Re: [ozmidwifery] re: goodbyes
well said Tania, I have been trying to think about all of this and what to say but am a bit fragile due to a difficult birth this week...talk about the politics and consequences of blood gases int hospital system for a baby transferred in! I would have Lisa's straight talking and advocacy in my corner any time...I do think it is a skill that we have to acknowledge some people are better at than others...I am not great on the in your face stuff, I wish I was, I am not good at confrontation and I really wish i was... I do what I believe I need to do and refuse to do what I don't think is needed but i take the stress with me and I find the fights eat up my energy which is definitely flagging Lisa reminds me that we need to support and embrace and argue and challenge - not to be afraid of our individuality or difference, I wish I had her energy and ability to speak out regardless of how we would see things I am a glass half full kinda person, I try to be anyway, if unsure assume the positive aspect rather than negative so that what is a debate does not get seen as personal, I often see people getting upset and am surprised because I didn't read it that way maybe we are so used to being out on a limb alone and always defending ourselves we struggle to see that difference in debate or practice or context is not a personal attack? Belinda Tania Smallwood wrote: I’d like to add to the current conversation about cord blood gases… I’ve been lurking just lately, as many of you know, I’ve had to make a difficult decision to stop practicing independently due to family commitments…and so, when the bloke I’m married to is actually here, I don’t spend as much time as I used to reading and contributing to Ozmid. Just yesterday I had a few moments to catch up, and when I read the thread on blood gases, I was sure that I’d missed some mails (perhaps I have, there seems to be a few problems with mails doubling up, or getting temporarily lost in cyberspace!). Halfway through the mails, it seemed to go from a lively and informative debate, (something that’s been missing from this list for a while IMHO) to a slinging match, with people getting upset that others are honest and up front about their views. Can I just say that I know Lisa B, and if there is a midwife who has walked in the shoes of every midwife torn between hospital policy, threat of losing her job, and what’s best for the women, it’s Lisa. She’s worked in a position of authority for over 2 years at one of Adelaide’s esteemed private hospitals, and I’m sure the conversations we’ve had about what she had to fight for there are only a small portion of what actually goes on. She’s well aware as we all are, of what a battle it can be in the system, and along with me, and all the IPM’s I know, has utter respect and admiration for those attempting to change things one birth at a time. I also see Lisa as a straight talker, and sometimes even I find it confronting to hear what she has to say, and I know her better than most on this list! But that doesn’t mean that I pack my bags and go away, I may not agree, or I might think hey, that’s a bit blunt, but I also think that she’s made me think about things that I’d otherwise just go along merrily with, and not look at in a truly critical light. I actually think that along with */everyone/* on this list, she has oodles of knowledge and skill, and heaps to contribute. I know I will never be a strong enough midwife to do what most of you do, go in every day and beat my head against that wall and hope to Goddess that a woman gets away with a good birth. But please, don’t stop contributing because it’s hard. Being a midwife is a hard road, no matter where you decide to direct your skill and passion. We’re a downtrodden minority group, with ideals about women that are not shared by most of the people in power. Refusing to keep the dialogue going is never going to be productive, all it will do is stagnate us where we are, and I think we all want midwifery and provision of evidence based maternity services to improve and become stronger in this country. That’s all from me for now, Tania x -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.408 / Virus Database: 268.13.4/476 - Release Date: 14/10/2006 No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.408 / Virus Database: 268.13.4/476 - Release Date: 14/10/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] re: goodbyes
Hugs to you Belinda, call me anytime, you know where I am :) and I make a mean coffee... Tania x -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Monday, 16 October 2006 9:29 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] re: goodbyes well said Tania, I have been trying to think about all of this and what to say but am a bit fragile due to a difficult birth this week...talk about the politics and consequences of blood gases int hospital system for a baby transferred in! I would have Lisa's straight talking and advocacy in my corner any time...I do think it is a skill that we have to acknowledge some people are better at than others...I am not great on the in your face stuff, I wish I was, I am not good at confrontation and I really wish i was... I do what I believe I need to do and refuse to do what I don't think is needed but i take the stress with me and I find the fights eat up my energy which is definitely flagging Lisa reminds me that we need to support and embrace and argue and challenge - not to be afraid of our individuality or difference, I wish I had her energy and ability to speak out regardless of how we would see things I am a glass half full kinda person, I try to be anyway, if unsure assume the positive aspect rather than negative so that what is a debate does not get seen as personal, I often see people getting upset and am surprised because I didn't read it that way maybe we are so used to being out on a limb alone and always defending ourselves we struggle to see that difference in debate or practice or context is not a personal attack? Belinda Tania Smallwood wrote: I’d like to add to the current conversation about cord blood gases… I’ve been lurking just lately, as many of you know, I’ve had to make a difficult decision to stop practicing independently due to family commitments…and so, when the bloke I’m married to is actually here, I don’t spend as much time as I used to reading and contributing to Ozmid. Just yesterday I had a few moments to catch up, and when I read the thread on blood gases, I was sure that I’d missed some mails (perhaps I have, there seems to be a few problems with mails doubling up, or getting temporarily lost in cyberspace!). Halfway through the mails, it seemed to go from a lively and informative debate, (something that’s been missing from this list for a while IMHO) to a slinging match, with people getting upset that others are honest and up front about their views. Can I just say that I know Lisa B, and if there is a midwife who has walked in the shoes of every midwife torn between hospital policy, threat of losing her job, and what’s best for the women, it’s Lisa. She’s worked in a position of authority for over 2 years at one of Adelaide’s esteemed private hospitals, and I’m sure the conversations we’ve had about what she had to fight for there are only a small portion of what actually goes on. She’s well aware as we all are, of what a battle it can be in the system, and along with me, and all the IPM’s I know, has utter respect and admiration for those attempting to change things one birth at a time. I also see Lisa as a straight talker, and sometimes even I find it confronting to hear what she has to say, and I know her better than most on this list! But that doesn’t mean that I pack my bags and go away, I may not agree, or I might think hey, that’s a bit blunt, but I also think that she’s made me think about things that I’d otherwise just go along merrily with, and not look at in a truly critical light. I actually think that along with */everyone/* on this list, she has oodles of knowledge and skill, and heaps to contribute. I know I will never be a strong enough midwife to do what most of you do, go in every day and beat my head against that wall and hope to Goddess that a woman gets away with a good birth. But please, don’t stop contributing because it’s hard. Being a midwife is a hard road, no matter where you decide to direct your skill and passion. We’re a downtrodden minority group, with ideals about women that are not shared by most of the people in power. Refusing to keep the dialogue going is never going to be productive, all it will do is stagnate us where we are, and I think we all want midwifery and provision of evidence based maternity services to improve and become stronger in this country. That’s all from me for now, Tania x -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.408 / Virus Database: 268.13.4/476 - Release Date: 14/10/2006 No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.408 / Virus Database: 268.13.4/476 - Release Date: 14/10/2006 -- This
RE: [ozmidwifery] re: goodbyes
Title: Message Tania, The easiest way to avoid conflict is to walk away. The bravest and strongest battle everyday, unfortunately people often don't see these battles and nobody pins a medal on their chest! Unfortunately, I personally feel this, those in management positions are put there by others to keep the waters still and they do generally turn their cheeks the other way in conflict. Midwives need to be supportive of each other, respect individuality and differing views and just keep moving forward in the hope one day we will all be working in an environment that supports our work. In the hope your daughter, grand daughter will have birth space respected.In achieving our goals don't forget family, they are important for grounding us and providing the shoulders we cry on. Sorry about you having to make that choice Tania but keep your dream. Cheers Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Tania SmallwoodSent: Sunday, 15 October 2006 10:52 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] re: goodbyes Id like to add to the current conversation about cord blood gases Ive been lurking just lately, as many of you know, Ive had to make a difficult decision to stop practicing independently due to family commitmentsand so, when the bloke Im married to is actually here, I dont spend as much time as I used to reading and contributing to Ozmid. Just yesterday I had a few moments to catch up, and when I read the thread on blood gases, I was sure that Id missed some mails (perhaps I have, there seems to be a few problems with mails doubling up, or getting temporarily lost in cyberspace!). Halfway through the mails, it seemed to go from a lively and informative debate, (something thats been missing from this list for a while IMHO) to a slinging match, with people getting upset that others are honest and up front about their views. Can I just say that I know Lisa B, and if there is a midwife who has walked in the shoes of every midwife torn between hospital policy, threat of losing her job, and whats best for the women, its Lisa. Shes worked in a position of authority for over 2 years at one of Adelaides esteemed private hospitals, and Im sure the conversations weve had about what she had to fight for there are only a small portion of what actually goes on. Shes well aware as we all are, of what a battle it can be in the system, and along with me, and all the IPMs I know, has utter respect and admiration for those attempting to change things one birth at a time. I also see Lisa as a straight talker, and sometimes even I find it confronting to hear what she has to say, and I know her better than most on this list! But that doesnt mean that I pack my bags and go away, I may not agree, or I might think hey, thats a bit blunt, but I also think that shes made me think about things that Id otherwise just go along merrily with, and not look at in a truly critical light. I actually think that along with everyone on this list, she has oodles of knowledge and skill, and heaps to contribute. I know I will never be a strong enough midwife to do what most of you do, go in every day and beat my head against that wall and hope to Goddess that a woman gets away with a good birth. But please, dont stop contributing because its hard. Being a midwife is a hard road, no matter where you decide to direct your skill and passion. Were a downtrodden minority group, with ideals about women that are not shared by most of the people in power. Refusing to keep the dialogue going is never going to be productive, all it will do is stagnate us where we are, and I think we all want midwifery and provision of evidence based maternity services to improve and become stronger in this country. Thats all from me for now, Tania x --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.408 / Virus Database: 268.13.4/476 - Release Date: 14/10/2006
RE: [ozmidwifery] Goodbye
Title: Message I am saddened you are leaving the list Sadie. Your reasoning and experiences has been wonderful to read. I agree too many fronts to battle leaves one exposed in the rear. Your health is far more important. Keep up the great work in the high risk environment I support you 100% because these women need midwives more than the straight forward births. Take care Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of SadieSent: Saturday, 14 October 2006 9:17 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Goodbye The time has come for me to leave the ozmidwifery mailing list. I have been an active member for 7 years and have made some fabulous friends and have shared the views, advice friendship of some incredible women who are as passionate about midwifery as myself. Unfortunately the criticism and 'back-biting'constantly being hurledby some members of this list towards their colleagues has become unacceptable to me - I have enough to contend with on a daily basis at work, without continuing tofight the battleon my own computer in my home. I choose to work in a high-risk hospital environment because these women also deserve good midwifery care, I need to pick my battles carefully. There are far more important issues for me, in my circumstances, than trying to make a stand against a policy regarding blood gases, that is firmly entrenched. Seems to me that if we cannot nuture our colleagues - how on earth can we nuture the women we care for? As midwives we are all different, working in different environments but surely with the one aim?To emotionally and spiritually walk alongside women of all ages, races, classes and social status, as they travel the childbirth path. This holdsthe primary place inmy midwifery agenda. See ya, Sadie "Laughter is the brush that sweeps away the cobwebs of the heart."
[ozmidwifery] risk
A difficult subject with thousands of references. No wonder we are all confused. The reference below is interesting. MM The cardinal rule of risk communication is the same as that for emergency medicine: first do no harm. BMJ2003;327:725-728(27September), doi:10.1136/bmj.327.7417.725 Education and debate Communication and miscommunication of risk: understanding UK parents' attitudes to combined MMR vaccination Paul Bellaby, director1
Re: [ozmidwifery] risk
Mary said, the reference The cardinal rule of risk communication is the same as that for emergency medicine: first do no harm. is interesting. What strikes you as particularly interesting about that Mary? I'm very interested in your perspective as you are one of the wisest women I know. warmly, Carolyn
[ozmidwifery] Sharing ideas
Hello all, I'm reading a wonderful book, "Spirituality and Mental Health Breakthrough" edited by Phil Barker and Poppy Buchanan. Phil and Poppy are a great couple. Phil was a professor of mental health nursing and Poppy a social worker. They often come to Australia and talk about mental health issues as 'spiritual emergencies' - which appeals to me no end. Phil has little round glasses, a long beard and a long pigtail, wearsblack, has rainbow socks and red clogs and speaks with a delightful Scottish accent. Totally delightful and totally respectful and kind about our humanity, in whatever form it takes. I'm reading a chapter by a David Brandon, a professor of community care about "meaning". He writes: "At the basis of all healing, for which we are simply a vehicle, is increasing self-awareness and compassion towards others. Nothing very special. This asks that we are increasingly gentle with ourselves and with others; that we recognise in our hearts our connectedness; that we surrender our different images of perfection as a deluded measure of the world and see it with honesty and love. As Sawaki Roshi commented: 'everybody is in his own dream. The discrepencies that exist between the dreams are the problem". Or perhaps those discrepencies are the flashpoints, the point of paradox where all change is possible? Pax, Carolyn (Hastie) Heartlogic www.heartlogic.bizPhone: +61 2 43893919PO Box 5405 Chittaway Bay, NSW 2261 "As a single footstep will not make a path in the earth, so a single thought will not make a pathway in the mind. To make a deep physical path, we walk again and again. To make a deep mental path, we must think over and over again the kind of thoughts we wish to dominate our lives" Henry David Thoreau
RE: [ozmidwifery] risk
Off the top of my head and without philosophical musings, I read thousands of words in dozens of references (just try googling health risk management) and this was the only thing I saw about doing no harm to the patient. Most of it was all about being blamed for harm that might be done and how to minimize being taken to the cleaners. It was not contained in the body of the quoted article by paul bellarmy whose article is interesting. I forget which one it was in, but could probably find it again if needed. Thanks for the compliment. MM What strikes you as particularly interesting about that Mary? I'm very interested in your perspective as you are one of the wisest women I know. warmly, Carolyn
RE: [ozmidwifery] risk
Visit BMJ2003;327:745-748(27September), doi:10.1136/bmj.327.7417.745 Strategies to help patients understand risks. J Paling. I have found his Palings Perspective Scale and P P Palette very useful in explaining the degree of risk to women re screening tests and possible outcomes of various actions. MM Off the top of my head and without philosophical musings, I read thousands of words in dozens of references (just try googling health risk management) and this was the only thing I saw about doing no harm to the patient. Most of it was all about being blamed for harm that might be done and how to minimize being taken to the cleaners. It was not contained in the body of the quoted article by paul bellarmy whose article is interesting. I forget which one it was in, but could probably find it again if needed. Thanks for the compliment. MM What strikes you as particularly interesting about that Mary? I'm very interested in your perspective as you are one of the wisest women I know. warmly, Carolyn
Re: [ozmidwifery] asthma in labour
Just to confuse the issue...Last week a woman experienced hypertonic uterus after induction by PG gels. There was a heated debate about the use of inhalation ventolin - one dr saying it only acts locally (in the lungs) according the evidence when inhaled. The other arguing she uses successfully prior to ECV's. The woman had five puffs and thecontractions slowed down to3 in 10. Ah its a pleasure working in a rural hsp where most the doctors couldn't give a fig for keeping abreast of latest research. NOT. and very confusing for the committed registrars trying to learn from them. As for the women - they are kept way out of the argument - sadly like lambs to the slaughter. Also very hard to entice them to join the midwives chorus to establish midwifery models of care it seems. Only the few families who have lived and birthed in other areas before know what they are missing out on. Suzi - Original Message - From: michelle gascoigne To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 11:38 PM Subject: Re: [ozmidwifery] asthma in labour Tia My Pharmacology for midwives makes no mention of this. However, as a young student midwife I do remember one obs. used to use bronchodilators something like 5 puffs one after the other to ' relax the cervix' to help in removal of retained placentas. To be honest it is too long ago for me to remember how effective this was. Shelly (Midwife England) - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:28 AM Subject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED] Internal Virus Database is out-of-date.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.12.12/461 - Release Date: 02/10/2006
Re: [ozmidwifery] We can make a difference
It is quite some time since I wrote on this list and after reading some of the posts recently it has made me really appreciate the job I am doing. I KNOW my job is encouraging women to change the way they give birth, again trusting their body's ability to just do it. Sorry this post is so long. I am not a midwife but part of childbirth education teaching the Australian calmbirth program. Previously I taught HypnoBirthing but becausethe USAhad such a stranglehold on what wecouldn't change to teach for Australia,the opportunity came alongto be a part of the Australian program so Igrabbed it knowing what a difference the previous program was already making and with an Australian influence it was even better. I also know many of you midwives out there are seeing a difference in the women who are coming in to birth their babies using these relaxation programs. I have beendoing a small study whichI only started a couple of months ago and of the last 17 couples who have birthed only one had medical intervention. They all listened to and worked with their bodies beautifully supported by their partners who also learn and appreciate how women birth. They also stood up to the system and said this is what I want. MY way! Only a week ago I returned home from Birsbane after a conferenceand one of my clients rang me to let me know she was in labour with her 3rd baby. Her first 2 births were horrendous. During her first birth she was losing controland her assigned midwife said "you think this is bad, wait until the pain is so bad you will beBEGGING us to help you, the only thing that will get rid of this posterior labour pain is an epidural". So guess what she lost it totally there and then. During her second birth she had a wonderful and supportive midwife for the first couple of hours and then guess what the SAME midwifecame on dutyagain. This time she said "it would be better for everyone this time if you just have the epidural right now".My clientwent into immediate panick and the same scenario happened again. When she was pregnant again she knew she HAD todo something different. Nature wastelling her to listen and this time she was. She rang in total fear of it repeating again and booked in for classes. When she spoke to me on the phone at the start of this 3rd labour she had been to the races and after going to the toilet realised she had, hada show. When she returned home she rang and said I am in labour but it is so different, it isn't painful, it is all in my backbut I am breathing through the contractions easily. She knew her baby was posterior again so I let her know the postions to help encourage baby to rotate and alsotold her I would be around if she needed me for support. Two hours later her hubby rang and asked me to come into the hospital because a midwife who had relieved her assigned midwife to go to tea had bounced her and she was getting fearful of the same scencario being set up again. I arrived at the hospital 30 mins later to have missed the birth by 5 minutes. When her assigned midwife came back into the room and realised what had happened she immediately went to my client and whispered in her ear " listen to your body, it knows what to do, just let it do it". From that moment there was no more panick, she was back on track. She said she just kept thinking to herself "my body knows what to do, keep out of it's way and let it do its job". Her baby floated into the world calmly and peacefully. When I walked into the room she looked at me beaming and said " I DID IT and it was so wonderful, my body is so wonderful". I NEVER had a doubt she could do it because we have birthed babies for thousands of years and our bodies just KNOW how to do it. She videoed the birth and it IS wonderful. So many times over the last five years I have been kicked in the face, riduculed, accused ofinterferring with "hospital policy" by telling women they have rightsANDfor daring to teach a program that encourages women to look back within and get back in touch with their natural ability to birth. In my early days I was shunned in the birthing room because others wanted to just take control of women's births and how dare I stand there and support a woman's rights. I stood my ground! You midwives out there ARE making a difference, please don't ever give up. I will never give up my support for women to have the births they deserve to have and having you wonderful women there fighting from within the system IS changing it one birth at a time. It only takes one pebble in a pond to start a ripple. I'm not naive, I know we have a long way to go but if I know birth IS changing one birth at a time then I am encourged to be there and continue the fight for the right to birth as nature intended. Thanks for listening. Diane Gardner Melbourne Dip Couns, Adv Dip Hypnosis NLP, HBCE ,calmbirth Prac. - Original Message - From: Päivi
Re: [ozmidwifery] asthma in labour
Title: Re: [ozmidwifery] asthma in labour Dear Suzi and all As the consumer who has experienced the other side in a small rural community I could have written the same post (except for the clinical nuts and bolts!) We too have Drs with no real interest in evidence and both they and half of the midwives show no interest in continuing education. Women too are lambs to the slaughter (and most cop it) What to do? Well I ponder this daily. I really think midwives have a responsibility to right the wrongs on the evidence. (You do need support for this I know). Remember you only need 2 committed consumers. They can do and say so much more. Why not set up a branch of MC (or link into one if you are close by). We will support the lobbying, media and advocacy. Together we can do it :-))) JC Justine Caines National Policy Co-ordinator Maternity Coalition Inc PO Box 625 SCONE NSW 2329 Ph: (02) 65453612 Fax: (02)65482902 Mob: 0408 210273 E-Mail: [EMAIL PROTECTED] www.maternitycoalition.org.au
Re: [ozmidwifery] asthma in labour
Have used it in similar circumstances via the nebuliser it worked really well. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: suzi and brett To: ozmidwifery@acegraphics.com.au Sent: Monday, October 16, 2006 10:42 AM Subject: Re: [ozmidwifery] asthma in labour Just to confuse the issue...Last week a woman experienced hypertonic uterus after induction by PG gels. There was a heated debate about the use of inhalation ventolin - one dr saying it only acts locally (in the lungs) according the evidence when inhaled. The other arguing she uses successfully prior to ECV's. The woman had five puffs and thecontractions slowed down to3 in 10. Ah its a pleasure working in a rural hsp where most the doctors couldn't give a fig for keeping abreast of latest research. NOT. and very confusing for the committed registrars trying to learn from them. As for the women - they are kept way out of the argument - sadly like lambs to the slaughter. Also very hard to entice them to join the midwives chorus to establish midwifery models of care it seems. Only the few families who have lived and birthed in other areas before know what they are missing out on. Suzi - Original Message - From: michelle gascoigne To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 11:38 PM Subject: Re: [ozmidwifery] asthma in labour Tia My Pharmacology for midwives makes no mention of this. However, as a young student midwife I do remember one obs. used to use bronchodilators something like 5 puffs one after the other to ' relax the cervix' to help in removal of retained placentas. To be honest it is too long ago for me to remember how effective this was. Shelly (Midwife England) - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:28 AM Subject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED] Internal Virus Database is out-of-date.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.12.12/461 - Release Date: 02/10/2006
Re: [ozmidwifery] asthma in labour
Same here Suzi, except no registrar!!! change dates at every prenatalvisit booked C/S at 37-38 weeks and when bub choppers out, It wasn't the C/S!! Really No midwifery input during pregnancy (except if you're Aboriginal) Shocked newcomers to town. What no midwives clinic? Not even a hospital antenatal clinic? Where do I get care!? My GP? but they're not even dip OB? Not even accredited with the hospital?Can't I see a midwife? some days I just want to give up but I need to pay the mortgage Louise rural NSW [EMAIL PROTECTED] ---Original Message--- From: ozmidwifery@acegraphics.com.au Date: 10/16/06 11:09:54 To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] asthma in labour Just to confuse the issue...Last week a woman experienced hypertonic uterus after induction by PG gels. There was a heated debate about the use of inhalation ventolin - one dr saying it only acts locally (in the lungs) according the evidence when inhaled. The other arguing she uses successfully prior to ECV's. The woman had five puffs and thecontractions slowed down to3 in 10. Ah its a pleasure working in a rural hsp where most the doctors couldn't give a fig for keeping abreast of latest research. NOT. and very confusing for the committed registrars trying to learn from them. As for the women - they are kept way out of the argument - sadly like lambs to the slaughter. Also very hard to entice them to join the midwives chorus to establish midwifery models of care it seems. Only the few families who have lived and birthed in other areas before know what they are missing out on. Suzi - Original Message - From: michelle gascoigne To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 11:38 PM Subject: Re: [ozmidwifery] asthma in labour Tia My Pharmacology for midwives makes no mention of this. However, as a young student midwife I do remember one obs. used to use bronchodilators something like 5 puffs one after the other to ' relax the cervix' to help in removal of retained placentas. To be honest it is too long ago for me to remember how effective this was. Shelly (Midwife England) - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:28 AM Subject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED] Internal Virus Database is out-of-date.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.12.12/461 - Release Date: 02/10/2006
Re: [ozmidwifery] cord blood gases
Hi Shelley, I recently attended a advanced fetal assessment course at our tertiary hospital and all the pros for cord blood gases were presented. CTG's were discussed with pros and cons such as 80% show some abnormality but 80% of babies are not sick or acidotic. It was presented as one of certain diagnostic tools for fetal acidosis and therefore useful for litigation. You mentioned the results are inaccurate. I'd be very interested in hearing why they are inaccurate. We don't do them and I don't agree with routinely doing them so any more information would be helpful. Thanks Melissa - Original Message - From: michelle gascoigne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 10:39 PM Subject: Re: [ozmidwifery] cord blood gases Naomi In England we have seen in increase in 'fear' of litigation. Obstetrics in this country has always taken a huge chunk of the litigation for most hospitals . We now have in our country CNST (clinical neglegence scheme for trusts). Trusts are what groups of health care organisations are called. CNST is an insurance that Trusts pay into so that litigation claims can be paid when won. The CNST set out standards for trusts and depending on how well you achieve the standards determines the insurance premiums, which you can imagine are huge figures. The trouble is that CNST requirements for the standards to be met are not always sensible or in the best interests of women. Some standards like (cord blood sampling for ph post birth) are simply taken to record results in the notes which may protect against litigation in the future. I have a million issues with this practice! We had a university supervised professional debate about this issue in the Trust where I worked when it first became an issue. The midwives against and the Obs. for. We won the debate but the CNST requirements meant that we could save the Trust loads of money if we did them so they were introduced. Some of us still refused to do them. I would only do them if it was explained in full to the mother and father and they agreed. I gave it to them warts and all (like the obs openly admit that it is just to defend them in cases of litigation.). I did not make the decision the parents did. Needless to say when you tell them how inaccurate the results are and that neither they nor the baby will benfit from the results. Many choose not to have it done. I will search out my references and post them seperately. Our debate was published in a midwifery mag here! Shelly Midwife - Original Message - From: Naomi Wilkin [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 13, 2006 9:07 AM Subject: [ozmidwifery] cord blood gases Hi all, Just wondering how common it is for cord blood gases to be done in maternity units. I work in a small metro. hospital with a very busy maternity unit and our medical 'powers that be' are pushing for them to be done at every birth. Something we, the midwives, are very, very reluctant to do. I was also wondering if anyone knows of any research that may help us to prevent this from becoming a routine thing. Thanks Naomi. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.12.12/461 - Release Date: 02/10/2006 -- 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] We can make a difference
What a lovely story Dianne, thanks for sharing it Do you know if anyone is teaching this in WA? Sue - Original Message - From: Diane Gardner To: ozmidwifery@acegraphics.com.au Sent: Monday, October 16, 2006 9:19 AM Subject: Re: [ozmidwifery] We can make a difference It is quite some time since I wrote on this list and after reading some of the posts recently it has made me really appreciate the job I am doing. I KNOW my job is encouraging women to change the way they give birth, again trusting their body's ability to just do it. Sorry this post is so long. I am not a midwife but part of childbirth education teaching the Australian calmbirth program. Previously I taught HypnoBirthing but becausethe USAhad such a stranglehold on what wecouldn't change to teach for Australia,the opportunity came alongto be a part of the Australian program so Igrabbed it knowing what a difference the previous program was already making and with an Australian influence it was even better. I also know many of you midwives out there are seeing a difference in the women who are coming in to birth their babies using these relaxation programs. I have beendoing a small study whichI only started a couple of months ago and of the last 17 couples who have birthed only one had medical intervention. They all listened to and worked with their bodies beautifully supported by their partners who also learn and appreciate how women birth. They also stood up to the system and said this is what I want. MY way! Only a week ago I returned home from Birsbane after a conferenceand one of my clients rang me to let me know she was in labour with her 3rd baby. Her first 2 births were horrendous. During her first birth she was losing controland her assigned midwife said "you think this is bad, wait until the pain is so bad you will beBEGGING us to help you, the only thing that will get rid of this posterior labour pain is an epidural". So guess what she lost it totally there and then. During her second birth she had a wonderful and supportive midwife for the first couple of hours and then guess what the SAME midwifecame on dutyagain. This time she said "it would be better for everyone this time if you just have the epidural right now".My clientwent into immediate panick and the same scenario happened again. When she was pregnant again she knew she HAD todo something different. Nature wastelling her to listen and this time she was. She rang in total fear of it repeating again and booked in for classes. When she spoke to me on the phone at the start of this 3rd labour she had been to the races and after going to the toilet realised she had, hada show. When she returned home she rang and said I am in labour but it is so different, it isn't painful, it is all in my backbut I am breathing through the contractions easily. She knew her baby was posterior again so I let her know the postions to help encourage baby to rotate and alsotold her I would be around if she needed me for support. Two hours later her hubby rang and asked me to come into the hospital because a midwife who had relieved her assigned midwife to go to tea had bounced her and she was getting fearful of the same scencario being set up again. I arrived at the hospital 30 mins later to have missed the birth by 5 minutes. When her assigned midwife came back into the room and realised what had happened she immediately went to my client and whispered in her ear " listen to your body, it knows what to do, just let it do it". From that moment there was no more panick, she was back on track. She said she just kept thinking to herself "my body knows what to do, keep out of it's way and let it do its job". Her baby floated into the world calmly and peacefully. When I walked into the room she looked at me beaming and said " I DID IT and it was so wonderful, my body is so wonderful". I NEVER had a doubt she could do it because we have birthed babies for thousands of years and our bodies just KNOW how to do it. She videoed the birth and it IS wonderful. So many times over the last five years I have been kicked in the face, riduculed, accused ofinterferring with "hospital policy" by telling women they have rightsANDfor daring to teach a program that encourages women to look back within and get back in touch with their natural ability to birth. In my early days I was shunned in the birthing room because others wanted to just take control of women's births and how dare I stand there and support a woman's rights. I stood my ground! You midwives out there ARE making a difference, please don't ever give up. I will never give up my support for women to have the births they deserve to have and having you wonderful women there fighting from within the
Re: [ozmidwifery] Goodbye
I agree with Felicity's comments Lisa please do not stop contributing to this list and sharing your valuable experience as even though I do not post often at all, I never miss reading everyone's posts and love learning from your valuable experience As you have stated Felicity, what is the point of everyone agreeing with everyone? Everyone's opinion is valuable and should be shared Carol. Stephen Felicity [EMAIL PROTECTED] wrote: Personally, I love Lisa Barrett's contributions. I've NEVER found her rude (though often matter of fact, and her words are issued without watering down - which I personally appreciate); the reason I believe some may struggle to accept her contributions is because she's not focused on the needs or benefit of Midwives, Doulas, or other professionals, nor interested in talking in circles; she's focused squarely on the birthing women, every time, in every case. Let's remember that they're the ones who suffer when receiving care that is less than optimal (difficult though the Midwife's plight may be, it doesn't even compare to the struggle of the birthing women in our country)and let's applaud the efforts of experienced, passionate Midwives like Lisa who never lose sight of that, even at the cost of being attacked by her colleagues and being unpopular. Granted, we all do our bit in different ways; INCLUDING Lisa. I salute you, Lisa. Please don't stop contributing; your comments not only provide balance (what is the point of everyone agreeing with everyone when clearly there are many things VERY wrong with our system) but inspire me on a daily basis - inspire my renewed faith in Midwifery and in women. You talk a LOT of sense and it's refreshing. Thankyou.Sadie, I've enjoyed many of your comments as well. I'm sorry if you feel you want to leave. Goodbye, and best wishes for the future. On Yahoo!7 Messenger: Make FREE PC-to-PC Calls
