Re: [ozmidwifery] VBAC booklet

[Kim Stead]

Me too. 

Kim. [EMAIL PROTECTED]

Many thanks!
---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 4/10/2005 10:02:02 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] VBAC booklet

Dear Jo, A CD would be valuable and ever reusable resource count me in
[EMAIL PROTECTED] Many Thanks Debbie


 Dear Jo,

 I'm with Judy here a CD would be very handy.

 Regards
 Anne Clarke

 - Original Message -
 From: "Judy Chapman" [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Monday, October 03, 2005 1:35 PM
 Subject: Re: [ozmidwifery] VBAC booklet


  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] birthing pool purchase

[Kim Stead]

HiJane

I'd like some more details too please... :-) [EMAIL PROTECTED].

TIA, Kim.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 2/10/2005 4:02:46 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] birthing pool purchase

Am very interested in a birth pool [EMAIL PROTECTED] Is that the real price love more info Thanks Debbie xx

- Original Message - 
From: Jane Palmer 
To: ozmidwifery@acegraphics.com.au 
Sent: Saturday, October 01, 2005 5:23 PM
Subject: RE: [ozmidwifery] birthing pool purchase

Dear Mary

I sell birth pools which I am happy to send to any area of Australia for $6.50. I can send details and an image off list.

Cheers
Jane Palmer
Pregnancy, Birth  Beyondwww.pregnancy.com.au 

-Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Lynne StaffSent: Saturday, 1 October 2005 10:28 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] birthing pool purchase
Hi Mary
A woman I am caring for at home has just purchased a hexagonal pool dorect from Clark Rubber. That may be an option.
Regards, Lynne

- Original Message - 
From: Mary Murphy 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, September 29, 2005 7:06 PM
Subject: [ozmidwifery] birthing pool purchase


Hi all, I have an enquiry for a woman on the Gold coast (I am in W.A) about buying a suitable pool for birthing. I would appreciate your local knowledge. Thanks, Mary Murphy 

Re: [ozmidwifery] 3rd degree tears

[Kim Stead]

Out of curiosity.. does anyone have any experiences of vaginal birth following previous 4th degree tear? I've just recently met a woman who wants to give vaginal birth a go - has new partner (says old one was huge!). She is smallish person - 60kg, last babe 10lbs (1st baby). What do you think. She will be birthing in hospital. I've asked her to get a copy of her obstetric records from previous hospital. Still in early pregnancy so can't gauge size yet. Is a later ultrasound a good idea for a gestimate on the weight? I know they can be so inaccurate.

Kiwi Kim,

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 29/08/2005 11:10:23 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] 3rd degree tears
Hi,I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital.The mindblowing element was the following statistics (copied from one of the handouts):

39-49% women tear or have an episiotomy needing sutures 

0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 

25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visibleListed as contributing factors were:

1st vaginal birth 
forceps/instrumental delivery 
long second stage 1 hour 
big baby 4kgs 
tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously.The handouts do not give references and as yet I have not had time to begin researching.Are you all as mindblown as I am??What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it??Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section.Sue

Re: [ozmidwifery]3rd degree tears, u/s and birthweight

[Kim Stead]

Thanks Maxine. It's interesting isn't it how we put so much trust in these professionals and their gadgets and make some pretty important decisions based on the information they provide only to be let down by the inaccuracies that we are not told about. Thanks for your thoughts.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 30/08/2005 2:42:32 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery]3rd degree tears, u/s and birthweight

On a personal note I had 3 ultrasounds at 35 weeks for various reasons I won't bore you with but the best (as in heaviest) weight they guesstimated was 500g less than her birthweight which is fairly significant difference when you are talking about a 2.3 kg bub. Suffice it to say I may have made very different decisions about the circumstances of her birth if it had not been for the scary and inaccurate information from u/s. I have no idea what the research says in this area.
Maxine

- Original Message - 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Tuesday, August 30, 2005 9:18 AM
Subject: Re: [ozmidwifery] 3rd degree tears





Out of curiosity.. does anyone have any experiences of vaginal birth following previous 4th degree tear? I've just recently met a woman who wants to give vaginal birth a go - has new partner (says old one was huge!). She is smallish person - 60kg, last babe 10lbs (1st baby). What do you think. She will be birthing in hospital. I've asked her to get a copy of her obstetric records from previous hospital. Still in early pregnancy so can't gauge size yet. Is a later ultrasound a good idea for a gestimate on the weight? I know they can be so inaccurate.

Kiwi Kim,

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 29/08/2005 11:10:23 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] 3rd degree tears
Hi,I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital.The mindblowing element was the following statistics (copied from one of the handouts):

39-49% women tear or have an episiotomy needing sutures 

0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 

25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visibleListed as contributing factors were:

1st vaginal birth 
forceps/instrumental delivery 
long second stage 1 hour 
big baby 4kgs 
tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously.The handouts do not give references and as yet I have not had time to begin researching.Are you all as mindblown as I am??What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it??Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section.Sue

Re: [ozmidwifery] Re:BF video

[Kim Stead]

Yeah, me too. 

Kim. [EMAIL PROTECTED]


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 27/08/2005 9:39:26 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Re:BF video

Is it possible to get a copy??? Everyone's replies has me curious...

:-)
Katrina


On 27/08/2005, at 7:27 PM, Ken WArd wrote:

 I would love to see this video too, please. Maureen

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED]]On Behalf Of Vedrana
 Valčić
 Sent: Saturday, 27 August 2005 5:02 PM
 To: ozmidwifery@acegraphics.com.au
 Subject: RE: [ozmidwifery] Re:BF video


 You're welcome!

 Vedrana

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED]] On Behalf Of Joy Cocks
 Sent: Saturday, August 27, 2005 8:20 AM
 To: Ozmidwifery
 Subject: [ozmidwifery] Re:BF video

 Dear Vedrana,
 Thanks so much for the video...I love it!!
 Joy

 Joy Cocks RN (Div 1) RM CBE IBCLC
 BRIGHT Vic 3741
 email:[EMAIL PROTECTED]

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Re: [ozmidwifery] Midwives clinic

[Kim Stead]

Hi Alan

I work at the Latrobe Hospital(in the Latrobe Valley). We also have a midwives clinic- run 2 days a week.There are about 6 midwives involved and we try where we can to book the women on theclinic's that we run. They still end up seeing 2 or 3 midwives and while there's no guarantee we'll see them in labour, the odd's are better than if they hadn't come to the clinic at all (still a long way from perfect). The women seemto enjoy the woman to woman chats,a friendly face to ask the 'not soimportant' or 'silly' questions. Not having to wait up to 2 hours is also a bonus. We do 'real antenatal education' compared to the standard 3 minute obstetric appt, encourage birth plans etc.We are seeing really good results(ie, low intervention etc with these particular women). The clinic has been going 2 years and now the doctors involved, now refer their own low riskwomen to us.In a small town, women also talkamongst themselves so we are always gettingcalls enquiring about how they can join (they need a referral). I don't see why you couldn't advertise your services in the medical centres, MCHN clinics (new mums can tell their friends), day carecentres and the like. We also tell them about the clinic at their booking in appt in the mainhospital. Word will get around. We're yet to offer caseload but working on it also. Like Andrea pointed out, advertise what youcan offer (perhaps complementary to what they are already receiving so not to ruffle any feathers) and I am sure it willlook pretty good alongside what they are currently getting. The more women who receive midwifery care the better in the long fight for improved maternity servives!!!

Kim

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 7/08/2005 2:31:17 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Midwives clinic

Alan are you offering continuity of carer or an alternative to the obs
and then they still get a different midwife in labour.
In Echuca they started a midwife clinic that offers shared care b/w the
GP/obs and the midwife clinic but it in fact means that instead of
having their antenatal care by one person they now have it by at least
three.And then they just get who ever in labour as well.

If you are offering continuity of carer then this is what you can sell
and it will be attractive to the women.Otherwise sell the things you
are offering that they dont get from the Ob.On time appointments,
longer appointments etc. In the country the bush telegraph is still the
best source of information so get women talking about it and a mail out
to known pregnant women, notices or poters in child care centres,
kindergartens etcsaying 'Do you know someone who is pregnanttell
them about the new choices that they have"

Good luck but keep pushing for a caseload if you dont have one its great

ANdrea Quanchi
On 07/08/2005, at 11:16 AM, Alan Rooney wrote:

 Advice needed
 I work in a small hospital in western NSW and we are about to start a
 Midwives clinic. The 2 obs in town are supporting us in this venture
 but I
 need some suggestions on how to inform the women of the town why they
 should
 choose the Midwives clinic and not visit the obs surgery, but I would
 like
 to do this without offending the obs. I would like to put this
 information
 in a pamphlet in all the Docs surgeries in the town. Any ideas would be
 appreciated.
 Also if anyone has research articles on this subject I would appreciate
 them.

 off list email
 [EMAIL PROTECTED]

 Thanks
 Alan.

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Re: [ozmidwifery] Birth Pool suitable for use in a small unit

[Kim Stead]

Hi Justine

I don't have any info for you but Itoo have been wondering where to source good quality 'birthingpools' from withinAustralia? I might post to the NZ Midwives site and see if there are any replies. If so, I'll let youknow.

Cheers,

Kiwi Kim.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 13/07/2005 2:02:51 p.m.
To: OzMid List
Subject: [ozmidwifery] Birth Pool suitable for use in a small unit

Dear All

Just wondering if anyone knows about a semi-permanent type birth pool
suitable for use in a small birth unit (220 births per year).

There is the opportunity for corporate sponsorship to get this happening so
we sort of need something more than a kids wading pool.

Any ideas?

JC
xx


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Re: [ozmidwifery] Problems with new models

[Kim Stead]

Wellsaid Deborah.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 16/06/2005 10:54:58 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Problems with new models

Hi All,
This is my first post, I was drawn toyour discussion about Caseload Midwifery via the BMid Student Collective website.I am a 2nd year B.Mid (direct entry) student at ACU in Melbourne. I amONLY interested in working caseload and I know I can speak for a number of my student colleagues, also. 

You may have heard of our Follow Through Journey experiences, in which we work one to one with 30 women through their childbearing continuum, with guidance and support from a mentor. This is preparing us inall sorts ofways to work caseload or independently-it proves to all involved the value of continuity of carer to women and midwives.This monthI am on call to support 3 of my wonderful women in their births.I have known them and their partners since their first trimester.I simply take my mobile phone to bed with me and forget about it unless it rings. Antenatal and postnatalmeetings are flexible and in decent hours of the day. I also work part time, have 2 children and am fortunate to have a very supportive partner.
I would not be interested in working professionally in any other model of care. In the hospital shift work I have donein placements I have feltfrustrateda lot of the time,I have not felt that I have been able toemploy evidence based practiceand I find constant early shifts unbearably disruptive to my family.
I feel so lucky to have been educated in this model of care and hope that by the time many moreBMidders are in the workforce it will become a more commonplace way of working. I don't see suturing or any other clinical issues as a barrier. We are keen to learn and practice these skills in order to work as independent practitioners within a framework of a collaborative health profession.
My best wishes to allmidwives and otherscurrently setting up caseload models in their units. Please keep up the great work.Lots ofBMiddersare dying tofill the vacancies as soon as we are able!!!

Thanks for the discussion.
Deborah Fox

RE: [ozmidwifery] Problems With new Models

[Kim Stead]

Hi Robyn

If it weren't for the distance - I'd be in boots and all but Warragul is about 1hr 15 from home - a little too far I think. I live in hope that one day I'll be able to practice to my full potential in my own area with support from other midwives and the hospital when need be! Well done to all of you already living this dream and those of you who have set up such programs!!!

Kiwi Kim

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 12/06/2005 7:27:38 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Problems With new Models


As you would guess, I am totally supportive of what Robyn says. Cheers, Mary Murphy





From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Robyn ThompsonSent: Sunday, 12 June 2005 4:11 PMTo: 'Kim Stead'Cc: ozmidwifery@acegraphics.com.auSubject: FW: [ozmidwifery] Problems With new Models

Hi Kim

We haven’t spoken for a while, when I read this message from Carol, I immediately thought of you. Are you interested? 

Carol it really is sad that midwives see being “on-call” a problem. Being on-call is much better than continuous shift work any time. I want to allay midwives fears of being on-call. Many Australian midwives like me are on call 24 hours, 7 days a week. We are not called out all the time, we enjoy our lives and still manage to provide a wonderful service for women. It wasn’t until I took a break for 3 months in USA, after 18 years of being readily available for women, that I realised how much I did need a break. My problem was that I made such a commitment that I forgot to plan regular breaks. 3 months away gave me time to clear my head and from that I learnt to reduce my workload and plan some breaks. I am still on-call and enjoy the challenge of being there for women when they need my services. Now I have more time to be proactive with midwifery issues, have some time to travel, spend time with my grandchildren and enjoy life in general. 

For those who feel concerned about the on-call hours, let me reassure you it is much better when you are in a team or group practice, you can really get yourselves well established with on-call work and still manage to have a full life. A good cohesive team can work wonders together and women enjoy the warmth of good team spirit. 

This note is to encourage midwives to have a go at ‘being with women’ in one-to-one or small team relationships, the personal and professional rewards are amazing. I am at the far end of my wonderful career now, as I look back I feel extremely happy and satisfied with the fact that I have been “on-call” for hundreds of women over 20 years of service in the home, and shift work in the hospital system 10 years prior to that. The world, the planet and the universe is better off by far, for the personalised care midwives provide women. My professional and life experience is overwhelmingly wonderful because of these mothers, babies and families, number 5 and 6 babies in some families, this makes on-call easy in the big scheme of things. 

Warm regards, Robyn



-Original Message-From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Carol Van LochemSent: Sunday, 12 June 2005 5:39 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Problems With new Models



Hi all, I have posted here from time to time, but mostly I'm a lurker.

I work in a team midwifery model at Warragul, where we have lots of midwives who believe in continuity of care, support the women as central to the whole prossess and have a supportive obstetrician to back us up. Our problem is in recruiting midwives to work in our model. Nobody wants to do "all that on call".They "want to have a life". After all these years of fighting for this type of thing it seems there are not enough of us around to fill this role. Many support the model in principal, but don't see how they can fit it into their own lives.



Our team started just 12 months ago. It is a modified case load, with 1 night per week on call, and 1 weekend a month. We are "available" for our "own" women during the day. We provide midwife led care for up to 60 low risk women per year, and shared care for up to a further 60 "high risk" women who benefit most from having a known midwife with them in labour. We are meant to be 5, but have recently lost one, who would have rather worked as a team only, with no case load.



To my knowledge there have been no applications for this position from with in existing staff, nor has there been a response to newspaper ads. It saddens me to think that this type of model will not be sustainable in the long term. Here we are in the position of having active finacial support from DHS after many years of lobbying for it, only to risk losing it all through lack of willing staff. This problem must be coming up for others in Victoria as caseload models are put forward in other regions.



Any 

[ozmidwifery] Attn. Jan

[Kim Stead]

Hi again Jan

Sorry for the delays in getting back to you. I'm just back from a trip back to NZ and luck has it, I'm going straight back for a funeral. Anyway, I've posted your request to the NZ Midwives list - a list like OzMid. Theaddress is [EMAIL PROTECTED]. Hope that helps! Thanks for all your work on the insurance issue!! It is much appreciated!

Kiwi Kim.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 24/06/2005 8:32:16 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] looking for Janie Paul-Smith

That could be great Kim -I have a Christmas card that is two years
old now and really want to re-establish contact with Janie- she did a
resfresher course with me many years ago when she was working in
Sydney,
also can I get the address of the NZ midwives list from you?Would be
good to have in my address book.I only have the NZ College address
plus a few academics.
Cheers
Jan

PS getting closer to solving the PI insurance problem - hope there is
some good news soon
Jan
Jan Robinson Independent Midwife Practitioner
National CoordinatorAustralian Society of Independent Midwives
8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546
4350
e-mail address: [EMAIL PROTECTED]website:
www.midwiferyeducation.com.au
On 23 Jun, 2005, at 20:42, Kim Stead wrote:

 Jan - would you like me to post thisto the NZ Midwives list for you??
 
 Kim
 
 ---Original Message---
 
 From: ozmidwifery@acegraphics.com.au
 Date: 20/06/2005 7:47:31 a.m.
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] looking for Janie Paul-Smith
 
 Hi ozmidders
 If anyone from NZ is lurking here I am anxious to re-establish contact
 with Janie Paul-Smith who I believe is now back home in NZ.
 She may be practising under the name of Paul or Smith
 If anyone knows of Janie's whereabouts please ask her to contact me
 Cheers
 Jan
 Jan Robinson Independent Midwife Practitioner
 National CoordinatorAustralian Society of Independent Midwives
 8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546
 4350
 e-mail address: [EMAIL PROTECTED]website:
 www.midwiferyeducation.com.au
 

 imstp_emo_en.gif

RE: [ozmidwifery] Problems With new Models

[Kim Stead]

Oh Carol

That's so dissapointing to read!!! Personally, I'd love to work in your hospital and with your model of care but currently I commute from Maffra to LRH and find that distance plenty enough! 

It really is a worry like you say, that so much work has been done to lobby for this change, then to find that midwives areunable for whatever reasons.to commit or at least consider all the benefits ofcaseloadmodels and continuity of care! Iam sure it isfear of the unknown and fear that 'we'll have no life'! 

Coming from NZ, I knowhow rewarding this model of care is!!! Enough rambling! Hoping you find some interest soon!

Kiwi Kim

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 21/06/2005 1:26:32 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Problems With new Models

Dear Carol,



Congratulations on your and your colleagues achievement in offering
continuity of care to women in Warragul.



I am sorry to hear you're having trouble recruiting a replacement for your
colleague.The College has a free section on our website for advertising
vacant positions, and we also have an e-bulletin list that goes to more than
1,000 subscribers.I would be happy to advertise your position on both of
these if you are still interested.



I also wonder if you've considered contacting the universities in Victoria
and elsewhere that are offering BMId programs.They may well be able to
promote your service to recent graduates.There will also be new graduates
emerging from the second intake of BMid students in only another 5 months -
I'm sure you would be likely to attract some interest from one or more of
such graduates (or students, if you have a capacity to wait).



The College is also looking at ways at present that we can help to inform
midwives about the benefits of working in the type of model you are
providing.There seem to be a lot of fairly negative myths around about the
realities of working this way which we are confident of being able to
balance out with good information from midwives working this way already.
The National Executive meeting in July will be considering some proposals in
this area and I'll let you know after that.They won't provide an immediate
solution to your problem, but they will at least help to address the bigger
picture problem of encouraging and supporting more midwives to give caseload
care a try, as you and your colleagues are doing.



Kind regards and best wishes for your service,



Barb.



Dr Barbara Vernon
Executive Officer
Australian College of Midwives
Ph +61 2 6230 7333
Mob 0438 855 529

'Midwifery: Pathways to Healthy Nations'
27th Congress of the International Confederation of Midwives
Brisbane Convention Centre, 24-28 July 2005
www.midwives2005.com/index.shtml

From: "Carol Van Lochem" [EMAIL PROTECTED]
Date: 12 June 2005 5:39:20 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Problems With new Models
Reply-To: ozmidwifery@acegraphics.com.au

Hi all, I have posted here from time to time, but mostly I'm a lurker.
 I work in a team midwifery model at Warragul, where we have lots of
midwives who believe in continuity of care, support the women as central to
the whole prossess and have a supportive obstetrician to back us up. Our
problem is in recruiting midwives to work in our model. Nobody wants to do
"all that on call".They "want to have a life". After all these years of
fighting for this type of thing it seems there are not enough of us around
to fill this role. Many support the model in principal, but don't see how
they can fit it into their own lives.

Our team started just 12 months ago. It is a modified case load, with 1
night per week on call, and 1 weekend a month. We are "available" for our
"own" women during the day. We provide midwife led care for up to 60 low
risk women per year, and shared care for up to a further 60 "high risk"
women who benefit most from having a known midwife with them in labour. We
are meant to be 5, but have recently lost one, who would have rather worked
as a team only, with no case load.

To my knowledge there have been no applications for this position from with
in existing staff, nor has there been a response to newspaper ads. It
saddens me to think that this type of model will not be sustainable in the
long term. Here we are in the position of having active finacial support
from DHS after many years of lobbying for it, only to risk losing it all
through lack of willing staff. This problem must be coming up for others in
Victoria as caseload models are put forward in other regions.

Any thoughts, suggestions, simmilar experiences?I am truely at my wits
end. Sigh :(

Thanks for listening
Carol
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Re: [ozmidwifery] Consent

[Kim Stead]

Hi Katrina

Where I work we obtain written consent for Hep B and oral consentfor the other two. It doesn't sit well with me as often these women have had little or noantenatal information and almost no midwifery input and we are making them make a 'so called informed choice' at a time when they are probably not in the best head space to be doing so. Sometimes we don't even give them the choice. just inform them it is happening.

It would seem that women just accept it as another one of those 'routine' things that happen in hospital. I wonder when someone will come backyears or monthsfrom nowand say, "I didn'tgive consent for that" and we have no written record? In an ideal world, such things would be discussed in the antenatal period anddetailed enough for the woman and family to be making truly informed choices not thrown at them straight after birth. 

Kim

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 27/05/2005 11:50:07 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Consent

Hi everyone

I was just wondering what people had experience with in regards to the
New Born Screening Test, Vit K and Hep B vaccine. Where I work, we
obtain written consent for the Vit K antenatally , oral consent for the
Hep B and NBST at the time. A midwife I worked with the other day was
saying that where she used to work it was the other way around, written
for Hep B and oral for the Vit K and NBST.

I was looking after a woman the other day that was actually booked into
Nepean and they obtain written consent for all 3 procedures...

I'm just wondering what other people have come across


Katrina

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Re: [ozmidwifery] Protecting breastfeeding

[Kim Stead]

Hi Pinky

Yes she isafab obstetrician!!! I wish I could bottle her and sell her on the Australian market. I would make a fortune!!

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 05/04/05 22:55:58
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Protecting breastfeeding

Check out this lovely article from the NZ Herald, byobstetrician, Alison Barrett -I will get to hear her talk when I speak at the same workshop in June, run bymidwives(Hamilton NZ). NZ women are very lucky - not only do they have a great midwifery system, it sounds as tho they also have at least one great obstetrician. 

http://www.nzherald.co.nz/index.cfm?c_id=466ObjectID=10123638

Pinky,
www.pinky-mychild.com

[ozmidwifery] Attn: Tania - NZ midwife

[Kim Stead]

Hi Tania

Here is the only reply I've got so far.




Hi Kim, Either me or one of my colleagues in the
Auckland Homebirth Midwivesgroup would be pleased to
provide care. I am on the Aotearoa Homebirth website
and she could call me on 09 5797886 or email me, Bye, jenny

Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.

[Kim Stead]

Hi Marilyn. I totally understand where you are coming frombut just to play devil's advocate..who is to care for these women who have made educated choices to birth their babiesin a setting they believe to be safer than the hospital? Someone has to do it (and it's not me at the moment either!!!).

I know it's not ideal and at times,very scarry notto be able to offer the full servicebut someone has to step up to the mark and provide this service and notcontinue to be bullied by this god forsakengovernment. Some of these women will birth unattended and do. If I were to ever have any more children (cross my legs as I write!!!),I'd have them at home. I'd like to think I could find a midwife to support me and can understand the ones whocontinue to birth unattended after exhausting all options to find midwifery or should I say 'woman-centred' care. The hospital setting is a frighting place for those who are 'birth educated'.

Just thinking out loud.

Kim.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/30/05 22:55:50
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.

I hopeI don't sound too rude but it highlights exactly why I am not practicing independently at the moment. Australian midwives do not have a mandate to be independent practitioners; I simply cannot imagine not being able to order path tests for the women I am caring for, not being able to order my own emergency drugs etc.. We are dependent on GP/Obs to do this for us and dependent on their records in case of transfer ahh!! sorry just had a couple of wines!!

marilyn

- Original Message - 
From: Sally Westbury 
To: ozmidwifery@acegraphics.com.au 
Sent: Friday, April 29, 2005 5:37 PM
Subject: RE: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.




Hi Gaye,

It is an interesting question about antenatal testing.

I ask all my clients are booked into a hospital as a backup. They are booked through antenatal clinics or GP/Obs or Obstetricians. There is a problem with getting this booking in done properly. As a midwife in WA I cannot order path tests, this is of course done by the doctors and it is their responsibility to provide results to the local hospital. I cannot book people into the hospital, this is the doctor’s responsibility also. Some of the doctors are great and provide copies of blood tests to me so that I can put them in my/clients antenatal records so that it is easy for hospital transfer situations. Other doctors are not so cooperative and will not provide them to me and make it difficult, even though the woman has a right to have copies, for the woman to have a copy. In these instances I trust what is passed on to me by the woman, hope the doctor follows up on anything abnormal and ask the woman to remind the doctor to provide copies for the hospitals records in case of transfer. Sometime the doctors do this, sometimes they don’t. Sometimes the ‘offical’ result documents are in some doctors surgery files only and not accessible in the middle of the night when a transfer has happened.

Having said this I have had a client that declined all blood tests, due to her own personal belief systems. It is her right. I did speak with her about why these test are done and clearly documented in my antenatal notes the discussion and we both signed the notes. 

Um… did that help clarify anything???

Sally Westbury

Hi All, Just hoping some of you wonderful Homebirth midwives out there can enlighten my ignorance regarding what "routine" antenatal investigations you order for or recommend to your clients, as part of your initial consultation. Is there a standard guideline that you must adhere to?(Apart from the "National Midwifery Guidelines for Consultation and Referral", that is). Or is it only up to the individual practitioner and his/her client to discuss and come to an agreement about what tests she will have and when she must go to hospital?  My reason for asking is the vague responses to our enquiries we recently encountered when a planned homebirth client presented to hospital for delivery. There was no accompanying antenatal record so we thought it feasible to ask basic questions of the client and her midwife such as blood group, last Hb, etc because it was no longer a normal situation. Is it probable these tests weren't done, because she was hitherto a normal, healthy woman with the right to choose what invasive procedures she had? Sorry to sound stupid but I'm used to the Obstetrician/G.P. who orders every test the lab has ever done and then some, you know - like the questionable Hep C and HIV without prior counselling, but I won't go there! I've done a couple of Web searches re the evidence (and lack of), and cost-effectiveness of the regular antenatal screen blood tests (I think I read it cost Medicare some $48 million dollars back in 1997), but wanted to know what you guys are 

Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.

[Kim Stead]

Um...??? Not sure.I don't know if it's necessarily accepted though??

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 05/01/05 05:23:36
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.

I totally agree Kim with everything you have said. I need to know how these limitations to practice autonomously have arisen and why it seems to be accepted.

marilyn

- Original Message - 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Saturday, April 30, 2005 7:33 AM
Subject: Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.





Hi Marilyn. I totally understand where you are coming frombut just to play devil's advocate..who is to care for these women who have made educated choices to birth their babiesin a setting they believe to be safer than the hospital? Someone has to do it (and it's not me at the moment either!!!).

I know it's not ideal and at times,very scarry notto be able to offer the full servicebut someone has to step up to the mark and provide this service and notcontinue to be bullied by this god forsakengovernment. Some of these women will birth unattended and do. If I were to ever have any more children (cross my legs as I write!!!),I'd have them at home. I'd like to think I could find a midwife to support me and can understand the ones whocontinue to birth unattended after exhausting all options to find midwifery or should I say 'woman-centred' care. The hospital setting is a frighting place for those who are 'birth educated'.

Just thinking out loud.

Kim.

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/30/05 22:55:50
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.

I hopeI don't sound too rude but it highlights exactly why I am not practicing independently at the moment. Australian midwives do not have a mandate to be independent practitioners; I simply cannot imagine not being able to order path tests for the women I am caring for, not being able to order my own emergency drugs etc.. We are dependent on GP/Obs to do this for us and dependent on their records in case of transfer ahh!! sorry just had a couple of wines!!

marilyn

- Original Message - 
From: Sally Westbury 
To: ozmidwifery@acegraphics.com.au 
Sent: Friday, April 29, 2005 5:37 PM
Subject: RE: [ozmidwifery] Antenatal Screening/Informed Choice Agreement. Vitamin D supps.




Hi Gaye,

It is an interesting question about antenatal testing.

I ask all my clients are booked into a hospital as a backup. They are booked through antenatal clinics or GP/Obs or Obstetricians. There is a problem with getting this booking in done properly. As a midwife in WA I cannot order path tests, this is of course done by the doctors and it is their responsibility to provide results to the local hospital. I cannot book people into the hospital, this is the doctor’s responsibility also. Some of the doctors are great and provide copies of blood tests to me so that I can put them in my/clients antenatal records so that it is easy for hospital transfer situations. Other doctors are not so cooperative and will not provide them to me and make it difficult, even though the woman has a right to have copies, for the woman to have a copy. In these instances I trust what is passed on to me by the woman, hope the doctor follows up on anything abnormal and ask the woman to remind the doctor to provide copies for the hospitals records in case of transfer. Sometime the doctors do this, sometimes they don’t. Sometimes the ‘offical’ result documents are in some doctors surgery files only and not accessible in the middle of the night when a transfer has happened.

Having said this I have had a client that declined all blood tests, due to her own personal belief systems. It is her right. I did speak with her about why these test are done and clearly documented in my antenatal notes the discussion and we both signed the notes. 

Um… did that help clarify anything???

Sally Westbury

Hi All, Just hoping some of you wonderful Homebirth midwives out there can enlighten my ignorance regarding what "routine" antenatal investigations you order for or recommend to your clients, as part of your initial consultation. Is there a standard guideline that you must adhere to?(Apart from the "National Midwifery Guidelines for Consultation and Referral", that is). Or is it only up to the individual practitioner and his/her client to discuss and come to an agreement about what tests she will have and when she must go to hospital?  My reason for asking is the vague responses to our enquiries we recently encountered when a planned homebirth client presented to hospital for delivery. There was no accompanying antenatal record so we thought it feasible to ask basic questions of the cl

Re: [ozmidwifery] midwife in NZ

[Kim Stead]

Hi Tania
 
There is a list like OzMid called NZ Midwives. I can put in a post for you
or you could join the list.  What would you prefer??
 
Kiwi Kim. 
 
---Original Message---
 
From: ozmidwifery@acegraphics.com.au
Date: 04/29/05 14:55:01
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] midwife in NZ
 
Is there a NZ midwifery list where I could put a call out for a midwife for
a friend living in West Auckland?
 
Thanks
 
Tania
 
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Re: [ozmidwifery] midwife in NZ

[Kim Stead]

Hi Tania
 
I can do that no problem. I know what you mean about joining MORE lists.
What do you mean by group practices?? Most midwives work in a collective in
order to support one another etc and have back-up should it be required but
take on their own individual caseloads. 
 
---Original Message---
 
From: ozmidwifery@acegraphics.com.au
Date: 04/29/05 17:39:15
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] midwife in NZ
 
Hi Kim
 
If you could post for me, that would be great, we're in the middle of a
computer upgrade and the last thing I need is to belong to any more lists at
the moment!
 
This woman is having baby #1, is about 10 weeks pregnant,and looking to
birth at home, with an independent midwife, not keen on the group practices.
She lives in West Auckland
 
Many thanks
 
TAnia
- Original Message -
From: Kim Stead [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Friday, April 29, 2005 5:27 PM
Subject: Re: [ozmidwifery] midwife in NZ
 
 
 Hi Tania

 There is a list like OzMid called NZ Midwives. I can put in a post for you
 or you could join the list. What would you prefer??

 Kiwi Kim.

 ---Original Message---

 From: ozmidwifery@acegraphics.com.au
 Date: 04/29/05 14:55:01
 To: ozmidwifery@acegraphics.com.au
 Subject: [ozmidwifery] midwife in NZ

 Is there a NZ midwifery list where I could put a call out for a midwife
for
 a friend living in West Auckland?

 Thanks

 Tania

 --
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 Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
 
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[ozmidwifery] Tania - midwife in NZ

[Kim Stead]

I think I follow Tania. I'm thinking she is referring to a caseload midwife.
When you have your own independent midwife, you are pretty much guaranteed
to have her attend your birth, or else her partner whom she would have met
on a few occasions.  Depending on the credibility of the midwife of course. 
She needs to be pretty upfront and interview potential midwives - how many
women do they take on, when is there rostered time off, their individual
philosophies etc.  It is common practice for women to interview approx 3
midwives before booking in with one of them.  Most midwives offering
homebirth are usually VERY woman centered. I'll post to the NZ Midwives site
for you and let you know of any responses. 

Kim.
 
---Original Message---
 
From: ozmidwifery@acegraphics.com.au
Date: 04/29/05 19:59:15
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] midwife in NZ
 
I'm told by this woman that there is a great difference (and someone correct
me if I'm wrong) between having your own independent midwife, who uses
another as back up, and being allocated a midwife as part of a group of
anything up to 8 midwives, with no guarantee that you will have someone
you've met with you in labour. She really wants to birth at home, with a
midwife she's built a relationship with, not in a birthing centre, with
someone from the same practice as her midwife. Hope that helps!
 
tania
 
- Original Message -
From: Kim Stead [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Friday, April 29, 2005 5:44 PM
Subject: Re: [ozmidwifery] midwife in NZ
 
 
 Hi Tania

 I can do that no problem. I know what you mean about joining MORE lists.
 What do you mean by group practices?? Most midwives work in a collective
in
 order to support one another etc and have back-up should it be required
but
 take on their own individual caseloads.

 ---Original Message---

 From: ozmidwifery@acegraphics.com.au
 Date: 04/29/05 17:39:15
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] midwife in NZ

 Hi Kim

 If you could post for me, that would be great, we're in the middle of a
 computer upgrade and the last thing I need is to belong to any more lists
at
 the moment!

 This woman is having baby #1, is about 10 weeks pregnant,and looking to
 birth at home, with an independent midwife, not keen on the group
practices.
 She lives in West Auckland

 Many thanks

 TAnia
 - Original Message -
 From: Kim Stead [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Friday, April 29, 2005 5:27 PM
 Subject: Re: [ozmidwifery] midwife in NZ


  Hi Tania
 
  There is a list like OzMid called NZ Midwives. I can put in a post for
you
  or you could join the list. What would you prefer??
 
  Kiwi Kim.
 
  ---Original Message---
 
  From: ozmidwifery@acegraphics.com.au
  Date: 04/29/05 14:55:01
  To: ozmidwifery@acegraphics.com.au
  Subject: [ozmidwifery] midwife in NZ
 
  Is there a NZ midwifery list where I could put a call out for a midwife
 for
  a friend living in West Auckland?
 
  Thanks
 
  Tania
 
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  Visit http://www.acegraphics.com.au to subscribe or unsubscribe.

 --
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 --
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 Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
 
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[ozmidwifery] Vaginal breech birth

[Kim Stead]

Hi again

Not sure what happened in theatre as I only heard about it afterwards but it sounded pretty straight forward after the initialpanic and getting to theatre before mum birthed her baby herself. What was really disappointing is the two people involved - a clinical nurse educator and student midwife.I don'tblame the student at all but think someone supposedly experienced enoughto be in a teaching role, should have known better and acted accordingly.. Afterwards the student was very overwhelmed and the nurse educator repeatedly kept saying, thank god we got her to theatre and saved her!!! I wascompletely speechless about the whole event. What message does this student take away from this situation and how will this affect her future midwifery practice???

I've never been fortunate enough to be present at a breech birth butknowing the mechanisms and rules of hands off etc, think that wewould all be capableof supporting mum to birth this baby herself. There is always senior staff on hand but perhaps that is where the problem lays?Just thinking out loud. 

I prey that I get to see this and vaginal twin birth before I retire.

Kim


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/24/05 12:54:07
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] ENDING GOVERNMENT DISCRIMINATION AGAINST MIDWIVES

yes this was very much a planned breech birth. we have a breech-very keen obstetrician and there have been 4 at that hospital this week including 2 breech twins. (this one was actually caught by the MW with him in the room)
the mum's attitude too, was such a huge part of it i think. she just thought 'why wouldnt i be able to birth her??' so she birthed her on the birth stool with no troubles :)what happened once in theatre kim? Kim Stead [EMAIL PROTECTED] wrote:







Thatsounds wonderful Emily. I 'assume' is was a known/planned breech birth??The last one at our hospital was an undiagnosed multi who wasfully, raced to theatre in order to 'save'mum and babe!! Arhh!! It is certainly a dying art.

Kiwi Kim


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/24/05 11:42:34
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] ENDING GOVERNMENT DISCRIMINATION AGAINST MIDWIVES

yepo mine is sent off too Jan.
BTW, this morning at 5am i was at a lovely vaginal breech birth and a new little black haired girl came in to the world on the night of the full moon. this was the first breech baby i had seen born - except for videos! - and i was amazed how quick it all was. about 3 hrs 1st stage and 18 mins of pushing. and an 8 pound 5 girl. 
perfect!Justine Caines [EMAIL PROTECTED] wrote:
Hi Nicole and allI believe I wrote this letter some time ago. I am unsure where it has resurfaced from!!Tony Abbott embarrassed? Who cares.The update on the Medicare safety-net is.It was purely from Obstetricians hiking their fees (70% in 12 months!!) that blew the safety net out. So what does the responsible Howard Government do?Doe they rope in Obstetricians gross increase? NoThey punish the poorest Australian’s and increase the safety net from $300 to $500.Remember this 70% increase only represents care for 30% of Australian women (as that’s how many private Obs care for).Rural women pay as taxpayers for Medicare to receive no service (within Cooee). While they subsidise Australia’s wealthiest speciali! sts a! nd women.So Tony Abbott has done ABSOLUTELY NOTHING to curb spending by Obs. I would hazard a guess that the majority of women accessing Private Ob services were not within the $300 safety net bracket anyway, they would of been in the higher $700 bracket. So this is an absolute JOKE, and Mr Abbott needs to know we are on to him. I think Fed Treasurer Costello needs a visit too!!JustineJustine CainesNational President Maternity Coalition IncPO Box 105MERRIWA NSW 2329Ph: (02) 65482248Fax: (02)65482902Mob: 0408 210273E-Mail: [EMAIL PROTECTED]www.maternitycoalition.org.au
__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com 









__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com 

Re: [ozmidwifery] Vaginal breech birth

[Kim Stead]

Thanks Jan and Jan!

Yes Iknow that thingsshould andhopefully one day, will be different. This student has a copy of Maggie'sbook. It just seems that someone in a'senior' position who thought thiscase was so dangerous and potentiallytragic, that the studentdisregardedher own knowledge and the ability of the woman to birth her own baby who was clearly coming one way or the other.

I am sure you can all appreciate thatwhen someone deems something 'an emergency situation', it is hard not to get sucked up into the rush and panic of the situation. I know it's not right but it happens. I know I've been there myself as a student and as a new practitioner in a medicalised/ defensive environment- brain intooverdrive thinking of all the 'emergency' things you should be doing as everyone else is the room is flapping around also. Youradrenalin is pumping and rational thought is at times fragmented especially when you are swimming against the current in the first place. It's difficult to trust your own knowledge or what you believe is right.

What is even more sad, is thatmost of these girls (students)have never seen a physiological third stage let alone vaginal breech or twin birth. Something so simple and natural is becoming a thing of the past.

Kim :-)


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/25/05 09:15:29
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Vaginal breech birth

and seek u out they do 
one little girl went to great lengths her parents planned a homebirth the universe greated enormous challenges the mums bp went up protein appeared in the urine the baby turned and remained breech a hospital birth was planned 
at 40 weeks mums bloods were still normal and bp high and protien high we escaped induction the family went on a picnic the dad entered a competetion racing in a bathtub down the banks of the river 
he broke his leg 
2 days later labour started 
the support persons ie drivers did not answer phone
mw went to family to drive to hospital arrived 30 before footling breech birth 
alls happy 
jan 


- Original Message - 
From: Jan Robinson 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, April 25, 2005 8:33 AM
Subject: Re: [ozmidwifery] Vaginal breech birth
You will KimOne day a little breech baby will seek you out and you'll be fine supporting it's mother.Make sure you all support this student and buy her a copy of Maggie Banks book Breech Birth Woman-Wise so she knows there is another way.JanJan Robinson Independent Midwife PractitionerNational Coordinator Australian Society of Independent Midwives8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350e-mail address: [EMAIL PROTECTED] website: www.midwiferyeducation.com.auOn 24 Apr, 2005, at 16:19, Kim Stead wrote:
Hi againNot sure what happened in theatre as I only heard about it afterwards but it sounded pretty straight forward after the initialpanic and getting to theatre before mum birthed her baby herself. What was really disappointing is the two people involved - a clinical nurse educator and student midwife.I don'tblame the student at all but think someone supposedly experienced enoughto be in a teaching role, should have known better and acted accordingly.. Afterwards the student was very overwhelmed and the nurse educator repeatedly kept saying, thank god we got her to theatre and saved her!!! I wascompletely speechless about the whole event. What message does this student take away from this situation and how will this affect her future midwifery practice???I've never been fortunate enough to be present at a breech birth butknowing the mechanisms and rules of hands off etc, think that wewould all be capableof supporting mum to birth this baby herself. There is always senior staff on hand but perhaps that is where the problem lays?Just thinking out loud.I prey that I get to see this and vaginal twin birth before I retire.Kim---Original Message---From: ozmidwifery@acegraphics.com.au
Date: 04/24/05 12:54:07
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] ENDING GOVERNMENT DISCRIMINATION AGAINST MIDWIVES
yes this was very much a planned breech birth. we have a breech-very keen obstetrician and there have been 4 at that hospital this week including 2 breech twins. (this one was actually caught by the MW with him in the room)the mum's attitude too, was such a huge part of it i think. she just thought 'why wouldnt i be able to birth her??' so she birthed her on the birth stool with no troubles :)what happened once in theatre kim? Kim Stead [EMAIL PROTECTED] wrote:Thatsounds wonderful Emily. I 'assume' is was a known/planned breech birth??The last one at our hospital was an undiagnosed multi who wasfully, raced to theatre in order to 'save'mum and babe!! Arhh!! It is certainly a dying art.Kiwi Kim---Original Message---From: ozmidwifery@acegraphics.com.au
Date: 04/24/05 11:42:34
To: ozmidwifery@acegraphics.com.au
Subject: Re

Re: [ozmidwifery] Vaginal breech birth

[Kim Stead]

Pleased to hear that Kate. 


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/25/05 12:32:36
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Vaginal breech birth

What is even more sad, is thatmost of these girls (students)have never seen a physiological third stage let alone vaginal breech or twin birth. Something so simple and natural is becoming a thing of the past.

I'm a 2nd year. One of our "young" students (17) attended her first birth last year - vaginal birth of twins. She, at least, is going to think that's the simple, natural, normal, obvious, first choice, etc way of birthing twins!

Kate

Re: [ozmidwifery] ENDING GOVERNMENT DISCRIMINATION AGAINST MIDWIVES

[Kim Stead]

Thatsounds wonderful Emily. I 'assume' is was a known/planned breech birth??The last one at our hospital was an undiagnosed multi who wasfully, raced to theatre in order to 'save'mum and babe!! Arhh!! It is certainly a dying art.

Kiwi Kim


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/24/05 11:42:34
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] ENDING GOVERNMENT DISCRIMINATION AGAINST MIDWIVES

yepo mine is sent off too Jan.
BTW, this morning at 5am i was at a lovely vaginal breech birth and a new little black haired girl came in to the world on the night of the full moon. this was the first breech baby i had seen born - except for videos! - and i was amazed how quick it all was. about 3 hrs 1st stage and 18 mins of pushing. and an 8 pound 5 girl. 
perfect!Justine Caines [EMAIL PROTECTED] wrote:
Hi Nicole and allI believe I wrote this letter some time ago. I am unsure where it has resurfaced from!!Tony Abbott embarrassed? Who cares.The update on the Medicare safety-net is.It was purely from Obstetricians hiking their fees (70% in 12 months!!) that blew the safety net out. So what does the responsible Howard Government do?Doe they rope in Obstetricians gross increase? NoThey punish the poorest Australian’s and increase the safety net from $300 to $500.Remember this 70% increase only represents care for 30% of Australian women (as that’s how many private Obs care for).Rural women pay as taxpayers for Medicare to receive no service (within Cooee). While they subsidise Australia’s wealthiest specialists a! nd women.So Tony Abbott has done ABSOLUTELY NOTHING to curb spending by Obs. I would hazard a guess that the majority of women accessing Private Ob services were not within the $300 safety net bracket anyway, they would of been in the higher $700 bracket. So this is an absolute JOKE, and Mr Abbott needs to know we are on to him. I think Fed Treasurer Costello needs a visit too!!JustineJustine CainesNational President Maternity Coalition IncPO Box 105MERRIWA NSW 2329Ph: (02) 65482248Fax: (02)65482902Mob: 0408 210273E-Mail: [EMAIL PROTECTED]www.maternitycoalition.org.au
__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com 

Re: [ozmidwifery] Brisbane hospitals alleged discriminatory employment

[Kim Stead]

I'm treated very well also on the ward andif anything, I think my colleagues are envious -some stating they wish they could have trained the same way - they only ever wanted to me midwives as well. They don't hold it against me when they have to be relocated but I am sure they feel it unfair. Hopefully the system will improve and we will all be treated as equal and with respect from our fellowobstetric colleagues.

Kiwi Kim

---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 04/01/05 08:51:48
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment

here in south australia we faced the same dilema however this is my first year out as a dem and i find that the midwives here are accepting of me and my group of grads being new everyone is always afraid of change. so keep in the course and you all will get there/

- Original Message - 
From: Helen and Graham 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, March 31, 2005 7:20 PM
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment

Hi Kim

Your comments about the faces of the nurses arriving at the station for duty on the maternity ward makes it occur to me that this fixation about Direct Entry Midwives not being registered to work in other areas, should apply both ways i.e. those general trained staff should not beregistered to work outside their areas of expertise i.e. maternity. Funny how they don't seem to consider that to be an issue isn't it??!!! I believe they should. The old "multiskilling" buzzword has been taken too far on the one hand but they won't even allow a direct entry midwife to do a few blood pressures in a general ward if they are needed.

I realise that direct entry midwives are predominantly interested in working in midwifery settings but it just seems a double standard to me when it seems a lot of you are quite happy to help out if needed on general areas and aren't allowed but general nurses can be made to work in maternity if it suits the hospital.

It also brings back memories of being "sent" to work in special care nursery before I became a midwife and floundering with little support. Those were the bad old days -or maybe that still happens too!

Just some thoughts

Helen Cahill

- Original Message ----- 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, March 31, 2005 10:35 AM
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment





Hi guys

I must jump in on this one as I too have been affected in this way here in rural Victoria. Two hospitals would not employ me being a 'BMid' despite the fact that one was actively advertising for midwives! I was told it was because I could not be relocated. Same old story! I also commented that I felt I was being discriminated against - I was a midwife needing work, they needed staff - what was the problem! 

I definitely felt a defensive 'feeling' when bringing up the word discrimination. Basically I was told it was a'management decision' with financial implications for the establishment - general nurses must be more cost effective? They needed versatile staff who could work in any area at any time of which I could not, bound by my registration not my unwillingness.  I have since been employed at one ofthese hospitals and so far all is going well.Other'shavebeen relocated on the odd time we have been quiet which is hardly ever - usually the other way around - not enough staff for the client-load. I can only recall this happening on one of my rostered shifts. Mostly it is a case of having to bring staff in to assist us.You should see the faces of the nurses arriving at the nurses station for duty on the maternity ward with all the chaos that goes on I think they are equally as scared and who could blame them. We also have one other DE midwife at the unit, more experienced and senior than I who arrived before me and kept the DE aspect of her training to herself. Can't say I blame her with all the affiliated rubbish that goes on with us 'special' midwives.

This particular hospitalare now introducing a grad program directed at DE midwives. I think they are finally realising the fact that they need staff and perhaps DE midwives might be part of the future workforce? I think they are also accepting the fact that team and caseload are coming and us "DE's" arefully equipped to work in this model.I do believe that things are beginning to change - hopefully for the better.

At times I find itquite humorous to remember that 'general nurses' as lovely as you all are - were once direct entry too.


Kiwi Kim - looking forward to this country getting their act together on maternity issues!




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/31/05 10:14:34
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discrimina

RE: [ozmidwifery] Brisbane hospitals alleged discriminatory employment

[Kim Stead]

Barb - I now reside in Victoria and deeply miss midwifery 'over there'.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/31/05 12:03:50
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment

I am interested in this alleged discrimination issue. As a QNU (not QNC) Councillor I would invite persons affected in Queensland to email me off list soI can take specifics, keeping people's identity out,to the next Council meeting. people can also contact QNU direct as well.I and others have heard of this particularly in regional  rural areas so I would be disappointed if this is occurring in a very larger tertiary institution that hasa large number of existingstaff, including non DEM not to have an issue with deployment. A major health organisation still denies there is a shortage of nurses/midwives!!
Unfortunately all staff in health areas are being devalued to the point to feeling they are only *tools* or a piece on a chess board that get moved around to plug up the gaps!! Workloads and its grievance format was introduced 2 years ago by the MX170 in Qld and yet we still have a major employer arguing how ones goes about closing beds- bunkum!! They do not want to know. 
How many midwives would be interested in joining the funded daily morning walk the DG has organised for their corporate staff? Yes this walk is funded! Wouldn't it be great to tell them how hard it is to deliver quality care at the coal face, how case loading will assist the recruitment and retention of midwives and how many Bl risk managers are frustrating the care given because you spend so much time crossing the t's and dotting the i each day!
I am becoming impatient. The Health Amendment Bill 2004 is being held up at the moment for very good reasons which Qld President ACMI Jenny Gamble has written about in the journal. I won't go into that in any depth as its been done to death but at least it is being held up. I hope the bureaucrat's listens and amend the offensive parts!

Kiwi Kim - isn't it great being a midwife over there.I have just come back from visiting family in Te Puke and it was inspiring to see shops/houses with these signs 'Midwifery-by-the Sea', 'Bay Midwives' and the respect people have of midwives especially the marginalised groups such as ethnics, Maori, islanders and rural communities. it is indeed a truly exciting time!
Cheers Barb


-Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mrs Joanne M FisherSent: Thursday, 31 March 2005 10:00 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment 
I think this decision is a relatively new one by this particular hospitalandis yet to be tested by any new Australian DEM's. The Rego Board (called the QNC here) probably isn't even aware of it. 
Another interesting point, the QNC also has to change one of it's by-laws 1st before QLD starts training their own DEM's asone of their by-laws still state thata midwife must 1st be a nurse! Theymay have already reviewed this by-law, but I have not heard about it yet, it's the only thing holding up starting DEM"s here.
Your email is the only ozmid mail that comes with an attachment to me, but as you said,probably just part of your email.

Cheers, Joanne. 

- Original Message - 
From: Sally-Anne Brown 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, March 31, 2005 9:26 AM
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment 

Thanks for the update Joanne and the reminder re my anti virus update. Had been away for a few days and was updated yesterday around the same time I was on line. Apologies I did not realise it wasn't finnished when I sent the email through. 

Nearly all my ozmid mail appears to have an 'attachment' when it comes in but actually doesn't. It is the email itself that is the 'attachment' if you know what I mean. So the answer to your query is no I did not send an attachment  my guess is it was the email itself.

All the best for the campaign to have all midwives employed who wish to work at the Brisbane hosi's you mentioned will not employ DEM's. I think they would need to be very careful they are not setting themselves up for a discrimination claim/s as it is the registration board that determines whether the training requirements of all midwives (here and o/s) have been met to register as a midwife, and not the area health services. What does the QLD rego board think about the hospitals taking the Rego board's laws into their own hands ?

One would think they might view this as the hospitals stepping over the line, as onewould imagine..!!


Kind Regards

Sally-Anne


- Original Message - 
From: Mrs Joanne M Fisher 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, March 30, 2005 7:18 AM
Subject: Re: [ozmidwifery] Re: testing my email again as I am receiving but 

Re: [ozmidwifery] Brisbane hospitals alleged discriminatory employment

[Kim Stead]

Hi guys

I must jump in on this one as I too have been affected in this way here in rural Victoria. Two hospitals would not employ me being a 'BMid' despite the fact that one was actively advertising for midwives! I was told it was because I could not be relocated. Same old story! I also commented that I felt I was being discriminated against - I was a midwife needing work, they needed staff - what was the problem! 

I definitely felt a defensive 'feeling' when bringing up the word discrimination. Basically I was told it was a'management decision' with financial implications for the establishment - general nurses must be more cost effective? They needed versatile staff who could work in any area at any time of which I could not, bound by my registration not my unwillingness.  I have since been employed at one ofthese hospitals and so far all is going well.Other'shavebeen relocated on the odd time we have been quiet which is hardly ever - usually the other way around - not enough staff for the client-load. I can only recall this happening on one of my rostered shifts. Mostly it is a case of having to bring staff in to assist us.You should see the faces of the nurses arriving at the nurses station for duty on the maternity ward with all the chaos that goes on I think they are equally as scared and who could blame them. We also have one other DE midwife at the unit, more experienced and senior than I who arrived before me and kept the DE aspect of her training to herself. Can't say I blame her with all the affiliated rubbish that goes on with us 'special' midwives.

This particular hospitalare now introducing a grad program directed at DE midwives. I think they are finally realising the fact that they need staff and perhaps DE midwives might be part of the future workforce? I think they are also accepting the fact that team and caseload are coming and us "DE's" arefully equipped to work in this model.I do believe that things are beginning to change - hopefully for the better.

At times I find itquite humorous to remember that 'general nurses' as lovely as you all are - were once direct entry too.


Kiwi Kim - looking forward to this country getting their act together on maternity issues!




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/31/05 10:14:34
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment

Sally-Anne,
I wondered that too!
I am a BMid student and have already been told that our local tertiary hospital would not employ me. I then wondered if that was not a case for discrimination.
Of course their stance is that i cannot be deployed elsewhere in the hospital. Funny how 100's of hospitals overseas and some here of course already employ DEM's!

Kirsten
~~~start life with a midwife~~~

- Original Message - 
From: Sally-Anne Brown 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, March 31, 2005 8:56 AM
Subject: Re: [ozmidwifery] Brisbane hospitals  alleged discriminatory employment 

Thanks for the update Joanne and the reminder re my anti virus update. Had been away for a few days and was updated yesterday around the same time I was on line. Apologies I did not realise it wasn't finnished when I sent the email through. 

Nearly all my ozmid mail appears to have an 'attachment' when it comes in but actually doesn't. It is the email itself that is the 'attachment' if you know what I mean. So the answer to your query is no I did not send an attachment  my guess is it was the email itself.

All the best for the campaign to have all midwives employed who wish to work at the Brisbane hosi's you mentioned will not employ DEM's. I think they would need to be very careful they are not setting themselves up for a discrimination claim/s as it is the registration board that determines whether the training requirements of all midwives (here and o/s) have been met to register as a midwife, and not the area health services. What does the QLD rego board think about the hospitals taking the Rego board's laws into their own hands ?

One would think they might view this as the hospitals stepping over the line, as onewould imagine..!!


Kind Regards

Sally-Anne


- Original Message - 
From: Mrs Joanne M Fisher 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, March 30, 2005 7:18 AM
Subject: Re: [ozmidwifery] Re: testing my email again as I am receiving but unable to send - sorry for the humbug

Not sure why, but an attachment came with your email, did you send one? Also, note at the bottom of this email the out-of-date internal virus datatbase.

Cheers, Joanne.

- Original Message - 
From: Sally-Anne Brown 
To: ozmidwifery@acegraphics.com.au 
Sent: Tuesday, March 29, 2005 5:38 PM
Subject: Re: [ozmidwifery] Re: testing my email again as I am receiving but unable to send - sorry for the humbug

Helen, 
The same thing has happenned to me over the past 2-3 weeks. I find the odd 

Re: [ozmidwifery] implanon and breastfeeding

[Kim Stead]

Just out of curiosity Is implanon theone you get inserted in your arm? What is it's recommended life? Has this replaced the Mireana (IUD)? 

Kiwi Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/22/05 15:55:09
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] implanon and breastfeeding

BTW is implanon now approved in Australia for breastfeeding mothers??

I was told it was. It didn't affect my milk supply. I had it inserted at 8 weeks, and removed after a year (due to intolerable side-effects!)

Kate

Re: [ozmidwifery] sharing 'different' info

[Kim Stead]

Well I would go to Holland and 'See' birth as it should bethen I would go to NZ and spend time with Maggie Banks - breech birth and guru midwife!!! I'd then probably go to the US and visit with Ina May Gaskin on the farm! Dreams are free!!!

Kiwi Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/18/05 11:51:59
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] sharing 'different' info

Spend 2 weeks with the midwives of the Community Midwifery program in
Western Australia! MM

 ideas on places or people or conferences that would be interesting/
 lifechanging etc etc that I can 'plan' to go and see??



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This mailing list is sponsored by ACE Graphics.
Visit http://www.acegraphics.com.au to subscribe or unsubscribe.

Re: [ozmidwifery] sharing 'different' info

[Kim Stead]

I'm totally for breastfeeding and have breastfed all 3 of my kids. What I am seeing at the moment (can only speak for this area) is so much emphasis on breastfeeding and solittle on anything else. Sure - breastfeeding is great and is the 'best' but I believe when a woman feels safe and supported, she willmost likely choose the best things for herself and her baby anyway.I know a lot of these mums who are pressured to breastfeed in hospital are giving up as soon as they leave the ward and the hospital are only interested in the fact that they are BF at discharge!!! Hello.. isn't the long term important too. It's time to get back to the basics- women need antenatal education, optimial health, healthy lifestylesetc. They need to be told that pregnancy and birth are normal life events unless otherwise indicated and not something that needs to be controlled or monitiored at every opportunity. When we give women more education, more time, more support, better care.then I am sure a good proportion will make the right choices for their individual circumstances which will include BF. A lot of these women don't even know what will be good for them in the long-term!

Of course we all have different views and interests and coming from the outside. this maternity system still has a very long way to go 

Just my thoughts. Crucify me if you wish.





---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/18/05 16:08:25
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] sharing 'different' info

I wouldn't glorify birthing in the Netherlands too much - their
breastfeeding rates are amongst the lowest in the World. A wonderful birth
experience is the best way to start (extrauterine) life - but to be
breastfed will have a longer term effect on the health and well being of
the baby and mother.

Denise

At 02:39 PM 18/03/2005 +1100, you wrote:
Well I would go to Holland and 'See'birth as it should be then I would
go to NZ and spend time with Maggie Banks - breech birth and guru
midwife!!!I'd then probably go to the US and visit with Ina May Gaskin
on the farm!Dreams are free!!!

Kiwi Kim

***
Denise Fisher
Health e-Learning
http://www.health-e-learning.com
[EMAIL PROTECTED]



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This mailing list is sponsored by ACE Graphics.
Visit http://www.acegraphics.com.au to subscribe or unsubscribe.

Re: [ozmidwifery] Waterbirth thread - maternity initiatives!

[Kim Stead]

 midwifery-led model, but I know that just as many would resist it strongly! 

Hope this helps add to the general info about what is happening 'out there'

Sue

- Original Message ----- 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Tuesday, March 15, 2005 1:52 PM
Subject: [ozmidwifery] Waterbirth thread - maternity initiatives!





Hi everyone

I've been followingthis thread with great interest. I am a bit confusedas to this new initiative and whether it in fact, means anything at all? Is tomorrow going to come and go and things continue to stay the same?? Some say that this whole 'initiative'it is just a tokengesture to calm the waters andat the end of the day.. the old boys have all the control and are not going to hand this over to midwives? 

Like Tina, I have too trained in the BMid model andfeel quite equipped to offer care across the whole continuum and work in a caseload model. The problem is... there are very few vacancies for us to work in the model we have been trained for. Icertainly hope this will improve. The hospital I am at is keen to offer caseload butthere are a fewhurdles in our way. I'd be interested to know whether this applies to other hospitals as well..

1.Lack of committed and skilled staff - or should I say, a huge fear that working caseload is going to impose on our lives too much!
2. Lack of obstetric/medial support when needed. There are lots of power struggles going on and obstetricans playing bullies!
3. How to fund this type of program with no additionalfunding? 
 - I realise there are grants available of which I understand we have been turned down for on our last attempt? I believe we are alsowaiting for the ANFto decide on salary packages for caseload type work.

Another concernthat I see is not only the opposition or fear of caseload by many midwives,but also the knowledge gapthat existsin the antenatal segment. I am not sure ifpreconception and antenatal care and education has been part of traditional midwifery training... and I realise it is not rocket science but I have also seen manymidwives who have become reliant on doctors instead of using their own extensive knowledge and skill base. Together we have a wealth of knowledge that we need to share with each other. I am sure you all agree and I hope you can understand where I am coming from. We know how to fill in pathology forms, how to do a bishop score etc, but we have not been 'alllowed' to perform such tasks. There are many more I can think of when midwives have been required to call in a doctor to follow protocols!

Is it the unknown or lack of confidence/skillsin this area that is contributing to the fearfactor?If so, what are we doing about it? If and when these types of models of care are initiated, how will westaff them with the current state of our workforce and lack of midwives? I believe each and everyone one of us has it in us to work to our full potential and it should be our right to move in and out of different models to suit our individual situations but I believe we are on the back-foot preparing and supporting each other to do this. I don't believe in my area that we would have adequate numbers to undertake Caseload in this area effectively and efficiently. It would be shame to start and burn out because it were not set upproperly. I can imagine who would be laughing too andsaying "I told you so!" How do the rest of you feel in the areas you live in? Is this a rural thing or does it apply to the metropolitan areas also? I'm in rural Victoria.

I have heard through the grapevine that there is money available for refreshing/reskilling of midwiveswhatever you would like to call it, but how and when is this going to take place? Do any of you know of any refresher type programs that are currently availbable? Shouldn't this already be happening in preparation for our day in the sun?

I also think the idea of independent midwives mentoring grad midwives is terrific in theory, but again. finding midwives who are still managing to work in these models is another difficulty in itself. I worked with a beautiful midwife yesterday (relatively new) who said she had never seen physiological 3rd stage. I wonder if she has ever truely seen a normal birth? How canwe expect midwives to facilitatenormal births when they have not had the opportunities to witness them? We need more MIPPS to help keep this balance with student midwives. We all know we need more support to encourage and support independent midwifery!!! 

I hope that this post is not offensiive to anyone as that is not my intention at all. I'm only new myself so full of passion and ideas but lacking in the experience department. I see that we can all offer each other so much and I really feel passionate that we need to begin working together and supporting one another in the drive for better employment options. 

I'dlike to see this happenbefore I die as well! Someone please tell me that this is going to

[ozmidwifery] Waterbirth thread - maternity initiatives!

[Kim Stead]

Hi everyone

I've been followingthis thread with great interest. I am a bit confusedas to this new initiative and whether it in fact, means anything at all? Is tomorrow going to come and go and things continue to stay the same?? Some say that this whole 'initiative'it is just a tokengesture to calm the waters andat the end of the day.. the old boys have all the control and are not going to hand this over to midwives? 

Like Tina, I have too trained in the BMid model andfeel quite equipped to offer care across the whole continuum and work in a caseload model. The problem is... there are very few vacancies for us to work in the model we have been trained for. Icertainly hope this will improve. The hospital I am at is keen to offer caseload butthere are a fewhurdles in our way. I'd be interested to know whether this applies to other hospitals as well..

1.Lack of committed and skilled staff - or should I say, a huge fear that working caseload is going to impose on our lives too much!
2. Lack of obstetric/medial support when needed. There are lots of power struggles going on and obstetricans playing bullies!
3. How to fund this type of program with no additionalfunding? 
 - I realise there are grants available of which I understand we have been turned down for on our last attempt? I believe we are alsowaiting for the ANFto decide on salary packages for caseload type work.

Another concernthat I see is not only the opposition or fear of caseload by many midwives,but also the knowledge gapthat existsin the antenatal segment. I am not sure ifpreconception and antenatal care and education has been part of traditional midwifery training... and I realise it is not rocket science but I have also seen manymidwives who have become reliant on doctors instead of using their own extensive knowledge and skill base. Together we have a wealth of knowledge that we need to share with each other. I am sure you all agree and I hope you can understand where I am coming from. We know how to fill in pathology forms, how to do a bishop score etc, but we have not been 'alllowed' to perform such tasks. There are many more I can think of when midwives have been required to call in a doctor to follow protocols!

Is it the unknown or lack of confidence/skillsin this area that is contributing to the fearfactor?If so, what are we doing about it? If and when these types of models of care are initiated, how will westaff them with the current state of our workforce and lack of midwives? I believe each and everyone one of us has it in us to work to our full potential and it should be our right to move in and out of different models to suit our individual situations but I believe we are on the back-foot preparing and supporting each other to do this. I don't believe in my area that we would have adequate numbers to undertake Caseload in this area effectively and efficiently. It would be shame to start and burn out because it were not set upproperly. I can imagine who would be laughing too andsaying "I told you so!" How do the rest of you feel in the areas you live in? Is this a rural thing or does it apply to the metropolitan areas also? I'm in rural Victoria.

I have heard through the grapevine that there is money available for refreshing/reskilling of midwiveswhatever you would like to call it, but how and when is this going to take place? Do any of you know of any refresher type programs that are currently availbable? Shouldn't this already be happening in preparation for our day in the sun?

I also think the idea of independent midwives mentoring grad midwives is terrific in theory, but again. finding midwives who are still managing to work in these models is another difficulty in itself. I worked with a beautiful midwife yesterday (relatively new) who said she had never seen physiological 3rd stage. I wonder if she has ever truely seen a normal birth? How canwe expect midwives to facilitatenormal births when they have not had the opportunities to witness them? We need more MIPPS to help keep this balance with student midwives. We all know we need more support to encourage and support independent midwifery!!! 

I hope that this post is not offensiive to anyone as that is not my intention at all. I'm only new myself so full of passion and ideas but lacking in the experience department. I see that we can all offer each other so much and I really feel passionate that we need to begin working together and supporting one another in the drive for better employment options. 

I'dlike to see this happenbefore I die as well! Someone please tell me that this is going to happen...? I'm only in my 30's!

Your in midwifery and forever learning so forgiveness please for my foot in mouth disease!!

Kiwi Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/15/05 14:12:14
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] waterbirth


Hello Tina

Bear in mind that our 

[ozmidwifery] Attn: Anne - midwifery model network.

[Kim Stead]

Hi Anne

What is your 'off-list' email contact? I would like to take this to myUnit Manager andkeep on the ball for this to happen in our hospital. I am sure united we can achieve a lot and like you say why reinvent the wheel!

Regards

Kiwi Kim,



---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/15/05 07:53:50
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] waterbirth

Dear All,

If anyone knows or would like to let a unit know that ishas aMidwifery model of care orwho would like their unitto be a Midiwfery model of care, I am going a little step further than Jo who is putting together a list of Midwifery led care.

Since Midwifery is now starting to grow in some areas I am suggesting to put together a Newsletter and furthercommunication lines with Midwives that is a little different than the ozmid list of general discussion.

I am happy to coordinate this initially. Of cours ozmid will still be a part of our lines of communication.

The purpose is to let colleagues know of what types of Midwifery led care is out there, act as a mentor, listening post, exchange ideas, problems etc etc etc. on a one to one, unit to unit basis. It can be very useful when introducing this model of care (in its many forms) brainstorm problems, new ideas, and not reinvent the wheel if someone has already gone through the process. Get the idea?

So it is up to you all to get back to me with:

1. names
2. locations
3. contact numbers
4. contact addresses 
5. snail mail
6. email contact
7. Summary of your model of care

I will put together a format - it will probably be through email

[ozmidwifery] We're here!

[Kim Stead]

Hoi - can hear you Jo!!! :-)



---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/14/05 18:22:33
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] anyone out there?


Just checking that these are getting thru. Emails I send are coming up on my email list but I seem to be missing some other’s posts and such.

Can you send me a hoi to let me know you can hear me ….or are you all ignoring me again! ;o)

Love Jo

Re: [ozmidwifery] Selangor Maternity

[Kim Stead]

Looks nice doesn't it!!! Here's a couple more sites ofbirth centres in NZ for anyone who may be interested.Both of these were set upby midwives and both centres are in the same town! Wouldn't it be great to see this sort of thing all around Australia. I live in hope.

http://www.riverridgeeastbc.co.nz/

http://www.waterfordbc.co.nz/waterford/index.php?ctnt=about.php

Kiwi Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/11/05 21:29:35
To: [EMAIL PROTECTED]; ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Selangor Maternity

Dear All
Mayne Health sold many of its hospitals to Affinity Health including Selangor 
below is the web address thru which you can do a virtual tour

Unfortunately you do not meet Lunne or Ted Weaver

http://www.affinityhealth.com.au/queensland/san/selangor.htm
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

Re: [ozmidwifery] Preconception care?

[Kim Stead]

Hi Julie

I haven't got much time to chat at the moment but I do believepre-conception care is part of our practice shouldwe be able to access women at this time.It's important to discuss the importance of a healthy body prior to conception - especially things such as diabetes control, listeria, toxoplasmosis, family histories (spina bifida comes to mind and increased folic acid) etc. There's quitea few other things that I discuss (not that many women make contact prior to conception). Must run for now.I look forward to other's perceptions on this topic.

Kiwi Kim



---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 03/05/05 09:58:28
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Preconception care?


Hello all you wonderful, wise people. 
I was wondering what your thoughts are on midwives providing preconception care.
Is it in our scope of practice as we are told at university or does our role really only beginning in the antenatal period? 
If we are involved, what are we telling couples other than to take folic acid supplements and have sex in the middle of the menstrual cycle.
I am beginning my final year of Midwifery at Flinders University and would like to explore and research this area further.
Cheers, Julie Garratt (champion Ozmid lurker and learnerJ 

Re: [ozmidwifery] RE: breech

[Kim Stead]

That's"Breech Birth Woman-Wise".Just to get technical! :-)




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 26/02/2005 8:39:57 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] RE: breech

Thanks for the help!! I will see whether I can locate the book "Breech Wise".

Cheers
Helen

- Original Message - 
From: Sally Westbury 
To: ozmidwifery@acegraphics.com.au 
Sent: Saturday, February 26, 2005 5:34 PM
Subject: RE: [ozmidwifery] RE: breech


Oh.. the other thing that I wanted to say is that at 32 weeks I would not be too worried. Babies are often that way at 32 weeks and then turn. If you were a client of mine I would be saying don’t worry until 34-35 weeks. Then do everything!!

Sally Westbury
Homebirth Midwife

"It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her." -Judy Slome Cohain

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Kim Stead]

Thanks Sue! I always appreciate the learning we get from our more superior peers! Keep it coming! It's a reminder to mehow fear can override the way in which we practice!

Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 25/02/2005 7:13:10 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

Hi,
I would definitely treat this woman like all others and assume
physiological 3rd stage is sufficient.
I have never actively managed a 3rd stage, and have given syntometrine 3
times only after placentas were born - all in my early days of homebirth.
I always prefer to;
a) make sure women are well hydrated going into 2nd stage so they can
tolerate volume loss
b) if bleeding is serious go into "deliver placenta mode"
I always catch and therefore can measure blood loss at a glance
I engage the mother first and tell her she's bleeding and that I need
her to focus and deliver her placenta
I always give herbs as a first line of attack- shepherd's purse has
always been my first choice
I would rub up a ctxn, add an ice pack to her uterus if one available
Then with her assistance pushing I would apply cord traction and see if
the placenta would come
Repeat this maybe twice
Then contemplate manual removal if necessary (not had to yet...)

I have managed 5 large haemorrhages (over 1.5 litres measured) in this
manner and have not had to transfer anyone yet.(I have a
haemoglobinometer with which I can measure Hbs on the spot over the next
few weeks if necessary..)
This management regime was taught to me by John Stevenson and always
seems to work.Up until very recently, I have always worked alone.

Isn't it interesting all the different ways we'd handle this depending
on our personal experiences?

By the way, late last year I witnessed the worst PPH I'd ever seen -
mainly because of the management in the hospital (it was a hospital
support not a homebirth), and with all the hands you could ever imagine
-I'd say too many - the woman was severley depleted. Drips in etc etc
but too much too late. A cord pulling midwife, and then no
acknowledgement of when she needed help (irrespective of my pleas) plus
she underestimated the blood loss by more than 100% (she thought 600ml,
and it was measured by weight (? accuracy) to be more like 1400ml) and
then the woman was taken to theatre - more time, more blood, why not a
manual removal then and there??

Aaaah. Expect no PPH but stay on your toes ...always my motto.

Sue

- Original Message -
From: "leanne wynne" [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, February 24, 2005 2:43 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT




Hi All,
I would be interested to hear from any experienced homebirth midwives how
they would care for a woman who is a G10P9 if she chose to birth at home.
She has had all normal, quick births so far. Would you use active


management


of third stage because she is a grand multip or would you still encourage


a


physiological third stage??
Leanne.



From: "Marilyn Kleidon" [EMAIL PROTECTED]
Reply-To: ozmidwifery@acegraphics.com.au
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Date: Thu, 24 Feb 2005 16:55:56 -0800

Excellent point. I do think the 500mL definition for PPH is spurious.
Having been educated by a homebirth midwifery school I have to say we


were


not concerned when the blood loss was less than 1000mL as most of our 3rd
stages were physiological. Very occassionally we did use oxytocin for
management of 3rd stage usually when the woman had a history of PPH


greater


than 1000mL or retained products etc.. However we were well versed in the
Cochrane studies and aware of that evidence so we had a high degree of
caution shall I say. We did carry 40 units of pitocin and also


ergometrine


both vials and tabs to births as well as herbal remedies. Syntometrine


does


not seem to be available in the USA at least not where I was. That being
said from what i have seen here postnatally, active management really
decreases the postpartum blood loss in most women. I am currently doing


the


extended midwifery service and visiting women in their home during the
first 1 to 10 days and most seem to have almost finished bleeding by day


5,


for most of the homebirth women I visited in the USA just from memory I
would say they were almost finished by day 10.Both the American College
of Nurse Midwives (ACNM) and the Midwives Alliance of North America


(MANA)


have been collecting stats for 5 to 10 years at least and must have good
stats on this topic. I know it isn't Australian data but itmight be
helpful.

marilyn
- Original Message -
From: Jenny Cameron
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, February 23, 2005 3:51 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Good point Michelle. If we used 1000ml as PPH definition the stats


would


not look so appealing for active mgmt. 

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Kim Stead]

Hi everyone. I agree with Marilyn but being 'newish midwife'.. I would have everything ready to go and cannulaand fluids on hand as well. I'd also makea real effort to ensure she fully understood the situation should you have to intervene in a hurry. I have seen a grand multip bleed like a 'stuck-pig' - (excuse the pun) and it was darn scarry even with everything ready and many hands on board. It's a shame that things like this stick in our minds but also useful to realise theseverity of the situationshould it arise. I also think a 2nd midwife is a good idea. On a brighter note - I am sure all will be fine!

Kim.



---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 25/02/2005 11:22:38 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

I would make sure I had a good supply of oxytocics on hand even maybe have
the syntocinon drawn up but unless she has a hx of PPH etc. I would not
assume a PPH is destined to happen. Of course if the woman requested active
management then that would be fine too. If the woman was confident to wait
and see what happens I would be too. I would want to have a recent FBC
available and IV fluids in my bag.And the woman totally informedof the
increased risk of PPH especially if she were to have a preciptitous or
prolonged labour. Definetly would be nice to have a 2nd midwife with me.
LOve to hear what others say.

marilyn
- Original Message -
From: "leanne wynne" [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, February 24, 2005 2:43 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


 Hi All,
 I would be interested to hear from any experienced homebirth midwives how
 they would care for a woman who is a G10P9 if she chose to birth at home.
 She has had all normal, quick births so far. Would you use active
management
 of third stage because she is a grand multip or would you still encourage
a
 physiological third stage??
 Leanne.

 From: "Marilyn Kleidon" [EMAIL PROTECTED]
 Reply-To: ozmidwifery@acegraphics.com.au
 To: ozmidwifery@acegraphics.com.au
 Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
 Date: Thu, 24 Feb 2005 16:55:56 -0800
 
 Excellent point. I do think the 500mL definition for PPH is spurious.
 Having been educated by a homebirth midwifery school I have to say we
were
 not concerned when the blood loss was less than 1000mL as most of our 3rd
 stages were physiological. Very occassionally we did use oxytocin for
 management of 3rd stage usually when the woman had a history of PPH
greater
 than 1000mL or retained products etc.. However we were well versed in the
 Cochrane studies and aware of that evidence so we had a high degree of
 caution shall I say. We did carry 40 units of pitocin and also
ergometrine
 both vials and tabs to births as well as herbal remedies. Syntometrine
does
 not seem to be available in the USA at least not where I was. That being
 said from what i have seen here postnatally, active management really
 decreases the postpartum blood loss in most women. I am currently doing
the
 extended midwifery service and visiting women in their home during the
 first 1 to 10 days and most seem to have almost finished bleeding by day
5,
 for most of the homebirth women I visited in the USA just from memory I
 would say they were almost finished by day 10.Both the American College
 of Nurse Midwives (ACNM) and the Midwives Alliance of North America
(MANA)
 have been collecting stats for 5 to 10 years at least and must have good
 stats on this topic. I know it isn't Australian data but itmight be
 helpful.
 
 marilyn
  - Original Message -
  From: Jenny Cameron
  To: ozmidwifery@acegraphics.com.au
  Sent: Wednesday, February 23, 2005 3:51 PM
  Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
 
 
  Good point Michelle. If we used 1000ml as PPH definition the stats
would
 not look so appealing for active mgmt. Also as someone stated women
having
 a physiological 3 stage tend to lose more in the first few hours after
 birth than those having active mgmt. As far as I am aware no-one has
 researched total postpartum (say in the first week) blood loss. Hb or Hct
 estimation is the best way of determining blood loss post partum but you
 need to have a pre-partum Hb/Hctas well.
 
  Jenny
 
  Jennifer Cameron FRCNA FACM
  ProMid
  Professional Midwifery EducationService
  0419 528 717
  - Original Message -
  From: Michelle Windsor
  To: ozmidwifery@acegraphics.com.au
  Sent: Wednesday, February 23, 2005 10:34 PM
  Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
 
 
  I haven't heard of a study of this type beingb done.I find it
 interesting that the NSW policy (similar to many others) of PPH is over
 500ml, and yet the WHO states that in healthy populations (ie not anaemic
 etc) up to 1000ml blood loss may be physiological.It is often said that
 blood loss at birth is underestimated I wonder how many women have
 blood loss of over 500ml 

Re: [ozmidwifery] Red heads

[Kim Stead]

Just to add my two cents. red heads are difficult toperform venipuncture on - or so thestory goes!!!Maybe it is because I am blonde!! :-)




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 21/02/2005 6:52:23 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Red heads
You may be right Kirsten. I read a very interesting article (in a medical journal) about how redheads respond to drugs quite differently, and in particular to anaesthetics. I found it fascinating.DeniseWho used to be a brunette. :-) At 03:53 PM 21/02/2005 +0930, you wrote:
evidently being a red head (naturally of course!) means we have a tendency to bleed more. Also prone to low iron retention.Something to do with a clotting factor missing.Genetic.Its all been researched and seems quite well known.KirstenA red head
***Denise FisherHealth e-Learninghttp://www.health-e-learning.com[EMAIL PROTECTED] 

[ozmidwifery] Active Management

[Kim Stead]

I haven't got any specific literature to quote but I do have a good book called "Delivering your placenta - the 3rd stage" but out by AIMS. Itdiscusses physiological and active managementand does mention waiting for signs of separation. It also discusses pro's and con's of both. A recommend reading it. I think I brought it from Birth International and it didn't cost a lot.

I too have seen many different approaches to active management - a few quite disturbing!




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 20/02/2005 10:20:22 a.m.
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] question

You must wait for placental separation, otherwise you risk inverting the uterus Maureen

-Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Susan CudlippSent: Wednesday, 9 February 2005 2:55 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] question
Dear ozmid list-ners
I have not been on the list for a while but have a question that I would welcome your input on.

When performing active management of the third stage, is it routine practiceto await signs of placental separation before commencing CCT, or to simply ascertain that there is uterine contraction?

Also, what is the current recommendation for management of retained placenta, or situations when the cord separates during CCT?

I know this may sound odd, and I know what I was taught and have practiced, but I am in the midst of a "difference of opinion" and I need to check what are the actual guidelines given. I have attempted to search this out myself but have not been able to find much in the way of actual step-by-step instructions for active management of the third stage.

With respect, I do not need to knowpeople's preferred methods or opinions on the rights and wrongs of active management, simply the actual guidelinesfor active management and when to commence CCT. I would be grateful if anyone can post this or lead me to it. I have tried many sites on the net without success and do not have easy access to up to date manuals.

Thank you in advance, I have been "off list" for quite a while due to being very busy! Looking forward to listening in again now that life is a bit quieter.

Susan Cudlipp

Re: [ozmidwifery] question

[Kim Stead]

Hi Jo

Thanks for your post!Now I am only a new midwife butsurely what youdescribe as 'active management' is actually management of a PPH? I've neverseen that in any texts that I have read - for active management that is??? Have others heard of this?

Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 20/02/2005 6:26:05 p.m.
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] question
Susan, where I work we use Synometrine IMI, and are told to clamp the cord immediately - the drug is supposed to be given with the anterior shoulder, but is rarely given that soon... it is often given after the cord is clamped. Then we await signs of separation before commencing CCT. This is the usual management it is not called active management... Active management is when a bag of 30IU syntocinon in 500ml CSL is commenced after the syntometrine is given IMI, at a rate of 240ml/hr and titrated down according to loss. Someone told me when I first started working there, "this woman is for active management of 3rd stage." I said, "I thought that was policy anyway..." "No, 30 units of synto in a 500ml bag is active management..." That is used for anyone with a previous PPH or a grand multipara. One of the private docs also uses that for red-headed women.Depending on which doctor is on how long before declaring 'retained placenta'. HTH!Jo (RM)Susan Cudlipp wrote: 




Thanks for this, and for the feedback so far - I'm sure more is on the way!
The situation is that I am contesting another practitioner's management of a delivery. One aspect of this delivery was that he commenced CCT on a friable cord (small baby- IUGR - scrappy cord) almost as soon as the oxytocic had been given (we use sytocinon not syntormetrine by the way Mary). The cord, not surprisingly, separated. And a chain of events ensued :-(
I challenged the fact that CCT had been commenced before signs of separation, and was told that the only factor needed to be ascertained was that the uterus was contracted.
I know that I was taught to await signs of separation before commencing CCT,even given that in those days we always used syntometrine,so this surprised me.
As this situation is now being taken further (there is obviously a lot more to the whole story) I need to have my facts and evidence to back up my opinion before the next stage. Unfortunately it still seems to be that this issue is unclear with most centres recommending waiting, and some recommending immediate CCT with the first uterine contraction. 'Active management' is a term used frequently with, it seems, an assumption that people know what it entails. I would be very interested to hear from student midwives on this - what exactly are you being taught nowadays?
The second point of contention in this issue is what defines a retained placenta - I would have thought this was patently clear with most authorities agreeing that a period of 60 minutes is acceptable in the absence of bleeding. As you will have guessed by now - this time was not given!
Just for clarification, the patient hadan empty bladder, an IVI with syntocinon infusion and was not bleeding.

Thanks again all
Sue

[ozmidwifery] Bach Mid

[Kim Stead]

Hello again Marcia and others interested in this thread.

Thanks for your intro Marcia. It's always nice to knowwho you are talking to. I guess I have become a bit guardedregarding my midwifery qualification as it's been atorturous road to find a supportive environment in which to practice. I live rurally - Gippsland to be precise. DE midwives are virtually unheard of in the rural areas and many are at a lossas to 'what to do with us' since we can't be relocated to otherwards - despite screaming out for midwifery staff. Some, like anything new, are veryresistant to change - mostly their own insecurities from what I can make out. 

Anyway, I arrived in Australia 18mths ago and applied at two hospitals for work - both turned me down because 1. I could not be relocated and 2. because they were 'too busy' training medical staff. I was also told that "I needed serious career advice if I thought I would ever be able to work in this country". That was from one individual but someone in a position who should have known better!!! You can imagine how that felt being a new, very enthusiastic graduate who had just sacrificed everything (family  financesincluded)to survive the 3 year 'full-on' degree!! It was soul destroying to say the least and I now fully understand the term 'horizontal violence'! Fortunately for me - it just made me stronger and more determined! Why does this profession 'eat their young' instead of nuture them? I thought as midwives and as women - we were the nuturing types? I know this is not true of all but the few that are like this leave a very bad taste in my mouth. 

Anyway... Since my 'failed applications', I hadbeen working in the community 'with woman'the best way possible in the current environment but have just recently taken up an offer at one of the hospitals previously mentioned. It is funny how things eventually have an about turn and how midwifery shortagesdon't change. It seemed they were impressedby mywork in the community and my dedication to 'midwifery philosophy' and keeping birth normal where possible. They wanted ME as part of their team...It was a little hard to stomach at first and the concept of 'working in an obstetric model' is still very challenging each day when I drive to and from work. I strive to work as
a midwife in a 'task orientated' environment where the focus is on the abnormal - either creating or correcting it. It's no easy task or for the faint hearted! I feel really sad that manymidwives in this country are unable to practice to their full potential and see midwifery for what it really is - or should be. Perhaps we can stand united and fight for improvements for not only women but for ourselves? We as women and midwives and mothersare a pretty strong force to be reckoned with! Food for thought!

The hospital I am at are beginning to understand that Bach of Mid is here to stay and that we may well be the midwives of the future. Many rural hospitals down this way are yet to take that on board.I think that us 'new breed' of midwives have a lot to offer and lots of new ideas to share and vice versa. I also believe that 'together' - all of us, can make a real difference and bring midwifery in this country into the 21st century - well at least inline with our other western sisters. I live in hope. it's what keeps me going! I hope my sharing some of my experience, that you can appreciate what it is like for us 'newbies'. We just want to be midwives like the rest of you and have been fortunate enough to experience an educationthat takes us straight there. We are not 'anti-nurses', just don't have a desire to be nurses. Of course I only speak for myself Enough waffle for now!

Kiwi Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/14/05 18:09:18
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] B/MID FOLLOW UP

Hello Kim and others,
I am a clinical midwifery educator at Werribee mercy hospital. I have been involved in the interviewing processes without knowing outcomes other than the 2 places we could offer. It seemed to me that because of the competitive numbersand an unknown number of postions being offered, that some girls may have missed out. I am interested in the overall outcomes now and in future.
marcia - Original Message - 

From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, February 14, 2005 5:25 PM
Subject: Re: [ozmidwifery] B/MID FOLLOW UP





May I ask why you are interested and who you are?

There is aBMid internet collective who I am sure will be happy toanswer any genuine questions you may have. I'm a recent BMid grad myself (not trained here though) so I'm always happy to chat about my experiences as well but I'm also aware that there's some among us (midwives) who like to eat their young!

Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/14/05 14:23:42
To: ozmidwifery@acegraphics.com.au
Subject: [Norto

Re: [ozmidwifery] Bach Mid

[Kim Stead]

Thanks Nicole!


---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/14/05 20:16:52
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Bach Mid

Hi Kiwi Kim,
I am a post grad educated midwife, and I ENVY the training that you Bmidders have had. Many of the hospitals which have put in for caseload midwifery funding will struggle to find adequately prepared midwives within their ranks. Bmidders fit the bill perfectly. So while in the short term it is difficult to gain employment, it will soon be different, I believe. All the very best.
Nicole.

- Original Message - 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, February 14, 2005 7:25 PM
Subject: [ozmidwifery] Bach Mid





Hello again Marcia and others interested in this thread.

Thanks for your intro Marcia. It's always nice to knowwho you are talking to. I guess I have become a bit guardedregarding my midwifery qualification as it's been atorturous road to find a supportive environment in which to practice. I live rurally - Gippsland to be precise. DE midwives are virtually unheard of in the rural areas and many are at a lossas to 'what to do with us' since we can't be relocated to otherwards - despite screaming out for midwifery staff. Some, like anything new, are veryresistant to change - mostly their own insecurities from what I can make out. 

Anyway, I arrived in Australia 18mths ago and applied at two hospitals for work - both turned me down because 1. I could not be relocated and 2. because they were 'too busy' training medical staff. I was also told that "I needed serious career advice if I thought I would ever be able to work in this country". That was from one individual but someone in a position who should have known better!!! You can imagine how that felt being a new, very enthusiastic graduate who had just sacrificed everything (family  financesincluded)to survive the 3 year 'full-on' degree!! It was soul destroying to say the least and I now fully understand the term 'horizontal violence'! Fortunately for me - it just made me stronger and more determined! Why does this profession 'eat their young' instead of nuture them? I thought as midwives and as women - we were the nuturing types? I know this is not true of all but the few that are like this leave a very bad taste in my mouth. 

Anyway... Since my 'failed applications', I hadbeen working in the community 'with woman'the best way possible in the current environment but have just recently taken up an offer at one of the hospitals previously mentioned. It is funny how things eventually have an about turn and how midwifery shortagesdon't change. It seemed they were impressedby mywork in the community and my dedication to 'midwifery philosophy' and keeping birth normal where possible. They wanted ME as part of their team...It was a little hard to stomach at first and the concept of 'working in an obstetric model' is still very challenging each day when I drive to and from work. I strive to work as
a midwife in a 'task orientated' environment where the focus is on the abnormal - either creating or correcting it. It's no easy task or for the faint hearted! I feel really sad that manymidwives in this country are unable to practice to their full potential and see midwifery for what it really is - or should be. Perhaps we can stand united and fight for improvements for not only women but for ourselves? We as women and midwives and mothersare a pretty strong force to be reckoned with! Food for thought!

The hospital I am at are beginning to understand that Bach of Mid is here to stay and that we may well be the midwives of the future. Many rural hospitals down this way are yet to take that on board.I think that us 'new breed' of midwives have a lot to offer and lots of new ideas to share and vice versa. I also believe that 'together' - all of us, can make a real difference and bring midwifery in this country into the 21st century - well at least inline with our other western sisters. I live in hope. it's what keeps me going! I hope my sharing some of my experience, that you can appreciate what it is like for us 'newbies'. We just want to be midwives like the rest of you and have been fortunate enough to experience an educationthat takes us straight there. We are not 'anti-nurses', just don't have a desire to be nurses. Of course I only speak for myself Enough waffle for now!

Kiwi Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/14/05 18:09:18
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] B/MID FOLLOW UP

Hello Kim and others,
I am a clinical midwifery educator at Werribee mercy hospital. I have been involved in the interviewing processes without knowing outcomes other than the 2 places we could offer. It seemed to me that because of the competitive numbersand an unknown number of postions being offered, that some girls may have missed out. I am 

Re: [ozmidwifery] Bach Mid

[Kim Stead]

HiTania

Just a quick reply as I am about to run out the door.

Not being able tobe relocated to other wards is not my point of view at all, but rather a restriction on my registration.Here in Vic,we are registered as Div 1nurses with restrictions to practice mid only. I understand that inSA, youwill be registering as midwives. It is something that you will need to clarify with your own nurses board but I would assume that you too could be working in a very 'grey' area caring for general medical cases?? Maybe someone else on the list could enlighten you on that one? I guess it's a matter of looking at our scope of practice not what we feel we are able to do? I don't know - just speculating.

I am not against looking after gynae patients etc but I am notwilling to put my neck on the line if technically, I am not allowed to do this and heaven forbid - something goesterribly wrong. I think the hospital feel the same way and it's no big stress as there are enough staff to do this on the odd occasion that it happens. The manager knows I am better allocated in other areas. I can takethe basic obs you refer to so that's not the issue and it's certainly not an insecurity on my part. The staff who I work with are allfantastic so I don't have issues with fitting in, being accepted etc and while Imay have appeared negative in my post,Ido try to make the most of situation I'm just frustrated by the limations placed on our practice, particularly here in the rural areas. The relocationissues with employment is morea managerial, cost effectiveness thing that has been discussed in another thread. I am not accountable to the board for finances so will leave that to the experts.

Kim :-)




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/15/05 12:14:53
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Bach Mid
yourself, I'm not anti-nurse, I just chose not to be one. I think if we are willing to do the extra bits to combat the myth that we can't do anything else, it can only help those who follow us and assist in changing the attitudes of those out there who are not so happy with the way mid education is going.

In an ideal world, we wouldn't have to fight and argue so hard about our abilities and competence, but it's not an ideal world so I do the best I can with what I've got and take on just about anything! (within reason of course).

Cheers
Tania

- Original Message - 
From: Kim Stead 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, February 14, 2005 6:55 PM
Subject: [ozmidwifery] Bach Mid





Hello again Marcia and others interested in this thread.

Thanks for your intro Marcia. It's always nice to knowwho you are talking to. I guess I have become a bit guardedregarding my midwifery qualification as it's been atorturous road to find a supportive environment in which to practice. I live rurally - Gippsland to be precise. DE midwives are virtually unheard of in the rural areas and many are at a lossas to 'what to do with us' since we can't be relocated to otherwards - despite screaming out for midwifery staff. Some, like anything new, are veryresistant to change - mostly their own insecurities from what I can make out. 

Anyway, I arrived in Australia 18mths ago and applied at two hospitals for work - both turned me down because 1. I could not be relocated and 2. because they were 'too busy' training medical staff. I was also told that "I needed serious career advice if I thought I would ever be able to work in this country". That was from one individual but someone in a position who should have known better!!! You can imagine how that felt being a new, very enthusiastic graduate who had just sacrificed everything (family  financesincluded)to survive the 3 year 'full-on' degree!! It was soul destroying to say the least and I now fully understand the term 'horizontal violence'! Fortunately for me - it just made me stronger and more determined! Why does this profession 'eat their young' instead of nuture them? I thought as midwives and as women - we were the nuturing types? I know this is not true of all but the few that are like this leave a very bad taste in my mouth. 

Anyway... Since my 'failed applications', I hadbeen working in the community 'with woman'the best way possible in the current environment but have just recently taken up an offer at one of the hospitals previously mentioned. It is funny how things eventually have an about turn and how midwifery shortagesdon't change. It seemed they were impressedby mywork in the community and my dedication to 'midwifery philosophy' and keeping birth normal where possible. They wanted ME as part of their team...It was a little hard to stomach at first and the concept of 'working in an obstetric model' is still very challenging each day when I drive to and from work. I strive to work as
a midwife in a 'task orientated' environment where the focus is on the abnormal - either creating or correctin

Re: [ozmidwifery] B/MID FOLLOW UP

[Kim Stead]

May I ask why you are interested and who you are?

There is aBMid internet collective who I am sure will be happy toanswer any genuine questions you may have. I'm a recent BMid grad myself (not trained here though) so I'm always happy to chat about my experiences as well but I'm also aware that there's some among us (midwives) who like to eat their young!

Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/14/05 14:23:42
To: ozmidwifery@acegraphics.com.au
Subject: [Norton AntiSpam] [ozmidwifery] B/MID FOLLOW UP

I would like to hear from anyone currently involved in follow -up of our
first graduates of the Bachelor of Midwifery .
Have all who applied for employment for 2005 been successful?
thanks Marcia


--
This mailing list is sponsored by ACE Graphics.
Visit http://www.acegraphics.com.au to subscribe or unsubscribe.

Re: [ozmidwifery] Telemetric?

[Kim Stead]

Thanks Michelle!

We obviously don't have one where I workwhich isa shame as almost everyone is tied down to a CTG at some stage. One of the many downsides to birthing in a medical setting I guess.

Thanks again. Kim




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/12/05 17:23:58
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Telemetric?

Á telemetric CTG is a cordless CTG. Mt Isa (Qld) had one (in 2000) and used it. More recently when I worked in Hobart in a private hospital, they had one.If you really have to have a CTG on, then these areway ahead of the tradition CTG. It allows the women to be mobile and the one in Hobart was water proof as well so they were able to use the shower and bath with it on. It had excellent reception - the birth suites were on the 3rd floor of the hospital and the CTG could still be picked up on the ground floor. I think they're actually safer in that you don't havecords there for the woman or others to trip up in.

Cheers
Michelle Kim Stead [EMAIL PROTECTED] wrote:








You'll have to excuse my ignorance butt.. what is a telemetric CTG compared to the standard contraption?





---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/12/05 15:39:09
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Student's support role

well, ours doesn't which I think is a shame, so that's why I am asking.

marilyn
- Original Message -
From: "shaz42" [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, February 10, 2005 1:46 PM
Subject: Re: [ozmidwifery] Student's support role


 mosthospitals have the telemetricctg available it is just the staff
 which dont tend to use this as it can be a bit fiddly.
 - Original Message -
 From: "Marilyn Kleidon" [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Saturday, February 12, 2005 12:07 AM
 Subject: Re: [ozmidwifery] Student's support role


  Just a question of interest: how common are telemetric ctg's here in
  Australia??
 
  marilyn
  - Original Message -
  From: "shaz42" [EMAIL PROTECTED]
  To: ozmidwifery@acegraphics.com.au
  Sent: Thursday, February 10, 2005 2:01 AM
  Subject: Re: [ozmidwifery] Student's support role
 
 
  Kirsten as a newly qualified midwife who has supported women during
birth
  when a student I wish you luck. You need to be very strong for both the
  woman and her partner in what she wants to get out of her birth. I
  suggest
  that when you are with the woman and her partner during the birth you
act
  as
  her advocate and speak up for her but at the same time ensure that both
  the
  wom,an and the unborn baby are not in any danger from what you are
  suggesting. A woman will adopt a position which she feels comfortable
and
  safe in. There are ways around monitoring such as intermittent
monitoring
  of
  the fetus using Doppler or using the telemetric ctg instead of forcing
  the
  woman to lay on the bed. Good luck with your role as support person.
You
  could try reading some of the birthing books that women read to find
out
  positions act or speak to the midwives at the clinic when you attend
with
  the womanthey are a invaluable source of information.
 
  Enjoyyour time as a student
  - Original Message -
  From: "Kirsten Wohlt" [EMAIL PROTECTED]
  To: ozmidwifery@acegraphics.com.au
  Sent: Thursday, February 10, 2005 9:17 AM
  Subject: [ozmidwifery] Student's support role
 
 
  Hi all,
 
  As a 2nd year BMid student with very limited experience of being
present
  at
  births, I wonder if I may ask for some tips on how to support women in
  labour. I have attended only 3 births, and have contributed to some
  degree
  by being there to hold a woman's hand or bring her ice or a cool cloth,
  or
  speak an encouraging word - very much been working on the 'less is
more'
  basis and being a quiet support presence.I have one woman now who is
  planning a VBAC and has some specific requests regarding my support
role,
  but I don't know where to start, and I don't want to go in there
feeling
  nervous and tense!Her first birth was long and painful, ending in an
  emergency c-section following a 'failed' induction. She remembers
  essentially lying in the bed the whole time, not walking around, and
  having
  several doses of pethadine.This time she wants to stay active and
  upright
  and would rather have limited/no drugs.She says that she knows she
will
  not want to walk once she is in labour and wants her husband and I to
be
  strong and 'make' her.She also wants me to think about ways to
  encourage
  her, or positions that may help.I don't have any idea how to
  start...any
  pointers?Articles, texts, experience?I will do web research and
look
  through my uni texts, but I know there will be an awful lot out there -
  some
  pointers which will help refine the search would be really appreciated.
 
  Many than

[ozmidwifery] Telemetric?

[Kim Stead]

You'll have to excuse my ignorance butt.. what is a telemetric CTG compared to the standard contraption?





---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 02/12/05 15:39:09
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Student's support role

well, ours doesn't which I think is a shame, so that's why I am asking.

marilyn
- Original Message -
From: "shaz42" [EMAIL PROTECTED]
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, February 10, 2005 1:46 PM
Subject: Re: [ozmidwifery] Student's support role


 mosthospitals have the telemetricctg available it is just the staff
 which dont tend to use this as it can be a bit fiddly.
 - Original Message -
 From: "Marilyn Kleidon" [EMAIL PROTECTED]
 To: ozmidwifery@acegraphics.com.au
 Sent: Saturday, February 12, 2005 12:07 AM
 Subject: Re: [ozmidwifery] Student's support role


  Just a question of interest: how common are telemetric ctg's here in
  Australia??
 
  marilyn
  - Original Message -
  From: "shaz42" [EMAIL PROTECTED]
  To: ozmidwifery@acegraphics.com.au
  Sent: Thursday, February 10, 2005 2:01 AM
  Subject: Re: [ozmidwifery] Student's support role
 
 
  Kirsten as a newly qualified midwife who has supported women during
birth
  when a student I wish you luck. You need to be very strong for both the
  woman and her partner in what she wants to get out of her birth. I
  suggest
  that when you are with the woman and her partner during the birth you
act
  as
  her advocate and speak up for her but at the same time ensure that both
  the
  wom,an and the unborn baby are not in any danger from what you are
  suggesting. A woman will adopt a position which she feels comfortable
and
  safe in. There are ways around monitoring such as intermittent
monitoring
  of
  the fetus using Doppler or using the telemetric ctg instead of forcing
  the
  woman to lay on the bed. Good luck with your role as support person.
You
  could try reading some of the birthing books that women read to find
out
  positions act or speak to the midwives at the clinic when you attend
with
  the womanthey are a invaluable source of information.
 
  Enjoyyour time as a student
  - Original Message -
  From: "Kirsten Wohlt" [EMAIL PROTECTED]
  To: ozmidwifery@acegraphics.com.au
  Sent: Thursday, February 10, 2005 9:17 AM
  Subject: [ozmidwifery] Student's support role
 
 
  Hi all,
 
  As a 2nd year BMid student with very limited experience of being
present
  at
  births, I wonder if I may ask for some tips on how to support women in
  labour. I have attended only 3 births, and have contributed to some
  degree
  by being there to hold a woman's hand or bring her ice or a cool cloth,
  or
  speak an encouraging word - very much been working on the 'less is
more'
  basis and being a quiet support presence.I have one woman now who is
  planning a VBAC and has some specific requests regarding my support
role,
  but I don't know where to start, and I don't want to go in there
feeling
  nervous and tense!Her first birth was long and painful, ending in an
  emergency c-section following a 'failed' induction. She remembers
  essentially lying in the bed the whole time, not walking around, and
  having
  several doses of pethadine.This time she wants to stay active and
  upright
  and would rather have limited/no drugs.She says that she knows she
will
  not want to walk once she is in labour and wants her husband and I to
be
  strong and 'make' her.She also wants me to think about ways to
  encourage
  her, or positions that may help.I don't have any idea how to
  start...any
  pointers?Articles, texts, experience?I will do web research and
look
  through my uni texts, but I know there will be an awful lot out there -
  some
  pointers which will help refine the search would be really appreciated.
 
  Many thanks,
 
  Kirsten
  --
  This mailing list is sponsored by ACE Graphics.
  Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
 
 
  --
  This mailing list is sponsored by ACE Graphics.
  Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
 
 
  --
  This mailing list is sponsored by ACE Graphics.
  Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
 


 --
 This mailing list is sponsored by ACE Graphics.
 Visit http://www.acegraphics.com.au to subscribe or unsubscribe.


--
This mailing list is sponsored by ACE Graphics.
Visit http://www.acegraphics.com.au to subscribe or unsubscribe.

RE: [ozmidwifery] caseload

[Kim Stead]

Hi Sally

I've just returned from a very quick trip back to NZ. I was toldby a colleague thatthe caseload midwives (well all midiwives acutally had just recieved a 30% pay increase!!). Caseload are now paying an annual salary of $75,000. I think there are 4 of them, working in pairs and I know they work very hard with predominiately high risk women (most low risk choose an independent midwife). I'll see if I can find out some more info.

Kiwi Kim.




---Original Message---


From: ozmidwifery@acegraphics.com.au
Date: 01/23/05 01:56:05
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] caseload


So the next question is do people who have worked in caseload models feel that they were being paid fairly for their on call commitment?

Sally Westbury
Homebirth Midwife

"It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her." -Judy Slome Cohain

Re: [ozmidwifery] Breech birth question

[Kim Stead]

Denise,

I'm not 100% sure but I can find out for you.




---Original Message---


From: [EMAIL PROTECTED]
Date: 11/28/04 12:55:53
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question

Dear Kim
Can Ausie midwives join this Kiwi Email list you mention??
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: Kim Stead 
To: [EMAIL PROTECTED] 
Sent: Saturday, November 27, 2004 12:31 PM
Subject: Re: [ozmidwifery] Breech birth question





I've just posted to the NZ midwives list. Will let you know if there are any responses.

Kiwi Kim




---Original Message---


From: [EMAIL PROTECTED]
Date: 11/27/04 13:59:41
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question






Interesting topic guys. I thought, (with your permission of course), we could share this with Maggie Banks (breech birth guru) for her comments. I'm not sure when standing became vogue (well it's not really with the invent of C/S) but thought her comments would be interesting. What do you both think?Kiwi Kim.

Hi Kim,

I think that is a good idea, Maggie is a wise woman. I read Maggies book on breech births not long ago, but I read so much about birth all the info gets muddled! lol! I borrowed it from a friend so don't have it here to look up.

Please feel free to pass on the email and I would love to hear Maggies thoughts and comments.

Love Abby




---Original Message---


From: [EMAIL PROTECTED]
Date: 11/27/04 08:13:27
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question

Hi Abby:

I would expect this midwife was trained in breech birth management sometime ago probably by an ob in the 70's who was still delivering babies at home as they did in some parts of the US at this time. This midwife's address is Massachusetts. It seems like she is reacting to the relatively new idea to deliver breech babies standing/squatting/on a birthing stool. It seems to me that "standing to deliver" a breech baby came into vogue from the early 90's does anyone know when this started happening?

I was more disturbed by this paragraph:
10. Now bring the mother's buttocks over the edge of the bed, keeping her legs supported by assistants. The baby's body will drop down, easily exposing the nape of the neck and usually both arms will come down as well. Keeping one hand on the mother's perineum, grasp the baby's feet witht he other hand and swing the body up and over onto the mother's abdomen. A towel or receiving blanket will help in holding on to slippery body. 

Just a "tad" to say the least more aggressive than most accounts of semi-reclining breech births I have read, seems quite dangerous to me, but I have only assisted with 2 vaginal breech births, one in the hospital (standing)and one at home (on a birth stool) and had one myself. I would be interested to read comments from midwives who haveattended breech births where the woman is semi-reclining.

I think "fear" is a much maligned word in midwifery circles so i will use another word: caution. Couple that with knowledge and common sense and you will cope with most midwifery situations including breech birth.

marilyn

- Original Message - 
From: Abby and Toby 
To: [EMAIL PROTECTED] 
Sent: Friday, November 26, 2004 3:53 AM
Subject: [ozmidwifery] Breech birth question

Hi,

Just reading about breech births and differences of opinions between caregivers. Came across this comment, on a homebirth midwifes page and found it kinda odd. I would expect it from some Obs and hospital staff,but not sure what to make of this. There are other things on the page that I think are weird eg. semi reclined position, do this, do that, I'm in charge kind of attitude, but this comment struck me as `fear`.

7. At this point the baby must be born quickly. STAY CALM! It is possible for the baby to suffocate if not born within 5 minutes. Note: Time seems to stand still when we are under stress. Have an assistant keep track of time. What will seem like twenty minutes to you will have probably have been two! 
http://www.moondragon.org/obgyn/pregnancy/breechhome.html

Any midwives out there that have differing views on breech births. I realise that these days most women are encouraged to have c-sections, but thought some of you would supported women at breech births.
I have learnt from a couple of wise women that the best way for women to birth a breech baby is just like any other baby, her way in her time.

Love Abby
(P.S. She also warns against the advocation of the squatting position, where as Michel Odent believes it should be insisted that women birth a breech baby squatting?? Any thoughts??)

Re: [ozmidwifery] Breech birth question

[Kim Stead]

Hi Marilyn and Abby

Interesting topic guys. I thought, (with your permission of course), we could share this with Maggie Banks (breech birth guru) for her comments. I'm not sure when standing became vogue (well it's not really with the invent of C/S) but thought her comments would be interesting. What do you both think?

Kiwi Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 11/27/04 08:13:27
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question

Hi Abby:

I would expect this midwife was trained in breech birth management sometime ago probably by an ob in the 70's who was still delivering babies at home as they did in some parts of the US at this time. This midwife's address is Massachusetts. It seems like she is reacting to the relatively new idea to deliver breech babies standing/squatting/on a birthing stool. It seems to me that "standing to deliver" a breech baby came into vogue from the early 90's does anyone know when this started happening?

I was more disturbed by this paragraph:
10. Now bring the mother's buttocks over the edge of the bed, keeping her legs supported by assistants. The baby's body will drop down, easily exposing the nape of the neck and usually both arms will come down as well. Keeping one hand on the mother's perineum, grasp the baby's feet witht he other hand and swing the body up and over onto the mother's abdomen. A towel or receiving blanket will help in holding on to slippery body. 

Just a "tad" to say the least more aggressive than most accounts of semi-reclining breech births I have read, seems quite dangerous to me, but I have only assisted with 2 vaginal breech births, one in the hospital (standing)and one at home (on a birth stool) and had one myself. I would be interested to read comments from midwives who haveattended breech births where the woman is semi-reclining.

I think "fear" is a much maligned word in midwifery circles so i will use another word: caution. Couple that with knowledge and common sense and you will cope with most midwifery situations including breech birth.

marilyn

- Original Message - 
From: Abby and Toby 
To: [EMAIL PROTECTED] 
Sent: Friday, November 26, 2004 3:53 AM
Subject: [ozmidwifery] Breech birth question

Hi,

Just reading about breech births and differences of opinions between caregivers. Came across this comment, on a homebirth midwifes page and found it kinda odd. I would expect it from some Obs and hospital staff,but not sure what to make of this. There are other things on the page that I think are weird eg. semi reclined position, do this, do that, I'm in charge kind of attitude, but this comment struck me as `fear`.

7. At this point the baby must be born quickly. STAY CALM! It is possible for the baby to suffocate if not born within 5 minutes. Note: Time seems to stand still when we are under stress. Have an assistant keep track of time. What will seem like twenty minutes to you will have probably have been two! 
http://www.moondragon.org/obgyn/pregnancy/breechhome.html

Any midwives out there that have differing views on breech births. I realise that these days most women are encouraged to have c-sections, but thought some of you would supported women at breech births.
I have learnt from a couple of wise women that the best way for women to birth a breech baby is just like any other baby, her way in her time.

Love Abby
(P.S. She also warns against the advocation of the squatting position, where as Michel Odent believes it should be insisted that women birth a breech baby squatting?? Any thoughts??)

Re: [ozmidwifery] Breech birth question

[Kim Stead]

I've just posted to the NZ midwives list. Will let you know if there are any responses.

Kiwi Kim




---Original Message---


From: [EMAIL PROTECTED]
Date: 11/27/04 13:59:41
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question






Interesting topic guys. I thought, (with your permission of course), we could share this with Maggie Banks (breech birth guru) for her comments. I'm not sure when standing became vogue (well it's not really with the invent of C/S) but thought her comments would be interesting. What do you both think?Kiwi Kim.

Hi Kim,

I think that is a good idea, Maggie is a wise woman. I read Maggies book on breech births not long ago, but I read so much about birth all the info gets muddled! lol! I borrowed it from a friend so don't have it here to look up.

Please feel free to pass on the email and I would love to hear Maggies thoughts and comments.

Love Abby




---Original Message---


From: [EMAIL PROTECTED]
Date: 11/27/04 08:13:27
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Breech birth question

Hi Abby:

I would expect this midwife was trained in breech birth management sometime ago probably by an ob in the 70's who was still delivering babies at home as they did in some parts of the US at this time. This midwife's address is Massachusetts. It seems like she is reacting to the relatively new idea to deliver breech babies standing/squatting/on a birthing stool. It seems to me that "standing to deliver" a breech baby came into vogue from the early 90's does anyone know when this started happening?

I was more disturbed by this paragraph:
10. Now bring the mother's buttocks over the edge of the bed, keeping her legs supported by assistants. The baby's body will drop down, easily exposing the nape of the neck and usually both arms will come down as well. Keeping one hand on the mother's perineum, grasp the baby's feet witht he other hand and swing the body up and over onto the mother's abdomen. A towel or receiving blanket will help in holding on to slippery body. 

Just a "tad" to say the least more aggressive than most accounts of semi-reclining breech births I have read, seems quite dangerous to me, but I have only assisted with 2 vaginal breech births, one in the hospital (standing)and one at home (on a birth stool) and had one myself. I would be interested to read comments from midwives who haveattended breech births where the woman is semi-reclining.

I think "fear" is a much maligned word in midwifery circles so i will use another word: caution. Couple that with knowledge and common sense and you will cope with most midwifery situations including breech birth.

marilyn

- Original Message - 
From: Abby and Toby 
To: [EMAIL PROTECTED] 
Sent: Friday, November 26, 2004 3:53 AM
Subject: [ozmidwifery] Breech birth question

Hi,

Just reading about breech births and differences of opinions between caregivers. Came across this comment, on a homebirth midwifes page and found it kinda odd. I would expect it from some Obs and hospital staff,but not sure what to make of this. There are other things on the page that I think are weird eg. semi reclined position, do this, do that, I'm in charge kind of attitude, but this comment struck me as `fear`.

7. At this point the baby must be born quickly. STAY CALM! It is possible for the baby to suffocate if not born within 5 minutes. Note: Time seems to stand still when we are under stress. Have an assistant keep track of time. What will seem like twenty minutes to you will have probably have been two! 
http://www.moondragon.org/obgyn/pregnancy/breechhome.html

Any midwives out there that have differing views on breech births. I realise that these days most women are encouraged to have c-sections, but thought some of you would supported women at breech births.
I have learnt from a couple of wise women that the best way for women to birth a breech baby is just like any other baby, her way in her time.

Love Abby
(P.S. She also warns against the advocation of the squatting position, where as Michel Odent believes it should be insisted that women birth a breech baby squatting?? Any thoughts??)

Re: [ozmidwifery] Arthritis in pregnancy

[Kim Stead]

Gosh this sounds terrible. I'm sorry I have no info or relevant experiences to share but I'd be interested in what the rest of the group can offer??

Kiwi Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 9/11/2004 3:51:58 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Arthritis in pregnancy

Have a friend whose 30 yr old cousin has developed arthritis, she is six months pregnant and confined to a wheelchair. This has only happened since she was pregnant, does anyone have any experience or has anyone heard of this before. I believe she is consulting a rheumatologist, but they are looking for any info out there.

Thanks

Sheena Johnson

Re: [ozmidwifery] Re:cold epidurals

[Kim Stead]

This isterrible. What next!"Would you like to come in at 35 weeks because I'm going on a golf convention and my colleague is fully booked with inductions, epidurals and post-partum haemorrhagesfor the next 3 months!! Makes you wonder doesn't it!

Kim.
---Original Message---


From: [EMAIL PROTECTED]
Date: 5/11/2004 3:34:27 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Re:cold epidurals

Larissa
thats exactly the same reason as the Ob stated up here, not once, but to
many woman i saw him with. "The anaesthetist isn't always available or at
work on certain days, so if you go into labour naturally you won't be
guaranteed any pain relief BUT if we induce you on Monday when hes available
and give you an epidural at the same time, you will get the pain relief and
won't have to worry about going into labour when hes not on.

What the OB said to MANY woman.I was nearly sick.

Kirsten
Darwin


...~~~start life with a midwife~~~
- Original Message -
From: "Larissa Inns" [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent: Friday, November 05, 2004 1:38 PM
Subject: [ozmidwifery] Re:cold epidurals


I just looked after a womanwho had one (epidural) booked prior to
 induction - reason given was that "the anaesthetist will be in surgery and
 it's not convenient for him to come and give you an epidural when you'll
 need one"
 And the women are paying how much for this "service"?!?!? The mind
 boggles.
 Hugs,Larissa
 FUSA 2nd yr student


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Re: [ozmidwifery] Maggie Banks midwifery intensive and NZ midwifery

[Kim Stead]

Couldn't agree more Kirsten. Maggie is from my home town and isone amazing woman!!! Pleased you enjoyed yourself Sue and yes. NZ midwives finallyhave itgood - or at least better than we do at the moment!!

Kiwi Kim



---Original Message---


From: [EMAIL PROTECTED]
Date: 30/10/2004 6:29:02 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Maggie Banks midwifery intensive and NZ midwifery

*sighs*
You make me so homesick. What the hell am i doing here??

Kirsten
Darwin

~~~start life with a midwife~~~

- Original Message -
From: "Sue Cookson" [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent: Saturday, October 30, 2004 5:32 PM
Subject: [ozmidwifery] Maggie Banks midwifery intensive and NZ midwifery


 Hi,
 I have just returned from a midwifery intensive held at Maggie Banks home
 in Hamilton, New Zealand.
 Fantastic venue, great food, and very midwife-centred (not
 obstetric-centred) hands on midwifery skills.
 The workshops are limited to 10 visitors, and our group had 3 from
 Australia and 7 New Zealanders.

 We covered shoulder dystocias, breech births, unusual presentations (cord
 prolapses, shoulder presentations etc), PPHs,resuscitation techniques,
 suturing, and intubation. Most of the work was done through discussion of
 case scenarios which therefore covered all aspects of the mother and
 baby's wellbeing and it was fascinating being aware of everyone's
 experience in birth as well as their life experiences, and how these
 affected their midwifery decisions and perspectives.(Maggie is the author
 of "Breech Birth Woman Wise" and "Homebirth Bound" - both available
 through Birth International.)

 I was really blown away by the ease of practice in NZ - the midwives have
 full prescribing abilities, have access agreements to all the hospitals
 and their PI insurance is covered in their yearly subscription to NZ
 College of Midwives.
 I knew all this stuff intellectually, but what I hadn't witnessed before
 was the way that working in a country where midwifery care is the norm
 becomes so self-affirming for the midwives. One of the newest midwives
 there, had taken on a case-load of 52 births in her first year out, some
 of them homebirths, and she had received $1950 for each woman she assisted
 (governement paid) , with a $450 extra payment for homebirths (which
 usually goes to the second midwife - a legal requirement at homebirths).
 This translates as over $100,000 for her first year of work.

 It wasn't the money that blew me away, it was the struggle free attitude
 of the midwives. Why do you need a GP back-up they asked? In NZ the GP's
 gave up attending births when the midwives were granted their current
 status with rights to prescibe and request pathology etc, so all blood
 tests, swabs, u/sounds etc are all managed by the midwives - if needed of
 course. When they take a woman into hospital, be that a planned hospital
 birth or a transfer in from a homebirth, the midwives can simply close the
 door of the hospital room, wait til baby's born, then take the family home
 when they're ready. No fight, no fuss, but more help there if required.
 Hmmm.

 I realise that the NZ midwives and community worked damn hard to attain
 their current work status, and I realise that something similar is what
 we're all working for over here, but boy, was it hard to get on the plane
 to come back home. And why are all you NZ midwives working over here when
 you've got such a great system??

 I know a number of Australian would-be midwives who are getting their
 wings ready for NZ, and I've also heard that their numerous B(Mid) courses
 are very willing to take in some Aussie counterparts!!

 Back to the Midwifery Intensives.
 The cost was about $500 (Aust) plus airfares of$400-$500 depending on
 who you fly with.(Freedom Air goes straiht into Hamilton airport from
 most large airports). All other costs are inclusive. Spectacular setting
 (and a great hubby who cooks superbly), which really helps you to
 understand Maggie's birthing perspective, but also the reality of birthing
 in rural and low risk settings.

 Maggie holds these intensives about once every month throughout the year.
 Check out the website www.birthspirit.co.nz for more details.

 Really inspirational, not too scary and a great way to both relax and
 learn.

 Sue Cookson










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Re: [ozmidwifery] AMA and midwifery-led care

[Kim Stead]

What a lot of rot! I like the bit about the PI cover - cheeky buggers!

Kiwi Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 19/10/2004 4:45:49 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] AMA and midwifery-led care

Fascinating Belinda!Thanks for sharing.

Also, here's a link for Royal Australian and New
Zealand College of Obstetricians and Gynaecologists
(RANZCOG) statement on Homebirth  others...
http://www.ranzcog.edu.au/publications/collegestatements.shtml

Jen

 --- Belinda Maier [EMAIL PROTECTED] wrote:
 The article by deCosta is interesting she also wrote
 Costa, C. d. (1999). "A noble instrument, the
 obstetric forceps." Medical
 Journal of Australia Vol. 170.
 she is very much of the medical perspective that
 satisfaction with
 childbirth is a selfish unimportant side issue and
 that medical control is
 still more important and education is about teaching
 women to be happy with
 whatever technology, intervention or impersonal care
 is deemed important by
 the medical person there. It is all about in my
 opinion, ensuring medical
 control and dominance and shuting up these pesky
 statistics, women and
 researchers who are continually showing women are
 not happy with high
 intervention births (except of course the wealthy
 educated ones!!! - being
 very cynical now thinking of journalists etc who
 seem to get to be seen and
 heard).
 My honors thesis was 'An analysis of how homebirth
 is constructed in medical
 policy.' Although the AMA told me a few times sa and
 head offices, that they
 have no policy I happened to find one on one of my
 fishing expeditions in
 the medical library. (Pure luck to find it - every
 now and then I used to
 spend time just grabbing journals from he archives
 and flicking through
 them - I have found some gems this way that I would
 otherwise not have
 found). It also shows their intent toward
 independent midwives (- there is
 no place for them in Australia where women have
 access to doctors) and their
 unionist push to sway government to support them
 (the AMA) not midwives or
 women.
 Australian Medical Association (AMA), 1990. AMA Home
 Birth Policy,
 Australian Medicine, May 7, pp. 8
 I can't imagine they have changed, unfortunately,
 they have too much money
 and prestige and control to lose if this midwifery
 lark catches on! - and I
 am allowing myself the luxury of my bias anger and
 passion when saying this!
 Belinda

Find local movie times and trailers on Yahoo! Movies.
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Re: [ozmidwifery] group B strep

[Kim Stead]

Hi Lieve

I would love to hear more about your practices in the Netherlands. I am sure we could learn a lot!!


Kiwi Kim
---Original Message---


From: [EMAIL PROTECTED]
Date: 5/10/2004 6:41:06 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] group B strep

Hoi Leanne,
We have a good leaflet of the Netherlands that explains very well the
problem with GBS. Their recommandations are not to screen routinaly, but
just incases:
- premature rupture of membranes
- rupture of membranes more than 24 hours before established labor
- several urinary tract infections during this pregnancy, caused by GBS
- fever during labor
- previous child that suffered from an infection with GBS at birth.
Also in those cases AB is not routinely given, but evaluated.
The hospitals here are not giving these info, they nearly all do routine
controle on GBS and when positive they give AB during labor, without asking
the parents. They just state that it would kill the baby if not.


We handle in all pregnancys and births the same:
- no vaginal check ups unless a real reason
- no rupturing of the membranes
- birth at the tempo of the mothers body
- undisturbed contact of baby and mother during at least 1,5 h after birth
en so
- undisturbed start of breastfeeding
- not cutting the cord before the pulsations stopped
- next days observation of the baby in his mothers arms

I think that is a better prevention for illness than giving Ab and than have
the right to not respect the birthing process.
We explain all this to the parents during pregnancy and they can choose what
they want, but I will not administre AB at home.

greetings
Lieve



- Original Message -
From: "leanne wynne" [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent: Tuesday, October 05, 2004 5:16 AM
Subject: [ozmidwifery] group B strep


 Hi All,
 I am interested to hear what those midwives who attend homebirths do in
 regard to group B strep. Do you screen for it or not? If you know a woman
is
 GBS positive do you give A/Bs to the mother during labour or just observe
 the baby?
 Thanks,
 Leanne.

 Leanne Wynne
 Midwife in charge of "Women's Business"
 Mildura Aboriginal Health ServiceMob 0418 371862

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Re: [ozmidwifery] anaemia article

[Kim Stead]

I thought about itbut realised I have so many papers in my office :-)



---Original Message---


From: [EMAIL PROTECTED]
Date: 29/09/2004 7:39:06 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] anaemia article

no worries. Lucky the whole list didn't respond heh!

marilyn

- Original Message - 
From: Liz Newnham 
To: [EMAIL PROTECTED] 
Sent: Wednesday, September 29, 2004 1:34 AM
Subject: [ozmidwifery] anaemia article

Thanks Marilyn!
Any wayI can pay you for the postage etc?
Not sure why this has turned italic - I didn't tell it to.
Thanks again
love,Liz.

Re: [ozmidwifery] Midwifery Intensives

[Kim Stead]

ThanksAndrea

I might see if I can try and tieone in on one mytrips back home.Air fares to NZ are pretty cheap too. :-)


Regards

Kim.

---Original Message---


From: [EMAIL PROTECTED]
Date: 25/09/2004 3:29:37 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Midwifery Intensives

Hi Kim,

At this stage we are still thinking about Melbourne - perhaps next year if
Maggie has time. Can't promise though. plane fares to Sydney are quite
cheap!

Regards,

Andrea


At 03:58 PM 23/09/2004, you wrote:
Andrea - will there be a venue in Melbourne??? Maggie is so fantastic!!!

Regards

Kiwi Kim,


---Original Message---

From: mailto:[EMAIL PROTECTED]gt;[EMAIL PROTECTED]
Date: 23/09/2004 3:18:57 p.m.
To: mailto:[EMAIL PROTECTED]gt;[EMAIL PROTECTED]
Subject: [ozmidwifery] Midwifery Intensives

For those of you who have been thinking of doing the ALSO Course, but
perhaps have hesitated because of its obstetric orientation, the Midwifery
Intensives that we are offering in November provide the perfect
alternative.This program, facilitated by Maggie Banks, is used by New
Zealand midwives to ensure they have the skills to handle emergencies that
may occur during labour and birth.

Places are limited to a maximum of 14 midwives and there are a few places
left - closing date is October 22. If you want to know more about this
program the details are at:

http://www.birthinternational.com/event/intensives2004/index.htmlhttp://www.birthinternational.com/event/intensives2004/index.html

For even more detail, check out the information listed on Maggie Banks' site:

http://www.birthspirit.co.nz/Education/Intensives/EvaluationOfIntensives.phphttp://www.birthspirit.co.nz/Education/Intensives/EvaluationOfIntensives.php

This is one program that all aspiring midwives will want to attend - to
refresh, update, re-vitalise and up-skill.

Warm 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: Letter to The Editor

[Kim Stead]

I like it!!



---Original Message---


From: [EMAIL PROTECTED]
Date: 23/09/2004 12:06:01 a.m.
To: MC Committee; OzMid List
Subject: [ozmidwifery] FW: Letter to The Editor
Her’s a bit for them to chew on.My hubby suggested the word impotent!!!JCxx-- Forwarded MessageFrom: Justine Caines [EMAIL PROTECTED]Date: Wed, 22 Sep 2004 22:31:50 +1000To: [EMAIL PROTECTED]Subject: Letter to The EditorDr Mourik’s opinion is factually impotent and is more an advertisement of his services than scientific fact.The safety of planned home birth versus hospital birth for low risk women has been systematically reviewed for the Cochrane Collaboration in 1997 and updated in 2003 (Olsen O  Jewell MD, 2003) concluding “there is no evidence in favour of planned hospital birth for low risk pregnant women”. Dr Mourik retract your untrue statement that “Home is the most dangerous place to have a baby.”Midwives are experts in normal birth and skilled at determining when obstetric management is needed and also at administering emergency action. Dr Mourik had want to hope so because it takes anywhere between 30 and 60 minutes to set up an operating theatre, so again his assertion that women are unsafe if they are without instant obstetric care is incorrect.Indeed, such are the demonstrated benefits of one-to-one continuous midwifery care to birthing women and their babies that an authoritative review of world –wide literature actually concludes that "it is inherently unwise, and perhaps unsafe, for women with normal pregnancies to be cared for by obstetric specialists, even if the required personnel are available".*Health Minister, Bronwyn Pike should be applauded for acknowledging women’s choice, medical evidence and cost effectiveness.Justine CainesNational President Maternity Coalition IncPO Box 105MERRIWA NSW 2329Ph: (02) 65482248Fax: (02)65482902Mob: 0408 210273E-Mail: [EMAIL PROTECTED]*Chalmers I, Enkin M, Kierse M eds Effective Care in Pregnancy and Childbirth , Oxford University Press, Oxford. -- End of Forwarded Message

Re: [ozmidwifery] Midwifery Intensives

[Kim Stead]

Andrea - will therebe a venue in Melbourne??? Maggie is so fantastic!!!

Regards

Kiwi Kim,



---Original Message---


From: [EMAIL PROTECTED]
Date: 23/09/2004 3:18:57 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Midwifery Intensives

For those of you who have been thinking of doing the ALSO Course, but
perhaps have hesitated because of its obstetric orientation, the Midwifery
Intensives that we are offering in November provide the perfect
alternative.This program, facilitated by Maggie Banks, is used by New
Zealand midwives to ensure they have the skills to handle emergencies that
may occur during labour and birth.

Places are limited to a maximum of 14 midwives and there are a few places
left - closing date is October 22. If you want to know more about this
program the details are at:

http://www.birthinternational.com/event/intensives2004/index.html

For even more detail, check out the information listed on Maggie Banks' site:

http://www.birthspirit.co.nz/Education/Intensives/EvaluationOfIntensives.php

This is one program that all aspiring midwives will want to attend - to
refresh, update, re-vitalise and up-skill.

Warm 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] websites

[Kim Stead]

Hi Marilyn

One of my good friends who is also a midwife designed it for me. If you are interested in getting one for yourself, I could ask her if she is interested in helping you out. She has designed her own one www.birth.net.nz and the NZ Homebirth website as well. Let me know what you think.

Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 16/09/2004 1:33:28 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] websites

Hi Kim:

I know you posted your website recently and I think it is amazing: who designed it? and is there anyone out there on the list who designs websites, maybe from afar? I am really incredibly ignorant about this (maybe I need to takea TAFE course?) and want to know more

marilyn

- Original Message - 
From: Kim Stead 
To: [EMAIL PROTECTED] 
Sent: Tuesday, September 14, 2004 12:32 AM
Subject: Re: [ozmidwifery] 





---Original Message---











--

Re: [ozmidwifery] Free Standing Birth Centres

[Kim Stead]

Good question Abby! I have no idea but would like to know what the reason isapart from the standard line "not enough anesthetists". One of my dreams is to build one so I will be keen to see if anyone knows the answers!

Kim.


---Original Message---


From: [EMAIL PROTECTED]
Date: 16/09/2004 7:48:01 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Free Standing Birth Centres

Hi,

Is there any such thing in Australia? Or are they all connected to hospitals
or government run etc?
Is it legal to have a free standing birth centre, if we don't have any in
Australia?

Thanks
Love Abby

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Re: [ozmidwifery] Free Standing Birth Centres

[Kim Stead]

Well guys - what shall we do about it??? Where do you all live because of course, I would love it right on my own door-step! Maybe we can franchise it!! :-)

Kim.

---Original Message---


From: [EMAIL PROTECTED]
Date: 17/09/2004 12:14:11 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Tania  Laurie wrote:

 I'm another with the same dream!
 Tania

 - Original Message -
 *From:* Ceri  Katrina mailto:[EMAIL PROTECTED]
 *To:* [EMAIL PROTECTED]
 mailto:[EMAIL PROTECTED]
 *Sent:* Thursday, September 16, 2004 7:53 PM
 *Subject:* Re: [ozmidwifery] Free Standing Birth Centres

 Kim
 You and I should talk, as I also have this same dream!!! :-)

 Katrina


 On 16/09/2004, at 7:57 PM, Kim Stead wrote:



 Good question Abby!I have no idea but would like to know
 what the reason is apart from the standard line "/not
 enough anesthetists"./One of my dreams is to build one so I
 will be keen to see if anyone knows the answers!

METOO!! Anyone in Northern Perth??

Jo ;)

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Re: [ozmidwifery] Free Standing Birth Centres

[Kim Stead]

Excuse my ignorance, but what's the deal with PI insurance and birth centres? I know midwives can't obtain any but wouldn't a birth centre facility actually own the insurance just like any other medical establishment?. As for obstetric back-up, you just transfer to hospital if that is what is required?? That is how it works in NZ. Run by midwives, no other medical staff other than nurse aids and when women require medical intervention or consultation, they transfer to hospital either by car or ambulance. I am getting the same comments in independent practice "but you don't have obstetric back-up". What do they think the hospital is? Are they not going to treat the woman because she has been foolish enough to chose safe and cost-effective maternity care to optimise the chances of a normal birth? Seems so simple to me but of course I am still a bit green! I would appreciate some enlightenment and bringing back down toearth if need be. :-) I just can't seem to understand why everyone wants to make it so complicated - present company excluded.

Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 17/09/2004 9:31:25 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Hi All,
I think the main issue is the lack of PI insurance and obstetric backup.
Leanne.


From: Ceri  Katrina [EMAIL PROTECTED]
Reply-To: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres
Date: Fri, 17 Sep 2004 08:55:26 +1000

Well I'm going to actually finish my course first!! Then who knows!!!
I live on the central coast of NSW

Katrina :-)
On 17/09/2004, at 7:05 AM, Kim Stead wrote:


Well guys - what shall we do about it??? Where do you all live because of
course, I would love it right on my own door-step! Maybe we can franchise
it!! :-)

Kim.

---Original Message---

From: [EMAIL PROTECTED]
Date: 17/09/2004 12:14:11 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Tania  Laurie wrote:

  I'm another with the same dream!
  Tania
 
  - Original Message -
  *From:* Ceri  Katrina mailto:[EMAIL PROTECTED]
  *To:* [EMAIL PROTECTED]
  mailto:[EMAIL PROTECTED]
  *Sent:* Thursday, September 16, 2004 7:53 PM
  *Subject:* Re: [ozmidwifery] Free Standing Birth Centres
 
  Kim
  You and I should talk, as I also have this same dream!!! :-)
 
  Katrina
 
 
  On 16/09/2004, at 7:57 PM, Kim Stead wrote:
 
 
 
  Good question Abby!I have no idea but would like to know
  what the reason is apart from the standard line "/not
  enough anesthetists"./One of my dreams is to build one so I
  will be keen to see if anyone knows the answers!
 
METOO!! Anyone in Northern Perth??

Jo ;)

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imstp_emo_en.gif


Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health ServiceMob 0418 371862

_
Searching for that dream home? Try http://ninemsn.realestate.com.aufor
all your property needs.

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Re: [ozmidwifery] Free Standing Birth Centres

[Kim Stead]

What if a private company or person was to build one themselves (as is the case for some of the newer birthing units in NZ)? I can just imagine the head-ache involved but surely it would be possible.



---Original Message---


From: [EMAIL PROTECTED]
Date: 17/09/2004 10:17:07 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

In ACT the Legislative Assembly Standing Committee on
Heath ( Maternity Services)enquiry made a strong
recommendation in its Report launched in May for the
ACT Govt to, among lots of other good things,
establish two free standing Birth centres. We are
awaiting the Gov't response to the Report - only 6
weeks late at present. I was told two weeks ago that
the response was imminent... I'm not holding my
breath... we are up for ACT elections in October as
well as Federal and I'm sure they're just biding time
and making no commitments. Strong obstetric forcefield
here!

And in mean time there are jobs going for midwives
wanting to work for the current BirthCentre (caseload
model).

Margie



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

 Is there any such thing in Australia? Or are they
 all connected to hospitals
 or government run etc?
 Is it legal to have a free standing birth centre, if
 we don't have any in
 Australia?

 Thanks
 Love Abby

 --
 This mailing list is sponsored by ACE Graphics.
 Visit http://www.acegraphics.com.au to subscribe
 or unsubscribe.


Find local movie times and trailers on Yahoo! Movies.
http://au.movies.yahoo.com
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Re: [ozmidwifery] Free Standing Birth Centres

[Kim Stead]

I don't thinkour 400 odd cows would enjoyQLD but I sure would!



---Original Message---


From: [EMAIL PROTECTED]
Date: 17/09/2004 10:54:52 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Kim,

I'd move down there to open one with you...just wait until i've finished my training!!!

Or I'd really like to move to QLD, so maybe we could move there

Kirsten

~~~start life with a midwife~~~

- Original Message - 
From: Kim Stead 
To: [EMAIL PROTECTED] 
Sent: Friday, September 17, 2004 9:26 AM
Subject: Re: [ozmidwifery] Free Standing Birth Centres






Excuse my ignorance, but what's the deal with PI insurance and birth centres? I know midwives can't obtain any but wouldn't a birth centre facility actually own the insurance just like any other medical establishment?. As for obstetric back-up, you just transfer to hospital if that is what is required?? That is how it works in NZ. Run by midwives, no other medical staff other than nurse aids and when women require medical intervention or consultation, they transfer to hospital either by car or ambulance. I am getting the same comments in independent practice "but you don't have obstetric back-up". What do they think the hospital is? Are they not going to treat the woman because she has been foolish enough to chose safe and cost-effective maternity care to optimise the chances of a normal birth? Seems so simple to me but of course I am still a bit green! I would appreciate some enlightenment and bringing back down toearth if need be. :-) I just can't seem to understand why everyone wants to make it so complicated - present company excluded.

Kim.



---Original Message---


From: [EMAIL PROTECTED]
Date: 17/09/2004 9:31:25 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Hi All,
I think the main issue is the lack of PI insurance and obstetric backup.
Leanne.


From: Ceri  Katrina [EMAIL PROTECTED]
Reply-To: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres
Date: Fri, 17 Sep 2004 08:55:26 +1000

Well I'm going to actually finish my course first!! Then who knows!!!
I live on the central coast of NSW

Katrina :-)
On 17/09/2004, at 7:05 AM, Kim Stead wrote:


Well guys - what shall we do about it??? Where do you all live because of
course, I would love it right on my own door-step! Maybe we can franchise
it!! :-)

Kim.

---Original Message---

From: [EMAIL PROTECTED]
Date: 17/09/2004 12:14:11 a.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Free Standing Birth Centres

Tania  Laurie wrote:

  I'm another with the same dream!
  Tania
 
  - Original Message -
  *From:* Ceri  Katrina mailto:[EMAIL PROTECTED]
  *To:* [EMAIL PROTECTED]
  mailto:[EMAIL PROTECTED]
  *Sent:* Thursday, September 16, 2004 7:53 PM
  *Subject:* Re: [ozmidwifery] Free Standing Birth Centres
 
  Kim
  You and I should talk, as I also have this same dream!!! :-)
 
  Katrina
 
 
  On 16/09/2004, at 7:57 PM, Kim Stead wrote:
 
 
 
  Good question Abby!I have no idea but would like to know
  what the reason is apart from the standard line "/not
  enough anesthetists"./One of my dreams is to build one so I
  will be keen to see if anyone knows the answers!
 
METOO!! Anyone in Northern Perth??

Jo ;)

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imstp_emo_en.gif


Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health ServiceMob 0418 371862

_
Searching for that dream home? Try http://ninemsn.realestate.com.aufor
all your property needs.

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[ozmidwifery] Re: the abortion topic

[Kim Stead]

Hi guys

I just wanted to add that I am not pro or against abortion - just understanding of women's difficulties and changing circumstances that come up and bite you in the bum when you least expect them!

I do know of women who have had abortions for very sound reasons (now I feel like I am having to justify their decisions or lack of them) and I have seen the heart-ache that this has caused for years to come. They have not been decisions that have been taken lightly and often they have affected many people in the wings - family and the professionals caring for them. I have also worked with some amazing midwives who have cared for women during the procedure (and not the early ones) because they have been 'dropped' by their midwives, doctors etc (and often ones they trusted)for the decision that had been made. They felt that were being judged by people (professionals) who should know better and who knew very little of their personal situations. The midwives who cared for these women often had anti-abortion feelings also but kept that part of their personal belief system and not for public knowledge.Others felt that this was not something that they could be involved with(ethical reasonsor emotional well-being)and professionally and kindly removed themselves from the situation making sure the woman was cared for by someone who could support her through one of the most difficult times of her life. Usually we knew of those such people and as professionals we supported them with their difficult task. Unit managers also knew which staff they could call on. 

As a student, one of my fellow colleagues wasvery openand somewhat ruthless in expressing her opinions. "I will not care for such women! I'm not that kind of midwife". As midwives, especially when working in the continuity model... you don't know who these women are going to be. They don't exactly have signs on their foreheads. Often the women don't know who they are either. Unfortuanately, abortion was almost a taboo subject in my training (issues with one the lecturer's I suspected) so I took it upon myself to research and present this topic as one of my special topic presentations. I thought it was important for all midwives (and other heath professionals) to know how complex the situation is, situations but more importantly, how to deal with the situation when it arises. As a woman and a mother, I have my own feelings and opinionsbut have also been very grateful that Ihavenever beenin such a situationbut asa midwife I hope to have a professional approach to the subject as well and wanted to be prepared in advance. I urge you all to give this some consideration so that the women we care for are treated in a respectful and non-judgemental manner. Know what services exist in your area and where these women and families can can help, advice and support.Be clear about your professional and personal boundaries.

I value this list for the opportunity to share feelings and experienes but like some others, I don't feel it is an appropriate place to lay judgement and stir up feelingsand emotions that lie deep within any one of us. We all have our own issues, passions and life experiences (both good and bad) and I know that certain topics are very close to home for me also.

Kiwi Kim.





Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 14/09/2004 3:30:59 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] abortion and working with women etc

Abby
I find your writings on abortion very judgemental of others. How can you sit in judgment when you personally have not been through abortion and know what it is like, or know why a woman would make that choice? It seems youhave never had to face a situation personally with abortion. Or if you have you need to deal with your feelings about it adequetly rather than sit in judgment of others.

I have had two abortions personally -one an unwanted pregnancy at a very young age with failed contraceptives and the other a very much wanted pregnancy and abortion due to medical reasons (my health not the fetus'). They werehard situations and the grief I have experienced is enormous. I have reflected on my views on abortion many times and althoughIdon't believe I wouldchoose an abortion again for myselfI still believe in a womans right to choose an abortion. 

Perhaps its time you turned the attention and energy around and focus on yourself and look at what it is inside yourself that you can't accept. 

I worry that someone who works with women regulary would hold such harsh views.How can you care and support them adequetly feeling the way you do?
Do you ask each woman before you work with them about their "abortion status" and decline working with them if they have had an abortion?

I didn't want to join this debate as it is such an emotive one and probably does no good, but your comments affected me and there are probably man

Re: [ozmidwifery] Prochiaden and breastfeeding?

[Kim Stead]

Hi Abbey

I thought I would look this up as I have an interest in mental illness and have a limited knowledge of pharmacology. Prochiaden is a tricyclic antidepressant and one of the 'older' depression drugs. More often SSRI's are being used. Was your friend on this medication before pregnancy and during pregnancy? Is this being prescribed by an appropriate professional. I assume he/she is aware that she is breastfeeding.

From my textbooks, it's suggests that postnatally, the amounts should be reduced to pre-pregnancy levels with close observation for emergent side effects. Side effects in the baby can include feeding difficulties, seizures, tachypnoea, pastrointestional stasis and bladder retention. Obviously quite serious and not to be taken without careful consideration and a detailed consultation.

It's reallynot something that a midwife has a lot of knowledge about unless she is specifically trained in that field, therefore difficult to advise and make statements or judgements. I too agreee that it's best to try more natural remedies first but in the case of mental illness, one (a professional) needs to decide how serious thesituation is and weigh up the advantages and disadvantages of taking/not taking the medication. It may well be that your friend needs to take this medication at this time and while it may affect the baby, her needs are important at ensuring her mental and emotional wellbeing in order for her to be an effective and loving mother.

Again...one of those not so black and white issues.

Hope this has been of some help. Probablly not I suspect!

Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 14/09/2004 4:24:18 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Prochiaden and breastfeeding?

Thought some of you wise women could help with a friends query. She has been
prescribed Prochiaden 25mg for depression and she is breastfeeding her 2
month old. She was worried about the side effects and what effects that
would have on bubs. I thought that most anti depressants would have similiar
side effects listed ie. drowsiness, dizziness, nausea(? spelling)
Do any of you know much about this drug? are there any safer anti
depressants for pregnancy ( DISCLAIMER- I am actually not a fan of anti
depressants at all. I believe most "depression" can be cured with exercise,
nutrition and various therapies. However, she is adimant about taking them
and so I want to find out the safest).
Could someone look it up in, is it Dr Hales, book?

Thanks so much.
Love Abby

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Re: [ozmidwifery] Prochiaden and breastfeeding?

[Kim Stead]

Thanks fine Abby - the reference is from "Fundamental of Pharmacology" - Galbraith, Bullock, Mania.

If anyone ever wants me to look anything up, just yell as I have some good books that are getting little use and they are so expensive to buy! In NZ we have prescribing rights so that's why I got them but they are useful to have.

Kim


---Original Message---


From: [EMAIL PROTECTED]
Date: 14/09/2004 5:50:51 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Prochiaden and breastfeeding?

Hi Kim,

That was very helpful, thankyou. Would you mind if I forwarded the info from your textbooks? I know she wants as much info as possible.

She came off anti-depressantsafter 6 years of being on them, just before she got pregnant. She wasn't taking Prochiaden though, it was something else. I am sure it was an SSRI, but can't remember the name. So she hasn't been on them at all through pregnancy.
Her doctor lives 4 hours away in Orange. He was the one who first prescribed them for her when she was 16 and feeling " a little bit down"but that is a whole other story.

Thanks again for the info.
Love Abby

Re: [ozmidwifery] NZCOM conference anyone?....

[Kim Stead]

I'm so envious!!! Couldn't quite make this one but I'll definitely be at the next one!!



---Original Message---


From: [EMAIL PROTECTED]
Date: 11/09/2004 4:11:25 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] NZCOM conference anyone?

Hi all,

Just wondering if there are any other fellow ozmidders going to the NZCOM conference next week? I'm flying out with my colleague and friend next Tues, and boy am I excited! Just managed to fit in our last birth yesterday, so we can heave a huge sigh of relief, and get on the plane with a skip in our step!

Cheers

Tania

Re: [ozmidwifery] NZ Midwifery

[Kim Stead]

Hi again.

My email is [EMAIL PROTECTED]. I'll do my best to answer any questions.

Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 11/09/2004 5:00:28 p.m.
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] NZ Midwifery

Hi Kim
I'm not sure how to email you off list so am replying here! I'm interested in doing my graduate year in NZ. Currently I'm studying the BMid at UniSA as one of the first 'direct entry' group. I'd have finished at the end of this year, but had a homebirth for baby no. 3 in July last year and will now finish end of 2005.

Thanks for link you provided - will take a look and see how I go. Could you let me know how to email you off list - just in case I have more questions?? Thanks.

Cheers
Tania

- Original Message - 
From: Kim Stead 
To: [EMAIL PROTECTED] 
Sent: Saturday, September 11, 2004 3:25 PM
Subject: Re: [ozmidwifery] NZ Midwifery





Hi Tania

I am from NZ and now living here so what precisely would you like to know? 

There are ample opportunities in NZ, more in rural areas where midwives are a bit scarce - both in indpendent practice, birth centres or tertiary hospitals. When you say grad mid program, are you meaning your midwifery training or a graduate year? I am quite sure that graduate diploma's in mid have been completely phased out and replaced with the bachelor program of which I am sure you would be able to get some cross credits. Most registered nurses still complete an additional 2full years to be accrediated the Bach of Mid. The NZ college of Midwives website would be a good place to start looking and investigating. http://www.nzcom.org.nz

Both Islands are great to live in, just depends on what you are looking for. The North is somewhat busier and the South a bit more laid back but of course both have it's pockets of each. I came from the Waikato in the central North Island which was great but cold and damp with lots of rain and fog. The Bay of Islands at the top of the North Island is beautiful and much warmer. The South Island has beautiful scenery but is pretty cold also. 

Email me off the list if you would like to know more but I reckon the NZCOM site will proably be able to answer most of your questions. There are sub branches of NZCOM throughout the country if you would like to make contact with one of them.

Regards

Kim.

Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 11/09/2004 3:26:41 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] NZ Midwifery

Hi everybody
I'm considering moving myself and family to NZ to do my grad mid program. If
anybody has some contacts over there who may be able to shed some light on
opportunities, where to go etc etc I would greatly appreciate it.

Thanks
Tania


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Re: [ozmidwifery] NZ Midwifery

[Kim Stead]

Hi Tania

I am from NZ and now living here so what precisely would you like to know? 

There are ample opportunities in NZ, more in rural areas where midwives are a bit scarce - both in indpendent practice, birth centres or tertiary hospitals. When you say grad mid program, are you meaning your midwifery training or a graduate year? I am quite sure that graduate diploma's in mid have been completely phased out and replaced with the bachelor program of which I am sure you would be able to get some cross credits. Most registered nurses still complete an additional 2full years to be accrediated the Bach of Mid. The NZ college of Midwives website would be a good place to start looking and investigating. http://www.nzcom.org.nz

Both Islands are great to live in, just depends on what you are looking for. The North is somewhat busier and the South a bit more laid back but of course both have it's pockets of each. I came from the Waikato in the central North Island which was great but cold and damp with lots of rain and fog. The Bay of Islands at the top of the North Island is beautiful and much warmer. The South Island has beautiful scenery but is pretty cold also. 

Email me off the list if you would like to know more but I reckon the NZCOM site will proably be able to answer most of your questions. There are sub branches of NZCOM throughout the country if you would like to make contact with one of them.

Regards

Kim.

Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 11/09/2004 3:26:41 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] NZ Midwifery

Hi everybody
I'm considering moving myself and family to NZ to do my grad mid program. If
anybody has some contacts over there who may be able to shed some light on
opportunities, where to go etc etc I would greatly appreciate it.

Thanks
Tania


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[ozmidwifery] Debriefing

[Kim Stead]

Hi Honey

Yes I most definitely debrief with the woman and her partner. Sometimes we talk about it briefly after the birth - sometimes it is just praise for all their hard work and joyous achievement. Sometimes it becomes more indepth, other times not - depends a lot on what has happened, where you are and who is present. By offering continuity of care, there is on-going discussion and opportunities for debriefing during the PN visits as well and often it takes a few days or weeks for things to sink in and questions to be asked. Before I hand over care to the MCH nurse and family GP, we also have another debriefing session to make sure there are no unresolved issues.Of course, not everyone will disclose all their feelings and concerns but I do try and provide an opportunity for the woman and her family to let me know how they feel and a listeningear.As I write this, I have had no experience of this since arriving in this country, my first client coming up due so I am aware that thecost of my visits and women choosing not to have as many visits as our NZ sisters (who get their maternity care 100% funded) this may impact on this slightly? I will tell you in a few weeks. Continuity of care alsomeans that we usually havebuilt a relationship of trust with each other that supports this process as well. 
 
Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 7/09/2004 7:32:23 p.m.
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] doula discussion

Kirsten- Do women in New Zealandask friends or relatives to support them at birth? 

Kirsten you wrote "That the selling of the need for a professional doula undermines a woman's belief that she can give birth by herself, and is disempowering." 

Women usually believe they need midwives and or doctors to give birth. On a very rare occasion do I see a woman who is prepared to birth on her own. I would say that sometimes when a woman chooses to have a doula she is actually doing something that is part of her empowerment intaking back the responsibility for her birth rather than leaving it in medical hands and asking a doula to support her in whatever her choices are, a lot of whatI have been learning is how to support a woman to empower herself, by asking the right questions such as when they ask for advice or say what did you do? I would reply something like "How do you feel about that? and Would you like some more information on that? Would you like to go through the different options available to you? etc we do not give opinions recommendations or advice, we provide information on the risks and benefits if they ask for it, and we support them whatever their choice. Even if that means choosing to bottle-feed, having an elective caesarean or planning to have an epidural from the moment they enter the hospital. It is all about them and their choices. Some women will choose not to be informed in their choice and will decide that they simply want to follow the doctors suggestion such as when he says "if you were my wife I would want you to have a caesarean!" we can offer information but if they don't want it we will support them in that choice. Does that make sense. 
I also have a trust in the women I serve,I know they can birth their babies, and I do not in any way suggest that they could not do it without me. 
Growing up my godmother was the equivalent of a doula although I didn't realise it at the time, she would attend all of the births in the valley where she lived, some of the women she new well and some of them she'd never met, she never had any formal training but as she'd birthed 7 of her own and attended many births she was accepted as the person you rang in labour, and she worked alongside the homebirth GP or midwife. 

I am still new to the birthing world, and I am open to learning and admit I know very little compared to most of you on this list, thankyou for allowing me to be part of the discussions.

A question for you all .
Is it standard practice for you to debrief a birth with a woman (and or couple) ? 
If so, do you leave it open for them to also do more debriefing down the track?

Thanks again
Honey

- Original Message - 
From: Callum  Kirsten 
To: [EMAIL PROTECTED] 
Sent: Tuesday, September 07, 2004 2:00 PM
Subject: Re: [ozmidwifery] doula article

I was not debating the validity of a doula, i was merely saying they are rare in NZ and why's that? I don't know the exact reason but it's interesting to compare the maternity systems and the popularity of Doulas here compared to the very small number in NZ.

I had 1-2-1 midwifery care and would never have considered the idea of a doula and the things that have been said about what a doula does, was in fact done by my brilliant midwives.

Now is that because i had independent midwives in NZ or not? I don't know. But i find it interesting.

I can see how the role of a doula for the post natal period m

[ozmidwifery] Doula work in NZ

[Kim Stead]

Hi Vida

I just wanted to say how impressed I am with what you are doing and offering these women (cool website as well). I wish you had of existed when I had my own children. While I had a wonderful midwife providing continuity of care, she also cared for 3 other women a month (which does not seem like a lot) and had a young family herself.While her visitsranged from 1 hour to 1.5 hours, shealreadyinvested more time than the average midwife and had other commitments in her life as a woman, mother and wife. I don't think she would have been interested in doing the housework or helping me catch up on some sleepas well, so I can see how doula's and midwives do complement each other very well.I also think that some midwives are more 'holistic' than others. Speaking from a midwife, I would find your presence very reassuring and helpful. While I strive to offer continuity of care to the best of my ability and under the constraints in which we work, there are limitiations to all that we can cover and in what detail. 

I am NZ trained and like Kirsten, never knew any doula's existed back home. I may have been ignorant butI never came across any, andneither were theyspoken of - in the workplace or at uni so 'out of sight, out of mind' almost... While I think that NZ women are very fortunate in comparison to their Australian counterparts, there are also many gaps that need filling, of which I can see a definite place for the doula. Moving to another country also gives us a greater understanding of different practices and environments and helps to peice together, the big picutre. Anyway, enough rambling... great work and thanks for sharing your thoughts with us. 


Kim Stead
Midwife : Birth-Wise Midwifery
www.birth-wise.com.

---Original Message---


From: [EMAIL PROTECTED]
Date: 5/09/2004 9:49:19 a.m.
To: [EMAIL PROTECTED]
Subject: RE: [ozmidwifery] doula article

Kirsten said:
I apologise i left NZ in 2002, as of then i should state i knew of no
doulas, although there could have been. I find the whole thing rather
confusing, can i ask why you choose to be a doula and not a midwife?(I'm
seriously asking, not being sarcastic either.)

No need to apologise Kirsten at all - I assure you I did not take offence
:o) - just thought I should say "Hi" so that people know that there are a
couple/few doulas at least in NZ and I was explaining how I see things
having moved to NZ as a doula already.Only yesterday I have found
another CBE and "doula" in NZ who contacted me from Auckland and I also
spoke with a disillusioned midwife here who wants to know more about being a
doula

You ask a hge question. I see the Doula and the Midwife as two
distinct roles that do however complement one another.I have no passion to
learn about the clinical aspects of pregnancy/birth care although I do
strongly believe in having a good knowledge about the natural physiological
aspects.I am proud to be a laywoman whilst at the same time I constantly
strive to improve my knowledge and experience by attending workshops/courses
about pregnancy and birth, and by being with women.Pregnancy, labour and
birth for me cover the emotional/mental/spiritual/practical/physical - a
really holistic look at things.In my experience, I do not see the majority
of midwives getting alongside women who are pregnant and preparing for
labour/birth on an emotional and spiritual level - most are too overworked
to be able to invest this much time in doing that and some don't have the
inclination to either - or they may see birth as much more a
medical/clinical event than that - and that is ok if the women that they are
supporting also see it in that way.However, there are many women who *do*
see the experience in a more holistic way.I think there are many midwives
that have become medicalised without actually realising it, and equally (as
in any walk of life/vocation/job there are the opposite extremes) there are
many who have a wonderful philosophy towards pregnancy/labour/birth.
Midwives usually have to work within the policies/procedures of their
hospital or Trust Board or whatever governing body they are under.There
are always *far* too many politics involved when it comes to working for
these bodies - something very simple is made much more (dangerously, in my
view) complicated.I have chosen not to be part of that.Being an
independent "consumer" (as I am called!) I feel I have more power to make a
difference...

I am self-employed and offer myself "out there" for the woman and her
partner to "choose" to have me if they feel that they need that extra
support, and I also offer my services voluntarily/or on sliding scale so
that it is not just those that can afford that getI have a passion for
my role and I share with them my experiences and try to encourage them to
take the responsibility for the birth of their baby back from "the medical
world" and to learn about the natural