Re: [ozmidwifery] Lymphedema

[Judy Chapman]

What is excessive pushing and who is to say that she will have
to do it? Is the downside of excessive pushing worse than the
downside of post CS infection, which I have seen some nasty
cases of. 
Cheers
Judy

--- Katrina Flora [EMAIL PROTECTED] wrote:

 Hi All, has anyone had any experience with caring for a woman
 with primary lymphedema?
 
 A friend of mine has this condition and is 24/40 at the
 moment. Her symptoms haven't worsened through the pregnancy up
 to this point. I have had a look at a few databases and texts
 and it seems there hasn't been any research done in this area
 and there aren't any guidelines for management of
 pregnancy/birth for these women.
 
 So I'm looking for any anecdotal evidence in this area. It
 seems that the real risk in this situation is with postpartum
 infection, so logic would say avoid acquiring a caesarean
 wound. But she has been told that excessive pushing during 2nd
 stage could be problematic for her in that most of the lymph
 nodes she's missing are in her groin and her edema is in her
 legs. 
 What do you think?
 
 Many thanks,
 Katrina Flora
 Student Midwife, 2nd year ACU
 
 


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Re: [ozmidwifery] Pinky on ACA TONIGHT - Channel 9

[Judy Chapman]

ACA was on after the cricket here so I saw the trailer and
stayed to watch. Great Pinky, you came across as much more
caring than the other woman. 
Cheers
Judy

--- Kelly Zantey [EMAIL PROTECTED] wrote:

 Check out ACA tonight at 6.30pm, Pinky will be on about babies
 and sleep.
 Don't forget to write in and say you liked the segment ask for
 more of Pinky
 :-)
 
  
 
 Best Regards,
 
  
 
 Kelly Zantey
 
 Creator,  http://www.bellybelly.com.au BellyBelly.com.au
 
 Conception, Pregnancy, Birth and Baby
 
 Australian Birth  http://www.abpnsconference2007.com.au/ 
 Post Natal
 Services Conference 2007
 
  
 
 


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RE: [ozmidwifery] Mum Gives Birth In Toilet - Monash Medical Centre

[Judy Chapman]

Hi Sharon,
It is very tempting to think of a fast labour as great,
especially for someone like me who had two CS for FTP. I have
learned, though, that many women who do have very rapid labours
can find them VERY intense, and very frightening as they are
s out of control. My imagination says it must be like being
picked up by a tornado and then dumped unceremoniously. I can
see her fear and agree that she probably had many expectations
left unmet. I hope someone has the wisdom to sit down with the
couple and debrief. 
Cheers
Judy

--- sharon [EMAIL PROTECTED] wrote:

 What I wonderful way to have a baby no intervention or
 medicalization of a
 natural process. The woman wants to be congratulated for that.
 A very rare
 way to have a baby nowdays unless you have the baby at home.
 As a student I
 was privy to this type of birth only once and although it was
 fast it was
 great. Regards  sharon 
 
  
 
_  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Nikki Macfarlane
 Sent: Wednesday, 24 January 2007 6:16 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Mum Gives Birth In Toilet - Monash
 Medical Centre
 
  
 
 You know what, I have a different take on this. If the
 newspaper article has
 reported accurately what the parents said (and I highly doubt
 they have, but
 for the sake of argument lets give themt he benefit of the
 doubt!), there
 are some serious failings of expectations here and little
 empathy going on
 from the medical staff.
 
  
 
 The mother was rushed to hospital by ambulance and arrived in
 the later
 stages of labor - this in itself appeared to be distressing
 for her as it
 appeared she was taken by surprise by the speed with which
 labor was
 progressing.
 
  
 
 So, now having arrived in advanced labor, she is not checked
 as she expects
 to be and does not appear to have a midwife in the room with
 her. Now that
 may be because she does not appear to be in strong labour, or
 that there is
 no midwife available. But from the mother's perspective, it is
 not what she
 expects. She feels out of control, in intense pain, and not
 receiving the
 level of hospital support she is expecting. She could have
 called for help
 and support or asked her husband to go and find a midwife. But
 her
 expectations were not being met. And it is a pretty reasonable
 expectation
 to have a midwife at the very least to reassure a mother who
 feels she is in
 strong labor, and realistically to be checking or staying by
 her side if she
 appears to be imminently birthing.
 
  
 
 At the point at which the baby is born, both parents describe
 themselves as
 frantic. This was not the experience they were hoping for.
 Yes, she did it
 without pain medication or any intervention. Yes, this is what
 many women
 aspire to. Yes, this is better for baby and mother healthwise
 in most
 circumstances. However, the mother felt unsupported, and the
 father felt
 panicky. And the hospital's response? We are as disappointed
 as Kay and
 Michael that the birth of their second child did not go
 according to plan,
 but babies have a mind of their own sometimes.  Really? What
 a leap! To
 make the assumption that the midwives feel the same degree of
 disappointment
 as the parents. Yes, babies do sometimes come quicker than
 anticipated. What
 would have been nice is for this mum and dad to have been
 heard and had
 their sense of distress and lack of support acknowledged.
 Whether the
 midwives felt justified in their actions or not, the parents
 still felt the
 way they did. The mum was in the hospital for at least an hour
 and appeared
 to have no midwifery support during that time. I get that
 there may have
 been none available. But to dismiss the whole affair with a
 patronising
 comment about how the midwives are just as upset as the
 parents is hardly
 effective communication and certainly not displaying good
 listening skills
 towards the parents. 
 
  
 
 Now of course, the whole newspaper article may be complete
 tosh and the
 parents/midwives may not have said anything that was
 attributed to them in
 the quotes. 
 
  
 
 Always a shame that such stories are not seen as an
 opportunity to talk
 about how incredible our bodies are or how tragic it is that
 the health
 system the world over is failing women because of shortages of
 experienced
 midwives, or a multitude of other approaches that would be
 more beneficial
 towards women and babies.
 
  
 
 Nikki Macfarlane
 
 Childbirth International
 
  
 
 
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Re: [ozmidwifery] hep b @ birth

[Judy Chapman]

Our unit gives it at the same time as the neonatal screen for
that very reason. 
Cheers
Judy

--- Lyle Burgoyne [EMAIL PROTECTED] wrote:

 
 Hi ,
 
 A number of staff in our unit have commented that babies who
 have Hep B
 immunisation just after birth seem much more unsettled for the
 first
 24-48 hrs than those babies who don't have the immunisation
 .Has anyone
 else noticed this or are we just imaging things ?? Our unit
 has only
 recently changed to offering Hep B immunisation after birth at
 the same
 time as the Konakion,we used to give it on day 3 or 4.
 Interested in any
 comments or if anyone knows if any studies have been done .
 
 Thanks 
 Lyle
 
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Re: [ozmidwifery] Strep B

[Judy Chapman]

This is fairly close to what happens at our hospital also. 
Cheers
Judy


--- [EMAIL PROTECTED] [EMAIL PROTECTED] wrote:

 Here at our local hospital of approx 530 births per annum we
 do not routinely screen all pregnant women.
 We offer (with a fair degree of pressure, I might add) IV
 antibiotics in labour of a woman has had Pre-labour ruptured
 membres for 18 hours or if she is in preterm labour 37 weeks
 or if she has a history of previous baby with GBS infection or
 previous GBS positive herself ( say for example on a past
 history from birth elsewhere with a previous baby)
 If a baby is born before antibiotics are able to be
 administered or a woman declines antibiotics we observe the
 baby for any signs of infection. 
 That is what happens here 
 Personally I am not in favour of routine GBS testing.
 Good luck.
 
   - Original Message - 
   From: nunyara 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Tuesday, January 09, 2007 12:49 PM
   Subject: [ozmidwifery] Strep B
 
 
   Hi all,
 

 
   I know info on this topic has been posted before but I
 deleted it all - silly me as I now wish to ask some questions
 which have probably already been covered.
 

 
   I am 34 weeks pregnant and was not going to have the STREP B
 test but I have done some further research and it suggests
 that all women SHOULD be tested but antibiotics used during
 labour for a positive result may not be the way to go. 
 

 
   To all the midwife's on this forum: is it necessary for me
 to have this test? Is it in my and my babies best interest to
 do this?
 

 
   If I tested positive (which I didn't with my first child, in
 fact I don't even remember having the test) is the intravenous
 antibiotic really necessary? I do not want this as I plan to
 have a water birth and I am also highly allergic to penicillan
 and other forms of backup antibiotics. 
 

 
   I will raise this at my midwife appointment I am due for
 this week I would just like some opinions.
 

 
   Kind Regards
 
   Jassy
 
 
 

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Re: [ozmidwifery] where has this list gone?

[Judy Chapman]

We try so hard where I work to give woman centered care which is
great when all goes according to plan. But if it doesn't: why no
IV (she was drinking well), why no catheter (she was voiding
well), why no CTG (frequent intermittant asucultation showed no
abnormalities) etc etc. This was a transfer for obstructed
labour. Even with all these things they could not manage a
vaginal birth but the criticism is there.
 cheers,
Judy

--- Sue Cookson [EMAIL PROTECTED] wrote:

 
 Hi,
 I'm still getting only the odd email so apologies if I repeat
 what 
 anyone else has said.
 Justine really has her finger on the pulse in terms of
 consumer 
 apathy/lack of knowledge. One thing that really struck me as I
 was 
 completing my midwifery degree though and doing my clinical
 placements, 
 was how scared most midwives working in the hospitals are of
 being sued. 
 They practice defensive midwifery/obstetrics becuase they are
 constantly 
 covering their arses.
 
 The same story of course with all the doctors. And that's how
 we are all 
 taught, as such. And as a student, when I dared to stand up
 for the 
 women to stay off the CTG or refuse a c/section just because
 it was 8pm 
 what did I get - abuse and fear thrown at me by 'senior'
 midwives - 'it 
 will be on your head if that baby dies' stuff. And I'm not
 kidding or 
 making this up. This is how we as students are taught - be it
 within a 
 BMid degree or as a post grad nurse... and we work besdie all
 the fear 
 based doctors...
 
 Of course I discussed CTG vs intermittent auscultation, etc
 etc and 
 placed the documents on the desk the next morning, but if I
 hadn't had 
 my 20 odd years of normal birth prior to doing my placements
 then I 
 would be learning to behave and think like others who work in
 and for 
 the system. I was even challenged fully for delaying cord
 clamping ..by 
 a young doctor ..who of course was taught that cutting the
 cord 
 stimulates the baby to breathe... and when I presented a PP
 presentation 
 to other midwives in the unit about delayed cord clamping -
 one 
 response? None of us cut the cord early here anyway. Duh - I
 nearly fell 
 over. This is why there is so little change
 
 And don't bite my head off either - I know there are also
 midwives 
 working in the system who are doing fantastic work to enact
 change - to 
 policies and attitudes, to empower the women ... bu in my
 mind, the 
 change will have to occur as a total change - like midwifery
 led units 
 with little doctor input, where midwives are happy to truly
 advocate for 
 the women and be prepared to continue to learn - like taking
 women past 
 41 weeks or even 42 weeks if all is well, taking on care of
 normal birth 
 with all its facets  birthing happier and healthier babies
 with 
 mothers intact about their birth process and should I say it
 .. maybe 
 even empowered as mothers and parents.
 
 Sue
 
 
 
 Nah, not throwing it out the window at all, I see it as
 having great
 potential and a great opportunity to learn and develop for
 Australia. It's
 great for everyone to know what you've just said Justine, as
 no-one really
 knows anything about what's going on, and all the work
 occurring behind the
 scenes. The more we know about progress, the more we can work
 together and
 understand the whys and hows and get excited. Also good for
 morale I think,
 seeing and hearing progress... but with that you also need to
 talk
 challenges, goals and improvements to be made. 
 
 Perhaps you might like to speak at the conference and let us
 know what you
 have been doing, what you are hoping to do and how you are
 working with NZ
 to help our case here? I would be more than happy, I am sure
 everyone would
 love to know and also ways they can help women have more
 options in
 Australia. Lyn Allison is going to be listening - its an
 opportunity to be
 heard which we can't miss, no matter how many times we have
 to say it.
 
 Best Regards,
 
 Kelly Zantey
 Creator, BellyBelly.com.au
 Conception, Pregnancy, Birth and Baby
 BellyBelly Birth Support
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Justine Caines
 Sent: Monday, January 08, 2007 1:47 PM
 To: OzMid List
 Subject: Re: [ozmidwifery] where has this list gone?
 
 Dear Kelly and all
 
 Some additional information may assist you before you totally
 throw the NZ
 model out the window.
 
 For those of us who have lobbied at high levels, and been
 involved with
 writing (and selling!) NMAP etc we needed to totally
 understand the good and
 the bad of NZ.
 
 Kelly your statements re intervention in NZ on a broad brush
 are not totally
 true.
 
 One of the major down falls of the stats (ie c/s) is the
 midwifery
 interaction with obstetrics (ie large metro units that have
 the greatest
 birth numbers).  To prove this look at the NZ rural units
 stats where
 midwives are providing a total care package without an
 obstetric unit and
 epidural service at the door. 

Re: [ozmidwifery] How do you deal with your fustrations?

[Judy Chapman]

So many women DON'T believe they can birth well. They are so
afraid of the pain and afraid of something going wrong. Then is
becomes a self fulfilling prophecy and they are then so thankful
they had the obstetrician. I, also, am so frustrated at the
choices sometimes but it will take a huge shift in birthing
culture to change that. It is like eating the proverbial
elephant, one bite at a time, converting one family at a time. 
We need some more high profile homebirthers like Elle McPherson
who would be prepared to tell about it in the popular press.
This may help some but not all. 
Cheers
Judy 


--- Dan  Rachael Austin [EMAIL PROTECTED] wrote:

 I get so fustrated when I know people who choose subordinate
 (in my opinion) 
 levels of care.  What I mean is, healthy women who choose care
 under an 
 obstetrician.  They get roped into the high tech repeated u/s,
 monitoring, 
 for the just in case ignorant way of thinking.  They end up
 having highly 
 intervened vaginal births (but they see as 'natural birth'
 because it is 
 vaginal) or worse a necessary unnecessary cs. Does this make
 sense?
 
 I have been up most of the night stewing over this, because a
 4 of my 
 rellies have recently choosen this type of care to end up with
 the same 
 results... and they think I'm weird because I choose to birth
 at home!  OK 
 so I'm a midwife (new at the game, but still), so maybe the
 extra knowledge 
 helped me to make 'good' or appropriate choices for me, but
 what stops women 
 from investigating choices for themselves? Why do they so
 blindly give 
 themselves to medical men in every sense of the word? Do women
 really 
 believe that they don't have the power to birth themselves and
 that they 
 really need help? Do they really think nature got it that
 wrong?  AHH!!
 
 How do you get 'over it'? How do you talk with these women
 about birth in 
 social conversatin without lecturing them?
 
 Hope this makes sense.. i'm tired! 
 
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Re: [ozmidwifery] Kaede` Anne

[Judy Chapman]

Congratulations Rachel and Dan. That sounds fantastic. I hope
postnatal goes as well. 
Cheers
Judy

--- Dan  Rachael Austin [EMAIL PROTECTED] wrote:

 Hi!
 
 I birthed Kaede` Anne yesterday morning at home in water after
 a gentle night of labour.  Born at 38 weeks, she weighed 6
 pound 14oz.  She is beautiful and adorned by her big brother
 Rhett. Rhett is going to give her some breastfeeding lessons
 this PM because she is having trouble getting it right! :)
 
 Love,
 Rachaelxx

_
 Dan  Rachael Austin
 Namcala
 418 Austin's Road 
 Theodore, QLD, 4719
 HPh: (07) 49931213
 Dan's Mob: 0409896285
 Rachael's Mob: 0419750780
 Fax: (07) 49931341


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Re: [ozmidwifery] Does anyone need help ...

[Judy Chapman]

One of the areas of concern with spam and email adresses -
forwarding on emails. So many people don't delete the adress of
the person who sent it to them and there are huge lists which
can end up anywhere. As well as that, emails that go to a lot of
people should have only one address in the 'to' line and the
rest in the BCC line which hides them from everyone else. 
I don't know how to address the issue of spam emails that don't
even have my email address on, why do I get them?? 

Cheers
Judy

--- Julie Garratt [EMAIL PROTECTED] wrote:

 Hi Kim,
  Me too, lots of spam from ?? banks, job offers, penis
 enlargement!! I 
 thought it was because someone typed my email address into
 UTUBE. Could they 
 have got it from the list somehow? 20/11/06 for example 12
 messages 10 of 
 them spam.
 Julie:)
 
 - Original Message - 
 From: Kim Hunter [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Monday, November 20, 2006 12:42 PM
 Subject: [ozmidwifery] Does anyone need help ...
 
 
  Hi everyone,
 
  As I have been inundated with far too much spam, I
  am concerned that I'm missing messages from people
  on the list who are having problems.
 
  If this is the case for anyone, let me apologise if I
  missed your bounced emails or not responded to you,
  its not been intentional, its just been out of my control.
 
  In order to help you resolve any current issues,  can
  you contact me directly (no through the list).  My email
  address is [EMAIL PROTECTED]  I will endeavour to
  help you resolve any current list issues as quickly as
  is possible.
 
  Regards
  Kim
 
 
 
  ---
  Kim Hunter
  List Administration
  Birth International
  ACE Graphics and Associates in Childbirth Education
 
  http://www.birthinternational.com/
  [EMAIL PROTECTED]
 
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Re: [ozmidwifery] hanging baby scales

[Judy Chapman]

Sonja,
Do they have a web site?
Cheers
Judy

--- Sonja  Barry [EMAIL PROTECTED] wrote:

 Cath  Mary,
 I purchased the hanging baby scales and sling from a company
 called in his hands.  they are based in Texas but they only
 took about 3-4 days to arrive.  The scales are digital and
 about the size of a cigarette packet and weigh in both grams
 and kilos upto 30kg.  They scales cost $35US and the sling
 cost $15US.  Postage was another $10US.  I love them and can't
 wait to weigh some babies!!
 Sonja


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RE: [ozmidwifery] getting synto etc

[Judy Chapman]

I have had the woman go to her GP and get a script. Only one so
far and that was ok, she also got a script for the Vit K. 
Re charges. As far as I know they vary very widely over the
country. I have only just started up and the first couple were
cheaper than the next one I have booked. I found that with the
distances I am travelling and the cost of fuel anyone who books
more that 50 km away from my home will need to add extra to the
basic price. For all so far I have had a minumum of an hour's
drive each way and that is exy. 
cheers
Judy

 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 cath nolan
 Sent: Tuesday, 14 November 2006 9:13 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] getting synto etc
 
  
 
 I have a few births at home coming up and was wondering about
 synto and
 other drugs in my kit. How do others purchase them? Do I have
 to have a
 script from a doctor? The other issue that I do find difficult
 is the issue
 of cost for homebirth.Others I have been involved in have been
 for friends
 and colleagues. Does anyone have a schedule of payment and
 cost that they
 use? I am meeting with a couple on Monday and would love to
 have a bit more
 idea. Any feedback will be greatly appreciated,
 
  
 
 Thanks Cath
 
 


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Re: [ozmidwifery] NO Births

[Judy Chapman]

Hush Hush was tried in mareeba but it leaked!! Tut, Tut. 
Cheers
Judy

--- brendamanning [EMAIL PROTECTED] wrote:

 Hush Hush is how these things happen.
 Same is about to happen to Rosebud midwifery but it's being
 kept quiet because we are 2 weeks from an election  it'll
 affect the voting  ! 
 How's that ??
 
 With kind regards
 Brenda Manning 
 www.themidwife.com.au
 
 
 With kind regards
 Brenda Manning 
 www.themidwife.com.au
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 FN:[EMAIL PROTECTED]
 ORG:themidwife
 TEL;HOME;VOICE:0359862535
 TEL;CELL;VOICE:0409194623
 TEL;HOME;FAX:0359862535
 EMAIL;PREF;INTERNET:[EMAIL PROTECTED]
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RE: [ozmidwifery] Rest phase before 2nd stage

[Judy Chapman]

I have seen it also and consider it normal. Psychology can play
a part. Two women, both friends, in the last year, waited at
that point for their rushed midwife to travel 60-90 mins to
reach them for the birth. Both started pushing within minutes of
her arriving. One at home, one at a rural hospital with another
midwife in attendance in case I could not make it.  
Cheers
Judy

--- Mary Murphy [EMAIL PROTECTED] wrote:

 I think this was a recent discussion?  I have seen if often
 enough to
 recognize it as a normal part of labour.  some women need 10
 mins, some 2
 hrs and even longer.  It is all about being aware and alert to
 the woman and
 baby's condition.  MM
 
  
 
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Kristin Beckedahl
 Sent: Sunday, 22 October 2006 9:51 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] Rest phase before 2nd stage
 
  
 
 I know this was recently discussed on the list - but I was
 wondering how
 long you lovely midwives have seen this occur for within a
 natural labour?
 
 I remember mine lasting about 10mins (enough time to get out
 of the car -
 not a great place to do transition! - and into BC)
 
 What is considered too long? 2 hours?  What are the 'typical
 time limits' -
 when would risk factors be considered?
 
 Thanks,
 
 Kristin   http://graphics.hotmail.com/i.p.emrose.gif 
 
 
 
 
   _  
 
 Research and compare new cars side by side at carpoint.com.au
 http://g.msn.com/8HMBENAU/2749??PS=47575  
 
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Re: [ozmidwifery] Trivial ? For hosp midwives

[Judy Chapman]

Hi Lisa,
In our small rural hospital the MW fills in the bit on the birth
reg papers regarding the date, Hospital, wt and MW, we also fill
out the centerlink form and give it all to the woman with the
baby's personal health record (Qld),Community health and sids
stuff and various other educational stuff. 
Cheers
Judy


--- meg [EMAIL PROTECTED] wrote:

 Hi Lisa,
 At our hospital the parents fill the birth reg papers out. The
 midwife fills
 in the centrelink declaration and the ward clerk puts together
 a pack for
 the parents but they need to fill it in.
 
 Regards,
 Meg.
 - Original Message -
 From: LJG [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, October 20, 2006 8:42 AM
 Subject: [ozmidwifery] Trivial ? For hosp midwives
 
 
  Hi all - am wanting to  ask a silly question - when do you
 give out the
  birth registration forms and who fills them in? i.e. is this
 done by m/ws
 or
  ward clerks??
  Thanks
  Lisa
  Feel free to pm me
 
 
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RE: [ozmidwifery] blood gasses and other policies

[Judy Chapman]

Ramona,
She may have to fight tooth and nail not to let the baby out of
her sight this time. Only way to make sure formula is not given.
Hope she succeeds this time. 
Cheers
Judy

--- nunyara [EMAIL PROTECTED] wrote:

 Hi Barb
 
  
 
 I had a client just last week for a pregnancy massage.  She is
 31 weeks and
 this is her second child.  She breasted her first bub until
 she was about 18
 months old.  However, she is TERRIFIED - not about the birth -
 but about her
 new baby being given formula whilst it is in hospital. 
 Apparently, this
 occurred with her first baby but without her knowledge and
 consent.  At the
 time, she was absolutely furious that this had occurred
 because she had let
 everyone know how very keen she was to breastfeed.  When she
 asked why this
 happened, she was given a variety of different reasons ranging
 from baby was
 hungry to a mere shrug of the shoulders.  She spoke to her obs
 about it and
 he did not seem to be concerned about all the fuss.  She
 couldn't
 understand why no-one seemed to think it was an issue because
 it was - for
 her.  In fact, she got really angry while talking about it
 during the
 massage and then she started crying - still upset after almost
 3 years!!!
 
  
 
 Ramona Lane
 
 Nunyara Healing
 
  
 
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Barbara Glare 
 Chris Bright
 Sent: Sunday, 15 October 2006 9:43 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] blood gasses and other policies
 
  
 
 HI,
 
  
 
 Interesting conversation about blood gasses. I frequently get
 reports from
 mothers and health professionals that they gave birth in a
 Baby friendly
 hospital, or a hospital with clear policies on breastfeeding,
 but that
 babies are given infant formula often without their parents
 consent, or not
 with their parents INFORMED consent.  This always intrigues me
 greatly.
 There seem to be no repercussions for staff who go against
 breastfeeding
 policies.  Reasons I have heard for staff giving babies
 formula when I've
 asked midwives why they gave a baby formula include the other
 midwife told
 me the baby was hungry, we didn't want to disturb the mother
 etc. Mothers
 tell me they were told that staff didn't want to wake/disturb
 the mother -
 they knew she was tired.  Told she had no milk.  Told the baby
 was hungry
 and needed something. And, my personal favourite, it's OK, at
 this hospital
 we give babies the formula that is closest to human milk 
 Rarely are they
 told WHY the midwife thinks these things. These are babies who
 are well,
 don't even start me on babies in the nursery where parent's
 rights seem to
 go right out the window. Some parents I have spoken to are
 very upset and
 angry.  I wonder why breastfeeding policy is in a *different*
 category in
 most hospitals?  Do others find this?
 
  
 
 Barb
 
 




 
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Re: [ozmidwifery] Fwd: term breech trial

[Judy Chapman]

I have given them Maggies book and they have read it and still
choose CS. They are s scared by what the Dr's say. 
Cheers
Judy

--- Janet Fraser [EMAIL PROTECTED] wrote:

 Re: [ozmidwifery] Fwd: term breech trial
 Consumers:  Put it out there that breech does not necessarily
 equal c/s and continue to mount the arguments of the furphy of
 risk (for much of obstetrics).  Support women we meet to
 demand choice.
 
 Yes yes! I haven't seen one woman decide to have a vb for
 breech in the system yet. If the staff don't scare them with
 how surgery is safer, they're too scared to even try because
 the staff tell them they have no skills to catch breech
 babies. No win situation. There are lots of scarred bellies
 for breech among women I know and in our anti-VBAC climate
 that is of particular concern for their future birthing
 careers.
 J
 




 
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Re: [ozmidwifery] IUGR

[Judy Chapman]

Is it really IUGR Kelly? Maybe like a greyhound, healthy but no
spare fat. At 36 weeks babies are taking on their genetic
predisposition to weight and this baby's may be small, like its
siblings. 
Serial US, some say they can cause IUGR!!! 
Cheers
Judy

--- Kelly @ BellyBelly [EMAIL PROTECTED] wrote:

 A mum and dear friend I am supporting is due on November 9th
 and has had two
 previous IOL for IUGR. At her scan today, she said:
 
 
 Head Circ around 31cm just a couple of days off Gestational
 Age... aka
 perfect
 Leg bone length - Perfect about 4 days off Gest Age
 BPD (not sure what that is) - Approx a week under Gest Age
 Amnio Levels - Perfect 
 Blood flow through cord - Perfect
 AC (stomach circ) - 4 weeks below gestational age - she
 checked it 3 times. 
 
 So they graphed it and the computer automatically plotted it
 and gave a
 weight reading. 
 
 4lb 11oz the computer was saying give or take 13% on each side
 of that. So
 looks like another tiny baby on my hands. Now we have to sit
 and wait what
 they say at my next antenatal appointment, at my last she said
 if there is
 an issue she may call me in early.
 
 They checked this scan against Kameron and Lachlans too at the
 same gest age
 and Ashton is not far off what they were predicted for both
 the boys.
 Lachlan at 35wks 1 day they predicted 4lb 9oz. I am 35wks 5
 days today. So
 pretty much the same, so I am expecting a 6lb something to be
 born.
 
  
 
 Can anyone offer and insight into this - is it an indicator
 that IUGR may be
 diagnosed again?
 
  
 
 Best Regards,
 
  
 
 Kelly Zantey
 
  
 
  
 
 




 
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Re: [ozmidwifery] No Contractions

[Judy Chapman]

Lisa, I am sure you have said what many of us think. I have
worked like that for years and one gets sick of the tightrope
all of the time. I am so glad that I am now working without drs,
it is just protocols now. 
Cheers
Judy

--- Lisa Barrett [EMAIL PROTECTED] wrote:

 Hi Sue,
 
 Thanks for sharing the information.  Your right it is almost
 impossible to avoid active intervention when birthing in the
 system even with great midwives like yourself supporting. 
 Part of the problem appears to be the lack of belief that
 waiting and doing nothing is going to work.  Some multips
 don't have full on labour until transition.  It is possible
 that when the head sits firmly on the cervix the contractions
 will pick up. I have not ever had to wait 12/15 mins from
 birth of a head to birth of a body.
 Physiology tells us that the uterus clamps down immediately
 after birth.  I don't think you'd wait another 12/15 mins for
 the uterus to contract after the birth and that's if you don't
 do an active third stage.
 
 It is not so hard to do other things when sytno drip isn't an
 option and you have no-one but yourself and the woman to trust
 in ( no idiot specialist in complications when your the
 specialist in the normal I mean).
 I think I have the easy job when it comes to midwifery because
 I know I'm the specialist in normal and I don't answer to
 anyone on that score.  Politics with birthing as far out of
 the system as I do is another thing altogether but in the
 birth space with women it isn't an issue.  I chose to work
 like this because it's less  waring than having to say F**k
 off to drs all the time.
 
 Lisa Barrett
 
  
 




 
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Re: [ozmidwifery] No Contractions

[Judy Chapman]

Fantastic story Andrea. As I am just starting in home birth I
love hearing these variations from hospital stuff. 
Cheers
Judy
PS, bet she was pleased after the fact that you had not
immediately jumped to ring an ambulance. 


--- Andrea Quanchi [EMAIL PROTECTED] wrote:

 Sometimes at home the women get just as despondent but the
 difference  
 is that no one is going to walk through the door and under
 mine me  
 and 'save' her.
 Last week I was with a women who was birthing at home after
 three  
 very different and for a variety of reasons not so great
 labours..  
 She had done a hypno birthing course and used the tools
 beautifully   
 and was so relaxed that I was not convinced that she was
 labouring  
 despite her telling me that the contractions were getting
 stronger  
 they were irregular and short.. She asked me to do a VE which
 showed  
 her Cx to be 75% effaced but 2 cm and quite tight. This really
  
 annoyed her and when I suggested she rest she was opposed to
 this and  
 so I suggested the alternative was to  get up and get active
 and send  
 her uterus the message that she wanted it to get into gear
 rather  
 than the message that it was obviously getting from all her  
 relaxation tapes, breathing etc.
 Almost immediately she started rocking and rotating her hips
 quite  
 dramatically during contractions, she was in the kitchen with
 the  
 lights on as opposed to being in the bedroom in the dark where
 she  
 had been before.  The response was dramatic and the
 contractions  
 became co ordinated and strong and within 10 min she asked her
  
 partner to run the bath.  She got in there and then became
 passive  
 again lying on her back and struggling with quite strong  
 contractions.  It was quite funny actually as after about half
 an  
 hour she opened one eye and told me I needed to call an
 ambulance as  
 she couldn't do this any more and needed to go to the
 hospital. ( For  
 those of you who haven;t been at a home birth women at home
 often ask  
 to go to the hospital in exactly the same way as women in
 hospital  
 often ask to go home).  She made no move to get out of the
 bath and  
 so at first I just ignored her but she became more insistent
 with  
 each contraction so eventually I pointed out to her that she
 couldn't  
 go anywhere while she remained lying in the bath and that if
 she  
 wanted to go to the hospital she needed to get out of the bath
 and  
 into the car as ambulances were for emergencies and this was
 not an  
 emergency. She did stand up then and get out of the bath,
 leaned  
 against me for two contractions as I helped her dry herself
 and then  
 I asked her did she want to have the baby in the bedroom or in
 front  
 of the fire in the lounge. She just looked at me and said the
 lounge.  
 So we moved there, she leaned over the ball and had the baby.
 All  
 this on 90 min since the VE.
 
 Andrea Quanchi
 
 On 07/10/2006, at 12:02 AM, Lisa Barrett wrote:
 
  Hi Sue,
 
  Thanks for sharing the information.  Your right it is almost
  
  impossible to avoid active intervention when birthing in the
 system  
  even with great midwives like yourself supporting.  Part of
 the  
  problem appears to be the lack of belief that waiting and
 doing  
  nothing is going to work.  Some multips don't have full on
 labour  
  until transition.  It is possible that when the head sits
 firmly on  
  the cervix the contractions will pick up. I have not ever
 had to  
  wait 12/15 mins from birth of a head to birth of a body.
  Physiology tells us that the uterus clamps down immediately
 after  
  birth.  I don't think you'd wait another 12/15 mins for the
 uterus  
  to contract after the birth and that's if you don't do an
 active  
  third stage.
 
  It is not so hard to do other things when sytno drip isn't
 an  
  option and you have no-one but yourself and the woman to
 trust in  
  ( no idiot specialist in complications when your the
 specialist in  
  the normal I mean).
  I think I have the easy job when it comes to midwifery
 because I  
  know I'm the specialist in normal and I don't answer to
 anyone on  
  that score.  Politics with birthing as far out of the system
 as I  
  do is another thing altogether but in the birth space with
 women it  
  isn't an issue.  I chose to work like this because it's less
   
  waring than having to say F**k off to drs all the time.
 
  Lisa Barrett
 
 
 
 
 
 




 
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Re: [ozmidwifery] New Inventors birth seat

[Judy Chapman]

Thanks for the feedback Anne. 
Which one do the women seem to like the best? I have only used
the one from the birthinternational catalogue and it seemed to
work well for the women. 
Cheers
Judy

--- Anne Clarke [EMAIL PROTECTED] wrote:

 Dear All,
 
 Labouring women in my practice, over 20 of them, tried this
 birth seat (although without the back part) and women have
 found it not so useful as they cannot lean forward or move on
 it easily.  Also if a woman has generous proportions they find
 it difficult to sit on it and many women find it difficult to
 reach down to grasp the handles and it limits women where they
 want to grasp for support.  Looking at the video from the New
 Inventors program the back part appears to limit women's
 movement too - although I have not used it in association with
 the chair.  As you all know some women lean far back (or
 forward) sometimes leaning forward with a contration and then
 far back in their supporters arms to rest inbetween
 contractions, and sometimes using a different position with
 each contraction with her supporter moving in unison to
 accomodate, the back on the chair in the video does not look
 like it appears to be as accommodating.
 
 I am all for women choosing to use a birth stool/chair if they
 find it does not inhibit movement of choice but not one of my
 clients who have tried this chair wanted to continue to use it
 e.g. when offered a different type of chair/seat these were
 found to be more accommodating.  
 
 When quizzed at their postnatal debrief ALL of them said it
 was either uncomfortable - for various reasons - but what most
 of them commented on was that they could sit comfortably in it
 as they couldn't move around (forward/back).  So it appears if
 you want to sit back and straight to give birth it maybe not
 so useful to use.
 
 I am not the only one in the practice that have found women
 have not liked using this chair and therefore it is gathering
 dust in the store room. We do have 2 other types of birth
 stool/chairs and find women happier with these less
 'technical' choices.
 
 Regards,
 Anne




 
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RE: [ozmidwifery] intact peri

[Judy Chapman]

With regard to Mary's comment. We had a primi birth in water a
couple of days ago, 4375 gm and peri intact, just a messy labial
tear I tacked together. No direction for the pushing or not
pushing at all, just moving as she wished (actually, I did tell
her to keep her bum IN the water, not go in and out)
Cheers
Judh

--- Mary Murphy [EMAIL PROTECTED] wrote:

 Not so clear cut.  On the whole it means not directed, as many
 of the women
 I care for are on their knees in a water tub and I can’t see
 their perineum.
 I talk about this during their pregnancy and try to remind
 them to “go
 gently”.  I find that women who are free to move their body as
 they choose
 (water is great for this) are able to be in touch with what
 they need to do.
 Does this mean hundreds of intact perineums?  No.  It means
 that sometimes
 there is a tear and sometimes not.  A hard question to get the
 right answer.
 MM
 
  
 
   _  
 
 A little off-topic – when you don’t do directed pushing you do
 not tell a
 woman when to push, but do you tell her when not to push? Or
 another way to
 put it – does directed pushing only include telling a woman
 when to push, or
 telling her when not to push as well?
 
  
 
 Vedrana
 
  
 
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Mary Murphy
 Sent: Monday, October 02, 2006 4:59 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] intact peri 
 
  
 
 Hi Paivi, I cannot give you statistics of homebirth as I do
 not have
 immediate access to them. I will see if we have any stats on
 our service
 that I can access.  Just in general, the main way to protect
 the perineum is
 not to tell the woman to push, but to allow her to use her
 natural open
 glottis pushing, an keep hands off.  At home we do not do
 directed pushing.
 I cannot speak for birth centres, but their philosophy is much
 the same.
 Each midwife does different things, but it is not usual to use
 compresses or
 perineal massage during birth.  Is that what you have found
 Jan?  I wouldn’t
 put too much weight on the Bastian research as not all of us
 completed her
 surveys.  I personally have done 3 episiotomies in 24 yrs, but
 would do one
 if I thought necessary.  Hospital midwives will have to answer
 the one about
 epidurals.  MM
 
  
 
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Päivi
 Sent: Monday, 2 October 2006 4:54 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] intact peri 
 
  
 
 Hi all,
 
  
 
 I am writing an article on episiotomy. I need to know what is
 the % of
 intact perineum among homemidwifes or birth centres? This is
 when the mother
 is having a natural birth.
 
  
 
 Does this change if the mother has an epidural and is having
 the baby in a
 hospital? What I mean is that how much can the hospital
 midwife do to save
 the perineum if the mother has opted for epidural? Is it still
 mainly to do
 with the skills of the midwife? Or is it a harder job with a
 medicated mom?
 
  
 
 Do you all practise hot compresses, perineal massage with oil
 (during birth)
 / perineal support?
 
  
 
 What is the % of intact peri in a waterbirth?
 
  
 
 Many questions... Thank you for any ideas or comments.
 
  
 
 Päivi
 
 




 
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Re: [ozmidwifery] Belinda birth story

[Judy Chapman]

Fantastic. Had I had any idea one could do that 32 yrs ago I may
have tried to have the 4 childen I wanted. Instead I stopped
after 2 CS. It was just too hard. For that reason I always get a
glow of satisfaction when I hear these stories. 
Cheers
Judy


--- [EMAIL PROTECTED] [EMAIL PROTECTED] wrote:

 getting back to birth - I had a great day today!
 I had a woman who lives out of town and has had two previous
 cesareans 
 sections have a beautiful birth at home of a chubby baby girl.
 After I had experienced a traumatic birth three months ago of
 a woman 
 who ruptured her uterus suddenly in second stage (in hospital)
 and a 
 traumatized but recovering mother and baby (long story) I had
 felt 
 anxious about birth and found myself second guessing myself
 all of the 
 time.
 Taking on this woman challenged me to either be the midwife I
 wanted to 
 be - that is trusting in women and supporting their decisions
 when they 
 have received all of the information, or allow myself to be
 engulfed 
 with fear and worry.
 This birth today was special for many reasons and healing for
 the mum 
 who was still emotional about her first two sections and
 desperate for a 
 vaginal birth, but it is I found also healing for me. I
 supported her 
 and cared for her and didn't let myself get caught up in the
 potential 
 fear that was hanging around me from my earlier trauma.
 
 Thankyou so much to the SAIMA midwives especially Lisa, Tania,
 Larissa, 
 Julie, Milly and Rosie  - all of you really, who have
 supported me as I 
 worked through my fears and trauma, the offers of support we
 so 
 appreciated, thankyou Lisa and Rosie for offering to sit
 outside the 
 house just to support me, it was great knowing you would do
 that for me 
 XXX
 midwives are good to each other
 Love Belinda
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Re: [ozmidwifery] Inductions for post term

[Judy Chapman]

All the guide lines do say that there is increased risk above 42
weeks. 100%. Of what? I can't recall the figures offhand but say
from 1% to 2% is 100% increase but that means that 98% will be
ok. Also you need to be sure your dates are right. LMP certain?
USS dates after about 12 wks are very open to error, the further
the pregnancy has advanced the greater the error. 
If women are empowered there is ALWAYS the option to say NO.
They will be hasseled but if they are strong enough they can
keep saying no. We have some who do that, they are happy to be
monitored with CTG 2nd daily (though in reality that won't tell
you much). They are in tune with their body and just know babe
is ok. 
If you get a chance to see them before they come in for IOL,
remind them about their ability to say no and how that comes
with the responsability for the outcomes of that decision. 
Cheers
Judy
--- renee [EMAIL PROTECTED] wrote:

 Hi all, I'm trying to get some information, opinions re:
 inductions for post
 term pregnancies. As a student I'm finding the majority of my
 birth
 experiences are with women getting induced which I find a
 little
 disheartening. Instinctively I'm of the opinion that all being
 well then
 leave alone and I'm excluding any complications or increased
 risk factors
 here, but the more I dig around for arguments the more it
 appears that
 inductions after 42 weeks is best practice. I have read
 somewhere that true
 post term pregnancies accounts for about 2%. You would think
 its more like
 25%, but anyway... 
 
 At the hospital I'm doing clinical at, women are preemptively
 booked in for
 induction and are 'told' at an antenatal visit that if they
 haven't had
 there baby by a certain date then they will be going in for an
 induction.
 There isn't an option.
 
 Do any of IM have women that get induced? I have read the
 research on
 cochrane and the NICE guidelines, and stats that say still
 births increase
 by 100%, and Im aware of the complexities around accurate
 dates etc, but it
 all just feels counter intuitive to me, but learning to base
 practice on
 evidence means often having to re-asses my own beliefs about
 these things,
 and not having the experience, I cant really form a judgment.
 Any help
 opinions on the matter would be most welcome.
 
 The rocky road to learning hey!
 
 
 This might have been a discussion in previous postings, if so
 and anyone
 remembers it could you let me know approx time.
 
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Re: [ozmidwifery] from MIDIRS

[Judy Chapman]

tut tut Mary. Why would you think that, if you think there is no
other way to do 'the job' than to induce? (says she cynically)
cheers
Judy

--- Mary Murphy [EMAIL PROTECTED] wrote:

 Predictors of cesarean section following elective post-dates
 induction of
 labor in nullipara with uncomplicated singleton vertex
 pregnancies - Saudi
 Medical Journal , vol 27, no 8, August 2006, pp 1167-1172
 Edris FE; von
 Dadelszen P; Ainsworth LM; et al - (2006) OBJECTIVE: Although
 post-dates is
 among the most common indications for induction of labor, no
 studies have
 identified the predictors of cesarean section (C/S) in that
 population. The
 high cesarean rate in our institution for this group of women
 triggered us
 to assess different induction practices to elicit potential
 causes. METHODS:
 We conducted a hospital-based retrospective cohort analysis
 using chart
 reviews of all nullipara women with induced labor at the
 Children's and
 Women's Health Centre of British Columbia, Vancouver, Canada,
 during the
 2-year period, April 1998 to March 2000. The C/S rate was
 compared among 3
 groups of women who were divided according to their induction
 method.
 RESULTS: Three hundred and thirty-nine women meeting the
 inclusion criteria
 were induced. Of the 25 women who received oxytocin ideally
 and the 111
 women who did not, 7 (28%) and 53 (48%) were delivered by C/S,
 (x2=3.228
 p=0.07; relative risks 0.59 [95% confidence interval 0.30,
 1.13]). A
 significantly lower C/S rate (x2=21.9, p0.0005) was found
 among women
 induced with prostaglandin (PG) alone (19.4%) compared with
 those induced
 with PG and oxytocin, whether oxytocin was given ideally
 (38.3%) or not
 ideally (45.4%). Of women who received oxytocin, there was no
 difference in
 chorioamnionitis (x2=0.485, p=0.49) between those who had an
 early membrane
 rupture (with or pre-oxytocin, 22.4%) and those who had
 membrane rupture
 following a period of oxytocin infusion (18.5%). CONCLUSION:
 The need for
 oxytocin or less than 2 doses of PG is associated with
 increased risk of
 C/S. Whether oxytocin was given according to protocol
 (ideally) or not, made
 no difference to the C/S risk in this population. (Author)
 
  
 
 Am I dumb, or is it them?  I would think that the question is
 is induction
 itself a predictor of C/S MM
 
 




 
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RE: [ozmidwifery] OMG what next?

[Judy Chapman]

Only in the US. The other item looked a bit expensive to get out
here, the hands. 
Cheers
Judy
--- Melanie Sommeling [EMAIL PROTECTED] wrote:

 Don't forget they have free postage and handling :-) 
  
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Mary Murphy
 Sent: Saturday, 2 September 2006 21:11
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] OMG what next?
  
 Just to play devils advocate, what is so terrible about
 something that helps
 women do what they are already being instructed to do??  Put
 your hands
 behind your knees, pull your legs up against your chest, put
 your chin on
 your chest, close your mouth and push as hard as you can down
 into your
 bottom.  This guy has just made an aid to make all those
 instructions a
 little easier to follow.  I think it is the perception of need
 for such an
 aid that is awful.  MM
  
  
 That is just awful!
 Shelly
 




 
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Re: [ozmidwifery] OMG what next?

[Judy Chapman]

It figures that an OB invented this one. 
Cheers
Judy

--- Päivi Laukkanen [EMAIL PROTECTED] wrote:

 What about this one?
 
 http://www.pregnancystore.com/pushpal_birthing_aid.htm
 
 Päivi
 
 - Original Message - 
 From: Jo Watson [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, September 01, 2006 5:30 PM
 Subject: [ozmidwifery] OMG what next?
 
 
  http://www.pregnancystore.com/zaky.htm
 
  I think this is actually a real product...
 
  Jo
 
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Re: [ozmidwifery] Vaginal examinations

[Judy Chapman]

I would have to look up the guidelines, haven't read them for a
while. In practice, as few as possible. No point if she is not
in labour, or if you know she is progressing well anyway. Some
women really need to know where they are, I will do it if they
really want. That just leaves the women having a few problems,
then maybe 4 hourly unless clinically indicated earlier or
later. 
Cheers
Judy

--- Sally @ home [EMAIL PROTECTED] wrote:

 Was wondering what guidelines others worked with regarding
 when to do 
 vaginal examinations...specifically in the hospital setting.
 And what 
 evidence they base their practice on.
 
 Thanks in advance.
 
 Sally 
 
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Re: [ozmidwifery] c/s and other stats for mid led units

[Judy Chapman]

Mareeba Maternity had recently compiled stats. You would need to
apply through Tableland Health Service District to access them. 
Cheers
Judy

--- Tania Smallwood [EMAIL PROTECTED] wrote:

  
 
 Hi all,
 
  
 
 Just doing a bit of my own research, and wondering if there
 are any stats
 yet for the newly formed midwifery led units such as Ryde, St
 George etc.  I
 have access to the ones that have been issued for the Women’s
 and Children’s
 in Adelaide (MGP), but I suppose there is also the Canberra
 one (is that
 still running) and also the Perth community midwifery
 programme.  Having
 just figured out what our personal stats for 5 years in
 practice together
 are, I’d like to be able to compare with these groups if the
 info is out
 there…anyone?
 
  
 
 Tania
 
  
 
 
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Re: [ozmidwifery] Fw: info required

[Judy Chapman]

Joy,
It takes an enormous amount of intestinal fortitude to do what
you did, I admire you so much. I am so fortunate to work in a
place without doctors hanging around and messing things up.
Please draw strength from your (and our) belief that you did the
right thing and sleep well tonight. 
Cheers
Judy

--- Joy Cocks [EMAIL PROTECTED] wrote:

 Dear Amy, Sazz and Suzi,
 Thanks so much for your support, it means a lot to me and
 confirms what I know in my heart.  Haven't heard anything more
 today, but I've been out for the day.  However, still can't
 stop thinking about it.  Have my grandson coming for a
 sleepover tonight so maybe that will take my mind of this
 ridiculous situation - see, I'm feeling stronger already!
 Joy x
 
 Joy Cocks RN (Div 1) RM IBCLC
 BRIGHT Vic 3741 
 email:[EMAIL PROTECTED]
   - Original Message - 
   From: adamnamy 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Friday, August 18, 2006 11:11 AM
   Subject: RE: [ozmidwifery] Fw: info required
 
 
   If you were my midwife, I would be so grateful that I had
 someone who would truly advocate on my behalf and protect me
 from the attitude that I was hospital property during my stay
 there.
 

 
   Hospital staff and doctors sometimes get their priorities
 mixed up don't they?
 

 
   As a consumer, I say thanks and good on you for standing up
 for her.
 

 
   Amy
 

 
 

--
 
   From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Joy
 Cocks
   Sent: Thursday, August 17, 2006 8:51 PM
   To: ozmidwifery@acegraphics.com.au
   Subject: Re: [ozmidwifery] Fw: info required
 

 
   Pheewww..Peiter Mourik used to come to our hospital and
 give inservices when he held clinics there.  I would back up
 Wendy's comments.  He's very clever with words and is god's
 gift to women - always saving them!  He believes that midwives
 can only be independant when they can do forceps/ventouse
 births!  
 
   Sorry, negative comments after a bad evening when I stood up
 for a labouring woman who did not wish to have a VE when the
 GP ob wanted to do one as how else would he know whether she
 was progressing or not.  He's writing an incident report about
 me for not supporting him. He asked how I planned to manage
 the labour and I told him that the woman was managing the
 labour and I would be worried if she became worried. The woman
 proceeded to birth without problem.  Just feeling upset and
 hurt as he is my GP and we usually work well together, but
 probably most other women are not as strong in standing up for
 themselves.
 
   Joy
 

 
   Joy Cocks RN (Div 1) RM IBCLC
   BRIGHT Vic 3741 
   email:[EMAIL PROTECTED]
 
 - Original Message - 
 
 From: cath nolan 
 
 To: ozmidwifery@acegraphics.com.au 
 
 Sent: Thursday, August 17, 2006 10:28 AM
 
 Subject: [ozmidwifery] Fw: info required
 
  
 
  
 
 - Original Message - 
 
 From: cath nolan 
 
 To: ozmidwifery@acegraphics.com.au 
 
 Sent: Wednesday, August 16, 2006 8:37 PM
 
 Subject: info required
 
  
 
 I will be meeting with Peter Miourik(obstetrician) amongst
 others in an informal dinner setting on Friday night as the
 hospital that I work at is having a review of obstetric
 services . I believe this is a man who is quite against
 midwifery led services and I'm a bit puzzled as to why I have
 been asked to be one of the 2 midwifery reps at this dinner.
 But very pleased at the same time, and more than happy to be a
 part of this. Can anyone fill me in on what they know of this
 man? Cath.
 







 
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Re: [ozmidwifery] Birth, Trauma Personality

[Judy Chapman]

Have just found these:
http://childbirthsolutions.com/articles/pregnancy/birthsoul/index.php

http://childbirthsolutions.com/articles/pregnancy/lifelong/index.php

Cheers
Judy
 
 Kelly @ BellyBelly [EMAIL PROTECTED] wrote:
 Help! Someone started a discussion on my
 forums about birth and how it shapes the baby as an
 individual. Of course, everyone thought that concept was
 ludicrous, think studies and percentages are rubbish and must
 think I am a quack for thinking otherwise LOL J Can anyone
 else back me up?! I need some support!!! If you aren’t signed
 up in my forums, please feel free to, or post here any
 suggestions or comments. 

   http://www.bellybelly.com.au/forums/showthread.php?t=17144
   Best Regards,
 
 Kelly Zantey
 Creator, BellyBelly.com.au 
 Gentle Solutions From Conception to Parenthood
 BellyBelly Birth Support -
 http://www.bellybelly.com.au/birth-support

 
 
 
  Send instant messages to your online friends
 http://au.messenger.yahoo.com 


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Re: [ozmidwifery] Isobel Joy has arrived...

[Judy Chapman]

Congratulations to you Janet and to the whole family. 
Cheers
Judy

--- Janet Fraser [EMAIL PROTECTED] wrote:

 Isobel Joy Stokes Fraser was born beautifully at home, in
 water, into her daddy's hands Thursday 13th July.
 
 She weighs 3.7kgs and has taken to life earthside with
 remarkable alacrity!
 
 Thanks to those who supported me through a challenging,
 lengthy labour. I couldn't have done it without you!
 
 Photos as soon as they're uploaded.
 
 From Janet, Trevor, Conor AND Isobel!
 
 For home birth information go to:
 Joyous Birth 
 Australian home birth network and forums.
 http://www.joyousbirth.info/
 Or email: [EMAIL PROTECTED]




 
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Re: FW: [ozmidwifery] AFI perienatal outcomes

[Judy Chapman]

Lisa,
Thanks for this and the other articles. Will keep me reading for
a while, then I take them into work for distribution. 
Cheers
Judy



 
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Re: [ozmidwifery] Trial of Scar

[Judy Chapman]

I prefer the term obstructed labour. Then one needs to properly
describe what the obstruction was, i.e. POP and not descending
despite best effors at positioning, etc. 
Or obstructed by medical ignorance of the natural process!
Cheers
Judy

--- brendamanning [EMAIL PROTECTED] wrote:

 When women tell me they were C/Sd for FTP I always explain
 this to them as your baby just couldn't come out
 because...??? I am looking for further information
 from them or imparting what I know of the situation which led
 to their surgery.
 I do NOT say: you didn't dilate ie it's your fault that your
 Cx 'failed' to open, or the baby to descend etc. Apportioning
 blame is not a productive exercise here.
 
 FTP is a 'blanket term' for heaps of things as Janet says.
 It would be much more helpful to the women in understanding
 what's happened to them if we isolated the problem  specified
 it rather than put it all under 1 heading which by its very
 wording assumes the mother is somehow at fault !
 
 With kind regards
 Brenda Manning 
 www.themidwife.com.au
 
   - Original Message - 
   From: Janet Fraser 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Thursday, July 06, 2006 1:36 PM
   Subject: Re: [ozmidwifery] Trial of Scar
 
 
   There's a thread on JB called FTP? FTW? which has research
 on it and how FTP is, oddly enough ; ) not something normally
 recognised or diagnosed in midwifery. FTP is one of the main
 reasons in Australia for c-sec, the other two reasons being
 breech and previous surgery. Shocking.
   J
 - Original Message - 
 From: Kelly @ BellyBelly 
 To: ozmidwifery@acegraphics.com.au 
 Sent: Thursday, July 06, 2006 1:35 PM
 Subject: RE: [ozmidwifery] Trial of Scar
 
 
 I'd love to use all three but I will stick with the one
 that women know well - most of the birth stories in our forum
 have that in it, unfortunately.
 
  
 
 Best Regards,
 
 Kelly Zantey
 Creator, BellyBelly.com.au 
 Gentle Solutions From Conception to Parenthood
 BellyBelly Birth Support -
 http://www.bellybellycom.au/birth-support
 
 


 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Janet Fraser
 Sent: Thursday, 6 July 2006 1:18 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Trial of Scar
 
  
 
 It's really failure to wait and failure to stop poking
 about...
 
   - Original Message - 
 
   From: Kelly @ BellyBelly 
 
   To: ozmidwifery@acegraphics.com.au 
 
   Sent: Thursday, July 06, 2006 1:19 PM
 
   Subject: RE: [ozmidwifery] Trial of Scar
 

 
   Oh yes we are having a big discussion about the wording
 after that post, and I told everyone I am going to write an
 article:
 

 
   Failure to Progress: Why Doctors Need to Move On
 

 
   LOL I will too ;)
 
   Best Regards,
 
   Kelly Zantey
   Creator, BellyBelly.com.au 
   Gentle Solutions From Conception to Parenthood
   BellyBelly Birth Support -
 http://www.bellybellycom.au/birth-support
 
 

--
 
   From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Janet Fraser
   Sent: Thursday, 6 July 2006 11:16 AM
   To: ozmidwifery@acegraphics.com.au
   Subject: Re: [ozmidwifery] Trial of Scar
 

 
   What a bloody crock. Yes, that's a common protocol to
 wave at birthing women who'd be doing just fine with a bit of
 evidence based care. I've heard limits of 38 weeks (yes,
 really!) through to 41 weeks on the time a woman with previous
 surgery is told she's allowed to gestate before being
 forcibly sliced open. It depends on the hospital and whether
 or not she employs a private surgeon.
 
   Tell her to run for the hills if she wants to be safe.
 And don't get me started on the intrinsically offensive nature
 of that term... TOS - trial of service is what it really
 means!
 
   J - whose sister is currently labouring for her HBAC at
 42+4 without ANY crap like that!
 
 - Original Message - 
 
 From: Kelly @ BellyBelly 
 
 To: ozmidwifery@acegraphics.com.au 
 
 Sent: Thursday, July 06, 2006 8:25 AM
 
 Subject: [ozmidwifery] Trial of Scar
 
  
 
 Just wondering what guidelines exist for trial of
 scar. a woman on my site said that she has been given until 41
 weeks to give birth or she'll be having another caesarean. Is
 this right? I am sure I have heard otherwise and seen
 otherwise. 
 
 Best Regards,
 
 Kelly Zantey
 Creator, BellyBelly.com.au 
 Gentle Solutions From Conception to Parenthood
 BellyBelly Birth Support -
 http://www.bellybelly.com.au/birth-support
 
  
 




 
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Re: Fw: [ozmidwifery] Blood pressure...

[Judy Chapman]

I have to totally agree with you Janet. 
Trust MUST be earned and I think that if all women did not
inherantly trust the professionals caring for them, if they ALL
questioned everything and made the professionals give good
evidence based reasons for interventions, all had second
opinions if at all practical, we would not have our maternity
systems in such a mess. A truly confident professional should be
happy to answer all the questions and produce the evidenc when
asked for so that women feel that they have been listened to and
respected and really understand the need for interventions or
non-interventions which ever is the case. 
It is only today that I listened to the story of a women with
two previous CS, one for breech and the second for you will
never do it naturally so you may as well have another CS type
of cr*p from Drs at a previous hospital. She is grieving and
really wanting a VBA2C. I have directed her to various sources
of info including this list so I hope she doesn't mind me giving
a general outline if she has already joined. She will need to be
very strong, where I work we are only for low risk births and
can't book her. 
My two CS were late in the afternoon after induction, now that I
am an experienced MW I KNOW that I was not 'failing to
progress', I just was not going fast enought to be done by
dinner time. How can you inherantly trust OB's when that sort of
story is rife among women. 
Cheers
Judy
--- Janet Fraser [EMAIL PROTECTED] wrote:

 
   By obtaining information from an internet
  list and offering this in opposition to the care the woman
 receives from
 the
  hospital can have a potentially damaging effect on her trust
 of the carers
  at the hospital that she has chosen.
 
 I'm afraid I see trust as something to be earned and trusting
 professionals
 because they're professionals is unwise. No one suggests we
 trust other
 professionals uncritically so why are midwives and doctors
 different? A
 second opinion is always recommended in other medical
 situations. Offering a
 woman genuine evidence that saves her and her baby from
 unnecessary
 intervention may not enhance her relationship with those she
 has employed
 but it might just save her life! Why should she uncritically
 trust
 everything she's told just because it's in a hospital?
 
 
  The woman should take her birthing
  plan and her queries regarding the blood pressure to the
 people at the
  hospital, where she can discuss what an induction means and
 why she may or
  may not need this.
 
 No, this woman should seek outside sources to confirm for
 herself what she
 feels comfortable with, not ask the people who want to
 intervene. What will
 their response be? Oh sure, we just offered induction because
 our time and
 motion issues and surgeons' timetables mean we prefer to
 induce women to our
 needs not theirs. Or will it be, Yes, you're deathly ill and
 if we don't
 induce you your baby might die. I know the latter response is
 the one I
 hear most reported back from consumers.
 
  My defense over the interference in hospitals stands only on
 this- that
  people interfere when they are concerned of the potential
 risk to the
 mother
  and baby, if we did nothing we are also putting them at
 risk.
 
 No, people interfere when the nexus of commerce, misogyny and
 ignorance
 around what birth really is comes together. We all know that
 rates of
 intervention in hospitals are way out of control and
 overservicing is the
 name of the game. You can't possibly be saying that primary
 c-sec rates are
 appropriate in this country and that all interventions are
 performed with
 pure hearts and women's lives in the balance? Birth isn't
 inherently
 dangerous but if you look at the outcomes in this country
 clearly birth in
 institutions is a risky business.
 
 There are no excuses for our outrageous rates of intervention
 but every
 reason for our concomitantly poor outcomes. As WHO says, when
 all women are
 treated in high tech units as if they are high risk, outcomes
 are crap. Too
 true!
 
 J
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Re: [ozmidwifery] It's A Girl

[Judy Chapman]

Fantastic Katrina,
I hope you are really enjoying your munchkin and congratulations
on your wonderful birth. 
Cheers
Judy

--- Ceri  Katrina [EMAIL PROTECTED] wrote:

 Hi Everyone
 I was hoping to announce my news along with the birth story,
 but the 
 story will have to come later!  ;-)
 
 Introducing my new little munchkin Lilly born @40+6
 Born last Saturday  24 June 2006
 Weighed: 3740grams
 HC 35.5cms
 Length 52cms
 
 Labour was 3.5hours, mostly spent in the shower.
 No drugs, intact peri, breastfeeding well.
 
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RE: [ozmidwifery] Low iron and inability to breastfeed?

[Judy Chapman]

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
 
 
 
 
 
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Re: [ozmidwifery] Kath's story

[Judy Chapman]

I just love hearing stories like that Andrea. Congratulations to
you both. 
Cheers
Judy

--- Andrea Quanchi [EMAIL PROTECTED] wrote:

 I was 'with' a woman on thursday night when she birthed that
 left me  
 on a real high
 Kath has been seeing me for her whole pregnancy and we had
 discussed  
 birthing at home many times but she had decided that she
 wanted to go  
 to the hospital to birth.
 perhaps if it was my second baby I might have it at home' she
 said.   
 Despite this I kept picturing her birthing at home and was
 puzzled  
 why because I don't try and change women's minds or convince
 them of  
 one way or the other but point out the advantages and
 disadvantages.
 
 She let me know wednesday night that she had had a few niggles
 and on  
 thursday morning that she was leaking. I visited after lunch
 and then  
 left her to it. She rang at 7pm to say that the liquor was
 pink  but  
 that they were OK for now, At 9pm they rang and asked me to
 come.
 I arrived at 9:15 pm to find her leaning over her bed having
 strong  
 contractions but she was able to chat to me easily between
 them. She  
 did tell me they were pretty strong but she felt she had ages
 to go  
 yet! We chatted, checked her BP FHR etc and I watched her to
 try and  
 assess where she was up to.
 
 She went to the loo at 9:45 and as I listened to her she made
 a noise  
 that got my attention. I asked her about it but she denied any
 urge  
 to push and then told me she just needed to open her  
 bowels!   I asked her to have a feel in her vagina
 and  
 she said she could feel something hard!  because she
 had been  
 so adament  that she wanted to birth at the hospital  I donned
 a  
 glove and had a quick feel.   I said well there's two choices
 we can  
 have the baby here or you can have it in the car because
 there's no  
 way your making it to the hospital. She looked at me with a
 grin and  
 said well I'd rather stay here than do that. So we did and ten
  
 minutes and three pushes later James arrived much to his
 parents  
 amazement and his midwives amusement.
 
 The whole thing was great, she sat up in bed an hour later and
 said  
 well I'd do that again as she put her baby to the breast
 without any  
 fuss.
 Three days later they are all loving every minute of their
 whole  
 experience and I feel truely blessed to have been part of it.
 
 Andrea Q
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Re: [ozmidwifery] ctg stuff

[Judy Chapman]

So true Andrea. 
Many years ago a woman consented to be admitted with a
transverse lie at term but rejected any treatment. She was a
mulipara. Many times over the next week the dangers were
explained (such explanation was well documented) and she
declined CS. Finally she consented and it was scheduled for the
next day. That evening SROM and thick mec. Emergency CS and a
beautiful boy around 9 lbs was born. Died next day of Mec
aspiration pneumonia. She blamed the hospital. That left us
feeling bad but eventually she came to realise just what
happened and when she came an gave us a potted plant for the
ward we knew she had done a lot of work with her grief and was
starting to come out the other side. 
Cheers
Judy 

--- Andrea Robertson [EMAIL PROTECTED] wrote:

 One aspect of choice that needs to be considered is that
 even when 
 all the pros and cons are weighted carefully and a very
 informed 
 choice is made, there is no guarantee that the option chosen
 will 
 prove to be the best in the final analysis. Mistakes can still
 be 
 made and decisions thought to be the best can turn out to be
 the 
 worst.  This may result in an unexpected outcomes, but is part
 of 
 life and often leads to rapid and useful learning.
 
 However, often when a poor choice leads to a bad outcome, the
 blame 
 starts flying and scapegoats are sought (part of the grieving 
 process). It can often be the mother who is blamed (for
 example in a 
 home birth) or the doctor, if the birth takes place in
 hospital.
 
 For example, if a woman decided, after being told all the
 advantages 
 and disadvantages of an induction and is counselled on likely 
 outcomes, then still choose this option then I belive she must
 be 
 supported in her decision.  It still may turn out OK (Sally
 Tracy's 
 work showed that if a perfectly healthy mother chooses an
 induction 
 for no medical reason she has a 40% chance of coming through
 without 
 further intervention). If things do turn out unexpectedly and 
 complications arise, then this women needs support postnatally
 so 
 that she learns from the event.  However, she may be blamed or
 left 
 feeling guilty or depressed without supportive counselling
 with no 
 opportunity to learn how her decision, even though taken
 carefully, 
 was in the event not the best one she could have made.
 
 I am all for choice and better options being made available. I
 also 
 believe that women will try and make the best decisions they
 can 
 given a chance, and even though they may decide to do things 
 differently than we would, they have a right to make those 
 choices.  Circumstances change too, and these may affect the
 decision 
 making process - labour can be much harder than anticipated
 and help 
 may be sought. This is where the options are really needed so
 that an 
 epidural is not the only option available, but baths, showers
 etc etc 
 are also at hand (and a lot of this will come down to
 midwifery 
 attitudes and skills).
 
 This is a tricky area - informed choice is really a myth, as
 so 
 many vested interests come into play, but we must support
 women once 
 they have made a considered decision. To do less would be to 
 undermine her further and to miss the opportunity for
 learning, even 
 of some of those lessons are unpalatable at the time.
 
 Not really expressing this well this morning.
 
 Regards
 
 Andrea
 
 
 
 
 At 03:29 PM 17/06/2006, you wrote:
 Dear Sue and all
 
 What an amazing thread!!
 
 Choice is the key.  The choices that are respected and funded
 are 
 those that prop up the medical monopoly of the big business
 of birth.
 
 So all you wonderful midwives out there, start/keep saying 
 it.  There are no rules or protocols for women, there is
 evidence 
 and advice and a duty of care for midwives but at the end of
 the day 
 a woman must be making the decision.  It is not until we have
 a full 
 complement of choice from homebirth to elec c/s can we say
 that 
 women are really making a choice.  Now it is choice within a
 vacuum 
 of medical dominance.
 
 I heard an interesting thing re ADHD on the radio the other 
 day.  The researcher said if we only ask Drs we will only
 ever get 
 a medical response.  Nothing new but nicely put.  By
 continuing to 
 defer to medicos when the majority of us have no medical
 condition 
 we will never make lasting change.
 
 I believe some midwifery stars were recently at a conference 
 espousing the benefits of managed 3rd stage and justified by
 saying 
 physiological could only ever be considered when things were
 totally 
 natural so there was no real point etc.  Whilst I understand
 the 
 pragmatics of that comment and the reality of the current
 system.  I 
 find this a real sell-out and on par with the CTG argument
 and many others.
 
 Just because something is the majority does not mean it is 
 right.  Sometimes all the fools are simply on the same side,
 rich 
 and very powerful ones I know.
 
 Recently I was told midwives greeted my 

Re: [ozmidwifery] RE:

[Judy Chapman]

Another reason for not giving something you have not checked and
drawn up yourself. 
cheers
Judy

--- Melissa Singer [EMAIL PROTECTED] wrote:

 Hi Amanda,
 
 I have worked places where they don't give Vit K until mum and
 baby have 
 returned to the ward.  They changed their practice so babies
 are not given 
 any routine medication at all in birth suite (unless for
 resus) because 
 their have been a few instances where baby inadvertently and
 tragically was 
 given the mothers syntocinon.  A way in  this could happen is
 someone else 
 prepared the synto, accidentally leaves it on the resus
 trolley.  The 
 primary midwife is unaware and gets her own synto and the
 second midwife 
 thinks she is giving Vik K.
 
 Regards,
 Melissa
 - Original Message - 
 From: Nicole Carver [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, May 26, 2006 6:35 AM
 Subject: [ozmidwifery] RE:
 
 
  Hi Amanda,
  Why not delay the Vit K and do both on day 1? We have just
 stopped giving
  vit K and weighing the babe in the birth suite so that there
 is less
  interruption to the early time between babe and parent/s and
 first breast
  feed. We generally give Hep B on day 2 or 3 if the parents
 want the babe 
  to
  have it.
  Regards,
  Nicole.
 
  -Original Message-
  From: [EMAIL PROTECTED]
  [mailto:[EMAIL PROTECTED] Behalf Of
 Amanda W
  Sent: Thursday, May 25, 2006 8:11 PM
  To: ozmidwifery@acegraphics.com.au
  Subject:
 
 
  Hi all,
 
  I have just started working at a new health facility that
 tends to give 
  hep
  B injections on day 2 or 3. I have come from a facility that
 gives hep B 
  at
  birth when vitamin k is given. Can anyone shed some light as
 to why the
  might do it this way. Any articles. They seem to not know
 why they do it. 
  I
  just want to change practice so that can be done at the same
 time as the
  vitamin k.
 
  Thanks.
 
 
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Re: [ozmidwifery] Re:

[Judy Chapman]

Penny, 
Does it have to be supplements. Could it be a good wholesome
diet including good sources of Vit K? 
cheers
Judy

--- penny burrows [EMAIL PROTECTED] wrote:

 One thing that I wonder about: 
 Routine supplementation with any vitamin seems to be a bad
 idea for pregnant women as well as for babies. Do we know the
 effects of supplementation with vitamin K on pregnant women?
 What intricate balances might this be upsetting? It seems like
 this could be another, if more natural form of blanket
 treatment.
 
 If we truly believe that mother nature has designed things
 well and the newborn low levels are there for a reason, then
 do we want to boost the levels available in mum's milk?
 
 More to ponder,
 Penny 
   - Original Message - 
   From: Sue Cookson 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Friday, May 26, 2006 8:11 PM
   Subject: Re: [ozmidwifery] Re:
 
 
   Hi,
   With the new Konakion MM it's the other way around. It has
 been designed by increasing it's absorbability in fat to be
 more affective if given orally. It has NOT been proven to be
 as effective as the old Konakion in being absorbed by the IM
 route. They are waiting to see if the surveillance of the new
 Konakion through Australia, Switzerland and a few other
 countries is as effective IM as it is oral. The oral route has
 been found to give a higher vit K cover than the IM route over
 a few weeks.
 
   THere is so much misinformation about vit K. It is available
 to the baby through breastmilk and maternal supplementation
 does increase neonatal serum K levels. What more do we want??
 
   And by the way, all formla fed babies should be excluded
 from any study due to the addition of vit K to formulas. ie
 babies planned to be formula fed do not need vit k!!
 
   Sue
   student midwife
   birth practitioner
   vit K has been my research assignment for the past three
 years
 
 If a solution is designed to be given IM is it absorbed
 effectively if given via the GI tract ?
 No mention of this in the literature accompanying the
 Konakion.
 Most IM meds are NOT designed to be administered or guaranteed
 by the pharmaceutical company to be effective if given orally.
 It may be neutralised by gastric secretions, I am unaware of
 any research re this.
 Anyone else know of any ?
 
 If you are going to introduce a foreign substance into the GI
 tract of a baby you'd want to have a good reason  be sure
 that it was being absorbed  wouldn't you ?
 
 With kind regards
 Brenda Manning 
 www.themidwife.com.au
 
 - Original Message - 
 From: diane [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, May 26, 2006 6:48 PM
 Subject: Re: [ozmidwifery] Re: 
 
 
   Apart from the fact it tastes like Sh** (very bitter). Been
 reading about 
 Vit K all day today . Seems like a pretty good option as far
 as the 
 statitistics go.
 http://www.nhmrc.gov.au/publications/_files/ch39.pdf
 
 they recommend further research into the effectiveness of
 supplimenting 
 brestfeeding mothers to increase the vit K in breastmilk as an
 effective 
 suppliment.
 
 Di
 - Original Message - 
 From: Kelly @ BellyBelly [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, May 26, 2006 5:30 PM
 Subject: RE: [ozmidwifery] Re:
 
 
 Just a side question if that's okay - what are your
 opinions on oral 
 vitamin
 K versus injection?
 
 Best Regards,
 
 Kelly Zantey
 Creator, BellyBelly.com.au
 Gentle Solutions From Conception to Parenthood
 BellyBelly Birth Support -
 http://www.bellybelly.com.au/birth-support
 
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Andrea Quanchi
 Sent: Friday, 26 May 2006 3:24 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] Re:
 
 The place I work we give it when we do the NST. It was a
 midwife
 decision not an evidence based one.  Like giving it with the
 vit K it
 is easier to do it at a predictable time so that it doesn't
 get
 overlooked.  The midwives wanted not to do it at birth as they
 were
 wanting to do as little as possible to interupt Mum and baby,
 As we
 need to have a signed consent form to give it and the mothers
 have
 often not filled this is prior to birth it was very
 interupting to
 get all thisDone on the birth day and we find it not an
 issue later
 when everyone has had time to sit down read the literature and
 discuss it.  Of course then we do have a number of mums who
 decline
 to have it which is their right and is not an issue at all.
 Andrea Q
 On 25/05/2006, at 8:10 PM, Amanda W wrote:
 
   Hi all,
 
 I have just started working at a new health facility that
 tends to
 give hep B injections on day 2 or 3. I have come from a
 facility
 that gives hep B at birth when vitamin k is given. Can anyone
 shed
 some light as to why the might do it this way. Any articles.
 They
 seem to not know why they do it. I just want to change
 practice so
 that can be done at the same time as the vitamin k.
 
 

Re: [ozmidwifery] Hep B, vit K

[Judy Chapman]

As far as I am award it IS the capture theory. Stick thousands
of babies with Hep B vax to maybe save one. 
For those who do consent at our hospital we give on the day of
the Neonatal screening. One of our midwives has looked into the
perinatal data in Qld and found that there were not figures for
babies who missed the birth dose and caught Hep B in the first
few months. 
We work on the premise that if it says on the hospital supplied
literature that babies may feel unwell and need extra fluids
after an immunisation, why are we doing that before they even
know how to suckle properly? Birth dose is classified as given
in the first week. The pressure to give 'at birth', before the
poor kid has had time to even draw breath properly, is so they
don't get lost in the system.
With midwifery clinics we are aware of women who live high risk
lifestyles and are at risk of defaulting when it may not be best
to do so and we just make sure that it is done before they go
home if it is before the neonatal screening. 
Cheers
Judy
 
--- Justine Caines [EMAIL PROTECTED] wrote:

 Dear Mary and Amanda
 
 Exactly Mary!
 
 Amanda have you read Sara Wickham's work on Vit K?
 
 What is the consent process for Hep B, Are parents aware of
 the specific
 populations of risk?
 
 I must say the Hep B at birth really shocks me.  What are the
 risk factors
 for babies who are not in contact with those in high risk
 groups such as
 those already infected or sex workers and intravenous drug
 users?
 
 It seems like a capture theory to me and I worry about the
 level of informed
 consent.
 
 JC
 
 
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Re: [ozmidwifery] high GTT result?

[Judy Chapman]

Need more info. Is that the one hour result or the two hour
result. If it is the two hour result she needs a consultation
with a diabetic nurse or Dr and it is high. 
Cheers
Judy
--- Janet Fraser [EMAIL PROTECTED] wrote:

 Hi all,
 can someone clue me in on what's considered a high result to
 get from the GTT? I have a woman wanting to swap to hb from a
 BC where her GTT result is considered dangerously high and
 she's been told she's highrisk. It was 9.8.
 Thanks!
 : )
 J
 For home birth information go to:
 Joyous Birth 
 Australian home birth network and forums.
 http://www.joyousbirth.info/
 Or email: [EMAIL PROTECTED]







 
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Re: [ozmidwifery] massage in pregnancy

[Judy Chapman]

I guess this has already been answered but I have been overseas and am just now catching up.   When I did massage years ago I was taught not to massage a pregnant woman's belly, not because of the risk of miscarriage but because of the risk of being blamed if a miscarriage should subsequently occur. Made sense to me.   Cheers  JudyJanet Fraser [EMAIL PROTECTED] wrote:  Hi all,  can anyone recommend a form of massage particularly beneficial in pregnancy? I've been in contact with a massage student who's been told that she must never on any account massage a woman in pregnancy as it can cause miscarriage.
 Personally I know that's a crock but I'd love to be able to give her better info, perhaps on traditional and well evidenced forms of massage in pregnancy.  TIA,  J  For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED]
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Yahoo! Personals: It's free to check out our great singles!  

Re: [ozmidwifery] managed versus physiological 3rd stage, was: after birth pains

[Judy Chapman]

I have done quite a few physiological third stages and, like labours, are all different. Have had a couple of women who have been in a lot of pain until the placenta delivered, then it was cured. They complained of back pain. Both eventually asked for synto to get the placenta out and stop the pain and both times it still took a while to come after the synto.   Cheers  JudyNikki Macfarlane [EMAIL PROTECTED] wrote:  When you were with the mother who had the physiological third stage Nicole, was there any touching, pulling or tugging on the umbilical cord? If a caregiver is not commonly
 practicing a physiological third stage they may be putting cord traction on the cord (pulling gently) anf this can cause the pain you spoke of. I have had four physiological third stages and none have been overtly painful. I have seen hundreds and the only time the woman has mentioned pain is when the caregiver is pulling on the cord or putting pressure on the top of the uterus.There is no reason why, if everything else is normal, you cannot decline synt until a time has been reached. A physiological third stage can take a lot longer - anything between a few minutes to 2 hours is still normal - although most hospitals would be uncomfortable waiting more than 30 minutes. There is no increased risk after 30 minutes - sadly, they are smply used to seeing a placenta come a lot quicker than that because managed care is the norm now. You can always choose to have the synt. 
   As with every other intervention, and with the option of expectant care, there are pros and cons and only you can now the acceptable option for you and your baby.Nikki Macfarlane  Childbirth International  www.childbirthinternational.com
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Re: [ozmidwifery] PPH C/S

[Judy Chapman]

She CAN always say no. How bad were the other PPH's? Enough to
really comprimise her? She is probably at risk of another but it
might still happen if she has a CS. 
Cheers
Judy

--- Kelly @ BellyBelly [EMAIL PROTECTED] wrote:

 Hello all,
 
  
 
 A woman on my forums has had two normal births of big babies -
 11lb3oz and
 13lb5oz and had a PPH with both. Her Ob is now recommending a
 c/s with her
 third bub and wants a scan at 34 weeks as a deciding factor of
 this. She
 wants a normal birth - is it okay just for her to say no
 without too much
 risk with PPH?
 
 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
 
  
 
 




 
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Re: [ozmidwifery] Larry

[Judy Chapman]

Speaking from Mareeba, we did ok, 40km north of the centre of the storm.   Bit scary going to work though at 0630.   Cheers  Judy  diane [EMAIL PROTECTED] wrote:  Hi,   Hope you gals up North managed to weather the storm without too much damage this morning. Any new little Larry's born in the storm?I was thinking of you, as I will be moving to N.Q at the end of the year (beachside too, I wonder if thats a wise decision!!!). I suppose you are all busy with!
  the
 clean up and waiting for power,so when you do get to read this,just know we were thinking of you all in N.QCheers,  Diane  
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RE: [ozmidwifery] Re: N/A

[Judy Chapman]

I have to back up what Barb says. I used to live 40 mins from
work and had to go up the range to get home. After twice waking
on the wrong side of the road and once having an accident I
learned to have a power nap when I got tired on the drive home.
What a difference. Please don't take as long to learn as I did,
you might not be so lucky. 
I currently work in a small rural unit which is not always busy
so I always have some craft in the car, if I need it I go out
and get it to keep the mind busy and awake. I get more hungry
during the night so I have adequate food, as a weight watcher I
make sure they are not too unhealthy, and eat as necessary. For
me I find that if I don't sleep in the morning I don't sleep, so
I go straight to bed, curtains drawn, not hungry, warm\cool
enough and work on sleeping till 1500 - 1600. 
Cheers
Judy

--- B  G [EMAIL PROTECTED] wrote:

 Oh to have nights like this. Most night shifts where I am it
 is rare to
 even get a chance for a toilet break let alone something to
 drink. We
 have been trying for years just to get somebody to provide
 meal relief
 shifts in all three areas of Mid - BS, SCN and the ward which
 also has
 general clients to care for. We only have two staff in each
 area so when
 one is out doing an emergency LSCS or having to do transfers
 to the
 tertiary we are told 'just manage'! No luck thus far.
 Take care on the trip home. make sure you have a plan when you
 are
 simply so tired you start have mini naps on the drive. Pull
 over and
 sleep for at least 20 minutes.
 I have lost several good friends to MVA's due to falling
 asleep at the
 wheel over the years and I have myself 'woken' to see a tree
 heading for
 me!
 Cheers Barb




 
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Re: [ozmidwifery] public-private birth centres

[Judy Chapman]

Interesting concept. Has he given any indication how he thinks
it would work? What is his reputation for birthing?
cheers
Judy

--- [EMAIL PROTECTED] wrote:

 Hi everyone, we have been approached by a doc here in the
 south west of
 WA about establishing a public/private birth centre, I am not
 aware of
 one in Australia but I could be wrong, if so could someone let
 me know
 how it works and any suggestions or thoughts on how it should
 work would
 be greatly appreciated.
 
 Yours in midwifery,
 
 Pete Malavisi
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Re: [ozmidwifery] of interest

[Judy Chapman]

They can't seem to get their head around women as individuals
and how each birth event should be treated individually and not
generalised into categories. 
cheers
Judy

--- Mary Murphy [EMAIL PROTECTED] wrote:

 Isn't it interesting that reasonably accurate is acceptable
 in medical
 research.  One can see the scenario that risk scoring will be
 used to
 increase caesareans rather than avoid it. 
 
  
 
 New risk score predicts cesarean after induction
 Source: Obstetrics  Gynecology 2006; 107: 227-33
 
 Simple scoring system may help decision-making when
 considering induction of
 labor. 
 
 The risk of cesarean delivery after induction of labor can be
 predicted
 reasonably accurately using four simple measures, British
 obstetricians
 report. 
 
 Elisabeth Peregrine and team from University College London
 Hospitals sought
 to develop a clinical model for predicting the outcome of
 labor induction.
 They evaluated maternal and ultrasound parameters in 267 women
 at 36 or more
 weeks of gestation immediately before induction of labor. 
 
 The most frequent indication for induction was postdates, and
 30 percent of
 the cohort subsequently required a cesarean delivery. 
 
 In logistic regression analysis, four factors emerged as
 significant
 predictors of cesarean delivery: parity (odds ratio [OR] =
 20.56), body mass
 index (OR = 6.17), height (OR = 0.94), and ultrasonic
 transvaginal cervical
 length (OR = 1.07).
 
 Peregrine's team used these to develop a simple risk scoring
 system, whereby
 a score of -65 to -55 indicates a more than 80 percent
 likelihood of
 cesarean delivery, and a score of -165 to -146 indicates a
 less than 1
 percent chance. 
 
 The model has reasonably good discriminatory ability, say
 the
 investigators, who conclude that it may allow more accurate
 counseling and
 better informed consent in the decision-making process when
 considering
 induction of labor.
 
 Posted: 22 February 2006
 
  
 
 




 
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RE: [ozmidwifery] pelvic floor information

[Judy Chapman]

Skipping isn't bad either if you don't have a trampoline on tap.

cheers
Judy

--- Megan  Larry [EMAIL PROTECTED] wrote:

 Ideally we all can benefit from pelvis floor excercises,
 including men.
  
 My dad had his prostate removed recently for cancer and I told
 him to start
 and excercise his pelvic floor pre-surgery to help with his
 recovery. He
 told his specialist what I said and he thought it was an
 excellent idea.
 Interestingly my Dad noticed improvement with his weeing
 just from this
 and did have a good recovery.
  
 Anyway, just my two bits,
  
 Megan
  
 PS trampolines are an excellent way to find out how strong
 your pelvic floor
 is, or isn't as you may find out. Hehehehe
 
   _  
 
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Kylie Carberry
 Sent: Wednesday, 22 February 2006 4:03 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] pelvic floor information
 
 
 
 
 Hi All,
 
 I was wondering if anyone can point me in the right direction
 with some
 research I am doing for a story on the importance of pelvic
 floor exercises.
 A lot of women are led to believe - I guess, by scalpel-happy
 OB's - that a
 weakened pelvic floor can be avoided a by having a c-section. 
 I recall,
 some time last year, reading an article disproving this
 theory, but, of
 course cannot remember where I read it.  If there is anyone
 who can help me
 out here, I would greatly appreciate if you could let me know.
  Any other
 thoughts on the topic would be welcomed also.
 
 Best wishes
 
 
 Kylie Carberry 
 Freelance Journalist 
 p: +61 2 42970115 
 m: +61 2 418220638 
 f: +61 2 42970747
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Re: [ozmidwifery] A first for me

[Judy Chapman]

Fantastic Andrea. At times like that one wonders why you would
do any other job. It is such a buzz for me still after all these
years. For us at work they are not allowed to be planned
waterbirths but our women know that we can only recommend they
come out, we can't make them so they just stay put. It is so
peaceful. 
Cheers
Judy

--- Andrea Quanchi [EMAIL PROTECTED] wrote:

 Today I had my first waterbirth.  It was so beautiful. All
 4.8kg of  
 him manipulated his way out all by himself. Mum was able to
 describe  
 his movements to us in a running commentary even down to
 telling us  
 that the shoulders were rotating after his head was born.
 
 tears in Dads ( and the midwives) eyes and complete awe on the
 face  
 of his 3 year old big sister ( who offered to put the slide
 into the  
 pool for mum). its such a buzz attending births like this.
 
 Planned second midwife was away and so we invited one who had
 not  
 attended a homebirth ( or waterbirth) before and she is
 herself  
 pregnant so I can only hope she was inspired to great things
 for  
 herself.
 
 I was glad that we had discussed  water birth at length in
 Maggie  
 Banks workshop last week  because I was not surprised when
 this baby  
 was so peaceful in the water that we actually had to remind
 him that  
 he needed to join those of us who breathe air. he just lay
 there in  
 his Mums arms looking around and didnt seem to get that idea
 for a  
 while.
 
 Addicted to birth
 
 Andrea Q
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Re: [ozmidwifery] fear

[Judy Chapman]

Yes, I have. 
When I was working in Saudi. Grand Multi, coule see the baby's
head at the introitus but she would not push, wanted a CS. 
It was a very interventionist place, a dribble of synto was
commenced, easy when all women had an IV, and eventually she
gave one big push and the baby came out. I could speak some
arabic but not enough to delve into the fears she had. Chances
are she had not wanted to be pregnant and possible did not
particularly want this baby. Or possibly the coming of the baby
would soon mean resumption of unwanted andvances from her,
possibly chosen for her, husband. 
Cheers
Judy

--- Ceri  Katrina [EMAIL PROTECTED] wrote:

 On 05/02/2006, at 12:36 AM, Susan Cudlipp wrote:
 
  What is your biggest fear right now?  She didn't answer
 for a couple 
  of contractions then suddenly burst out  My biggest fear is
 that I 
  won't be able to birth the baby  What do you know - lip
 went and baby 
  started to appear!
 
 
 
 This fascinates me too.
 Is is just a matter of verbalising that fear???  I know it
 sounds dumb, 
 but most women when questioned say that they fear the
 pain.no 
 denying that it is going to hurt, so is it a matter of just
 verbalising 
 it??
 
 On a similar matter
 the last couple of weks, I have had 2 women simply stump me.
 One with 
 an epidural, one without. Both reached 9 then 10 cms dilation,
 and 
 decided they did not want to push. They were adament they did
 not want 
 to push, that they wanted the baby pulled out!!!  Despite
 reasurrance 
 that they could do it, and that unless they were unwell or the
 baby 
 distressed, they baby would NOT be pulled out and they
 certainly would 
 not be taken for a LSCS, they continued to say No I dont want
 to 
 push, I'm not going to push it is going to hurt too much!
 
 They eventually had the baby when the next shift took over,
 but I was 
 wondering if anyone else had encountered this before??
 
 
 




 
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RE: [ozmidwifery] Post cs support

[Judy Chapman]

Barb, 
So sorry to hear you have had such a shocking time. I can offer
no tips, not having been there myself but I pray that there will
come a time that you can settle into more normal pre-trauma type
of life. 
Cheers
Judy

--- B  G [EMAIL PROTECTED] wrote:

 There is no 'cure' for PTSD!! You just learn to manage the
 triggers but
 even then the physiological responses sometimes get away from
 you. Some
 people wonder why you are so serious- so would you if you had
 this
 constant mind battle to control triggers.
 Barb- chronic PTSD sufferer, 8 years after an assault and
 prolonged
 torture by an unsupervised prisoner in an Intensive Care Unit.
 
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Jo
 Bourne
 Sent: Saturday, 4 February 2006 11:34 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Post cs support
 
 
 Talking therapies may be the only cure, that certainly
 sounds right to
 me. However I can't imagine having been raped, assaulted OR
 traumatised
 by my birth experience and then wanting to do that talking in
 the place
 or with the people where it happened. Perhaps in the last
 stages of
 healing, as a final letting go/closure thing, but certainly
 not in the
 very first days of the shock. I did not have a remotely
 traumatic birth
 experience but have had other traumas in my life and have had
 a lot of
 talking to do about them, I can't think of one occasion I
 wanted to go
 back to the person/place that was the source of the trauma.
 
 At 11:19 AM +1100 4/2/06, Janet Fraser wrote:
 I remember it but I disagree with it entirely. It struck me
 as no more 
 logical and useful than the obstetric refusal to offer OFP
 because a 
 study showing a crude, almost silly form of it didn't have
 the desired 
 effect. (10mins a day on hands and knees rather than the
 lifestyle 
 operation that is true OFP) Talking therapies are pretty much
 the only 
 cure for PTSD and that's been well demonstrated over and
 over. The 
 one study showing otherwise holds no weight. J
 
 - Original Message -
 From: mailto:[EMAIL PROTECTED]Mary Murphy
 To: 

mailto:ozmidwifery@acegraphics.com.auozmidwifery@acegraphics.com.au
 Sent: Saturday, February 04, 2006 10:58 AM
 Subject: RE: [ozmidwifery] Post cs support
 
 I believe there is some research out there that looked at
 de-briefing 
 women after birth, particularly traumatic births.  As I
 remember it,
 the research did not show that this debriefing had
 particularly helpful
 outcomes.  Of course it is all in the Who, the When and the
 How.  Does
 anyone remember it?  Mary Murphy
  
 
 Andrea wrote:
 Any suggestions. Should all women have a follow up
 appointment with the
 
 midwife who was at her birth, is this appropriate as they may
 have been
 part of the problem, should all women have a follow up
 appointment but
 the woman be allowed to choose who she wants the appointment
 with, at
 what stage would this be appropriate, 2 weeks, 8 weeks 3
 months? How
 does this fit with the MCH nurses who are now involved in the
 woman's
 on going care? How does her doctor, be it her own GP, obst or
 the one
 who attended (or not) her birth  be involved in this?
  
 
 
 -- 
 Jo Bourne
 Virtual Artists Pty Ltd
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RE: [ozmidwifery] Post cs support

[Judy Chapman]

I am sure that debriefing helps even if it does not cure. I
remember one particular woman at my previous place of work who
rang me many times and needed to talk about her EM CS (possible
not necessary) and I felt sad for her when I left there as we
had not finished debriefing. I think it helped a bit but she was
still a bit of a mess. 
For my self, I would loved to have had a sympathetic ear, it
took me nearly 25 years to come to terms with the 2 CS that I
had. Fortunately I have been able to channel into midwifery,
trying hard not to let women get the raw deal that I had. 
Cheers
Judy


--- Nicole Carver [EMAIL PROTECTED] wrote:

 HI Mary,
 I remember reading about that research and being surprised. I
 have discussed
 it with the psych nurse employed where I work, who spends time
 nearly every
 day with women who have experienced traumatic births (or
 perceived them to
 be even when we might not have called them such). She feels it
 does help.
 Even one visit can help women who want to understand what
 happened to them
 and why. Some require much more, and thankfully our maternity
 support
 workers are great with these women. However, it is a tragedy
 that we need to
 have these workers. They do also work with antenatal and
 postnatal
 depression.
 I can't remember the specifics, but I don't recall being
 particularly
 impressed with the methodology of the study that you mention.
 And if women
 want to talk about their experience they should be able to,
 whether it is
 formal debriefing or whatever. I suppose you don't want to
 treat all women
 the same, ie what is appropriate debriefing for one woman,
 would not
 necessarily work for another. If you did try to treat them the
 same it would
 not be surprising if it did not work.
 Nicole Carver.
   -Original Message-
   From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of Mary
 Murphy
   Sent: Saturday, February 04, 2006 10:59 AM
   To: ozmidwifery@acegraphics.com.au
   Subject: RE: [ozmidwifery] Post cs support
 
 
   I believe there is some research out there that looked at
 de-briefing
 women after birth, particularly traumatic births.  As I
 remember it, the
 research did not show that this debriefing had particularly
 helpful
 outcomes.  Of course it is all in the Who, the When and the
 How.  Does
 anyone remember it?  Mary Murphy
 
 
 
 


 --
 
   Andrea wrote:
 
   Any suggestions. Should all women have a follow up
 appointment with the
 midwife who was at her birth, is this appropriate as they may
 have been part
 of the problem, should all women have a follow up appointment
 but the woman
 be allowed to choose who she wants the appointment with, at
 what stage would
 this be appropriate, 2 weeks, 8 weeks 3 months? How does this
 fit with the
 MCH nurses who are now involved in the woman's on going care?
 How does her
 doctor, be it her own GP, obst or the one who attended (or
 not) her birth
 be involved in this?
 
 
 




 
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RE: [ozmidwifery] Weight gain in pregnancy

[Judy Chapman]

Sorry Nicole, but I was working on the premise gained from
research and the media that a large proportion of the obesity in
western society was directly linked to an increase in fats,
sugars and the volume of food available along with decreasing
exercise rates. 
There are always people with metabloic problems but I had
believed they were in the minority, not the majority. 
The woman I spoke of chose to start eating a better diet, not
'dieting', and to increase her exercise levels. I would not be
the one to tell her that she may not do that because of
'toxins'. 
Going back to the discussion last year on the problems of very
high BMI in pregnancy and problems anticipated with births was
another reason I would not tell her that she may not change her
(admitted by her) previous poor dietry habits. 
Cheers
Judy

--- B  G [EMAIL PROTECTED] wrote:

  Given that it is usually poor diet and lifestyle that
 cause the
 obesity...Hopefully this woman has learned to clean up her
 lifestyle on
 a permanent basis for hers and future children's benefit.
 
 
 OOOH Judgement statement!!
 We are very quick to lay blame. Many of these women are
 victims. Victims
 of the Metabolic Syndrome where they quickly gain weight
 especially
 centrally, have dyslipidemia, hyperinsulinaemia which causes
 insulin
 resistance, hirsuitsm which leads to poor self esteem and
 other terrible
 symptoms. Being obese doesn't mean they cannot participate in
 life
 changing experiences such as having a baby.
 Another cause are often that these women are victims of
 childhood sexual
 and physical abuse hence have psychological hang ups of
 appearing
 'pretty'.
 Many women I see in ANC talk about the difficulties shopping
 in the
 supermarket - the trolley Nazi's. Family get together and as
 she wasn't
 working family - sisters- gave her a shopping list for a
 celebration.
 She was stopped in the aisles and unsolicited advice was given
 that she
 shouldn't buy that ... because that would put weight on. She
 was all of
 28 weeks pregnant wore large clothes covering her belly and I
 am sure
 this person didn't even know she was pregnant. She weighed
 110kg, walked
 4 km every day and did gym work so never assume anything with
 these
 ladies. There are those that really do work hard and are very
 aware of
 their physical failings. As one woman said 'we are easy
 targets, we
 can't hide the cigarettes or the drugs like others. These do
 more harm
 than eating healthy and exercise'. 
 The toxins people allude to are you referring to ketones? 
 Barb
 
 
 
 
 
 
 
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RE: [ozmidwifery] Weight gain in pregnancy

[Judy Chapman]

That would be great if families really planned and prepared
properly for pregnancy but most don't. Given that it is usually
poor diet and lifestyle that cause the obesity, they probably
have toxins running around anyway. 
Hopefully this woman has learned to clean up her lifestyle on a
permanent basis for hers and future children's benefit. 
Cheers
Judy

--- Nicole Carver [EMAIL PROTECTED] wrote:

 One concern which has been raised about loss of fat during
 pregnancy, is the
 release of toxins which are stored in fat. I would imagine it
 would be best
 (perhaps not always possible) to lose weight well prior to
 conception so
 that these toxins are out of mum's system.
 Regards,
 Nicole.
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of Judy
 Chapman
 Sent: Friday, January 27, 2006 11:04 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Weight gain in pregnancy
 
 
 One of the women I cared for last year decided to lose some
 weight while she was pregnant and got hold of the weight
 watchers diet (couldn't join officially because of pregnancy),
 which, as most would know is just good balanced eating, and
 combined it with lots of walking and lost about 6 kg while she
 was doing this. This translated to a large loss of fat and she
 looked and felt really good because of it. Her baby was 4kg
 and
 healthy. It helped that she was staying with her Mum (husband
 was in Iraq) who also followed the diet with her (and got her
 cholesterol down to the best it has been in years), and her
 sister owns a gym so supervised the exercise.
 What most of us think of as dieting where we really cut the
 calories to low levels does not give us the necessary
 nutrition
 for pregnancy but balanced eating and cutting out the rubbish
 that may have contributed to the weight gain should give good
 results.
 Cheers
 Judy
 
 --- Kylie Holden [EMAIL PROTECTED] wrote:
 
  I have another question for you all!
 
  I know a woman who is pregnant, currently about 27 weeks. 
 She
  has been told
  by her doctor that as she is very overweight (100+kg) she
  should put on as
  little weight as possible during pregnancy.  At 27 weeks she
  has only put on
  three quarters of a kilo, and doctor is very pleased!  I
  didn't know what to
  say to her.  Is such a small weight gain safe for the baby?
  According to
  the textbooks, average weight gain is 3-4kgs in the first 20
  weeks and then
  half a kilo every week after that (of course, wide variances
  occur and every
  woman is different), but the books that I have don't say if
  it's different
  for obese women.
 
  Less than a kilo of weight gain at 27 weeks...any thoughts?
 
  Thanks
  Kylie
 
 

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Re: [ozmidwifery] Weight gain in pregnancy

[Judy Chapman]

One of the women I cared for last year decided to lose some
weight while she was pregnant and got hold of the weight
watchers diet (couldn't join officially because of pregnancy),
which, as most would know is just good balanced eating, and
combined it with lots of walking and lost about 6 kg while she
was doing this. This translated to a large loss of fat and she
looked and felt really good because of it. Her baby was 4kg and
healthy. It helped that she was staying with her Mum (husband
was in Iraq) who also followed the diet with her (and got her
cholesterol down to the best it has been in years), and her
sister owns a gym so supervised the exercise. 
What most of us think of as dieting where we really cut the
calories to low levels does not give us the necessary nutrition
for pregnancy but balanced eating and cutting out the rubbish
that may have contributed to the weight gain should give good
results. 
Cheers
Judy

--- Kylie Holden [EMAIL PROTECTED] wrote:

 I have another question for you all!
 
 I know a woman who is pregnant, currently about 27 weeks.  She
 has been told 
 by her doctor that as she is very overweight (100+kg) she
 should put on as 
 little weight as possible during pregnancy.  At 27 weeks she
 has only put on 
 three quarters of a kilo, and doctor is very pleased!  I
 didn't know what to 
 say to her.  Is such a small weight gain safe for the baby? 
 According to 
 the textbooks, average weight gain is 3-4kgs in the first 20
 weeks and then 
 half a kilo every week after that (of course, wide variances
 occur and every 
 woman is different), but the books that I have don't say if
 it's different 
 for obese women.
 
 Less than a kilo of weight gain at 27 weeks...any thoughts?
 
 Thanks
 Kylie
 

_
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Re: [ozmidwifery] Vaginal breech in hospital

[Judy Chapman]

What a great story Sue, that doesn't happen much. 
Recently we had a breech birth at our small rural hospital. Not
meant to happen. 
Primip, booked for ECV and immediate CS if not succesful though
she certainly did not want that. 
Came in and had a precipitate labour, managed to drop a foot out
before she could get on the ambulance trolley so then it was
definitely not safe to transfer to tertiary hosp. Bit of a
circus but the woman's midwife (who has done a couple of breech
homebirths) managed to fend of a GP OB attempt to interfere and
so was born a cute little sprog with little interference.
Parents very happy with the scenario. 
Cheers
Judy

--- Sue Cookson [EMAIL PROTECTED] wrote:

 Hi all,
 Had the honour of assisting a 38 year old primip to
 successfully birth
 her breech baby vaginally yesterday in a large hospital.
 She has been told she had to have a c/section  but negotiated
 her way to
 trying a vaginal delivery. We drew up birth plan specifying
 freedom of
 position, midwife delivery, intermittent auscultation, no
 episiotomy,
 physiological third stage etc.
 Went into labour on her due date with the baby sitting with
 its bottom
 and right foot at the cervix. Arrived at the hospital amidst a
 flurry of
 panic but after presenting them with the birth plan and the
 'team'
 arriving - myself as support person and a friend as filmmaker
 - the 
 staff settled down to document the plan including refusal of
 elective 
 c/section, choice to have no epidural, no CTG, etc.
 A FANTASTIC Indian female registrar arrived and showed genuine
 excitement at the prospect of a breech birth. The couple then
 agreed to
 a PV and ultrasound just to confirm baby's position. She was
 8cm with
 intact membranes, and bottom and foot palpable - baby was 'a
 nice size'
 according to the registrar 'G'.
 There were a few midwives always around but it was G who
 forged a
 relationship with us all and was incredibly respectful of the
 woman's
 choices. The midwives showed concern when G could palpate the
 foot but
 G was fine. We discussed the choice to birth upright and it
 was agreed
 that we would assist the mother into a more 'conventional'
 position if
 it was required.
 So labour continued with a few more hours in transition during
 which
 time baby rotated to the anterior. We changed positions often
 and it was
 whilst in the bath that the membranes ruptured with fresh
 meconium
 appearing.
 
 Another VE was performed briefly and foot and bottom were
 close to
 crowning. We were on the floor with the mother supported
 upright, using
 mirrors to watch progress and the first foot began to appear
 at 5.30pm.
 I had a closer look and found a second foot. The baby appeared
 slowly,
 double footlings breech and G gently assisted the baby's head
 to birth
 at 5.45pm. The placenta followed the baby out, so although
 we'd had good
 cord pulse a few minutes before the baby was certainly on his
 own at
 birth. Baby was minimally resuscitated - away from the mother
 which was
 my only slight criticism, but very understandable - and  G
 actually
 helped the mother to move across the floor to the resus
 trolley.
 
 WOW!! Baby had apgars of 6, then 9 and is just fine. 6lb 11oz.
 Peri
 intact, lotus birth...
 
 G stated that she had delivered many breech babies in India
 and New
 Guinea and I believe she was an obstetrician overseas but not
 in
 Australia. She was excited at delivering an upright breech
 as she had only ever delivered them in obstetric positions
 before. She
 was also very OK about the lotus birth which was a different
 response
 for that hospital.
 
 It was a wonderfully affirming birth - a testament to my
 belief of being
 informed, prepared and corageous too!! I am very aware that
 this birth
 hinged on G being in attendance - I truly doubt that many
 other 
 practitioners would have shared her enjoyment of the challenge
 of this 
 birth. Her experience in other countries was so vital ... it
 is possible 
 that she put her hand up for this birth when it was discussed
 a week or 
 so before (the parents had a two hour meeting with another
 doctor and 
 obstetrician - the ob stated he would not support their
 decision, so it 
 truly was an amazing outcome!!).
 
 Hail to those women who stand strong in their belief of normal
 birth and
 also to those of us who can support them. I really felt
 honoured to be
 there.
 
 I hope by telling this story that more women and midwives may
 feel 
 encouraged to attempt to negotiate their way through the
 obstetric maze 
 which surrounds vaginal breech births.
 
 Sue
 
 
 
 
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Re: [ozmidwifery] Scheduled Caesareans...?

[Judy Chapman]

I have thought this for years but seeing how hard it is to
eliminate Failure to Progress from the OB language I think it
would be harder to change EL CS to SCS or Booked CS. 
Cheers
Judy

--- Kelly @ BellyBelly [EMAIL PROTECTED] wrote:

 One of the women in my forums posted this comment which I
 think is very
 interesting, while I know there are far too many c/s as is, I
 think she has
 a valid point. What do you think?
 
  
 
 I was just thinking that the name 'elective C/S' should be
 changed to
 'scheduled C/S'. So many people don't elect caesareans but
 have them as a
 matter of medical necessity and the term elective implies a
 choice that may
 not exist and IMO probably contributes to the whole 'too posh
 to push'
 perception that alot of people have of scheduled C/S's...
 
  
 
 I know that lots of these scheduled caesarians are probably
 unnecessary, but
 of course some aren't.
 
 Best Regards,
 
 Kelly Zantey
 Creator,  http://www.bellybelly.com.au/ BellyBelly.com.au 
 Gentle Solutions For Conception, Pregnancy, Birth  Parenthood
  http://www.bellybelly.com.au/birth-support BellyBelly Birth
 Support
 
  
 
 




 
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Re: [ozmidwifery] belly dancing midwives:)

[Judy Chapman]

Hi Julie,
I have been doing a bit of bellydancing for 6 years and I
believe my back is a lot stronger for it. I don't get anywhere
near the amount of low back pain I used to get. More fun than
formal exercise too. 
Are you protecting your back by trying to stay at the same level
with the woman by sitting on the floor or a foot stool? 
Don't forget to make sure your abdominals are strong enough to
support your back also. Bellydancing will help there too. Or do
a few crunches (not situps). 
Cheers
Judy

--- Julie Garratt [EMAIL PROTECTED] wrote:

 Hi all,
 I've just started work as a midwife and I think I need some
 exercise to strengthen my back, feeling a bit stiff after
 catching babies in the shower, bath, floor, birth stool ect. I
 think it is a sustainability issue of practice, a good strong
 back. I don't ever want my physical ability to dictate how a
 woman wants to birth. Anyone tried pilates or belly dancing?
 Any other good suggestions?
 Ta Julie:)


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Re: [ozmidwifery] Peaceful birth

[Judy Chapman]

Fantastic, congratulations, what a woman. Oh for a world of
consumers with as much commitment as you have. 
Cheers
Judy


--- Justine Caines [EMAIL PROTECTED] wrote:

 Dear All
 
 Here¹s the news and even a little pic! Thank you all so much
 for your lovely
 wishes!
 
 JC
 xx 
 
 
 
 http://au.geocities.com/homebirthau/twins.html
 







 
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Re: [ozmidwifery] CF screening

[Judy Chapman]

This article on the birthinternational site is good for decisions re downs, I am sure it could be extrapolated to CF.   http://www.birthinternational.com/articles/dietsch01.html  Cheers  JudyRobyn Dempsey [EMAIL PROTECTED] wrote:  Who says that because testing is available, that you have to terminate?  The testing allows choice.  My sister has made friends who have children with CF, they knew they carried the gene and took the attitude " I know what to do with CF kids, it doesn't bother me".  On!
 ce again,
 I read judgment.Testing allows choice.the choice to terminate, or the choice to prepare for a child with extra needs.Robyn D  
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Re: [ozmidwifery] Newborn Examination question

[Judy Chapman]

We use the opthalmascope and check the red reflex. We had an
inservice with a Paediatrician. 
Cheers
Judy

--- Helen and Graham [EMAIL PROTECTED] wrote:

 Something happened to that last email of mine... but I wanted
 to say thanks to those who responded to my question. 
 Interesting variation in responses with some workplaces
 requiring further accreditation for midwives to perform the
 newborn exam, some recommending the GP do it and some with the
 midwives doing it routinely themselves.  For those of you who
 do the examination yourselves, could you please tell me if you
 perform fundoscopy i.e using an ophthalmoscope? And for those
 who require accreditation, could you tell me how this is
 obtained and what it consists of?
 
 Midwives do the newborn examination at my current workplace
 but we don't currently perform fundoscopy. Thanks again for
 your responses.
 
 Helen
 
   - Original Message - 
   From: Helen and Graham 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Thursday, December 01, 2005 3:24 PM
   Subject: Re: [ozmidwifery] Newborn Examination question
 
 
   T
 - Original Message - 
 From: Judy Chapman 
 To: ozmidwifery@acegraphics.com.au 
 Sent: Wednesday, November 30, 2005 9:08 AM
 Subject: Re: [ozmidwifery] Newborn Examination question
 
 
 We do the newborn examination after birth but then
 recommend that they go for the 5 - 10 day well baby check with
 their GP. This is just since we have been working as a birth
 centre.
 Cheers
 Judy
 
 
 Helen and Graham [EMAIL PROTECTED] wrote: 
   Hi everyone
 
   I have a question regarding midwives performing the
 newborn examination postnatally prior to discharge.  
   Having worked in several hospitals, I am used to this
 exam being performed by a doctor/paediatrician.  The midwife
 does an initial check at birth but on about day 3 o! r 4, or
 at least prior to discharge, a thorough physical examination
 performed, including fundoscopy etc. by a doctor.
 
   Interested in your experiences and for those of you who
 do perform it, have you had any further education on the
 subject?
 
   Cheers
 
   Helen Cahill
 
 
 
 
 
 


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Re: [ozmidwifery] Newborn Examination question

[Judy Chapman]

  We do the newborn examination after birth but then recommend that they go for the 5 - 10 day well baby check with their GP. This is just since we have been working as a birth centre.  Cheers  JudyHelen and Graham [EMAIL PROTECTED] wrote:  Hi everyoneI have a question regarding midwives performing the newborn examination postnatally prior to discharge.   Having worked in several hospitals, I am used to this exam being performed by a doctor/paediatrician. The midwife does an initial check atbirthbut on about day 3 o!
 r 4, or
 at least prior to discharge, a thorough physical examination performed, including fundoscopy etc.by a doctor.Interested in your experiences and for those of you who do perform it, have you had any further education on the subject?CheersHelen Cahill
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Re: [ozmidwifery] Mother friendly hospitals

[Judy Chapman]

This is one reason the people of Mareeba fought so  hard for their maternity ward. We have 3 rooms which used to be two  bedded and have been converted to just one with a Queen size bed, TV,  fridge, table and chairs and an easy chair. Partners are welcome to  stay as are close others if partner not available. I have known a time  when we could not get into a room because of the swags on the floor.  The family lived a long way out and stayed like that a couple of days.  She did not really require help from us, just the ability to get the  bonding going with the rest of her children.   Even if the 3 rooms are in use, we put a camp stretcher for the visitor  in a single room and as soon as a double is avilable they move. It is a  lovely way to work.   Cheers  JudyJohn  Jenny Turnbull [EMAIL PROTECTED] wrote:  Brenda I love your idea!Weather a hospital is baby or mother friendly or not, is kind of a moot point these days, you are booted out the door so fast.When I had my first child, having just moved to a small country town, no friends or family I was very much on my own, in reflection it was quite a lonely experience. Having some where to stay longer than a few days, for women who have no support would make all the difference.  It would be fantastic to see a trust started for lower income women who could apply to the trust to have a doula for support during the birth and in the first weeks and months (maybe it could be government funded??? here's hoping).  I am only just being to realise how important the experience a mother has in the first few weeks and months of her babys life really is to her, what an imprint it leaves on her heart and psyche.- Original Message - From: "Barbara Glare  Chris Bright"!
  To: Sent: Wednesday, November 23, 2005 6:03 AMSubject: Re: [ozmidwifery] Mother friendly hospitals Hi, I really disagree that baby friendly hospitals are OK for the baby but  tough on the mother.  And if your baby friendly hospital is tough on the  mother, then you should be looking at why - because it shouldn't be that  way.  The newborn mother and baby are a unit.  They both surely need to be  cared for as though they were one.  I think it's part of the problem of  society that mothers and babies are pitted against each other almost from  birth. Mothers and babies are both usually happier and calmer when together.  If  a mother is of the believe that she needs the baby away from her to rest,  a common enough belief in our society, maybe all that needs to happen is a  little empathy and g!
 ood
 explanations from the staff "I know you are tired,  but what we find is that mothers and babies actually rest better when they  rest together." Just like you would explain to a mum that she doesn't need  to rush off straight away and have a shower - there'll be time for that  later.  Her baby needs to smell her familiar smell and get to know his mum  (and breastfeed) Surely hospitals can be flexible enough for staff to take the baby for a  while if needed - carrying in a sling is great modelling for the mum and  keeps baby calm, or dad or grandma can help out. For every mother I hear when I'm assessing baby friendly hopitals who say  they would have liked a nursery, I hear many, many more whom the staff  told that they must be tired and they would take the baby so the mother  could rest - the mothers lay unsleeping and rigid in their beds, worrying  if that baby t!
 hey could
 hear crying was their baby. Barb - Original Message -  From:  To:  Sent: Wednesday, November 23, 2005 12:27 AM Subject: Re: [ozmidwifery] Mother friendly hospitals Wouldn't it ? I always say baby - friendly is OK for the baby but often it's really  tough on the mothers. We ought to be able to do service to both, compromise being the operative  word. The old days of 'lying in  convalescing' were good for mothers  babies,  I agree with the previous post about too much being expected of new  mothers. Especially after a C/S which after all is major surgery. Yes, birth is a natural process but never the less it's exhausting, hard,  manual  mental labour. Women need to recover  recuperate to co!
 pe with
  the demands of mothering, feeding  running a household. The old 'lying in hospitals ' were not such a bad idea were they ? In  fact I've often thought of the need for a private facility offering those  services nowadays. Like an extended stay unit where women go post birth  for 1 or 2 weeks  get fed,nurtured, educated, assisted with feeding,  shown postnatal exercises, encouraged to rest, have massages, see  naturopaths re healing remedies if needed etc. In fact Wholistic Care !! What do you think ? Idealistic ?? Dean  Jo  wrote: Ahhh! mother friendly hospitals...now that would be worth pursuing! --  No virus found in this outgoing message. Checked by AVG Free
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Re: [ozmidwifery] Antibiotics and Ceasars

[Judy Chapman]

We used to do 3 doses of Keflin but that has  ceased not. I think the anaesthetist, depending on who it is, just  gives a one off dose of cephtriaxone nowdays.   Cheers  Judy  PS Hi Dot, good to see you progressing on, hope all is going well. Dorothy Thomas [EMAIL PROTECTED] wrote:  I have a question to put out to you all, I would just like to know what yourexpereiences are with IV antibiotics and women who have had a C/S as at thehospital in which I work the OB's current trend is to put women who have hadCeasars either elective or emergency on triple AB's for three to five days.The Regieme includes Daily Gentamicin usually 240 mg, Cehpazolin 2g TDS orQID and Flagyl 500 mg TDS, this is usually for 3 Days then they go onto oralFlagyl400mg TDS and oral Cephalexin or sometimes
 Amoxicilin for a furtherfive to ten days.  These are women who are well and healthy who have no realindication for AB's except that they have had surgery,well thats the OB'sexcuse anyway.  So would just like to know what other units are practicingin regards to this and thank you  in advance for any feed back you can giveme.RegardsDorothy ThomasMidwife--This mailing list is sponsored by ACE Graphics.Visit  to subscribe or unsubscribe.
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Re: [ozmidwifery] question from Year 10 student

[Judy Chapman]

I would take a punt at the even pressure of the fluid filled
uterus along with the baby's blood pressure adjusting naturally
to that position. 
Cheers
Judy
--- Bowman Family [EMAIL PROTECTED] wrote:

 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 the boys 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 said I would get back to
 him.  
 It possibly is obvious but I have asked a few peers and no-one
 is definite they have the correct answer.  I thought I would
 throw it open to OzMidwifery for discussion.
 
 Linda




 
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Re: [ozmidwifery] Abby's Birth Announcement

[Judy Chapman]

Fantastic and Congratulations Abby. Love to heare those so
positive stories. 
Cheers
Judy

--- Abby and Toby [EMAIL PROTECTED] wrote:

 HI,
 
 Sorry for the x-post, but thought I would share that
 thismorning at 3:46am I
 gave birth to a beautiful little girl, Runah. After a couple
 of days of
 crazy 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 two
 friends there.
 After having a very traumatic c-section with my first
 daughter, this was
 truly amazing!!
 I am sore, tired and truly EMPOWERED!!
 
 Love Abby
 
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RE: [ozmidwifery] level 2 midwives

[Judy Chapman]

As well, there are limited number of positions for NO2 so that
many midwives who is able to care for complex care patients are
restricted to NO1 positions purely because one does not get the
position and hence pay, on ability but on the number of such
positions avialable. 
Cheers
Judy

--- B  G [EMAIL PROTECTED] wrote:

 Level 2 or Clinical Nurse (now known as Nursing Officer 2)
 midwives do
 not have to be shift coordinators. The position description
 (generic)
 primarily refers to a midwife (nurse) who is able to care for
 complex
 care clients. Unfortunately it is Queensland Health and
 managers who
 have added that aspect of co-ordinating shifts AND taking
 complex
 patient load AND having portfolio's as you describe. this is
 of course
 in your own time as there is never anytime allocated for
 off-line time
 to do these portfolio's If you look at the Nurses Award Qld
 and MX170
 you will find full details of generic position descriptions. 
 In our organisation NO1's co-ordinate as well even with a NO2
 on the
 same shift. They actually get more money for it as it
 incorporates a 'in
 charge of shift allowance' NO2's don't get this. They also
 work in all
 areas you describe as these are not restricted to NO2's. I do
 not have
 on my name badge Clinical Nurse just Midwife.
 It is hoped with Peter Forster's review published 30/9 this
 whole
 workload and off-line time will be reviewed.
 Midwives who work in BC have their salary averaged (all
 penalties) and
 are paid at  NO2
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Alese Koziol
 Sent: Tuesday, 1 November 2005 5:20 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] level 2 midwives
 
 
 Thanks for the clarification Melissa, which state are you
 referring to?
 
 - Original Message - 
 From: Melissa Singer mailto:[EMAIL PROTECTED]  
 To: ozmidwifery@acegraphics.com.au 
 Sent: Tuesday, November 01, 2005 4:37 PM
 Subject: Re: [ozmidwifery] level 2 midwives
 
 Hi Alese,
  
 Level 2 midwife (in a ward hospital setting) is the senior
 midwife on
 that shift who is responsible for the co-ordination of the
 shift as well
 as being a resource person for level 1 midwives.  There is
 usually at
 least one on per shift.  They also have portfolio's such as
 clinical
 indicators, best practice, equip etc.  Other level 2 midwives
 are
 usually early discharge home visiting midwives,  staff
 development
 midwives, midwives responsible for the co-ordination of ANC,
 childbirth
 classes and such.
  
 Midwives who work independently in birth centers here are also
 level
 2's.
  
 Hope that helps
 Melissa
 
 - Original Message - 
 From: Alese  mailto:[EMAIL PROTECTED] Koziol 
 To: ozmidwifery mailto:ozmidwifery@acegraphics.com.au  
 Sent: Tuesday, November 01, 2005 12:47 PM
 Subject: [ozmidwifery] level 2 midwives
 
 Dear list
 Amongst the discussions recently there was mention of a 'level
 2
 midwife'. Could someone please enlighten me... which state was
 this
 terminology used for and what exactly is a level 2 midwife?
 Have a
 medico trying to bully us into using a policy which he has
 obviously
 'borrowed'  which also uses this terminology. It is not used
 in
 Victoria. Many thanks in anticipation
 Alesa
  
 Alesa Koziol
 Clinical Midwifery Educator
 Melbourne
  
 
  
 
 




 
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Re: [ozmidwifery] FYI: News article for QLD maternity

[Judy Chapman]

Hope they save some for up north here.
Judy

--- Megan  Larry [EMAIL PROTECTED] wrote:

 This was on news.com, 
 Megan
 
 Extra $52m for maternity services
 From: AAP 
 
 October 31, 2005 
 QUEENSLAND has announced an extra $52 million for maternity
 services in the
 state's public hospitals.
 Premier Peter Beattie said the Government would provide an
 extra $8.63
 million for maternity services in 2005/06 and the same amount
 for each of
 the next five years to meet increasing demand. 
 On average about 100 babies are born in our public hospitals
 every day,
 which can also stretch maternity services in some areas, Mr
 Beattie said. 
 The $52 million funding boost starts immediately and is
 targeted to enable
 health districts to provide more maternity services and better
 access to
 them. 
 The funding included recurrent allocations of $2.2 million a
 year to the
 Redcliffe-Caboolture district, $1.63 million to the Gold
 Coast, $1.5 million
 to the Bayside district based around Redcliffe hospital, and
 $1.5 million to
 the Logan-Beaudesert area. 
 The money would provide additional beds, staff, equipment and
 support
 services. 
 
 




 
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Re: [ozmidwifery] Re: Midwifery Educators

[Judy Chapman]

Sounds like the birth through water the other day. Said when she
told me she felt like pushing I am obliged to ask you to get
out of the bath, but I can't make you. She stayed. 
Cheers
Judy

--- Maxine Wilson [EMAIL PROTECTED] wrote:

 Ha ha - I remember doing the same in my mid training tho we
 didn't have to do shaves. I could give you an enema if you
 would like one! I would offer.  Never had any takers  The
 power of consent
 Maxine
   - Original Message - 
   From: Ken WArd 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Tuesday, October 25, 2005 9:09 PM
   Subject: RE: [ozmidwifery] Re: Midwifery Educators
 
 
   When I started my mid we were doing shaves and enemas.  It
 was my group of students that facillated change. Maybe because
 we were a generally older lot.  the women were informed they
 wold be shaved and given an enema. If any objection or query
 of the procedure was made they were quickly told that they
 could refuse. All did, and by the time our 12 months were up
 there were no shaves or enemas taking place. Midwives can
 effect change. As to cutting the cord quickly if baby needs
 resus. I have resused 2 flat babies with cord intact, on the
 bed with mum. Bub is getting 02 from mum, and mum is not
 nearly so stressed. Both babies responded well.
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of
 Nicole Carver
 Sent: Tuesday, 25 October 2005 10:36 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] Re: Midwifery Educators
 
 
 Hi Barbara,
 Do your parents have any say in the cord clamping? Perhaps
 they need more information such as at their education
 sessions? We also do active management, but Dad's are still
 able to cut the cord. Not many of our Mum's do physiological
 third stage. However, we had a lotus birth recently which went
 well.
 I believe that although midwives do not have a lot of
 power in hospitals, parents requests are often listened to.
 There is an opportunity to harness this to bring about a
 cultural change, and if parents continue to request certain
 practices they will break down the resistance to change. 
 I have not given pethidine through an epidural before. We
 have infusions though. They are Fentanyl/Marcain and we do obs
 5 minutely for 30 minutes, then full set of obs with pain
 score, sedation score, dermatomes and motor function, then
 pulse, BP, resps and sedation score hourly, with dermatomes
 and motor function 4 hourly. I think it is good to keep your
 obs consistent to save confusion, particularly with new or
 inexperienced staff.
 Cheers,
 Nicole.
 
   -Original Message-
   From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of
 Barbara Stokes
   Sent: Tuesday, October 25, 2005 10:15 AM
   To: ozmidwifery@acegraphics.com.au
   Subject: [ozmidwifery] Re: Midwifery Educators
 
 
   Dear Midwives,
 
   I have just returned from our small hospital midwives
 and doctors breakfast meeting.  This is to encourage
 communication.  We have 4 GP/Obs and 9 midwivies.
 
   On discussion was a new policy for epidural-top ups:
 both pethidine only and marcain/fenytal .
 
   Policy is now insistent on bp obs 5minutely for 30
 minutes for both top-ups.
 
   Other hospitals have had the pethidine only top-ups: 
 prior giving top-up bp, in 5 minutes and then in 15 minutes.
 

 
   Does anyone have an email address for me to contact?
 

 
   Also does anyone have policy or guidelines re allowing
 dads to cut cord?  This meeting has decided that no cord
 clamps (plastic) will be put on set up so the forceps are
 used, Dad can do a token cutting later (?how later) when cord
 clamp (plastic) is to be put on.
 
   I was hailed down when I suggested that a well baby
 could be put onto mum and continue with the cord clamp/ dad
 cutting cord when ready.  If the baby needed active
 resuscitation then quick transfer to resus. trolley would be
 normal procedure.
 

 
   As you will have noticed our GP's only do active 3rd
 stage, mothers have never heard of physiological 3rd stage
 even though same discussed at ante-natal classes.
 

 
   Thanks from a disappointed midwife,
 
   Barbara
 




 
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Re: [ozmidwifery] Re: Midwifery Educators

[Judy Chapman]

They can't be too busy if they have nothing better to do than
nitpick on cord cutting like that. It has been more years than I
can remember that I have put the plastic clamp on first and only
one metal and had dad cut. Of course in emergency you do what is
best at the time, but a Policy or guideline for that?
Cheers
Judy

--- Barbara Stokes [EMAIL PROTECTED] wrote:

 Dear Midwives,
 I have just returned from our small hospital midwives and
 doctors
 breakfast meeting.  This is to encourage communication.  We
 have 4
 GP/Obs and 9 midwivies.
 On discussion was a new policy for epidural-top ups: both
 pethidine only
 and marcain/fenytal .
 Policy is now insistent on bp obs 5minutely for 30 minutes for
 both
 top-ups.
 Other hospitals have had the pethidine only top-ups:  prior
 giving
 top-up bp, in 5 minutes and then in 15 minutes.
  
 Does anyone have an email address for me to contact?
  
 Also does anyone have policy or guidelines re allowing dads to
 cut cord?
 This meeting has decided that no cord clamps (plastic) will be
 put on
 set up so the forceps are used, Dad can do a token cutting
 later (?how
 later) when cord clamp (plastic) is to be put on.
 I was hailed down when I suggested that a well baby could be
 put onto
 mum and continue with the cord clamp/ dad cutting cord when
 ready.  If
 the baby needed active resuscitation then quick transfer to
 resus.
 trolley would be normal procedure.
  
 As you will have noticed our GP's only do active 3rd stage,
 mothers have
 never heard of physiological 3rd stage even though same
 discussed at
 ante-natal classes.
  
 Thanks from a disappointed midwife,
 Barbara
 




 
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Re: [ozmidwifery] Obs first visits

[Judy Chapman]

In Mareeba the women are booked under the Midwife's name. I
guess it takes a long time to change. We are not rocking the
boat right now as what we are doing is very different to what
most of the rest of Qld does and we are just too happy to still
be alive. Working with the OB's in Cairns is one of the
conditions of our survival. 
Cheers
Judy

--- wump fish [EMAIL PROTECTED] wrote:

 
 It is very depressing to hear that even when women have
 midwifery-led care 
 they either have to see a dr or have their notes reviewed by a
 dr. As 
 midwives we are the experts in normal and competent at
 identifying when 
 things are high risk or becoming abnormal. Why the hell do the
 drs waste 
 their time 'checking' notes incase we have missed something?
 Is it because 
 the women are booked under their name, therefore they think
 they are 
 responsible for a stuff-up? In the UK low risk women were
 booked under their 
 mw's name unless there were problems. We would get into
 serious trouble if 
 we had missed something and it resulted in a poor outcome
 (very very rarely 
 happened). Responsibility goes hand in hand with autonomy.
 
 Rachel
 

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Re: [ozmidwifery] Re: twins birth story

[Judy Chapman]

Fantastic Yvette.
I have been wondering a lot lately how you went. I wish you all
the best for the future. 
Cheers
Judy

--- Lindsay  Yvette [EMAIL PROTECTED] wrote:

 Hi all,
 Some of you may remember me going on about trying to plan a
 vaginal twins birth.  Babies are 8 weeks old now  here's the
 full birth story.
 http://bellybelly.com.au/forums/viewtopic.php?t=15647
 
 Kind Regards,
 Yvette
 Mum of 5
 http://www.babiesonline.com/babies/t/twingirlslb/




 
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Re: [ozmidwifery] Obs first visits

[Judy Chapman]

At Mareeba the women are not seen by an OB. They are supposed to
have just one visit sometime with a Dr to check they are normal
healthy but that does not always happen. 
All charts are case conferenced with the supporting OB and
suggestions for care are discussed if there is anything out of
the ordinary in their history and it in then that they are
classed as fit to birth with us or needing to go to Cairns. 
Cheers
Judy

--- Sonja  Barry [EMAIL PROTECTED] wrote:

 
 Dear all,
 I am hoping for some information about midwifery/maternity
 units that don't require women to be seen by an obstetrician
 at any stage throughout their pregnancy.  Info I need is do
 the midwives listen for heart sounds etc, do they see a GP, or
 is this all quite irrelevant and thus no needs to do any of
 these checks?  Some places call this a first visit, whilst
 others may use these checks to allow women access to birth
 centres etc.  I hope this makes sense.
 Regards Sonja




 
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RE: [ozmidwifery] Infant Sleep

[Judy Chapman]

Just like they hide sugar in everything. 
Judy

--- Ken WArd [EMAIL PROTECTED] wrote:

 Having a little one with milk protein allergy I have learnt to
 check all
 labelling. They hide milk in just about everything.
   -Original Message-
   From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of
 Emily
   Sent: Thursday, 20 October 2005 2:09 PM
   To: ozmidwifery@acegraphics.com.au
   Subject: Re: [ozmidwifery] Infant Sleep
 
 
   hi there
   im vegan so heres a few yummy dairy free breakfast ideas: u
 can use rice
 or soy milk on cereals
   - porridge with tahini, honey and fruit
   - corn puffs (organic bags sold in coles and woolies) with
 fruit and soy
 yoghurt
   - weet-bix are dairy free too
   - rye toast with avocado and tomato  / baked beans (protein)
 / tahini and
 fruit / soy cream cheese and tomato
   - you can get nuttelex margarine if you miss butter
   - you can use silken tofu to make a scramble sort of like
 scrambled eggs
 and add whatever you like to it (tomato, parsely, herbs)
   - soy milk smoothies with fruit, honey and cinnamon
   ..
   etc etc
   hope you (and bub) enjoy
   love emily
 
   Pinky McKay [EMAIL PROTECTED] wrote:
 ??porridge/ buckwheat pancakes without eggs? wholemeal
 toast and jam/
 honey/
 avocado/ banana?
 It really is a change of mindset isnt it?
 
 - Original Message -
 From: JoFromOz
 To:
 Sent: Monday, October 17, 2005 10:38 PM
 Subject: Re: [ozmidwifery] Infant Sleep
 
 
  Pinky McKay wrote:
 
  Jo- as I am researching for sleep book - in one sleep
 study in UK -
 12 %
  of bubs for whom no other reason for sleeplessnes was
 discovred, were
  found to be sensitive to dairy- dairy removed for 5
 weeks and then
  challenged - all but one bub reacted again with
 sleeplessness. Bubs
  challenged again 12 months later and 10 / 15 still
 reacted. Allergic
  symptoms are not necessarily gut related - there is
 also a diff !
 between
  food allergy and intolerance. Would be very suss if
 your breastfed
 bub
  has excema that he is sensitive to something dietary.
 You would need
 to
  eliminate ALL dairy - including milk in bought
 biscuits/ yoghurt etc
 etc
  for at least ten days - but it could be worth a try.
 
  Pinky
 
  Oh wow, I didn't realise it could show up in non-gut
 ways. Ok, this
 could
  be tough, but hell, it's worth it. Eggs on toast for
 breakfast for me!
  (no butter). Could he be sensitive to eggs, too? Damn,
 fruit for
  breakfast... ;)
 
  Thanks :)
 
  Jo
 
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Re: [ozmidwifery] Infant Sleep

[Judy Chapman]

My sister found out that it was carbonated softdrinks that was
upsetting her second baby and driving her nuts. Not fizz, no
fuss. Many thanks to the Child Health Nurse who twigged to it. 
Judy
--- Pinky McKay [EMAIL PROTECTED] wrote:

 clever bub refusing to drink the chamolmile - its related to
 severe allergic 
 reactions in some bubs.
 Jo another thought - have you seen Sue Dengates work? She is
 an absolute 
 wealth of knowledge on food additives -and not just artificial
 stuff, 
 although I heard her speak a couple of weeks ago and she
 mentioned a baby 
 who cried 18 hrs a day -mum and bub both admitted to hospital
 (any 
 wonder?) - turned out to be  areaction to preservatives in
 bread. There can 
 be naturally occuring chemicals in otherwise healthy foods
 too.
 
 Check out Sues website
 http://www.fedupwithfoodadditives.info
 
 Pinky




 
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Re: [ozmidwifery] Scottish dads push wives toward C-sections? I don't think so

[Judy Chapman]

Just beware the documentation. It is not enough to say that you
discussed the pro's and con's of the course of action, you have
to write exactly what you said. 
Cheers
Judy

--- wump fish [EMAIL PROTECTED] wrote:

 People will try and sue for a poor outcome regardless of the
 info given etc. 
 But, if you have provided them with adequate info, and they
 have made their 
 choice and you exercise the 'expected' level of skill - their
 case will be 
 unsuccessful.
 
 I've just finished a legal, risk management course and learned
 a lot. People 
 will sue whatever (and unpredictably sometimes), but you can
 protect 
 yourself against them being successful. Women and their
 partners need to 
 take responsibility for their birth experiences, and we should
 be 
 encouraging them to do so.
 
 Rachel
 
 
 From: brendamanning [EMAIL PROTECTED]
 Reply-To: ozmidwifery@acegraphics.com.au
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Scottish dads push wives toward
 C-sections? I 
 don't think so
 Date: Sun, 16 Oct 2005 15:27:07 +1000
 
 Whilst I agree totally in theory..
 Bad workmen always blame their tools.
 I mean we are all talking about 35 years exp of 'seeing'
 births or 
 deliveries here are we not ? I too had a KRF del x 1  was OK
 afterwards so 
 it isn't a personal bias (mind you, made sure I had the next
 babies at home 
 !!). Just observation  experience.
 Whatever the instrument, NB, Wrig, Keill  it's
 incidental, whatever the 
 surgery it's incidental, damage happens. Some places don't
 use Keill 
 anymore because they cause maternal damage, in inexp hands,
 if they kept 
 using them knowing this, we'd consider them negligent
 wouldn't we ?
 Some folks love the Ventouse, some hate it.
 Some folks love EL C/S, some condemn it.
 We've all seen horrific outcomes from what we thought ( to
 all intents  
 purposes appeared) to be NVDs at the time haven't we ?
 I have actually been present on more than one occasion when
 an OB has given 
 what I considered (given the time, energy  urgency in the
 situation) to be 
 a very reasonable  balanced summary of events with choices,
 options, 
 rationales, possible sequalae etc  the woman  her support
 team have made 
 their choices  then.. sued later.
 
 Go figure
 As I say, emotive, subjective stuff all the way isn't it ?
 
 With kind regards
 Brenda Manning
 www.themidwife.com.au
 
 
 - Original Message - From: Ken WArd
 [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Sunday, October 16, 2005 2:34 PM
 Subject: RE: [ozmidwifery] Scottish dads push wives toward
 C-sections? I 
 don't think so
 
 
 Sorry, I too have seen some dreadful injuries, but not with
 Kielland, and 
 my
 own experience with the Kielland was okay, no episi and only
 a very small
 tear. Which I thought was pretty good considering the huge
 epises I'd had
 with the others. It was the Neville Barnes forceps that did
 the damage, 
 not
 to me but the baby, and I think it was the stuck shoulders
 that caused the
 neck.  Some of the worse injuries I have seen have been
 wriggleys lift 
 outs.
 Dreadful placement of the blades, although my 2 wriggleys
 births were 
 fine,
 no probs with me or the babies. We do need to remember that
 not all forcep
 births result in injury, and are sometimes necessary
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of
 brendamanning
 Sent: Sunday, 16 October 2005 12:12 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Scottish dads push wives toward
 C-sections? I
 don't think so
 
 
 Ken,
 
 Your story is a very common one.
 I think we all saw a good many Keillands Rotations in our
 day  often the
 dreadful resulting lacerations  pain, injury  suffering
 that went along
 with them for mother  baby.
 I agree with Rachel in that often this was caused by
 operator error, the 
 Reg
 'practising' (foot on the end of the bed stuff, makes me
 shudder to think
 about it).
 Fourth degree tears were not uncommon  the long-lasting
 damage to babies,
 womens minds, pelvic floors  pelvic organs was horrendous.
 BUT.and I realise this could be construed as
 inflammatory but
 it's not intended to be, really !!
 Perhaps in the age of 'new obstetrics' if women ceased
 sueing OBs for
 everything that went wrong then they (the OBs) wouldn't all
 be resorting 
 to
 C/S at absolutely any excuse.
 Really it's a very emotive argument  the OBs are damned if
 they do  
 damned
 if they don't. Sometimes we midwives are in the same boat !!
 I'm not defending them overly here, just telling it like it
 is.
 The OB is the story below emerges as skilled but he could
 just as easily
 have had the arse sued off him for mishandling or something
 if the outcome
 had been less favourable couldn't he?
 
 
 With kind regards
 Brenda Manning
 www.themidwife.com.au
 
 
 - Original Message -
 From: Ken WArd [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 

Re: [ozmidwifery] 4ft 9 and birthing

[Judy Chapman]

When will the actually look at the woman. Most women of that
size will have an appropriately sized baby and no problems -
something we have all had experience with. 
Cheers
Judy


--- Robyn Dempsey [EMAIL PROTECTED] wrote:

 Wump fish was saying last week an Ob said a primip who was 4ft
 9' should have a c-section over natural childbirth.
 
 Well, that's my height, my husband is 6ft 2! I'm a midwife,and
 was doing my training when I fell pregnant with my first baby.
 I  had sooo many Obs telling me that 'you'll be a c-section',
 that, had I been any other person, it would have totally
 eroded my confidence to birth.
 
 I've had 3 babies, all born at home..does anyone
 realize that 1/3 of the worlds population is about that
 height?
 
 Robyn Dempsey




 
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Re: [ozmidwifery] Scottish dads push wives toward C-sections? I don't think so

[Judy Chapman]

Be good to start a trend with that one!!!
Judy


--- Maxine Wilson [EMAIL PROTECTED] wrote:

 What about when you feel like giving the drugs to the
 obstetrician!
 Maxine
   - Original Message - 
   From: Ken WArd 
   To: ozmidwifery@acegraphics.com.au 
   Sent: Friday, October 14, 2005 11:04 AM
   Subject: RE: [ozmidwifery] Scottish dads push wives toward
 C-sections? I don't think so
 
 
   I have given women drugs in labour at their partners demand.
 Also epidurals and c/s organised because the partner wasn't
 coping. It is devesting when a woman is labouring well, and
 her partner, or sometimes her mother, isn't coping and
 undermines the woman's confidence in her body. I have often
 felt like giving him the drugs. One feels hopeless and
 helpless when adverse comments and stressed support people
 influence the woman. And lets face it, in the hospital setting
 who has the strongest and personal relationship, and therefore
 more likely to influence ?
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of
 Gloria Lemay
 Sent: Friday, 14 October 2005 5:59 AM
 To: Undisclosed-Recipient:;@uniserve.com;;;
 Subject: [ozmidwifery] Scottish dads push wives toward
 C-sections? I don't think so
 
 
 This is a group that no one has thought to blame the high
 cesarean rate on.  Hmm.  Gloria
 
 
 
 Scotland on Sunday - October 2, 2005
  
 Squeamish men pushing wives towards Caesareans 
 
 RICHARD GRAY 
 HEALTH CORRESPONDENT 
 
 
 FRETTING fathers-to-be are fuelling Scotland's soaring
 Caesarean section
 rate because they do not like to see their pregnant
 partners in pain,
 midwives have warned. 
 They claim many worried husbands are afraid of the mess
 and noise that
 accompanies natural childbirth. 
   Instead they are encouraging their wives to give birth
 at large
 consultant-led hospital units where they can get powerful
 painkillers and
 surgery. 
 But midwives claim these over-protective men are
 unwittingly causing their
 partners to have unnecessary Caesarean sections and drugs
 by taking them to
 these baby factories. 
 They say more women would have natural births if they used
 smaller
 midwife-run maternity units. 
 The proportion of women choosing to have Caesareans has
 leapt from 6.2% to
 9% in the last 10 years with more than 4,600 women
 choosing to have the
 major surgical procedure in 2004. 
 Experts claim the increase in popularity is mainly due to
 the misconception
 that Caesareans are a safer and pain-free option to
 traditional childbirth. 
 But the abdominal surgery can leave mothers in pain for
 weeks afterwards and
 they are prone to getting infections in their wound. 
 The controversy surrounding Caesareans has led to tensions
 between midwives
 and doctors over the best way of providing services to
 pregnant women. 
 Earlier this year the Royal College of Midwives launched a
 campaign to
 promote normality in childbirth. 
 Phyllis Winters, a midwifery team leader at Montrose
 Community Maternity
 Unit, believes the celebrity trend of opting for
 Caesareans has helped
 create the myth that surgery is the easier option. 
 But she believes squeamish husbands have also played a
 part in the decline
 of natural childbirth. 
 She will present her claims at a conference organised by
 the National
 Childbirth Trust (NCT) and the Royal College of Midwives
 in Dunfermline,
 Fife, on Thursday. 
 Winters said: A lot of couples take decisions about
 childbirth together and
 men in particular feel wary about childbirth. 
 They are frightened about seeing their partner in pain
 and about what can
 go wrong. As a result they often prefer to go to the
 consultant led unit
 where they perceive there is a higher level of care. 
 Unfortunately there is also a higher level of
 intervention when it is not
 needed. In Montrose less than 8% of the births we deal
 with at the
 midwife-led unit get transported to the specialist unit
 due to complications
  
 Women need more positive role models to have natural
 births and perhaps
 then we will see a change in the way society views what is
 a natural life
 event. 
 Men also have to understand that by going to a
 midwife-led service they are
 not taking a risk. 
 Currently just 63% of all babies born in Scotland are
 delivered naturally,
 but midwives claim the vast majority of births using
 Caesarean sections and
 induction should be allowed to happen naturally. 
 Patricia Purton, director of the Royal College of Midwives
 Scotland, agreed
 that fathers-to-be played a significant role in helping
 women choose their
 method of birth. 
 She added: I would go further, as a lot of women's
 mothers have only ever
 experienced consultant led services and so that 

RE: [ozmidwifery] Induction and third stage labour

[Judy Chapman]

I think I would be tempted to say that mild jaundice is normal.
I can't see primative man cutting the cord so quickly as we do
and somehow he managed to survive and even proliferate. Where I
work we do a lot of physiological third stages, late cord
clamping and early breastfeeding and many babies have a bit of
jaundice colour but it is not pathological. We do very few SBR
blood tests. Probably helps that we don't have onsite pathology,
it has to go to the tertiary hospital so it makes one think if
one really needs to. Haven't had to use the phototherapy for
ages. 
Cheers
Judy
 
--- Nicole Carver [EMAIL PROTECTED] wrote:

 There are some who believe the higher levels of antioxidants
 caused by
 jaundice may be protective of babies, and mild jaundice 'may'
 be normal.
 Nicole.
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] Behalf Of lisa
 chalmers
 Sent: Wednesday, October 05, 2005 11:48 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Induction and third stage labour
 
 
 My experience of this, is that if the cords are not cut until
 they have
 finished pulsing, babies seem to develop jaundice for
 longer..(that the
 usual standards) . That makes complete sense to me, since they
 get more
 blood than babes that had cords clamped and cut quickley.
 I'm sure I read somewhere that babies are deprived of as much
 as 25% of
 their blood volume by cutting the cord.
 Nearly everyone I know that did not cut the cord, had babies
 that developed
 Jaundice. Nothing serious just yellowing.
 - Original Message -
 From: Andrea Quanchi [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Wednesday, October 05, 2005 9:33 AM
 Subject: Re: [ozmidwifery] Induction and third stage labour
 
 
  There are many reasons that influence whether a baby gets
 jaundiced or not
   Two of these are
  1. prematurity ( of the liver as well as dates, some babies
 livers take
  ages to be efficient enough to clear the jaundice.
 
  2. Not passing mec soon after birth. The longer the mec
 stays inside the
  more bilirubin is reabsorbed increasing the workload of the
 immature
  system.  This is usually influenced by how quickly the baby
 is able to
  feed.
 
  The thing about synt is that it is often used to augment
 labour in a woman
  who has been labouring for hours or to induce labour in a
 woman who is not
  yet ready to go into labour and the result is a tired mother
 and baby who
  often dont come together well to feed without good
 assistance. This is
  often not forthcoming in the hurry to get things cleaned up,
 the  move to
  the postnatal ward and paper work to be done.  Ask your
 friend and she
  will probably not have seen jaundice in a woman who has had
 synt but had a
  quick labour.  Most women who birth in hospitals have synt
 in some form or
  other for 3rd stage and the level of jaundice in some
 settings is very
  low.  I would suggest it may be in direct relationship to
 the length of
  time until feeding is established.
 
  I think the whole reason synt is being used is the concern
 rather than
  blaming the synt for jaundice alone.
 
  Andrea Q
  On 06/10/2005, at 2:03 AM, Belinda wrote:
 
  I have a friend who has been a ipm for many years and she
 believes that
  babies are more likely to get jaundiced when the mother has
 had synto, it
  makes sense of they get that extra unneccessary boost of
 blood.
  Belinda
 
 
 
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Re: [ozmidwifery] VBAC booklet

[Judy Chapman]

Jo,
I would prefer a CD and run off copies at work. That way we can
catch all women who need it rather than just the ones who can
afford it. 
Cheers
Judy

--- Dean  Jo [EMAIL PROTECTED] wrote:

 Hi to everyone who has requested a copy of the booklet.
 I am waiting on Carolyn to come back from a well deserved
 holiday so we
 can confirm the cost for the booklet.  Hard copies will be
 pricey due to
 the size of the booklet and postage, so I am investigating th
 option of
 burning it onto a CD which people can the use to run their own
 copies
 off.  Would this be a more suitable option for people or would
 yu prefer
 hard copies?
 I have taken you names and such and will send an email out
 with all the
 confirmed details.
 Thanks for your support!
 Cheers  
 Jo
 CARES SA
 
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Re: [ozmidwifery] Indigestion at breakfast....

[Judy Chapman]

Excellent letter Justine, I only hope she is open to listening. 
Cheers
Judy

--- Justine Caines [EMAIL PROTECTED] wrote:

 Dear All
 
 My response to Miranda.
 
 JC
 xx
 
 
 Dear Miranda
 
 Your headline today was perfect.  It is unfortunate that the
 story did not
 follow.
 
 I am a Mother of 4, with twins due in November (yes I know
 what
 contraception is!).
 
 I live in rural NSW and have been without a maternity service
 for 15 years
 (long before I had my babies).
 
 We have no specialist Obstetrician nor a GP with obstetric
 training and
 probably never will.
 
 We do however have 3 local midwives who would provide care to
 low risk women
 in our local hospital.
 
 Currently I travel 150 kms to receive antenatal care.  I have
 no choice in
 this care, and the conditions of the nearest unit are
 pre-historic.
 
 Miranda I read some time ago about your experiences and
 understand (correct
 me if I am wrong) that you chose caesarean section.  I respect
 that you made
 that choice.  Do you believe that as a woman I too should have
 choice?
 Because currently like 50% of rural women I have none.
 
 Do you believe that the safety of both myself and baby is
 important? (From
 your story it would seem so)
 
 If you do a little more research on what is happening in the
 majority of
 rural units and even some on metropolitan fringes then you
 would  understand
 that I (as a healthy woman) would be much safer in my local
 community with
 midwifery care (even without on site medical care).  My
 ³choice² now is to
 dodge Kangaroos in labour (no doubt in the middle of the
 night) in an area
 with no mobile coverage, or risk an ambulance ride if it is
 all too quick.
 Why do I say Œrisk¹ well our Ambo¹s who are amazing people are
 not equipped
 for a post partum haemorrhage (they do not carry syntocinon
 which stops
 bleeding, a drug midwives are trained to use and carry). So if
 I have the
 baby enroute and have a big bleed after they simply become
 good drivers.
 Most women do not know this and when we are often talking 2
 hour (road)
 transfers (and then some!) this is very important. If I was in
 my local
 community in a midwifery unit a midwife would have the drug
 and the required
 knowledge to stop the bleeding.
 
 My 3rd baby was a 50 minute labour from one small pain to a
 baby in arms.  I
 know I am much safer with midwives caring for me in a system
 that already
 has safe transfer arrangements for all other conditions (we
 live and drive
 cars and work on farms and have accidents in the country that
 require
 transfer).
 
 By the way where I live is by no means remote, It is in the
 Upper Hunter
 Valley, 2 and a half hours north west of Newcastle.
 
 Women and babies deserve better.  Midwifery clinics can offer
 a choice to
 women that are patently unsafe now.  Midwifery clinics are not
 just better
 than birth on the side of the road, they can safely assist the
 majority of
 women with healthy pregnancies and refer the minority of women
 needing
 medical assistance.  At the moment none of this happens.
 
 I would be happy to talk with you should you be open to
 hearing stories of
 rural women in this situation.
 
 Kind regards
 
 Justine Caines
 
 Phone (02) 65482248
 
 
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RE: [ozmidwifery] Oral EPO dose for cervix?

[Judy Chapman]

This one? 
http://www.spontaneouscreation.org/index.htm
Cheers
Judy

--- Vedrana Valèiæ [EMAIL PROTECTED] wrote:

 I remember I was reading somewhere about how 40 weeks is not
 the mean duration of pregnancy, it is more, and it is
 different for first and subsequent pregnancies. I can't seem
 to find that article anywhere. This might be of interest to
 her, if I could just find it somewhere... It was pretty old, I
 think from the sixties last centry.
 
 Vedrana
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Kelly @ BellyBelly
 Sent: Thursday, September 22, 2005 3:58 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] Oral EPO dose for cervix?
 
 Thank-you so much for this, have forwarded it to her... She's
 still going at
 40w3d with no signs of anything happening as yet, appointment
 with the high
 risk Ob tomorrow where I know there will be talk of induction
 / caesar...
 Can you please tell me more about this balloon induction - not
 heard of it
 before? Want to be armed with info for what's to come with the
 challenge
 tomorrow... 
 
 Best Regards,
  
 Kelly Zantey
 Director, www.bellybelly.com.au  www.toys4tikes.com.au
 Gentle Solutions For Conception, Pregnancy, Birth  Baby
 Australian Little Tikes Specialists
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Kathy
 McCarthy-Bushby
 Sent: Tuesday, 20 September 2005 5:49 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Oral EPO dose for cervix?
 
 
 Hi Kelly,
 The website www.birthrites.org has a page on natural induction
 including
 information on EPO doses either orally or vaginally, nipple
 stimulation,
 accupressure (4 fingers above the inner aspect of the ankle
 bone). EPO, is
 great for women planning a vbac for ripening the cervix, but
 if she doesn't
 get into labour naturally, EPO can make the cervix ripe for
 ARM and the
 balloon induction has been safely used for vbac women with an
 unripe cervix.
 kathy
 - Original Message -
 From: Kelly @ BellyBelly [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Monday, September 19, 2005 12:05 PM
 Subject: [ozmidwifery] Oral EPO dose for cervix?
 
 
 Hello everyone,
 
 I know it's probably a bit late to try this, but I have a mum
 who's hoping
 for a VBAC, EDD today but in order to beat a caesar (they wont
 induce her of
 course) we're thinking of giving EPO a go to help with
 ripening her cervix.
 I have read somewhere that 500mg tid is often used - can
 anyone confirm or
 recommend dosage they have used? She'll ask a herbalist none
 the less, but
 often I find they aren't well versed on specifics for preg 
 baby like this.
 Also her BP is creeping up a little, she had pre-eclampsia
 with the first
 but obviously done well with this pregnancy - will this still
 be okay with
 EPO or is there something else I could recommend? I think
 she's actually
 quite frightened having had a previous caesar hence the blood
 pressure
 (she's had a great BP otherwise) so I am going to meet with
 her tomorrow to
 hopefully relax her about a vaginal birth. She's told me in
 fewer words
 she's frightened but I think she's keeping it in - will have a
 big chat
 tomorrow.
 
 Best Regards,
 
 Kelly Zantey
 Director, www.bellybelly.com.au  www.toys4tikes.com.au
 Gentle Solutions For Conception, Pregnancy, Birth  Baby
 Australian Little
 Tikes Specialists
 
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Re: [ozmidwifery] Question

[Judy Chapman]

The only experience I have had of this is as the admitting
midwife when a woman came in from a home birth with a 4th degree
tear. She fed babe while waiting for OR, had the repair and went
home again when she had recovered from the anaesthetic. As I saw
her around town many times later I found that she had no
problems with it. 
Cheers
Judy


--- Philippa Scott [EMAIL PROTECTED] wrote:

 This question/assumption was put forward on another list  I
 wondered whether you wonderful women would be able to answer
 it for me as I have no idea really.
 
 What happens if the mother sustains a 3rd or 4th degree tear
 at a homebirth?
 
 Do they then have to travel to a hospital to get it all
 repaired? Surely this would increase the possibility of
 infections and post birth problems?
 
 I know there is NO WAY a midwife could stitch up that serious
 a tear so was just curious about what would happen in that
 situation (if anyone knows??)
 
 
 Cheers
 Philippa Scott
 Doula
 Birth Buddies
 Supporting Women ~ Creating Life
 President - Friends of the Birth Centre Townsville




 
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Re: [ozmidwifery] Tears and repairs

[Judy Chapman]

Honey,
I feel that 3rd and 4th deg tears are getting out of the
ordinary and the woman needs a really good repair to function
well afterwards, this puts it in the realms of an OB. As well as
that the repairs can be quite painful and it is not unreasonable
to offer a proper anaesthetic for it. There is an upper limit on
the amount of local one can give, probably not enough for such
an extensive tear. 
I watched an OB repair a 4th deg tear once and he explained each
step. By definition the rectal mucosa has been torn and it must
be repaired with no stitches through into the surface of the
mucosa, that increases the chance of infection and formation of
fistulas etc, very tricky work. Then the torn ends of the anal
sphincter muscles must be located and properly repaired or she
may end up with faecal incontinence. After that the perineum and
vaginal mucosa. A good repair takes ages. 
Cheers
Judy

--- Honey Acharya [EMAIL PROTECTED] wrote:

 I am curious about something (and I know it is fairly rare
 with homebirth) but for experienced midwives I assume you
 would stitch tears yourself even if they were 3rd or 4th
 degree, but I don't want to make assumptions so is that the
 case? Or would you transfer to hospital to have a doc stitch
 it,  or for  the extra pain relief so you could stitch it
 yourself? At what point?
 
 Thanks
 Honey
 




 
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Re: [ozmidwifery] wyong reopens

[Judy Chapman]

Fantastic news, Congratulaions to all. 
Cheers
Judy

--- diane [EMAIL PROTECTED] wrote:

 Hi everyone,
 Hot breaking news today... Wyong birthing unit is opening next
 Monday as a low risk birthing unit. Anything outside the ACMI
 guidelines are refered or transfered to Gosford. We're so
 excited
 Cheers
 Diane




 
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Re: [ozmidwifery] care of the newborn

[Judy Chapman]

They obviiously don't believe the babies are normal healthy babies.
Judysally williams [EMAIL PROTECTED] wrote:
I am sure we have discussed this before but as usual discarded info coz notrelevant to me at that point!!Does anyone have guidelines for care of the normal healthy term infant? I amembarrassed to ask, really, because for me it is not an issue. However, somemidiwves in our unit are doing pre-feed obs on all newborns until they gohome!!!Very frustrating, but true. I need something in black and white to put infront of them to show it is utterly and completely unnecessary.Thanks in advanceSally- Original Message -From: "Jo Bourne" <[EMAIL PROTECTED]>To: Sent: Friday, September 16, 2005 9:41 PMSubject: Re: [ozmidwifery] another fyi... I can't give you a bunch of references but my understanding is that thereis a lot of research out there supporting this !
 and none
 that contradicts it,at least in terms of fertility, I don't know as much regarding pregnancy.IVF clinics break down their stats by age for a reason. Here are SIVFsstats: http://www.sydneyivf.com/pages/success/index.cfm Most clinics give stats slightly differently (ie by clinical pregnancy orby live birth, by transfer or stim cycle) but they all break them down byage and SIVFs stats are probably better than average for older women. If youask your Fertility Specialist (if you are unfortunate enough to need one)about your specific chances a good clinic can give you stats for your ageand diagnosis. Age ALWAYS comes into it. The older you get the greater the chance is that a small problem thatmight have delayed conception will become a big problem that prevents it.Sometimes women who needed IVF for #1 fall pregnant naturally or more easilythe second time around but I seem to hear far more!
  often
 that #2 turns outto be even harder - the initial problem having been worsened by a couplemore years passing. Also to address something from the article that is not really correcthere - in Australia the highest risk of multiples is with lower end assistedreproduction such as ovulation induction or IUI, not IVF. In my case forexample we abandoned ovulation induction in favour of IVF to preventmultiples. In fact putting back only one embryo at a time you have lesschance of twins doing IVF than conceiving naturally (you can still getidentical twins, at a slightly higher rate than natural identicals, but yourule out fraternal twins which are far more common). Not really relevant tothe age thing but it's an annoying misconception. cheers Jo At 10:04 PM +1200 16/9/05, Safetsleep wrote: wonder how many studies involved .i would be interested to see theactual s!
 tudies
 and stats., miriam  - Original Message - From: "Jennifairy" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]>; Sent: Friday, September 16, 2005 9:37 PM Subject: [ozmidwifery] another fyi...  http://news.bbc.co.uk/2/hi/health/4248244.stm  Delaying babies 'defies nature' *Women who wait until their late 30s to have children are defying natureand risking heartbreak, leading obstetricians have warned. *  Over the last 20 years pregnancies in women over 35 have risen markedlyand the average age of mothers has gone up.  Writing in the British Medical Journal, the London-based fertilityspecialists say they are "saddened" by the number of women they see who haveproblems. 
 They say the best age for pregnancy remains 20 to 35.  Over the last 20 years the average age for a woman to have their firstbaby has risen from 26 to 29.   * The message that needs to go out is 'don't leave it too late' * Peter Bowen-Simpkins, Royal College of Obstetricians and Gynaecologists  The specialists, led by Dr Susan Bewley, who treats women with high-riskpregnancies at Guy's and St Thomas' Hospital, warned age-related fertilityproblems increase after 35 and dramatically after 40.  Other experts said it was right to remind women not to leave it toolate.  * 'Having it all' *  In the BMJ, the specialists write: "Paradoxically, the availability ofIVF may lull women into infertility while they wait for a suitable partner!
 and
 concentrate on their careers and achieving security and a comfortableliving standard."  But they warn IVF treatment carries no guarantees - with a high failurerate and extra risks of multiple pregnancies where it is successful.  For men, there are also risks in waiting until they are older to fatherchildren as semen counts deteriorate with age, they say.  Once an older woman does become pregnant, she runs a greater risk ofmiscarriage, foetal and chromosomal abnormalities, and pregnancy-relateddiseases.  They add: "Women want to 'have it all' but biology is unchanged.  "Their delays may reflect disincentives to earlier pregnancy or maybe anunderlying resistance to childbearing as, despite the advantages broughtabout by feminism and equal opportunities legislation, women still bear fulld!
 omestic
 burdens as well as work and 

[ozmidwifery] I am steaming mad

[Judy Chapman]

Have just heard from my brother. One of his daughters has just
had her second baby, somewhere Melbourne way. First baby, normal
birth, not small but I don't know the weight. She was told this
one was big, probably over 11 lbs so she was scared and had a
CS. Came out less than 9 lb. Child is in SCBU (surprise,
surprise). Grrr
Judy

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Re: [ozmidwifery] Re: ] Friend with breach baby...told CS only options.

[Judy Chapman]

Thanks for this Gloria,
It makes things a lot clearer.
Cheers
Judy

--- G Lemay [EMAIL PROTECTED] wrote:

 
 There ARE some important things with breech.  This is where
 your anatomy
 and physiology of the newborn is very important. 
 Understanding the
 circulatory system of the baby, the way the bones in the head
 fold over
 each other and the concept of creating an airway are some
 important
 considerations.  The main rule is HANDS OFF, however, that
 is not all
 there is to it. With breech births it's important to have a
 period of 45
 mins from the time the woman feels like pushing till when she
 actively
 pushes, in order to prevent the head being caught on an
 undilated
 cervix.  Once the baby is born to the umbilicus, you have 7
 mins to
 complete the birth.  You want to avoid rushed handling but you
 also
 don't want to sit there like a lump.  The baby can be provoked
 to draw
 breath or shoot his/her arms above the head by meddlesome
 handling.  The
 body hanging (and I especially like the all 4's position for
 this) is
 Nature's way of bringing the back hairline to the introitus of
 the
 vulva.  Sometimes, even without stim. the arms will be up and
 it's
 important to turn the babe's hips using a cloth and not
 touching the
 delicate organs in the belly (you can rupture organs with your
 pointy
 little fingers when the baby's abdomen is engorged and your
 adrenal is
 running) so that the shoulders are antero-post diameter in the
 pelvis,
 then reaching in and gently sweeping them down.  sometimes
 this requires
 a second demi rotation for the second arm.  Once the babe's
 hairline is
 visible, then, it's important NOT to let the crown of the head
 POP.
 Popping can result in a fatal tear to the cerebral
 tentorum---a drumlike
 membrane over the brain.  So, at this point, you reach a
 finger in, get
 the baby's lower jaw and gently pull the mouth and nose into
 sight.
 Once there, the mother is told Stop all pushing.  Then she
 can stay
 like this for a very long time and all is well.  You want her
 to easy,
 easy, easy get the top of the head born so there is no pop
 and you
 know you have an airway to that baby.
 
 One of the guidelines that Michel Odent stresses is to watch
 the first
 stage to tell you how the second stage will go with a breech. 
 If you
 have a smooth, progressive first stage, the second stage will
 follow
 that way.  If you're having a breech birth where the progress
 gets hung
 up or stuck and the butt doesn't come down to the vulva on its
 own, you
 want to consider cesarean as a safer option.
 Gloria
 
   Vedrana Valèiæ wrote:
 
   Thank you, Gloria. In this article, it is said again that
 nothing must
   be done except flexing the head at the end and putting the
 woman in
   hands and knees position (or any position she feels right,
 I
   suppose?). Is there more to it than I'm getting. Because if
 there
   isn't, it sounds really simple to me. Do not interfere,
 just like in
   other kinds of births.
  
  
  
   Vedrana
 
 
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Re: [ozmidwifery] FW: Article re. caesars....

[Judy Chapman]

Probably should send this one to Pesce if you already have not.
Judy


--- Denise Hynd [EMAIL PROTECTED] wrote:

 
 Subject: RE: [MCMgtCte] FW: Article re. caesars
 
 
 See: http://www.forensic-psych.com/articles/artMedMal.html
 
  
 
 A Plaintiff's Verdict: Meador v. Stahler and Gheridian -
 The $1.5 million award to a Massachusetts woman and her family
 in Meador v. Stahler and Gheridian3 made news as a rare
 instance of a malpractice judgment based on an allegedly
 unwanted and unnecessary cesarean section rather than a
 failure to perform such an operation. The plaintiff, Mary
 Meador, did not claim that the procedure was negligently
 performed or that the rare and disabling physical
 complications that resulted from it (which left her largely
 bedridden and unable to work or meet her family
 responsibilities for several years) were foreseeable. Instead,
 she claimed that the defendant obstetricians had
 misrepresented the risks of the alternative procedure (vaginal
 birth after prior cesarean) and ignored her persistent pleas
 for this alternative. Moreover, she alleged, they compelled
 her passive assent to the surgery in an emotionally coercive
 manner while she was progressing normally in labor, despite
 their having previously agreed to such a trial of labor. -
 Because the consequences of the cesarean were unforeseeable,
 and because Meador had signed a consent form for the surgery
 (to be used in case of emergency), this case did not meet the
 technical requirements specified under Massachusetts law4 for
 an action based on informed consent. Instead, the case was
 brought on the theory that the physicians' failure to obtain
 the patient's informed consent constituted substandard,
 negligent medical care. The forensic psychiatrist's expert
 testimony emphasized that the pro forma signing of a consent
 form did not constitute true informed consent, especially in
 light of the physicians' alleged disregard of the patient's
 expressed wishes and their inaccurate representation of the
 risks and benefits of the approach she preferred. 
 - The psychiatrist also explained to the jury how Meador's
 life history left her vulnerable to experiencing the denial of
 informed consent as a highly traumatic event. Having coped
 since childhood with serious illnesses in her family, Meador
 had viewed doctors and nurses as nurturing figures who helped
 her gain control of potentially tragic situations. She had
 learned that choice was still possible even amidst illness and
 death. She had even been inspired to become a nurse herself
 and to teach this discipline to others. Thus, when she
 experienced a sudden loss of choice and control during
 childbirth, she reacted with intense fear and horror and felt
 she had been betrayed by health professionals, whom she now
 feared and mistrusted. In this way she lost her accustomed
 strategy for coping with life. Moreover, having helped hold
 her original family together in the face of tragic illness,
 Meador saw the family she had created torn apart by her sudden
 and devastating loss of control in a medical situation. The
 jury's recognition of the importance of the emotional facts of
 the case was highlighted by its awarding almost one-third of
 the total damages for loss of consortium. -
 Thus, it was not simply the physically disabling consequences
 of the surgery, but the loss of personal decision-making power
 concerning her body, her health, and the birth of her child,
 that caused Meador to suffer from Post-Traumatic Stress
 Disorder. Similarly, her husband's experience of loss of
 consortium was exacerbated by the physicians' failure to
 consult him to interpret his wife's wishes during labor.
 Instead of having participated in a true informed-consent
 process, he was left to feel powerless and helpless. In this
 way, forensic psychiatric testimony established a persuasive
 causal link between the lack of informed consent and the
 physical and emotional damages suffered by the patient and her
 family.
 
  
 
 Cheers,
 
  
 
 C
 
 


 
 Subject: [MCMgtCte] FW: Article re. caesars
 
  
 
 The Midwife Strikes Back This is timely with NCAD next
 weekend but I
 must say Andrew P has his facts wrong. A woman sued an OB for
 an unnecessary
 cs in the US and this year won!
 
 Cheers,
 
 Subject: Article re. caesars
 
 http://www.news.com.au/story/0,10117,16490659-421,00.html
 
 One third of Australian births to be caesars
 
 By Adam Cresswell
 05-09-2005
 From: The Australian
 
 THE number of women giving birth by caesarean section is
 rising fast, and
 could soon hit a record of 32 per cent of deliveries - far
 higher than in
 countries such as Britain and New Zealand.
 
 There are more than 250,000 births a year nationwide, and
 emerging hospital
 data indicates the increase in caesarean rates since the
 mid-1990s may be
 accelerating.
 Sally Tracy, associate professor of 

Re: [ozmidwifery] Re:

[Judy Chapman]

Yeah,
We have an expert GP (not) who wants all women to be assessed
by a Dr on admission!!!  This in Mareeba where the Dr has not
been involved at all in normal birth for years and years. You
can imagine our reaction. Our OB in Cairns is NOT impressed and
has written to the appropriate place to say so. 
Cheers
Judy

--- Susan Cudlipp [EMAIL PROTECTED] wrote:

 Yes it was Brenda who wrote that, but I have also been a
 midwife long enough 
 to have seen many breech births - back in the UK, and
 delivered a few 
 myself.  Not all good, mostly quite 'managed' but at least
 they were mostly 
 seen as being manageable vaginally! My own elective C/S
 (nearly 21 years old 
 now!) was for primip breech, although I was given the choice
 of vaginal 
 birth, I knew just what that would entail within the large
 unit that I was 
 obliged to attend - epidural, forceps, episiotomy, and I chose
 not to go 
 there, however at that time there was no question that I would
 not be able 
 to have VBAC with the next - nowadays that is not so.
 
 A year or so back we had a multi with a breech who was lucky
 enough to see a 
 less interventionist OB (as you so rightly guessed Melissa
 :-)) and she 
 chose to have a vaginal birth. Of course it had to be induced
 on the 'right' 
 day, but was very straight forward. Apart from that  we really
 don't see 
 them anymore, and at least one of the few docs who does do
 them does such a 
 horrendous job that I would personally prefer a C/S rather
 than submit to 
 his handling.( you can probably guess that one too Mel!)
 
 It is sad that student midwives today will not learn these
 essential skills 
 within the hospital system.  Personally I feel confident that
 I can handle 
 an unexpected breech, but cannot see how the next generation
 are going to 
 cope with this, there is so much fear of what is really only a
 different 
 variety of birth, in the same way that any 'different'
 presentation is. 
 Anyone who has had the pleasure of hearing Maggie Banks speak,
 watched her 
 video, or that of Michel Odent's work in Pithiers will know
 that this is 
 true
 
 Rachel, I totally empathise with how you are feeling having
 just come to 
 Australia from the UK (been here 15 years myself).  It was a
 real shock to 
 me to see how much all births are seen as being the doctor's
 property.  One 
 of my first births here was in a small hospital and I called
 the GP as per 
 protocol.  He arrived as I had the head in my hands and
 proceeded to rush 
 in, without even washing his hands and virtually pushed me out
 of the way! 
 I looked at him with horror and said quietly  I think I may
 as well finish 
 the job now don't you?  He did step back and let me finish. 
 Some years 
 later he admitted that he had learned a few things from me -
 one of which 
 was to wait for restitution before trying to deliver the
 shoulders!  They 
 were always in such a goddamn hurry to drag the baby out, it
 drove me mad.
 
  When they are faced with an 'expert' obstetrician (often a
 male authority 
  figure) telling them their baby is in danger - they will
 chose to protect 
  their child because as a mother that is their instinct.
 
 An example of this happened to me just this week - the head
 was well and 
 truly crowned (primip, long labour, NO fetal distress) but OB
 insisted on 
 listening to FH immediately ctx ended - it was about 100, and
 he took over 
 from me to apply forceps.  I was not concerned for the baby as
 I knew there 
 had been no compromise throughout and that he would be born
 within minutes, 
 but within the system I am obliged to defer to the doctor's
 judgement, 
 whether or not I agree with it.  Believe me, I know well what
 happens when 
 one tries to argue!!
 
 I hope you maintain your own integrity and autonomy - it is
 very different 
 here to what we knew in UK, but we do need to keep pushing for
 midwifery led 
 care.   I feel that much of the problem lies with how we are
 percieved and 
 presented within this system.  We are seen as being secondary
 and forced 
 into a 'waitress' role, while doctors are glorified as being
 all-knowing 
 experts.  I have spent ages discussing things with couples
 only to have 
 everything overturned by a 5 minute doctor appointment.
 Nice to have your input on the list
 Sue
 The only thing necessary for the triumph of evil is for good
 men to do 
 nothing
 Edmund Burke
 - Original Message - 
 From: brendamanning [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Thursday, September 01, 2005 10:26 AM
 Subject: Re: [ozmidwifery] Re:
 
 
  Rachel,
 
  Actually that was me (Brenda)not Sue,  who wrote about the
 physiological 
  breeches, and I do realise now that experience is rare.
  When you speak about choice  what you'd do if you had a
 breech baby 
  yourself you are really limited because there are not many
 of us in PP who 
  have experience with breeches.
  I would definitely not alter  plans to birth at home if my
 baby was 

Re: [ozmidwifery] More news on midwifery units

[Judy Chapman]

I hope the people of Mona Vale get behind the midwives and jump
up and down, loud and long as they did in Mareeba. If they don't
their service will be shelved for good. 
We certainly got somewhere with the help of the Hirst report and
the support of the Cairns OB's. 
Cheers
Judy

--- Andrea Robertson [EMAIL PROTECTED] wrote:

 These two stories are in the Sydney Morning Herald today,
 along with a big 
 colour photo, on page 3:
 
 
 Pregnant pause as birth program gets the push
 
 By Ruth Pollard, Health Reporter
 September 2, 2005
 
 No continuity … Lisa McLean, with son Luke, two, has lost her
 midwife.
 Photo: Peter Morris
 
 The NSW Government has abandoned a midwife project at Mona
 Vale and Manly 
 hospitals, leaving up to 200 women - some of whom are due to
 give birth in 
 the coming month - to scramble to find places at other
 hospitals.
 
 Just days before the project was to go ahead, the Northern
 Beaches Health 
 Service decided to shelve it and undertake a review of
 maternity services 
 in the area.
 
 Lisa McLean, who is due to give birth in eight weeks, has been
 affected by 
 the change. She was attracted to the program because of the
 continuity of 
 care it provided to expectant mothers, who were to have been
 allocated to 
 one midwife for prenatal, birthing and postnatal care.
 
 Now, the women must choose to give birth at the unit without
 personalised 
 midwives, or find obstetricians or birthing centres elsewhere.
 
 Mrs McLean will stay with the unit but has no idea which
 midwife will be 
 caring for her and her baby. It was to become more of a
 personal, 
 one-on-one experience; they are on call, they are there for
 the birth and 
 the follow-up afterwards. That is the reason a lot of women go
 to 
 obstetricians, even though they don't really need to, to have
 that 
 continuity of care.
 AdvertisementAdvertisement
 
 The general manager of the Northern Beaches Health Service,
 Frank Bazik, 
 said he was not prepared to give his final approval to the
 project before 
 having all maternity services reviewed to determine which
 birthing model 
 was appropriate for each hospital.
 
 Insisting that it had been deferred for only two to three
 months, Mr Bazik 
 said there had been no safety concerns about the program.
 There have been 
 some meetings with the obstetricians about this proposed model
 and they are 
 supportive of it.
 
 However, the Herald understands that staff have been told that
 severe 
 budget problems at the health service were a factor in the
 decision.
 
 Sally Tracy, an associate professor of midwifery practice
 development at 
 the University of Technology, Sydney, said there was no reason
 to defer the 
 program. I have no doubt that they have been bullied into not
 allowing 
 this service to go ahead … Clearly, there are people who have
 vested 
 interests in this, who do not want to see a service where
 women go to 
 midwives.
 ---
 
 
 
 
 Doctors irked at lack of say in midwifery talks
 
 September 2, 2005
 
 
 A rift has emerged between the NSW Government and the
 Australian Medical 
 Association, which says it has been shut out of consultations
 on the 
 development of maternity services.
 
 So deep is the division that the association has begun a
 vigorous campaign 
 to reclaim ground in the debate.
 
 Andrew Pesce, an obstetrician and senior member of the
 association, told 
 the Herald that while a recent review of six international
 studies had 
 found some modest benefits from midwife-assisted births, it
 had also 
 found significant risks.
 
 It showed an 83 per cent increase in the risk of infant
 mortality, he said.
 
 Dr Pesce said NSW Health had made a policy decision to exclude
 the 
 association from consultations, presumably because they know
 how we will 
 respond. But Kathleen Fahy, the dean of midwifery at the
 University of 
 Newcastle, and the co-author of the review, Denis Walsh, have
 disputed Dr 
 Pesce's interpretation.
 AdvertisementAdvertisement
 
 The review, by the international non-profit group the Cochrane
 
 Collaboration, had not found a significant difference in baby
 deaths and 
 it is less then honest of Dr Pesce … to imply that it did,
 Professor Fahy 
 said. After reviewing each of the studies included in the
 review she found 
 60 per cent of women who were supposed to give birth assisted
 by a midwife 
 had been transferred to a hospital.
 
 Yet all the baby deaths were blamed on the birthing centres,
 even if the 
 baby died hours, days or months after transfer to medical
 care.
 
 Most deaths were due to gross prematurity, gross abnormality
 or an 
 unexplained stillbirth, she said.
 
 Their [the doctors'] fear is that midwives will get a
 Medicare number and 
 set up in competition and women may choose midwives as their
 primary care 
 providers rather than doctors.
 
 The association's NSW president, John Gullotta, said yesterday
 that he had 
 also received no response to a request for a 

RE: [ozmidwifery] Re: Breech Babies

[Judy Chapman]

I have just been surfing this site, some good stuff. I have a
multi with a breech at 36+ wke at the moment and I dearly want
her to be able to birth here. 
Cheers
Judy

--- Vedrana Valèiæ [EMAIL PROTECTED] wrote:

 A very interesting discussion on breech births and midwives:
 
 http://www.radmid.demon.co.uk/breech.htm 
 
 Vedrana
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Miriam Hannay
 Sent: Friday, September 02, 2005 6:10 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Re: Breech Babies
 
 I totally understand, Susan about the whole fear of
 breech birth. We have a couple of OBs who will 'let'
 women birth a breech babe vaginally, but fully
 managed, IOL, 16 gauge bores in both arms, hartmann's
 up, McRoberts, episi, full extraction. To me this
 seems torture. I am a second year Bmid student and
 intending to go into independent practice, so am
 availing myself of every extra learning opportunity
 available.
 
 A fellow student and I (my lovely partner in crime),
 attended Maggie Banks' emergency skills workshop in
 Melbourne recently which was SO valuable, and we feel
 much more comfortable about the possibility now. 
 
 I have a dear friend whose first 'catch' as an RM was
 an undiagnosed breech at home, so it does happen. We
 need to be prepared and develop the skills to handle
 this situation. What a shame and potential danger it
 is if these skills fall by the way.
 
 Everyone who can should hear Maggie Banks speak, she
 dispells fears and demystifies like no-one else.
 
 Regards, Miriam (FUSA)
 
 --- Susan Cudlipp [EMAIL PROTECTED] wrote:
 
  Yes it was Brenda who wrote that, but I have also
  been a midwife long enough 
  to have seen many breech births - back in the UK,
  and delivered a few 
  myself.  Not all good, mostly quite 'managed' but at
  least they were mostly 
  seen as being manageable vaginally! My own elective
  C/S (nearly 21 years old 
  now!) was for primip breech, although I was given
  the choice of vaginal 
  birth, I knew just what that would entail within the
  large unit that I was 
  obliged to attend - epidural, forceps, episiotomy,
  and I chose not to go 
  there, however at that time there was no question
  that I would not be able 
  to have VBAC with the next - nowadays that is not
  so.
  
  A year or so back we had a multi with a breech who
  was lucky enough to see a 
  less interventionist OB (as you so rightly guessed
  Melissa :-)) and she 
  chose to have a vaginal birth. Of course it had to
  be induced on the 'right' 
  day, but was very straight forward. Apart from that 
  we really don't see 
  them anymore, and at least one of the few docs who
  does do them does such a 
  horrendous job that I would personally prefer a C/S
  rather than submit to 
  his handling.( you can probably guess that one too
  Mel!)
  
  It is sad that student midwives today will not learn
  these essential skills 
  within the hospital system.  Personally I feel
  confident that I can handle 
  an unexpected breech, but cannot see how the next
  generation are going to 
  cope with this, there is so much fear of what is
  really only a different 
  variety of birth, in the same way that any
  'different' presentation is. 
  Anyone who has had the pleasure of hearing Maggie
  Banks speak, watched her 
  video, or that of Michel Odent's work in Pithiers
  will know that this is 
  true
  
  Rachel, I totally empathise with how you are feeling
  having just come to 
  Australia from the UK (been here 15 years myself). 
  It was a real shock to 
  me to see how much all births are seen as being the
  doctor's property.  One 
  of my first births here was in a small hospital and
  I called the GP as per 
  protocol.  He arrived as I had the head in my hands
  and proceeded to rush 
  in, without even washing his hands and virtually
  pushed me out of the way! 
  I looked at him with horror and said quietly  I
  think I may as well finish 
  the job now don't you?  He did step back and let me
  finish.  Some years 
  later he admitted that he had learned a few things
  from me - one of which 
  was to wait for restitution before trying to deliver
  the shoulders!  They 
  were always in such a goddamn hurry to drag the baby
  out, it drove me mad.
  
   When they are faced with an 'expert' obstetrician
  (often a male authority 
   figure) telling them their baby is in danger -
  they will chose to protect 
   their child because as a mother that is their
  instinct.
  
  An example of this happened to me just this week -
  the head was well and 
  truly crowned (primip, long labour, NO fetal
  distress) but OB insisted on 
  listening to FH immediately ctx ended - it was about
  100, and he took over 
  from me to apply forceps.  I was not concerned for
  the baby as I knew there 
  had been no compromise throughout and that he would
  be born within minutes, 
  but within the system I am obliged to defer to 

Re: [ozmidwifery] Emailing: video05 you will like this

[Judy Chapman]

It's not bad, all in spanish but you get the drift with the
acting and prior knowledge of what goes on. 
Cheers
Judy

--- Ceri  Katrina [EMAIL PROTECTED] wrote:

 I got it, it was a email link for a video of a guy having a
 baby in a 
 very medicalised setting.
 
 
 
 On 03/09/2005, at 3:51 AM, Gloria Lemay wrote:
 
  my virus scanner eliminated it.  Gloria
  - Original Message -
  From: Susan Cudlipp
  To: ozmidwifery@acegraphics.com.au
  Sent: Friday, September 02, 2005 8:06 AM
  Subject: Re: [ozmidwifery] Emailing: video05 you will like
 this
 
  Is this a genuine message or a virus?
  I thought that attachments could not be sent to the list -
 please all 
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  do nothing
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  - Original Message -
  From: lyn lyn
  To: ozmidwifery@acegraphics.com.au
  Sent: Friday, September 02, 2005 7:16 PM
  Subject: [ozmidwifery] Emailing: video05 you will like
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Re: [ozmidwifery] Re-learning how to do breech births

[Judy Chapman]

We northerners really enjoyed the workshop in Townsville last
year and I imagine there would be enough midwives to do another
up north, maybe sunny Cairns this time? 
Cheers
Judy

--- Andrea Robertson [EMAIL PROTECTED] wrote:

 Hello Denise,
 
 There is a lot of interest in this workshop, but where and
 when we can get 
 it organised will depend on Maggie's availability. She is keen
 to help 
 Aussie midwives, and between us, we'll see what we can
 arrange. I know you 
 are keen in Perth will keep you posted.
 
 Regards,
 
 Andrea
 
 
 At 04:53 PM 3/09/2005, you wrote:
 Dear Andrea
 When will you add Perth to the this program??
 Denise Hynd
 
 Let us support one another, not just in philosophy but in
 action, for the 
 sake of freedom for all women to choose exactly how and by
 whom, if by 
 anyone, our bodies will be handled.
 
 - Linda Hes
 
 - Original Message - From: Andrea Robertson 
 [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, September 02, 2005 8:43 AM
 Subject: [ozmidwifery] Re-learning how to do breech births
 
 
 Hello listers,
 
 Yesterday I was talking to Maggie Banks about scheduling
 some more of her 
 wonderful Birthspirit Intensive workshops for 2006. We hope
 to take in 
 Adelaide and Brisbane as well as Sydney and Melbourne next
 year, given 
 their enormous popularity (still a few places left in the
 December 
 program:

http://www.birthinternational.com/event/intensives2005/index.html
 
 Anyway, she mentioned that she now has a program designed to
 teach 
 midwives how to manage breech births, that is in the process
 of being 
 fully credentialled through the NZ College of Midwifery. She
 is now 
 touring NZ offering this program so that midwives feel
 confident in 
 facilitating this kind of birth, if it happens.
 
 Would there be enough interest in Australia for me to
 approach her to 
 present some of these workshops here?  It would make a very
 good 
 alternative to the ALSO program, and is completely midwifery
 based. As 
 far as I know, it is a one day program too.
 
 
 There has been quite a lot of discussion about breech births
 on the list 
 and the loss of skills as a result of the swing towards
 C/Sec. This might 
 be one way to help halt the slide.
 Please email me if you are interested. My email address is 
 [EMAIL PROTECTED]
 
 Regards,
 
 -
 Andrea Robertson
 Birth International * ACE Graphics * Associates in
 Childbirth Education
 
 e-mail: [EMAIL PROTECTED]
 web: www.birthinternational.com
 
 
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 -
 Andrea Robertson
 Birth International * ACE Graphics * Associates in Childbirth
 Education
 
 e-mail: [EMAIL PROTECTED]
 web: www.birthinternational.com
 
 
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RE: [ozmidwifery] Men at births

[Judy Chapman]

 One of the most moving father involvements I have seen was many
years ago. Their first baby, she was sweaty and untidy and in
pain etc and he just kept whispering in her hear You're
beautiful, I love you. Tear making stuff. They are still a
happy couple after another three children and 20 years. 
cheers
Judy
--- Miriam Hannay [EMAIL PROTECTED] wrote:

 I'm with you, Megan!
 
 To give birth to a beloved child is the ultimate
 expression of the emotional and sexual love my husband
 and I share.
 
 He described me during labour and birth as being
 'awesome, powerful, sexy, strong, more beautiful than
 ever before'. He even commented that the involuntary
 noises I made during birth were similar to the noises
 I make during orgasm!
 
 Obviously, such an experience relies on the nature of
 the birth itself, We had three babes at home and one
 in hospital, all beautiful physiological births with
 no intervention. 
 
 With regard retaining your 'sexual mystery', I'm not
 quite sure what there is about sex and sexuality
 that's 'mysterious'. If a couple's sexual relationship
 is open, honest, loving and passionate, does there
 need to be any 'mystery'? To me this smacks a little
 of patriarchal notions of women's role as sexual
 object... Gee, I hope my husband doesn't find anything
 about me mysterious after fourteen years, otherwise
 how would he know what I need and desire?!
 
 What would be fantastic for men would be for all
 practitioners to actively facilitate a role for them
 during the birth process that makes them feel involved
 and reflects the extraordinary beauty of the
 experience. If only... regards, Miriam.
 
 --- Megan  Larry [EMAIL PROTECTED] wrote:
 
  Its interesting how the conversation focuses on the
  womans vagina.
  What about the rest of her body?
  My husband loved the feeling of my muscles working
  in my body, he says they
  have been different for each birth. 
  The last 3 were water births, so no vagina watching
  by any one. 
  Speaking on his behalf, I know that he was and is so
  awe inspired by
  watching me have our babies, it only added to his
  desire and love. 
  So I guess the total experience of how women birth
  is what we are looking
  at. No surprises there!
  The book, I think titled, Father Time, which is a
  collection of interviews
  of Australain men, discusses this and the men who
  experienced homebirths
  very clearly did not experience the trauma. 
  
  I'm not sure about this sexual mystery thing
  though. As a woman I take
  great pride in having a uterus, vagina and breasts
  that have created and
  given life 4 times, its not all about toys for
  boys.
  (Although having 4 sons kind of retracts that
  statement)
  
  My thoughts anyway
  Megan
  
  
  
  -Original Message-
  From: [EMAIL PROTECTED]
  [mailto:[EMAIL PROTECTED] On
  Behalf Of Andrea Robertson
  Sent: Wednesday, 31 August 2005 10:26 AM
  To: ozmidwifery@acegraphics.com.au
  Subject: [ozmidwifery] Men at births
  
  This is an interesting report in today's Sydney
  Morning Herald. I remember
  Michel Odent talking about research done in the US
  that explored the effect
  on a couple's sexual relationship when the man had
  been exposed to the birth
  process. Michel was advocating that women might want
  to retain some of their
  sexual mystery by excluding men from the birth
  room. I have been at births
  where I wondered how the father was taking the sight
  of a practitioner
  cutting an episiotomy.
  
  What does everyone think about this?
  
 
 http://www.smh.com.au/articles/2005/08/30/1125302566185.html
  
  Regards,
  
  Andrea
  
  -
  Andrea Robertson
  Birth International * ACE Graphics * Associates in
  Childbirth Education
  
  e-mail: [EMAIL PROTECTED]
  web: www.birthinternational.com
  
  
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RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)

[Judy Chapman]

Thank God there are some who support us, they are just not vocal
enough. Without the support of the Cairns OB's Mareeba would be
history. 
Cheers
Judy

--- wump fish [EMAIL PROTECTED] wrote:

 As a newcomer to Australia from the UK - it seems that the obs
 are behaving 
 like threatened children.
 
 Firstly, their stats can flawed. Other developed countries
 have also looked 
 at the evidence and concluded that midwife-led,
 community-based care is 
 effective, efficient and safe. For example, the UK is moving
 towards a 
 midwifery-led birth centre model based on research about what
 women want and 
 what is safe.
 
 Secondly, even if midwifery-led birth is unsafe (which it is
 not). Surely 
 women's right to choose this option should be maintained. 
 Women should be 
 able to access a wide range of birth options from independent
 mws to 
 elective c-section. Interesting that a woman's right to opt
 for an elective 
 c-section/induction is upheld by the obs despite the wealth of
 research 
 demonstrating it is not the safest choice for mother or baby.
 However, they 
 want to block a woman's right to choose midwifery-led care
 based on safety 
 claims. Is this about safety or power?
 
 I am deeply disturbed by the amount of hostility directed at
 mws by obs. We 
 should be working together - mw being the experts in
 physiological birth, 
 and obs being the experts in complicated birth.
 
 Rachel
 
 
 From: Sally-Anne Brown [EMAIL PROTECTED]
 Reply-To: ozmidwifery@acegraphics.com.au
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] Fw: 'Higher risk' in midwife
 deliveries 
 (http://theaustralian.com.au report)
 Date: Tue, 30 Aug 2005 08:23:49 +1000
 
 
 - Original Message -
 From: Sally
 To: Sally-Anne Brown
 Sent: Tuesday, August 30, 2005 8:11 AM
 Subject: 'Higher risk' in midwife deliveries
 (http://theaustralian.com.au 
 report)
 
 
Sally ([EMAIL PROTECTED]) suggested you might be
 interested in this 
 http://theaustralian.com.au report.
 
 
  'Higher risk' in midwife deliveries
  Adam Cresswell, Health editor
  30 August 2005
 
  THE safety of midwife-led birthing units has
 been doubted and 
 the most reliable evidence suggests babies born in such
 centres are 85 per 
 cent more likely to die during or shortly after birth,
 compared with babies 
 born in major hospitals.
 
 
  Leading obstetrician Andrew Pesce said yesterday
 that a review 
 by the international Cochrane Collaboration - considered the
 best source of 
 evidence for medical claims - found that home-like settings
 for births were 
 associated with modest benefits.
 
  Dr Pesce said these benefits included higher
 rates of 
 breastfeeding, more satisfied mothers and slightly higher
 rates of 
 spontaneous vaginal childbirth (as opposed to surgical
 deliveries).
 
  However, the Sydney-based Dr Pesce - who is also
 secretary of 
 the industrial lobby group the National Association of
 Specialist 
 Obstetricians and Gynaecologists - said the review, published
 late last 
 year, also found babies born in home-like settings such as
 midwife-run 
 centres ran an 85 per cent higher risk of death around the
 time of 
 childbirth. However, the overall rate is still very low -
 about eight 
 babies in 1000 live births in 2002, according to the
 Australian Bureau of 
 Statistics.
 
  Dr Pesce also said studies that midwives
 sometimes used to 
 back up their safety claims were scientifically inferior,
 usually because 
 their subjects were not randomised - an accepted technique to
 remove bias.
 
  Everybody says it's been shown to be safe - but
 it's not. 
 It's been shown to be reasonably safe, but without question
 there's a worry 
 about increased risk of perinatal mortality, he said.
 
  There's a positive effect (of birthing
 centres), but it's a 
 lot lower than you would be led to believe by people who
 advocate this 
 model.
 
  Kathleen Fahy, professor of midwifery at the
 University of 
 Newcastle, said Dr Pesce was using the Cochrane deaths data
 to imply that 
 something is significant when it isn't.
 
  What's going on here is a desire to prevent
 midwives from 
 practising their profession, and using safety to do so, she
 said.
 
  Sally Tracy, associate professor of midwifery
 practice 
 development at the University of Technology Sydney, said she
 had recently 
 finalised a study using data from more than 1million
 Australian births, 
 which would be published shortly in a major medical journal.
 
  Although prevented under medical journal
 requirements from 
 discussing the findings before publication, she said the
 results were 
 positive for midwife centres.
 
  In an article to be published next month in
 NASOG's 
 newsletter, Dr Pesce - who also represents obstetricians and
 gynaecologists 
 on the Australian Medical 

RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)

[Judy Chapman]

You are so right about many Australian Midwives being prevented
from gaining the full spectrum of skills necessary for total
care of well women. As you said the answer is to give midwives
the opportunity to learn what they should not just want OB's
want them to learn. Those midwives who work independently, in
birth centres and some in hospitals have had to actively chase
the knowledge and experience necessary to do their work
properly. It is hard work sometimes. All worth it though when
you have a satisfying birth with a woman who you have developed
a relationship with antenatally. 
Cheers
Judy

--- wump fish [EMAIL PROTECTED] wrote:

 I think there is a difference between the training and skills
 of Australian 
 mw and UK mw. But, this largely exists due to the different
 maternity 
 systems and the blocks placed on practice by the obs. Your mw
 training is 
 reliant on the experiences you are able to access. For
 example, as a direct 
 entry mw in the UK my training began in the community with a
 community 
 midwife providing midwifery-led care with a family focus. By
 the end of our 
 course we were expected to be able to provide total care for
 'normal' women 
 (including suturing).
 
 I realise that I have a limited viewpoint at present, but I
 have noticed 
 that the mainstream perception of midwives is that we are
 nurses with a mid 
 specialisation, and even refer to each other as nurses. People
 are getting a 
 bit sick of me correcting them when they call me a nurse.
 Midwives are 
 prevented from maintaining and developing skills by hospital
 systems. For 
 example, I have been told I am not allowed to suture! Many mw
 do not rotate 
 and will only work in one area eg. postnatal. I am working on
 an escape plan 
 to get out of the maternity system as I can see my midwifery
 skills being 
 worn away.
 
 I am sure that the independent mws and birth centre mws are
 more than able 
 to provide total care for women. But, I wonder if mws who have
 been trained 
 in the mainstream system and have only worked in this system
 would have the 
 skills, experience or confidence to provide total care for
 women.
 
 If Dr Giltrap is correct, then the answer is not to leave
 birth the the obs, 
 but to improve mw education and empower the mw profession.
 
 Rachel
 
 From: Vedrana Valèiæ [EMAIL PROTECTED]
 Reply-To: ozmidwifery@acegraphics.com.au
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife
 deliveries 
 (http://theaustralian.com.au report)
 Date: Tue, 30 Aug 2005 08:54:14 +0200
 
  Obviously scary rubbish makes better news than
 truthful lovely births.
 
 I think you are SO right there.
 It seems to me that viewing birth as a disaster just waiting
 to happen, 
 even if it is a normal birth, is Dr Giltrap's problem.
 Plus, I'm still 
 trying to understand what he meant by:
 Dr Giltrap claimed Australian midwives were not as well
 trained as their 
 European counterparts and Australian standards were often
 higher than those 
 in Europe.
 
 There is a resolution by EU which states how many hours of
 what midwives 
 have to have, and I doubt that it is more than you have in
 Australia.
 
 
 
 
 -Original Message-
 From: [EMAIL PROTECTED] 
 [mailto:[EMAIL PROTECTED] On Behalf Of
 Janet Fraser
 Sent: Tuesday, August 30, 2005 6:22 AM
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife
 deliveries 
 (http://theaustralian.com.au report)
 
 Rachel (welcome btw!) I hear everything you're saying and I
 concur. It's so
 transparently about a professional monopoly but their own
 brilliant
 misinformation campaign is so entwined with our current
 cultural fears
 around normal physiological birth that very little gets into
 the media to
 contradict it. Of course what I really want is for them to
 have to answer
 how all the guff they spout really stands up against the
 research but the
 seven second soundbite only allows long enough for scare
 tactics, not
 evidence. It's interesting to me that in many years of
 writing letters to
 SMH and The Age, I have never had one published on birth
 issues. I've got
 quite a track record on political issues of other kinds, but
 not even the
 most benign letter on home birth or midwifery has made it
 into their
 publications. Obs and midwives get published a bit but very
 rarely
 consumers. I sent letters to every major paper plus regionals
 for Home 
 Birth
 Awareness Week last year, and not one was published. That's a
 lot of 
 editors
 making the same decision. Obviously scary rubbish makes
 better news than
 truthful lovely births.
 Food for thought!
 J
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 Don’t just search. Find. 

[ozmidwifery] Re:

[Judy Chapman]

What a load of claptrap they write.
'There is none so blind as he who will not see!' seems to be
appropriate for those 600 OB's who obviously don't read the
evidence.
Cheers
Judy

--- [EMAIL PROTECTED] wrote:

 
 
 In todays Australian


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