considered to be something we as human beings have a right to do as a normal part of our birthing processes. Also the "tsk tsk for shame" in this article seems to be solely directed at the birthing women, and not the professionals willing to intervene in the birth process to suit a timetable. Women aren't doing their own Inductions and Caesareans. - Original Message -From: Megan LarryTo: ozmidwifery@acegraphics.com.auSent: Sunday, June 18, 2006 3:31 PMSubject: 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 born on his timing 2 weeks before the magic date) Baby bonus creates hospital havoc18jun06THE 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.
Re: [ozmidwifery] Episiotomy
Hi Alice This came to me but it was not me that posted the question, so don't know if you just maybe hit the wrong button? Sue. - Original Message - From: Alice Morgan [EMAIL PROTECTED] To: [EMAIL PROTECTED] Cc: ozmidwifery@acegraphics.com.au Sent: Monday, June 19, 2006 1:38 PM Subject: RE: [ozmidwifery] Episiotomy Hi Suzi, I have several studies that show thiscan't think of them all off the top of my head, but will find them for you and send you the info. I'll have to dig out my thesis (I've been somewhat pretending it doesn't exist at the moment). As a start, I think the recent (2005) JAMA published study talks about it, as do Thacker and Banta (1983) and Woolley (1995). There's also one that compares mediolateral and midline episiotomies (Thacker, 2000 from the British Medical Journal). Hope this helps as a start...I'll try to see what else I can find and send to you. Alice From: suzi and brett [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Episiotomy Date: Mon, 19 Jun 2006 09:28:24 +1000 Can anyone point me in the right direction for good evidence that episiotomys have an increased risk of extending to 3 or 4 th degree? or am i remembering - interpreting incorrectly and the best evidence that we have only conclude generally that restrictive epis. has lowered morbidity because the women mostly doesnt end up with as much truama as anticipated. Little discussion i am having with one of our doctors - who says mediolateral cut is not at an increased risk of extending, only midline. My arguement was that only fetal distress with no time to wait for streaching ( or well informed maternal request?) is the only reasons for episiotomy. Im sure if it was a slice down the eye of a penis and the posibility of the man having painful sex and other morbidity for the next year - some doctors may think twice. Love Suz x _ New year, new job - there's more than 100,00 jobs at SEEK http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t=752315885_r=Jan05_tagline_m=EXT -- 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.
[ozmidwifery] reflective practice
I thought I saw a workbook on reflective practice advertised on either Birth International or Capers bookstore. I dont believe that it was the one by Beverly Taylor as that is not a workbook. Can anyone help here? Thanks, MM
Re: [ozmidwifery] reflective practice
Hi Mary, We recently advertised the new workbook released by the ACMI called Practice Development Resource, which is designed as a reflective practice tool to help midwives prepare themselves for working in autonomous settings (birth centres, caseloads, teams, independently etc). The details are here: http://www.birthinternational.com/product/book/bk907.html Is this what you were looking for? The other alternative is: Reflective Practice by Beverley Taylor http://www.birthinternational.com/product/book/bk907.html Hope this helps, Andrea PS If anyone is missing out on getting news of these new releases, they should join our E-Bulletin, which will now be the main source of info on our books, videos, DVDs and events. Details on how to join are here: http://www.birthinternational.com/bulletin/index.html At 01:06 AM 20/06/2006, you wrote: I thought I saw a workbook on reflective practice advertised on either Birth International or Capers bookstore. I don't believe that it was the one by Beverly Taylor as that is not a workbook. Can anyone help here? Thanks, MM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RE: {RMA} quote of the week
Since 1990, the number of women giving birth with a midwife has doubled, signaling a growing trend among women who seek a more natural -- as opposed to medical -- childbirth. While only 4 percent of women gave birth with a midwife in 1990, 8 percent of women chose a midwife in 2003, according to the National Center for Health Statistics. Pregnancy and birth are expensive when it comes to medical care, so insurance coverage plays a major role in the decision for a lot of families. Many insurance companies do cover the use of a midwife, as long as she is licensed and working in a hospital or birthing center. Coverage for midwives who are not certified, or who work outside of a hospital setting, is less widespread and varies by state and health plan. However, the major reason why most families chose a midwife was to experience a more natural birth. Contrary to traditional hospital births, midwives generally encourage using drug-free, natural methods of childbirth. Those who have used a midwife describe the experience as soothing and private, and say having the freedom to go through labor and give birth in a way that feels comfortable to them, such as in a bathtub, was empowering. Yahoo News May 30, 2006 Dr. Mercola's Comment: The United States and Canada are the only countries in the world where highly trained surgeons called obstetricians attend the majority of normal births. Cesarean section can save the life of the mother or her baby. Cesarean section can also kill a mother or her baby. How can this be? Because every single procedure or technology used during pregnancy and birth carries risks, both for mother and baby. The decision to use technology is a judgment call -- it may either make things better or worse. Merely putting yourself in the hands of a high-tech doctor and a high-tech hospital does not guarantee you the safest birth. You yourself musttake responsibility for your own child's birth, including the decision to have technology used on you and your baby. 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. Try Juno Platinum for Free! Then, only $9.95/month! Unlimited Internet Access with 1GB of Email Storage. Visit http://www.juno.com/value to sign up today! -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 6/19/2006 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 6/19/2006
RE: [ozmidwifery] Low iron and inability to breastfeed?
We have recently been directed to use the ferretin level as a measure to suppliment or not as it is more reliable that the Hb. The OB argues that a woman may have adequate iron stores but still show a low Hb in the blood but she does not need to take extra iron. If this woman's Hb does not come up despite suppliments then she may have good stores anyway. I have seen many anaemic women successfully breastfeed and recover very well without all that crap she has been threatened with. cheers Judy --- leanne wynne [EMAIL PROTECTED] wrote: Ignorance and arrogance are a bad combination!! ...in fact concentrations of 95-115 g/L with a normal mean corpuscular volume (84-99fL) should be regarded as optimal for fetal growth and well-being and are associated with the lowest risk of preterm labour. Steer PJ 2000 American Journal of Clinical Nutrition, Vol 71, No 5, May There is evidence to suggest that most doctors are too quick to promote iron supplementation in pregnancy. Leanne Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 From: Kelly @ BellyBelly [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Low iron and inability to breastfeed? Date: Mon, 19 Jun 2006 13:34:03 +1000 Yeah my jaw dropped too. any advice for this mum?: I was wondering if anyone else has been told they would have trouble b/f as their iron levels are too low? I'm due any day now and have never leaked or had any signs that I will be able to produce milk... The midwife at the BC told me that as my iron levels were below 100 I would have trouble b/f... this has upset me greatly as I really want to be able to do this.. I was wondering if she could be wrong, or if anyone else has had a similar experience and what happened? Best Regards, Kelly Zantey Creator, http://www.bellybelly.com.au/ BellyBelly.com.au Gentle Solutions From Conception to Parenthood http://www.bellybelly.com.au/birth-support http://www.bellybelly.com.au/birth-support BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. On Yahoo!7 Answers: Real people ask and answer questions on any topic. http://www.yahoo7.com.au/answers -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] reflective practice
Thanks, it was the ACMI workbook. MM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Low iron and inability to breastfeed?
I have heard this point of view, but when talking to the microbiologist, was told that ferritin is actually not a good measure in pregnancy. Some more talking to the lab people might be helpful? MM We have recently been directed to use the ferretin level as a measure to suppliment or not as it is more reliable that the Hb. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] compulsory vaccination for health workers/students
Remember a thread about this sometime ago so thought some might be interested. From www.avn.org.au - Meryl Dorey- President Update on the legal situation with forced vaccinations for health students Thanks to an unkown member who forwarded my appeal last week asking for a solicitor to help with the situation whereby students studying health issues were being forced to vaccinate in order to continue their education, we have obtained the pro bono services of a Barrister in NSW who will help us fight this issue. In order for this to be the most effective case possible, we need to contact others who have lost their place in school because they chose not to vaccinate. We also want to know about people who have been coerced into vaccinating against their wishes and those who have taken the vaccine against their wishes but have suffered adverse effects as a result of the shots. According to our barrister, a Representative (Class) action will be the best way to proceed with this. Therefore, we need to be put in contact with people who have been affected by this new regulation. In addition, as mentioned in the last edition of Doing the Rounds, next year, this will be affecting anyone and everyone who works in a hospital. Nurses, doctors, orderlies, psychologists, physiotherapists, orderlies...etc. If we sit back and do nothing, it will send a very clear message to the government that we are willing to accept forced compulsory vaccination. We have already been told quite clearly that if there is one case of bird flu reported here, everyone will have to get the shot. If we accept this compulsion for health professionals, we and our children will be the next targets! Please spread this information as far as you can, get anyone who has been affected to contact us here on 02 6687 1699 or by emailing [EMAIL PROTECTED], and don't forget that we are still asking for a $26 donation from every member to help us with our goals as stated in the last Doing the Rounds. Thanks so much, Meryl
