Re: [ozmidwifery] Mum Gives Birth In Toilet - Monash Medical Centre
You know what, I have a different take on this. If the newspaper article has reported accurately what the parents said (and I highly doubt they have, but for the sake of argument lets give themt he benefit of the doubt!), there are some serious failings of expectations here and little empathy going on from the medical staff. The mother was rushed to hospital by ambulance and arrived in the later stages of labor - this in itself appeared to be distressing for her as it appeared she was taken by surprise by the speed with which labor was progressing. So, now having arrived in advanced labor, she is not checked as she expects to be and does not appear to have a midwife in the room with her. Now that may be because she does not appear to be in strong labour, or that there is no midwife available. But from the mother's perspective, it is not what she expects. She feels out of control, in intense pain, and not receiving the level of hospital support she is expecting. She could have called for help and support or asked her husband to go and find a midwife. But her expectations were not being met. And it is a pretty reasonable expectation to have a midwife at the very least to reassure a mother who feels she is in strong labor, and realistically to be checking or staying by her side if she appears to be imminently birthing. At the point at which the baby is born, both parents describe themselves as frantic. This was not the experience they were hoping for. Yes, she did it without pain medication or any intervention. Yes, this is what many women aspire to. Yes, this is better for baby and mother healthwise in most circumstances. However, the mother felt unsupported, and the father felt panicky. And the hospital's response? We are as disappointed as Kay and Michael that the birth of their second child did not go according to plan, but babies have a mind of their own sometimes. Really? What a leap! To make the assumption that the midwives feel the same degree of disappointment as the parents. Yes, babies do sometimes come quicker than anticipated. What would have been nice is for this mum and dad to have been heard and had their sense of distress and lack of support acknowledged. Whether the midwives felt justified in their actions or not, the parents still felt the way they did. The mum was in the hospital for at least an hour and appeared to have no midwifery support during that time. I get that there may have been none available. But to dismiss the whole affair with a patronising comment about how the midwives are just as upset as the parents is hardly effective communication and certainly not displaying good listening skills towards the parents. Now of course, the whole newspaper article may be complete tosh and the parents/midwives may not have said anything that was attributed to them in the quotes. Always a shame that such stories are not seen as an opportunity to talk about how incredible our bodies are or how tragic it is that the health system the world over is failing women because of shortages of experienced midwives, or a multitude of other approaches that would be more beneficial towards women and babies. Nikki Macfarlane Childbirth International
Re: [ozmidwifery] paed burn cream
Kristin, My son was badly burned in an accident at home in February this year when the gas cylinder under the stove exploded. He was 12 at the time so not exactly a babe but the treatment I used worked wonders. I live in Singapore and after dousing him with room temp water for as long as we could, we took him to the closest hospital. The ambulance service pretty much leaves a lot to be desired here so we took him ourselves. When i got to A E found there was not one nurse or doctor who knew how to deal with burns, so we had a pink fit until they finally got containers for us to put water in and await a burns specialist. Burns adhesives were used to protect his arms and legs which had extensive second degree burns. We took him home the next day where I felt I could nurse him more effectively than was being done in hospital. After a few days the burns began to exude copious amounts of exudate - pretty disgusting stuff. It was running out of the dressings and he was getting very uncomfortable. they also did not appear to be healing at all although what i was researching seemed to be in line with his progress. I decided to switch tact completely and took the dressings off. We cleaned the wounds by running sterile water over them - did not touch but just let the water clean them. I then wet soft gauze swabs with the sterile water and squeezed out the excess water and then slatheered the swabs with manuka honey. I pured manuka honey over the wounds, then placed the gauze swabs on the top. Finally, wrapped the whole thing in crepe bandage. We would change the dressings three times a day or more often if needed. Within 24 hours there was no exudate at all and the wounds were becoming pink again. Within 72 hours he was off all pain meds and beginning to move around. I continued to redress for about seven days. Now, 10 months later, he has almost no scarring. The worst affected area was his wrist which was borderline third degree. There is no scarring there at all and full mobility in his wrist and hand. The only noticeable sign is where the hair follicles appeared to be burnt and he now has small brown marks on his lower legs - they look like odd pigmentation. I followed up with the Manuka Research unit at Waikato University and got some interesting research papers from the professor there. For us, this worked really well. There was minimal pain - redressing was only difficult when there was not enough honey on the edges of thee swabs so it stuck a little to the healing wounds. For this we just ran sterile water over it until it all softened up. I would give him pain meds about 20 minutes before we started redressing and this would help as well. The burns specialist we were seeing was impressed with his healing and told me that it was significantly more rapid and had an improved appearance compared to the dressings they used. I cannot remember the name of the dressings but it was the clear type that could allow oxygen through. I had read in several places that it was the treatment of choice but for us it was nowhere near as effective as the honey. Nikki Macfarlane Childbirth International -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Alternative GBS
Nicole, There has been some research done on the effects of antibiotics in labour to prevent the transmission of GBS to babies. What appears to be the case from current research is that the rates of GBS transmission do not change significantly as a result of the antibiotics but the babies who are exposed to the GBS are less liekly to become ill from GBS infection. However, there is an increase in the risk of e-coli and other infections that are resistent to the antibiotics, and therefore can result in more devastating infeections as they cannot be treated with standard antibiotics. So yes, the risk of GBS illness is reduced, but the risk of other antibiotic resitent infections is increased. I am fascinated to note that having now worked in the UK, Australia and Asia as a doula and in my role as a doula trainer have students from all over the world, the risk of GBS illness is so much higher in the USA than other comparitive developed countries. Another thing I struggle to understand on the topic of GBS. If the GBS is diagnosed it is determined that it came from the mother if she was GBS positive. However, a significant portion of woman can be GBS at any given time. If the baby is separated from the mother at birth and taken to the nursery, as is the case in the USA in most birth settings, and increasingly happening in other countries, or if the baby is routinely handled by staff at birth who may have been exposed to other babies or woman with GBS (e.g. handling soiled materials from a mother who had already delivered and was GBS positive), how do we know that the GBS was transmitted by the mother and not by the staff? I noted when I worked in the UK that GBS was rare, and babies were not handled by the staff as much as in the USA and certainly never went to nurseries because there weren't any in the public hospital system. here in Singapore, I have never seen a GBS affected baby amongst our clients, despite having had clients who were GBS positive (some took abx and some did not), but it is seen more commonly amongst other women here - the difference? The clients we work with have their babies roomed in, have minimal handling of their babies by staff etc, whereas the majority of woman have their babies taken to the nursery and held, bathed, fed etc by staff. Would be interested in seeing research that compares GBS infection rates amongst woman having low intervention births in settings that have close mother/baby contact compared to those rates in more actively managed settings. Nikki Macfarlane Childbirth International www.childbirthinternational.com - Original Message - From: Nicole Carver [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, November 17, 2006 8:01 PM Subject: RE: [ozmidwifery] Alternative GBS Hi Melanie, I suppose it is all about comparing the risks associated with having antibiotics with the risk of the baby being affected by GBS. The antibiotics are unlikely to do harm, except perhaps by damaging the woman's normal flora for a time. The consequences of things going wrong with the baby should it contract GBS are devastating. The chance of complications of either is small but the complications of GBS are so devastating as to warrant giving the antibiotics, I believe. Not all intervention is bad. All the best, Nicole. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] The Purple Line
As the baby's head descends Megan, the sacrum moves out and this results in the line appearing. It is something you statr to see, in most cases, when the woman is fully dilated, so is a great visual clue as to the stage of labour she is at. Occasionally you also see it earlier in labour if the baby is posterior and rotating past the sacrum. In this case though it does not tend ot be as long and disappears again as the baby rotates towards the mother's left hip. Nikki Macfarlane Childbirth International www.childbirthinternational.com - Original Message - From: Megan Larry [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, September 01, 2006 11:19 AM Subject: RE: [ozmidwifery] The Purple Line For us non-midwives, now that I've seen the photo and understand the purple line, what does this mean regarding the birthing woman? Megan -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Manual rotation
There is a low intervention alternative to encouraging babies to turn when they are posterior or ROA in labour - Rotational Positioning. It does not involve any manual manipulation, vaginal examinations or any other intervention and it is successful. Unfortunately no controlled trials, only anecdotal evidence but so far proving to be extremely effective when done. Reduces intervention rates significantly, turns babies alot quicker than any other technique and focuses ont he mother and baby dyad. Nikki Macfarlane Childbirth International -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] managed versus physiological 3rd stage, was: after birth pains
Title: Message When you were with the mother who had the physiological third stage Nicole, was there any touching, pulling or tugging on the umbilical cord? If a caregiver is not commonly practicing a physiological third stage they may be putting cord traction on the cord (pulling gently) anf this can cause the pain you spoke of. I have had four physiological third stages and none have been overtly painful. I have seen hundreds and the only time the woman has mentioned pain is when the caregiver is pulling on the cord or putting pressure on the top of the uterus. There is no reason why, if everything else is normal, you cannot decline synt until a time has been reached. A physiological third stage can take a lot longer - anything between a few minutes to 2 hours is still normal - although most hospitals would be uncomfortable waiting more than 30 minutes. There is no increased risk after 30 minutes - sadly, they are smply used to seeing a placenta come a lot quicker than that because managed care is the norm now. You can always choose to have the synt. As with every other intervention, and with the option of expectant care, there are pros and cons and only you can now the acceptable option for you and your baby. Nikki Macfarlane Childbirth International www.childbirthinternational.com
Re: [ozmidwifery] brown sugar
I told the doctor that it is not unusual for babies who are on breast milk often go for a week without passing a stool and was told that is rubbish. They should go every couple of days. Then his experience in babies fed fully on breastmilk is pretty limited! Even though this baby was premature, its system at 5 weeks is now able to take everything from teh milk that there is little left to get rid of. As others have mentioned, it is more important to see if there are other indications of a problem - weight gain, how content the baby is etc. Also, how does the mum feel about this? Is she concerned or does she feel the baby simply does not need to poo more often? How does she feel about giving sugar? Nikki Macfarlane -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Birth Attendant / Doula Directory
Title: Message Kelly, Findadoula.com is a free listing service as you know. If people do not list, then they will not appear on the listing. We sent out more than 2000 emails more than a month ago to doulas on our mailing list and on other lists and the response to list was moderate. I run several mailing lists and hear all the time that doulas would like more places to become registered so women can find them - this was the driving force behind setting up Findadoula.com. We do promote the service on google and we are finding more and more people listing everyday with many women now finding doulas and educators through the list. People can also list midwifery services, yoga classes, birth photography etc. There are lots of places to list - but it takes a lot of work to find them all. We hope that Findadoula.com can become a central reservoir of information on doulas for women. There are no restrictions, it is free, certified and non certified or students can list and people can also list all the organisations they are certified with. So everybody who doesn't done so already - get your name out there! The services are available but they are only helpful to women if they are utilised! NikkiMacfarlane
Re: [ozmidwifery] Birth Attendant / Doula Directory
Title: Message You may have been unlucky Kelly. The listing for findadoula.com does come up if you put in "find a doula" australia. It comes up as a paid advertisement on the left of the page. In addition, the link to Childbirth International comes up and the page that it links to promotes findadoula.com. With paid google advertising if the ad has appeared a fixed number fo times that day t will not appear again until the following day and this may be why you have had no luck with our ad appearing. Nikki Macfarlane
[ozmidwifery] Making a Difference workshop in Sydney
Childbirth International is delighted to announce that we will be running our popular Making a Difference workshop in Sydney in April 2006. The workshop is suitable for aspiring doulas and childbirth educators, those already working in these fields, midwives and nurses. You can choose to participate in the workshop to enhance your skills, build knowledge and increase your confidence. Once you ahve completed the workshop, you can then continue with a Childbirth International certification program as a doula or childbirth educator if you wish to - discounts are available for those who participate in the workshop. Making a Difference will show you how to truly make a difference to the women you work with. We will spend time exploring Childbirth International tools such as rotational positioning (how to help women with posterior babies and reduce interventions), WIGWAM (how to recognize where your clients are and what they want, then how to help them achieve that) as well as numerous other CBI tools. These workshop has been exceptionally popular in the USA. For more information, visit our website at www.childbirthinternational.com Dates: April 21-23Location: Y-Hotel, SydneyTimes: April 21 - 4-9pmApril 22 - 9-5pmApril 23 - 9-5pm Cost: $210 early bird price$250 standard price$180 student discount price All student materials, workbooks and light refreshments included. Nikki Macfarlane[EMAIL PROTECTED]
Re: [ozmidwifery] Cervical dystocia
Dot, The question you are being asked seems very odd. Cervical dystocia per se would not necessarily cause any discomfort to the mother - it just means that the cervix is not dilating. If there was a cervical lip and the caregivers were requesting the mother not to push, this may cause discomfort. But I cannot understand why the cervix taking a rest would cause any discomfort. The only discomfort I can think if is the discomfort of regular vaginal examinations to measure whether or not there is any progress or the mental distress by being told that she is not making progress. If a midwife is focusing on the mother and her needs, and she is comfortable and content with taking a break, why would the cervix slowing in dilatation cause any discomfort? This question sounds like they are focusing on the need to continually progress at a fixed rate which is obstetric active management not expectant woman centred care. There is no discomfort just because the cervix is not dilating. There is discomfort when caregivers constantly do VE's to diagnose dystocia. And there is mental anguish when a woman is told she is not keeping up with the required timeframes and may require intervention to do so. Following a woman and baby's cues does not, on its own, cause discomfort. If vaginal examinations were not carried out, there would be no way of assessing this so called dystocia. It certainly is not a requirement for caesarean section. It is an indication that the mother needs some space, privacy and the opportunity to find her own rhythm to get on with the hard work of having a baby rather than meeting some abstract and arbritrary time limits imposed by those who do not understand that the unique dance that every labor requires to find its own time to get going. Some women progress regularly through each stage of labor. Others take rest periods for the woman to catch her breath, rest and refind her focus. How about coming to the answers from a totally midiwfery and woman centered approach, recognizing the need to be woman centred rather than repeating some textbook solution? Nikki Macfarlane Childbirth International www.childbirthinternational.com - Original Message - From: Dorothy Thomas [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, August 08, 2005 7:52 AM Subject: RE: [ozmidwifery] Cervical dystocia There is no time frame discussed all the question states is that after examination it was fourn that the woman has a degree of cervical dystocia and what are the practical steps that the midwife can take to ease the discomfort of this condition. Regards Dot -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] face presentation
Perhaps mechanical delivery is not possible, but certainly a mother birthing a baby herself is possible even when the baby is presenting face first. There was an excellent photo diary on the web last year but was removed after a few weeks. I had printed off the photos and they are just beautiful. I guess when a person calls a birth a mechanical delivery they are not going to see many things that happen as nature intended, or is that just my bias? Nikki Macfarlane www.childbirthinternational.com
Re: [ozmidwifery] New to list - Hi
Nicola, Welcome to the list! I work for Childbirth International - we offer doula programs you can study for at home. Feel free to contact me offlist if you would like to know anything at all. Nikki Macfarlane Childbirth International www.childbirthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidural research
A lot of this research (at least from the press release) is sort of a "duh!" moment. The control group were having narcotics. So no surprise that the babies in the epidural group fared better on Apgar scores. There is no doubt that babies exposed during labour to narcotics given IV are significantly more likely to experience breathing problems post delivery so their Apgar scores would be expected to be lower than in an epidural group. On the measure of length of labour, it is interesting that researchers so often comment on this. We know that length of labour is not associated with poor outcomes, so why should faster time to delivery be a goal we should be striving for? And again, the control group were having IV narcotics. Narcotics are known to be poor performers in reducing pain significantly. A woman in intense pain, who is now distressed and unable to communicate this because of the narcotics is more likely to have a longer labour simply because pain causes stress which therefore influences the efficiency of contractions due to the impact on catecholamines. Re the c section rate. There has long been evidence that epidurals do not increase the caesarean rate when compared to other forms of pain relief. Since it is commonly used in conjunction with oxytocics to hasten delivery, and the assisted delivery rate has been shown to be significantly higher with epidural use, you would expect to see the cesarean rate slightly lower or the same when compared to narcotic use. No surprises there. When are researchers going to start using realistic controls - women who are having no forms of pain relief and continuous support. The only positive thing I can see about this research is it again reinforces the pointlessness of offering narcotics due to their lack of benefit to mother and baby and direct harm to babies in the form of breathing complications. Nikki Macfarlane Director of Training, Childbirth International www.childbirthinternational.com
Re: [ozmidwifery] mw needed
Denise, I am still living in Singapore. Would be happy to answer anything on homebirth or other birth options here. Homebirth does happen - albeit pretty rarely!The system is obstetrics based but we do work in one hospital that is very supportive and many clients arrivepushing and leave within a few hours. Also have a few very supportive doctors here. Let me know any questions. Nikki Macfarlane For info on doula services, refer to www.parentlink.org
Re: [ozmidwifery] Vegan and pro-choice (was abortion etc)
Abby, This is clearly an issue that you feel very strongly about and one that you are willing to fight for. I applaud you for having such a passion. Thought it might be worth considering the perspective of others for short time. Abortion for most women is not an easy decision. It is not something they do without an enormous amount of consideration and addressing each of the alternatives. Yet for many, there simply is not a viable alternative. There are women who choose abortion following a rape, or a diagnosis of abnormality - sometimes one that is incompatible with life. For others they decide to have an abortion because their financial circumstances, their emotional state or their immaturity are not compatible with the raising of a child. Yes, for many adoption is an option. However, this is not something many women wish to consider since it still means continuing with a pregnancy that they do not want. You may see this as convenience, but to do so negates the emotional impact of an unwanted pregnancy on a woman's life. You may also argue that in these cases the mother is not considering the emotional impact on the baby who did not ask to be conceived and certainly would not ask to be aborted. Perhaps. At the end of the day though, if abortion were not a viable alternative for women legally, it would still take place illegally and would increase the health risk to many many women. You said that you judge the choice rather than the woman. However, in using such emotional language your argument comes across as being extremely judgemental of the woman. I fail to see how you can judge the choice and not the woman who made it. Judging someone does not mean that you cease to be friends with them as you seemed to imply when you mentioned that your close friend had an abortion. Judging someone is about thinking less of them for their choices or lifestyle. Can you honestly say that you still have the same respect for your friend after she chose an abortion? If you have ever been in a position where you had to face an unwanted pregnancy, then I applaud you again for making the decision to keep your baby against the odds or for making an extremely difficult choice of adoption. If you have never been in this position then please consider how it feels to walk the shoes of a woman who discovers she is pregnant and feels simply devastated by this and unable to continue with her pregnancy. Women who choose abortion know all too well that they are ending a life. They also understand the magnitude of such a decision. It is not light hearted nor is it a choice they want to make. Surely our goal should be to help women have healthy babies when they want them, provide support to those who choose to adopt their babies out and show compassion for those who feel they can no longer continue with their pregnancy and choose abortion. Clearly those on the pro life and the pro choice sides of the fence are never going to see eye to eye on this issue. But if our focus is on helping women in all their choices to make the choice that is best for them, and providing education to help women understand their options, we are at least working towards the same goal. Respectfully, Nikki Macfarlane www.childbirthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] co-sleeping
I do remember saying help yourself Im asleep (which did seem to offend but I was too tired to give a damn on that particular occasion). but I never found breastfeeding to inhibit desire or lubrication etc. I have found myself the odd one out in discussions which tend to blame breastfeeding for lack of interest. I actually felt really sexy -I had tits!! for the first time, so I guess we can be victims of our conditioning whether it is the madonna whore effect which some mums explain means they dont feel that they can equate being a mother with being spontaneous, or who the breasts belong to - me actually! Loved the help yourself comment Pinky. I see an enormous range of normal amongst mothers. Being exhausted makes an enormous differnce to how interested a person is going to be in sex. As does stress. I am not sure the lack of desire many women feel while breastfeeding is simply conditioning. Speaking from absolute personal experience, I thoroughly enjoy sex when I am not breastfeeding and have a particularly good time when I am pregnant and definitely have a supercharged libido. I am not able to blame housework on my lack of interest - living as an expat I don't have any. Stress from looking after the kids is not the issue either - three of them are at school all day and then I have full time help with them in the afternoons and they are not exactly exhausting like they were when they were little (two now in early teens). I never feel tired or run down. I never feel particularly stressed. But I am very definitely not interested in any form of sex while I am breastfeeding. It is purely a hormonal issue - once I stop feeding I get those old feelings all flooding back - at least that has happened the last 3 times so fingers crossed for this one! On the opposite end of the scale I have worked with many women who have been hotter than hot from soon after giving birth despite feeding. Just depends on the woman I guess! Nikki Macfarlane -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] sleep stuff
thats fantastic cas. and you are absolutely right - we should do what feels right for us. the problem with co-sleeping or not co-sleeping is that many people are influenced by books, friends, health professionals etc telling them that it is bad for them and their children if they do co-sleep, despite what their instincts may tell them to do and if co-sleeping actually helps them get a better nights sleep. if it does not feel right and the child sleeps fine on their own, no issue. but if parents are told they must put their children in a separate room because of someone else's expectations of what is right and what is not then that is wrong. Good luck for tonight! Nikki - Original Message - From: Wayne and Cas [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, March 19, 2004 6:18 AM Subject: [ozmidwifery] sleep stuff Well, we tried the side car thing last night and he went down without any hassles at 8.30, then woke up at 10pm so I fed him and gently rolled him over to the cot and he didn't stir until 5am this morning. So far so good. It was the best night's sleep I've had in weeks. Thanks for all of your suggestions. I wanted to add though that sleeping with children and babies is not right for everyone. I don't actually know too many adults or children that seem affected by the fact their parents made them sleep in a cot when they were babies. There is a lot more to parenting than whether you co-sleep or not. Ie. If you don't love your kids unconditionally, no amount of co-sleeping is going to give the added security a child needs. I think we are all individuals and so are our children and we just need to work out what best suits them. When Liam was the same age as Daniel he was very hands off, didn't want hugs, didn't want the breast a lot and it hurt me at the time but it was what he needed. Daniel is a totally different baby. I will let you know if our good fortune last night continues. Cheers Cas. Cas, Wayne, Liam and Daniel McCullough [EMAIL PROTECTED] www.casmccullough.com -- 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] sleep stuff
We have 4 children - one did not co-sleep and three have. Our one year old is in a bed beside ours to give us extra space. Our relationship is stronger than it has ever been. My partner is very content with our arrangement that we developed together. He enjoys having the baby beside him at night. his view is that he gets to spend so little time with the kids during the day there is something special about having her cuddle up to us at night. In terms of sex, well, frankly, it is not the highlight of our life at the moment. Not because we are co-sleeping but because I am breastfeeding and am never particularly interested during that time. Is it an issue for us? I have to say not at all. We are intimate, just not at it like rabbits. We have been together now for 17 years and our relationship has never been stronger. My husband has a wonderfully close relationship with all our kids which is not specifically to do with co-sleeping. Co sleeping is part of a whole package of how we choose to bring our children up. If we had the baby in a separate room I really don't believe we would be any more intimate. If I was up for several hours each night trying to settle the baby it certainly would not do anything for our relationship. We feel that for us, me being exhausted all the time would put additional stress on our relationship. He has always managed to sleep through the kids crying and has never been keen on pacing the floor with them. If anything, if I had to do the settling while I watched him sleep I would be resentful towards him which would cause more problems. This is a formula that works for us. Not one I would advocate for anybody else.Knowing what works for your children and your relationship is what is important here. Not some prescription that should work universally for everybody. Nikki Macfarlane - Original Messa ge - From: Sylvia Boutsalis [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, March 19, 2004 7:10 AM Subject: RE: [ozmidwifery] sleep stuff I don't mean to be judgmental in relation to co-sleeping but I am curious about what happens to the couples relationship? I am not a selfish person but I do regard my bed time to be something shared with -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] sleep issues
Title: Message Cas, how about reclaiming your bed and helping him to sleep near you as a copromise? You have already said that he is more contented when he sleeps beside you. If the objective is to get as much sleep as possible, perhaps a sidecar arrangement would work best? Place his cost or a single bed, beside your bed, up against the wall. Then push your bed up against that. Remove the bars off one side of the cot so you can reach him easily. This gives you and your husband enough space, while also giving him the closeness that he is craving. I think within our society we are so completely focused on having the baby in another room, we lose sight of the fact that what is most important is what works, rather than what our friends are all doing or what a book tells us is right. Many times I will hear mothers identify what works best, i.e. having the baby in bed, but they will then say in the next breath "but I don't want to get into that habit" or "I don't want to go down that path". What do you think would happen if you did make that choice? Unlikely the baby would still be there when he was 5 years old although if he was and you were all still sleeping, would that bother you? And if so, why? What would be your concerns? Before you can find a solution, you first need to identify your priorities and your concerns/fears. If having the baby in your bed works but it would cause you excessive distress then this may not be the option. As a mum of 4 who chose co sleeping with babies 2,3 and 4, a childbirth educator and a doula, I have to say that any fears about the baby being spoilt or never moving into their own room are unwarranted. My kids have all moved quite comfortably to their own beds at around 3-4 years of age. Exactly the same time that otehr friends who insisted on cots in seprate rooms had children who started to settle better at night.It doesn't really appear to makea lot of difference which method you try in terms of getting them to sleep through the night. Several points to remember: 1. Some babies just do sleep through night regardless of what their parents do or don't do - it is just luck of the draw 2. Some babies need more close connection with their parents for the first 3 years 3. It is more important to get sleep than to have good intentions - without sleep you have no ability tocarry through the good intentionsanyway! 4. Most babies tend to settle a lot more once they get beyond 3 years - regardless of what you did in the first 3 years Think about why him being in his own bed is so important to you. Is it because of preconcdeived ideas about what constitutes a good mother? Or what other's expectations of you are? Or having to explain to other people (perhaps not tewlling anyone else is a viable alternative here!) Good luck. Having had my first child who did not sleep through the night until he was four years old and after sharing countless sleepless nights with him, I can completely empathise. Nikki Macfarlane Director, Childbrith International www.childbirthinternational.com - Original Message - From: Wayne and Cas To: [EMAIL PROTECTED] Sent: Wednesday, March 17, 2004 7:36 PM Subject: [ozmidwifery] sleep issues Hi all, I am hoping someone on this list can offer me some advice about sleep. For some time now our baby boy (who is now 10 months old) refuses to go down in the cot. Everytime I lean over the cot, no matter how I do it, he wakes up. I only have to bend over and he wakes up. We've tried settling him with a hand on his back, with massage, with singing, and he just cries and cries sometimes for more than an hour. One night I got him to sleep after a marathon 1.5 hours crying session, never leaving his side, arm through the cot bars killing me and he woke up 15 minutes later. I was exhausted. In the end he ends up in bed with us all night where he sleeps fine but hubby ends up on the floor and I end up not sleeping so great because he thrashes around or wakes up for feeds all hours of the night (and ofcourse cause it is easy to settle him that way and I am exhausted I just end up feeding him to sleep). The other issue with him crying in his cot is that it wakes up his older brother or conversely, the cat goes in there tinkling her bell and scratching at the carpet and wakes the baby up. Argh! I am getting more weary of not getting enough sleep and my hubby is getting weary of not getting to sleep in our bed! I really don't know what else to do but I feel we need to reclaim our bed and get him to sleep in his cot. Any suggestions? Cheers, Cas McCullough Cas, Wayne, Liam and Daniel McCullough info@casmccullough.com www.casmccullough.com
Re: [ozmidwifery] sleep stuff
I wish you all the best Cas - lets hope you can find a solution that works for all of you. Interesting you mentioned your husband has a very traditional outlook on the sleep issue - if more people were more traditional they would see that traditionally we had our babies in bed. It is a relatively new phenomonen to have babies in separate rooms - started when the standard of living improved and people became wealthier - enabling them to have a bedroom for each person in the family. Before that kids all shared one bed - I remember my father in law telling me that when he grew up in a poor area of Glasgow him and his two brothers shared a bed that dropped down from the wall in the kitchen since there was only one other room in the house and that was their parents bedroom. You mentioned not having a lot of support Cas - you're based in Brisbane aren't you? I have two students in Townsville - not that close I know - who have a really open minded approach to parenting. Would you like me to put you in email contact with them? Not quite the same as face to face support but perhaps helpful. I know there are also a couple of doulas in Brisbane who may be able to point you in the right direction for support groups of other mums who can help. I am pretty sure they are listed on the database on my website - go to Find a Doula and type in Brisbane and you will see their contact details. Nikki Macfarlane www.childbirthinternational.com - Original Message - From: Wayne and Cas [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, March 18, 2004 11:32 AM Subject: RE: [ozmidwifery] sleep stuff Thanks for your replies. I am going to move the cot back into our room and try the side car thing. I've managed to talk hubby into giving it a go although he sees it a backwards step... His tradition outlook is quite frustrating at times. Anyway, I'll let you all know how I get on. Pinky I don't have any support here really although a good friend from MC came over briefly this morning which was great as I was pretty much a basket case and will probably be for most of today. Blessings Cas. Cas, Wayne, Liam and Daniel McCullough [EMAIL PROTECTED] www.casmccullough.com -- 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] Urgent: Need Info on Eating In Labour Policies
and their justification for such a policy is what The only reason to even consider NBM during labour is when considering the risk of Mendelsohn's syndrome, and the risk for that is present with general anaesthesia. since somebody having an epidurla is highly unlikely to require a GA why on earth prevent them from eating? do they have statistics on the percentage of women who go from having an epidural to then requiring a GA? Mendelsohn's, even if the risk exists, is now known to still be a risk even when NBM is followed. Good anaesthetic procedure is more improtant than any other factor. Having a policy of NBM does NOT prevent aspiration of stomach contents, reduce acidity of stomach contents or ensuring an empty stomach. Are the anaesthetists saying something about their confidence in their own anaesthetic technique? Nikki Macfarlane Director, Childbrith International www.childbirthinternational.com Original Message From: ljgTo: [EMAIL PROTECTED]Sent: Monday, March 01, 2004 10:13 AMSubject: [ozmidwifery] Urgent: Need Info on Eating In Labour Policies Hi all Need some information from hospital based midwives re: your units policies in regards to women eating in labour. Need this info by Wednesday our anaesthetic department have taken it upon themselves to direct midwives to keep women who have epidurals NBM, and Im sure there will be further in regards to women who dont have epidurals. If you could email me off list with what you policy says and where you are from I would greatly appreciate it! Ahh the battle goes on!! Lisa g [EMAIL PROTECTED]-- Babies are Born... Pizzas are delivered.
Re: [ozmidwifery] Doulas in the Blue Mountains
There are two listed on our website in the blue mountains, Abby Nathalie. Go to: www.childbirthinternational.com and click on Find a Doula, then enter Australia as the country. Any doula or childbirth educator can list on these pages for free so a good place to start a search if looking for someone. Nobody at the moment in Tasmania, Western Australia, South Australia or Northern Territory. Only one doula in Brisbane, none in Sydney or Canberra. Could do with some more listings for Australia! And nothing yet for NZ! Nikki Macfarlane - Original Message - From: Melissah Scott @ Spilt Art To: [EMAIL PROTECTED] Sent: Sunday, February 15, 2004 4:10 PM Subject: [ozmidwifery] Doulas in the Blue Mountains I have someone who is about 18 weeks pregnant and fairly recently moved to the blue mountians (Katoomba) She is unsure of where to birth at the moment and is concidering birthing at nepean private to make use of her private health insurance. She is hoping to stay in hospital for about 5 or so days, and at nepean private her husband can stay with her. She wants to stay in for a few days because she is nervous about being able to breastfeed and take care of her bub, as she feels she has not much idea of what she is doing. So I sugested to her that maybe a doula could be of great benifit to her by the way of childbirth info, birthing and post natal care/advice etc. She is quite interested in talking to some doulas in the area. So, I thought Id try to get together a list of Doulas in the area to pass on to her. If anyone is interested, could you please either reply or email me directly with all your details [EMAIL PROTECTED] I know your around Abby, but I cant find your contact details. Thanks! Melissah www.Splitart.com
Re: [ozmidwifery] URGENT INFO NEEDED
Abby, the numbers can be confusing, especially when they use two different scales which is what they have done here. The 300, 280 and 380 are on one scale. The 22 is on another scale. To get the same scale, multiply the 22 by 17, or divide the larger numbers by 17. The 300 and 280 are not that unusual for a term healthy baby. The 380 is quite high but still not panic stations if other indications such as alertness and feeding are all normal. I am amazed they have said she cannot feed on demand - this is absolutely the most important thing the baby needs to shift the jaundice. Breastmilk will help the baby to frequently clear its bowels - bilirubin is excreted in the faeces. If the baby does not feed it will not poo, and the bilirubin will sit in the intesting for longer periods and subsequently be reabsorbed, thus lengthening the period it has jaundice for. Absurd approach. I can understand the desire to put the baby under lights but the advice to feed every 4 hours sucks - this baby needs as much breastmilk as mum can get itno it. It will help excrete the bilirubin and will also prevent dehydration and prevent the baby's blood sugar level from dropping. A low blood sugar level will lead to a sleepy baby whoi then doesn't want to wake for feeds and ends up in a vicious circle. I see an enormous amount of routine jaundice treatment here for levels as low as 12 (204). All babies are routinely tested so we frequently get to see the consequences of a diagnosis of jaundice. Remember that the levels naturally begin to drop from day 6 onwards. This usually conincides with the treatment which of course everyone says worked, but it may have been that the baby's levels were dropping anyway. The phototherapy equipment is often on wheels - the baby can be given phototherapy but be in the same room as mum. In fact, in most places the equipment is available for hire and mum can give at home. Good luck. Nikki Macfarlane Director, Childbirth International www.childbirthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Twilight delivery - Still used
Twilight sleep is still used in some countries sadly. One of my colleagues is training with me as a doula. She had her fourth baby with our group last year. Her first two were born in the Phillipines 10 and 8 years ago. She had what she called twilight sleep - administered through her IV when she said the pain was very strong - she was almost fully dilated and had wanted a "Lamaze" birth. She was completely unconscious and has absolutely no recollection of the birth at all. Her babies were both born vaginally, she suspects with forceps. Her third and fourth were born here in Singapore. Number 3 was an induction for supposed hypertension at 38 weeks. Her fourth, when she moved to our group and the ob we work with, was a wonderful natural birth. She talks about the exp[erience of her first two births as being very frightening and having difficulty bonding with her babies afterwards. She is unsure of the drugs that were used but the description of the effects sounds veyr much like scopolamine. And we get frustrated about evidence based care not being followed in the West! Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas
Re: [ozmidwifery] OT: spam
Jo, today alone I have been offered the opportunity to view awesome chicks get dirty, take out a government loan, take care of My Abobo's money for him in his secret bank account, get a university diploma, consolidate my loans and reduce my debt(twice!)se an electric scooter, purchase digital cable, order a banned cd that represents the moral decay of society(three times), help mr owen alaba in his venture proposition (twice!), buy viagra pills online(twice!), get free prescriptions(twice!), purchase norton, chat with sexy chicks online now, take pills that will help me lose weight while i sleep, buy a contact tracing program. and that is just one day - seriously. i this is not on a free email program like hotmail - i pay for this stuff! One of the downsides of having my email address online. Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 17, 2003 5:28 AM Subject: [ozmidwifery] OT: spam Sorry for the OT email, but is anyone else being bombarded with 'how to enlarge your penis' emails?? Or is it just me? BTW, I am now off birthing suite and on the postnatal ward again - I think I prefer it there - less intervention! Jo --Babies are Born... Pizzas are delivered.
Re: [ozmidwifery] (no subject)
Tina, I am so envious! I patiently (or maybe not so patiently!) await the day when I can begin calling myself a midwife. Living here in Singapore the direct entry midwifery programs were simply unattainable for me. Since we did not know how long we would be living overseas I decided to start the Bachelor of Nursing Science degree offered by distance learning - i am so thankful that i started when I did. I am now in my final stretch. Just 3 semesters to go of a 6 year part time course done by distance learning. It has been a long slog, challenging to study nursing by distance particularly without any peer group for support at all. Returning to placements has been interesting, but also difficult to arrange to say the least given that i have had 3 young children throughout the whole course and now have a fourth to add to the mix. Breastfeeding my youngest two, fitting that in with placements and residentials, exams and essays, maanging to work as a doula and build a practice here, develop a training organisation for doulas and childbirth educators, all has made this a fascinating journey. Now with only 3 placements ahead of me it is starting to really seem achievable. I am off to Townsville again in July with my newest baby and then 4 weeks of placement - if I can find somewhere in Qld that will take me! I am really starting to feel that i may one day be ready to apply to do my Midwifery post grad. How I am going to get my 12 months practical experience and then organise 20 weeks clinical experience is beyond me but perhaps something will pass that will make it achievable - everythign else seems to have fallen into place when it was needed. Oh how I envy those who were able to do direct entry. Saying all of that, it has surprised me how much I have enjoyed nursing - I never would have believed that i would one day be saying that palliative care is as fascinating to me as birth. Two ends of the spectrum and each with so many parallels to the other. Well done to the work you have achieved so far Tina. I hope one day soon to have the same privilege as the rest of you with being able to provide women with the choices they wish to explore. Until then, I work beside wonderful caregivers and provide the emotional support that so many are looking for during their pregnancy and births. Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Sent: Monday, June 16, 2003 8:55 PM Subject: [ozmidwifery] (no subject) Hello fellow ozmiddersjust a note to say hello to you all and to say I am still here lurking in cyber space. I have just completed my pain/pharmacology exam today (YEHAAA)...feeling great to have now completed 3 of the 6 semesters of the B Mid...yes I am half way thru the course, can you all believe that!! I still can't. I pinch myself every day, to make sure I'm awake and not dreaming. It only seemed like yesterday that I sat at the NZCOM conference in
Re: [ozmidwifery] Re Episiotomy
Thanks for the comments Andrea. Your comments are certainly borne up by our experiences here in Singapore as well. Whilst we only have a small sample to use as an example (about 90 births so far) they are for the most part natural, vaginal births with hands poised, in positions chosen by the women themselves with absolutely no direction from anyone else, a calm, dimmed environment, no controlled pushing techniques, and completely natural third stages. I have seen 2 PPH's - one with a managed third stage and one with a physiological, both with the same caregiver. Those women who have birthed vaginally almost always choose to birth their babies in an all fours position or standing, and usually their partner catches the baby with caregiver guidance if needed. I have seen one third degree tear in a woman who had serious pre-eclampsia and severe oedema to her tissues. Our episiotomy rate is only 3%. No fourth degree tears. Some second degree but predominately intact or first degree, and rarely any stitching for these. No retained placentas diagnosed at all. Although several have taken more than an hour to be born. So our conclusions based on small sample size? Hands poised works best in an environment where the woman is well supported, provided with good information, has a suportive caregiver and a normal labour. It has no impact on perineal postnatal pain, no impact on infant outcomes, and no impact on placental problems. Oh yeah. The caregiver we work with? He is a Singaporean obstetrician. No midwifery care here - just doesn't happen. The midwives are limited in what they are able to do and effectively restricted to working as obstetric nurses. Nikki Macfarlane Childbirth International www.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re Episiotomy
Oh Denise, so beautifully asked - without a trace of rancour or cynicism! Physiological third stage is one of my more obvious irritations - the one I probably become most passionate about. Listening to caregivers talk about the Cochrane trials and how they recommend managed third stage drives me nuts. Having scoured through all the original papers used for the Cochrane trial it is so clear that there were many flaws in the studies they reviewed. Bath was only one of many! Third stage is even more of an issue here now with an amazingly high number of parents opting for cord stem cell storage through private companies - there is no public bank. They are always surprised when we communicate to them that their obstetrician will receive $500 from the storage company for each stem cell collection he/she makes.We currently have a big drive from EPI-No as well of the same ilk - each doctor stocking these ridiculous contraptions receives a payout. No surprise then that many doctors are encouraging the women they care for to use them. Never mind that Epi-No were unable to satisfactorily reply to any of my questions to them. Bit the same as the storage of stem cell companies here - asked them some pretty direct questions 6 months ago - they were going to find out the answers but clearly were unable to - or unable to share their findings! Not that I am a believer in "money driving the health care system" of course. Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Sunday, June 15, 2003 2:39 AM Subject: Re: [ozmidwifery] Re Episiotomy Dear Nikki Are you sensing that possibily the results of the HOOP study maybe reminiscent of the Bath study on physiological third and more recently the Breech Trial in that the results may be influenced or contaminated by the expereince of the operators?Denise - Original Message - From: Nikki Macfarlane To: [EMAIL PROTECTED] Sent: Friday, June 13, 2003 4:02 AM Subject: Re: [ozmidwifery] Re Episiotomy Thanks for the clarification Lesley and Marilyn. The HOOP trial conclusions was what I had read in MIDIRs some time ago and had assumed that this was what was being recommended by midwifery organisations. I am pleased to see that the trial results have been interpreted differently by some. After reading the HOOP trial I was frustrated that they did not seem to provide enough information to determine why it was that the hands poised group had a significantly higher rate of manual removal of placenta. I can't think of any reason why this would be so - unless the midwives caring for these women were applying a different type of care for the third stage, either consciously or subconsciously, to the hands poised group. If they were providing different care, why was this? Perhaps a different subconscious attitude towards this type of care? Or something they were uncomfortable with? And if so, how did that affect other aspects of the trial? Can anyone else think of any reason the hands poised group would have significantly higher levels of manual removal? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas
Re: [ozmidwifery] Re Episiotomy
I am confused by this discussion so hoping for some clarification! My understanding of the results of the HOOP trial was that it favoured the use of Hands On - a finding that the midwives in the UK were surprised by. I had read summaries that clearer pointed out an improvement in perineal outcomes with a hands on approach. Was there re-analysis carried out that found the opposite to be true? It sounds from this discussion that the HOOP trial is now being said to have favoured hands off. Can someone help? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, June 14, 2003 12:43 AM Subject: Re: [ozmidwifery] Re Episiotomy Actually Mary, if you want to get your hands on, the only position you can't is water birth (unless you are in the tub too (joke)) and possibly a deep squat. We used the deBuy birth stool a lot there and trust me, you can definetly get your hands on. By hands on i am not meaning anything beyond perineal support (which as the article discusses is favoured by US midwives), and a gentle hand on the baby's head (not really doing much). Mum's (mom's) I attended in the USA truly expected this, perineal support especially is promoted in birth literature there. This means the midwife is also in many and varied positions. I know it isn't usually done here, I don't know for how long it hasn't been done: before or after the Hoop trial? It will be interesting to see what the outcomes of this study are, especially to see if it leads to practice change. By this I mean if the study supports "hands off", then will US midwives change their practice? And if it supports "hands on" will Australian and Uk midwives change theirs? Or will we have to do a repeat study here? Possibly the result will be ambiguous and claim there is no significant difference betweeen practices and so no change will happen anywhere. Interesting that's all. marilyn - Original Message - From: Mary Murphy To: [EMAIL PROTECTED] Sent: Thursday, June 12, 2003 5:30 AM Subject: Re: [ozmidwifery] Re Episiotomy Marilyn Wrote. I must admit after my training in the USA it has been hard to do and I am definetly more "hands on" than "hands off". I find discussions about hands on and off interesting, given that if a woman is birthing in a pysiological position, (upright squat, hands and knees or kneeling leaning forward), there is nowhere for a midwife's hands to be except in the "catch" position, especially if a woman is birthing in water. I wonder if all this discussion and trials would be going on if birth was truly in the hands of women? MM
Re: [ozmidwifery] Episiotomy - when to cut?
Jo, What a frustrating situation for you, her other caregivers and of course the woman herself. Can I ask what position she was in when she was pushing. Also,how she was pushing - following her own urge with everyone following her pace or with counting, held breath and purple pushing? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 7:59 PM Subject: [ozmidwifery] Episiotomy - when to cut? Hi all fellow midwives and students and all :) Looking after a woman last night who was a primigravida, term, induction for SROM, not in labour. RMO needed birth experience, so he did the catching. He did not cut an episiotomy, and nor would I have, but this woman ended up with horrible tears, in all directions, almost to the clitoris on both sides. We were 'scolded' by the consultant for not doing an episiotomy.
Re: Cosleeping
My understanding is that the current recommendations are: 1. No co sleeping if either parent smokes 2. No co sleeping if either parent takes reacreational drugs or consumes large amounts of alcohol 3. No co sleeping on settees (couches) The reason for the smoking is that the second hand cigarette smoke puts the baby at risk of sids The reason for the alcohol drugs is the impairment in levels of sleep and the inability of an inebriated or drunk adult to recognise if they have rolled on a baby The reason for the couches is that the studies show babies that sleep with their parents on settees are more at risk of sids. There is no evidence that a baby in bed with its parents who are not inebriated, smokers or heavy drinkers is at any more risk that any other baby. In fact, there is some evidence that it reduces the risk of sids. Studies that were carried out some time ago in an area of Wales UK found that babies born in Asian families had significantly lower rates of sids than caucasian babies in the same area. The hypothesis was that these babies co slept in a family bed and this was thought to possibly confer some benefit. There is some thought that it may be normal for a baby to stop breathing briefly and that being beside an adult who is breathing may stimulate the baby to take another breath, thus reducing the risk of sids. There is also very clear evidence that breastfeeding 100% offers benefits to babies against the risk of SIDs. I personally have known several women who have lost a baby to SIDs through my work witha miscarriage, stillbirth and neonatal death support group I worked with in the UK for some time. During the year I was involved I knew 5 women who had lost a baby to SIDs and had the babies in cots in another room. There was one woman whose baby coslept and died in her parents bed while they were beside her. I remember the women who lost a baby that slept in another room and then went on to have another baby all intended to co sleep with their next baby since they felt their babies would be less at risk if they were closer. Just anecdeotal but interesting. I am interested that the fact that 2 babies died in one area has resulted in advise not to co sleep. Were these two babies co sleeping with parents who were not smokers, heavy drinkers or drug users? How many babies died of SIDs in the same area that were not co sleeping? Did anyone know the details of these two deaths or is this one of those stories passed on from one person to the next without any real foundation? This sounds like the policy at the hospitals here that says the babies cannot be born in the birthing pool because a baby died in a birthing pool in the UK. Never mind all the babies that died out of the birthing pool. Or the actual reason for the death. Why are health professionals often so keen to jump down on anything remotely "natural" or "non-interventionist" yet happily embrace high risk activities that have not been adequately tested and proved beneficial? And even will continue to use high risk practices that have been proven to be high risk? Ridiculous. Nikki Macfarlane Singapore - Original Message - From: Janelle Lyndon Webb To: ozmidwifery Sent: Tuesday, June 11, 2002 11:16 AM Subject: Cosleeping All the sharing on the list about the wonderful benefits of cosleeping has stirred my conscience. I have not had children, but can see that this is a very natural thing to do. However, the is a big SIDS prevention push at the hospital where I work, and one of the big no, nos is cosleeping. One of the paeds is on the SIDS committee and apparently there where two cases in our area last year, two cases too many. We have been asked to get parents to sign a form stating that they have received the information on safe sleeping, including the information that cosleeping is not recommended. A midwives, many of us feel uncomfortable with telling mothers that they must not sleep with their babies, and in my practice I was beginning to encourage more and more mothers to "kanga cuddle" their babies and have a snooze together in the days following the birth. Especially if they were having feeding issues. I do know however, that there are also midwives that if they find a mother and baby asleep in bed together, will remove the baby from the bed! I know that there is also alternative research on cosleeping which I should try and track down, but are there any thoughts from the wise women of this list as to how to approach the current recommendations on SIDS?
Re: 'educated' women
Debby, You rightly point out one of the dilemnas of childbirth education - how much do we teach and what perspective do we teach from? How on earth to get across the myriad of information so women can make truly informed choices? If we tried to teach even a tenth of all the possible things that could happen in their pregnancy, labour, birth, postpartum or with breastfeeding, it would take hundreds of hours of childbirth education or piles and piles of brochures. Then the problem that all women you are working with have a different knowledge base to start with, a different level of interest and motivation, and a different capacity to absorb and understand the information. So how do we tackle it at all? I work at this from two perspectives. Firstly, teach NORMAL pregnancy, NORMAL birth, NORMAL neonatal issues, NORMAL breastfeeding. For example, I don't talk about pain relief options. Why not? Because my clients do not need me to cover anything they can read for themselves in a pregnancy book or a women's magazine. We talk about pain. How pain is normal. Why labour hurts. What it is telling us. How will it benefit the woman and her baby. How she has everything within her capacity to deal with it. How her body will utilise amazing hormones to work with her pain. How she has so many options available to her to help her deal with it. Pain is normal. Labour will hurt. I don't try and talk about ways to make it go away. I do the same with normal labour. I don't talk about fetal distress. Only one women in twenty that I teach might even experience this problem. So how do I make sure that if she is the one in twenty that she has some way of making informed choices? This is the second aspect of my classes. I teach her skills that she can utilise in ANY situation where labour does not take the path she had deemed the most optimal one. Decision making tools. Questioning and communication tools. Techniques for determining the type of caregiver she had chosen and how to go about exploring other options if she decides she has the wrong one for her needs. These skills are not only helpful for gaining further information when a doctor tells her he thinks her baby is in distress. They will also help her to explore her options if she has gestational diabetes diagnosed. Or her membranes rupture before the onset of contractions. Or if her labour is not progressing as quickly as her caregiver would like. Or her baby is thought to have jaundice and the caregiver has suggested testing. Or if she is experiencing problems with breastfeeding. Or even 5 years later when she is trying to resolve a problem with her son or daughter related to their school classroom. TRhese are life skills. They are not unique to labour. They do not require a massive accumulation of knowledge on every single possibility. Teach simple tools that develop skills for communication, decision making and questioning. Teach effective listening techniques by example. Teach assertiveness by example. Really beieve in what you teach and then practice it yourself. Your clients will follow your lead - not every time but for those who are in a place on their own journeys where they are ready to do so, they will see your example of "walking your talk" and develop those same skills themselves. A long way to not say very much I think! Nikki Macfarlane Singapore - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 5:40 PM Subject: Re: 'educated' women I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice.
Re: consumer representation
I wrote the following for another list I am on for doulas. This is my Gold Standard: What I would like to see, and aim for having established, in all institutions and practices that support pregnant and labouring women and new parents. The following is my gold standard. Perhaps yours is different. perhaps we should each have our own if we have any hope of effecting change. The Gold Standard for All Birthing Women: Antenatally: No routine testing for fetal abnormality: full explanations given of the false positive negative rates, the benefits and risks, the decisions that need to be considered when there is a positive outcome to a test. No routine ultrasound scanning except by maternal request Full information provided on self help and dietary considerations for women diagnosed with GBS, gestational diabetes, pre eclampsia, anaemia and high blood pressure Quality antenatal education available for all Exercises taught to all women for encouraging a breech or posterior baby to turn ECV moxibustion suggested and practiced wherever possible for breech babies All doctors taught the techniques skills necessary for vaginal births of breech babies Consent forms for caesarean and epidural made available antenatally for women to read, ask questions about and understand Hospital policies and routines published and made available antenatally Labour Birth The following not to occur unless there is a medical indication, which is explained ot the mother with the benefits, risks, alternatives and possible outcomes if nothing is done provided for her: IV's heplocks episiotomy electronic fetal monitoring suctioning eye drops induction pain relief lying on the bed stirrups time limits AROM Vaginal examinations restrictions on eating and drinking stitching for first degree tears cord traction fo rnatural third stage drapes enemas The following made available in every birthing environment: massage oil mattress on the floor dimmed lighting adjustable temperature water in the form of bath or shower low lighting heat packs variety of seating (rocking chair, bean bag, birth ball etc) perineal compresses music All babies to be with mother immeidately after delivery, unless there is a medical need for baby to be separated Baby to be weighed and measured in labour room and returned straight to mother No baby to be washed or cleaned except by maternal request All mothers to be able to be upright and mobile if they wish to be, encouraged by the staff to do this Privacy available for all women, with all staff and attendants knocking before entering her room No pain relief to be offered by anyone in attendance, but available for any woman who would like it No limit on number of attendants that mother wishes to have around her Vaginal examinations only by maternal request unless there is a complication during labour Postnatally All mothers to be supported and encouraged to offer breastfeeding to baby within one hour of delivery No routine jaundice testing No baby's in nursery unless requested by mother No pacifiers or water to be offered No artificial milk to be offered to breastfed babies unless there is a medical indication Full information on the risks and benefits of vaccination Full information on the risks and benefits of circumcision A room set aside in the special care baby unit for intensive care babies for the parents to stay while their baby is in special care Breastpump to be available to all women with babies in special care All postnatal staff to be fully trained in breastfeeding techniques and possible problems All postnatal staff to be fully trained in recognising postnatal depression Support groups available, and contacts given to all women, of groups to support mothers with any problems or just to have support of other women postnatally That is what I am working towards. How do I do it? Empowerment of my clients. Education of the doctors I work with. Speaking up if I see something that I know is not supported by evidence and research. Don't sit back and expect things to change. They won't unless we make it happen. Don't blame doctors for being thoughtless, insensitive and not offering choice. If we, and our clients, don't ask for it to be any different it never will be. People do not change because everyone else is muttering to themselves about how awful they are. They change because of pressure. Because they start to hear of another way. Nikki Macfarlane - Original Message - From: Johnston [EMAIL PROTECTED] To: ozmidwifery list (E-mail) [EMAIL PROTECTED] Cc: Robin Payne (E-mail) [EMAIL PROTECTED] Sent: Sunday, April 14, 2002 5:07 PM Subject: FW: consumer representation This message is from Robin Payne, who is a consumer activist extraordinaire, and runs the Choices for Childbirth work in Melbourne. Dear friends I have become the consumer rep. on the Royal Australian New Zealand College of Obstetricians and Gynaecologist's (RANZCOG) curriculum development
Re: Alternative birth options in Brisbane
Isn't there a birth centre attached to the Royal Women's in Brisbane? Julie Lawson used to be the manager of the unit - don't know if she still is.The Friends of the Birth Centre have a website: http://www.fbc.org.au/main.htm There is also the Home Midwifery Association in Brisbane who may have more info on choices available. Their telephone number is 07 3839 5883 Another source of info may be Childbirth Education Brisbane - tel. 3359 9724. I think also the Boothville Maternity Hospital is staffed by midwives and offers an alternative to the typical obstetrics model. Nikki Macfarlane Singapore -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
