Re: [ozmidwifery] Wyong
Diane It is great that you have reestablishedthe service. It is distressing for a community to losesuch vital service. Your situation sounds similar to ours in Mareeba. Congratulations and good luck with the inevitable ongoing fight. regards Sandra Eales - Original Message - From: diane To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 20, 2005 11:06 AM Subject: [ozmidwifery] Wyong Im a midwife at Wyong just north of Gosford. We have a long established, wonderful midwifery led low risk unit with big baths in all three rooms. New unit opened in Feb this year, team model of care, and hopefully soon "case"load care also, BUT., the unithas beenclosed for births and has been since May. The official spiel stated the "SHORT"!!! term closure is because of staffing issues which are not very well specified on the few occasions it has been in the media. The ED doctors who provide back up care in case of neonatal probs are the ones with staffing and industrial issues and the families of the Wyong shire are paying the price. Often that price, especially for the primips, is the obligatory CS or ventouse. There is a lovely new postnatal unit at Wyong, with 14 single rooms for those who wish to stay. I believe we are avoiding the Midwifery Led terminology and are using something along the lines of Primary Maternity Care unit. We have always had obstetric cover and i believe this is to continue in those cases where transfer to Gosford is not advised Cheers Di. Internal Virus Database is out-of-date.Checked by AVG Anti-Virus.Version: 7.0.323 / Virus Database: 267.10.7/70 - Release Date: 11/08/2005
[ozmidwifery] Re:Midwifery models support group
Anne I think this is a great idea to support and progress development of midwifery models. Sandra Eales Mareeba - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Tuesday, March 15, 2005 6:45 AM Subject: Re: [ozmidwifery] waterbirth Dear All, If anyone knows or would like to let a unit know that ishas aMidwifery model of care orwho would like their unitto be a Midiwfery model of care, I am going a little step further than Jo who is putting together a list of Midwifery led care. Since Midwifery is now starting to grow in some areas I am suggesting to put together a Newsletter and furthercommunication lines with Midwives that is a little different than the ozmid list of general discussion. I am happy to coordinate this initially. Of cours ozmid will still be a part of our lines of communication. The purpose is to let colleagues know of what types of Midwifery led care is out there, act as a mentor, listening post, exchange ideas, problems etc etc etc. on a one to one, unit to unit basis. It can be very useful when introducing this model of care (in its many forms) brainstorm problems, new ideas, and not reinvent the wheel if someone has already gone through the process. Get the idea? So it is up to you all to get back to me with: 1. names 2. locations 3. contact numbers 4. contact addresses 5. snail mail 6. email contact 7. Summary of your model of care I will put together a format - it will probably be through email
Re: [ozmidwifery] gestational diabetes and antenatal ebm
Marilyn There might not be much on expressing antenatally, but there is quite a bit of research on the increased risk of children developing type1 diabetes if they are exposed to cow's milk. In fact I heard just the other night on the news that there is a multi centre study going on - they were trying to recruit pregnant women or babies where one parent was diabetic.. hoping to follow 6000 kids. I don't recall the details of where it was being done though. Sandra - Original Message - From: Marilyn Kleidon [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, November 18, 2004 10:56 AM Subject: Re: [ozmidwifery] gestational diabetes and antenatal ebm Way to go Denise, I totally agree. However, am part of a working group for BFHI reaccreditation and was asked to find the evidence. So, I was just wondering if there was some that I had missed. marilyn - Original Message - From: Denise Fisher [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Tuesday, November 16, 2004 3:41 PM Subject: Re: [ozmidwifery] gestational diabetes and antenatal ebm Hi Marilyn I won't swear to it but I don't know that there is any research out there on this practice. However to give newborns their own mother's milk is kinda natural and not really something that we need research to prove is a good thing do we? Wouldn't it be more to the point to ask those who are giving newborns something other than breastmilk to come up with the evidence to prove that what they are doing is not detrimental?? I'd like to see that ... could have them running around in circles for years trying to find anything to support that practice as opposed to giving mother's own colostrum. All you really need proof of is that expressing antenatally won't put a mother into preterm labor, which it won't and I'm sure you'll find plenty out there on that - then ensure that the mothers know how to store and transport their milk safely when the time comes. There's lots more than just giving breastmilk though that can stabilise the newborn's glucose levels quickly and efficiently - starting with undisturbed skin-to-skin on mother's chest from the moment of birthing. I really do implore everyone to think long and hard before scampering around trying to find research articles to prove what is normal and natural while practices using what is detrimental to birthing/breastfeeding/whatever continue without questioning. Please consider looking the perpetrators in the eye and saying First, do no harm! - your practice is not 'normal' - prove to me that it is doing no harm!! Cheers Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Ab Fab birth - wandering off topic
Kirsten The bloke was in the Young Ones. He has a little more grey hair these days. Sandra - Original Message - From: Kirsten Blacker [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, July 23, 2004 12:13 PM Subject: Re: [ozmidwifery] Ab Fab birth - wandering off topic and would SOMEBODY tell me what else those tacky americans have been in. Both the actors looked familiar Kirsten - Original Message - From: Marianne Callinan [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, July 23, 2004 10:11 AM Subject: RE: [ozmidwifery] Ab Fab birth Hi Andrea, It was funny, especially the placenta baby! Marianne -Original Message- From: Andrea Robertson [mailto:[EMAIL PROTECTED] Sent: Thursday, 22 July 2004 4:43 PM To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Ab Fab birth Hi Everyone, I have seen this episode twice (on a plane somewhere?) and it is very funny. It is indeed a home birth but the midwife gets locked out and she ends up doing it herself (with assistance, of sorts). A definite must see! Cheers Andrea At 01:56 PM 22/07/2004, you wrote: It looks like Saffron has her baby on Absolutley Fabulous tonight, ABC,8.30pm. From the ad it seems to be a birth at home, with the usual toppings that Ab Fab do so well. Cheers Megan -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.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. -- 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] Queensland Midwives - Response required
Title: Message Thanks Jackie It should be helpful to have the same concerned feedback coming from the universities as well as the midwives directly affected in hospitals. Sandra - Original Message - From: Jackie Doolan To: [EMAIL PROTECTED] Sent: Wednesday, March 24, 2004 5:43 PM Subject: RE: [ozmidwifery] Queensland Midwives - Response required will do. J -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Sandra J. EalesSent: Tuesday, March 09, 2004 11:37 AMTo: [EMAIL PROTECTED]Subject: [ozmidwifery] Queensland Midwives - Response required Queensland Health havefinally released their position on the Qualifications Allowance which was part of the award determined by the IRC last June/July. This allowance (3.5% pay rise) is for post graduate tertiary qualifications or post graduate qualifications that the "employer values as equivalent". The initial response from QH was that all midwives working in that clinical area would be entitled to this. After gestating for 8 or 9 months however, they have now decided that only university trained midwives will receive it. This ill-judged and unjust decision will create division and resentment within midwife ranks. Many of the most experienced and valuable midwivesare hospitaI trained and their initial response has been that they no longer want to be involved with students. Midwives need a strong and united response to this matter. I would urge all Qld midwives, whether your school ofmidwifery was located in a hospital or university, to write a letter to the Premier or Health Minister Gordon Nuttall and let them know that this is unacceptable. Sandra Eales
[ozmidwifery] Queensland Midwives - Response required
Queensland Health havefinally released their position on the Qualifications Allowance which was part of the award determined by the IRC last June/July. This allowance (3.5% pay rise) is for post graduate tertiary qualifications or post graduate qualifications that the "employer values as equivalent". The initial response from QH was that all midwives working in that clinical area would be entitled to this. After gestating for 8 or 9 months however, they have now decided that only university trained midwives will receive it. This ill-judged and unjust decision will create division and resentment within midwife ranks. Many of the most experienced and valuable midwivesare hospitaI trained and their initial response has been that they no longer want to be involved with students. Midwives need a strong and united response to this matter. I would urge all Qld midwives, whether your school ofmidwifery was located in a hospital or university, to write a letter to the Premier or Health Minister Gordon Nuttall and let them know that this is unacceptable. Sandra Eales
Re: [ozmidwifery] Queensland Midwives - Response required
Title: RE: [ozmidwifery] Queensland Midwives - Response required Ping I don't have your email but would be interested in seeing your letter. My address is [EMAIL PROTECTED] Thanks Sandra - Original Message - From: hplerchbacher To: [EMAIL PROTECTED] Sent: Tuesday, March 09, 2004 12:31 PM Subject: RE: [ozmidwifery] Queensland Midwives - Response required Just returned from QNU workshop on "Knowing your entitlements". Midwives from Royal Brisbane-Women's have drafted a powerful letter. Our midwives have adapted that letter and many have signed and ready to be sent to the Premier and Gordon Nutall. If anyone want a copy of the letter, please email me off the list. The maternity units could not function without the hospital trained midwives. Ping Bullock ---Outgoing mail is certified Virus Free.Checked by AVG anti-virus system (http://www.grisoft.com).Version: 6.0.616 / Virus Database: 395 - Release Date: 08/03/2004
Re: [ozmidwifery] Re: presentation - words of wisdom?
Jan, Nola and All Thisquestion of rights of patients to medical interventions and informed choice is complex and varied as there are many factors are involved. Balance of risk of interventionvs risks of no intervention Sourceof information - is it biased Subjectivity/objectivity of both client and caregiver Medical interventions -Should the offering of these interventions be made on medical need or client demand? It is a constant balancing act as the following cases show One woman, at booking, insisted on c/s as first birth was traumatic (PIH, induction, forceps, dyspareunia for many months) and the first 12 months were a huge struggle though she breastfed well andwas properly infatuated with her baby. She was living in difficult conditions - isolated on a remote cattle station, generator power for a few hours/day only, alone with baby all day and with heavy additional workload. They hadvery changed circumstances the second time around as they had shifted into town where there was lots of good family support and I felt sure that vaginal birth second time around would have been adifferent and probably healing experience for her, but in her mind the wholedifficult year was due to her delivery. She went on to have elective c/s which was what she felt she needed to do for her emotional well being. (This woman had shared care with GP after her initial booking) Another woman, 40 year old primip,also presented at antenatal booking determined to have an elective c/s. This decision was also fear based - and after several visits and much discussion she changed her mind and gradually developed confidence in her ability to give birth vaginally which she did end up doing with relative ease and much satisfaction even though she had to transfer to a neighbouring town to give birth as that weekend we had no obstetrical cover!!!. (This woman had continuity of care with a midwife in the antenatal period after her booking) Another 40 year old primip lawyer I met recently had an elective c/s so that she could be "in control" (This woman only ever saw an obstetrician) I have recently had a couple of women quite insistent on their "right" to a c/s when they were in labour.The caregivers involved denied their requests as there was no good medical indication and had to be quite forceful at the time. The women were later very thankful for the "denial" of their "rights" and though difficult the caregivers were able to deny them because of therelationships developed throughout the antenatal period. We all know that many, many women verbalisefear based desires when they are in transition or at a difficult point in labour or pregnancy - should we take these at face value? I guess if you don't know the woman already it is much harder to make the right judgements. ROLL OUT NMAP! Sandra - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Tuesday, September 16, 2003 8:22 AM Subject: Re: [ozmidwifery] Re: presentation - words of wisdom? I think thats it it has to come from the woman ie I want an active birth. ie Thanks fior that information but at the moment I dont want whatever ie arm ctg Yes its possible in a public hospital to be in charge as long as the midwife supports the woman and thats the problem to often the mw has her own agenda ie active birth no drugs intact perinem time management etc if a woman is making an informed chioce then we should support her . [also give har alternatives etc ] Recently I supported a woman through her planned c/s no medical reason the woman had a wonder ful birth experience and her baby and her are bonded and b/f with passion. Her last birth was "normal" and she had severe PND was medicated b/f a disaster and problems with 4 yr old still .She needed to run the show and she did jan ps it was hard for me - Original Message - From: Nola Aicken To: [EMAIL PROTECTED] Sent: Tuesday, September 16, 2003 1:03 AM Subject: [ozmidwifery] Re: presentation - words of wisdom? Thanks Jo and Melissa for your responses. Whilst your comments are invaluable, I was actually wonderingabout midwives perceptions on whether they think it is possible to have an active birth in a public hospital. As a clinician myself, I find that it is becoming a rarity to see a woman come intotheunit in which I work and have an active birth, without some formof intervention.Indeed it is not all about the obstetrical model. The last woman I cared for in labour, duringa night shift, was in the unit 10 minutes and stated, "I want an epidural. It is my right!"That's a hard call! Nola
[ozmidwifery] Shoal Haven Model of Care
I would like to contact anyone connected with the Shoal Haven birthing unit. I recall that they have recently commenced a practice without medical coverage and am interested in expanding this as a viable option elsewhere. Sandra Eales [EMAIL PROTECTED]
Re: [ozmidwifery] Shoal Haven Model of Care
Title: Re: [ozmidwifery] Shoal Haven Model of Care Oops! Yes I did mean Shell Harbour. You know how it is..from up here in far north Queensland any place south of Townsville is just clumped together as the "deep dark south"! Where are all these places anyway? Thanks Justine Sandra - Original Message - From: Justine Caines To: OzMid List Sent: Wednesday, September 10, 2003 10:02 PM Subject: Re: [ozmidwifery] Shoal Haven Model of Care Sandra do you mean Shellharbour?I will contact off list with contactsJustine CainesI would like to contact anyone connected with the Shoal Haven birthing unit. I recall that they have recently commenced a practice without medical coverage and am interested in expanding this as a viable option elsewhere. Sandra Eales[EMAIL PROTECTED]
Re: [ozmidwifery] Cervidil mailout
Tania I recieved the same in the post yesterday and felt the same indignation that you do. Pharmaceutical companies (along with formula companies) and the manipulating behaviours they engage inin pursuit of profits are a major cause for concern. They figure high onmy list of the most corrupt and insidious negative influences on mankind - I am appalled at the knowledge that my professional body has assisted their corrupting influence to spread. They already have a powerful influence over the information fed to doctors and policy makers. I will also be writing to the ACMI to express my disappointment. I do hope there are more than just 2 of us who are disturbed by this. Sandra - Original Message - From: Tom, Tania and Sam Smallwood To: [EMAIL PROTECTED] Sent: Monday, July 07, 2003 8:07 AM Subject: [ozmidwifery] Cervidil mailout Was anyone else on the list the lucky recipient of the cute little Cervidil brochure last week? I wondered how they accessed my details and so fired off this email to the product manager using some of the quotes they spout off as the benefits of Cervidil ""Dear Sue, I am writing to request information on how I managed to become a recipient of the recent mailout of information about Cervadil. I am not aware of having provided my details to CSL, although I may have, and would be interested to know how my name became included on your list. I would also appreciate it if you would not send any further information, and please remove me from your mailing list. I work as an independent midwife, and have no interest in ripening women's cervices, as the women I birth with seem to be able to manage this quite well without any interference from me! I provide 'effective and well tolerated' support as a midwife, and I'm told by the WHO that my services are 'cost effective' too! Thank you, in anticipation of your response, Tania Smallwood" Now comes the good bit, I'm appalled to say that this was her response "Hi Tania,CSL hired the list for the mailing from the Australasian College of Midwives. We hired the list as a once-off and will not hire it again.However, you are obviously completely within your rights to ask them to keep your name off all future mailings. It would probably be best if you do this as I don't think I can do this on your behalf.Thanks for your response.Regards, Sue" Does it disturb anyone else that the ACMI are selling our details to a drug company (or anyone for that matter?), or am I jumping the gun? I just normally recycle this type of propaganda, but this really has me riled up. I'm in the middle of writing to the ACMI for an explanation, but was just wondering if anyone else thought the same way as I did? Cheers Tania
Re: [ozmidwifery] Bullying - doing something about it
Barb Congratulations on your election to council. Good to have a practicing midwife on it. I'm sure you'll do a good job. Catch up with you at conference Sandra - Original Message - From: B G [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, April 06, 2003 10:00 AM Subject: RE: [ozmidwifery] Bullying - doing something about it Sandra, What you have written is so true. People like to 'leave it to someone else' or 'I'm too busy' yet are so critical when things don't pan out the way they wish. I also feel some of that behaviour is indicative of repressed groups. Bullying behaviours are so rampant in health many people fail to see it as this, they think it is normal behaviour. Keep up your union activities up north Sandra. Good to see the media is picking up and reporting maternity service concerns. Cheers Barb -- 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] Workloads - doing something about it
Not skewed at all Robin. This is exactly what I'm talking about. This is the situation we need to be fighting about and not simply accepting the management determination of what our job is and how long it takes. 15 minutes would be just for the paperwork, then there are physical checks of mother and baby, assistance, demonstration, discussion of breastfeeding, infant behaviour and other parenting education, to say nothing of the emotional psychological assessment, support and reassurance. We do need to make a habit of articulating what we do - for ourselves and others to understand the value of what we do. Midwives and nurses need to stop:- 1)doing antenatal classes and the preparation for them in their own time (as is I was told last week at the local ACMI subbranch meeting is happening in a neighbouring hospital in this region and many others I suspect) 2)skipping meal breaks to fit the jobs in 3)doing unpaid overtime as they catch up on that paperwork that didn't get done because they were debriefing someone who had been through a traumatic event 4)accepting the unacceptable We need to argue with superiors and managers who consistently underestimate our workloads and undervalue us. We need to be assertive and less accepting of the restrictions placed on us. Nothing less than a revolution will do. I'm starting to foam at the mouth now so I'll stop...for a while anyway. Sandra - Original Message - From: Robin Moon [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, April 07, 2003 12:27 PM Subject: Re: [ozmidwifery] Workloads - doing something about it a slight skewed observation to the conversation, but I once knew a num who told her staff on the early discharge program that they only needed 15 minutes per woman per visit. Therefore they could come back and take a patient load in the unit as well. Impossible to measure how much time is needed when being with women. In fact, I often find the mistakes i make with documentation or time management occur when I have spent much time talking, listening, debriefing and just being with them. I've literally forgotten the paperwork in lieu of what I believe is a higher priority. Unfortunately the hospital system does not recognise this input in their DRG's, and does not value this input enough to support midwives who do this. Robin. - Original Message - From: Sandra J. Eales [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, April 07, 2003 11:12 AM Subject: [ozmidwifery] Workloads - doing something about it Nurses and their unions have been struggling with tools for workload management for a long time. The ratios in Victoria look promising as you say but I imagine there will still be inherent problems as Marilyn mentioned the complexity needs to be taken into account. but more than the medical complexity. Two women with the same DRG may require quite different levels of midwifery time. Medically they may be judged uncomplicated because they had a spontaneous vaginal birth but one will breeze through it and the next will be very traumatised and need much more support to recover emotionally and physically to be able make the transition to motherhood, breastfeeding, parentcraft. The problem comes down to articulating and measuring the value of nursing or midwifery work The most valuable part of caring for a woman is the being with her - talking her thru the hard parts and coaching her to relax, rubbing her back or showing the partner what to do in, supporting her physically and emotionally. This isn't properly measured though - For most tools that try to measure workloads, jobs are broken down to tasks - doing observations, giving medications. The value of the time that is used by a midwife in being with a labouring woman or a vulnerable postnatal mum trying to breastfeed, or the nurse who stops running for a moment to comfort the sick or dying by just being with them. Nurses and midwives don't articulate the value of this part of our job and are as likely to criticise those who do. The clients appreciate it and know that this is one of the most important elements of our job but where is it expressed in terms of workload justification. Deep within us when know we have done a good job and have job satisfaction only when we have this time to be with our clients. Too often nurses and midwives spend their whole work day racing frantically from one task to the next without making the deeper connection required for caring and healing. We are the only ones who can make this time available. We need to recognise the value of caring and demand the time to do it properly. Sandra - Original Message - From: Heartlogic [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, April 06, 2003 3:49 PM Subject: RE: [ozmidwifery] Bullying - doing something about it Hmmm, you Barb and Sandra are amazing
Re: [ozmidwifery] re: article in the Advertiser
Good on you Tania. We need to take every opportunity to get the correct information out there. Sandra - Original Message - From: Tom, Tania and Sam Smallwood To: [EMAIL PROTECTED] Sent: Friday, April 04, 2003 8:53 AM Subject: [ozmidwifery] re: article in the Advertiser Here's my response I refer to 'Less travel, GP care for mums-to-be' (The Advertiser 3/4/03) When will our government stop spending taxpayers money on plans which margianalise women and blatantly ignore world's best practice guidelines? The World Health Organisation clearly states that the most appropriate and cost effective care-provider for the vast majority of pregnant women is a MIDWIFE. Continuity of care is achieved when a woman has access to one care provider for antenatal care, during labour and for the birth of her child, and for the postnatal period. Contracting GP's who have no intention of being involved in thelabour and birth to provide antenatal care, under the guise of providing continuity of care is lucicrous.More funding for community based one-to-one midwifery care, such as the Northern Women's Community Midwifery Program would be a more honest and woman-friendly gesture, and a step in the right direction for women who wish to be seen as individuals, not 'cases'. Oh, and by the way, women give birth, pizza's are delivered!
Re: [ozmidwifery] Bullying - doing something about it
Fantastic Carolyn. A union is only as strong as the membership involvement. Nurses and midwives have the power of numbers but we can't realise that power if we are not involved and being active. I have been a Qld Nurses Union activist for many years and am often frustrated at the apathy and avoidance of being involved or even aware of the power each individual nurse has to effect change. Too content to run ragged in poor working conditions, complaining about workloads in the tea room to colleagues but not to take responsiblity for allowing that situation develop and continue. Good nurses don't argue and find it very hard to say no to more work being piled on them. The branch structure of the QNU is very democratic and allows enormous input by individual branch members into the overall policies (both industrial and professional). The union officials take their direction from the Annual Conference which is attended by representatives from all branches. Any branch member whether in the Torres Stait or Brisbane can put up a resolution. Most don't take up that option or challenge to make a difference. They think that the Union is separate from them and avoid any responsibility. We are a powerful force if only we can realise it. Good luck for your elections. I am sure you will bring positive change. Sandra - Original Message - From: Heartlogic [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Saturday, April 05, 2003 8:58 AM Subject: RE: [ozmidwifery] Bullying - doing something about it Dear Colleagues, This is a fantastic workshop Andrea has put together and will be so useful to managers and leaders everywhere. Good on you Andrea for doing this, wonderful to see. One of the many strands in this complex issue is that of learned helplessness. The pattern of learned helplessness has to be overcome in our profession and in that of nursing. I have been horrified by the working conditions in hospitals since I have been back as midwifery educator. People are overworked and overstretched. People are working too hard for little satisfaction. From what I see, the complexity of the clientele, the simply dreadful midwife/motherbaby ratio, the skill mix, the paperwork mountain, plus the responsibilities of new domestic violence and child reporting legislation, not to the mention burgeoning use of technology and the ever present fear of litigation in the approach to maternity care, are creating a fertile ground for all sorts of unconscious reactions/responses and inappropriate behaviour. And as for the students, the staff do their best and work hard to help them learn, but there is no time to teach on the job. This is just from my midwifery perspective, nursing is a whole other kettle of frogs. You know that saying, if you put a frog in hot water it will immediately jump out, but put a frog in cold water and heat it up and it doesnt realise what is happening and before it does, it expires from the heat. The health system is heating up to expiry point. At our place, we have been told there will be a 20% increase in women to care for, as GP's stop bulk billing and obstetricians stop doing private obstetrics, already there were 2000 more occasions of service at the prenatal clinic in the last 6 months - but there will be no more staff and no more resources. WHAT? That's right. However, there is another layer of senior management happening and the line of management is through a doctor - no senior midwife manager directly reporting to the executive. Grrr. So I figured what we need is serious action. I've joined the union (NSWNA) and become a branch delegate. I've been reading and searching for ways to address these and other issues and have joined a team called The real nurses team as they are have a real grasp of the issues facing both nursing and midwifery. They are dedicated to remaining independant from any political party to pursue safe and effective staff/patient and midwife/womanbaby ratios and other urgent requirements. I have been nominated for council for this team, along with two other midwives, Michael Whaites and Liz McCall. The election for General Secretary, Assistant General Secretary and councillors from the committee of Delegates will be held by postal vote and closes 17th June 03. The details of all the nominees will be in the next Lamp. For those of you in NSW, please ensure your membership is current and investigate the nominees and choose who you will vote for and please vote. We need your voice. Please have a look at the Real Nurses Team site, it's www.realnurses.net For midwives working in other states, please join the union or if already members become actively involved. We are working for name change, to include midwifery in the title of the union. It is time to get real, to address the real issues facing our twin professions. There is power in numbers and many issues are the same for nurses and midwives, it is
Re: [ozmidwifery] Hep B for newborns, att Sandra
I agree Megan. Many more useful ways to spend those tax dollars within health system too..or what about an incentive payment for breastfeeding! Much more benefiial in terms of economic and health outcomes. Sandra - Original Message - From: Larry Megan [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, March 23, 2003 8:29 AM Subject: RE: [ozmidwifery] Hep B for newborns, att Sandra Hi Sandra, Make you own minds up about the payments, but my husband just commented on how can you expect an unbiased opinion in this case. I always thought it would be good if this payment was collected and given to a children's charity. cheers Megan. VISA's reply to US study, Probably - I'll have a dig - here's the reference from my handy little 'Investigate Before You Vaccinate' booklet! - Linder N., et al, Unexplained fever in neonates may be associated with Hepatitis B vaccine, Arch Dis Child Fetal Neonatal Ed, Nov 1999;81:F206-207 - I'd have a copy somewhere...but you could get it from Medscape. Thanks for the go-ahead - it is important news! Kathy S also a response from Dr Baratozy regarding incentive payments, etc. Hi Kathy. As fas as the Hep B goes, as far as I know, it's all or nothing. You have to have all vaccines to be elegible for payment. Missing out just one makes you incomplete therefore in-elegible. So therefore I believe you have to become a conscientious objector to just miss out on 1 vaccine and still get your money. Doctors get their payment based on each individual vaccine given. In the end they also get a vaccine bonus based on percent fully immunised in the practice. That is the PIP (Practice Incentive Programme)payment. I hope that answers your query. Peter -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Sandra J. Eales Sent: Tuesday, 18 March 2003 5:33 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Hep B for newborns, att Sandra Megan I am happy for them to reprint my email and thanks for the other info. I would like to know of the US study you mentioned that had reported the same experience. Sandra -- 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] Hep B for newborns, att Sandra
Megan I am happy for them to reprint my email and thanks for the other info. I would like to know of the US study you mentioned that had reported the same experience. Sandra - Original Message - From: Larry Megan [EMAIL PROTECTED] To: ozmidwifery [EMAIL PROTECTED] Sent: Tuesday, March 18, 2003 4:15 PM Subject: [ozmidwifery] Hep B for newborns, att Sandra Hi Sandra, VISA (Vaccination Information South Australia), have asked if they can reprint your email dated 11/03/03 on Hep B in their newsletter, i had passed it on to them. I also asked your Questions re payments etc, reply follows. To answer your questions - as HepB is part of the schedule refusal of just that component would mean that requirements aren't met and you would have to go through the C.O. Form process to claim Maternity Immunisation Allowance and you also need proof of immunisation according to the schedule for child care benefit. As for doctor bonuses I'm not sure - at birth it is through the hospital and when the subsequent doses are given by the doc HepB is attached to Hib or DPT anyway. Omitting the HepB and having the others will mean that vaccines are being given anyway so docs would get payment bonuses. I'll check with Dr Baratosy. There is a study from the US reporting the same experience in the hospitals there and I know that since the re-introduction of HepB there they are very reluctant to give it. they can be contacted on email, Kathy Scarborough [EMAIL PROTECTED], excellent support and information provided. cheers Megan -- 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] Hep B Vaccine at Birth
Thank you Robin. There arereferences (
I thought I had included them but they obviously got left off in all the cutting
and pasting). I am currently working on a discussion paper which I will
hope to get published.
Sandra
- Original Message -
From:
Robin
Moon
To: [EMAIL PROTECTED]
Sent: Wednesday, March 12, 2003 6:45
AM
Subject: Re: [ozmidwifery] Hep B Vaccine
at Birth
Wow, at last someone has eloquently described
something that has been bothering me for ages. Well Done, Sandra.
Does anyone have references to support this
argument? Because, we're gonna need them if we can effect any
change.
Robin
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Tuesday, March 11, 2003 11:37
AM
Subject: Re: [ozmidwifery] Hep B
Vaccine at Birth
Marilyn wrote: "Sandra you are so
brave." A long time agoe some ancient philosopher wrote something
like this: "In order for evil to flourish, good men do nothing"
I think that covers Sandra's stand. MM
- Original Message -
From:
Sandra J.
Eales
To: [EMAIL PROTECTED]
Sent: Sunday, March 09, 2003 6:30
PM
Subject: [ozmidwifery] Hep B
Vaccine at Birth
I have previously expressed concerns related to the
administration of Hep B Vaccine (HBV) to all babes at birth ie that the
midwives in my unit had become aware of marked increase in numbers of
irritable babes and many more with breastfeeding difficulties in the
first few days, since May 2000 when the new schedule was
introduced.
Sincethen we have done some investigation and as
we became convinced of the connection we have been much more
conscientious aboutgaining "informed consent" prior to
administration of birth dose of Hep B ie "full disclosure of
risks/benefits without coercion or fraud". As
a result, parents are not consentingand the rate of uptake of the
birth dose in our unit has dropped off dramatically.(It is
generally much nicer to come to work these days too with fewer screaming
babies, distraught mothers and frantic fathers!)
We (the midwives) are nowcopping flak because we
show up very large on the radar in the 'Early Warning System' of
theauthorities pushing the universal immunisation issue. The
pressure to conform has come from Public Health Unit, District Manager,
Medical Superintendent as well as letters of complaint from a local GP
(who may be fearful that he will lose his incentive payments if the
children who return to hispractice have missedthe birth dose!). We
have been told that we must "actively encourage" our clients to accept
the vaccination..that "it is frequently reported that the unit works
well because of the high degree of trust and respect. Herein lies the
opportunity to disseminate the positive effect of early Hepatitis
vaccination" We have been told that we must "act in line with the
Code of Conduct"to actively promote this policy.
I do believe this is a terribly important ethical
issue and will not persuade my clients to act against there best
interests and instincts.
We use the materials and information provided by Qld
Health and "immunise Australia"when we discuss the issue with the
parents.It is acknowledged in the "Understanding infant
hepatitis B immunisation" pamphlet put out by the "immunise Australia
Program" that among the common side effects are mild fever, joint pain,
irritability and baby going "off its food for a short time". - discuss
how this might affect their newborn in the first few days of life.
Whilst these common and perhaps transient side effects may be of
little concern in an older child they are liable to be of much greater
significance in a newborn child who is already facing many challenges at
this deeply important point in its life. Challenges to the newborn
(physiological and iatrogenic pathology)
adaptation to extrauterine life profound physical changes in all
systems respiratory, circulatory, neurological, sensory,
digestive/alimentary
organisation of suck to enable feed
overcome effects of pharmacological substances used in labour,
birth an postnatally
recovery from the traumatic effect of birth eg head moulding and
other birth injury
We also give them the Qld Health Hep B Informationwhich has
Re: [ozmidwifery] Vaccination Incentive Payments
Thanks Ann I thought that was the case but wasn't entirely sure about the conscientious objector form. Sandra - Original Message - From: Ann green [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Tuesday, March 11, 2003 8:11 PM Subject: Re: [ozmidwifery] Vaccination Incentive Payments Dear Sandra, I don't know if this helps but here goes.Although I am happy enough for my babies to have the full immunisation program I was not happy with the idea of the Hep.B at birth.I checked with my G.P and a paed. as to whether the lack of injection at birth would stop the baby from having full protection against Hep B.Both stated that there was no medical evidence that the Hep B at birth,except for Hep B mothers was necessary.When my baies turned 18 months I was entitled to that $250 + allowance.Ann --- Sandra J. Eales [EMAIL PROTECTED] wrote: Wonder if anyone can help me with a couple of questions or references where I might find out the answers? Do doctors miss out on their $18.50 incentive payment if the child doesn't have the Hep B birth Dose but completes the rests of the vaccination schedule? What about parent's incentive payment - do they still have to go through the whole conscientious objection deal - given that the child is still fully immunised and there is no catch up required? Sandra __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.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] Oxytocin Trust
In 1998 I heard a Swedish Pathologist
/pharmacologist talk about the"mulitifaceted role of oxytocin during
lactation". Her name is Professor Kerstin Uvnas-Moberg from the Karolinska
Institute. Her work was facinating. She had been researching the stuff for
many years - I think she was brought over to australia for the (?)ALCA
conference in Sydney or Melbourne then she flew up here to Cairns for a one day
workshop.
I just did a quick google search (oxytocin kerstin
uvnas-moberg) and got 38 sites which I'm sure will be worth a visit if you have
time
Sandra
- Original Message -
From:
Lynne
Staff
To: [EMAIL PROTECTED]
Sent: Sunday, March 09, 2003 8:04
AM
Subject: Re: [ozmidwifery] Oxytocin
Trust
Hi Denise - I got back into it this morning and
have cut and pasted the intros and addresses for the articles I found. I went
into Radio National and down to the "Keyword" box and typed in oxytocin and
this came up.
Hope this helps(I am fascinated by this
stuff)
Warm regards,Lynne
All In The Mind - 21/7/2002: The Myths of Monogamy
The Buzz Earthbeat Health Report In Conversation
Ockhams Razor Science Show The Lab Health Matters Catalyst Quantum Science
News The Myths of Monogamy Sunday 21 July2002 repeated ... totally favourite
brain chemical that I would synthesise and make into perfume if I could, which
is oxytocin. And oxytocin is really like Love Potion No. 9. Its
a brain chemical thats released in females ... released in both sexes during
orgasm, during touch, and in females during communication. If you give
oxytocin to male guinea pigs, for example, instead of fighting with
each other they sit around and ...http://www.abc.net.au/rn/science/mind/s611249.htm - 40k - Cached - Last Modified: 21 jul
2002
Health Report - 6/09/99: Biology of LoveRadio National with Rae Fry Biology of Love Monday 6 September1999
Summary: The effect of love on the chemical state of our brains. Being in love
is an all-consuming kind of exper ... sciences have begun to think that that
feeling of attachment is associated with vasopressin and oxytocin which
are different chemicals in the brain. So we basically have sort of different
brain systems ... http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s49793.htm - 12k -
Cached - Last Modified: 6 sep
1999
Life Matters - 3/19/2002: Life Matters News Australia Talks Back Background Briefing Big Ideas Breakfast The
Business Report The Europeans Late Night Live The Law Report Life Matters The
Media Report National Interest Persp ... Dr Laura Cousino Klein points out
that the key to the contrasting female response is the hormone oxytocin
usually released during childbirth and breast-feeding. It helps the uterus
contract during labour ... When a woman is stressed, she gets a quick surge of
the stress hormones one of the last being oxytocin. The female
hormone estrogen seems to give oxytocin a boost, setting in motion the
...http://www.abc.net.au/rn/talks/lm/stories/s507278.htm - 22k - Cached - Last Modified: No
Date
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Sunday, March 09, 2003 2:38
PM
Subject: Re: [ozmidwifery] Oxytocin
Trust
So did I and could not find anything so I sent
an enquiry but no reply as yet
So well done and did you do a save on the web
address for the article??Denise
- Original Message -
From:
Lynne
Staff
To: [EMAIL PROTECTED]
Sent: Friday, March 07, 2003 4:52
PM
Subject: Re: [ozmidwifery] Oxytocin
Trust
I went to the Radio National link and
wandered around in there for a bit
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, March 08, 2003
10:30 AM
Subject: Re: [ozmidwifery] Oxytocin
Trust
Hi Lynn, On which link did you find those articles?
MM
- Original Message -
From:
Lynne Staff
To: [EMAIL PROTECTED]
Sent: Saturday, March 08, 2003
7:30 AM
Subject: Re: [ozmidwifery]
Oxytocin Trust
I had a look yesterday and the articles I
found were on oxytocin and love, also sexual "fidelity" for want of a
better word - I guess trust comes into this one!
- Original Message -
From:
Sandra
J. Eales
To: [EMAIL PROTECTED]
Sent: Thursday, March 06, 2003
10:33 AM
Subject: Re: [ozmidwifery]
Oxytocin Trust
Denise
Re: [ozmidwifery] Hep B Vaccine at Birth
Tina Making us feel like "bad parents" if we refuse this vaccination is the blatant and stated strategy to ensure conformity. It is written up the the summary of recommendations from the meeting of "chiefs" from the Antwerp conference that I included in my first posting. Most women in Australia (and the US where they have had this in place for many more years than us) with Early Discharge Programs or the HB being given on discharge, probably go home and have to cope with stressed babe with no support. We do not keep rates of "new mothers who fall in a heap" when they go home. We don't know how when or why they stop breastfeeding. Adverse reactions are hugely underreported because they go to their GP and are sloughed off with the same sort of tender care and understanding that your sister experienced. We need to start a revolution! Sandra - Original Message - From: Marty Tina To: [EMAIL PROTECTED] Sent: Monday, March 10, 2003 9:59 PM Subject: Re: [ozmidwifery] Hep B Vaccine at Birth Dear Sandra, My sister had her baby ata large public hospital in QLD just 4 months ago. I discussed many things with her prior to birth Hep B vaccine was one of them. As a result she chose not to have her baby vaccinated at birth. She was made to feel like a "bad" mother at every turn this coupled with poor breastfeeding management, poor communication compassion by staff, traumatic birth experience she ended up with postnatal depression. (sorry off the topic there for a minute). Anyway, when she went for her 6 week check-up with her GP she asked when the best time to start Hep B immunisation would be (from now on). Her GP rudely told her that it was too late because she hadn't had it at birth... this distressed her even more in her depressed state. Just another way of belittling her as a mother. Also, on the point of some of the effects such as irritability going of food etc.I wonder how some parents cope when going home after having this injection... I say this with regards to one hospital that I can think of that gives the Hep B at same time as NNST which is usually day of discharge. Hope I'm making sence with my tired pregnant brain (BABY NO. 4 DUE TOMORROW - BUT HAPPY TO GO OVER A WEEK OR THREE). Tina H.
Re: Re:[ozmidwifery]Hep B Birth dose
Jane We don't give out any literature other than what is supplied by QHealth and Immunise Australia.(We did not wantto load the guns of thepowers-that-be) There is enough in those, when parents attention is brought to the relevant and worrying sections to make room for a discussion about the risks/benefits for that individual family. Eg "Extra Fluids before your milk comes in? pain and fever from Hep B atthe same time as your baby is recovering from birth? Is this necessary? What is the risk of you baby getting thedisease? If you plan on getting your baby immunised at 2 an 4 months then it will be covered then anyway." We do have an advantage that the women know and trust us as they see a particular midwife throughout the pregnancy but midwives everywhere should be having the same conversations with parents prior to administration of the vaccine. It is a requirement of informed consent that there is full disclosure of risks of treatment vs risks of disease. Sandra - Original Message - From: CJ Knight To: ozmidwifery Sent: Monday, March 10, 2003 10:40 PM Subject: Re:[ozmidwifery]Hep B Birth dose Hi Sandra Got to say how much I admire your approach to this vaccination. Like you I have problems sticking a baby with a needle before they have had a chance to adapt to extrauterine life.We give out a consent form but when I give it to women booking in I make it clear that this is their decision and that it is important that they research it further. We have a handout which was adapted from an article written by a WA home birth midwife which we can provide to parents who want further information.The only time I could see it may have to be given at birth is where a child is being placed in day care at an early age or the parents are going to a country where Hep B is endemic. I have been vaccinated and initially seroconverted. Another antibody level done following a needlestick injury about 7-8 years after the initial immunisation showed low antibody levels and I was advised I would not seroconvert if I received another booster. However when I had levels done following a recent needlestick injury( Drs and their sharps-don't you love them) it showed high levels of antibody again. I can only assume I had been exposed at some stage and my immune system kicked in as a result of the original immunisation. Regards Jane
Re: [ozmidwifery] Hep B Vaccine at Birth
Thanks for your feedback Mary and Lois. You
are somewhat advantaged in that the clientele who are assertive enough to choose
homebirth are less fearful of "bucking the system" and are often clear, well
informed and strong enough to risist the subtle and not so subtle pressures that
might be applied to make them conform. We have a small assertive element
amongst our clientele as well ( around 15% of mothers in our unit resisted the
HB push from the start). The letters from "above" started arriving with
the last compilation of rates when there was only 25% who refused the birth
dose. There is bound to be some squawking and feathers flying when they
compile the next lot and discover that it is up to about 75%!!
Sandra
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Monday, March 10, 2003 9:29
PM
Subject: Re: [ozmidwifery] Hep B Vaccine
at Birth
Congratulations, Sandra on a
comprehensiveand GUTSYaccount of the Hep.B at
birth situation. This information needs to be disseminated all over
Australia. I work with Mary M. and have a similar approach to the Hep.B
question when askedby clients etc. Keep up the great efforts
towards enlightenment. I look forward to your published
work! Kind regards, Lois
- Original Message -----
From:
Sandra J.
Eales
To: [EMAIL PROTECTED]
Sent: Monday, March 10, 2003 10:30
AM
Subject: [ozmidwifery] Hep B Vaccine at
Birth
I have previously expressed concerns related to
the administration of Hep B Vaccine (HBV) to all babes at birth ie that the
midwives in my unit had become aware of marked increase in numbers of
irritable babes and many more with breastfeeding difficulties in the first
few days, since May 2000 when the new schedule was introduced.
Sincethen we have done some investigation
and as we became convinced of the connection we have been much more
conscientious aboutgaining "informed consent" prior to administration
of birth dose of Hep B ie "full disclosure of risks/benefits without
coercion or fraud". As a result,
parents are not consentingand the rate of uptake of the birth dose in
our unit has dropped off dramatically.(It is generally much
nicer to come to work these days too with fewer screaming babies, distraught
mothers and frantic fathers!)
We (the midwives) are nowcopping flak
because we show up very large on the radar in the 'Early Warning System' of
theauthorities pushing the universal immunisation issue. The
pressure to conform has come from Public Health Unit, District Manager,
Medical Superintendent as well as letters of complaint from a local GP (who
may be fearful that he will lose his incentive payments if the children who
return to hispractice have missedthe birth dose!). We have been told
that we must "actively encourage" our clients to accept the
vaccination..that "it is frequently reported that the unit works well
because of the high degree of trust and respect. Herein lies the opportunity
to disseminate the positive effect of early Hepatitis vaccination" We
have been told that we must "act in line with the Code of Conduct"to
actively promote this policy.
I do believe this is a terribly important
ethical issue and will not persuade my clients to act against there best
interests and instincts.
We use the materials and information provided
by Qld Health and "immunise Australia"when we discuss the issue with
the parents.It is acknowledged in the "Understanding infant
hepatitis B immunisation" pamphlet put out by the "immunise Australia
Program" that among the common side effects are mild fever, joint pain,
irritability and baby going "off its food for a short time". - discuss how
this might affect their newborn in the first few days of life.
Whilst these common and perhaps transient side effects may be of little
concern in an older child they are liable to be of much greater significance
in a newborn child who is already facing many challenges at this deeply
important point in its life. Challenges to the newborn (physiological
and iatrogenic pathology)
adaptation to extrauterine life profound physical changes in all
systems respiratory, circulatory, neurological, sensory,
digestive/alimentary
organisation of suck to enable feed
overcome effects of pharmacological substances used in labour, birth
an postnatally
recovery from the traumatic effect of birth eg head moulding and other
birth injury
We also give them the Qld Health Hep B Informationwhich has this
advice "give extra fluids e.g more breast feeds or water" - we
Re: [ozmidwifery] Hep B Vaccine at Birth
Megan Go for it. Spread it far and wide. I want to see lots of little blips showing up on the "Early Warning System". Thanks Sandra - Original Message - From: Larry Megan To: [EMAIL PROTECTED] Sent: Tuesday, March 11, 2003 10:59 AM Subject: RE: [ozmidwifery] Hep B Vaccine at Birth Dear Sandra, I remembered when you first raised this, congratulations and a big thankyou for following it through. With your permission I would like to pass on your inspiring e-mail to Adelaides vaccination support group, let me know if you agree, [EMAIL PROTECTED] best of luck with it Megan -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Sandra J. EalesSent: Monday, 10 March 2003 1:01To: [EMAIL PROTECTED]Subject: [ozmidwifery] Hep B Vaccine at Birth I have previously expressed concerns related to the administration of Hep B Vaccine (HBV) to all babes at birth ie that the midwives in my unit had become aware of marked increase in numbers of irritable babes and many more with breastfeeding difficulties in the first few days, since May 2000 when the new schedule was introduced. Sincethen we have done some investigation and as we became convinced of the connection we have been much more conscientious aboutgaining "informed consent" prior to administration of birth dose of Hep B ie "full disclosure of risks/benefits without coercion or fraud". As a result, parents are not consentingand the rate of uptake of the birth dose in our unit has dropped off dramatically.(It is generally much nicer to come to work these days too with fewer screaming babies, distraught mothers and frantic fathers!) We (the midwives) are nowcopping flak because we show up very large on the radar in the 'Early Warning System' of theauthorities pushing the universal immunisation issue. The pressure to conform has come from Public Health Unit, District Manager, Medical Superintendent as well as letters of complaint from a local GP (who may be fearful that he will lose his incentive payments if the children who return to hispractice have missedthe birth dose!). We have been told that we must "actively encourage" our clients to accept the vaccination..that "it is frequently reported that the unit works well because of the high degree of trust and respect. Herein lies the opportunity to disseminate the positive effect of early Hepatitis vaccination" We have been told that we must "act in line with the Code of Conduct"to actively promote this policy. I do believe this is a terribly important ethical issue and will not persuade my clients to act against there best interests and instincts. We use the materials and information provided by Qld Health and "immunise Australia"when we discuss the issue with the parents.It is acknowledged in the "Understanding infant hepatitis B immunisation" pamphlet put out by the "immunise Australia Program" that among the common side effects are mild fever, joint pain, irritability and baby going "off its food for a short time". - discuss how this might affect their newborn in the first few days of life. Whilst these common and perhaps transient side effects may be of little concern in an older child they are liable to be of much greater significance in a newborn child who is already facing many challenges at this deeply important point in its life. Challenges to the newborn (physiological and iatrogenic pathology) adaptation to extrauterine life profound physical changes in all systems respiratory, circulatory, neurological, sensory, digestive/alimentary organisation of suck to enable feed overcome effects of pharmacological substances used in labour, birth an postnatally recovery from the traumatic effect of birth eg head moulding and other birth injury We also give them the Qld Health Hep B Informationwhich has this advice "give extra fluids e.g more breast feeds or water" - we discuss the implication of thisat initiation of breastfeeding. We also discuss the risk factors for contracting the disease both in infancy and throught the lifespan. All women are screened for HBsAg antenatally so that babes of HB positive mothers can receive both Immunoglobulin and vaccination at birth. This has been shown to be extremely effective in managing the risk of vertical (mother to baby) transmission The risk factors (for contracting the disease) are IV drug use, unsafe sexual practices and certain ethnic groups have high endemnicity so may have a slightly elevated risk of transmission (e.g aboriginal, TSI, particular asian groups for whom we have had an effectective 3 dose targetted
[ozmidwifery] Vaccination Incentive Payments
Wonderif anyone can help me with a couple ofquestions or references where I might find out the answers? Do doctors miss out on their $18.50 incentive payment if the child doesn't have the Hep B birth Dose but completes therests of the vaccination schedule? What about parent's incentive payment - do they still have to go through the whole conscientious objection deal - given that the child is still fully immunised and there is no "catch up" required? Sandra
Re: [ozmidwifery] Bicornuate uterus
I recently cared for a woman in her second pregnancy with a bicornuate uterus. Her first pregnancy was uncomplicated until the end when she had an elective caesarean for primip breech. (breech presentation is quite common apparently) The bicornuate was not noticed at this delivery! It was diagnosed by ultrasound when she had a miscarraige. This last pregnancy was fairly terrible as she was in and out of hospital for months with APHs. She had to move down to Cairns (80 km away) for the last several weeks as they did not want her to go more than 5 minutes away from the Base Hospital. Very hard on all the family. They told her the problem was that the placenta had implanted at the juncture and as one side grew and the other shrunk the placenta was peeling off. She was delivered by emergency Caesarean at 31 weeks and the consultants advised her that she should never have any more children - too life threatening for her they said. They ended up scaring her so much that she went in for a tubal only a few weeks after the baby was born - whilst it was still not in a particularly healthy condition. I'm sure that I have met women before this who had not problems at all - Bicornuate seen on routine ultrasound who went on to have spont. vag. births. I so believe these women have a higher than average risk of spont abort. prob to do with site of implantation. Sandra - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, March 09, 2003 5:31 AM Subject: [ozmidwifery] Bicornate uterus Hello wise women, I have met a midwife here in Ireland (where I am now presenting workshops) who would dearly love a home birth. She says she has a bicornate uterus and a double cervix. She feels this puts her at high risk, although her obstetrician seems to think she could labour OK and get by without a caesarean (is he stringing her along, I wonder?). Have any of you had any expereince with this kind of labour and how would you feel about a home birth? She lives close to the hospital and I did suggest that she could always see how labour progresses and if there is a problem transfer quickly. She has yet to engage a midwife, although there is one here who will do twins at home and has many years of experience, who may be able to help. It seems that after today's workshop she is feeling inspired and would like to reconsider a home birth (having reluctantly given up on the idea). Any thoughts would be very gratefully received - I will email them on to her Andrea - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.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] Hep B Vaccine at Birth
You are right Mary. I don't think it is question of bravery. I don't believe I amputting myself at riskby my actions. I do think it is a little intimidatingif I consider that my goal must be to get the immunisation schedule changed. The opposing forces aretoo great for me. Howeverwe need only concentrate on "informing parents" as we encounter them and we are obliged to do this. They are entitled to the information "free of coercion". It is frightening to consider that these powerful profit-driven organisations have tentacles of their network covering the globe, influencing the most reputable and powerful policy makers e.g WHO and government They are very good at controlling information in the media and the health systems and have immense experience at presenting research which they fund and control results of. (not unlike the cigarette company operations in years past) Sandra - Original Message - From: Mary Murphy To: [EMAIL PROTECTED] Sent: Tuesday, March 11, 2003 10:37 AM Subject: Re: [ozmidwifery] Hep B Vaccine at Birth Marilyn wrote: "Sandra you are so brave." A long time agoe some ancient philosopher wrote something like this: "In order for evil to flourish, good men do nothing" I think that covers Sandra's stand. MM - Original Message ----- From: Sandra J. Eales To: [EMAIL PROTECTED] Sent: Sunday, March 09, 2003 6:30 PM Subject: [ozmidwifery] Hep B Vaccine at Birth I have previously expressed concerns related to the administration of Hep B Vaccine (HBV) to all babes at birth ie that the midwives in my unit had become aware of marked increase in numbers of irritable babes and many more with breastfeeding difficulties in the first few days, since May 2000 when the new schedule was introduced. Sincethen we have done some investigation and as we became convinced of the connection we have been much more conscientious aboutgaining "informed consent" prior to administration of birth dose of Hep B ie "full disclosure of risks/benefits without coercion or fraud". As a result, parents are not consentingand the rate of uptake of the birth dose in our unit has dropped off dramatically.(It is generally much nicer to come to work these days too with fewer screaming babies, distraught mothers and frantic fathers!) We (the midwives) are nowcopping flak because we show up very large on the radar in the 'Early Warning System' of theauthorities pushing the universal immunisation issue. The pressure to conform has come from Public Health Unit, District Manager, Medical Superintendent as well as letters of complaint from a local GP (who may be fearful that he will lose his incentive payments if the children who return to hispractice have missedthe birth dose!). We have been told that we must "actively encourage" our clients to accept the vaccination..that "it is frequently reported that the unit works well because of the high degree of trust and respect. Herein lies the opportunity to disseminate the positive effect of early Hepatitis vaccination" We have been told that we must "act in line with the Code of Conduct"to actively promote this policy. I do believe this is a terribly important ethical issue and will not persuade my clients to act against there best interests and instincts. We use the materials and information provided by Qld Health and "immunise Australia"when we discuss the issue with the parents.It is acknowledged in the "Understanding infant hepatitis B immunisation" pamphlet put out by the "immunise Australia Program" that among the common side effects are mild fever, joint pain, irritability and baby going "off its food for a short time". - discuss how this might affect their newborn in the first few days of life. Whilst these common and perhaps transient side effects may be of little concern in an older child they are liable to be of much greater significance in a newborn child who is already facing many challenges at this deeply important point in its life. Challenges to the newborn (physiological and iatrogenic pathology) adaptation to extrauterine life profound physical changes in all systems respiratory, circulatory, neurological, sensory, digestive/alimentary organisation of suck to enable feed overcome effects of pharmacological substances used in labour, birth an postnatally recovery from the traumatic effect of birth eg head moulding and other bi
[ozmidwifery] Hep B Vaccine at Birth
I have previously expressed concerns related to the administration of Hep B Vaccine (HBV) to all babes at birth ie that the midwives in my unit had become aware of marked increase in numbers of irritable babes and many more with breastfeeding difficulties in the first few days, since May 2000 when the new schedule was introduced. Sincethen we have done some investigation and as we became convinced of the connection we have been much more conscientious aboutgaining "informed consent" prior to administration of birth dose of Hep B ie "full disclosure of risks/benefits without coercion or fraud". As a result, parents are not consentingand the rate of uptake of the birth dose in our unit has dropped off dramatically.(It is generally much nicer to come to work these days too with fewer screaming babies, distraught mothers and frantic fathers!) We (the midwives) are nowcopping flak because we show up very large on the radar in the 'Early Warning System' of theauthorities pushing the universal immunisation issue. The pressure to conform has come from Public Health Unit, District Manager, Medical Superintendent as well as letters of complaint from a local GP (who may be fearful that he will lose his incentive payments if the children who return to hispractice have missedthe birth dose!). We have been told that we must "actively encourage" our clients to accept the vaccination..that "it is frequently reported that the unit works well because of the high degree of trust and respect. Herein lies the opportunity to disseminate the positive effect of early Hepatitis vaccination" We have been told that we must "act in line with the Code of Conduct"to actively promote this policy. I do believe this is a terribly important ethical issue and will not persuade my clients to act against there best interests and instincts. We use the materials and information provided by Qld Health and "immunise Australia"when we discuss the issue with the parents.It is acknowledged in the "Understanding infant hepatitis B immunisation" pamphlet put out by the "immunise Australia Program" that among the common side effects are mild fever, joint pain, irritability and baby going "off its food for a short time". - discuss how this might affect their newborn in the first few days of life. Whilst these common and perhaps transient side effects may be of little concern in an older child they are liable to be of much greater significance in a newborn child who is already facing many challenges at this deeply important point in its life. Challenges to the newborn (physiological and iatrogenic pathology) adaptation to extrauterine life profound physical changes in all systems respiratory, circulatory, neurological, sensory, digestive/alimentary organisation of suck to enable feed overcome effects of pharmacological substances used in labour, birth an postnatally recovery from the traumatic effect of birth eg head moulding and other birth injury We also give them the Qld Health Hep B Informationwhich has this advice "give extra fluids e.g more breast feeds or water" - we discuss the implication of thisat initiation of breastfeeding. We also discuss the risk factors for contracting the disease both in infancy and throught the lifespan. All women are screened for HBsAg antenatally so that babes of HB positive mothers can receive both Immunoglobulin and vaccination at birth. This has been shown to be extremely effective in managing the risk of vertical (mother to baby) transmission The risk factors (for contracting the disease) are IV drug use, unsafe sexual practices and certain ethnic groups have high endemnicity so may have a slightly elevated risk of transmission (e.g aboriginal, TSI, particular asian groups for whom we have had an effectective 3 dose targetted program for many years). Certain occupational groups, eg health workers, have a higher than average risk and are generally vaccinated witha 3 dose progam. World Health Organisation classifies Australia as a "low" risk for Hep B with low endemnicity of 2%, transmission rates in infancy are "rare" and "infrequent" in childhood. Qld Health Notifiable Diseases Annual Report 1997 -2001 did not count any in the age group of 13 years. The majority of notifications in the 15 -39 yr age range. WHO recommendation is for universal Hep B immunisation in childhood for those countries with "high" endemnicity and the recommended program is for 3 doses. Immunisation success (90% sero-conversion which is as high as it gets) occurs after the 2nd dose, so a child will become immunised at 4.5 rather than 2.5 months if they choose not to have the birth dose but elect to have the 2,4 6 month doses. Breastfeeding rates are not monitored after discharge from hospital even though there are mountains of scientific evidence on the economic value and health benefits to be gained from increasing breastfeeding rates. I wonder if there were
Re: [ozmidwifery] Immunisation before university/employment - Hep.B
Victoria I had just sent off my own Hep B issue to the list when I downloaded yours - must be something in the air. I am a midwife and was immunized about 15 yrs ago when I first graduated with little thought and few questions (I think it might even have been produced from human source in those days - it is now reproduced in yeast or something like). I have maintained immunity to the present day from that initial 3 dose course and probably the odd encounter with infected body fluids to act as booster? However I have many colleagues who have had repeated full courses and boosters who just never sero-convert. I think the conversion rate for adults is around 80% and 90% in childhood after 2 doses (but noone is sure how long the immuity will last). I do still feel that it is a protective advantage for me in my profession but am growing more frustrated with the big brother tactics of the immunisation police and cynical about the motivating force behind the enormous energy to push and coerce whole populations into using more and more of them. I think the strongest motivatoris money - there are huge profits to be made in this industry and the money makers are well organised and very influential. You probably would be discriminated against if you are not immunised - whether you need it or not. Sandra - Original Message - From: Victoria Couldwell To: [EMAIL PROTECTED] Sent: Monday, March 10, 2003 10:19 AM Subject: [ozmidwifery] Immunisation before university/employment - Hep.B Dear All, As a prospective Bach. Midwifery student, I have been invited to attend an interview and health assessment in the UK (I am an Australian, living in Sydney).As part of the health assessment, I am required to advise my immunisation status, which is fine except for Hep.B I am unsureabout undertaking this immunisation. * Do you feel that this immunisation is necessary for a midwife? Why/why not? * Have any midwives, childbirth educators, doulas undertaken the Hep.B immunisation? * Is there any alternative? Can I refuse? Is it mandatory for employment? I would appreciate any comments. Thanks, Victoria Couldwell MSN Instant Messenger now available on Australian mobile phones. Find our more. -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Oxytocin Trust
Denise Have you checked out the abc website. They normallykeep a pretty good record of there programmes often containing references and links. www.abc.net.au Sandra - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Sent: Thursday, March 06, 2003 1:45 AM Subject: [ozmidwifery] Oxytocin Trust Did any Radio National Breakfast listeners hear the report on Oxytocin and trust on Monday 3/3/03?If so do you have the reference for the study??Denise
Re: [ozmidwifery] Community Cabinet Meetings - QUEENSLAND
I was part of a deputation to Health Minister, Wendy Edmond at the Country Cabinet Meeting in Cairns in June. The main issue I discussed was therationalisation/centralisation of birthing services in regional areas because of reduction of number of doctors doing obstetrics and for short term budget reasons. Health Minister was pretty clueless and her right hand man ??deputy-director general of QHealth had the traditional doctor view of birth as a perilous event that is extremely hazardous to mother and baby without the heroic hand of the doctor. I gave them a copy of NMAP (which promptly got buried under a pile of other stuff) and had a short discussion about it- only had about 5 minutes to give my spiel. Neither of them had heard about it at that stage and I left feeling that I had wasted my time but I do believe every little bit helps. We need to make sure they keep hearing about it from many different people in many different places. I guess they area little more familiar withthe NMAPnow. We need to make sure it keeps cropping up where ever they are. We have to NAG. Nagging, as my 7 year old son can vouch, is a very effective tool for getting what you want! Sandra - Original Message - From: Joyce, Sally To: [EMAIL PROTECTED] Sent: Tuesday, December 03, 2002 8:08 AM Subject: [ozmidwifery] Community Cabinet Meetings - QUEENSLAND Hi everyone, Just a bit on the community cabinet process as it is a fantastic opportunity to actually meet with Ministers. QLD Cabinet Ministers meet in regional areas regularly. In 2002, Community Cabinets have beenheld at Stanthorpe (South East QLD), the Brisbane Convention Centre, Moranbah (Central QLD), the State Library (Brisbane), Sunnybank Hills (Brisbane), Cairns (North QLD), Barcaldine(Central QLD), Longreach (Western Queensland),the Royal Queensland Show (the Ekka -Brisbane), Gympie (South East QLD), Ipswich (South East QLD) and Chatsworth (North West QLD). In addition a full Cabinet has meet in Townsville (North QLD). The cabinet meetingsare part of the Government election promises to get out of hear what the community is saying. "It's part of the commitment to being a Government for everybody no matter where they live in Queensland" You can request a formal deputation or just rock up on the day and hope for the best. A formal deputation is the better option as you get allocated time but you have to get in early. The Department of Premier and Cabinetoffice handles the Community Cabinet so if anyone is interested in attending one next year (I don't think there are any more this year)I suggest you contact the Department and find out where they are being held. In addition there are quarterly Ministerial Forums which are held in each region of QLD. At the Forums, two Cabinet Ministers meet with twenty regional representatives, who represent a broad cross section of the community to discuss ideas and issues of regional significance. The purpose of the quarterly Forums is for regional communities to identify priority issues, needs and problems they want to raise with Government, and provide the mechanism for those issues to be presented directly to State Government Ministers by community members. This is another good opportunity to target the Pollies. There are opportunities for local individuals and groups can raise proposals directly with the State Government through these Forums . For more information you need to talk to Regional Communities Division (Department of Premier and Cabinet) on (07) 3235 9027 I am not sure if other states have similar processes as it was an initiative that the Labour party set up as part of it's election campaign. Sally. -Original Message-From: Denise Hynd [mailto:[EMAIL PROTECTED]]Sent: Monday, 2 December 2002 8:51 AMTo: [EMAIL PROTECTED]Subject: [ozmidwifery] Fw: Dear Listers I am forwarding part of an email from the daughter of a friend in Brisbane to share with you her efforts and enthusiasm I did not know any premier had open house cabbinet meetings??denise Hi Denise, I went withfriends to the community cabinet meeting at Ipswich recently which starred Peter Beatty, Wendy Edmund etc and mmy friend put a question to them at question time re what are they doing about improving the maternity care for women and babies in QLD, in view of the horrendous intervention and c-sec rates. Of course Peter stumbled and bumbled and basically said that NMAP has been presented to the Federal govt and itÂ’s up to them to do something about it and provide the funding and that he would refer our concerns to them. Deb and I will be visiting our local member
Re: [ozmidwifery] jittery newborn
We recently had a babe unable to maintainBSLregardless of intake due to rare metabolic disorder - required partial pancreatectomy Sandra - Original Message - From: Kirsten Blacker To: [EMAIL PROTECTED] Sent: Monday, November 25, 2002 6:01 AM Subject: Re: [ozmidwifery] jittery newborn by day 6 if bf well I'd exclude hypoglycaemic, especially if output is good. Prophet of doom in me says maybe something neurological? Kirsten - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Sent: Sunday, November 24, 2002 1:15 AM Subject: [ozmidwifery] jittery newborn Case to ponder 4 hr 1st stage 1hr 40 mins 2nd MI till 30 mins before birth at term plus 2days PG 4000 gram babySVD under water at home apgars 9+10 .breast feed well mother GBS+ AND DECLINED absunless PROM or prem birth etc etc No signs of sepis at birth or subsequent days some transient rapid resps and early jaundice problem periods of jittering when disturbed not cold not hypo bf non stop if limbs held then jittereing ceasesno associated high pitch in cry or unusual stare in eyes babe is well and now d6 still jitters at times not confused with moro a real tremor fine motor type Any mws out there come across this before?I havn't in an otherwise well babe and I've been around 30 years love jan
Re: [ozmidwifery] birth and the power of the mind
I often use this devise to get a woman on track in second stage. The change in feelings and increase pain and pressure sensations will often cause a woman to hold back, resist and try and suck it up into themselves -(pain avoidance and fear) - I will direct their vocalisation from high to low pitch (and explain what is happening and the need to head towards the pain rather than pull back from it) and they glide on smoothly into second stage. Sandra - Original Message - From: Aviva Sheb'a To: [EMAIL PROTECTED] Sent: Wednesday, November 20, 2002 10:37 PM Subject: [ozmidwifery] birth and the power of the mind Spot on, Megan. I teach voice and movement too...listen to the voice...if your abdominal, vaginal and throat muscles are relaxed, your voice is deep, if your voice is high-pitched, you're tensing your belly, vagina and throat; they're connected. (Great way to increase your vocal range.) Quote from I Ching that's used in Active Birthing (lots of which is taken from Yoga): Rain is only rain; it is not bad weather. So also, pain is only pain, unless resisted, when it becomes torment. Aviva - Original Message - From: Larry Megan To: ozmidwifery Sent: Wednesday, November 20, 2002 10:42 PM Subject: Re: [ozmidwifery] birth and the power of the mind I have been doing yoga for over 5 years now, attending pre-natal yoga withmy three pregnacies and it has to have made a difference. The power of thebreath in helping to let go is true. I was taught as you inhale you invisagethat enrgising breath going to where the discomfort is and then on theexhale breath soften and allow the body to stretch . Very important to mewas remebering to keep my lips soft which in turn kept my vagina(lips) softallowing the cervix to relax and open.
Re: [ozmidwifery] NMAP
Thanks Gabe Nice to hear from you. What are you up to these days? Where are you working? I'm thinking of bringing the boys down to Sunshine coast and Brisbane for a couple of weeks after Xmas. Camping!...owing to budgetry constraints..I'm a glutton for punishment! Perhaps we could catch up. Sandra - Original Message - From: Gabrielle Williams To: [EMAIL PROTECTED] Sent: Monday, November 18, 2002 7:27 AM Subject: Re: [ozmidwifery] NMAP Well done Sandra, I'm sure you lobbied hard for that.Queensland needs as much support as it can get to get this one heard. Gabrielle - Original Message - From: Sandra J. Eales To: [EMAIL PROTECTED] Cc: Barbara Cook ; Bruce Sent: Saturday, November 16, 2002 8:44 PM Subject: [ozmidwifery] NMAP Thought I would let you all know aboutanother little step taken today. Regional ALP Conference held in Cairns today unanimouslycarried the motion - "That the conference endorse the National Maternity Action Plan and recommmend it to the State and Federal Health policy committees for consideration and implementation" Sandra
[ozmidwifery] Radio National - Life Matters
Anyone hear Geraldine Doogue on Life Matters this morning interview with 2 women from La Trobe University (Dr Rhonda Small and Pranee Lianputtong) who have done some research around migrant women and the difficulites they face in australia related to childbirth theinadequacies of hospital childbirth care from point of view of migrant women - not too different to that of australian born women- lack of kindness from staff, lack of power felt by the women, high level of fear and isolation becausethey were left alone too much. Sandra
Re: [ozmidwifery] NMAP
Title: Message It would be nice to meet you Vicki. I will certainly phone if it all comes off as planned Sandra - Original Message - From: Vicki Chan To: [EMAIL PROTECTED] Sent: Monday, November 18, 2002 11:21 PM Subject: RE: [ozmidwifery] NMAP We on the Sunny Coast will expect a call, Sandra Vicki 0402140769 -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Sandra J. EalesSent: Monday, November 18, 2002 6:38 PMTo: [EMAIL PROTECTED]Subject: Re: [ozmidwifery] NMAP Thanks Gabe Nice to hear from you. What are you up to these days? Where are you working? I'm thinking of bringing the boys down to Sunshine coast and Brisbane for a couple of weeks after Xmas. Camping!...owing to budgetry constraints..I'm a glutton for punishment! Perhaps we could catch up. Sandra - Original Message - From: Gabrielle Williams To: [EMAIL PROTECTED] Sent: Monday, November 18, 2002 7:27 AM Subject: Re: [ozmidwifery] NMAP Well done Sandra, I'm sure you lobbied hard for that.Queensland needs as much support as it can get to get this one heard. Gabrielle - Original Message - From: Sandra J. Eales To: [EMAIL PROTECTED] Cc: Barbara Cook ; Bruce Sent: Saturday, November 16, 2002 8:44 PM Subject: [ozmidwifery] NMAP Thought I would let you all know aboutanother little step taken today. Regional ALP Conference held in Cairns today unanimouslycarried the motion - "That the conference endorse the National Maternity Action Plan and recommmend it to the State and Federal Health policy committees for consideration and implementation" Sandra
[ozmidwifery] NMAP
Thought I would let you all know aboutanother little step taken today. Regional ALP Conference held in Cairns today unanimouslycarried the motion - "That the conference endorse the National Maternity Action Plan and recommmend it to the State and Federal Health policy committees for consideration and implementation" Sandra
Re: [ozmidwifery] Love of midwifery
Title: Love of midwifery Dear Fiona Don't give up. I'm sure you are making a difference for a lot of individual women and it is possible that you will be an agent of change in this unit. It can seem like an impossible task with insurmountable barriers (doctors and management) but you do have more power than you realise. You do need to ensure that you maintain your strength however. Join forces with like-minded midwives and support each other and take regular nourishment for your midwife soul by meeting other midwives at conferences and workshops. Make a plan of how you want to change your unit - you can't change everything at once but many small steps will get you a long way along the path ..plan small changes to start with - maybe simple changes in the physical layout - make up information sheets (referenced and evidence based) to hand out to the women about whatever issues you feel they need exposure to alternative views to that being presented by the MOs - having info in printwill often add weight - might even shine some light into the closed MO minds. With regards to the admission CTG - if you can't at this point change the policy (though don't stop trying) then encourage and support women to refuse admission CTG as is their right - As you say there is plenty of evidence to support yourview so if the policy makers aren't interested thenensure that the womenget the information - you could do up an info sheet about the CTGs as well as something on the Bill of Rights. Others on the list have suggested starting your own childbirth ed classes this can be empowering for yourself as well as for those you are teaching. I have been a midwife for 15 years and have spent most of that time working in hospitals. I fully understand what you are feeling. I have had many sleepless nights and know well that feeling in the gut which churns with anger and frustration as I lay there and think about all the things I would like to have told some smart arse doctor who knows nothing of value about childbirth but seems to think he is an authority because he has a medical degree.A nursing background is a handicap that is difficult to overcome when it comes to being assertive!..but practice makes perfect..I have often found it a challenge to have the confidence and strength of mind to resist and shake the obstinate belief some doctors seem to have that they are "the keepers of all knowledge". I know well the hissing. spitting, frustration of dealing with the arrogant young doctor with two minutes experience of childbirth who has denigrated the profound knowledge of midwiveswho have been deeply involved with childbirth for decades as being 'airy fairy nonsense'But I also know thesatisfaction of working in a cooperative team where there is mutual trust and respect. It is important thatpassionate midwives continue to work in the mainstream services where the majority of women give birth.Whilstwe continue to fight to change the system these women need the support and protection thatonly a passionate midwifecan give. We do have to protect the women from the contagion of fear and the skewed world view of the medicos who practice in fear. We need to be there for support when a woman chooses not to take the advise given by the doctor.We have toallow women access to the knowledge and wisdom contained in our art of midwifery rather than leave them exposed to theundiluted and so often self righteous"expert advice"in the medical system. The advocacy role of the midwife in the hospital situation is so important for the health and well being ofwomen and their families. It is a difficult path to walk for the midwife and can sometimes feel like you are working in a war zone, full of fear and conflict, when it should (and can) be positive, nurturing and cooperative We need to keep tapping away to get the system changed so that all women have access to good midwifery care we have to arm ourselves with evidence - scientific facts and figures are what appeal to these folk so arm yourself and keep presenting it to them and arguing. We need to be tenacious and dogged in our defence both of the birthing women we advocate for as well for the truth of midwifery knowledge. We need to learn to be assertiveas well diplomatic - we do need to have a cooperative team for the benefit of the woman as well as ourselves - it is often difficult to know when to bite your tongue and when to dig in and say no you are wrong and I am right. We don't want a war of egos going on over the top of a woman who is labouring. She needs to be allowed to focus on herself rather than on the conflict between midwife and doctor - we need to remember the woman is first consideration and our job is to protect her interests. We need to build an environment of mutual respect and trust between doctors and midwives. Sometimes to achieve this you first have to belt them around the head a few times before that
Re: [ozmidwifery] Any help would be great.
Isn't life a wonderful mystery. I have encountered a couple of women with ulcerative colitis over the years. One who thought she was infertile and did not realise she was pregnant until she was full term - shehad to have an emergency c/s for severe fetal distressprior to onset of labour - only a day or two after she discovery of the pregnancy!! Another woman I have known for several years and have cared for her intwo pregnancies. She suffers from ulcerative colitis and coeliac disease. The first pregnancy did not affect her colitis at all or may even have improved it. She was induced at term with prostin because the drug that she was on (?methalazine)apparently inhibits the onset of labour - she was also starting to feel very uncomfortable with the pressure on the bowel by the end of both pregnancies. With the second pregnancy her colitis didget worse and she had to be on prednisone throughout - there was some concern that this would interfere with wound healing if she had a caesar or peri wound but as she hadnormal vaginal birth with intact perineum there was no problem. She was also using acupuncture therapy throughout the second pregnancy. I have spoken to this woman and she would be more than happy to be contacted by your friend for some moral support and to share her experience. If you contact me off the list I will pass on her email address. love Sandra - Original Message - From: Rhonda To: [EMAIL PROTECTED] Sent: Friday, October 25, 2002 5:11 PM Subject: [ozmidwifery] Any help would be great. Well, this is a strange one - I mentioned a little while ago about my friend who seemed to think she had to have an abortion due to the steroids and drugs she was on for colitis. So doingwhat her doctor recommended she went and had the abortion. And for those of you who believe in miracles - the day before she had itI had a strange "visit" fromwho we worked out to be her grandfather - I got some very strong feelings that he did not want her to have the abortion and was very comforting telling her not to worry. Other things that I felt lead us to believe who it was - I got heavy in the chest and had strong chest pains/pressure, she tells me he died of lung cancer. Unfortunately, by the time i had relayed what had happened - she had already gone through with it. (NB: her grandfatherhad died when she was 12 yrs old.) Well the abortion didn't work. Something or someone protected this baby. Any guess as to who! Now she is back to where she started though and would still like any advice or help from anyone who knows anything at all about Colitis (inflamation of the bowel) treatement of this condition and pregnancy and also of her having a natural delivery as she had a c/s for her last and I know would like to have a VBAC. But is unsure of everything and not terribly confident in her body as she isrun down, on steroids and feeling in general particularly miserable. Thanks Rhonda IncrediMail - Email has finally evolved - Click Here
[ozmidwifery] virus alert
There was a virus attached to posting from Denise "RANCOG on NMAP" virus name "WORM_BUGBEAR.A"
Re: [ozmidwifery] NMAP
Liz We felt a little bit out of it up here in North Queensland as well so we had a little stall in the local shopping centre and passed out pamplets (adapted from the FAQs Answers that Denise recently posted on the list) and collected signatures for the petition. I am also going to speak to the local ABA group at their next Coffee Discussion morning. If you are a member of ANF (or any other organisation) you could get it on the agenda for your next branch meeting. The federaloffice of ANF has endorsed the plan but it is worth getting local branch endorsement both for the awareness raising as well as to show that support is widespread. Letter writing and just talking about the issue at every opportunity. Nag, nag, nag as someone else on the list recently suggested! Many of us who had nothing to so with the writing of NMAP have taken it onas our own. Somebody else wrote the song but we can all sing it. I'm sure the country is full of individuals (midwives and mothers) who have been fightingbattles in their own parts of the world in order to achieve better maternity services. The NMAP is an opportunity to gain strength and support from each other and to realize that we are not alone in the fight. Sandra - Original Message - From: ec newnham To: [EMAIL PROTECTED] Sent: Wednesday, October 02, 2002 9:50 PM Subject: [ozmidwifery] NMAP Hi all, just wanted to say (as someone who wasn't involved) thanks to all you wonderful people whoworked so hard onNMAP.Now what do I do to help make sure these recommendations are implemented. Am in SA so can't attend the rally in Sydney unfortunately. I suppose writing to pollies may do something. Can anyone enlighten me a little more? Yours in admiration and solidarity, Liz.
Re: [ozmidwifery] Midwifery advocacy
You are right Leanne we should use every opportunity to talk about this to those people who it does and will affect. They have a right to the real information and we have a responsibility to spread the word. The system will only get changed by this type of grass roots activism. We should be talking about it at every opportunity. It is no use being Quiet Achievers - just quietly struggling (against the system) to do a good job and hoping someone will notice and advocate for us. We need to be able to articulate the value of good midwifery care. We should be discussing it in classes, clinics, coffee mornings of the local ABA groups, outside the school gates where mothers are waiting in groups to pick up their kids, Rotary Clubs and playgroups. All our little voices joined together will make one hell of a noise (or sing a wonderful song!), loud enough for all policy makers to hear the votes in the issue! Sandra - Original Message - From: John, C [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, October 02, 2002 9:12 PM Subject: Re: [ozmidwifery] Midwifery advocacy Dear all, Just reading back over ozmidwifery emails i see the NMAP received mixed media.While I have never really been interested in politics it makes me so mad that woman can choose to have an elective caesarian but not to be cared for by a midwife. I think we need to really start a movement at grass roots level to educate and motivate parents to write to their local member .As Bob Carr said its votes their interested in. I'm informing my parents in prenatal classes and at booking in, about midwives and their role or what should be their role, caring for well women throughout pregnancy, birth and beyond ( many dont even know their is a difference between midwives and nurses). They will all be speaking to friends and family about it. At a prenatal class reunion I was speaking to a couple of women about NMAP. They had positive, first birth experiences recently ( with 1 on 1 midwifery support through their labour, no drugs, no complications)They just never had the opportunity to meet their midwife before they arrived in labour. Anyway , they are now fired up and are all writing to the local MP. Maybe we can all start doing this around the country. The time is right. love to all, Leanne Crumpton -- 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] Chronic Fatigue and Pregnancy
We admitted a woman last week about 10 days postnatal with mastitis and some breastfeeding difficulties. She had had a homebirth and she said that it it gone very well. She said that she just slept between contractions and that was how she was able to cope with the physical work of labour - said she could cope with most things as long as she could take her time and rest along the way. She was struggling much more with the physical work of caring for the baby - the demanding and relentless nature of it. She was unable to carry the baby or hold it for very long. Her partner was very supportive and was doing most of the physical work and was planning to be a full time carer. They were also going to see if they could get some homehelp. Sorry there's not much wisdom here for you. The best thing we were able to do was support her breastfeeding - at least that is quality parenting that she could do lying down! Sandra - Original Message - From: Sally Westbury [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, September 27, 2002 10:33 AM Subject: [ozmidwifery] Chronic Fatigue and Pregnancy Have people had experience of birthing with women with severe chronic fatigue. I'd love to hear your wisdom. Sally Westbury -- 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] Hep B at Birth
Hep B immunisation at birth was introduced in May 2000 for all babies. When we were getting inservice prior to the introduction of the new schedule we were told another recommendation of the advisory body was that flu vax was recommended for all pregnant women! It wasn't included on the "free" list and so wasn't being pushed at that time but we were told that this would be the next step! Just keeps getting scarier and scarier doesn't it? Sandra - Original Message - From: Aviva Sheb'a To: [EMAIL PROTECTED] Sent: Thursday, September 26, 2002 12:51 PM Subject: Re: [ozmidwifery] Hep B at Birth I nearly fell off my chair when I read about Hep B at Birth. It occurred to me long ago that if you bombard a baby's immune system with foreign bodies before it even has a chance to develop, surely it will go haywire. I had the opportunity of bailing up Dr. Adrian Baume (I think I have the name right), then (don't know about now) head of the federal government's health body that was pushing compulsory vaccinations against everything possible -- at the same congress where I delivered the paper on mothers, babies, weight gain and subsequent self-image. I asked him if this bombardment could be connected with immune problems later in life. The answer? Shuffling of well-studied feet and oh I must run, I'm late, goodbye. My son became asthmatic at the age of 4 -- when I succumbed to pressure and had him immunised with MMR. I think we need to spend squillions on researching a condom that fits over the entire baby in utero, so it will be born in a safe environment. Aviva in disbelief, dismay and disgust. - Original Message - From: Pinky McKay To: [EMAIL PROTECTED] Sent: Thursday, September 26, 2002 10:53 AM Subject: Re: [ozmidwifery] Hep B at Birth Hear hear!!! Well said Denise!!! I actually had a 'discussion' recently with a mum who said she was happy her baby had hep B at birth -(i told her about 2of my kids being rescusitated after vaccinations -one as an infant and one 19 year old who had cut his hand on rusty iron at work - the others remain unvaccinated)it is insurance she said --?? as protection against all those risky behaviours?? Perhaps they arevery advanced for their age!! Pinky - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Thursday, September 26, 2002 10:26 AM Subject: Re: [ozmidwifery] Hep B at Birth Go for it! Those babies will have to learn to stop those risky behaviours of unprotected sex, being bitten by and needle sharing with possible Hep B carriers then they won't need those risk free injections which our government is funding no questions asked!!!Denise
Re: [ozmidwifery] Hep B at Birth
We have certainly considered delaying the firstdose until discharge and some of the parentsalready elect to do that.It is still a major concern though if we are giving it just before we send them home and not observing the effects.We are in the process at the moment of working out how and when to observe the babes so we can make a clearer judgement about the effectand to furnish the sort of proof that would be needed to get the whole schedule reconsidered. Wehave always supported parents in their decision to refuse it altogether.We discuss the risks of their baby contracting Hep B with parents in the antenatal period and many parents make that informed decision not to have it. Many more though go along with it because they don't believe it would be recommended by the gov't if it was harmful! One of the midwives from our unitrecently attended a training session for immunisation endorsement andcame under attack by the Director of Public Health because our unit has a relatively low immunisation rate at birth - ours is not as low as 50% though so I guess we have a bench mark now! We'll have to see how low we can go! Sandra - Original Message - From: Vance Edwina To: [EMAIL PROTECTED] Sent: Thursday, September 26, 2002 5:32 PM Subject: RE: [ozmidwifery] Hep B at Birth We also give Hep B on d/c or with the day 3 stuff (weigh, cord clamp removal, etc). We have done this since the beginning of Hep B at birth, it would be interesting to see if the community midwives who visit post d/c have noticed any effect on b/f since Hep B introduction. Interestingly we only have about 50% of parents consenting to Hep B at birth it depends on which doctor they have! - Edwina -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Lois WattisSent: Wednesday, 25 September 2002 10:49 PMTo: [EMAIL PROTECTED]Subject: Re: [ozmidwifery] Hep B at Birth Dear Sandra - what an interesting observation. Very thought provoking. I can only add that the hospital where I worked when the Hep.B. directive was received initially gave it at birth at the same time as the Vit. K (one in each leg, poor little mites). Then the paed. expressed concerns that it was a double whammy, and given before the babe has even been properly assessed/observed. The decision was made to give the Hep. B on discharge i.e. Day 2 or 3 for vaginal births, Day 5 C.S.(with parental consentof course), and to my knowledge that is what still happens in that hospital. Maybe it's a worthwhile strategy to consider, and continue to observe your babes as thoughtfully as you obviously do. Well done. I haven't given an IM Vit.K or Hep. B. since working in the Community. We give oral Vit. K if the parents want it at all, and the Hep. B is commenced at the 2 month immunisation visit if the parents decide to go with immunisation. If they want the Hep.B injection sooner they can go to their doctor. Best wishes, Lois From: Sandra J. Eales To: [EMAIL PROTECTED] Sent: Wednesday, September 25, 2002 8:56 AM Subject: [ozmidwifery] Hep B at Birth Have been cogitating about this for a while and thought I would throw it out to the list to see if it rings any bells with anyone else out there. I work in a small unit where we tend to get to know the mother's and babies pretty well and follow their progress with interest. We have low intervention rates and low usage of intrapartum narcotics and have well established baby friendly breastfeeding practices. However I have been conscious for some time ofan increase in babies that display problems feeding day 2-3...babe's that feed well initially..but a day or 2 later and they don't seem to know what they are doing...uptight, irritable ..uncoordinated suck...some just downrightcranky and bordering on breast refusal. Initially I thought that it was perhaps just normal disinclination to feed whilst recovering from birth (perhaps a little cerebral oedema peaking 24 -48 hrs post birth related to molding) that had been compounded by mishandling by midwives and anxious mothers trying to force the babe to the breast when it wasn't ready and creating problems for the babe. Many of these babes though haven't had any obvious cause for the often extreme behaviour ie no excessive molding, or obvious birth trauma, no drugs in labour. I have been thinking for a while that I should do a bit of a research project to try and explain what I have been seeing, thenthinking about the timeframein which we have noticed these problems it suddenly dawned on me that the only real systemic change we have had has been
Re: [ozmidwifery] Severe Nausea
PCIP is also very good for breast fed babies with eczema - Mother takes the PCIP - Original Message - From: Vicki Chan [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, September 25, 2002 9:35 AM Subject: RE: [ozmidwifery] Severe Nausea Blackmores PCIP is a wonder for mastitis, I've found! -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Lyle Burgoyne Sent: Tuesday, September 24, 2002 8:51 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Severe Nausea After reading about Blackmores SSPC on this list awhile ago I have suggested its use to a number of women with severe hyperemisis with very good results.Vomiting seems to settle completely and they say they feel great.SSPC is only available with a naturpath prescription or from a chemist that has a naturpath(which we are lucky to have in this town).Have asked Blackmores about its safety in pregnancy and they say its totally safe Lyle [EMAIL PROTECTED] 09/17/02 10:38pm Does anyone on the list have any more suggestions for a friend who has severe morning sickness is now 9+ weeks pregant? SShe has tried acupuncture chinese herbs as well as being admitted for IV rehydration being given Maxalon, Vit B6 even dexamethasone. I thought I'd consult the list for any more ideas. Thanks in anticipation. Rose -- 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.
[ozmidwifery] Hep B at Birth
Have been cogitating about this for a while and thought I would throw it out to the list to see if it rings any bells with anyone else out there. I work in a small unit where we tend to get to know the mother's and babies pretty well and follow their progress with interest. We have low intervention rates and low usage of intrapartum narcotics and have well established baby friendly breastfeeding practices. However I have been conscious for some time ofan increase in babies that display problems feeding day 2-3...babe's that feed well initially..but a day or 2 later and they don't seem to know what they are doing...uptight, irritable ..uncoordinated suck...some just downrightcranky and bordering on breast refusal. Initially I thought that it was perhaps just normal disinclination to feed whilst recovering from birth (perhaps a little cerebral oedema peaking 24 -48 hrs post birth related to molding) that had been compounded by mishandling by midwives and anxious mothers trying to force the babe to the breast when it wasn't ready and creating problems for the babe. Many of these babes though haven't had any obvious cause for the often extreme behaviour ie no excessive molding, or obvious birth trauma, no drugs in labour. I have been thinking for a while that I should do a bit of a research project to try and explain what I have been seeing, thenthinking about the timeframein which we have noticed these problems it suddenly dawned on me that the only real systemic change we have had has been the introduction of Hep B immunisation at birth. The challenge of transition from intrauterine existance to the extrauterine world is huge. What if the added insult of Hep B vaccine at this time of major developmental change and adjustment is just too much for them to process. Perhaps this could explain why we have been having so many more babes who are having a difficult time making the transition...babes who have had drug free and relatively gentle birth..feeding beautifully initially then just absolutely hitting the wall. We have started to investigate and plan to do some research into it but I wonder if anyone else has noticed any change in newborn behaviours in the last two years since the introduction of the immunisation at birth. Is anyone aware of any study done orcurrently underway. I would appreciate your observations. Sandra
[ozmidwifery] Mareeba NMAP Launch!
Since we missed all the excitement and Launch celebrations in the capital cities we are having our own little NMAP launch out here in the sticks! Tomorrow the Mareeba Midwives will have a stall set up in the shopping centre (similar to what we do for Midwives Day). We will have a photo board of many of the babes who have been born throughout the year (most of their mothers being attended by a known midwife!). This photo board always attracts attention in our small community where everyone knows everyone else. We will have the NMAP petition for people to sign and will be discussing the NMAP and distributing information about it. Congratulationsto all of you who have worked on putting the NMAP together and coordinating the campaign thus far... stilla good bit of work to be done judging by a couple of the responses I have heard from various pollies and health spokespersons so far. Keep up the good work Sandra
Re: [ozmidwifery] lactation /stillbirth
Jan I know that the traditional wisdom is that lactation should be suppressed as quickly as possible. I think this attitude comes from the traditional difficulty doctors and midwives have in dealing with the emotions surrounding stillbirthor death of child after birth. The need to "fix" it and to remove alloutward sign of the sad event.I don't think this is necessarily the best thing for the greiving mother though I do not have any first hand experience. My intuition says that treating the breasts kindly in this time would actually be more beneficial to the mother in coping with her grief. The "breasts should be allowed to weep". Most of the science available in this area (ie suppression of lactation) suggest thatprolonged weaning is more benficial for the physiology of the breasts than an abrupt cessation. Whilst I have not seen a lot of researchspecifically related to lactation supression after the loss of child my intuition is that it is probably better for the psychology as well if the process is allowed to be more gradual. I think that breast massage and or gentle expression to relieve the pain and tension in them would be more therapeutic than the hands off advice generally given. Her milk will dry up when there is no baby there to sustain it and we should be giving the usual advice for prevention of blocked ducts and mastitis.ie non constrictive clothing, cabbage leaves, cold compresses etc Regards Sandra Eales IBCLC and Midwife Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Sent: Thursday, September 19, 2002 10:30 AM Subject: [ozmidwifery] lactation /stillbirth Advice appreciated Apart from firm support cold packs ice/cabbage leaves sage tea and no stimulation of breasts .Has anyone ant ideas to mimimize lactation in a term mother of stillborn baby. regards Jan
Re: [ozmidwifery] NMAP Support
Barb I just got the notice for the conference this afternoon and emailed Lisa Rayner at the party office about the possibility of putting the NMAP on the agenda (maybe conducting a workshop on it) but I am in North Queensland and am unlikely to be able to attend without travel subsidy. I was wondering if someone a little closer to Briz would be able to do this. This would be a wonderful forum to increase general awareness and garner support for the plan. Sandra - Original Message - From: Greg Barbara Cook To: [EMAIL PROTECTED] Sent: Friday, September 13, 2002 7:40 PM Subject: Re: [ozmidwifery] NMAP Support Sandra, Are you participating in the ALP's women's conference 5/10? I will be talking to some members of a faction about NMAP etc and I am hoping NMAP will be accepted as an urgency motion at this conference but I need to know midwives who will be there to support this and speak as I am not to articulate in things I am passionate about at times. Cheers Barb - Original Message - From: Sandra J. Eales To: [EMAIL PROTECTED] Sent: Thursday, September 12, 2002 10:33 PM Subject: [ozmidwifery] NMAP Support Fellow NMAP Supporters There was a very positive response from my local ALP branch when we discussed the NMAP this evening and it will be endorsed by the branch atour next meeting. The branch will also put it up as an agenda item at the next regional meeting of delegates. Sandra (Mareeba)
[ozmidwifery] NMAP Support
Fellow NMAP Supporters There was a very positive response from my local ALP branch when we discussed the NMAP this evening and it will be endorsed by the branch atour next meeting. The branch will also put it up as an agenda item at the next regional meeting of delegates. Sandra (Mareeba)
Re: [ozmidwifery] Day 3 weight loss
Irene You can probably guess my advice about weighing on day 3 - STOP it! It only causes stress to mothers and many midwives and doctors. Observation of feeds, output (passage of mec and transitional stools) and baby condition and behaviour is much more useful than day 3 weight to assess how well the babe is making the transition to extrauterine life. This way you identify if and what the particular problem is e.g. poor attachment and deal with that rather than jumping in with artificial comps which will create more problems. If there is in fact a general problem with babies not adapting and feeding well you would need to look at what is happening to them in your system. I would look at the basics - narcotic use in labour, do they go to the breast within the first 1 hour of birth, are they demand feeding, rooming in with mum or being babysat at night to let the mum get some rest...mothers and babies do and will make this transition well and healthily as long as they are not sabotaged by our poor professional assistance. Good Luck Sandra - Original Message - From: Irene Munro [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, September 09, 2002 11:41 AM Subject: [ozmidwifery] Day 3 weight loss I am finding an alarming amount of babies losing more than 10% of their birth weight on day 3. Is anyone else out there experiencing this and are there any studies on this subject. This is particularly babies of caucasian mothers. Can anyone shed light on this for me? Irene Munro Alice Springs __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.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] Mastitis
You are right Sheena definitely tell her to keep feeding.The most important treatment is to get the breast flowing and the baby is by far the most effective way to do this. Some doctors create more problems than they solve when it comes to Breastfeeding! Also anytime mother or baby have been on antibiotics it is important to be aware of possibility thrush developing which can cause breastfeeding problems.Oral thrushmay cause babe to alter how it attaches and so effect how it empties the breast and cause nipple damage. Antibiotics also can play havoc with their gut and I have found that Natren Lifestart (bifidobacterium) will recover this. Sandra Eales - Original Message - From: Sheena Johnson To: [EMAIL PROTECTED] Sent: Sunday, September 08, 2002 1:04 PM Subject: [ozmidwifery] Mastitis Any of the lactation consultants out there give me some advise on feeding on the affected breast if the woman has mastitis. Ruby's mum has just got mastitis after Ruby slept through for 5 hours. Just to make life really miserable Ruby has had bronchitis and is also on antibiotics. The doctor advised Lynley not to feed off the affected side but to express, I thought the thing to do was to keep on feeding? Sheena Johnson
Re: [ozmidwifery] Bottled water
I think the lack of mineral content in distilled water is the main reason for using it. There are more than enough minerals contained in the formulas. Some hospitals use (or used to) small bottles of sterile water which come from the formula companies specifically for making formula - it is pure H2O. Sandra - Original Message - From: James Stephanie Fairbairn [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, September 05, 2002 5:09 PM Subject: Re: [ozmidwifery] Bottled water A quick addition to the debate on bottled water - NEVER use distilled water to make up bottles, or indeed drink yourself as it contains no minerals and will actually leach them from your body. Stephanie. - Original Message - From: Sandra J. Eales [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, September 05, 2002 10:53 AM Subject: Re: [ozmidwifery] Bottled water Irene There are many different types of bottled water. You can buy distilled water which would be fine as it is just H2O, but spring or mineral water would nnot be appropriate - I think they all generally have a list of the minerals which are contained in them on the labels. Sandra - Original Message - From: Irene Munro [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, September 04, 2002 2:53 PM Subject: [ozmidwifery] Bottled water Does anyone have any info regarding the use of bottled water when making up formula. I have just heard that it contains more sodium than tap stuff, is this true? irene Munro LC Alice Springs __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.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. -- 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] Cup and fingerfeeding
Irene I have not seen any evidence either first hand or published research to indicate pneumonia assoc. with cup or finger feeding. We still use both those methods as appropriate. The only relationship I am aware of is that formula fed babes have higher risk of chest infection. Perhaps you could ask your informant for the reference or source of the ban. Cheers Sandra - Original Message - From: Irene Munro [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, September 04, 2002 2:22 PM Subject: [ozmidwifery] Cup and fingerfeeding Can anyone enlighten me as to the recent developments in cup and fingerfeeding? I have just been informed that it has been 'banned' because of the increase in upper lobe pneumonia in infants. Is this true? Irene Munro LC Alice Springs __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.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] Bottled water
Irene There are many different types of bottled water. You can buy distilled water which would be fine as it is just H2O, but spring or mineral water would nnot be appropriate - I think they all generally have a list of the minerals which are contained in them on the labels. Sandra - Original Message - From: Irene Munro [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, September 04, 2002 2:53 PM Subject: [ozmidwifery] Bottled water Does anyone have any info regarding the use of bottled water when making up formula. I have just heard that it contains more sodium than tap stuff, is this true? irene Munro LC Alice Springs __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.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] Aust Midwfery
Denise I need to correct your info about Mareeba model of care. We do not have a birth centre as such. Our unit is part of the hospital but is like birth centre in that we have family rooms so that partners, children or significant others can stay with the womanthroughout her stay in hospital. All women are allocated to or choose a particular midwife's clinic at booking and she sees that midwife throughout the antenatal period. Most women will see a doctor once during their pregnancy for a general medical assessment but otherwise are under midwife care. Whilst we cannot guarantee the same midwife at birth, we do have a fairly small team and 2 midwives on a shift mean one to one care in labour. The women have usually met the birthmidwifeat some stage during her pregnancy as the antenatal clinic is conducted within the unit.Our model of care has evolved over the last 10 years by committed midwivesstriving to improve the birthing services available to all women in our community. We have had somefairly difficult hurdles to overcome and tough battles to fight to gain the ground that we have...but we are only able to providethe service we do because we have a couple of wonderfully supportive doctors who are happy to play the supportive role rather than the traditional "starring" role of the doctor "in charge". We carry the constant nagging fear that if these doctors move on or thereare none willing to take on this supportive role then we will face closure as we have seen occur in many small units around the country in recent times. We do need to be working and talking about the issues on as many fronts as possible. It is reassuring to see some of the activism that is occurring through people on this list. At the Qld Nurses Union Annual conference in July the Mareeba branch put up a resolution "That the QNU support the rights and the health of families in the rural areas by lobbying the government to resist the growing trend to "rationalise/centralise" (birthing) services away from these communities." The resolution was passed unanimously. I think the NMAP should be brought to the attention of the ANF(Australian Nursing Federation) state branches and wonder if anyone has sought endorsement by them as yet. I know there has been nurse vs midwife struggles in the past but the nursing unions being majority female organisations should have a strong interest in birthing issues. Nurse unions are becoming more politically strong/active. There are a couple of QNU councillors on the State ALP Health Policy Committee. I will pass the NMAP on to them. The Federal Office of the ANF is now located in Canberrra andis well placed to be a positive voice. The ANF Federal Secretary Jill Iliffe I think has a history of midwifery and community nursing and may well prove to be a useful advocate. The more places this is being discussed and the more unified the voice the better chance small units like Mareeba will have of staying operational. All women deserve to have the safe care of a midwife in or near there homes before, during and after childbirth. Sandra Eales --- Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Wednesday, August 21, 2002 1:36 AM Subject: [ozmidwifery] Aust Midwfery Dear All Below my latest summary list of models of funded midwifery care available in Australia at the moment if you want it as an attachment email me off list please notify me if you know of any other additions or deletions Denise Hynd FUNDED AUSTRALIAN MODELS OF MIDWIFERY CARE. A MIDWIFERY MODEL OF CARE; is based on Primary Health Care Principles whereby the midwife provides continuity or the majority of care as the primary care provider through the antenatal, intrapartum and postpartum period. The midwife aims to work in partnership with the woman and collaboratively with other members of the health care team to provide a pattern of care within this framework. FUNDED; Operating costs are predominantly borne by sources other than the consumer or individual practitioner (as per most Midwife in Private Practice cases), either by government, private companies or health funds. The following information was gathered from participants of the Ozmidwifery mailing list by Denise Hynd (updated 19/8/02). QUEENSLAND The Royal Women's Hospital, Brisbane Birth Centre has a waiting list of upto 80 clients/month. Selangor Private Hospital (Health Care of Aust) has no routines, each woman is an individual. Cairns Base Hospital uses a team basis for all midwifery care. Mackay Birth Centre and Hospital had admission rights for MIPPs. Mareeba Hospital offers a range of models of midwifery care, including a Birth Centre. AUSTRALIAN CAPITAL TERRITORY The Canberra Hospital has a Birth Centre and Community Midwives Caseload based program. SOUTH
Re: [ozmidwifery] back on the list
Marilyn I saw a documentary on this hospital on SBS a year or two ago and remember that the reason for the high incidence of fistulas from obstructed labours was because of the extreme youth of the women when they became pregnant. Most of them were "child-brides" often married before they started menstruation. Mostly muslim population felt that girls needed to be married whilst still "pure". Their bodies and hips are not fully developed when they become pregnant at the very beginning of adolescence and sothe high incidence of obstructed labour. Campaign to convince religious leaders to encourage delay of marraige was a total failure. Heartbreaking to see these little giggling 10 and 11 yr old girls playing with dolls being sold off in marraige with promise from the groom and his family that he would wait until after menarche to consumate the marraige and when TV crew returned to village a short time (weeks or months) later the "child-bride" is withdrawn and unsmiling and no longer a virgin despite the fact that she still has not had her first period. Sandra Eales - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Sunday, August 25, 2002 11:45 PM Subject: Re: [ozmidwifery] back on the list Sounds like an obstructed labour to me. On that note, could any of you who have read "A hospital by the river" fill me in on why so many obstructed labours were/are occuring in Ethiopia. I had imagined, before I read the book, that it was because of adhesions as a result of female circumcision, however, the author never once even hints at this practice. Her explanation is lack of medical care, women birthing first babies alone at a young age miles from hospital. The discriptions of such births are similar to Rhonda's description below with the exception that the woman is alone and c/s is not a possibility so she remains undelivered until the baby dies and passes macerated. Again, the description of the fistulas occurence is bladders bursting and tearing of the vaginal wall etc.. Is it just that with a population as large as in sub Saharan Africa, even a small percentage of women having this problem is a large number of women, is it malnutrition causing women to have deformed pelves, or was a political decision made not to mention the practice of female circumcision? Or is it some combination of all of these? The author says that such fistulas occured in Europe and America before the advent of successful obstetrical intervention (c/s, forceps). I am not trying to cast an doubt on the authors work, I think what she and her husband did for these women and what the hospital continues to do is invaluable, but I am really curious as to the origins of the fistulas. marilyn - Original Message - From: Rhonda To: [EMAIL PROTECTED] Sent: Saturday, August 24, 2002 5:07 AM Subject: Re: [ozmidwifery] back on the list To explain this I can only say what she has relayed to me - they thought the head was on show and she had been pushing and pushing when a second membrane burst and what 'they' had thought was the babies head was a huge bulb of fluid. The head was still right up there and not on show at all. This was when the GP id the internal and said - "It wont fit!" She was at this stage saying "shoot me NOW! i just want to die." She was in labour for 26 hours before the c/s and was totally exhausted - couldn't move for days, she was so bruised. Couldn't pass urine for 2 days or use her bowels for over a week. It was her last baby! Hmm. Rhonda. ---Original Message--- From: [EMAIL PROTECTED] Date: Saturday, August 24, 2002 21:12:06 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] back on the list I have never heard of any one pushing for 8 or 10hours! Comments please.Love Lina Davern.From: "Rhonda" lt;[EMAIL PROTECTED]Reply-To: [EMAIL PROTECTED]To: lt;[EMAIL PROTECTED]Subject: Re: [ozmidwifery] back on the listDate: Sat, 24 Aug 2002 00:40:40 +1000 (AUS Eastern Standard Time)Whoops - in this case she had been pushing hard for at least 8 to 10hoursand the head had still not moulded. She had C/S and his poor little headwas brused and baby was unable to straighten his head for months his neckwas sort of cricked. He was 9lb 8oz which was big for her.Her second baby's head was 37cm - 8lb baby and she had a lot of troubleending in forceps and large episiotomy (Ob saying - this should have been ac/s.)The first
Re: [ozmidwifery] SIDS
Sheena You might try Natren Lifestart which is a powder form of bifidobacterium. Babies will often get gut pain from oversupply as they get too much of the sugar component of the milk which causes the explosive diarrhoea that you mentioned. When this occurs the baby's gut gets depleted of theenzyme which deals with the sugars which causes a form of lactose intolerance ie increased gas production, gut pain and unsettled behaviour. The bifidobacterium helps to mature the gut of the newbornand increase their lactase (enzyme from small intestine) production. It is very helpful to recover the gut damage that can occur from this type of lactose overload from oversupply or from antibiotic therapy in either mother or baby. Hope this helps SandraEales IBCLC - Original Message - From: Sheena Johnson To: [EMAIL PROTECTED] Sent: Sunday, August 11, 2002 10:26 AM Subject: [ozmidwifery] SIDS I am a mid student and have just joined this site. I also have a new 5 week baby living with us, she was 3 weeks prem and is our grandchild. I was wondering if anyone can help. Baby Ruby has not slept for 2 weeks now, she has really bad colic. Lynley has done all the right things regarding breastfeeding, spent the day with the Lactation Consultatant, sorted out too much fore milk which was contributing to explosive green stools, tried everything to get Ruby to sleep. Lynley and partner (my stepson) live 200 yards away from us. Last night I invited Lynley over to our house and I did night duty, changing and burping Rubywhile Lynley just woke to feed. I got two hours sleep for the night. The only time Ruby slept was when she was face down on my chest when I was lying on the couch. In desperation this morning I put her down in the bassinette on her stomach and bingo! she is still asleep. When I put her on her side or back the wind pains wake her up and hurt her; on her stomach she grunts and pulls her knees up, wriggles around, then goes back to sleep. So what do we do now, with all the advice against stomach sleeping? Does anyone have any advice out there. Regards Sheena Johnson
