Re: [ozmidwifery] question from Year 10 student
Perhaps the pressure exerted on the baby's headby the contracting uterus aids venous return andkeeps the blood from pooling in the brain? Regards Fiona Rumble - Original Message - From: Bowman Family To: ozmidwifery@acegraphics.com.au Sent: Monday, November 07, 2005 7:10 PM Subject: [ozmidwifery] question from Year 10 student I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of theboys asked "how come the blood doesn't rush to the baby's head like it does for us if we are upside down" I didn't know the correct answer and saidI would get back to him. It possibly is obvious but I have asked a few peers andno-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda
Re: [ozmidwifery] mackay midwives
Kirsten is off to Selangor Private in Nambour. Regards Fiona Rumble - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Friday, November 04, 2005 3:25 PM Subject: Re: [ozmidwifery] mackay midwives Dear Fiona, Where is Kirsten going? RegardsAnne Clarke - Original Message - From: FIONA AND CRAIG RUMBLE To: ozmidwifery Sent: Friday, November 04, 2005 6:20 AM Subject: [ozmidwifery] mackay midwives Did you know Kirsten Small (one of only two OBS)has resigned, leaving July? Great opportunity to highlight the need for more midwifery care and encouragement for the Birth Centre. I mentioned same to ABC reporter yesterday and a Doctor (my boss) poo hoo-ed me saying there were too many problems at the BC already. All the more reason to push forward Regards Fiona Rumble__ NOD32 1.1275 (20051103) Information __This message was checked by NOD32 antivirus system.http://www.eset.com
Re: [ozmidwifery] Abby's Birth Announcement
Congratulations Abby. Love and prayers to you, your little one, and all the family. Job well done! Regards Fiona Rumble (Birth International workshop co-participant) HI,Sorry for the x-post, but thought I would share that thismorning at 3:46am Igave birth to a beautiful little girl, Runah. After a couple of days ofcrazy prelabour and 5 hours of active labour she was birthed in warm water,in my own home, into my friends hands with just her daddy, mummy and twofriends there.After having a very traumatic c-section with my first daughter, this wastruly amazing!!I am sore, tired and truly EMPOWERED!!Love Abby--This mailing list is sponsored by ACE Graphics.Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] mackay midwives
Did you know Kirsten Small (one of only two OBS)has resigned, leaving July? Great opportunity to highlight the need for more midwifery care and encouragement for the Birth Centre. I mentioned same to ABC reporter yesterday and a Doctor (my boss) poo hoo-ed me saying there were too many problems at the BC already. All the more reason to push forward Regards Fiona Rumble
Re: [ozmidwifery] Infant Sleep
Jo, have you thought of trying a baby hammock? I used one for my second and third and did not have any problems as the baby's own movement bounces the sling and the movement puts baby back to sleep. If you lived near Mackay I would lend you one. The hammock was the best baby item I ever bought and most of my friends and family have tried it and also swear by the baby hammock. Have a look at the website. Cheers Fiona http://www.babyhammocks.com/ Regards Fiona Rumble - Original Message - From: JoFromOz To: ozmidwifery@acegraphics.com.au Sent: Monday, October 17, 2005 1:56 PM Subject: [ozmidwifery] Infant Sleep Hi All...Just wondering if any of you have any thoughts on this Q/A: http://www.awareparenting.com/answer13.htmThe question seems to relate strongly to our situation at the moment. Will is waking VERY often over night. He only seems to need feeding twice, as the other times he just semi-wakes and cries, and needs rewrapping, and dummy back in. I counted 18 awakenings the other night, and I think the number came close last night. This happens whether co-sleeping or puting him in his cot in our room. He seems to go to sleep quite easily, but doesn't stay asleep. The answer suggests not giving the dummy for sleep, but letting baby cry-it-out, only in your arms. It says that babies need this crying time to release stress of the day and once it's gone, they will sleep well (until they're hungry, of course). If they don't get this crying time, because the parents use rocking, dummy, wrapping, whatever to calm them, then they need to wake often to cry, and try to release the stress. It's all so confusing! I hate the idea of letting him cry, whether I'm holding him or not, especially when it's so easily fixed! Thanks for listening!Jo (Mum to Will, 4.5 months old)--This mailing list is sponsored by ACE Graphics.Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Convenience
Have I missed something/??? Regards Fiona Rumble - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Wednesday, October 12, 2005 7:17 PM Subject: Re: [ozmidwifery] Convenience Oh yeah! Can we take out full colour pages in all the major dailies with this on it? I'd like to add a PS Bottlefeeding IS NOT more convenient than breastfeeding and has dire consequences when it goes wrong! J
Re: [ozmidwifery] Induction and third stage labour
Here is one study. Induction of labour leads to caesarean sections, instrumental delivery and shoulder dystocia Maternal and neonatal outcomes after induction of labour without an identified indication.Am J Obstet Gynecol. 2000 Oct;183(4):986-94.Dublin S, Lydon-Rochelle M, Kaplan RC, Watts DH, Critchlow CWDepartment of Epidemiology, University of Washington. OBJECTIVE: This study was undertaken to examine associations between induction of labour and maternal and neonatal outcomes among women without an identified indication for induction. Study Design: This was a population-based cohort study of 2886 women with induced labour and 9648 women with spontaneous labour who were delivered at 37 to 41 weeks' gestation, all without identified medical and obstetric indications for induction. RESULTS: Among nulliparous women 19% of women with induced labour versus 10% of those with spontaneous labour underwent caesarean delivery (adjusted relative risk, 1.77 ; 95% confidence interval, 1.50-2.08). No association was seen in multiparous women (relative risk, 1.07; 95% confidence interval, 0.81-1.39). Among all women induction was associated with modest increases in instrumental delivery (19% vs 15%; relative risk, 1.20; 95% confidence interval, 1.09-1.32) and shoulder dystocia (3.0% vs 1.7%; relative risk, 1.32; 95% confidence interval, 1.02-1.69). CONCLUSION: Among women who lacked an identified indication for induction of labour, induction was associated with increased likelihood of caesarean delivery for nulliparous but not multiparous women and with modest increases in the risk of instrumental delivery and shoulder dystocia for all women. Regards Fiona Rumble - Original Message - From: karen shlegeris To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 04, 2005 11:21 AM Subject: [ozmidwifery] Induction and third stage labour Dear List, Im a birth educator and prenatal yoga teacher in Townsville. I hope these questions are appropriate for this list and would appreciate information from you: Induction. Andreas Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and thats what Ive always taught in my Active Birth classes. However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a women passes her EDD. Can anyone clear this up for me? Third stage of labour. I was under the belief that if active management of third stage was chosen, the cord had to be clamped and cut quickly to avoid an over-transfusion of blood from the placenta into the baby. However, an OB recently told a client of mine that even if she had a Synto injection, the cord could be left until it stopped pulsing. Ive checked Myles textbook for midwives but its not clear on this. I appreciate your support. Best wishes, Karen Shlegeris in Townsville
Re: [ozmidwifery] Induction and third stage labour
Two more Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term.Obstet Gynecol. 2000 Jun;95(6 Pt 1):917-22.Maslow AS, Sweeny ALDepartment of Clinical Outcomes and Quality Improvement, Franciscan Health System, Tacoma, Washington, USA. OBJECTIVE: To determine the effects of elective induction on the risk of cesarean delivery in a cohort of women with low-risk term pregnancies and to evaluate the costs of elective induction services within our hospital system. METHODS: Records of 1135 eligible women with low-risk, singleton, vertex pregnancies at 38-41 weeks' gestation who were eligible for vaginal delivery were analyzed retrospectively after elective induction (n = 263) or spontaneous labor (n = 872). Outcome measures included cesarean delivery and direct costs. Variables evaluated were parity, maternal age, estimated gestational age, birth weight, prior cesarean delivery, epidural anesthetic use, and provider category. Analysis was by univariable and multivariable regression modeling. RESULTS: Elective induction placed nulliparas at a twofold higher risk for cesarean delivery (odds ratio 2.4, 95% confidence interval 1.2, 4.9) after adjustment for birth weight, maternal age, and gestational age. We found a significantly increased risk of cesarean delivery with increased birth weight for nulliparas (2-66.7%). Increasing maternal age increased the risk of cesarean delivery in all parity groups (P.05), but particularly among nulliparas (3-26.3%) (P .001). Electively induced labors that ended in vaginal delivery cost $273 more and required an average of 4 hours more in the hospital before delivery than did noninduced vaginal deliveries (P .001). CONCLUSION: Elective induction significantly increased the risk of cesarean delivery for nulliparas, and increased in-hospital predelivery time and costs. PMID: 10831992 Women having their first babies are twice as likely to get sections when labor is induced Induction of labor and the relationship to cesarean delivery: A review of 7001 consecutive inductions.Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):628-33.Yeast JD, Jones A, Poskin M Saint Luke's Perinatal Center, Saint Luke's Hospital of Kansas City, Kansas City, Missouri 64111, USA. OBJECTIVE: The goal of this project was to study the increasing risk of induction of labor in a community hospital and to determine whether it had an adverse effect on the rate of cesarean delivery. Study Design: From January 1, 1990, through July 31, 1997, 18,055 consecutive singleton pregnancies in women who were candidates for labor were reviewed via a comprehensive perinatal database. The risk of and indication for induction were reviewed. Cesarean delivery rates were calculated for nulliparous and multiparous patients by indication for induction and were compared with rates for patients who had spontaneous labor. Overall trends in cesarean delivery were reviewed for the duration of the study period. RESULTS: The annual induction rate significantly rose from 32% to 43% at the conclusion of the study period. Labor was induced in nearly 40% of nulliparous patients. Postdate pregnancy was the most common indication for induction, although few patients were at or beyond 42 weeks' gestation. The cesarean delivery rate remained at or below 20% for the years of the study. No increase was noted in spite of the increasing risk of induction. However, for nulliparous patients who had elective induction of labor, the risk of cesarean delivery was twice that of nulliparous patients who had spontaneous labor. CONCLUSION: The use of induction methods has significantly increased in this community hospital. More than 40% of patients are now candidates for induction. The cesarean delivery rate remains low in this facility in spite of a marked increase in risk of operative delivery for nulliparous patients who undergo induction Comment in: Am J Obstet Gynecol 1999 Nov;181(5 Pt 1):1273-4PMID: 10076139, UI: 99176971 Regards Fiona Rumble - Original Message - From: karen shlegeris To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 04, 2005 11:21 AM Subject: [ozmidwifery] Induction and third stage labour Dear List, Im a birth educator and prenatal yoga teacher in Townsville. I hope these questions are appropriate for this list and would appreciate information from you: Induction. Andreas Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and thats what Ive always taught in my Active Birth classes. However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a
Re: [ozmidwifery] Induction and third stage labour
and another. Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol. 1999 Oct;94(4):600-7.Seyb ST, Berka RJ, Socol ML, Dooley SLDepartment of Obstetrics and Gynecology, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, Illinois, USA. OBJECTIVE: To quantify the risk of cesarean delivery associated with elective induction of labor in nulliparous women at term. METHODS: We performed a cohort study on a major urban obstetric service that serves predominantly private obstetric practices. All term, nulliparous women with vertex, singleton gestations who labored during an 8-month period (n = 1561) were divided into three groups: spontaneous labor, elective induction, and medical induction. The risk of cesarean delivery in the induction groups was determined using stepwise logistic regression to control for potential confounding factors. RESULTS: Women experiencing spontaneous labor had a 7.8% cesarean delivery rate, whereas women undergoing elective labor induction had a 17.5% cesarean delivery rate (adjusted odds ratio [OR] 1.89; 95% confidence interval [CI] 1.12, 3.18) and women undergoing medically indicated labor induction had a 17.7% cesarean delivery rate (OR 1.69; 95% CI 1.13, 2.54). Other variables that remained significant risk factors for cesarean delivery in the model included: epidural placement at less than 4 cm dilatation (OR 4.66; 95% CI 2.25, 9.66), epidural placement after 4 cm dilatation (OR 2.18; 95% CI 1.06, 4.48), chorioamnionitis (OR 4.61; 95% CI 2.89, 7.35), birth weight greater than 4000 g (OR 2.59; 95% CI 1.69, 3.97), maternal body mass index greater than 26 kg/m2 (OR 2.36; 95% CI 1.61, 3.47), Asian race (OR 2.35; 95% CI 1.04, 5.34), and magnesium sulfate use (OR 2.18; 95% CI 1.04, 4.55). CONCLUSION: Elective induction of labor is associated with a significantly increased risk of cesarean delivery in nulliparous women. Avoiding labor induction in settings of unproved benefit may aid efforts to reduce the primary cesarean delivery rate. Regards Fiona Rumble - Original Message - From: karen shlegeris To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 04, 2005 11:21 AM Subject: [ozmidwifery] Induction and third stage labour Dear List, Im a birth educator and prenatal yoga teacher in Townsville. I hope these questions are appropriate for this list and would appreciate information from you: Induction. Andreas Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and thats what Ive always taught in my Active Birth classes. However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a women passes her EDD. Can anyone clear this up for me? Third stage of labour. I was under the belief that if active management of third stage was chosen, the cord had to be clamped and cut quickly to avoid an over-transfusion of blood from the placenta into the baby. However, an OB recently told a client of mine that even if she had a Synto injection, the cord could be left until it stopped pulsing. Ive checked Myles textbook for midwives but its not clear on this. I appreciate your support. Best wishes, Karen Shlegeris in Townsville
