Re: [ozmidwifery] Wyong

2005-09-19 Thread Sandra J. Eales



Diane 
It is great that you have reestablished the 
service.  It is distressing for a community to lose such 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 unit has 
  been closed 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.
  
  

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Re: [ozmidwifery] caseload payment

2005-08-15 Thread Sandra J. Eales



I would also be interested in caseload payments and 
classification structures.
The Qld Nurses Union is currently working on 
an industrial framework to support midwifery models.
 
I would also be interested in workloads 
determination tools that have been developed.
Most of the caseload models I have 
seen discuss a 30 - 50 cases/FTE for low risk women.  However some 
services discharge the women after birth and others provide extended postnatal 
services.
 
I would be interested if there are any caseload 
models that also include some provision of care to high risk women eg shared 
care with midwife providing care A/N and P/N but with birth in obstetric 
care.
 
Or other mixed services where a midwife may have a 
caseload as well as provide other services eg management, lactation 
consultation, women's health screening, immunisation, support for "at risk" 
mother's and babies.
 
All help would be appreciated.
Thanks
 
Sandra EalesMidwife 
Mareeba Midwifery ServiceMareeba 
Hospital
 
Work 4092 9367Home 40926 196Mobile  
0428 610 605
 
- Original Message - 

  From: 
  Sally Westbury 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, August 15, 2005 7:22 
  PM
  Subject: [ozmidwifery] caseload 
  payment
  
  
  Anyone have a decent 
  caseload payment within their health department that they could share with 
  me??
   
  Sally 
  Westbury
  Homebirth 
  Midwife
  "Learn 
  from mothers and babies; every one of them has a unique story to tell. Look 
  for wisdom in the humblest places - that's usually where you'll find 
  it."
  — 
  Lois 
  Wilson
   
  
  

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[ozmidwifery] Re:Midwifery models support group

2005-03-14 Thread Sandra J. Eales



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 is has a Midwifery model of care or who would like their 
  unit to 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 
  further communication 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

2004-11-17 Thread Sandra J. Eales
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]

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Re: [ozmidwifery] Ab Fab birth - wandering off topic

2004-07-23 Thread Sandra J. Eales
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  to subscribe or unsubscribe.
>
>
> -
> Andrea Robertson
> Birth International * ACE Graphics * Associates in Childbirth Education
>
> e-mail: [EMAIL PROTECTED]
> web: www.birthinternational.com
>
>
> --
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Re: [ozmidwifery] Queensland Midwives - Response required

2004-03-24 Thread Sandra J. Eales
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 have finally 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 midwives are 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 
of midwifery 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

2004-03-08 Thread Sandra J. Eales
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 
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[ozmidwifery] Queensland Midwives - Response required

2004-03-08 Thread Sandra J. Eales



Queensland Health have finally 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 midwives are 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 of midwifery 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] Re: presentation - words of wisdom?

2003-09-16 Thread Sandra J. Eales



Jan, Nola and All
This question 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 intervention vs risks of no 
intervention
Source of 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 and was 
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 had very 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 
a different and probably healing experience for her, but in her mind the 
whole difficult 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 the relationships developed 
throughout the antenatal period. 
We all know that many, many women 
verbalise fear 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 wondering about 
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 into the unit in which I 
work and have an active birth, without some form of 
intervention. Indeed it is not all about the obstetrical model. The 
last woman I cared for in labour, during a night shift, was in the unit 
10 minutes and stated, "I want an epidural. It is my right!" That's a 
hard call!
 
Nola
 
 
  


Re: [ozmidwifery] Shoal Haven Model of Care

2003-09-10 Thread Sandra J. Eales
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] 



[ozmidwifery] Shoal Haven Model of Care

2003-09-10 Thread Sandra J. Eales



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] Cervidil mailout

2003-07-07 Thread Sandra J. Eales



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 in in 
pursuit of profits are a major cause for concern.  They figure high 
on my 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] Workloads - doing something about it

2003-04-06 Thread Sandra J. Eales
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 fro

Re: [ozmidwifery] Bullying - doing something about it

2003-04-06 Thread Sandra J. Eales
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.
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Re: [ozmidwifery] Bullying - doing something about it

2003-04-05 Thread Sandra J. Eales
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 numb

Re: [ozmidwifery] re: article in the Advertiser

2003-04-05 Thread Sandra J. Eales



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 the labour 
  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] Hep B for newborns, att Sandra

2003-03-23 Thread Sandra J. Eales
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
>
> --
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> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.

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Re: [ozmidwifery] Hep B for newborns, att Sandra

2003-03-17 Thread Sandra J. Eales
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  to subscribe or unsubscribe.

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Re: [ozmidwifery] Hep B Vaccine at Birth

2003-03-12 Thread Sandra J. Eales



Thank you Robin.  There are references ( 
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.
Since then we have done some investigation and as 
we became convinced of the connection we have been much more 
conscientious about gaining "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 consenting and 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 now copping flak because we 
show up very large on the radar in the 'Early Warning System' of 
the authorities 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

Re: [ozmidwifery] Vaccination Incentive Payments

2003-03-11 Thread Sandra J. Eales
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
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> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.

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Re: [ozmidwifery] Hep B Vaccine at Birth

2003-03-10 Thread Sandra J. Eales



You are right Mary.  I don't think it is 
question of bravery.  I don't believe I am putting myself at 
risk by my actions.  I do think it is a little intimidating if I 
consider that my goal must be to get the immunisation schedule changed. The 
opposing forces are too great for me.  However we 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.
  Since then we have done some investigation and as 
  we became convinced of the connection we have been much more conscientious 
  about gaining "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 
  consenting and 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 now copping flak because we 
  show up very large on the radar in the 'Early Warning System' of 
  the authorities 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 e

Re: [ozmidwifery] Bicornuate uterus

2003-03-10 Thread Sandra J. Eales
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
>
>
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[ozmidwifery] Vaccination Incentive Payments

2003-03-10 Thread Sandra J. Eales



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


Re: [ozmidwifery] Hep B Vaccine at Birth

2003-03-10 Thread Sandra J. Eales



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.
Since then we have done some investigation 
and as we became convinced of the connection we have been much more 
conscientious about gaining "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 consenting and 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 now copping flak 
because we show up very large on the radar in the 'Early Warning System' of 
the authorities 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 Information which has this 
advice "give extra fluids e.g more breast feeds or water"  - we discuss 
the implication of this at 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 effectec

Re: [ozmidwifery] Hep B Vaccine at Birth

2003-03-10 Thread Sandra J. Eales



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 
  comprehensive and GUTSY account 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 asked by 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.
Since then we have done some investigation 
and as we became convinced of the connection we have been much more 
conscientious about gaining "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 consenting and 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 now copping flak 
because we show up very large on the radar in the 'Early Warning System' of 
the authorities 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 Information which has this 
advice "give extra fluids e

Re: Re:[ozmidwifery]Hep B Birth dose

2003-03-10 Thread Sandra J. Eales



Jane
We don't give out any literature other than what is 
supplied by QHealth and Immunise Australia.(We did not want to load the 
guns of the powers-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 at the 
same time as your baby is recovering from birth?  Is this necessary?  
What is the risk of you baby getting the disease?  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

2003-03-10 Thread Sandra J. Eales



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 at a 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: [ozmidwifery] Oxytocin & Trust

2003-03-10 Thread Sandra J. Eales



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. It’s 
  a brain chemical that’s 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] 
 

Re: [ozmidwifery] Immunisation before university/employment - Hep.B

2003-03-09 Thread Sandra J. Eales



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 
motivator is 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 unsure about 
  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.


[ozmidwifery] Hep B Vaccine at Birth

2003-03-09 Thread Sandra J. Eales



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.
Since then we have done some investigation and 
as we became convinced of the connection we have been much more conscientious 
about gaining "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 consenting and 
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 now copping flak because 
we show up very large on the radar in the 'Early Warning System' of 
the authorities 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 Information which has this advice 
"give extra fluids e.g more breast feeds or water"  - we discuss the 
implication of this at 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.

Re: [ozmidwifery] Oxytocin & Trust

2003-03-05 Thread Sandra J. Eales



Denise 
Have you checked out the abc website. They 
normally keep 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

2002-12-03 Thread Sandra J. Eales



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 the rationalisation/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 are a little 
more familiar with the NMAP now.  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 been held 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 meetings are 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 Cabinet office 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 with friends 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 it’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 w

Re: [ozmidwifery] jittery newborn

2002-11-25 Thread Sandra J. Eales



We recently had a babe unable to 
maintain BSL regardless 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 baby SVD under water at 
home apgars 9+10 .breast feed well
mother GBS + AND DECLINED abs unless 
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 ceases no 
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

2002-11-20 Thread Sandra J. Eales



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

2002-11-18 Thread Sandra J. Eales
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 
about another little step taken today.
Regional ALP Conference held in Cairns 
today unanimously carried 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

2002-11-18 Thread Sandra J. Eales



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
the inadequacies 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 because they 
were left alone too much.
 
Sandra


Re: [ozmidwifery] NMAP

2002-11-18 Thread Sandra J. Eales



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 
about another little step taken today.
Regional ALP Conference held in Cairns today 
unanimously carried 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

2002-11-16 Thread Sandra J. Eales



Thought I would let you all know about another 
little step taken today.
Regional ALP Conference held in Cairns today 
unanimously carried 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

2002-10-29 Thread Sandra J. Eales
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 print will 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 your view so if the policy makers aren't interested 
then ensure that the women get 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 midwives who have 
been deeply involved with childbirth for decades as being 'airy fairy 
nonsense'But I also know the satisfaction of working in a cooperative 
team where there is mutual trust and respect.
 
It is important that passionate midwives 
continue to work in the mainstream services where the majority of women give 
birth.  Whilst we continue to 
fight to change the system these women need the support and protection 
that only a passionate midwife can 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 to allow women 
access to the knowledge and wisdom contained in our art of midwifery rather than 
leave them exposed to the undiluted 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 of women 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 assertive as 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 a

Re: [ozmidwifery] Any help would be great.

2002-10-28 Thread Sandra J. Eales



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 - she had to have an emergency c/s for 
severe fetal distress prior 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 
in two 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 did get 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 had normal 
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 doing what her 
doctor recommended she went and had the abortion. 
 
 And for those of you who believe in miracles - the day 
before she had it I had a strange "visit" from who 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 grandfather had 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 is run down, on 
steroids and feeling in general particularly miserable. 
 
Thanks
Rhonda

  

  
  


  IncrediMail 
  - Email has finally evolved - Click 
  Here 


Re: [ozmidwifery] Midwifery advocacy

2002-10-03 Thread Sandra J. Eales

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
>
>
>
> --
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> Visit  to subscribe or unsubscribe.


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Re: [ozmidwifery] NMAP

2002-10-03 Thread Sandra J. Eales



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 federal office 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 on as 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 fighting battles 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 
  who worked so hard on NMAP. 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.


[ozmidwifery] virus alert

2002-10-03 Thread Sandra J. Eales



There was a virus attached to posting from Denise 
"RANCOG on NMAP"
 
virus name "WORM_BUGBEAR.A"
 
 


Re: [ozmidwifery] Hep B at Birth

2002-09-27 Thread Sandra J. Eales




We have certainly considered delaying the 
first dose until discharge and some of the parents already 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 effect and to furnish the sort of proof 
that would be needed to get the whole schedule reconsidered.
 
We have 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 unit recently 
attended a training session for immunisation endorsement and came 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 consent of 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 
of an 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 
downright cranky 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, then thinking about the timeframe in which we have 
noticed thes

Re: [ozmidwifery] Hep B at Birth

2002-09-27 Thread Sandra J. Eales



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  
  2 of 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 are very 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] Chronic Fatigue and Pregnancy

2002-09-27 Thread Sandra J. Eales

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
>
>
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Re: [ozmidwifery] Severe Nausea

2002-09-25 Thread Sandra J. Eales

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
>
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[ozmidwifery] Mareeba NMAP Launch!

2002-09-24 Thread Sandra J. Eales



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.
 
Congratulations to all of you who have worked 
on putting the NMAP together and coordinating the campaign thus far... 
still a 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 


[ozmidwifery] Hep B at Birth

2002-09-24 Thread Sandra J. Eales




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 of an 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 downright cranky 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, 
then thinking about the timeframe in 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 or currently underway.
 
I would appreciate your observations.
 
Sandra
 


Re: [ozmidwifery] Refusing the breast

2002-09-21 Thread Sandra J. Eales



Dear Sheena
Breast refusal is often multi factorial and 
difficult to give good advice over the internet without being able to see 
exactly what is going on.  Have you been to see a Lactation Consultant? 

Babies usually do have a pretty good (and logical) 
reason for their behaviour. We just have difficulty reading it 
sometimes.
 
If she is breast feeding well at night but refusing 
during the day then you need to look at what is different.  This also makes 
it very hopeful that you should be able to remedy the situation relatively 
easily once you recognise the cause of the behaviour.
Is it

  different feeding postion? - sometimes if 
  they have been stressed at the breast by upset mum in pain, being held in 
  uncomfortable position, being forced to the breast e.g. hand behind the head 
  etc. then the babe will struggle against this.  If it is held for comfort 
  in one position - say, up on the shoulder and then shifted to a different 
  position to feed and it associates that position with struggle and stress 
  then it will be thrown into a panic as soon as it is shifted from the 
  "comfort" position to the "struggle" position - side lying with minimal 
  handling of babe is often most comfortable for mum and babe in this 
  situation.. and re-educating the babe (and mum) that the breast is a place of 
  comfort and feeling good.. use the breast feeding hold at other times just to 
  be close and cuddle...
  mum and baby sleepy and relaxed at the night 
  feeds?..relaxation bath with mum and babe and lots of skin on skin time 
  that is enjoyed by both mum and babe is important
  larger supply and quicker let down at 
  night?..hungry babes will often get frustrated if milk is not coming quick 
  enough - supply-line may be useful in this case until the supply has 
  increased
If mum or babe have been on antibiotics at any 
stage then this can wreak havoc on the babies gut and immune system - can cause 
thrush which can effect the way a babe sucks and cause lots of tummy pains - 
Natren Lifestart which is a probiotic (bifidobacterium) will normalise these 
effects from the antibiotics.
 
I would be fairly confident that the cause of the breast refusal has little 
to do with the "period" unless there has been retained placental 
fragments which has been suppressing lactation.  If this is the problem 
then besides the removal of the fragments the are various solutions for 
increasing her milk supply.
Poor attachment is often another contributing cause of these types of 
difficulties (both supply problems and breast refusal issues).  Use of 
dummy is also often associated with poor attachment .  I would strongly 
recommend seeking out an LC.
 
Hope something here is useful to you
 
Good Luck 
 
Sandra

  - Original Message - 
  From: 
  Sheena Johnson 
  To: [EMAIL PROTECTED] 
  Sent: Friday, September 20, 2002 7:17 
  PM
  Subject: [ozmidwifery] Refusing the 
  breast
  
  Hi List
   
  Ruby Rainbow our 10 week old (3 weeks prem) 
  baby grand-daughter is now refusing the breast most feeds. We have been 
  through colic and reflux. Mum has had mastitis twice and a vaginal infection. 
  Ruby started to refuse the breast the same time that her Mum started her 
  ?period. She has had an ultra sound that is inconclusive, the doctor says that 
  what is showing could just be the uterus involuting, but the Mum says that 
  babe has been refusing the breast since she has been losing blood. Have also 
  resorted to glycerine on the dummy and on the nipple to entice her to feed. 
  She only put on a couple of ounces last week. Babe seems to feed ok during the 
  night, but in the daytime, starts crying and won't feed. Any advice out there. 
  I favour going back to her obstetrician and asking for a second opinion on the 
  ultrasound reading. This Mum is on Aropax 30mg a day.
   
  Appreciate any advice going
   
  Thanks Sheena 
Johnson


Re: [ozmidwifery] lactation /stillbirth

2002-09-18 Thread Sandra J. Eales



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 stillbirth or death of child after birth.  
The need to "fix" it and to remove all outward 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 that prolonged weaning is more benficial 
for the physiology of the breasts than an abrupt cessation.  Whilst I have 
not seen a lot of research specifically 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

2002-09-13 Thread Sandra J. Eales



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 at our 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

2002-09-12 Thread Sandra J. Eales



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 at our 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

2002-09-09 Thread Sandra J. Eales

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
>
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Re: [ozmidwifery] Mastitis

2002-09-07 Thread Sandra J. Eales



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 thrush may 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

2002-09-06 Thread Sandra J. Eales

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
> > >
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> >
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Re: [ozmidwifery] Bottled water

2002-09-04 Thread Sandra J. Eales

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
>
> __
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Re: [ozmidwifery] Cup and fingerfeeding

2002-09-04 Thread Sandra J. Eales

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
>
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Re: [ozmidwifery] Raise ProfileOf Midwfery

2002-08-31 Thread Sandra J. Eales



For the last couple of years on International 
Midwives Day we have a stall in the local shopping centre.  We have a photo 
board of all the babes with their mums and dads that have been born with us in 
the last year.  This is always hugely popular in a small small community 
like ours where everybody knows everybody else.  It also helps to 
strengthen in the public consciousness the connection of birth with 
midwives.  It is always a nice social morning as many of the mums come to 
visit and show off how well their bubs are doing, to ask breastfeeding or 
weaning advice, or just to share a cuppa.
One year to celebrate Midwives Day we went for a hot air balloon ride and hung a huge banner 
from the basket as we drifted over the outskirts of our town.  I 
don't know how many people saw it at that time of the morning but we all 
got a buzz from it!   
 
Sandra
(Mareeba Midwife)

  - Original Message - 
  From: 
  Denise Hynd 
  To: [EMAIL PROTECTED] 
  Sent: Monday, August 26, 2002 9:49 
  AM
  Subject: [ozmidwifery] Raise ProfileOf 
  Midwfery
  
  Dear List
  One of the reasons it is difficult to push 
  midwifery options in this country and so gain  increased family centred 
  birthing options for Australian families, midwives and our community is 
  the invisibility of midwifery in our community and media
  So to help I would ask list  midwifery 
  supporters to think and act on ways to raise the profile of midwifery and our 
  communities awareness of their care.
   
  For example 
  1) go to the ABC and other stations web sites and 
  write and suggest program about midwives and midwifery options you know about 
  on life style programs!! 
   
  2) nominate a midwife for an Order of 
  Australiaat 
  http://www.itsanhonour.gov.au/about/how_to_nominate.html
   
  Please help in some way Denise 
   


Re: [ozmidwifery] Aust Midwfery

2002-08-30 Thread Sandra J. Eales



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 woman throughout 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 birth midwife at 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 midwives striving to improve 
the birthing services available to all women in our community.  We have had 
some fairly difficult hurdles to overcome and tough battles to fight to 
gain the ground that we have...but we are only 
able to provide the 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 there are 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 and is 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 Midw

Re: [ozmidwifery] back on the list

2002-08-25 Thread Sandra J. Eales



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 so the 
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" <[EMAIL PROTECTED]>>Reply-To: 
  [EMAIL PROTECTED]>To: 
  <[EMAIL PROTECTED]>>Subject: 
  Re: [ozmidwifery] back on the list>Date: 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 
  10hours>and the head had still not moulded. She had C/S and his 
  poor little head>was brused and baby was unable to straighten 
  his head for months his neck>was 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 trouble>ending in forceps and 
  large episiotomy (Ob saying - this should h

Re: [ozmidwifery] SIDS

2002-08-11 Thread Sandra J. Eales



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 the enzyme 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 
newborn and 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
 
Sandra Eales
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 Ruby while 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


Re: [ozmidwifery] Pls send feedback to Life Matters

2002-07-15 Thread Sandra J. Eales

Hello
I have been a silent subscriber (rather than a "lurker") for some time.
I am attaching a copy of my email to Life Matters - rather long winded -
perhaps a result of being silent for so long.  It is reassuring to see that
there are so many out there fighting the same fight albeit in slightly
different arenas.  Sometimes we get overwhelmed by the enormity of the
problems but lots of small voices can deliver a pretty loud message.
I was on the recently famous "Chunder Bucket Express" which travelled from
Cairns to Brisbane to attend a Rally outside Parliament House to protest
against the governments neglect of chronic problems in the nursing
profession.  There were a group of midwives from Maryborough who told us
that the birthing unit at Maryborough is to be closed down at the end of
this month. This is a tragic tendancy and one we in Mareeba live in fear of.
Last month I was in a delegation to the Health Minister when a "Country
Cabinet Meeting" was held in Cairns.  I presented a similar argument as is
contained in my email to Life Matters.  I don't feel as though I made a
great impression at the time but perhaps one of the peripheral advisers will
read what I wrote or follow up some of the references.  As more little
voices express similar concerns and ideals perhaps we will make a greater
impression.

More power to you all
Sandra Eales
- Original Message -
From: Vernon at Stringybark <[EMAIL PROTECTED]>
To: ozmid <[EMAIL PROTECTED]>
Sent: Monday, July 15, 2002 10:18 PM
Subject: [ozmidwifery] Pls send feedback to Life Matters


> Dear all,
>
> I've been reliably informed that a positive way to encourage the Life
> Matters program to give further air time beyond tomorrow's program to
> midwifery and consumer issues is for there to be lots of feedback from
> listeners expressing interest in/opinions on the issues raised in a given
> program.
>
> Pls send emails to Life Matters <[EMAIL PROTECTED]> or write a
> letter after tomorrow's program and encourage others to do the same,
> especially pregnant women, mothers and midwives!
>
> cheers Barb.
>
>
> Dr Barbara Vernon
> National President
> The Maternity Coalition
> PO Box 269
> LYNEHAM  ACT  2602
>
> --
> This mailing list is sponsored by ACE Graphics.
> Visit  to subscribe or unsubscribe.

--- Begin Message ---



Dear Geraldine and Team
 
I always enjoy your program but was particularly 
interested in your discussion this morning about midwifery and choices in 
childbirth.  I am a mother of two boys and work as a midwife in a public 
hospital in a rural town (Mareeba District Hospital in North Queensland).  
This is such an important issue for women across the country but particularly 
for women in country towns.
Choices are already limited for women who live 
outside of the metropolitan areas.  There is a nationwide trend to shut down birthing services in small 
hospitals and make women travel to a larger centre in order to give birth in a 
hospital.  (Maryborough Hospital which has approximately 300 births/year is 
about to lose its birthing unit at the end of this month.)    
This decision is often based on the difficulty of maintaining medical model of 
care i.e there are not enough doctors trained or specialising in 
obstetrics.  All the evidence shows that this is not the best model of care 
anyway.  This "rationalisation 
of services" in rural areas threatens the existence of small country hospitals.  
Loss of acute services in a small rural hospital is a disaster because once you 
lose acute services you effectively turn it into a nursing home.  
Without the professional expertise of a functioning 
obstetric and midwifery service the rural hospital is less equipped to deal with 
the inevitable emergencies so perinatal morbidity and mortality outcomes will 
deteriorate.

Senate report into Childbirth Procedures - Rocking The 
Cradle (page 73) "...the NSW study found that deliveries continue to occur in 
hospitals without an obstetric unit and will still present unbooked and often in 
preterm labour. This often occurs in small towns with where the units have been 
closed because of low numbers of deliveries, lack of support services or 
proximity to larger hospitals. Without the professional experience of a 
functioning obstetric and midwifery service, perinatal mortality and morbidity 
figures tend to be sub-optimal.
This highlights the need to keep small rural obstetric units 
open and to staff them adequately. Rural women will continue to want care closer 
to home and have every right to expect a safe, accessible service."
With "rationalisation of services" healthy women lose the 
benefits of giving birth close to their homes and families. There is increased 
stress on the family unit if husband and other family members have to travel 50 
or 100 km either way to visit the woman. Many women have false starts. 
..spurious labour on and off for days...a 100 km trip for check up and 
reassurance will surel