Re: [ozmidwifery] Fw: Making it easier for women to breastfeed
Absolutely brilliant!! Sally - Original Message - From: Denise Hynd [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, February 27, 2007 7:08 PM Subject: [ozmidwifery] Fw: Making it easier for women to breastfeed Hello all, Please send far and wide. This is fantastic, warmly, Carolyn Rachel Myr [EMAIL PROTECTED] 02/25/07 9:30 pm This video montage from numerous 'nurse-ins' was made by a breastfeeding enthusiast in Canada after the wave of demonstrations by breastfeeding mothers following the expulsion of a mother from a Delta airlines flight (BEFORE departure :-)) when she declined to stop feeding her child on board. If enough people go to youtube and view it, it gets moved up to a more visible placement on the youtube website, and more people who don't normally think about breastfeeding will see it. It's a nice film, and the music is well chosen. I was alerted to it on Lactnet by the person who did the video montage you can see here, and am trying to do my bit to get it some more circulation. Enjoy. Nurse-Ins across http://youtube.com/watch?v=kmgLgIUB2T4 America cheers Rachel Myr, well and truly snowed in, in Kristiansand, Norway -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.412 / Virus Database: 268.18.4/702 - Release Date: 25/02/2007 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.446 / Virus Database: 268.18.4/703 - Release Date: 26/02/2007 2:56 PM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Midwives eat their young, don't they?
Thank you Andrea, The article is brilliant...I will definately be using this in our workplace...many of us have been subject to this sort of behaviour. The main culprits have not been pulled aside or cautioned for their behaviour, so it goes on! What once was a lovely unit to work in, and it's only coming up to 2 years in operation, has turned into a divisive and unpleasant snakepit! Really good midwives are leaving, and apathy and disillusionment abound. Carolyn, you are brilliant, and I wish you were down here. Sally x - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, January 15, 2007 7:22 AM Subject: Re: [ozmidwifery] Midwives eat their young, don't they? Hi Honey and others, A more recent article on this issue can be found here: http://www.birthinternational.com/articles/hastie02.html and an earlier article on the same topic, also by Carolyn Hastie is here: http://www.birthinternational.com/articles/hastie01.html Both should be widely read and circulated. Cheers Andrea At 10:27 PM 13/01/2007, you wrote: For the lister who asked for this in the past week, I have found my paper copy. It is in Birth Issues Volume 4 Number 3 1995. Carolyn Hastie. Midwives eat their young, don't they? A story of horizontal violence in midwifery. If you would like me to fax it to you email me off list. Regards Honey -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.432 / Virus Database: 268.16.10/626 - Release Date: 14/01/2007 8:29 PM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] waterbirth
Lynne, Would you be willing to send me a copy of your learning package? Sally - Original Message - From: Lynne Staff To: ozmidwifery@acegraphics.com.au Sent: Monday, January 01, 2007 11:57 AM Subject: Re: [ozmidwifery] waterbirth Hi Helen When I get to work tomorrow, I will send you the reference list from my recently updated (Oct 2006) warm water immersion in labour and birth learning package for midwives. This may be helpful - re publishing our figures - this is a goal for 2007! Warm regards, and a happy and fruitful 2007! - Original Message - From: Helen and Graham To: ozmidwifery@acegraphics.com.au Sent: Friday, December 22, 2006 9:54 AM Subject: Re: [ozmidwifery] waterbirth Hi Lynne Can you point me to some research that I can use to support the safety of waterbirth. I have just read the following reference in the SA Women's and Children's Waterbirth Policy as sent in by Fiona to Ozmid as follows: There is no evidence that perinatal mortality and morbidity, including admissions to special care nurseries for babies born into a warm water environment, is significantly different to babies born out of water (Geissbuehler et al 2004; Gilbert Tookey 1999). but wondered whether you had any other references to call on. Also wondering if you had thought about publishing Selangor's own findings? It would be a great contribution to hospitals trying to weigh up the risk benefits of waterbirth. There still seems to be such fear surrounding the whole issue in the majority of the hospital system that it would be great to have some positive local experiences/research to quote. Thanks in advance. Helen - Original Message - From: Lynne Staff To: ozmidwifery@acegraphics.com.au Sent: Thursday, December 21, 2006 10:04 PM Subject: Re: [ozmidwifery] waterbirth Hi Mary At Selangor we - midwives, obstetricians and paediatricians - have 'officially' supported women for waterbirth since Feb 1998. Our rate is 35% of vaginal births and over 1600 babies have been waterborn since we opened. We will continue to do so as it has benefits for women, their babies and is safe. Regards, Lynne - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, December 21, 2006 12:50 PM Subject: [ozmidwifery] waterbirth Hi everyone, I know this question has been asked before, but I can't remember the answer. Do we have any maternity units, birth centres etc who officially do waterbirth? I know homebirthers do, but I want to know about institutions. Thanks, MM __ NOD32 1933 (20061221) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.432 / Virus Database: 268.16.1/611 - Release Date: 31/12/2006 12:47 PM
Re: [ozmidwifery] What happened with this birth?
Carolyn, You are amazing...after being completely denigrated by the medicos and some of my colleagues for believing that women DO NOT need V'E's every 4 hours to assess progress of labour, what you have written is a breath of fresh air, with your permission I would like to forward your previous email to my colleagues, to make those who practice obsteric nursing aware and to support those who truly work with women. Have you got some info on Taylorism, I would like saome background on it. Thanks heaps. regards Sally - Original Message - From: Gail McKenzie [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, December 29, 2006 5:07 PM Subject: Re: [ozmidwifery] What happened with this birth? WOW!!! Thank you thank you thank you. Carolyn, that was just what I needed. Are you going to the homebirth conference this year? If so, I would dearly love to catch up with you everyone else who contributes to the ozmidwifery site. maybe we can wear a flower or something so we recognise each other. Much love and admiration, Gail From: Heartlogic [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] What happened with this birth? Date: Fri, 29 Dec 2006 13:24:40 +1100 Dear Gail, Firstly, your instincts are spot on. This is a very distressing story. It is not a coincidence that these women's labours stalled following his VE's, that is absolutely to be expected and is the result of a mindless disruption of the women's optimal state of neurophyiological functioning. Taylorism, that is an industrial, efficiency management model, has no place in the dynamic fluid process of birth, sadly it has become merged into the 'health' care system with this sort of unconscious abuse becoming more common. 'Discussions' with the doctors at that stage will do nothing except breed resistence and further intervention; in mindless individuals it can even result in payback situations where intervention will be done just because you are the midwife. The right to rule is still endemic in the maternity services. the first thing to understand is that these people really believe they are doing the right thing. the second thing to understand is that they are taught all about the abnormalities of birth, they have absolutely no idea about normal physiology as applied to birth (gross generalisation, I know) the third thing is that they are terrified of birth the fourth thing is that they are taught throughout medical school that they are the boss of everything and the government and health departments agree and structure everything (I know, there are exceptions) to reinforce that idea the fifth and probably MOST important thing is that they do get taught about 'patient' autonomy and the need for consent. So, here is where it gets interesting and where our opportunity lies. It is vitally important that you use every moment with birthing women to help them understand the situation, without making it combatative and engendering a siege mentality and ask them what they want to have happen, how they would like things to go, so they can say what they want - be left alone, checked in another hour a few more hours, more time, a bath, move freely, have the baby listened to by doppler in the shower/bath etc if women have the information that can help them with the deeply damaging throw away lines that get trotted out like 'stillbirth' 'brain damage' etc, then women can say what they want and we as midwives can support them in that and remember to DOCUMENT what women want. To do things against rational people's will is abuse. To argue about medical intervention with midwives is a nuisance and an affront to power beliefs. Getting strategic is important. Learning tactical support of birthing women is a midwifery art form and a very challenging one. It is crucial that you avoid blame, judgement and criticism as these emotional states are damaging for everyone and lead to despair. It is useful to come from the point of view that they mean well but are ignorant about birth physiology and are taught to look for problems. Neuroscience and quantum physics teaches us we find what we are looking for. That also means we make it up if it is not there. Our job is to work with women and their processes, to give women information to make their own decisions and to help them actualise their decisions and to help doctors know what women want. :-) makes it so simple really. Simple does not, however, mean easy. Every time you find yourself with a pregnant and/or birthing woman ask questions of yourself like 'how can I best inform her of her options?' ' how can I best explain the process of birth so she knows what to expect?' 'how can I support her with what she wants?' ' how can I best let her know how well she is doing so that she can feel secure in asking for more time if
[ozmidwifery] temp in labour
I was just wondering if my last post landed as I have had absolutely no replies. Would like to know what ppl consider a temp in labour, on land or in water. Sally - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 12:06 AM Subject: Re: [ozmidwifery] Use of sports drinks in labour I used Endura during my 4 and a half labour - and really felt like I needed it due to the pace of things (and an early vomit !?!). I've also supported a couples of births where I have brought this along with me for the woman. Both of these births were *unremarkable* with mums birthing normally with no intervention etc with reasonably fast labours; 6 and 9hours. Kristin CBE Naturopath From: Helen and Graham [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Use of sports drinks in labour Date: Sun, 10 Dec 2006 21:31:34 +1100 Thanks for the replies about the sports drinks in labour however I must say I am still a bit confused. I will have to do some more research I think Helen - Original Message - From: Honey Acharya To: ozmidwifery@acegraphics.com.au Sent: Saturday, December 09, 2006 10:51 AM Subject: Re: [ozmidwifery] Use of sports drinks in labour I believe in the value of drinks with electrolytes, not just water. Commonly used things are herb tea and honey, their own labour aide, juice, or sports drinks - one that I have used myself and seen recommended by others is Endura which has electrolytes and magnesium, lemon lime flavour is preferred and obtainable in a powder form in a tub for approx $30 at the health food shop or chemist. I haven't seen any evidence on it but to me it makes sense, we don't perform other physical activities for long periods and expect our bodies to keep functioning well on just water and without sustenance, muscles continue to need energy and electrolytes to contract. If there are not studies done on it can you compare with studies on athletes? - Original Message - From: Helen and Graham To: ozmidwifery Sent: Saturday, December 09, 2006 8:38 AM Subject: [ozmidwifery] Use of sports drinks in labour Is anyone recommending women use sports drinks such as Poweraid etc when in labour? I have read some good evidence to suggest it is better than water in long labours but don't have the source at my fingertipsinterested in your thoughts/findings. I figure anything that can help keep a woman from tiring and being labelled by doctors as a fail to progress has got to be worth a try as long as it is evidence based. Helen __ NOD32 1911 (20061208) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com -- Advertisement: Fresh jobs daily. Stop waiting for the newspaper. Search Now! www.seek.com.au -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.432 / Virus Database: 268.15.15/581 - Release Date: 9/12/2006 3:41 PM
[ozmidwifery] maternal temperature
What would be considered a pyrexia in a labouring woman? Sally - Original Message - From: leanne wynne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, November 27, 2006 9:12 AM Subject: [ozmidwifery] article FYI - another example of technology that promises more than it delivers Fetal O2 Monitoring Doesn't Change Outcomes or Cesarean Rates By Neil Osterweil, MedPage Today Staff Writer Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. November 22, 2006 DALLAS, Nov. 22 -- Fetal oxygen saturation monitoring doesn't alter the rate of caesarean deliveries or improve outcomes for newborns, researchers in a large randomized study reported. When investigators monitored more than 5,300 women in first-time labor with fetal pulse oximetry, but randomly masked the data from half of the observers, there were no significant differences in outcomes or in Caesarean rates, reported Steven L. Bloom, M.D., of the University of Texas Southwestern Medical Center here, and colleagues elsewhere. The delivery teams equipped with fetal oxygen saturation data and those kept in the dark acted similarly, the investigators reported in the Nov. 23 issue of the New England Journal of Medicine. The findings suggest that fetal pulse oximetry may be another example of a technology that promises more than it delivers, they authors added. The widespread adoption of intrapartum electronic fetal monitoring in the early 1970s has been cited as an example of the incorporation of technology without proof of benefit, they wrote. The development of fetal oxygen saturation might improve understanding of fetal well-being during labor and thus reduce the rate of cesarean delivery for the indication of abnormal fetal heart rate, they continued. Our trial confirms the value of rigorous assessment of new forms of technology by showing that knowledge of fetal oxygen saturation does not lead to a significant reduction in cesarean births overall or for the indication of a nonreassuring fetal heart rate. In an accompanying editorial, Michael F. Greene, M.D, of the Massachusetts General Hospital in Boston agreed that those who seek a technological fix to the problem of fetal monitoring need to keep searching. The reduction in the rate of cesarean deliveries that were performed out of concern for intrapartum fetal asphyxia seen in previous studies was not observed in this trial, nor was there the enigmatic increase in cesarean deliveries for the indication of dystocia among women with non-reassuring fetal heart-rate patterns, Dr. Greene wrote. The performance of electronic fetal heart-rate monitoring as a screening test for fetal oxygen desaturation was poor. Neonatal outcomes were not significantly different between the groups. Although electronic fetal monitoring is used in about 85% of all live births in the United States, its benefits, if any are uncertain, and critics maintain that it may contribute to the surge in caesarean deliveries, the authors noted. Fetal pulse oximetry, approved conditionally by the FDA in 2000, was intended to provide continuous fetal oxygen saturation data when there is a non-reassuring fetal heart-rate pattern. The device involves a sensor placed through the mother's dilated cervix after her membranes have ruptured. The sensor is placed against the fetus' face, and measures the fetus oxygen saturation levels during labor. To determine whether knowledge of fetal oxygen saturation during labor would have an effect of clinical practice or fetal outcomes, the investigators conducted a multicenter study. A total of 5,341 women who had never before given birth were enrolled at 14 centers. All women were assigned to electronic fetal monitoring with fetal pulse oximetry, but in half of the cases the investigators were blinded to the pulse oximetry data, while in the other half the clinicians were allowed full access to the data. The investigators collected data on fetal heart-rate patterns before randomization, and used the information to stratify the study population into two groups: one with non-reassuring fetal heart-rate patterns, for whom fetal oximetry was primarily intended, and the other without fetal heart-rate abnormalities before the time of randomization. They defined a non-reassuring fetal heart-rate pattern, using criteria from an earlier trial of fetal oximetry, as: Severe variable decelerations (70 beats per minute for at least 60 seconds) Late decelerations Bradycardia (110 beats per minute) Tachycardia (160 beats per minute) Diminished heart-rate variability (5 beats per minute over a period of at least 30 minutes) One or more variable decelerations in two consecutive 30-minute windows Increased heart-rate variability (25 beats per minute over a period of 30 minutes) Baseline rate of at least 100 to 120 beats per minute without accelerations
Re: [ozmidwifery] I need to vent!!!
Well done Carolyn. Sally - Original Message - From: Heartlogic To: ozmidwifery@acegraphics.com.au Sent: Friday, October 20, 2006 9:46 PM Subject: Re: [ozmidwifery] I need to vent!!! I was asked to judge a baby contest in the late 70's. Of course I was horrified at the time, but was compelled because of where I worked etc etc. I gave all the babies first prize. :-) ' They' didn't ask me again. :-) Great idea to send those letters Barb. I keep getting the official replies from some poor bunny in the 'office' - I know, I've been one myself at one time. But the numbers do matter. Each letter represents in political terms, 100 voters, so if everyone on this list wrote :-) politically yours, (which reminds me, I'm standing for the Democrats again next election, just got officially 'selected') Carolyn (Hastie) - Original Message - From: Jackie Kitschke To: ozmidwifery@acegraphics.com.au Sent: Friday, October 20, 2006 9:02 PM Subject: Re: [ozmidwifery] I need to vent!!! Not to mention the "Pick my pretty baby"competitions. Jackie - Original Message - From: Barbara Glare Chris Bright To: ozmidwifery@acegraphics.com.au Sent: Friday, October 20, 2006 6:37 AM Subject: Re: [ozmidwifery] I need to vent!!! HI, They won't have free rein if we all (mothers and health professionals COMPLAIN) It amazes me that amidst the ocean of media report about healthy eating and obesity, the importance of breastfeeding is ignored, or ridiculed on television as it was on "Sunrise" yesterday morning (and probably will be on 60 minutes on the weekend) or crucified like it was on "Life at One" last week. The media needs to lift it's act, and they will only do so when they get the message from US. Yesterday morning "Sunrise" did an article on David Suzuki, talking about in 1992 more than 1/2 of the world's scientific Nobel Laureats wrote an open letter warning of the damage to the enviromnment. No media outlet in the world ran the story. Then Sunrise spoke about a poll they were running. Breast v. bottle, and the announcer tut-tutting about how breastfeeding was a personal choice and women shouldn't be judgemental of each other. Excuse me! they had just set it up! Breastfeeding is not a choice like wearing your blue top or your red top tonight. And getting information to women and health professionals has nothing at all to do with guilt - the usual excuse used by the media to ( and promoted by the formula companies to ultimately promote their wares) Anyway, as to complaining Write to your member of Parliament asking him to write to/forward on the material you send to Tony Abbott, Minister for Health. This way you kill 2 birds with the one stone. You educate your local MP and Let Tony Abbott know that health professionals and mothers of Australia are NOT HAPPY Also, write to the APMAIF panel, enclosing any brochures etc that you have. Don't worry about whether it is technically a breech of the agreement. If it is enough to offend you as a mother or a health professional, send it in - let them know how you feel! APMAIF SecretariatDepartment of Health and AgeingMail Drop Point 15GPO Box 9848ACT 2601 While you are at it, you could complain to the Victorian Office of Children about their decision to keep having their Maternal and child health nurses educated by Wyeth. You could write to the CEO Gill Callister [EMAIL PROTECTED] And send a copy to Minister Sheryl Garbutt at the same time. Warm Regards, Barb - Original Message - From: jesse/jayne To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 19, 2006 10:35 PM Subject: Re: [ozmidwifery] I need to vent!!! Arethe formula companies really giving infant FORUMULA samples to pregnant women here? Are they breeching the WHO Code so blatantly here? I thought it was fairly well regulated - unlike many other countries. If it does happen at the Expo, you should report them to the ABA for further action. Unfortunately they have free reign with that toddler milk crap in a can/drink dispensing machine whatever. Jayne - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au
Re: [ozmidwifery] mec staining
The research now states that suctioning of babies with mec stained liquor actually makes no difference to outcome. Mec stained liquor really is quite common...the most important aspect I think is whether it is fresh/thick/particulate. Or old/thin. This can happen with/without fetal distress. Sally - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Friday, September 15, 2006 4:21 PM Subject: [ozmidwifery] mec staining Hi all, Are all cases of mec liquor staining considered serious or treated as an emergency? Can you have staining and fetal heart rate be OK? Thanks, Kristin-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.0.405 / Virus Database: 268.12.4/448 - Release Date: 14/09/2006
Re: [ozmidwifery] Vaginal examinations
Exactly, Shelley. In practice I do very few VE's as well, relying on all the external signs we, as midwives, use everyday. However, having one's knowledge and experienced completely disregarded is extremely disheartening. We are organising a forum to try and alter the policy/guideline, but have very little time to prepare...hence the plea for help :o) Thanks Sally - Original Message - From: michelle gascoigne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 31, 2006 10:17 PM Subject: Re: [ozmidwifery] Vaginal examinations Introducing myself and replying at the same time. My name is Shelly I am a midwife in England and the mother of two boys. We are thinking of a move to Aus and so joined this list as it came recomended. I am on a few lists in the UK. Sadly for the medics much of what midwives do is art and not science. We often do not have scientific evidence to back what we do (or more to the point don't do). The good thing is neither do they so turn the tables and ask them to provide the evidence for what they are suggesting. Much routine and ritual care is just that and not based on any sound evidence. A couple of excellent UK authors to check out are Soo Downe and Sara Wickham. They write on normality as a rule. In practce I do very few VE's and often have to discuss this with colleagues and at supervision. If you watch women who are labouring (without an epidural) they move in certain ways they say certain things and there are external physical signs of progress. In the notes I write these in and explain why at this point is will or will not be following the 'guidelines'. In the UK they are generally guidelines and not policies. Shelly - Original Message - From: Sally @ home [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, August 30, 2006 2:31 PM Subject: Re: [ozmidwifery] Vaginal examinations Just to add to this... There was an extremely heated discussion at a meeting with docs and midwives where I work about how doing a VE is the only way to ascertain progress in the normal labour of uncompromised healthy women. The midwives now have to come up with evidence showing that doing a VE within 1- 4 hours of admission to hospital (then 4-6 hourly thereafter) is not necessary as we are able to assess progress in different ways (all of which have been poo-pooed by the medicos)...so...am needing the help of all you wonderfully wise women out there. Thanks in advance. Sally - Original Message - From: Sally @ home [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 29, 2006 10:30 PM Subject: [ozmidwifery] Vaginal examinations Was wondering what guidelines others worked with regarding when to do vaginal examinations...specifically in the hospital setting. And what evidence they base their practice on. Thanks in advance. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.0.405 / Virus Database: 268.11.6/428 - Release Date: 25/08/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.375 / Virus Database: 268.6.1/344 - Release Date: 19/05/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.0.405 / Virus Database: 268.11.6/428 - Release Date: 25/08/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Vaginal examinations
Just to add to this... There was an extremely heated discussion at a meeting with docs and midwives where I work about how doing a VE is the only way to ascertain progress in the normal labour of uncompromised healthy women. The midwives now have to come up with evidence showing that doing a VE within 1- 4 hours of admission to hospital (then 4-6 hourly thereafter) is not necessary as we are able to assess progress in different ways (all of which have been poo-pooed by the medicos)...so...am needing the help of all you wonderfully wise women out there. Thanks in advance. Sally - Original Message - From: Sally @ home [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 29, 2006 10:30 PM Subject: [ozmidwifery] Vaginal examinations Was wondering what guidelines others worked with regarding when to do vaginal examinations...specifically in the hospital setting. And what evidence they base their practice on. Thanks in advance. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.0.405 / Virus Database: 268.11.6/428 - Release Date: 25/08/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Vaginal examinations
Was wondering what guidelines others worked with regarding when to do vaginal examinations...specifically in the hospital setting. And what evidence they base their practice on. Thanks in advance. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] midiwfe in Vic
Yes, I work at Casey Hospital, have been since it opened last year. We provide midwifery led care to women who are 'low-risk'. It is a lovely hospital (as hospitals go) and the midwives are great!! Sally - Original Message - From: Mike Lindsay Kennedy To: ozmidwifery@acegraphics.com.au Sent: Monday, August 21, 2006 10:16 PM Subject: Re: [ozmidwifery] midiwfe in Vic Casey hospital in Berwick appears to be a low risk low intervention hospital. On 8/22/06, Belinda Maier [EMAIL PROTECTED] wrote: I have a client in midwifery group practice who would like to birth in Melb with her family, she is over 34 weeks so i am assuming she wont getinto birth centers?? She is close to Monash, is there anyone who couldtalk to her regarding her options there??Belinda SA--This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.-- My photos online @ http://community.webshots.com/user/mike1962nzMy Group online @ http://groups.yahoo.com/group/PSP_for_PhotographersNew Photo site@Mike - http://mikelinz.dotphoto.comLindsay - Http://likeminz.dotphoto.com"Life is a sexually transmitted condition with 100% mortality and birth is as safe as it gets." Unknown No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.0.405 / Virus Database: 268.11.3/423 - Release Date: 18/08/2006
Re: Re: [ozmidwifery] ctg stuff
Well said, Sue. There are 2 sides to the face of the choice coin...we may not agree with some women's choices, but if they are adamant and they have been given all the pros and cons then, really, who are we to dictate to them about what they choose? Sally - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 2:20 PM Subject: Re: Re: [ozmidwifery] ctg stuff Choice is an interesting concept: if we trulysupport choice then surely even 'bad' choices should be respected? One of our obs has joked about having a sign made for the ANC saying 'please do not ask for an induction as a refusal often offends' because the request comes so often. However, the other obs will often agree to a woman's request without too much argument. I have seen instances where the Ob has told the woman - you are not ready to birth, there is no reason to induce and if we try you will have a lengthy and horrible labour. The reply was "I DONT CARE- I WANT TO BE INDUCED" How can the ob refuse in this instance? The reverse is not true - if a woman reaches T+10 she is booked for IOL - there is little 'choice' within our policy for anyone who wishes to wait longer - despite the evidence or the individual circumstances. Occasionally requests for'social' induction can be for very valid personal reasons and such instances should also be respected. I have discussed with some of our obsthe mentality of agreeing to elective C/S for no other reason than maternal request, given that we are a public hospital -should we bewasting taxpayers money on non-essential surgery etc etc. Again the question of choice. If a woman demands an elective C/S despite discussion of the pros and cons, the usual route is to go with her wishes - presumably for fear of litigation if the birth does not go well. I did challenge one ob who agreed without hesitation to a woman's request for repeat C/S and asked him what his attitude would have been if she had asked for VBAC - did not get much in the way of response! Not saying that I agree with this you understand but it does cause some tricky moral dilemmas. I feel the key issue is one of respect and honest discussion - ah but that is all too often missing within the medical model of care. That and education - women don't know that they have choices to challenge the usual practice of whoever their care provider happens to be, sadly those who do challenge are often seen as 'troublesome radicals' if their challenge is against 'routine' interventions. (Of course they are not seen the same way if their challenge is to request unecessary interventions! :-)) Sue - Original Message - From: Emily To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 8:49 AM Subject: Re: Re: [ozmidwifery] ctg stuff hi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only collective inertia and fear that has led to everyone still using it. the fact that it has sneakily become the best practice standard. in the big cochrane review on the subject the only benefit seen was a reduction in neonatal seizures seen in the CTG group. this was used as evidence that it may reduce the incidence of cerebral palsy in this group also. actually, there was follow up studies done on all the studies included in the review some years later and it actually showed no difference in cerebral palsy rates in most studies. one study amazingly actually showed a higher rate of cerebral palsy in the CTG group !! this has been conveniently forgotten. CTGs are still sold to women as being a safety net to prevent cerebral palsy despite the fact that there is absolutely no evidence whatesoever of this being the caseall that remains to be the benefit of CTGs is for care providers. it makes many people feel safe to have a neat little print off documenting what has been happening. the other thing is that apparently in the court system, parents can only be 'compensated' if a no fault verdict is made and that requires a CTG. anyway i wrote a huge article about this titled 'the irony of obstetric risk analysis' and handed it in with my end of term work. i am waiting with bated breath to hear the feedback and whether i will fail for being so blatently anti-obstetrics to my obstetric supervisors!!! but i figured theres less
Re: Re: [ozmidwifery] How long before synto is used?
You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] How long before synto is used?
I haveto say that, unfortunately, many women are not in tune enough with their bodies to know whether theyhave ruptured their membranes or not. this is evidenced by what they say on the phone...eg " I'm not sure if I have broken my waters or not". And we have had incidences of women desperate to be induced tipping a glass of water down their pants to make it look like they have!! Policies and guidelines are not necessarily 'a load of rubbish' either, they are not just a bunch of words written down at the whim of an individual person. Believe me, having been on a guidelines development committee, with everyone from the Director of Obstetrics to midwives from the birth centre. It has taken over 18 months to review and rewrite only a handful of guidelines. Unfortunately, we need these so that we all do the same thing.There is enough confliciting adveice dished out by midwives as it is. Not all of these guidelines are restrictive and if women know enough to challenge them then I see that as good for the system. I just wish there were more women out there who would challenge the system. However, whilst I was practicing as an independent midwife...I treated the women I wasworking with the respect and honour that they deserved and would definately watch and wait in cases like this. Sally - Original Message - From: jo To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:26 PM Subject: RE: [ozmidwifery] How long before synto is used? I always find it amazing that what is happening to a womans body (i.e SROM) is not believed and that she has to go in for confirmation. Surely the woman would know and wouldnt need it confirmed - so the hosp needs evidence because women cant be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldnt deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days constant water trickling 37 +1 labour started 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, its all a load of rubbish. Jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ homeSent: Thursday, 15 June 2006 11:10 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] How long before synto is used? We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the
Re: [ozmidwifery] How long before synto is used?
We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the induced labour be more likely to stress baby? And the fact mum couldnt cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie SlaterSent: Thursday, 15 June 2006 12:05 AMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] How long before synto is used? The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBellySent: Wednesday, 14 June 2006 8:48 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.8.3/360 - Release Date: 9/06/2006
Re: [ozmidwifery] rooming in
I'm with you Brenda...if we were living in larger communities, or extended families rather than the very restrictive nuclear families, there would be lots of helpers to care for the babies when the mothers needed a rest. One homebirth I attended the woman had both her mother and mother-in-law with her. After the birth all she had to do was feed the baby and rest, the other 2 did everything else, it was wonderful.. I'd never take a baby out of a room unless it was specifically requested...Baby Friendly can mean Mother Friendly too. Sally - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, November 21, 2005 11:27 AM Subject: Re: [ozmidwifery] rooming in I work some night duty in a small unit if mothers ask me to 'mind' their babies take them back for feeds overnight then I do, willingly. I'm heavily into nurturing women, odd eh ?? The Mums know what they want, if they need to sleep, why would I say no ? I am being paid to stay awake care for women babies, that's what we do ! If they want us to mind their babies we do, it might be the only uninterrupted sleep they get for months. We don't ever 'take' the babies away, but always respond when asked unless we are flat out. Are we wrong to help out when requested ? When we take the babies back for feeds, we help with the nappy changing if needed, sit with the Mums,make them tea, provide analgesia or hotpacks give them something to eat after feeds. Isn't that just a huge basic part of 'caring for women' OR 'mothering the mother' ? Wouldn't our mothers do that for us if they were around for the feeds in the wee small hours ? Or would our support people shut the door say go for it, see you in the morning Welcome to motherhood ! How supportive is that ? Wrong again ??? With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: islips [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, November 21, 2005 11:00 AM Subject: Re: [ozmidwifery] rooming in The obs dont like the idea of mucousy babies staying in the rooms with mums. However in most cases where the woman has had a c/s we get the fathers to stay the night to help out. There were other issues such as unwell mums etc. The women who complained were all multis and basic reason was that they were tierd. Last time i checked i was a midwife not a nanny Since we implemented the rooming in policy our primips are BF better and going home so much more confident. It will be a shame if it goes back. Zoe - Original Message - From: Cheryl LHK [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, November 20, 2005 10:29 PM Subject: RE: [ozmidwifery] rooming in Just a query? What are the obst's complaints based on - the same 3 mothers complaints? No doubt they were tired and wanted a bit of rest!! Welcome to motherhood. From: islips [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] rooming in Date: Sun, 20 Nov 2005 14:56:48 +0800 I wonder if someone can help me put together some stats regarding 'rooming in' . I work at a large private hospital in Perth . We recently closed our night nursery and implemented a 'rooming in policy'. This has worked very well in enhancing BF , mothercrafting etc. However due to 3 mothers and 3 obs complaining it looks as though we will have to change the policy. we have a meeting on tuesday and i would like to present some current research to the medical profession regarding the benefits of rooming in. thanks zoe - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Saturday, November 19, 2005 7:28 AM Subject: RE: [ozmidwifery] question Jenny, could you give us the reference please? Thanks, MM - - , one study demonstrated zero oxygen, because there is no longer any utero-placental circulation. This is part of the stimulation for the baby to breathe, but the baby is receiving some circulatory volume. Jennifer Cameron FRCNA FACM -- 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.
