[ozmidwifery] Article about preterm birth and treatment for cervical changes
Precancerous changes and preterm births Issue 01: 8 Jan 2007 Source: BJOG: An International Journal of Obstetrics and Gynaecology 2007;114:70-80 A study has provided new insights into the association between precancerous changes in the cervix and the risk of subsequent preterm birth. The findings suggest that diagnosis of precancerous changes, regardless of the treatment given, is associated with a significantly increased risk of delivery before 37 weeks' gestation. Researchers at centers in Carlton, Australia, conducted a retrospective cohort study, investigating the records of 5,548 women who: 1.. Were referred to a cervical dysplasia clinic at the Royal Women's Hospital in Carlton between 1982 and 2000 for assessment of an abnormality detected on a routine Pap smear or for evaluation of a cervix that appeared abnormal; and 2.. Subsequently had a birth recorded in the Victoria state perinatal data collection system. The birth studied was the first after the referral, for women who were untreated, and the first after treatment, for women who received treatment. The follow-up period for the women ranged from 2 years to 20 years after referral. The researchers report their findings in a new paper published in the BJOG: An International Journal of Obstetrics and Gynaecology. Overall, there were 533 observed preterm births in the cohort of 5,548 women, significantly higher than the 312 cases expected based on national figures. The main findings included the following: a.. The risk of preterm birth (defined as within 37 weeks of gestation) was significantly higher for both treated and untreated women compared with the general population. b.. The risk of preterm birth was significantly higher among the treated women than among the untreated women. c.. Other factors significantly associated with an increased risk of preterm birth were a history of induced or spontaneous abortion, illicit drug use during pregnancy, and a major maternal medical condition. In terms of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP), and diathermy were associated with preterm birth; after adjustment for potentially confounding factors, only the association between diathermy and preterm birth remained statistically significant. d.. Women treated with laser ablation did not have a significantly increased risk of preterm birth. Discussing their findings, the researchers say the study is the largest to date examining pregnancy outcomes following diagnosis and treatment for precancerous changes in the cervix. They conclude: Women presenting with precancerous changes in the cervix are at an increased risk for preterm birth, a risk that appears to be increased by treatments that remove or destroy substantial amounts of cervical tissue. They suggest that, in light of these findings, there needs to be a re-evaluation of treatment programmes involving a see and treat policy for the management of abnormal Pap smear results. In addition, the use of ablative techniques such as laser ablation need revisiting, the researchers state.
RE: [ozmidwifery] where has this list gone?
Dear all It's been quite a while since my last posting on this list. But never the less, I enjoy reading the posts every day - and forwarding the most insteresting posts to the communities here in Denmark. Cherished. I seem to get all the posts without any problems. Thank you all for making this list worth while! And off course to you, Andrea, for making it possible! Please, please keep it on. In my view the issues presented are all relevant and the discussions educational. Even though I'm a member of a society, - Denmark- you consider being superior to your own. We're nothing of the kind, and still struggling hard to provide amble midwifery care! Warm regards Kirsten in Denmark C/o Birth Committee Denmark -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes
Dear all Twice in one night out of two years I feel compelled to answer posts on the list! This study has been used as a propellar for inaugerating new studies performed on the pregnant here in Denmark! Actually they claim to have a vaccine given to young girls up to 15 years old, that would solve this problem. I have great dificulties getting totally convinced a vaccine could solve this particular cancer problem. And this at a moment where the National Health Institute finally has acknowledged major problems with screening of breast cancer and the like (a.o. Down's Syndrome), because of poor results as to positive/negative readings followed by distress due to trauma caused by the readings. What is really the agenda? Kirsten in Denmark -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Helen and Graham Sent: 10. januar 2007 23:04 To: ozmidwifery Subject: [ozmidwifery] Article about preterm birth and treatment for cervical changes Precancerous changes and preterm births Issue 01: 8 Jan 2007 Source: BJOG: An International Journal of Obstetrics and Gynaecology 2007;114:70-80 A study has provided new insights into the association between precancerous changes in the cervix and the risk of subsequent preterm birth. The findings suggest that diagnosis of precancerous changes, regardless of the treatment given, is associated with a significantly increased risk of delivery before 37 weeks gestation. Researchers at centers in Carlton, Australia, conducted a retrospective cohort study, investigating the records of 5,548 women who: 1. Were referred to a cervical dysplasia clinic at the Royal Womens Hospital in Carlton between 1982 and 2000 for assessment of an abnormality detected on a routine Pap smear or for evaluation of a cervix that appeared abnormal; and 2. Subsequently had a birth recorded in the Victoria state perinatal data collection system. The birth studied was the first after the referral, for women who were untreated, and the first after treatment, for women who received treatment. The follow-up period for the women ranged from 2 years to 20 years after referral. The researchers report their findings in a new paper published in the BJOG: An International Journal of Obstetrics and Gynaecology. Overall, there were 533 observed preterm births in the cohort of 5,548 women, significantly higher than the 312 cases expected based on national figures. The main findings included the following: * The risk of preterm birth (defined as within 37 weeks of gestation) was significantly higher for both treated and untreated women compared with the general population. * The risk of preterm birth was significantly higher among the treated women than among the untreated women. * Other factors significantly associated with an increased risk of preterm birth were a history of induced or spontaneous abortion, illicit drug use during pregnancy, and a major maternal medical condition. In terms of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP), and diathermy were associated with preterm birth; after adjustment for potentially confounding factors, only the association between diathermy and preterm birth remained statistically significant. * Women treated with laser ablation did not have a significantly increased risk of preterm birth. Discussing their findings, the researchers say the study is the largest to date examining pregnancy outcomes following diagnosis and treatment for precancerous changes in the cervix. They conclude: Women presenting with precancerous changes in the cervix are at an increased risk for preterm birth, a risk that appears to be increased by treatments that remove or destroy substantial amounts of cervical tissue. They suggest that, in light of these findings, there needs to be a re-evaluation of treatment programmes involving a see and treat policy for the management of abnormal Pap smear results. In addition, the use of ablative techniques such as laser ablation need revisiting, the researchers state.
Re: [ozmidwifery] Article about preterm birth and treatment for cervical changes
MessageHi Kirsten, Are you talking about the HPV (genital warts) vaccine? They say HPV is responsible for approx 70% of cervical cancer cases although I have seen that figure stretched beyond the 70% for the sake of advertising of the HPV vaccine. I'm not sure where the figure comes from. I would say money figures heavily on the agenda :) The vaccine is now available in Australia and the US. I'm not sure where else at present. Regards Jayne - Original Message - From: Kirsten Lerstrøm To: ozmidwifery@acegraphics.com.au Sent: Thursday, January 11, 2007 10:19 AM Subject: RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes Dear all Twice in one night out of two years I feel compelled to answer posts on the list! This study has been used as a propellar for inaugerating new studies performed on the pregnant here in Denmark! Actually they claim to have a vaccine given to young girls up to 15 years old, that would solve this problem. I have great dificulties getting totally convinced a vaccine could solve this particular cancer problem. And this at a moment where the National Health Institute finally has acknowledged major problems with screening of breast cancer and the like (a.o. Down's Syndrome), because of poor results as to positive/negative readings followed by distress due to trauma caused by the readings. What is really the agenda? Kirsten in Denmark -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Helen and Graham Sent: 10. januar 2007 23:04 To: ozmidwifery Subject: [ozmidwifery] Article about preterm birth and treatment for cervical changes Precancerous changes and preterm births Issue 01: 8 Jan 2007 Source: BJOG: An International Journal of Obstetrics and Gynaecology 2007;114:70-80 A study has provided new insights into the association between precancerous changes in the cervix and the risk of subsequent preterm birth. The findings suggest that diagnosis of precancerous changes, regardless of the treatment given, is associated with a significantly increased risk of delivery before 37 weeks' gestation. Researchers at centers in Carlton, Australia, conducted a retrospective cohort study, investigating the records of 5,548 women who: 1.. Were referred to a cervical dysplasia clinic at the Royal Women's Hospital in Carlton between 1982 and 2000 for assessment of an abnormality detected on a routine Pap smear or for evaluation of a cervix that appeared abnormal; and 2.. Subsequently had a birth recorded in the Victoria state perinatal data collection system. The birth studied was the first after the referral, for women who were untreated, and the first after treatment, for women who received treatment. The follow-up period for the women ranged from 2 years to 20 years after referral. The researchers report their findings in a new paper published in the BJOG: An International Journal of Obstetrics and Gynaecology. Overall, there were 533 observed preterm births in the cohort of 5,548 women, significantly higher than the 312 cases expected based on national figures. The main findings included the following: a.. The risk of preterm birth (defined as within 37 weeks of gestation) was significantly higher for both treated and untreated women compared with the general population. b.. The risk of preterm birth was significantly higher among the treated women than among the untreated women. c.. Other factors significantly associated with an increased risk of preterm birth were a history of induced or spontaneous abortion, illicit drug use during pregnancy, and a major maternal medical condition. In terms of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP), and diathermy were associated with preterm birth; after adjustment for potentially confounding factors, only the association between diathermy and preterm birth remained statistically significant. d.. Women treated with laser ablation did not have a significantly increased risk of preterm birth. Discussing their findings, the researchers say the study is the largest to date examining pregnancy outcomes following diagnosis and treatment for precancerous changes in the cervix. They conclude: Women presenting with precancerous changes in the cervix are at an increased risk for preterm birth, a risk that appears to be increased by treatments that remove or destroy substantial amounts of cervical tissue. They suggest that, in light of these findings, there needs to be a re-evaluation of treatment programmes involving a see and treat policy for the management of abnormal Pap smear results. In addition, the use of ablative techniques such as laser ablation need revisiting, the researchers state.
RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes
Hi Jayne It's actually a new - socalled revolutionary vaccine - against cervical changes. I do not not know that much about the actual compund yet - vague press info so far, but they do stress making it universal for all girls at onset of puberty and before sexual beginning, thus 15 years of age. Here, it's sold as an option for these girls without parental consent. So many issues, that just scream concern without/before further knowledge. We're in the midst of complete governmental change these days, so actions like this, is really possible to push through without any notice going on. Best regards, Kirsten in Denmark -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jayne/jesse Sent: 11. januar 2007 02:33 To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Article about preterm birth and treatment for cervical changes Hi Kirsten, Are you talking about the HPV (genital warts) vaccine? They say HPV is responsible for approx 70% of cervical cancer cases although I have seen that figure stretched beyond the 70% for the sake of advertising of the HPV vaccine. I'm not sure where the figure comes from. I would say money figures heavily on the agenda :) The vaccine is now available in Australia and the US. I'm not sure where else at present. Regards Jayne - Original Message - From: Kirsten mailto:[EMAIL PROTECTED] Lerstrøm To: ozmidwifery@acegraphics.com.au Sent: Thursday, January 11, 2007 10:19 AM Subject: RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes Dear all Twice in one night out of two years I feel compelled to answer posts on the list! This study has been used as a propellar for inaugerating new studies performed on the pregnant here in Denmark! Actually they claim to have a vaccine given to young girls up to 15 years old, that would solve this problem. I have great dificulties getting totally convinced a vaccine could solve this particular cancer problem. And this at a moment where the National Health Institute finally has acknowledged major problems with screening of breast cancer and the like (a.o. Down's Syndrome), because of poor results as to positive/negative readings followed by distress due to trauma caused by the readings. What is really the agenda? Kirsten in Denmark -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Helen and Graham Sent: 10. januar 2007 23:04 To: ozmidwifery Subject: [ozmidwifery] Article about preterm birth and treatment for cervical changes Precancerous changes and preterm births Issue 01: 8 Jan 2007 Source: BJOG: An International Journal of Obstetrics and Gynaecology 2007;114:70-80 A study has provided new insights into the association between precancerous changes in the cervix and the risk of subsequent preterm birth. The findings suggest that diagnosis of precancerous changes, regardless of the treatment given, is associated with a significantly increased risk of delivery before 37 weeks gestation. Researchers at centers in Carlton, Australia, conducted a retrospective cohort study, investigating the records of 5,548 women who: 1. Were referred to a cervical dysplasia clinic at the Royal Womens Hospital in Carlton between 1982 and 2000 for assessment of an abnormality detected on a routine Pap smear or for evaluation of a cervix that appeared abnormal; and 2. Subsequently had a birth recorded in the Victoria state perinatal data collection system. The birth studied was the first after the referral, for women who were untreated, and the first after treatment, for women who received treatment. The follow-up period for the women ranged from 2 years to 20 years after referral. The researchers report their findings in a new paper published in the BJOG: An International Journal of Obstetrics and Gynaecology. Overall, there were 533 observed preterm births in the cohort of 5,548 women, significantly higher than the 312 cases expected based on national figures. The main findings included the following: * The risk of preterm birth (defined as within 37 weeks of gestation) was significantly higher for both treated and untreated women compared with the general population. * The risk of preterm birth was significantly higher among the treated women than among the untreated women. * Other factors significantly associated with an increased risk of preterm birth were a history of induced or spontaneous abortion, illicit drug use during pregnancy, and a major maternal medical condition. In terms of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP), and diathermy were associated with preterm birth; after adjustment for potentially confounding factors, only the association between diathermy and preterm birth remained statistically significant. * Women treated with laser ablation did not have a significantly increased risk of preterm birth.
[ozmidwifery] job
Hi list members, I wanted to send this email under how do you deal with your frustrations?' but the text is not really an answer to that discussion. Therefore I started a new one. I just quit my job at the local hospital, because I could no longer accept the way women and staff (lower in rank and peers) were treated there by the other staff (higher in rank). However, I would like to work where staff can be civil towards each other and their clients, preferably in education or midwifery (or both). I have a Graduate Diploma in Childbirth Education and a Master of Midwifery. If there is no job like this in Australia for me, I might have to go to Holland. Because I have my children here and grandchildren as well I prefer to stay in Australia. If anyone can help, please let me know here or on my email at home: [EMAIL PROTECTED] Thank you. Anke Dalman
Re: [ozmidwifery] job
Hi Anke - a happy New Year to you Bullying is the name of the game in most Autralian maternity units. I can only suggest that you start working with women again and not with colleagues. Set up your own practice. It is so satisfying working one-to-one rather than deal with disgruntled staff who are working their butts off trying to provide a service for which they just don't have the numbers. You could start up your own community classes as a private childbirth educator Run them in your home initially and move into a local church or community hall as your class number increase. Jan Jan Robinson Independent Midwife Practitioner National Coordinator Australian Society of Independent Midwives 8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350 e-mail address: [EMAIL PROTECTED] website: www.midwiferyeducation.com.au On 11 Jan, 2007, at 14:04, Anke Dalman wrote: Hi list members, I wanted to send this email under “how do you deal with your frustrations?’ but the text is not really an answer to that discussion. Therefore I started a new one. I just quit my job at the local hospital, because I could no longer accept the way women and staff (lower in rank and peers) were treated there by the other staff (higher in rank). However, I would like to work where staff can be civil towards each other and their clients, preferably in education or midwifery (or both). I have a Graduate Diploma in Childbirth Education and a Master of Midwifery. If there is no job like this in Australia for me, I might have to go to Holland. Because I have my children here and grandchildren as well I prefer to stay in Australia. If anyone can help, please let me know here or on my email at home: [EMAIL PROTECTED] Thank you. Anke Dalman
RE: [ozmidwifery] job
Hi Jan, I thought of that, but there are already 2 childbirth educators here and they are good practitioners. I don't like to 'steal' their income. They are too good and nice for that. Also I like to help the women to birth too much. I'm addicted. Love Anke
[ozmidwifery] How do you deal with your fustrations?
I'm emailing again because I don't think the email I wrote yesterday went through? At least I didn't get it on my computer. To help me deal with my frustrations, so to speak, I am contemplating doing some more study so that I can do some independent antenatal education. I would love some advice and guidance from the wise ladies/men on this list please. A bit of history about me. I live rurally and have a 6 week oldbaby and a 3y.o, and I am tandem breastfeeding them. I would prefer something that I could study from home, but am prepared to travel if necessary. I have found these courses, but would like to know what else is available, so that I can enrol in the best or most suitable course for me at this stage in my life. As far as I'm aware there is no one who does independent childbirth education in any form in this district or surrounding districts, so I'd have potential to start a business, at least one that is child friendly and I can pick and choose my own hours..oh and no one staff politics!. Like many of you have said working in a hospital setting no longer appeals to me whatsoever. I'd love to work with a MIPP to gain experience as I've only not long graduated my GD of midwifery, but there is no one around this area as I said before., so to make the most of my suitation i think this is a good idea...So tell me what courses are there avaibable, what courses/studies have you done? These are the ones I've looked into. Graduate Diploma in Childbirth Education (not available as far as I'm aware) Master of Midwifery. Hypnobirthing Practitioner training Calmbirthing practitioner training ICEA: CBE course Bradely Method ABA community educator course IBLCE lactaion course Natural Birth Education Research Center: G.D (or G.C) of natural birth Infant Massage Instructor training Over time I would love to do a number of these to cater to the wide and varying needs of childbearing women and their families. But for now, I'd love to hear some advice and recommendations from you! PLEASE!! TIA, Rachael
RE: [ozmidwifery] How do you deal with your frustrations?
You could learn pregnancy massage and some of the natural therapies. Try the Australian College of Natural Therapies. Or a counselling degree / diploma - this complements midwifery very nicely. Try the Australian Institute of Professional Counsellors - I know they run a distance education course. A certificate IV in work place assessment and training is always handy to have. Melissa Maimann Essential Birth Consulting Email: mailto:[EMAIL PROTECTED] [EMAIL PROTECTED] Mobile: 0400 418 448 _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Dan Rachael Austin Sent: Thursday 11 January 2007 15:34 To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How do you deal with your fustrations? I'm emailing again because I don't think the email I wrote yesterday went through? At least I didn't get it on my computer. To help me deal with my frustrations, so to speak, I am contemplating doing some more study so that I can do some independent antenatal education. I would love some advice and guidance from the wise ladies/men on this list please. A bit of history about me. I live rurally and have a 6 week oldbaby and a 3y.o, and I am tandem breastfeeding them. I would prefer something that I could study from home, but am prepared to travel if necessary. I have found these courses, but would like to know what else is available, so that I can enrol in the best or most suitable course for me at this stage in my life. As far as I'm aware there is no one who does independent childbirth education in any form in this district or surrounding districts, so I'd have potential to start a business, at least one that is child friendly and I can pick and choose my own hours..oh and no one staff politics!. Like many of you have said working in a hospital setting no longer appeals to me whatsoever. I'd love to work with a MIPP to gain experience as I've only not long graduated my GD of midwifery, but there is no one around this area as I said before., so to make the most of my suitation i think this is a good idea...So tell me what courses are there avaibable, what courses/studies have you done? These are the ones I've looked into. Graduate Diploma in Childbirth Education (not available as far as I'm aware) Master of Midwifery. Hypnobirthing Practitioner training Calmbirthing practitioner training ICEA: CBE course Bradely Method ABA community educator course IBLCE lactaion course Natural Birth Education Research Center: G.D (or G.C) of natural birth Infant Massage Instructor training Over time I would love to do a number of these to cater to the wide and varying needs of childbearing women and their families. But for now, I'd love to hear some advice and recommendations from you! PLEASE!! TIA, Rachael
Re: [ozmidwifery] job
Hi Anke Where are you geographically? You say you want to be around birthing women. How about setting up in private practice as Jan says?? You dont have to steal income from other childbirth educators. What about a complete midwifery practice, antenatal care, birth support in hospital, homebirth, postnatal care...Steal it back from the medical profession!!.I have to warn you though! Its terribly addictive. I heard a rumor from a midwife in Katherine there is an interesting job going up there soon. (Hi Anne...!!). Something perfect will come up for you and by the way a huge congratulations for refusing to compromise your principles. Wendy - Original Message - From: Anke Dalman To: ozmidwifery@acegraphics.com.au Sent: Thursday, January 11, 2007 2:04 PM Subject: [ozmidwifery] job Hi list members, I wanted to send this email under how do you deal with your frustrations?' but the text is not really an answer to that discussion. Therefore I started a new one. I just quit my job at the local hospital, because I could no longer accept the way women and staff (lower in rank and peers) were treated there by the other staff (higher in rank). However, I would like to work where staff can be civil towards each other and their clients, preferably in education or midwifery (or both). I have a Graduate Diploma in Childbirth Education and a Master of Midwifery. If there is no job like this in Australia for me, I might have to go to Holland. Because I have my children here and grandchildren as well I prefer to stay in Australia. If anyone can help, please let me know here or on my email at home: [EMAIL PROTECTED] Thank you. Anke Dalman -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.410 / Virus Database: 268.16.8/621 - Release Date: 1/9/2007
RE: [ozmidwifery] job
Thank you Wendy, Homebirths would be ideal, but not at this present time due to litigation worries. Going into hospital is no deal either. As a hospital midwife there was no autonomy and there are no visiting rights and no insurance. I am in Townsville at the moment. Thanks Anke
Re: [ozmidwifery] job
Townsville is in desperate need of IMs. I believe there's one newly on the scene there atm? Out of interest, has anyone been sued since the insurance rubbish began? J - Original Message - From: Anke Dalman To: ozmidwifery@acegraphics.com.au Sent: Thursday, January 11, 2007 4:26 PM Subject: RE: [ozmidwifery] job Thank you Wendy, Homebirths would be ideal, but not at this present time due to litigation worries. Going into hospital is no deal either. As a hospital midwife there was no autonomy and there are no visiting rights and no insurance. I am in Townsville at the moment. Thanks Anke
