Re: [ozmidwifery] hb mw byron bay?
Hi Janet, I'm local to Byron. 02 6680 2717 Sue Cookson Hi all, I have a couple of enquiries atm for Byron. Who's local? : ) TIA, J For home birth information go to: Joyous Birth Australian home birth network and forums. http://www.joyousbirth.info/ Or email: [EMAIL PROTECTED] mailto:[EMAIL PROTECTED] __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Midwives eat their young, don't they?
Hi Rachel, I am so sorry that you have had that experience which I know to be endemic in the system. With the managerial heirarchy that exists - the blame game is all that is played out, with nurturing an unknown component. WE as midwives sit at the door - of life and death - with all its amazing facets. When truly in our realm as midwives the work is enormous but very satisfying ... Unfortunately the medicalised system has separated birth into so many compartments which one by one are to be controlled, that the ability to work as true midwives is almost impossible. Perhaps your actions may lead you to a different place where you can work in your true capacity. Take care of you, you're a special person. Sue Unfortunately I can't get into the articles. I have just resigned and asked for a demotion and feel very much that the system I work in fails to nuture its midwives who are therefore less able to nurture new mothers. Rachel -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] where has this list gone?
Hi, I'm still getting only the odd email so apologies if I repeat what anyone else has said. Justine really has her finger on the pulse in terms of consumer apathy/lack of knowledge. One thing that really struck me as I was completing my midwifery degree though and doing my clinical placements, was how scared most midwives working in the hospitals are of being sued. They practice defensive midwifery/obstetrics becuase they are constantly covering their arses. The same story of course with all the doctors. And that's how we are all taught, as such. And as a student, when I dared to stand up for the women to stay off the CTG or refuse a c/section just because it was 8pm what did I get - abuse and fear thrown at me by 'senior' midwives - 'it will be on your head if that baby dies' stuff. And I'm not kidding or making this up. This is how we as students are taught - be it within a BMid degree or as a post grad nurse... and we work besdie all the fear based doctors... Of course I discussed CTG vs intermittent auscultation, etc etc and placed the documents on the desk the next morning, but if I hadn't had my 20 odd years of normal birth prior to doing my placements then I would be learning to behave and think like others who work in and for the system. I was even challenged fully for delaying cord clamping ..by a young doctor ..who of course was taught that cutting the cord stimulates the baby to breathe... and when I presented a PP presentation to other midwives in the unit about delayed cord clamping - one response? None of us cut the cord early here anyway. Duh - I nearly fell over. This is why there is so little change And don't bite my head off either - I know there are also midwives working in the system who are doing fantastic work to enact change - to policies and attitudes, to empower the women ... bu in my mind, the change will have to occur as a total change - like midwifery led units with little doctor input, where midwives are happy to truly advocate for the women and be prepared to continue to learn - like taking women past 41 weeks or even 42 weeks if all is well, taking on care of normal birth with all its facets birthing happier and healthier babies with mothers intact about their birth process and should I say it .. maybe even empowered as mothers and parents. Sue Nah, not throwing it out the window at all, I see it as having great potential and a great opportunity to learn and develop for Australia. It's great for everyone to know what you've just said Justine, as no-one really knows anything about what's going on, and all the work occurring behind the scenes. The more we know about progress, the more we can work together and understand the whys and hows and get excited. Also good for morale I think, seeing and hearing progress... but with that you also need to talk challenges, goals and improvements to be made. Perhaps you might like to speak at the conference and let us know what you have been doing, what you are hoping to do and how you are working with NZ to help our case here? I would be more than happy, I am sure everyone would love to know and also ways they can help women have more options in Australia. Lyn Allison is going to be listening - its an opportunity to be heard which we can't miss, no matter how many times we have to say it. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Conception, Pregnancy, Birth and Baby BellyBelly Birth Support -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine Caines Sent: Monday, January 08, 2007 1:47 PM To: OzMid List Subject: Re: [ozmidwifery] where has this list gone? Dear Kelly and all Some additional information may assist you before you totally throw the NZ model out the window. For those of us who have lobbied at high levels, and been involved with writing (and selling!) NMAP etc we needed to totally understand the good and the bad of NZ. Kelly your statements re intervention in NZ on a broad brush are not totally true. One of the major down falls of the stats (ie c/s) is the midwifery interaction with obstetrics (ie large metro units that have the greatest birth numbers). To prove this look at the NZ rural units stats where midwives are providing a total care package without an obstetric unit and epidural service at the door. These stats are stunning. The funding arrangement is NZ is wonderful. It gives parity to each maternity health professional undertaking the same work. It has been legislated (s88). It also places the woman at the centre to choose her carer and direct payment accordingly. The consumer focus re dispute resolution is stunning. (Are you aware of this Kelly) Compare all of this with Australia. Women are mostly treated as a piece of meat that will make them money. Last week I heard a GP/Ob respond to 6 complaints with Well I'm trying to run a business. Australian women have no real choice. Choice of a
[ozmidwifery] where has this list gone?
Hi, after being on this list for a long, long, time i just have to ask: where has this list gone to? it used to be fully midwifery - issues, questions, politics - to inform , incite, advocate - for better maternity care systems across australia - for all women. sure, i've been studying and not contributing like i used to, but there has hardly been a day where i haven't checked my ozmid email. and now - can i say - it's boring- it's tame - very little new information - my recent questions about mental health and women giving birth - so few responses - why- 10% of the population have mental health issues - how do we as midwives deal with them - who knows cos only a few have answered? and how do we as midwives create change? by 'eating' each other, by gossiping about each other or back-biting - or by sharing/respecting/acknowledging our differences? hey, to each and everyone of you 'lurking' out there, let's have some dialogue. what do you think about me attending women who are medicated for mental health issues? what do you think about homebirths for breech babies? for twins? what do you think about independent homebirth midwives working alone? where's the thinking gone? where's the dialogue? i so miss it sue cookson -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] frustrating
Hi all, My email obviously went out about the direction of the list as I have recieved a couple of personal replies but my own email and other replies to the list have not appeared for me!! So frustrating. Can someone please email me copies of the discussion so I can participate?? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] birth and mental health
Thanks Alesa. Can you share the thoughts you had about what other choices you know to be available to women on Lithium? Particluarly interested in breastfeeding ... The woman I am seeing has no issues about her ability to cope with motherhood and is very well supported - just trying to work through the options re place of birth, level of back-up, breastfeeding - if so would comp feeding or milk banking be necessary/beneficial? Thankyou, Sue HI Sue Recently worked with a woman who has been on Lithium for many years. Pregnant with her first and on advice had chosen to remain on this throughout pregnancy and also chose not to breastfeed and quite happy with this decision as she wanted to stay 'stable normal' (her words). Following birth we kept a close eye on the infant for any signs of toxicity- there were none and they went home after an uneventful hospital stay.When I last caught up with five weeks after birth, she was really pleased with her whole pregnancy/birthing/parenting (so far) experience. Especially pleased with her ability to care for her infant as she had severe doubts about this prior to birth. Reflecting on her experience I see many areas where I would have made different choices, but was once again was reminded that the journey truly is for each woman to make her own Cheers (and congratulations) Alesa Alesa Koziol Clinical Midwifery Educator Melbourne - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, January 03, 2007 6:03 PM Subject: [ozmidwifery] birth and mental health Hi, Do any of you have stories relating to the use of Lexapro and Lithium (two different women) and birth - particularly homebirths. Would appreciate any feedback re outcomes and neonatal well being. Also how the women manage their medication both pre and post birth. As usual there is a lot of info out thereand a lot of it conflicting, Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] birth and mental health
Thanks Pinky, That's great information and very insightful. I didn't know about increasing the lithium - she talked about decreasing it as it takes 6 months off lithium for her to become symptomatic. It's so hard to work through all the conflicting research and getting info from practitioners who specialise in one area only - like the psychiatrists who want to change her meds so she can breastfeed - surely we can milk bank or whatever initially to prevent baby's dehydration/ maternal sleep deprivation - the two main problems that I can see - and meantime keep her on meds that she is confident with and keep her well balanced. Any further info or stories would be very welcome, Sue Hi Sue -I have vivid memories of a mum who came off lithium so she would be able to breastfeed- went into psychosis and didnt even recognise her bub. It was years ago . According to Hale(Medications in mothers milk. 11th edition) - lithium is generally increased (dosage) during preg due to increased renal clearance . After birth, levels need to be closely monitored as mother's renal clearance drops to normal. Several cases of lithium toxicity have been reported in newborns. According to Hale, breastfeeding is not necessarily contraindicated as long as babys levels are monitored and there are no symptoms of toxcicity but other anti manic drugs such as valproate may be a better option for breastfeeding mums. Of course this depends how confident the woman is re changing meds if the lithium is effective and balanced for her. Living with a family member on lithium ( male so not giving birth) the sad thing I have observed is that as people with mental illness become unwell they lose the insight that would tell them they were becoming unwell and so tend to blame others around them to rationalise their symptoms. I would suggest the woman and her partner/ family member give you a list of 'early warning signs' of her illness before she has her bub and that she keeps in good contact with her psychiatrist throughout pregnancy and postpartum. Home birth may be much better than hospital as she will be in familiar surroundings so will be monitored by loved ones who know her well and not treated with 'kid gloves' for what may well be 'normal' postpartum mood changes. Except of course that severe mania can happen very quickly and be very scary for everyone around to contain. What would be their plan if she became unwell? Get them to write this as they woudl a birth plan. Pinky - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, January 03, 2007 6:03 PM Subject: [ozmidwifery] birth and mental health Hi, Do any of you have stories relating to the use of Lexapro and Lithium (two different women) and birth - particularly homebirths. Would appreciate any feedback re outcomes and neonatal well being. Also how the women manage their medication both pre and post birth. As usual there is a lot of info out thereand a lot of it conflicting, Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] birth and mental health
Hi, Do any of you have stories relating to the use of Lexapro and Lithium (two different women) and birth - particularly homebirths. Would appreciate any feedback re outcomes and neonatal well being. Also how the women manage their medication both pre and post birth. As usual there is a lot of info out thereand a lot of it conflicting, Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] waterbirth
TRIPLETS THIS TIME JUSTINE??? smirking, Sue Hi Lynne and all Me too please!! The Upper Hunter of NSW is one hell of a back water for birthing. Water immersion? Is that Greek? A couple of wonderful midwives still hanging on need to write a policy here too. Great to share what’s already been successful . Happy New Year to all. I have a very big dream for 2007 that I will share soon JC / /Justine Caines National President Maternity Coalition Inc PO Box 625 SCONE NSW 2329 Ph: (02) 65453612 Fax: (02)65482902 Mob: 0408 210273 E-Mail: [EMAIL PROTECTED] www.maternitycoalition.org.au __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] For Sue
Hi Amy, Not sure which Sue you are asking, but I don't know swans or swan valley centre... Maybe another Sue, Sue Cookson Hi Sue, Now I have to ask…are you the Sue at swans who I know from a few shifts we did together at the swan valley centre and recently on restorative? It is a very small world indeed and that would make me smile if it were so, after the whinge I had about my most recent birth experience to you a couple of weeks ago (if my guess is right). Amy __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] What happened with this birth?
Hi Carolyn, Gail and others, I can't agree with you enough Carolyn. Having just completed (yes!!) my BMid degree after attending homebirths for 23 years without a degree, I agree with everything that you have written - in particular the need to work with the doctors not against them, talk to your colleagues, don't just turn off or walk away. We as a society have participated in all that has been set up - the heirarchies, the 'powerful' few, the fear that has permeated and changed women's respect and understanding of birth. And it will only be through quiet, respectful but definite changes - mainly working with and truly understanding the nature of birth and the role that we as midwives can and do play, that anything at all will change. Through my clinical placements over the past two years I have seen many absolutely horrific situations in hospitals and I honestly can't remember one where it wasn't in my eyes due to the management - be it the dominance, the belittling of the woman, the panic from care providers, lots of practices that are not evidence-based and should be changed yesterday, poor practice and often simply the lack of understanding of normal labour by the care providers causing haemorrhages, depressed babies , separation, interference... And so at fifty years old I enter a new faze in my life - not totally sure where or how but it will certainly be building bridges, informing people - families and practitioners alike - of safe and effective practice, agitating for change and then more change. As a mother of four homeborn beautiful kids I feel now like a warrior/lioness ready to move into a new era and will be challenging all those shitty old practices and attitudes as I go. */ Never doubt that a small group of thoughtful, committed people can change/* */the world. Indeed, it is the only thing that ever has./*/ / /Margaret Mead (1901-1978)/ *//* Happy New Year to all of you, Sue Dear Gail, Firstly, your instincts are spot on. This is a very distressing story. It is not a coincidence that these women's labours stalled following his VE's, that is absolutely to be expected and is the result of a mindless disruption of the women's optimal state of neurophyiological functioning. Taylorism, that is an industrial, efficiency management model, has no place in the dynamic fluid process of birth, sadly it has become merged into the 'health' care system with this sort of unconscious abuse becoming more common. 'Discussions' with the doctors at that stage will do nothing except breed resistence and further intervention; in mindless individuals it can even result in payback situations where intervention will be done just because you are the midwife. The right to rule is still endemic in the maternity services. the first thing to understand is that these people really believe they are doing the right thing. the second thing to understand is that they are taught all about the abnormalities of birth, they have absolutely no idea about normal physiology as applied to birth (gross generalisation, I know) the third thing is that they are terrified of birth the fourth thing is that they are taught throughout medical school that they are the boss of everything and the government and health departments agree and structure everything (I know, there are exceptions) to reinforce that idea the fifth and probably MOST important thing is that they do get taught about 'patient' autonomy and the need for consent. So, here is where it gets interesting and where our opportunity lies. It is vitally important that you use every moment with birthing women to help them understand the situation, without making it combatative and engendering a siege mentality and ask them what they want to have happen, how they would like things to go, so they can say what they want - be left alone, checked in another hour a few more hours, more time, a bath, move freely, have the baby listened to by doppler in the shower/bath etc if women have the information that can help them with the deeply damaging throw away lines that get trotted out like 'stillbirth' 'brain damage' etc, then women can say what they want and we as midwives can support them in that and remember to DOCUMENT what women want. To do things against rational people's will is abuse. To argue about medical intervention with midwives is a nuisance and an affront to power beliefs. Getting strategic is important. Learning tactical support of birthing women is a midwifery art form and a very challenging one. It is crucial that you avoid blame, judgement and criticism as these emotional states are damaging for everyone and lead to despair. It is useful to come from the point of view that they mean well but are ignorant about birth physiology and are taught to look for problems. Neuroscience and quantum physics teaches us we find what we are looking for. That
[ozmidwifery] an 18 year old's perspective on birth
Here's a story - a true one to help us understand why birth is as it is. This is the way and 18 year old saw her first birth two days ago - her elder sister's first baby. Due 30.12.06 Booked into a small hospital, shared care with midwives and GP. Planned normal birth. Good pregnancy; no problems. Early labour; membranes ruptured or leaked - slight old mec stained liquor (grade 1) - TRANSFER to tertiary hospital. So no longer 'normal' in family's eyes. 3pm. Birthing now with strangers. Hassle over number of support people - 2 sisters, mother and partner - different policy at this hospital. CTG applied - no ctxs registering, therefore she wasn't in labour (machine was faulty). Graduate midwife on - first day, nice, sweet, introduced herself. Senior midwife 'crabby' - didn't introduce herself, constantly made negative comments about 'young staff', undermining. 8pm Request for pain relief (plan was for none, maybe to use water - small hospital allows water births/immersion, not this one) - pv finds cervix at 3cm. Staff change. Really crabby midwife now on duty - sweet one leaves. Morphine given about 8.30-8.45 pm Team still hassled about numbers - taking it in turns to support. (This hospital has the smallest waiting area and the family waiting for this baby alone numbered 10 - includes the immediate support - only 3 chairs in waiting room ... hospital with 800 odd births per year). Very quick labour once well established to birth at 10.30pm . Baby OK for about 10 minutes, then went into respiratory depression, required resuscitation, narcan, to SCN for night. Some panic and everyone asked to leave ... !8 year old's perspective; The birth was sort of OK - big sister smiled a lot BUT birth is so scary - terrified of baby needing more help. I'd be too scared to come home. The good bit - that the partner helped to lift baby out. The staff - apart from the new graduate, they'd all forgotten that it was my sister's special day - they were pretty awful and tired and grumpy. Noone explained that morphine might have that effect on the baby. Hospital space was shocking - small, cramped, unwelcoming. She was yelled at for using the wrong corridor by another grumpy person (she didn't know there was another one to use - and she's not stupid!!). and so it went on. This is what is wrong with birth today. Crabby, grumpy, panicky, unwelcoming, scary, lack of information... Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] What happened with this birth?
Thanks Andrea. It is a funny one - I'm still giggling a bit myself!! Sue Congratulations Sue on hanging in there and having just completed my BMid degree'. I'd say welcome to the sisterhood but it feels like I'd be doing it 23 years too late. Andrea Q On 30/12/2006, at 2:14 PM, Sue Cookson wrote: Hi Carolyn, Gail and others, I can't agree with you enough Carolyn. Having just completed (yes!!) my BMid degree after attending homebirths for 23 years without a degree, I agree with everything that you have written - in particular the need to work with the doctors not against them, talk to your colleagues, don't just turn off or walk away. We as a society have participated in all that has been set up - the heirarchies, the 'powerful' few, the fear that has permeated and changed women's respect and understanding of birth. And it will only be through quiet, respectful but definite changes - mainly working with and truly understanding the nature of birth and the role that we as midwives can and do play, that anything at all will change. Through my clinical placements over the past two years I have seen many absolutely horrific situations in hospitals and I honestly can't remember one where it wasn't in my eyes due to the management - be it the dominance, the belittling of the woman, the panic from care providers, lots of practices that are not evidence-based and should be changed yesterday, poor practice and often simply the lack of understanding of normal labour by the care providers causing haemorrhages, depressed babies , separation, interference... And so at fifty years old I enter a new faze in my life - not totally sure where or how but it will certainly be building bridges, informing people - families and practitioners alike - of safe and effective practice, agitating for change and then more change. As a mother of four homeborn beautiful kids I feel now like a warrior/lioness ready to move into a new era and will be challenging all those shitty old practices and attitudes as I go. */ Never doubt that a small group of thoughtful, committed people can change/* */the world. Indeed, it is the only thing that ever has./*/ / /Margaret Mead (1901-1978)/ *//* Happy New Year to all of you, Sue Dear Gail, Firstly, your instincts are spot on. This is a very distressing story. It is not a coincidence that these women's labours stalled following his VE's, that is absolutely to be expected and is the result of a mindless disruption of the women's optimal state of neurophyiological functioning. Taylorism, that is an industrial, efficiency management model, has no place in the dynamic fluid process of birth, sadly it has become merged into the 'health' care system with this sort of unconscious abuse becoming more common. 'Discussions' with the doctors at that stage will do nothing except breed resistence and further intervention; in mindless individuals it can even result in payback situations where intervention will be done just because you are the midwife. The right to rule is still endemic in the maternity services. the first thing to understand is that these people really believe they are doing the right thing. the second thing to understand is that they are taught all about the abnormalities of birth, they have absolutely no idea about normal physiology as applied to birth (gross generalisation, I know) the third thing is that they are terrified of birth the fourth thing is that they are taught throughout medical school that they are the boss of everything and the government and health departments agree and structure everything (I know, there are exceptions) to reinforce that idea the fifth and probably MOST important thing is that they do get taught about 'patient' autonomy and the need for consent. So, here is where it gets interesting and where our opportunity lies. It is vitally important that you use every moment with birthing women to help them understand the situation, without making it combatative and engendering a siege mentality and ask them what they want to have happen, how they would like things to go, so they can say what they want - be left alone, checked in another hour a few more hours, more time, a bath, move freely, have the baby listened to by doppler in the shower/bath etc if women have the information that can help them with the deeply damaging throw away lines that get trotted out like 'stillbirth' 'brain damage' etc, then women can say what they want and we as midwives can support them in that and remember to DOCUMENT what women want. To do things against rational people's will is abuse. To argue about medical intervention with midwives is a nuisance and an affront to power beliefs. Getting strategic is important. Learning tactical support of birthing women is a midwifery art form and a very challenging one. It is crucial that you avoid blame, judgement
Re: [ozmidwifery] waterbirth
Hi Mary, In northern NSW/southern Qld two centres offer waterbirths: Mullumbimby Hospital which is a small unit for low risk women, about 130 births/annum John Flynn Private Hospital in Cooloangatta Qld offer water births, don't know numbers also just read that Coffs Harbour Health Campus do waterbirths, 850 births/annum Sue Hi everyone, I know this question has been asked before, but I can’t remember the answer. Do we have any maternity units, birth centres etc who officially do waterbirth? I know homebirthers do, but I want to know about institutions. Thanks, MM __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] paed burn cream
Hi, Don't know about that one, but Martin Pleasance, the homeopathic company make a great burn cream available at most health food outlets. Not expensive and very effective for all types of burns. Sue I started nursing in late 80s and Silvazine was being used then. I can remember it being used for burns on adults and children, but other than that I don’t know anything else. Midwifery took over in the mid 90s and I haven’t given Silvazine another thought. Cath -Original Message- *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *Kristin Beckedahl *Sent:* Friday, December 08, 2006 6:59 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* RE: [ozmidwifery] paed burn cream Thanks Cath...My Mum remembers it from her nursing days 15-20years ago - was this around then? And doy ou know much about it? Kristin From: /A C Palmer [EMAIL PROTECTED]/ Reply-To: /ozmidwifery@acegraphics.com.au/ To: /ozmidwifery@acegraphics.com.au/ Subject: /RE: [ozmidwifery] paed burn cream/ Date: /Fri, 8 Dec 2006 18:56:05 +1000/ Is it Silvazine? Cath Palmer -Original Message- *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *Kristin Beckedahl *Sent:* Friday, December 08, 2006 4:37 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] paed burn cream I'm trying to find out the name of the burn cream used in paed (and maybe others) wards for childrens burns - apparently been around for years and really helps to rapidly heal the wounds?? Any idea? Thanks, Kristin Advertisement: Fresh jobs daily. Stop waiting for the newspaper. Search Now! www.seek.com.au http://g.msn.com/8HMBENAU/2752??PS=47575 -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. Join the millions of Australians using Live Search. Try live.com.au http://g.msn.com/8HMAENAU/2731??PS=47575 __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] independent midwifery/national standards
I was just wondering if there had been any responses to the discussion of national standards etc?? I haven't received anything at all, Sue An interesting discussion. Brings me to the assignment I've just completed on the variation in education, regulation and registration of midwives and competency assessments that occur across our wide brown land. And these will be the things that bring us to be either supportive or not of hospital birthing. South Australia maternity system is definitely much better organised and funded than the New South Wales one. Can't speak for any other. I've done clinical placements in both states and working in environments with new equipment, standard spa baths, and midwives who collectively practice evidence-based midwifery with supportive services is delightful compared with the other - outdated equipment, tired midwives and outdated policies and protocols. I've also attended many years of homebirth and as Tania says, there is simply no comparison in experience or outcome when working with families you know and trust. I am still and alwys will be in awe of what midwives can do when working with women they don't know. I always believe however that even when entering an institution that may be outdated and tired with the odds of normal birth against us, that my presence can always make a difference to a woman who has invited me to assist her. So I also offer hospital 'supports' because I believe and do make a difference. The NSW area where I live and work has limited midwife antenatal clinics even, and midwifery group practices just don't exist. Birth practices are disjointed and outdated but they are changing and the last five births I attended in the capacity of a final year student were simply great within the limited scope of practice that exists in this neck of the woods. I guess we can all try and see the good that each area/service/midwife can bring to the women we all serve and help to create change where needed. Perhaps standardisation of education, registration and competency assessments through nationalising maternity service (like in NZ and other OECD countries) would be for the best for women and midwives - may create a more predictable, evidence based active group of committed midwives. ??? Sue Absolutely agree Jo that it is the women who are perhaps at higher risk that would most benefit from the continuity of care from a known midwife, the outcomes at the Women's and Children's in Adelaide have clearly shown that the women who are in high risk groups going through the MGP are having better outcomes, less intervention and more normal births, than the low risk women going through the medical model of care. Definitely food for thought...goes to show that the research is indeed right. I feel that it's the right place here to put in my 2c worth too, about IPM's and homebirth. Please remember that IPM's, while at times appearing to be superhuman - and I say that from my experience as a consumer of IPM care, they are also human. Building up a rapport with a woman over the space of a shift is indeed an art, and something I am amazed that my colleagues can do, day in day out. Really knowing a woman, having a relationship with her and her whole family that spans months, and sometimes years, having an emotional investment in helping her to achieve the best birth possible, is something that simply can't be compared with working on a shift by shift basis. If you have never stood by, and watched a woman be lied to, or coerced with untruths, or half truths, if you have never been treated appallingly by those who are your equals, but feel you are beneath them, if you have never seen the look of defeat in a woman's face as all the positive energy leaves the room and someone calls her stupid and naïve for trying to have her baby without intervention, then you have no idea about the pain that is felt, and the helplessness, and even the feeling of betrayal you feel because you can no longer protect or hold the space, for that woman. I have been in these situations, and I can really understand why some midwives prefer not to provide care to women choosing to birth in the hospital system. There is an element of self preservation about it too, let's not forget that. Sometimes, it's just too painful to go willingly and knowingly into a situation that you know is not going to go the way the woman wants. Transferring in for an obstetric need is of course, something completely different... And that's not to say that the care you provide Sharon, in the hospital in which you work, is not the best you can do, with the circumstances you have. What we all know is that it is not the best thing for all women, and according to the research, it's actually not the best thing for most women...just because it's all that's on offer doesn't mean we shouldn’t be looking to improve it, and one midwife one woman care is just the
[ozmidwifery] independent midwifery/national standards
An interesting discussion. Brings me to the assignment I've just completed on the variation in education, regulation and registration of midwives and competency assessments that occur across our wide brown land. And these will be the things that bring us to be either supportive or not of hospital birthing. South Australia maternity system is definitely much better organised and funded than the New South Wales one. Can't speak for any other. I've done clinical placements in both states and working in environments with new equipment, standard spa baths, and midwives who collectively practice evidence-based midwifery with supportive services is delightful compared with the other - outdated equipment, tired midwives and outdated policies and protocols. I've also attended many years of homebirth and as Tania says, there is simply no comparison in experience or outcome when working with families you know and trust. I am still and alwys will be in awe of what midwives can do when working with women they don't know. I always believe however that even when entering an institution that may be outdated and tired with the odds of normal birth against us, that my presence can always make a difference to a woman who has invited me to assist her. So I also offer hospital 'supports' because I believe and do make a difference. The NSW area where I live and work has limited midwife antenatal clinics even, and midwifery group practices just don't exist. Birth practices are disjointed and outdated but they are changing and the last five births I attended in the capacity of a final year student were simply great within the limited scope of practice that exists in this neck of the woods. I guess we can all try and see the good that each area/service/midwife can bring to the women we all serve and help to create change where needed. Perhaps standardisation of education, registration and competency assessments through nationalising maternity service (like in NZ and other OECD countries) would be for the best for women and midwives - may create a more predictable, evidence based active group of committed midwives. ??? Sue Absolutely agree Jo that it is the women who are perhaps at higher risk that would most benefit from the continuity of care from a known midwife, the outcomes at the Women's and Children's in Adelaide have clearly shown that the women who are in high risk groups going through the MGP are having better outcomes, less intervention and more normal births, than the low risk women going through the medical model of care. Definitely food for thought...goes to show that the research is indeed right. I feel that it's the right place here to put in my 2c worth too, about IPM's and homebirth. Please remember that IPM's, while at times appearing to be superhuman - and I say that from my experience as a consumer of IPM care, they are also human. Building up a rapport with a woman over the space of a shift is indeed an art, and something I am amazed that my colleagues can do, day in day out. Really knowing a woman, having a relationship with her and her whole family that spans months, and sometimes years, having an emotional investment in helping her to achieve the best birth possible, is something that simply can't be compared with working on a shift by shift basis. If you have never stood by, and watched a woman be lied to, or coerced with untruths, or half truths, if you have never been treated appallingly by those who are your equals, but feel you are beneath them, if you have never seen the look of defeat in a woman's face as all the positive energy leaves the room and someone calls her stupid and naïve for trying to have her baby without intervention, then you have no idea about the pain that is felt, and the helplessness, and even the feeling of betrayal you feel because you can no longer protect or hold the space, for that woman. I have been in these situations, and I can really understand why some midwives prefer not to provide care to women choosing to birth in the hospital system. There is an element of self preservation about it too, let's not forget that. Sometimes, it's just too painful to go willingly and knowingly into a situation that you know is not going to go the way the woman wants. Transferring in for an obstetric need is of course, something completely different... And that's not to say that the care you provide Sharon, in the hospital in which you work, is not the best you can do, with the circumstances you have. What we all know is that it is not the best thing for all women, and according to the research, it's actually not the best thing for most women...just because it's all that's on offer doesn't mean we shouldn’t be looking to improve it, and one midwife one woman care is just the beginning... Tania -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] independent midwifery
Hi Rachael, I'd say the same as Robyn. I can provide whatever she needs and assuming that I am familiar with the local hospital's protocols etc I can provide the woman and the hospital with appropriate documents Sue northern rivers nsw -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Intradermal sacral sterile water injections
Hi Carolyn, I presented the intradermal protocol and GBS protocol to the CNC at Lismore the other day. She asked me if you could provide evidence to support the intradermal injections, but was interested in the concept. Anything would be great - I haven't done looking myself as I'm just completing my degree. Did my last official birth last night - now for the portfolio and remaining assignments. Thanks, Sue Hello Andrea, thanks for your kind words. As for the sacral water injections, we have only used them for late first stage and second stage. So repeats haven't been an issue for us. Yes, it does sting, but all the women, bar one, found the injections wonderful. One of the women I saw for her three week postnatal visit and she voluntarily told me all about the injections with great wonder. I didn't know she had them, and when I asked her all about her experience with our service and the birth of her baby etc, she waxed lyrical about the change in sensation with the injections. Very interesting. And yes, because it stings so much, two midwives give the injection at the same time, the women would not let you do it again immediately after, they swat your hands away - or try to. :-) I appreciate the logic with giving them both at the same time. The midwives at JHH have been using them in the birth centre as well. They reckon the injections are great too. I haven't heard any feedback about the refusal for long labours, I'll check that out and get back to you. I'll send you the protocol from work, it's on my work computer, warmly, Carolyn - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 23, 2006 7:06 AM Subject: Re: [ozmidwifery] Intradermal sacral sterile water injections Hi Carolyn, It is so good to hear that Belmont is doing well - what a great standard bearer for midwifery and women! Can I ask you something about the sterile water injections? When I was in the Colac area earlier this year doing a workshop, I was told that although this method was brilliant at relieving the pain, especially with posterior labours, women were often reluctant to have the injections a second time, when the effects of the first round had worn off (it was suggested the effect would last for 2 -3 hours). I found this interesting, and speculated that the pain of the injections must have been bad, for women to think that a short lived sting would be worse than long painful contractions that often come with an OP labour. What has been your experience with doing follow up injections, especially during a long labour? I was also told that it was a good idea to have two midwives do the injections simultaneously - that way the pain was shorter (but presumably more intense with two injections being done at the same time). Can you shed any light on this aspect as well? Many thanks, Andrea PS I would love a copy of your protocol as well, if you email it me. At 02:00 AM 18/11/2006, you wrote: Whilst I'm on the soapbox, I was thinking that you may be interested in the intradermal water injections and their efficacy. We had Janice Deocampo come to Belmont and give a seminar on the use of this technique for women with excruciating back pain. Midwives came from Gosford, Maitland, John Hunter and Taree. Janice presented her information and we all practised on each other (OUCH). It feels like a wasp sting. One of the midwives had back pain which was cured for six hours with the injection she received that day! It took us MONTHS to get the procedure through clinical governance. However, it is through. We have used the injections for about eight women since only one was not completely successful. We have even found them fantastic for late first stage when the backache has stopped the woman from progessing and even second stage when women wouldn't push because the backache was too bad. After the injections, voila - baby! John Hunter midwives are also now using this technique too with great success. Janice Deo Campo did a research project and the results are in the Birth Issues Journal from CAPERS. It is a wonderful, effective tool which may just help someone avoid an epidural or even make birth much more manageable for those women with excrutiating backache. If anyone wants the protocol and information sheet, please email me at work mailto:[EMAIL PROTECTED][EMAIL PROTECTED] and I will send it to you. warmly, Carolyn Heartlogic http://www.heartlogic.bizwww.heartlogic.biz Phone: +61 2 43893919 PO Box 5405 Chittaway Bay, NSW 2261 As a single footstep will not make a path in the earth, so a single thought will not make a pathway in the mind. To make a deep physical path, we walk again and again. To make a deep mental path, we must think over and over again the kind of thoughts we wish to dominate our lives Henry David Thoreau -- This mailing list is sponsored
Re: [ozmidwifery] Intradermal sacral sterile water injections
Thanks Pauline, it would be great to receive the research on intradermal water injections, Sue Here in Colac we have a copy of the research, and findings, that was done to support the sterile h2o injections, if that would be of any help. Pauline - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, November 24, 2006 8:51 AM Subject: Re: [ozmidwifery] Intradermal sacral sterile water injections Hi Carolyn, I presented the intradermal protocol and GBS protocol to the CNC at Lismore the other day. She asked me if you could provide evidence to support the intradermal injections, but was interested in the concept. Anything would be great - I haven't done looking myself as I'm just completing my degree. Did my last official birth last night - now for the portfolio and remaining assignments. Thanks, Sue Hello Andrea, thanks for your kind words. As for the sacral water injections, we have only used them for late first stage and second stage. So repeats haven't been an issue for us. Yes, it does sting, but all the women, bar one, found the injections wonderful. One of the women I saw for her three week postnatal visit and she voluntarily told me all about the injections with great wonder. I didn't know she had them, and when I asked her all about her experience with our service and the birth of her baby etc, she waxed lyrical about the change in sensation with the injections. Very interesting. And yes, because it stings so much, two midwives give the injection at the same time, the women would not let you do it again immediately after, they swat your hands away - or try to. :-) I appreciate the logic with giving them both at the same time. The midwives at JHH have been using them in the birth centre as well. They reckon the injections are great too. I haven't heard any feedback about the refusal for long labours, I'll check that out and get back to you. I'll send you the protocol from work, it's on my work computer, warmly, Carolyn - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 23, 2006 7:06 AM Subject: Re: [ozmidwifery] Intradermal sacral sterile water injections Hi Carolyn, It is so good to hear that Belmont is doing well - what a great standard bearer for midwifery and women! Can I ask you something about the sterile water injections? When I was in the Colac area earlier this year doing a workshop, I was told that although this method was brilliant at relieving the pain, especially with posterior labours, women were often reluctant to have the injections a second time, when the effects of the first round had worn off (it was suggested the effect would last for 2 -3 hours). I found this interesting, and speculated that the pain of the injections must have been bad, for women to think that a short lived sting would be worse than long painful contractions that often come with an OP labour. What has been your experience with doing follow up injections, especially during a long labour? I was also told that it was a good idea to have two midwives do the injections simultaneously - that way the pain was shorter (but presumably more intense with two injections being done at the same time). Can you shed any light on this aspect as well? Many thanks, Andrea PS I would love a copy of your protocol as well, if you email it me. At 02:00 AM 18/11/2006, you wrote: Whilst I'm on the soapbox, I was thinking that you may be interested in the intradermal water injections and their efficacy. We had Janice Deocampo come to Belmont and give a seminar on the use of this technique for women with excruciating back pain. Midwives came from Gosford, Maitland, John Hunter and Taree. Janice presented her information and we all practised on each other (OUCH). It feels like a wasp sting. One of the midwives had back pain which was cured for six hours with the injection she received that day! It took us MONTHS to get the procedure through clinical governance. However, it is through. We have used the injections for about eight women since only one was not completely successful. We have even found them fantastic for late first stage when the backache has stopped the woman from progessing and even second stage when women wouldn't push because the backache was too bad. After the injections, voila - baby! John Hunter midwives are also now using this technique too with great success. Janice Deo Campo did a research project and the results are in the Birth Issues Journal from CAPERS. It is a wonderful, effective tool which may just help someone avoid an epidural or even make birth much more manageable for those women with excrutiating backache. If anyone wants the protocol and information sheet, please email me at work mailto:[EMAIL PROTECTED][EMAIL PROTECTED] and I will send it to you. warmly
Re: [ozmidwifery] Alternative GBS
Propolis tincture taken orally is supposed to be effective against GBS - again, little research in the alternate area perhaps because of the mega$$ pharmaceutical and diagnostic industries around childbirth. And the research really shows that although IV antibiotics decreases the number of babies with GBS, it also increases the number of babies with other blood borne infections that can also be dangerous (the ABs killoff the GBS but allow other bugs to gain resistance). And the babies whose mothers were given IV antibiotics in labour have an increased resistance to that antibiotic - obviosly more of an issue for premmie and sick babies... An interesting article by Christa Novelli 2003 which discusses the risk of the mother taking antibiotics as well: www.mothering.com/articles/pregnancy_birth/birth_preparation/group-b.html How great is the risk from antibiotics? The recommended antibiotic for treating GBS during labor is penicillin. Fewer bacteria currently show a resistance to penicillin than to other antibiotics used to treat GBS. The options are fewer for women known to be allergic to penicillin. Up to 29 percent of GBS strains have been shown to be resistant to non-penicillin antibiotics.46 For women not known to be allergic to penicillin, there is a one in ten risk of a mild allergic reaction to penicillin, such as a rash. Even for those women who have no prior experience of a penicillin allergy, there is a one in 10,000 chance of developing anaphylaxis, a life-threatening allergic reaction. We can compare this to CDC estimates that 0.5 percent of babies born to GBS-positive mothers with no treatment will develop a GBS infection, and that 6 percent of those who develop a GBS infection will die. Six percent of 0.5 percent means that three out of every 10,000 babies born to GBS-positive mothers given no antibiotics during labor will die from GBS infection. If the mother develops anaphylaxis during labor (one in 10,000 will), and it is untreated, it is likely that the infant, too, will die. So, by CDC estimates, we save the lives of two in 10,000 babies-0.02 percent-by administering antibiotics during labor to one third of all laboring women. We should also keep in mind that this figure does not take into account the infants that will die as a result of bacteria made antibiotic-resistant by the use of antibiotics during labor-infants who would not otherwise have become ill. When you take that into account, there may not be any lives saved by using antibiotics during labor. Nothing we do or take in life can be an absolute - and some of this stuff takes lots of sorting out. Where I have been doing my clinical placements, if a mother had GBS in her previous pregnancy (but not necessarily this one) she is still treated with IV antibiotics. Yet the research clearly states that a previous baby with GBS disease is an indicator for GBS treatment in subsequent pregnancies, not merely being GBS positive in the previous pregnancy. So midwives, women and the medical profession seem to be all over the place with different interpretations of research and policy directives. It must come down to individual's perception of risks and safety - and that there can be no assurances that treatment or non-treatment will work. As Novelli states, women with negative GBS cultures still have a 1:2000 risk of her newborn developing GBS disease. I guess all we can do is give the information and trust that the decision made by the parents will be one that they are happy with ... Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Alternative GBS
Hi, Some more on the GBS line. Propolis tincture taken orally is supposed to be effective against GBS - again, little research in the alternate area perhaps because of the mega$$ pharmaceutical and diagnostic industries around childbirth. And the research really shows that although IV antibiotics decreases the number of babies with GBS, it also increases the number of babies with other blood borne infections that can also be dangerous (the ABs killoff the GBS but allow other bugs to gain resistance). And the babies whose mothers were given IV antibiotics in labour have an increased resistance to that antibiotic - obviosly more of an issue for premmie and sick babies... An interesting article by Christa Novelli 2003 which discusses the risk of the mother taking antibiotics as well: www.mothering.com/articles/pregnancy_birth/birth_preparation/group-b.html How great is the risk from antibiotics? The recommended antibiotic for treating GBS during labor is penicillin. Fewer bacteria currently show a resistance to penicillin than to other antibiotics used to treat GBS. The options are fewer for women known to be allergic to penicillin. Up to 29 percent of GBS strains have been shown to be resistant to non-penicillin antibiotics.46 For women not known to be allergic to penicillin, there is a one in ten risk of a mild allergic reaction to penicillin, such as a rash. Even for those women who have no prior experience of a penicillin allergy, there is a one in 10,000 chance of developing anaphylaxis, a life-threatening allergic reaction. We can compare this to CDC estimates that 0.5 percent of babies born to GBS-positive mothers with no treatment will develop a GBS infection, and that 6 percent of those who develop a GBS infection will die. Six percent of 0.5 percent means that three out of every 10,000 babies born to GBS-positive mothers given no antibiotics during labor will die from GBS infection. If the mother develops anaphylaxis during labor (one in 10,000 will), and it is untreated, it is likely that the infant, too, will die. So, by CDC estimates, we save the lives of two in 10,000 babies-0.02 percent-by administering antibiotics during labor to one third of all laboring women. We should also keep in mind that this figure does not take into account the infants that will die as a result of bacteria made antibiotic-resistant by the use of antibiotics during labor-infants who would not otherwise have become ill. When you take that into account, there may not be any lives saved by using antibiotics during labor. Nothing we do or take in life can be an absolute - and some of this stuff takes lots of sorting out. Where I have been doing my clinical placements, if a mother had GBS in her previous pregnancy (but not necessarily this one) she is still treated with IV antibiotics. Yet the research clearly states that a previous baby with GBS disease is an indicator for GBS treatment in subsequent pregnancies, not merely being GBS positive in the previous pregnancy. So midwives, women and the medical profession seem to be all over the place with different interpretations of research and policy directives. It must come down to individual's perception of risks and safety - and that there can be no assurances that treatment or non-treatment will work. As Novelli states, women with negative GBS cultures still have a 1:2000 risk of her newborn developing GBS disease. I guess all we can do is give the information and trust that the decision made by the parents will be one that they are happy with ... Sue
Re: [ozmidwifery] Delaying synto with active 3rd stage
Hi Andrea, I am not aware of the practice you have mentioned in America. Have you any references for this? Any idea what occurs if the placenta takes longer to arrive than the 20 minutes or so?? Sue Hello Sue, The question of third stage management has a cultural aspect as well. In the US, as far as I know, the syntometrine is not given until after the placenta arrives. It is then given to prevent excessive bleeding. Interesting to speculate on how this major difference developed, and why it is acceptable to wait the 20 or so minutes for the placenta to come physiologically in the US when it is unacceptable in the UK/Australia. Another one of those examples of how habit/routine becomes standard practice and is not questioned. Regards, Andrea At 11:00 AM 14/11/2006, you wrote: Hi, I'm interested if there is any research on delaying synto for say up to 5 minutes in 'active 3rd stage'. Have been doing actively managed third stage throughout my clinical placements as a student (nearly finished!!) with some practitioners cutting the cord immediately, and most at about 10 - 20 seconds. I've just prepared a powerpoint presentation on delayed cord clamping but know I will get into a discussion around the seeming conflict between active 3rd stage and delaying the clamping. Obviously if you don't want the effects of synto's action - strong uterine contraction with excess blood being pumped into bub, then you need to delay the entire process of actively managed 3rd stage until the cord is clamped. Does anyone practice delaying the synto injection for those first few minutes? Any evidence of harm in doing this? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Delaying synto with active 3rd stage
Hi, I'm interested if there is any research on delaying synto for say up to 5 minutes in 'active 3rd stage'. Have been doing actively managed third stage throughout my clinical placements as a student (nearly finished!!) with some practitioners cutting the cord immediately, and most at about 10 - 20 seconds. I've just prepared a powerpoint presentation on delayed cord clamping but know I will get into a discussion around the seeming conflict between active 3rd stage and delaying the clamping. Obviously if you don't want the effects of synto's action - strong uterine contraction with excess blood being pumped into bub, then you need to delay the entire process of actively managed 3rd stage until the cord is clamped. Does anyone practice delaying the synto injection for those first few minutes? Any evidence of harm in doing this? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] lotus placenta
Hi Mary, There is always plenty of blood in placental veins - even a fair while after the birth. I remember one time I was collecting blood for a homeopathic preparation and got to it about an hour after the birth - still easy to get the blood. Always makes me aware of blood exchanges occurring bt baby and delivered placentas whilst cord still intact. So I just wipe the cord over a good vein and insert needle - can take it from a few veins if necessary. Sometimes it leaks a bit from the vein afterwards - I don't jump in to it - probably 20 mins or so after placenta is delivered. Sue Hello wise women, I need advice about a lotus birth, (not new to me) who is also Rh neg. I need to get enough blood for group and coombes. In your experience, is there sufficient blood in the placental vessels after a physiological 3^rd stge ? What is the best way to hndle this? I have had lots of Lotus Placentae but not with RH neg. women. Thanks, MM __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Inductions for post term
Hi renee, I've attended many homebirths and am currently a student also. I am finding the same within the hospital where I do my clinicals - women induced at 40+10 days give or take the weekend!! As a birth practitioner, I am happy to take women to 43 weeks if they are healthy normal women with well growing babies, good liquor volume and extra surveillance - two visits/week post 42 weeks. This is actually supported in some of the research (Enkin) which basically talks about increased problems with postdates with IUGR babies. The other aspect of postdates is that there is more mec stained liquor - research suggests up to 25% past 41/42 weeks will have mec staining. If this is a big problem for you or the hospital you work in, then it's all about (as always) risks and benefits. From personal observation, women do far better with normal labours, not induced by artificial means, and I include complementary therapies in that. Dctor John Stevenson, the homebirth doctor from Melbourne in the 80's, had over 10% of his practice go over 42 weeks, with no fetal losses. (1146 homebirths in the data I have). The other argument is about the original classification of dates or term at 40 weeks - research shows that to be inaccurate and that for primips it is more like 40 +6-8 days anyway, and multis at 40+3 days. Something like that anyway - this is all off the top of my head tonight. It is really difficult to address this issue - as you say, women don't think they have a choice, but the better informed we are, the more informed and supported the women can be... Still births don't increase by 100% - not by 43 weeks anyway, but there is supposedly an incremental increase. Giving continuity of care will put you in touch with how the woman is travelling - re baby's growth and movements and her psychological state - who knows what initiates labour - thankfully that still remains a mystery, but what we do know is that everything has to line up - baby's needs, mother's needs, and social, emotional states. Women with big issues hapening will usually wait. I've always trusted that if a baby really needs to be born it will be. Hope all this helps, Sue Hi all, I'm trying to get some information, opinions re: inductions for post term pregnancies. As a student I'm finding the majority of my birth experiences are with women getting induced which I find a little disheartening. Instinctively I'm of the opinion that all being well then leave alone and I'm excluding any complications or increased risk factors here, but the more I dig around for arguments the more it appears that inductions after 42 weeks is best practice. I have read somewhere that true post term pregnancies accounts for about 2%. You would think its more like 25%, but anyway... At the hospital I'm doing clinical at, women are preemptively booked in for induction and are 'told' at an antenatal visit that if they haven't had there baby by a certain date then they will be going in for an induction. There isn't an option. Do any of IM have women that get induced? I have read the research on cochrane and the NICE guidelines, and stats that say still births increase by 100%, and Im aware of the complexities around accurate dates etc, but it all just feels counter intuitive to me, but learning to base practice on evidence means often having to re-asses my own beliefs about these things, and not having the experience, I cant really form a judgment. Any help opinions on the matter would be most welcome. The rocky road to learning hey! This might have been a discussion in previous postings, if so and anyone remembers it could you let me know approx time. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Trial of Scar
I recall a woman in Canberra about 6 years ago who had her 8th baby at home after 7 c/sections. Take heart, Sue My sister had a lscs for pih / failed induction (don't ask) and then went on to have a failed attempt at a VBAC (same Dr) he noted a thin lower segment. I agree with the natural state theory and discussed this thought with my sister, as the dr advised her not to have any more children suggesting that she was at risk of uterine rupture. She has since moved to Brisbane, had another lscs, and the OB never mentioned anything unusual with her uterus. She is now trying to fall pregnant with her 4th. megan
[ozmidwifery] Compulsory vaccinations for health workers
Hi, This is a copy of an email sent by Meryl Dorey of the Australian Vaccination Network. Obviously relevant to all midwives and students. Very scary stuff... Sue Action needed urgently! We currently have two issues which will need your action both of them important both of them more than timely. The first one has been touched on in the last issue of Doing the Rounds. It is the fact that every single state and territory in Australia has instituted policies which require students studying in the health professions to be doctors, nurses, physiotherapists, etc, to be fully vaccinated before commencing or completing their practical work. Without these vaccines (and the list of required shots is extremely long with some of these poor souls receiving 8 vaccines at one time!), they will have to cease their education and or lose out on placings in hospital. In NSW, this new regulation is called Policy Directive 2005_338 and it states that, Compliance with this policy directive is mandatory. It basically says that starting this year, in 2006, all health students who are affiliated with the hospital system or with NSW Health, will be required to be vaccinated against Diphtheria, Tetanus, Whooping Cough (Pertussis), Hep A and Hep B, Chicken Pox (Varicella), Measles, Mumps and Rubella and Influenza. Starting next year, this requirement will be extended to include everyone doctors, nurses, orderlies, office staff even those who work for laundries that are contracted by the hospital! This is supposedly for the protection of patients though, if the various health departments across the country were truly concerned with patients health, they would require any staff member receiving a live virus vaccine (eg MMR (measles mumps and rubella), OPV (oral polio), Varicella (chicken pox) and Hep A to stay home for 90 days because they are carrying these viruses around and communicating them to those they are in contact with for up to that long a period of time. There are two ways to get out of this requirement. One is to have a valid medical exemption either because you have had a serious reaction (eg anaphylactic shock) after a dose of a certain vaccine in which case you will only be exempted from that particular vaccine) or to have a blood test showing you have high levels of antibodies to any of the diseases listed above. We have been contacted by several people who have had these vaccines with serious ill effects including being diagnosed with cancer shortly afterwards. We have also been in contact with people who have lost their placement due to their refusal to be vaccinated. This is a situation which we must not stand for! No matter your opinion on vaccination, every thinking person must agree that all medical procedures carry with them certain risks and it is unethical (and illegal under our current constitution) to require anyone to submit to medical procedure against their will. Today it is the health professionals of Australia tomorrow, it will be our children and ourselves if we allow this to happen. Where do you come in? There are three things we need here. 1 We need lawyers who are willing to take cases against the health departments of every state. We currently have a barrister in NSW who is investigating the best way to approach this issue. Read more about this in point 3 below. He will definitely need lawyers to assist him as this could end up being a huge and precedent-setting case so if you are a lawyer or know of one who is on side and does some public-advocacy work, please get in contact with me. 2- Are you a health professional? Are you a health student? Do you know someone who is? Chances are you do and chances are that either you (as the health professional or student) or they are unaware of these new rules. Please spread the word. Make copies of this part of the newslettersand distribute it to hospitals in your area or forward it by email to friends, family and other interested parties and ask them to do the same. Send to doctors surgeries and to schools that have a medical faculty. Make everyone aware of what is being done I dont believe that even the most pro-vaccination medico will be happy about being forced to be vaccinated or about vaccinating anyone without their express consent. We will also need financial support to keep this initiative going. If you know of people who should be members give them one of the attached membership forms and ask them to join the AVN and subscribe to Informed Voice. Tell them why it is so important. Also, please consider giving us a donation of $26 if every member donates this amount, a pittance when you think of it in the grand scheme of things we will be able to achieve our goals as stated in past issues of Doing the Rounds. 3- We need lobbyists in each state and territory. Currently, it looks like the only way in which we can fight this issue is by first going through the Anti-Discrimination Tribunals which may sound like a good thing buthere
[ozmidwifery] PPH levels soar
Hi, This article appeared in last week's Sydney Morning Herald. I think it's amazing and it appears that some of the information is incorrect in that the article states that NSW Health implemented active thrid stage and early cord clamping in 2002. Surely syntometrine and syntocinon have been used for many more years than just the last four, in which case this study is a real eye-opener if you believe we are stopping women from bleeding by using drugs in third stage. What do you think? Sue Transfusions soar for women giving birth Julie Robotham Medical Editor June 3, 2006 RECORD numbers of NSW women need transfusions to treat massive blood loss after giving birth, in an epidemic that doctors say is threatening new mothers' health and fertility and sometimes their lives. The number of women diagnosed with post-partum hemorrhage has rocketed by nearly 30 per cent, and almost one in nine births was affected in 2002, compared to one in 12 in 1994, University of Sydney research has shown. Of those, the proportion whose condition was severe enough to warrant a blood transfusion increased sixfold, from 2 per cent to 12 per cent. "It's extremely important," said Ken Clark, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Bleeding was "still a very real cause of the death of women but also a great deal of [ill health] that has a tremendous impact on women and their families". In the worst cases mothers had to undergo emergency hysterectomies to save their lives, but even less dramatic surgery to clamp blood vessels or anaemia could be debilitating. "To have that on top of all the other stresses and strains of motherhood it's the last thing people need," Dr Clark said. The NSW findings are the first large-scale confirmation of the impression among individual doctors and hospitals across Australia that major bleeding is increasing. Carolyn Cameron, who led the statewide analysis, said neither the well-documented rise in caesarean section births nor the growing number of older mothers could explain the increase in hemorrhages. It was possible more borderline cases were being identified, but this alone was unlikely to account for the increase. "We have to search for something else. It's a mystery," said Ms Cameron, a research officer at the Centre for Perinatal Health Services Research. The group would now look at how many previous pregnancies women had and the length of their labours to see whether these offered clues to the reasons for hemorrhage - diagnosed when more than 500 millilitres of blood is lost after a vaginal birth, or more than 750 millilitres after a caesarean. Blood loss - usually from the site where the placenta detaches - is currently the single largest cause of pregnancy-related death in Australia. Between 1997 and 1999 - the most recent period for which figures are available - eight women died as a consequence, including two who refused transfusions for religious reasons. Ms Cameron's research, published in the Australian and New Zealand Journal of Public Health, was based on the medical records of more than 52,000 women who had a birth-related hemorrhage in NSW between 1994 and 2002. It is not yet clear whether the pattern has continued since 2002, when NSW Health recommended the use of drugs to expel the placenta and early clamping of the umbilical cord to limit bleeding. David Ellwood, professor of obstetrics and gynaecology at the Australian National University Medical School in Canberra, said: "All of the major hospitals around the country have been noticing an increase." Women who gave birth vaginally after a previous caesarean, or those carrying twins, might be at increased risk, he said. Rising birthweights might also contribute to the trend. Increasing transfusion numbers indicated that the severest bleeding was also rising, Professor Ellwood said - because doctors were reluctant to transfuse women with less serious hemorrhages. A group of maternity hospitals was researching women's recovery from birth hemorrhages to see whether they affected breastfeeding or triggered post-natal depression, he said. http://www.smh.com.au/news/national/transfusions-soar-for-women-giving-birth/2006/06/02/1148956546560.html#
[ozmidwifery] new centrelink forms
Hi, Anyone out there have any idea how women/couples who choose to birth unattended or with non-registered attendants can get there babies centrelink/medicare form from? Used to be a matter of getting baby sighted by a GP and the appropriate forms signed. The new forms are all registered to the care provider and most GPs don't have them. Any thoughts? Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] consent to formula feed?
Hi again, this question originated after a scenario at the hospital i'm doing a placement at. twins born by elective s/section at 36+6 weeks twin one 2550g, twin two 2210g mother's intention to breastfeed BSLs requested at 1 hr. twin one 2.7, twin two 2.3 paed requested formula feed for both i queried this condsidering the above - good bsl's, mother's request to b/feed scu nurse replied 'the doctor said so' i asked her when she'd stopped being an advocate for the mother and the baby i then came across the father and asked him if he realised his babies had been formula fed his face said it all, but he muttered that the doctor probably knew best what do you do?? that's why i've asked the question cos i looked in the hospital policy and where it had printed written consent, that had been crossed out and verbal handwritten above written in the policy. not impressed, sue nb: mike, that's why i asked who was consented - maybe the father's are not always fully passionate about how this happen - in this case it seemed like that and i guess ultimately it's the mother who has to do all the work involved with either feeding twins or expressing for twins, supported of course by the father. i don't mean to demean the father's role, but it may not always be that clear cut Interesting question about the consenting rights of the father. He seems to have no rights. The baby is baby of the mother. What is the fathers legal position? Any other time the parents have equal rights and one or other can sign. rgds mike -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] consent to formula feed?
Hi, just wondering what the policies are concerning consent to give formula to a baby (any baby). is the consent to be written or verbal, and is it gained from either parents or just the mother? sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re:
Hi, With the new Konakion MM it's the other way around. It has been designed by increasing it's absorbability in fat to be more affective if given orally. It has NOT been proven to be as effective as the old Konakion in being absorbed by the IM route. They are waiting to see if the surveillance of the new Konakion through Australia, Switzerland and a few other countries is as effective IM as it is oral. The oral route has been found to give a higher vit K cover than the IM route over a few weeks. THere is so much misinformation about vit K. It is available to the baby through breastmilk and maternal supplementation does increase neonatal serum K levels. What more do we want?? And by the way, all formla fed babies should be excluded from any study due to the addition of vit K to formulas. ie babies planned to be formula fed do not need vit k!! Sue student midwife birth practitioner vit K has been my research assignment for the past three years If a solution is designed to be given IM is it absorbed effectively if given via the GI tract ? No mention of this in the literature accompanying the Konakion. Most IM meds are NOT designed to be administered or guaranteed by the pharmaceutical company to be effective if given orally. It may be neutralised by gastric secretions, I am unaware of any research re this. Anyone else know of any ? If you are going to introduce a foreign substance into the GI tract of a baby you'd want to have a good reason be sure that it was being absorbed wouldn't you ? With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: "diane" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 6:48 PM Subject: Re: [ozmidwifery] Re: Apart from the fact it tastes like Sh** (very bitter). Been reading about Vit K all day today . Seems like a pretty good option as far as the statitistics go. http://www.nhmrc.gov.au/publications/_files/ch39.pdf they recommend further research into the effectiveness of supplimenting brestfeeding mothers to increase the vit K in breastmilk as an effective suppliment. Di - Original Message - From: "Kelly @ BellyBelly" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 5:30 PM Subject: RE: [ozmidwifery] Re: Just a side question if that's okay - what are your opinions on oral vitamin K versus injection? Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Andrea Quanchi Sent: Friday, 26 May 2006 3:24 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Re: The place I work we give it when we do the NST. It was a midwife decision not an evidence based one. Like giving it with the vit K it is easier to do it at a predictable time so that it doesn't get overlooked. The midwives wanted not to do it at birth as they were wanting to do as little as possible to interupt Mum and baby, As we need to have a signed consent form to give it and the mothers have often not filled this is prior to birth it was very interupting to get all this"Done" on the birth day and we find it not an issue later when everyone has had time to sit down read the literature and discuss it. Of course then we do have a number of mums who decline to have it which is their right and is not an issue at all. Andrea Q On 25/05/2006, at 8:10 PM, Amanda W wrote: Hi all, I have just started working at a new health facility that tends to give hep B injections on day 2 or 3. I have come from a facility that gives hep B at birth when vitamin k is given. Can anyone shed some light as to why the might do it this way. Any articles. They seem to not know why they do it. I just want to change practice so that can be done at the same time as the vitamin k. Thanks. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] Re:
Hi Brenda, The surveillance is the reporting of neonates suspected of having HDN caused by low levels of vit K - not a randomised trial - everyone agrees an RCT would be impossible due to the low numbers of babies who do have problems, and the difficulty proving that the problem is caused by whatever vitamin K deficiency may be. Levels of vitamin K drop due to other problems such as liver or gut related pathologies - most of the babies who have died from late onset K deficiency have in fact had undiagnosed liver problems. And the discussion around diet, supplements etc is interesting, but if you spend enough time around big hospitals and see the pitiful state a lot of women are in these days - obese, addicted to coca cola, first choice of a meal after birth is a Big Mac, than you start to see a whole picture of why we might need to make sure people are getting some food groups. Hmm, Sue Thank youSue, So. why haven't hospitals in Oz been given this info when they are administering this drug, mainly IM (perhaps ineffectively)on a daily basis to 100's of babies ?? The healthy neonates aside, what if it doesn't work effectively on the 'at risk' babies it was designed to assist? Are they part of a randomised trial,happening without parental consent ? Brenda - Original Message - From: Sue Cookson To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 8:11 PM Subject: Re: [ozmidwifery] Re: Hi, With the new Konakion MM it's the other way around. It has been designed by increasing it's absorbability in fat to be more affective if given orally. It has NOT been proven to be as effective as the old Konakion in being absorbed by the IM route. They are waiting to see if the surveillance of the new Konakion through Australia, Switzerland and a few other countries is as effective IM as it is oral. The oral route has been found to give a higher vit K cover than the IM route over a few weeks. THere is so much misinformation about vit K. It is available to the baby through breastmilk and maternal supplementation does increase neonatal serum K levels. What more do we want?? And by the way, all formla fed babies should be excluded from any study due to the addition of vit K to formulas. ie babies planned to be formula fed do not need vit k!! Sue student midwife birth practitioner vit K has been my research assignment for the past three years If a solution is designed to be given IM is it absorbed effectively if given via the GI tract ? No mention of this in the literature accompanying the Konakion. Most IM meds are NOT designed to be administered or guaranteed by the pharmaceutical company to be effective if given orally. It may be neutralised by gastric secretions, I am unaware of any research re this. Anyone else know of any ? If you are going to introduce a foreign substance into the GI tract of a baby you'd want to have a good reason be sure that it was being absorbed wouldn't you ? With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: "diane" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 6:48 PM Subject: Re: [ozmidwifery] Re: Apart from the fact it tastes like Sh** (very bitter). Been reading about Vit K all day today . Seems like a pretty good option as far as the statitistics go. http://www.nhmrc.gov.au/publications/_files/ch39.pdf they recommend further research into the effectiveness of supplimenting brestfeeding mothers to increase the vit K in breastmilk as an effective suppliment. Di - Original Message - From: "Kelly @ BellyBelly" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 5:30 PM Subject: RE: [ozmidwifery] Re: Just a side question if that's okay - what are your opinions on oral vitamin K versus injection? Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Andrea Quanchi Sent: Friday, 26 May 2006 3:24 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Re: The place I work we give it when we do the NST. It was a midwife decision not an evidence based one. Like giving it with the vit K it is easier to do it at a predictable time so that it doesn't get overlooked. The midwives wanted not to do it at birth as they were wanting to do as little as possible to interupt Mum and baby, As we need to have a signed consent form to give it and the mothers have often not filled this is prior to birth it was very interupting to get all this"Done" on the birth day and we find it not an issue later when everyone has had time to sit down read the literature and discuss it. Of c
[ozmidwifery] Re: First breastfeeds
Hi Melissa, I only have anecdotal evidence from 20 odd years of homebirthing where I've observed quite a number of babies not breastfeed even within the first 24 hours. These are babies who have very normal deliveries, no drugs and full access to the breast. As much as it can be uncomfortable to watch based on the texts and current managed practices, these babies all started sucking strongly when they needed to. As i am not also involved in wieghing babies on day 3 or whatever to determine weight loss/gain and don't have to hand them over to paeds etc, I am free to use my observations of wellbeing such as skin turgor, alertness, jaundice levels etc, and individualise my service to the woman. I have been working in a largish hospital on and off over the past 6 months and have been truly horrified by the interference than can and does happen with those first breastfeeds in the name of institutionalised policies. I have no answers about how this can change as there is also a huge discrepancy between the knowledge base of the staff involved. Some of the things I hear are so outrageously wrong with respect to breastfeeding and I'd have to add that so much depends on the midwife's personal story. We all should know how our own experiences play part in our attitudes and understanding of certain situations. Lots of babies are born with little interest in immediate breastfeeding and it seems we increase the stress levels of new mums so much by expecting these babies to latch on within the first hour. I do know there is research around that suggests that the first feed doesn't have to occur in that first hour. Lots of babies like to be at the breast and lick and smell but maybe not latch and suck. I've seen new mums 'attacked' by 2 or more midwives around the 6 hour mark muttering about having to feed, waking sleeping babies, grabbing women's breasts and trying (unsuccessfully) to get baby to latch on. This appears to be a common story in some hospitals, as are repeat BSL's done on an otherwise perfectly healthy newborn. What's the saying - if we keep looking for trouble we'll soon find it? It's also pretty obvious that quite a number of babies born with epidurals are slower to wake and suck - I guess in my mind this is a different situation - again I have no solutions, but I do find it all fascinating. Sue Melissa Singer wrote: Hi all wise women, I know this is something already widely discussed, but at work this morning we were discussing redeveloping our breastfeeding policy. A hot debate occurred in relation to timing of the first breastfeed. In particular if the baby does not show interest in feeding in the first few hours, length of time before we start interfering. 6 hours was being tossed around before doing BSL's, NGT feeding, gastric lavage etc. I was wondering if anyone had any links or references at hand to support allowing the healthy term baby to go longer and to have his first breastfeed when he is ready. Thanks Melissa __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
[ozmidwifery] proud moment
Hi guys, just to let you know of a proud moment in my life. not only do i have a firstborn daughter who can deliver calves by herself by c/section in the middle of paddocks, but i now have a second born daughtermed student who has helped birth her first woman. she sat through twelve hours of labour for a sixth birth and 'caught' her first baby. said it was the best thing she'd ever done and understands me more because of it. at a particularly stressful time in my student career i really appreciate the important things in life... Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] EFM on satellite systems
Hi, I was a student at a large Adelaide hospital and last year I witnessed most of the midwives staying at the front desk for most of the time watching 'their' women's CTGs. I found it appalling - that we as students were observing this as modern midwifery management; that the women were treated with such lack of compassion and skill; that this was a large teaching hospital - no wonder most of the young doctors have no idea about normal birth. Needless to say I complained to appropriate sources and have refused to revisit that hospital for a clinical placement. Let me get a sore back and dirty knees any day and maybe I'd also have some idea of the woman I was assisting through birth and some idea of how I could help her achieve what she wanted. Sue the efm on satellite systems does not subsitute for the registered midwife in the rooms. We have this at the hosp that i work in and you still have to stay in the room with the woman whilst she is labouring. Not all clients are on moniters and some are intermittenly monitored with a doppler hand held. I find this appaling that the midwives can even think of not bieng in the room with the woman and her partner during labour. They are used as a sort of backup so the shift co-ordinator can see what is happening in the room and also for the medical officer who is always in the labour ward to glance at sometimes as the individual midwife in the room's ability may be on different levels it is like a saftey system i guess for both the woman and the midwife attending her. regards - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Friday, April 28, 2006 1:25 PM Subject: [ozmidwifery] EFM on satellite systems I was at a birth the last few days @ RWH and the midwives were telling me hospitals (RWH included) are soon changing to new EFM machines which are linked to a satellite system, so women can be monitored by the midwives from the ward desk. They were joking about it too, how they could have a loudspeaker go off and ask them to adjust the monitor next, should it not be in the right spot. Does anyone know anything more about this and what are your thoughts? One to one midwifery care seems further off sometimes, which is very, very sad Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] Options for twins
Hi, Homebirth could be an option for this woman if she find practitioners willing to attend. Remember she will receive twice the maternity allowance of $4000 (from July on) so the costs of the homebirth will be covered. My med student daughter only yesterday was with an obstetrician who stated that the only real reason for c/sections was placenta praevias - so encourage the woman to keep that firmly in mind. If the first baby settles head first then there is a very good chance that she can birth the twins vaginally - at home if midwives are willing or in reasonable hospitals if appropriate care and care-providers can be found. Sounds like she has the courage to work for the birth that she wants, so good luck. I'm not familiar with the scene in Melbourne but there is a good lot of support there for women wishing to avoid the obstetric treadmill. Sue Dear list, I hope you can suggest a few options for a friend's daughter who is pregnant with twins and looking for women-friendly care. Her holistic background combined with initial visits to GP and obstetrician has left her disturbed, defiant, and wary of getting caught up in the system. But she is unsure of her options. I've given her some general information about multiples (from 'Midwifery Matters', UK Midwifery archives, this list, AIMS, 'Birth Matters', details of MIPP etc.) together with some very-much-needed positive twin birth stories - all of which has affirmed her strong desire to keep this pregnancy and birth normal. She lives in outer S.E. suburbs of Melbourne. Is open to independent midwifery care, although money is an issue. Also no private health insurance. She's feels limited in her options and pushed to obstetric care by default, and is asking for names of women-friendly practitioners. (Heard there was someone out Warrigal way?) What are her options? As 'high risk' does she qualify for any midwifery care programs? Are there any decent public shared care options in the area? And if she is pushed to find the money for private care how would the cost of independent midwifery care compare with an obstetrician? Any suggestions most welcome at this stage. Many thanks, Lesley -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] C/section lotus
Hi all, Just want to put it out there that it a lotus birth after c/section was successfully negotitated and managed here on the north coast NSW again. The handover from surgeon to midwife was made and the midwife then simply waited whilst the placenta was delivered (ie peeled off the uterine wall - usually about 2 minutes later), and then taken to the paed who had okayed the lotus birth prior to surgery. So all the team had been asked prior to the surgery and provided the baby was not in need of resuscitation and the mother not bleeding excessively, the lotus was to be handled. This is despite the many negative answers we were given prior to the c/section by various other obstetric team members. We just waited our time until the right people came along and the request was made by myself privately to the registrar acknowledging both the desire for the lotus birth by the mother (who had planned a homebirth) and the uncertainty by the registrar - of hygiene, of process, of the why?? of lotus. Hope this may help others to remain advocates for the women they serve, it seems we can move mountains and retain integrity for the birthing women; just takes the right question at the right time to the right people. I again thank the most fantastic female registrar I have ever met/ could ever think of meeting for her respect and understanding of women's needs. Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Maternal Vitamin K?
Hi Mary, Vitamin K does not appear to cross the placenta in major quantities - some thoughts that low vitamin K levels in baby's blood is to do with the need for cells to replicate at an enormous rate and that high levels of K can inhibit that... (don't have the reference off the top of my head and there is more research looking for the reason...). Vitamin K maternal supplements post birth have been found to increase baby's serum K levels - Greer (not Germaine!) has done reserch on this and was on the NHMRC party who wrote the last guidelines for Vit K. Apparently colostrum is higher in K than breastmilk due to its fat content which would also mean that hindmilk is higher in K than foremilk - more and more reasons to allow nature to be!! Colostrum also provides the bacteria which initialises production of vit K in the newborn gut. A lot of the vitamin K debate seems to be around the definition of vitamin K deficiency bleeding - having liver function problems or gut problems appears to be the major reason why baby's own supply of K would suffer - and liver problems can be caused by infections with viruses, bacteria, maternal intake of various drugs/poisons, and gut problems being coeliac disease, ulcerative colitis etc. There is no doubt that in 3rd world countries fewer babies die after supplementation of K. The question here would obviously still revolve around maternal and fetal/newborn health/nutrition etc. K is my 'pet' subject through my BMid course. I usually pass on information to parents to assist in their decision making by discussing the fact that not all developed countries routinely give IM Vit K to newborns ; the Netherlands give 1mg oral K at birth then daily supplements of K drops up to 3 months I think, Denmark gives 1mg at birth then weekly and both have levels of VKDB equivalent to those gained by the more invasive IM route. Same sort of riks/benefits as any vaccination concept - oral vs IM route with IM bypassing normal modes of K intake which is either dietary or produced in the gut, IM including preservatives etc within the product. Hope all this helps, Sue Midwives et al... Is there any way maternal Vitamin K can be accumulated prior to birth and therefore passed onto her baby, in order to prevent thenewborn requiring neonatal Vitamin K??? Thanks in anticipation... Mary Doyle Early Parenting Manager Alpine Health __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] Maternal Vitamin K?
Hi Jo, I wasn't very clear with that bit - all states use the same product in Australia and so the preservatives etc are present irrespective of the route given. The IM route however bypasses the mucosal route which is one of the body's first line of defence against foreign agents. The IM route with vit K has been linked with some cancers - some at the site of the injection. We are actually loading the muscle site with 1-2 times a 'normal' level of vit K and research to date has failed to understand where and how that depot of vit K is used. The cancer link has been difficult to replicate but it is usually acknowleded that the risk of cancer after IM Vit K although small, remains a possibility. The new Konakion MM was developed to make it more easily assimilated through the oral route by changing some of its components to increase the oil factor. It still has preservatives etc and so is still of question to parents, but perhaps the oral route more closely replicates normal vit K intake. Hope this makes sense, Sue On 24/03/2006, at 1:11 PM, Sue Cookson wrote: Same sort of riks/benefits as any vaccination concept - oral vs IM route with IM bypassing normal modes of K intake which is either dietary or produced in the gut, IM including preservatives etc within the product. Hi Sue Here in WA the same preparation is used for oral and IM vitamin K (Konakion). So the preservatives you write about in the IM are also present in the oral. Jo -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1454 (20060321) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Propolis for GBS
Hi, At the end(?) of the Novelli article it mentions Propolis, a bee product. I have used this very successfully with BGS+ve women - 2 weeks of taking that orally once per day, reswabbed and no GBS. Propolis is the only product that I have found that is specific for Strep infections. It's marketed for sore throats commercially now, so is easy to locate in health food stores. Also great for mouth infections, sore teeth, sore ears - take it orally; must really target some specific bugs. Sue Here's a great article on GBS and theoveruse of antiobiotics and the potential for alternative remedies such as Garlic, Echinacea, Vitamin C taken internally combined with herbal vaginal washes. It starts about half way down page - Treating Group B strep: are antiobiotics necessary? Christa Novelli Samantha B.Mid student/Herbalist http://onyx-ii.com/birthsong/page.cfm?gbs ---Original Message--- From: Tania Smallwood Date: 03/02/06 00:20:03 To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Garlic for GBS? Judy Slome Cohain had an article published in the Winter 2004 (number 72) edition of Midwifery Today, called GBS, Pregnancy and Garlic, be a part of the solution. Not sure if its available online, or if it was published elsewhere, but she talks about the research shes been doing and protocols etc for trying the use of garlic for treatment and prophylaxis. Hope that helps Tania From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of diane Sent: Wednesday, 1 March 2006 6:21 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Garlic for GBS? Does anyone have anygood references on the use of garlic to treat GBS??? We have several women with previous GBS approaching "swab time" who are interested in this. Ta, Di __ NOD32 1.1420 (20060227) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
[ozmidwifery] Direct Coombs positive
Hi all, Just wondering if any of you have experience with babies who come up with a poistive Direct Coombs test? A cord blood sample from a newborn showed baby was A pos with anti-A antibodies - they would have been passively transferred from the O neg mum. It's pretty likely therefore to be an ABO incompatibility which seems to be a minor issue. Have done a few bilirubin levels which are all way under the range for even phototherapy (58 hours was 215), but the GP involved is being really precious about it all - as if it's likely the baby will suddenly set up major problems. Obviously baby is feeding well, alert, only mildly jaundiced by observation, well and truly cleared his mec... Any comments?? Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Vaginal breech in hospital
Hi all, Had the honour of assisting a 38 year old primip to successfully birth her breech baby vaginally yesterday in a large hospital. She has been told she had to have a c/section but negotiated her way to trying a vaginal delivery. We drew up birth plan specifying freedom of position, midwife delivery, intermittent auscultation, no episiotomy, physiological third stage etc. Went into labour on her due date with the baby sitting with its bottom and right foot at the cervix. Arrived at the hospital amidst a flurry of panic but after presenting them with the birth plan and the 'team' arriving - myself as support person and a friend as filmmaker - the staff settled down to document the plan including refusal of elective c/section, choice to have no epidural, no CTG, etc. A FANTASTIC Indian female registrar arrived and showed genuine excitement at the prospect of a breech birth. The couple then agreed to a PV and ultrasound just to confirm baby's position. She was 8cm with intact membranes, and bottom and foot palpable - baby was 'a nice size' according to the registrar 'G'. There were a few midwives always around but it was G who forged a relationship with us all and was incredibly respectful of the woman's choices. The midwives showed concern when G could palpate the foot but G was fine. We discussed the choice to birth upright and it was agreed that we would assist the mother into a more 'conventional' position if it was required. So labour continued with a few more hours in transition during which time baby rotated to the anterior. We changed positions often and it was whilst in the bath that the membranes ruptured with fresh meconium appearing. Another VE was performed briefly and foot and bottom were close to crowning. We were on the floor with the mother supported upright, using mirrors to watch progress and the first foot began to appear at 5.30pm. I had a closer look and found a second foot. The baby appeared slowly, double footlings breech and G gently assisted the baby's head to birth at 5.45pm. The placenta followed the baby out, so although we'd had good cord pulse a few minutes before the baby was certainly on his own at birth. Baby was minimally resuscitated - away from the mother which was my only slight criticism, but very understandable - and G actually helped the mother to move across the floor to the resus trolley. WOW!! Baby had apgars of 6, then 9 and is just fine. 6lb 11oz. Peri intact, lotus birth... G stated that she had delivered many breech babies in India and New Guinea and I believe she was an obstetrician overseas but not in Australia. She was excited at delivering an upright breech as she had only ever delivered them in obstetric positions before. She was also very OK about the lotus birth which was a different response for that hospital. It was a wonderfully affirming birth - a testament to my belief of being informed, prepared and corageous too!! I am very aware that this birth hinged on G being in attendance - I truly doubt that many other practitioners would have shared her enjoyment of the challenge of this birth. Her experience in other countries was so vital ... it is possible that she put her hand up for this birth when it was discussed a week or so before (the parents had a two hour meeting with another doctor and obstetrician - the ob stated he would not support their decision, so it truly was an amazing outcome!!). Hail to those women who stand strong in their belief of normal birth and also to those of us who can support them. I really felt honoured to be there. I hope by telling this story that more women and midwives may feel encouraged to attempt to negotiate their way through the obstetric maze which surrounds vaginal breech births. Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Peaceful birth
Hey Justine, enjoy, anchor, and birth those beautiful babies deep breaths, Sue Dear friends This evening as the moon transcends into an aquarian quarter one of our most dynamic and fabulous women of consumer maternity reform in Australia is preparing for the birth of her twins. Justine Caines (for those of you who do not know of her - yet !!) is a woman of great strength and courage and has without doubt transformed the political climate for birth reform in this country in a way that has never been acheived before. I ask all of you to send Justine and her husband Paul and their 4children - Ruby (6) Clancy (4) Wil (3) and Toby (18mths) lots of the good midwifery and womanly vibes fora wonderful and peaceful birth. For those of you who are able and wish to - could you please light a candle in support andencouragement for Justine and her family. Peace at birth Peace on Earth (adapted from the 2004 MC campaign for rural women's birthing services) Kind Regards Sally-Anne __ NOD32 1.1311 (20051202) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.10/189 - Release Date: 30/11/2005 __ NOD32 1.1311 (20051202) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] Dr John Stevenson
Hi Mary, Yes John is still alive and well at 83 years old. I have emailed you privately with his details. Sue An ex-client and long-time supporter is looking for information about John. He is still alive isnt he? Does anyone have a recent contact address? I will pass on any information. Thanks, Mary Murphy __ NOD32 1.1311 (20051202) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] POP statistics
Hi Brenda, Just been taught that 5% stay OP of the 10-15% that present as OP. NO research to support that, only texts. Other stats suggest that up to 20% births begin as OP - Jean Sutton's optimum positioning info. Hope this helps, I haven't seen an OP in 23 years of homebirths - pretty careful with positions in pregnancy and info to help mums to rotate their babies prior to labour. Sue Information seeking.. please ozmidders Does anyone have stats (or know where to access them) on the percentage of posterior babies who rotate during labour or whilst birthing ? Esp relevant to Mg with SVDs previously ? How many babies actually remain OP do ore don't obstruct how many rotate birth spontaneously ? Any help greatly appreciated. With kind regards Brenda Manning www.themidwife.com.au
Re: [ozmidwifery] Melb Ob's Supportive of Lotus Birth
I'd have to add that if she is looking for 'permission' to have a lotus birth, she needs to work harder to understand it is her right to make choice irrespective of whether that choice is understood or supported by others. If she firmly stands in her place with her decision to have a lotus birth, then those who are invited to her birth will oblige. I have assisted women with lotus birth at home and in a variety of hospital settings, including c/sections - she may have to stay very firm about it - just like not cutting the cord early for other people. All sorts of excuses may be made - what she says and how she says it will determine the outcome. The more people access their rights, the more familiar everyone will be with the different choices people can make. Sue Message you could contact the college of spiritual midwifery and ask if they can refer someone? cheers Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Kelly @ BellyBelly Sent: Monday, November 14, 2005 2:41 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Melb Ob's Supportive of Lotus Birth A girl in my forums has asked of any Melbourne Ob’s / GP’s etc that are supportive of Lotus Birth for her birth – anyone? I’ve suggested Lionel Steinberg as a possible and also Peter Lucas – but other than that I have no idea where to start. Best Regards, Kelly Zantey Director, www.bellybelly.com.au www.toys4tikes.com.au Gentle Solutions For Conception, Pregnancy, Birth Baby Australian Little Tikes Specialists -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.12.8/162 - Release Date: 11/5/2005 __ NOD32 1.1284 (2005) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.12.8/162 - Release Date: 11/5/2005
Re: [ozmidwifery] emergency skills
I attended Maggie's Intensive in October 2004 in New Zealand at Maggie's house. It's a wonderful workshop to either reaffirm the work midwives already do, particularly if you work independently, or to give you many new persepectives and questions about why you do what you do, where your teaching/training comes from and to learn new skills based in woman-centred tradition, not obstetric land!! A very different perspective. Sue Hi everyone, I was just wanting to know if anyone had been to Midwifery Skills for Emergencies run by Birth International with Maggie Banks as the facilitator. It's just that it is quite expensive ($1095) , which is dearer than the ALSO course. Thanks, Joan THIS E-MAIL IS CONFIDENTIAL. If you have received this e-mail in error, please notify us by return e-mail and delete the document. If you are not the intended recipient you are hereby notified that any disclosure, copying, distribution or taking any action in reliance on the contents of this information is strictly prohibited and may be unlawful. Eastern Health is not liable for the proper and complete transmission of the information contained in this communication or for any delay in its receipt. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1284 (2005) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re: [hbo] Check out Hudson Valley Lactivism
Hi , I took each of my 4 children to births with me over many years. they obviously didn't need to come once they were weaned but if i thought i might be away for a fair while then the toddlers came too. i had some problems with one of mine, my only boy, who seemed to not be able to hang in so well, so he stopped coming along at about 8 months which did add to my partner's workload (had to bring him to me a number of times at long labours). i have very distinct memories of my babies sitting watching, or sleeping, or once i had to leave my 12 month old at the door as the house was a 'no food inside' place and she was chewing on a biscuit. i used to work alone, so for some of the longer drives etc i would take my sister or an older child as my support person. none of the families ever complained or asked me not to bring my children ... tessa went to many births in this capacity em!! sue hi everyone anyone know of any similar groups in australia? i liked their idea of handing out information at public places re breastfeeding laws and rights to increase awareness and acceptance. going in to workplaces to educate workers about rights for breastfeeding/expressing breaks and providing legal support for discrimination sounds great too.. how many australian employers would hire someone known to be breastfeeding who needed breaks every few hours? probably few and i think people would be too scared to ask . ideally i think we need to move towards more baby friendly workplaces where bubs go along with mum to work, like in most places in the world. but it sounds too extreme to even bring up in our current cultural climate of children and work life being so separate do many of you have experience of working witha baby in tow? do the hb mw's take their babies to births at all? love emily
Re: [ozmidwifery] Re: Midwifery Educators
Hi Brenda, I've probably missed some info - but where do you work that such marvellous practices have been implemented? Sue A big impetus to change the cord cutting routine at our unit was to revamp the birth bundles. We broke the bundles down intoseparate items originally as a saving of work for CSSD in sterilising unused stuff. So now having everything separately peel packed it is very easy to just not include a pair if scissors when you grab the birth stuff for the actual event. We (in our own practice) don't have Drs for births the newer MW soon got used to having to go get scissors for any cutting they wanted to do. The bundles just have a large kidney dish or bowl 2 artery clampsin them. We have removed the scissors from them entirely, episis haven't been done for years anyway as no one cuts tight cords anymore or feels for them around necks the resus is done on the bed, initially anyway, then baby is only moved to resus cot if really necessary. It all seems to work well, we often don't cut cords till placentas are out, Dads or partners do it 99% of the time catch 80% of the time so we are just the gate keepers often anyway. Really you need to read the current research it backs up all that you are suggesting, perhaps print it off present it at the next meeting, nothing like the written word for initiating change. Failing that, hide the scissors! With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Maxine Wilson To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 25, 2005 10:02 PM Subject: Re: [ozmidwifery] Re: Midwifery Educators Ha ha - I remember doing the same in my mid training tho we didn't have to do shaves. "I could give you an enema if you would like one!"I would offer. Never had any takers The power of consent Maxine - Original Message - From: Ken WArd To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 25, 2005 9:09 PM Subject: RE: [ozmidwifery] Re: Midwifery Educators When I started my mid we were doing shaves and enemas. It was my group of students that facillated change. Maybe because we were a generally older lot. the women were informed they wold be shaved and given an enema. If any objection or query of the procedure was made they were quickly told that they could refuse. All did, and by the time our 12 months were up there were no shaves or enemas taking place. Midwives can effect change. As to cutting the cord quickly if baby needs resus. I have resused 2 flat babies with cord intact, on the bed with mum. Bub is getting 02 from mum, and mum is not nearly so stressed. Both babies responded well. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Nicole Carver Sent: Tuesday, 25 October 2005 10:36 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Re: Midwifery Educators Hi Barbara, Do your parents have any say in the cord clamping? Perhaps they need more information such as at their education sessions? We also do active management, but Dad's are still able to cut the cord. Not many of our Mum's do physiological third stage. However, we had a lotus birth recently which went well. I believe that although midwives do not have a lot of power in hospitals, parents requests are often listened to. There is an opportunity to harness this to bring about a cultural change, and if parents continue to request certain practices they will break down the resistance to change. I have not given pethidine through an epidural before. We have infusions though. They are Fentanyl/Marcain and we do obs 5 minutely for 30 minutes, then full set of obs with pain score, sedation score, dermatomes and motor function, then pulse, BP, resps and sedation scorehourly, with dermatomes and motor function 4 hourly. I think it is good to keep your obs consistent to save confusion, particularly with new or inexperienced staff. Cheers, Nicole. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Barbara Stokes Sent: Tuesday, October 25, 2005 10:15 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Re: Midwifery Educators Dear Midwives, I have just returned from our small hospital midwives and doctors breakfast meeting. This is to encourage communication. We have 4 GP/Obs and 9 midwivies. On discussion was a new policy for epidural-top ups: both pethidine only and marcain/fenytal . Policy is now insistent on bp obs 5minutely for 30 minutes for both top-ups. Other hospitals have had the pethidine only
Re: [ozmidwifery] Induction and third stage labour
Here here Mary, I've also been doing physiological third stage for 22 years and have not seen any jaundice worth investigating. Cords are usually left for at least two hours, mostly longer... Placentas not held higher or lower ... no fuss. No synto and no 'milking ' of the cord. One significant jaundice was an ABO incompatibility... Sue Given that I have been doing physiological 3rd stage for 23 yrs, I feel I can add my bit to this theme. It has not been my observation that babies get more jaundiced if the cord is left unclamped. I rarely have a pathological jaundice and this is usually ABO and do not often have anything more than very mild physiological jaundice, mostly no jaundice at all. My long term interest in this are has led me to conclude that as well as the liver immaturity, the re-absorption of the bile in the mec. and the normal breakdown of excess foetal red blood cells, it may have to do with the ABO component and antibody formation in O pos mothers with A or B pos babies. Some are worse than others. A very interesting thread. Cheers. MM Nearly everyone I know that did not cut the cord, had babies that developed Jaundice. Nothing serious just yellowing. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1240 (20051003) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Northern Rivers
Hi Diane, I'm doing a student clinical placement at Lismore at present in the Birthing Suite. I live about an hour away and drive there and back each day - beats flying to Adelaide for weeks at a time. Lismore is a typically underfunded teaching institution, doing it's best under the circumstances. There are about 1300 births per annum, with 4.5 birth rooms and 2 midwives on per shift. So there is no true facility for woman centred care, and being a teaching hospital, it's not low intervention either. There is no specific place to separate low and high risk women or the care they receive ... the midwives do their best... Mullumbimby is not a birth centre - it is not midwife run, but it does only take 'low risk' women. There is somewhere between 25-33% transfers out of Mullum to other institutions. There are 4 male GP's who provide care at Mullum, and women can only book in if under a GP care. There are only about 120 births per year, with midwives working between the birth rooms (3 of them) and the hospital. We can only hope that there may be future case load serices at Lismore, but as I said, it's a tertiary teaching hospital and there are always lots of young doctors willing/needing to attend births... Hope this helps. Feel free to email me off line if you want to ask more. Sue Hi Listers, Just a question about birthing services in the Northern Rivers region of NSW. Hoping to buy a property in the hills behind Lismore in the next year or so, when my son finshes his HSC. Looking like I will still have to work about three shifts a week for financial security and also some self employment stuff like lactation services(I am IBCLC)and calmbirth, which i plan to train in next year. I am aware that Mullumbimby has a great birth centre, but we may be living a good 60 mins away from there. I also hope to move into homebirthing in the future. Is anyone familiar with birthing services at Lismore? Is it woman centred, low intervention, midwife friendly care? I am currently a team midwife on the central coast and am hoping to continue working with low risk women. Any info would be appreciated as my family and I are so looking forward to this downshift, we are currently so stressed with full time work and travelling long distances in opposite directions to work while our lonely kids wait at home!! Thanks Di __ NOD32 1.1233 (20050926) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
Re: [ozmidwifery] perinatal stats
Hi Jan and Andrea, Hate to disagree Jan, but up this way at least it's the registered midwives who are not putting in their stats. That's about laziness and an unwillingness to be involved in the 'politics' of birth. Seems to me it creates the opposite effect - full ability of political interference cos our stats simply don't reflect the population wishes and choices. And for the unregistered midwives there has always been a way of putting in stats so they will be included without being traceable. That simply isn't a problem. In my role up here I have even sent perinatal stat forms around to some of the reg midwives and asked them to fill them in - still have 2 or 3 major offenders and it certainly frustrates me just as much as everyone else who is trying to help create change in our horrenous maternity care system. Sue Hi Andrea Yes it is a huge discrepancy but the law only relates to births attended by registered doctors or midwives. Registered health professionals have an obligation to report the details of each birth they attend whether they occur at home or in a hospital. They have to provide the NOTIFICATION OF BIRTH to BDM and submit the perinatal data to the appropriate department of their Dept of Health. It is the parents responsibility to register the birth of their child. I assume that MOST of the unreported home births are that way because lay people would be unaware of their state laws. Individuals who are aware of the laws also understand that if they DO report any births that they attend also run the risk of "holding themselves out to be a midwife" and that is PUNISHABLE by law. It would be interesting for midwives to approach their own state/territory Dept of BDM as to the number of babies registered as being born at their home address and then get the figures from the perinatal data collections to compare. Anyone want to get cracking in their state? I'd love to get data from around the country. I have some Tasmanian figures and I have some from Victoria but they are not as easy to interpret as the NSW data. At the moment we are using the NSW figures to try and convince the Health Minister to publicly fund the home births and therefore provide a legitimate choice of skilled home birth practitioner for ALL women wanting a home birth. Cheers Jan Jan Robinson Independent Midwife Practitioner National Coordinator Australian Society of Independent Midwives 8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350 e-mail address: [EMAIL PROTECTED] website: www.midwiferyeducation.com.au On 15 Sep, 2005, at 08:23, Andrea Quanchi wrote: Jan that is a huge discrepancy, How many of these ones not reported to Data Collection are attended by registered midwives do you think? Surely the data collection could approach these people not reporting, through the births deaths and marriages, through the families that they are attending to cover the privacy issues, informing them of their duty to report and where they can access the data collection material. You wont get all of them but you might get some more. Are they scared of being identified if they are not registered? Maybe it needs to be free from this issue if you want the data Andrea On 15/09/2005, at 7:58 AM, Jan Robinson wrote: Hi Andrea, Denise et al I have just been in touch with our Dept of Births Deaths and Marriages again for an update on babies registered as being born at home. The numbers change each year as there are some people who don't register their child until they need to go to school so I get updates for each year. So far what we have in NSW is actual number of home births registered number of PLANNED HOME BIRTHS reported to perinatal data collection (NSW Midwives Data Collection) 1999 493 139 2000 394 108 2001 388 144 2002 322 99 2003 383 109 2004 359 don't have the 2004 figures from NSWMD collection yet - hope to have them soon - the BDM are much more organised with data collection but I guess that is because they have motivated providers of their data (the parents). Even though there has been a law since the 1990s that states all doctors and midwives who attend home births must submit their data - the NSWMD knows a lot of health professionals fail to report. There is no law that states unattended home births have to be reported to the NSWMDC. 2005 to date 197 You can see there is quiet a difference in the records I'd love some budding Master's student to get busy on this one as I won't have time for it until I retire and that won't be until we get the home births publicly funded across the country. I feel sure that if primary care midwives had the medicare provider number a lot of those unattended women would have a registered midwife with them for the birth. Cheers Jan
Re: [ozmidwifery] 3rd degree tears
Hi Lindsay, At what gestation did the u/sound miss your twins pregnancy? Anyone else have a similar story? Sue I had ultrasounds on the day of birth of my last two babies, I was overdue both times and had to see Obstetrician. These were my 4th and 5th children. Number 4 he said would be large. At least 9lbs. He was 7lb 3oz. Number 5, I think he was remembering his previous error and said this was not a big baby. He was 9lb 1oz. I have little faith in USS. Keeping in mind that my twins were also missed on USS and picked up on Abdo palp. Lindsay
Re: [ozmidwifery] 3rd degree tears
Hi again, I also forgot to add that the nurse practitioner also stated that an episiotomy rate of 10-15% for birth was justified and there was only 'soft evidence' for promoting tears over episiotomies. I do fully intend to follow this with a research search. For those of you who have commented about intact perineums and home births and birth centres and ways of delivering heads slowly etc - she is maintaining that all those categories have hidden or closed 3rd degree tears. I did enter into a discussion with her about the benefits of well informed women birthing heads consciously (the women I see all read particular articles, watch videos and we talk talk talk about slowly letting the head through...), but what research do I have to give to her to point out the evidence-based evidence for this?? This is certainly highlighting the need for eidence-based information to be very carefully examined, which I will do and will share my findings. Sue Hi, I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital. The mindblowing element was the following statistics (copied from one of the handouts): 39-49% women tear or have an episiotomy needing sutures 0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visible Listed as contributing factors were: 1st vaginal birth forceps/instrumental delivery long second stage 1 hour big baby 4kgs tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously. The handouts do not give references and as yet I have not had time to begin researching. Are you all as mindblown as I am?? What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it?? Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section. Sue __ NOD32 1.1203 (20050827) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com
[ozmidwifery] 3rd degree tears
Hi, I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital. The mindblowing element was the following statistics (copied from one of the handouts): 39-49% women tear or have an episiotomy needing sutures 0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visible Listed as contributing factors were: 1st vaginal birth forceps/instrumental delivery long second stage 1 hour big baby 4kgs tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously. The handouts do not give references and as yet I have not had time to begin researching. Are you all as mindblown as I am?? What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it?? Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section. Sue
Re: [ozmidwifery] BF video
Hi Judy, Yes please for the video. [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] shoulder dysticia
Hi Mary, I remember reading one of Leila McCracken's unassissted birth stories which related the woman birthing an 11 pound baby by herself, feeling the baby was a bit 'stuck' and leaning backwards over the end of her bed which freed the baby. I guess if we rely on our instincts and primal brain, as birthing mums we can move mountains (and babies). Sue Is anyone familiar with this technique? MM From Midwifery Today E-news 7.17 Aug 17 2005 In case of shoulder dystocia one shoulder is caught above the pelvic bony inlet. The length of the conjugata vera can be increased by 3/4 inch by stretching the hip joints, like when a woman is standing in a straight up standing position. This also guarantees the baby's own weight taking care of its body coming down without any pulling on the neck and brachial nerve. It comes from a very old technique by which a woman is laid hanging backward over the edge of a table with her legs hanging down freely. The Arabs in Spain some 500 years ago were familiar with it as a method to widen the pelvic inlet in order to promote engagement of the baby's head. Later when the English came to Spain they called it the Walcher's Position. Nowadays it has become rare when there are ample facilities to have a cesarean section. The true Walcher's Position is very uncomfortable of course, but the idea is to illustrate that one still can play with the measurements of the pelvic inlet in order to resolve a shoulder dystocia without doing any harm to either mother or baby.**— Gre Keijzer,** midwife __ NOD32 1.1195 (20050816) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] sounds during labour/birth
Where are all those sound-proofed labour rooms so we can bellow to our hearts content without worrying about the 'neighbours'? Who designs these places anyway? I remember feeling like I bellowed so loudly that my mudbrick house shook! I'm sure the whole valley heard me as I struggled to hold on through a stormy 1.5 hour labour. I didn't make as much noise fourth time around - different labour different baby different needs. Labour is so dynamic!! Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] intermittent auscultation
Interesting line on intermittent auscultation. If mws aren't given the OK to listen intermittently, then every woman would be strapped to a CTG machine with its accompanying restrictions of time and position. Having done a placement recently where CTG's were the norm because of the hospital's tight risk guidelines - VBACs, PROM, anyone with oxytocin up for induction or aumentation, any mec (even if it was only thought to be mec), slow progress, and then the more real risks with unhealthy moms or babes; there were so few women who were in the category for intermittent listening. I totally agree that listening every 5 minutes would be disturbing to any woman's sacred space and time, and have had the luxury of self regulating how and when I listen in second stage by working independently. With today's dialogue around evidence based practice etc, mws are going to have to get their research hats on quickly to add to our unique body of knowledge, otherwise these crazy guidelines will stay in place. There may not be good evidence to support 5 minutely monitoring in low risk women, but we're in a world where the alternative is continuous monitoring and the benefits of this are not well supported either, just preferred by too many. The NICE guidelines also suggest continuous monitoring for 15 minutes every hour as an alternative to totally continuous monitoring thus allowing some change of position and ambulation. ??? My radical nature says unplug all the machines and get back to truly supporting women -high or low risk by giving them proper continuity of care by midwives working as midwives not technicians. The taste of high tech land I'm getting is very sour. Anyone know what the guidelines are in The Netherlands, where midwife supported homebirths abound and their PMR, c/section rates, epidural rates are all so much lower than ours?? Sue Just a thought Sally - the real argument would become whether abnormal states in labour, in this case in second stage, can be detected by other means - such as observation or mother's intuition etc etc. I would suggest they can but again our research hats need to be applied to support the things we do know. I would like to go further with today’s radical thought. I believe there is not evidence to support the 5 minutely interval of intermittent monitoring in a low risk population in second stage of labour. What do people think about this. Do you think I could argue this point effectively?? Sally Westbury __ NOD32 1.1176 (20050722) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Birth Pool suitable for use in a small unit
Hi Justine, Mullumbimby Hospital up north here have been successfully using a wooden sided, easily assembled and dissembled birthing pool with liners that are cleaned according to health and safety protocols. The ones used at Mullumbimby were designed for the rooms, and are a bit lower and smaller than the other pools hired out for homebirths. The woman to contact about these is Gayle on 6684 7056. Sue Dear All Just wondering if anyone knows about a semi-permanent type birth pool suitable for use in a small birth unit (220 births per year). There is the opportunity for corporate sponsorship to get this happening so we sort of need something more than a kids wading pool. Any ideas? JC xx -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1.1167 (20050713) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Homebirth of twins
Hi again Yvette and others, These babies weren't identical at all, although by ultrasound they were monochorionic diamniotic twins. My twins book says all monochorionic are identical so I am confused. My guidelines for twins at home have always been first baby head down, of even size and 37 weeks plus. This is the fourth set I have had prime care of - all have arrived head/head, after 37 weeks and pretty even in size. I am sure that setting clear guidelines to all involved makes a huge difference. Perhaps I sure try a time guideline as well!! This mum had an early u/sound, then chose to have another at 35 weeks to check for above criteria. (Totally her choice tho as I was quite clear of their position). The placenta, as attached, was very round - not obviously fused, but had a very thick fusion of membranes running down the centre. The cords were very different in size and length, and the placenta on baby#1 side was thick, and on baby#2 was thin and different coloured. I can't answer the question about the cervix - I only checked once and that was purely to stop my hair going greyer whilst I worried about position - I really didn't want a shoulder presentation... The assessment I did was about 5 hours after baby #1 and the cervix was nearly fully dilated. I guess I felt it was probably always at about that dilation. The contractions really didn't stop completely at any time, just weren't so strong for many hours, and definitely picked up in intensity whilst and after breastfeeding. The books say the intensity changes with the stretching and pressure of the presenting part coming into the vagina, so although she didn't exhibit transitional symptoms for all those hours, I think her cervix probably didn't alter much, but others may know more... As far as sharing the placenta goes, watching the mother's uterus reform around the second baby and placenta was pretty amazing and very obvious. It no doubt helped her uterine muscles to contract to the right size for the remaining one baby and large placenta. After baby # 2 was born, it then had less effort to contract again to expel the placenta whihc it did very efficiently, with minimal blood loss. I can imagine a very different scenario if baby # 2 was either forced through by oxytocin if her labour wasn't considered effective enough, or membranes broken and baby extracted by the end of the first hour ( or have we heard a much lesser time allowed between first and second babies?). This management would surely predispose a big bleed considering the enormous effort the uterus would have to make to contract quickly down around the now empty uterus always much to learn with every birth. Justine, you're amazing!! We'll look forward to your amazing story unfolding over the months. Just remember to really rest up and eat and drink well. Optimum health is a must for twins. Yvette, birth is a truly amazing journey each time. Birthing two can be a simple as one if you believe, prepare and have a solid team around you. Good luck and you are welcome to email me privately. I have attempted to post some pictures of the twins and their placenta, but it isn't working. I'll get my son onto it! Sue
[ozmidwifery] Homebirth of twins
Hi everyone, I thought to let you know about a lovely homebirth of twins on Monday 4th July. Two little boys, 6lb7oz and 5lb 12oz, born 10.5 hours apart. SRM 3.30 am and birth of baby #1 at 6.49am. Then a few hours where ctxs were fairly regular but not so strong unless baby#1 was breastfeeding. You could see the second baby positioning itself and the uterus working hard to pull down into shape for baby#2. I'd clamped the cord of baby#1 after 10 mins in case of bleedthrough, and clamped the other end as well so that the placenta retained its size until after baby#2 was born. After about 4 hours I asked to check baby #2 position. It was too hard to palpate so I did a VE and found head there, not well applied, but there. Cervix was 9 ish cms. So we waited, fetal heart always good and strong. Set up the pool and mother relaxed for an hour or so with ctxs beginning to pick up again. She decided to hop out and at 5.05 pm baby#2 emerged in his caul. She birthed the placenta unaided 35 minutes later. Blood loss 300ml. (Her Hb and ferritin levels were both low). It was a huge leap of faith, but there was nothing happening to raise any alarm bells. Both babies are really gorgeous, feeding well and very happy. I am once again humbled by the strength of women Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] broken collar bone subsequent birth
Hi all, I saw a clavicle broken in a homebirth many years ago. I was only an apprentice at the time, but it was a big bub, it did appear very stuck and we were counting the minutes. At about the 8 minute mark the midwife managed to begin to extract an arm. It was during this extraction that there was a distinct noise. All up I've always been taught that broken clavicles are not that severe. This bub was fine - didn't need setting, just watching and careful movement for a few weeks. Sue Jennifer wrote: A # clavicle is not a big issue in a neonate and doesn't necessarily mean excessive force was used. The neonates bones are pliable and the # is usually a 'greenstick' or partial break or /Well, I have NEVER seen a #clavicle in 26 yrs of both hospital home midwifery, even in big babies where some force has been used. MM / __ NOD32 1.1131 (20050606) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Midwifery in East Timor
Hi Margaret, I fully agree with Denise that the high mortality rates are more to do with nutrition than practices by traditional midwives. Sue Kildea has actually got some programs together for Aboriginal women in NT, who suffer from the same high mortality and morbidity rates as other malnourished impoverished women around the world. Her work is fascinating. Google CRANA (remote nurses group) and then put in Kildea in the search place. Alternatively search Maningrida which is a remote Aboriginal community where Sue and the Indigenous women have created a website talking about education etc to assist women in childbirth. Good luck with your work - wish I was free to join you for a while, Sue Cookson Dear Margaret I respond as one who spent time in PNG in the 1980's as a midwifery tutor where I actually learnt more from the village/traditional culture of birth there than here until I became involved with Homebirth women and midwives!! As in other countries including Australia in the past, I suspect a large proportion of the higher maternal and neonatal mortality rate in Timor is more a reflection of the poor state of the nutrition, housing and sanition of the people than their birthing practices. For example where I was in PNG most women had hookworm, malaria with enlarged spleen and other diseases we do not! Haemoglobin in PNG was rarely more than 6!! But the women who were not western educated knew their bodies gave birth and nutured their babies Thus the traditional women taught me alot about how to labour, birth and breast feed babies But the western educated would be good patients and therefore have many similar problems as our women for example get on the beds and need drugs, forceps etc! I understand now the Safe Motherhood programs and similar efforts concentrate teaching hygeine to traditional birth attendants and otherwise re-inforcing their knowledge of active birth abilities I understand there are web sites for this and similar teaching programs for TBAs? Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. — Linda Hes - Original Message - *From:* Margaret Aggar mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Sunday, June 19, 2005 12:34 PM *Subject:* [ozmidwifery] Midwifery in East Timor Dear All, I am a Midwife and Childbirth Educator working on the Central Coast of NSW. I went to East Timor in May, after hearing that their mortality rate is 100 times that of Australia! Only 10% of the women birth with a trained professional present. Many birth alone, or with an untrained relative or friend. There are village women who assist with births in the remote villages. One village I visited was a 9 hour bus trip from Dili (just 180 kms away). I have been asked to provide some training for these women in the remote villages so that they are able to better care for these women and reduce the poor outcomes, and to be able to recognise problems during the pregnancy so that they can be moved into Dili before birth. I am working on a training package at present, which will need to be translated into Tetum. The training will take place at a Clinic in Dili where there are about 60 births / month. I also need to become more fluent in their language - Tetum. I will return to East Timor either later this year, or early next year. This is a voluntary venture, and the training will be provided free of charge for the village women, with accomodation included. I will be looking for sponsorship for this as well as resources for these women to use in their villages at the completion of the training. It is anticipated that this will be on-going, with maybe two trips / year to check and see how they are going and provide more training. There are 5 women interested in the training at present. If there is anyone who may have an interest in assisting with this training, or assisting in some way, or would like to know more, please contact me via email. Regards, Margaret Send instant messages to your online friends http://au.messenger.yahoo.com No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.7.3/15 - Release Date: 14/06/2005 __ NOD32 1.1131 (20050606) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] face presentation
Hi, I helped a woman give birth some time ago to a baby born face first. I remember flipping though the 'textbook in my brain' until I came to chin to pubes. By then of course baby had presented exactly that way and born normally. 2nd degree tear as head flexed through the peri, but apart from that, no problems. I have been taught that if the face presents the other way, ie face to anus, then the head can't flex under the pubis. Hope this helps, Sue hi im really sorry that i think this has been discussed not to long ago but i had a frustrating incident with a collegue today who told me very confidently that 'face presentations cannot mechanically be delivered.' i told her i was quite sure it wasnt impossible as i had seen one but she said something like 'no they cant. you might like to think they can but they cant.' i have sent her a photo diary of one little chubby face presenting and birthing without a problem but would like some references or comments from others especially if someone has seen one. thanks so much emily Do you Yahoo!? Read only the mail you want - Yahoo! Mail SpamGuard http://us.rd.yahoo.com/mail_us/taglines/spamguard/*http://promotions.yahoo.com/new_mail/static/protection.html. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gastric washes
Hi all, Need your help finding references/articles on gastric washes for neonates, also any first hand observations or thoughts. I've just returned from a week in Adelaide doing a postpartum placement and was amazed to see so many gastric washes being done. When I queried the practice and asked for protocols and policies to look at, I was told that 'we've been doing them for 30 years and they work'. To hell with best practice and evidence!! Any comments would be welcomed, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gastric washes
Hi again and thanks to Robyn and Marilyn for your replies so far, I fully agree that gastric washes are not warranted, but having been faced with babies who receive no breastmilk at all when the mothers choose to artificially feed, I wonder at their different mechanism of clearing a gut full of mucous/blood/mec. Colostrum kick starts all sorts of mechanisms - from mechanical to hormonal etc etc. Really surprises me that there is no formula substitute for colostrum to start these A/F babies off with. That's not to say that all the babies who received gastric washes were a/f, they weren't. Also Marilyn if you talk of babies who are born rapidly, then I guess every c/section baby would fit this category... The mechanised birthing and protocols and the way most midwives just follows things and don't query them really amazes me. One amazed and frustrated student, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RE Twins
Hi Yvette, Good luck with your twins birth - I've only attended twins at home, but I can empathise with your desire and concerns about wanting a normal birth in a hospital setting. I am currently looking at twins births through all my texts - including one called 'High Risk Pregnancy Delivery' and most of the major concerns are around the mono/mono scene where there is a higher risk of entanglement of cord/bodies etc. Your situation looks great for a good birth, and as you've been told, best if first baby is head down for everyone's peace of mind. You could really encourage this as I'm sure you're aware, by dialoguing with your babes. The time limit of ten minutes between babies seems absurd - I have records here for 18 sets of homeborn twins. The average time between babies for 16 births was 27 minutes, ranging from 7 mins to 90 minutes, with only 5 sets arriving within the 10 minute time frame. One of the other sets were 23 hours apart, and the other I don't have the time difference for. Placentas were birthed between 1 and 60 minutes after the second baby. There was one cord prolapse of a first born breech twin, who then came quickly and was fine. One of the sets of twins died in utero before labour began at 38 weeks (they shared a placenta and were possibly identical as they both has the same slight abnormality, but I can't confirm that), and all the others arrived in fine form. Their gestational ages varied from 42 days early to 14 days overdue for 15 sets, with 7 sets arriving 21-42 days early, 2 sets 7 days early and 6 sets term or overdue; 2 dates were unknown and one set I don't have that information. I am also currently waiting for statistics from The Farm where Ina May Gaskin and her team of midwives have delivered twins. I am aware of current hospital practice of rushing the second baby, usually then born by c/section, but in the last year I have heard about 2 sets born normally at our local large teaching hospital, so it does happen and there is hope, particularly if you are armed with your own midwife, and are well informed. Good luck Yvette and I hope this information helps, Sue Cookson -Original Message-[Ken Ward] *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of *Lindsay Yvette *Sent:* Thursday, 26 May 2005 3:26 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] monochorionic diamniotic twins birth in a public hospital, hopefully vaginal. Hello list. I've subscribed so I can submit details of my situation for anyone who wants to respond, and so I can keep an eye out for anything that comes up about twins births. I'm not a midwife or anything, so I hope it's ok to do this. I'm a public patient at Box Hill hospital in Melbourne, and due to have twin girls on 5th Sept, or by 38 weeks which is 22nd Aug. They are identical, sharing a placenta but each in her own amniotic sac. I want a vaginal birth without unnecessary intervention provided this is safe. I'm looking for any advice, information, studies, articles, comments etc relevant to my situation. I'm having ultrasounds every 2 weeks, and no signs of TTTS as yet, though their sizes have been varying. The baby girls have been fine and are kicking and wiggling nicely. The hospital has a 'know your midwife' thing, so I know and am happy with the midwife who will be attending me. She was with me for the birth of my 11 month old son at the same hospital. I'll also have my husband and a support person with me, and hopefully my 2 daughters, 12 8. My daughters were both born at home, and all 3 of my births so far have been vaginal with no drugs or intervention. I'm 39 and in good health, no GD, no high BP ever, no health probs. I'm 5'6 and 75 kg at 25 weeks. I've always gone 13 hours from the very first contraction, and the waters have always broken 1-3 hours before the birth, with the head never engaging until well into labour. My son turned himself from posterior a couple of hours before birth while I was lying on my side. The hospital tell me I will have one of the 11 consultants attending me, and he/she will be running it, but my midwife may get to catch the first baby. They say I must be induced if I get past 38 weeks, and they very much want me to have an epidural incase of needing to reach in for the second baby. They don't want more than 10 mins between babies. One Ob I saw said no vaginal births are done for this type of pg, one I've seen since then says it can be attempted if 1st one presents head down, but 65% of all twins in Melb are born by c/section. I've asked about having the epi in with no drugs in it, but it seems it depends on the views/wishes of whichever anaesthetist happens to be on when I get there. If I go earlier than 32-34 weeks I get
Re: [ozmidwifery] monochorionic diamniotic twins birth in a public hospital, hopefully vaginal.
Hi Yvette, Good luck with your twins birth - I've only attended twins at home, but I can empathise with your desire and concerns about wanting a normal birth in a hospital setting. I am currently looking at twins births through all my texts - including one called 'High Risk Pregnancy Delivery' and most of the major concerns are around the mono/mono scene where there is a higher risk of entanglement of cord/bodies etc. Your situation looks great for a good birth, and as you've been told, best if first baby is head down for everyone's peace of mind. You could really encourage this as I'm sure you're aware, by dialoguing with your babes. The time limit of ten minutes between babies seems absurd - I have records here for 18 sets of homeborn twins. The average time between babies for 16 births was 27 minutes, ranging from 7 mins to 90 minutes, with only 5 sets arriving within the 10 minute time frame. One of the other sets were 23 hours apart, and the other I don't have the time difference for. Placentas were birthed between 1 and 60 minutes after the second baby, and in one case both placentas arrived between the baby's birth with no problems to second baby who arrived 8 minutes later! There was one cord prolapse of a first born breech twin, who then came quickly and was fine. One of the sets of twins died in utero before labour began at 38 weeks (they shared a placenta and were possibly identical as they both has the same slight abnormality, but I can't confirm that), and all the others arrived in fine form. Their gestational ages varied from 42 days early to 14 days overdue for 15 sets, with 7 sets arriving 21-42 days early, 2 sets 7 days early and 6 sets term or overdue; 2 dates were unknown and one set I don't have that information. I am also currently waiting for statistics from The Farm where Ina May Gaskin and her team of midwives have delivered twins. I am aware of current hospital practice of rushing the second baby, usually then born by c/section, but in the last year I have heard about 2 sets born normally at our local large teaching hospital, so it does happen and there is hope, particularly if you are armed with your own midwife, and are well informed. Good luck Yvette and I hope this information helps, Sue Cookson -Original Message-[Ken Ward] *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of *Lindsay Yvette *Sent:* Thursday, 26 May 2005 3:26 PM *To:* ozmidwifery@acegraphics.com.au *Subject:* [ozmidwifery] monochorionic diamniotic twins birth in a public hospital, hopefully vaginal. Hello list. I've subscribed so I can submit details of my situation for anyone who wants to respond, and so I can keep an eye out for anything that comes up about twins births. I'm not a midwife or anything, so I hope it's ok to do this. I'm a public patient at Box Hill hospital in Melbourne, and due to have twin girls on 5th Sept, or by 38 weeks which is 22nd Aug. They are identical, sharing a placenta but each in her own amniotic sac. I want a vaginal birth without unnecessary intervention provided this is safe. I'm looking for any advice, information, studies, articles, comments etc relevant to my situation. I'm having ultrasounds every 2 weeks, and no signs of TTTS as yet, though their sizes have been varying. The baby girls have been fine and are kicking and wiggling nicely. The hospital has a 'know your midwife' thing, so I know and am happy with the midwife who will be attending me. She was with me for the birth of my 11 month old son at the same hospital. I'll also have my husband and a support person with me, and hopefully my 2 daughters, 12 8. My daughters were both born at home, and all 3 of my births so far have been vaginal with no drugs or intervention. I'm 39 and in good health, no GD, no high BP ever, no health probs. I'm 5'6 and 75 kg at 25 weeks. I've always gone 13 hours from the very first contraction, and the waters have always broken 1-3 hours before the birth, with the head never engaging until well into labour. My son turned himself from posterior a couple of hours before birth while I was lying on my side. The hospital tell me I will have one of the 11 consultants attending me, and he/she will be running it, but my midwife may get to catch the first baby. They say I must be induced if I get past 38 weeks, and they very much want me to have an epidural incase of needing to reach in for the second baby. They don't want more than 10 mins between babies. One Ob I saw said no vaginal births are done for this type of pg, one I've seen since then says it can be attempted if 1st one presents head down, but 65% of all twins in Melb are born by c/section. I've asked about having the epi in with no drugs in it, but it seems it depends
Re: [ozmidwifery] Epidural top-up Policy
Hi Justine, Marilyn and all you passionate women, Whilst researching for a recent essay on research in midwifery, I came across articles about Dutch midwifery and scope of practice. With a country that still has about 33% babies born at home, 9%c/section, 6%epidural, and where midwives are the first person a pregnant woman sees and the ones to refer on to an obstetrician if required, it seems the Dutch midwives have very clearly defined their practice scope, and are constantly doing so in response to consumer lead demands ... such as now introducing u/sounds to mid practices because the women want them... 70% midwives work in homebiths, 15% in hospitals and the other 15% provide back-up/locum for the homebirth midwives. They are also establishing birth clinics where fertility issues, contraception and everything in between is discussed, apparently seeing the need to stay very connected to the women and where they can further support and promote their own position in the birthing field. I have to agree Justine, as a student midwife now, I am just taking deep breaths at what I'm being asked to learn and do as part of attaining an Australian registration. I'm not sure how or where midwives in Australia could stop working in such a medicalised support role - the whole system just rolls on as it does ... would take a major, united leap for midwives here to change their role ... and I don't think there are enough midwives who desire the same change... Maybe Aussie midwives could spend more time in the community running birth clinics where grass roots information, research, support for the midwives role could be fostered. It's what I intend to do anyway ... Still holding my breath every time I'm faced with clinical practice, Sue - Original Message - *From:* Justine Caines mailto:[EMAIL PROTECTED] *To:* OzMid List mailto:ozmidwifery@acegraphics.com.au *Sent:* Thursday, May 19, 2005 5:07 AM *Subject:* Re: [ozmidwifery] Epidural top-up Policy Dear Lisa and All You seem to have missed my point. I did not advocate against women choosing an epidural, I said the use of epidurals should not be within a midwifery scope of practice and I stand by that. I find it insane when a fraction of midwives actually work as midwives and yet we yell and scram to keep supporting all the obstetric who ha. Don't worry all that stuff is very safe. I agree every woman needs a midwife, regardless (but topping up the epidural is not being a midwife) As to who should do it, yes let the Drs go for it, it's their domain! If midwives determined what was and wasn't midwifery then we would have real change in this country NOW. We will never see midwifery practiced fully while there is such support for an obstetric model with all its trappings. The balance is so severely skewed it is time to get realand establish what is midwifery and the right of healthy women to access it exclusively. With less than .2 of 1% of women being able to be cared for by a known midwife and yet women being able to demand epidurals, social inductions, and elec c/s I know where the work needs to be done. As a woman I have paid $14,000 for homebirths, with not a cent in return. Yet I pay for the 30% rebate for privately insured women to have the works. Something has to give. I really believe midwifery on the whole to be with well women with only an emotional and supportive role for women accessing medical care and intervention. Just because 80% of women currently receive intervention and many blindly ask for it doesnt mean its right, or that they are informed. Most women are told an epidural cant harm the baby!! How can we say women really want/need an epidural when 99% of them are forced to share their most intimate moment with a stranger and nearly as many of them cant even use warm water immersion and they are in a system that sets them up for failure (pelvis too small, big baby, unreal labour time frames etc etc!). What we know is that where midwives form a relationship with women the use of drugs is slashed. In our local unit Epidurals are hard to obtain and consequently 2 are done each year, what makes these women different to the city women where it is peddled?? Hope this clarifies Justine __ NOD32 1.1100 (20050518) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Iron infusion
Hi, Not too sure if this isn't part of the same thread about 'dramatic' women,. What do any of you know about the risks/benefits of iron infusions after a PPH? Hb @ 5 weeks is 91, but mother active, walking, good milk supply (always), happy... Anyway, she's been advised by a medico to have an iron infusion and I can find very little in any of my Obs or midwifery texts. Looking forward to your wise responses, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Quote
ME TOO!!! Sue I am amazed to have been a midwife from the era in which women marched in the streets, demanding normal births without medication, to a time when they expect an epidural as soon as it is allowed in labor, even planning elective cesareans and giving up the gift of birthing their children altogether. **Katherine Jensen** __ NOD32 1.1075 (20050423) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Homebirth in Grafton/Maclean
Hi Justine, I think this area is often covered by the midwives from Bellingen, or even from Byron/Ballina/Lismore. Grafton's only 2 hours from me and I'm 20 minutes north of Byron. Bellingen is probably about the same distance south from Grafton. Hope this helps, Sue Dear All I have not heard of any IPMs in the Grafton/Maclean area but wondering if any of you have. Any info would be most appreciated. Justine /Justine Caines Secretary Homebirth Australia PO Box 105 Merriwa NSW 2329 Ph: (02) 65482248 /E-Mail : [EMAIL PROTECTED] www.homebirthaustralia.org __ NOD32 1.1075 (20050423) Information __ This message was checked by NOD32 antivirus system. http://www.nod32.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Independent midwife numbers
Hi all, Just completeing my assignment - anyone know approximately how many independently practising midwives there are across Australia? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Contemporary midwifery critique
Thanks Lieve, those references were great - just what I needed, sue Hoi Sue, Robbie Davis-Floyd wrote some excellent articles about midwifery care and 'technocratic, humanistic and holistic' approach of care http://www.davis-floyd.com/art_index.html Succes Lieve Lieve Huybrechts vroedvrouw 0477/740853 -Oorspronkelijk bericht- Van: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Namens Sue Cookson Verzonden: vrijdag 15 april 2005 1:16 Aan: ozmidwifery@acegraphics.com.au Onderwerp: [ozmidwifery] Contemporary midwifery critique Hi all, Am in the midst of an assignment which includes a critical analysis of contemporary midwifery. I need some references to validate what I'm saying - fragmented care vs continuity of care, educational methods, medical dominance, socially constructed health care systems, mechanistic view vs humanistic etc etc. I'm hoping there's lots of good references amongst all of you, Many thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Foetal positioning
Hi all, I also took that last bit as being positive, but I've still yet to hear real stories of women in hospitals pushing for longer than a few hours in most cases, at least in my area. Also just to keep adding to our own stories, I have yet to see an OP birth with the women I have given care to in over 22 years- fully believe in giving them good information about best positions etc for birth, and as for those asynclitic/deflexed heads, the external lifting technique works more often than not. The indicator is the head not well applied to the cervix at full dilatation, particularly after good pushing. The technique is simple, pain free and I believe safe, though obviously no research has been done, (only anecdotal I'm afraid, but one would think it to be safer than heading off for a c/section). Technique done between ctxs, woman lying down (works well in bath, pool too), locate shoulders and gently lift up out of pelvis rotating leading shoulder to anterior. The lift is often no more than say an inch, but you'll usually feel a rotation occur. I was taught to attempt it a few times, and if no success, then keep thinking of other techniques - like high stepping or asynclitic positions through ctxs etc etc. Sue What I thought was interesting about this article is the following statement Guidelines that propose norms for expected labour duration should take into consideration position of the foetal head at full dilatation and the strategy of pushing, conclude the researchers. I took this in the positive.. eternally the optimist, that we should be allowing longer for women who have babies positioned in interesting positions. **Sally Westbury** **Homebirth Midwife** It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her. -Judy Slome Cohain -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Contemporary midwifery critique
Hi all, Am in the midst of an assignment which includes a critical analysis of contemporary midwifery. I need some references to validate what I'm saying - fragmented care vs continuity of care, educational methods, medical dominance, socially constructed health care systems, mechanistic view vs humanistic etc etc. I'm hoping there's lots of good references amongst all of you, Many thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Post placental hypotension with synto
No Tina, Simply an IM injection. I've checked out the info that goes with synto and 1 article was very clear that a side effect could be hypotension, elevated heartrate, nausea etc etc. JUst didn't seem to be the right response for such a lightweight bleed - her Hb's and ferritins were good going into the birth ... Always trying to 'work it out' ... Sue Hi all, Just doing some research on the effect of syntocinon on a newly birthed mum. I have recently witnessed a severe post placental hypotension after synto was given with a fast (but not too severe) bleed - about 700ml in total. Drop from 100/70 to 70/40 within 5 mins ... any thoughts?? She came up again within 45 mins, but I thought this was pretty severe... Anyone have some recent research?? Many thanks, Sue HI Suehow was the syntocinon administered...as an IV bolus?? Cheers Tina Pettigrew -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Post placental hypotension with synto
Hi all, Just doing some research on the effect of syntocinon on a newly birthed mum. I have recently witnessed a severe post placental hypotension after synto was given with a fast (but not too severe) bleed - about 700ml in total. Drop from 100/70 to 70/40 within 5 mins ... any thoughts?? She came up again within 45 mins, but I thought this was pretty severe... Anyone have some recent research?? Many thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Homeopaths in Melbourne
Hi, Needing some homeopathic help for a couple in Melbourne at present with their 2.5 yr old daughter having surgery. Can anyone recommend an outlet for homeopathics easily accessible to the Children's Hospital? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Midwives in Lennox Head?
Hi Julia, There are a few of us around the Byron Bay area who would be happy to assist your relative. She could pop along to the Byron Bay Pregnancy Support Group which meets every Wednesday at the Community Centre, Jonson Street, Byron Bay. From 10.15 -11.30 there is bodywork of some description - either yoga or belly dancing or singing or meditation, followed by morning tea and then a discussion from 11.45 - 1.00pm. Cost is $10. She'll meet midwives, doulas .. lots of helpers who support at home and in hospitals. If the group isn't possible, I suggest she contacts Penny Mason on 02 6687 1625 or Heli Murray on 02 6685 6523. Hope this helps, Sue Goodafternoon, Hi to everyone, I'm not a midwife, but was hoping that I could seek some information from the list. My name is Julia Sillitoe from Kempsey NSW. I have a relative living in Lennox Head (near Ballina, Byron Bay). She is about 12 weeks pregnant and would like to find out whether there are any midwives working in her area that she could make contact with. She isn't keen on a homebirth, but would like to have someone with whom she can have her Antenatal care and possibly have at the hospital with her. If anyone works in that area, or knows of anyone who does, I would really appreciate some contact details that I could pass on to her. This is her first baby and understandably she is a little nervous about the whole thing. I thank you for you advice. Warmest Regards Julia (who one day dearly wants to be a BMid - if it ever comes to Southern Cross Uni)!!! -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] folic acid and retained placentas
Hi Sonja, Don't have anything on a research level to do with adherent placentas, but do have some anecdotal stuff. John Stevenson who was a homebirth doctor in Melbourne for some years during the 80's, always asked women as part of their history, if they'd ever had severe dysentery, and if so, how had they recuperated? He maintained that with severe diarrhoea caused perhaps by certain organisms, it was possible the uterus became invaded with the organism and was altered slightly, thus making the uterine environment 'abnormal'. The outcome of this abnormality to the uterine lining, based on his years of experience in his homebirth practice, was likely to be difficulty with the placenta coming away from the uterine wall - varying degrees of accreta, sometimes requiring manual removal. I have incorporated this into my practice for the last 20 years, and although have had few placental problems, have definitely followed through numerous stories of retained placentas and this type of medical history. I have had one retained placenta, some 15 years ago and the woman had a history of retained placentas (3 in total) but had also had had dysentery. After that birth, I suggested she work on the health of her uterus (with the help of herbalist/homeopath) and she birthed about 4 years later without any placental dramas. Other women who have spoken of their retained placentas (I've run birth groups for many years), have more often than not been able to recount some sort of severe problem with prolonged diarrhoea - spastic colitis etc. As I said, no rocket science here, just related observations. Anyone else able to make similar connections? Sue Dear all, Wondering if any you wise women/men know if the intake of additional folic acid via vitamin tablets etc causes a placenta to adhere more firmly to the uterine wall, thus requiring a manual removal of placenta. Also wondering if anyone has ideas thoughts or research related to this. Thanks Sonja -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] [Fwd: Ear tags and Wilm's tumors]
---BeginMessage--- Hi, Whilst we're on the subject of unusual occurrences and their possible outcomes: One of my babies born 3 years ago had 3 eartags (we called them earrings) on her left ear. Cylindrical units, the largest being a double matchstick head size. Lotus birth, so no opportunity to check arteries/veins in cord. She has just been diagnosed with a Wilm's tumor in her right kidney and the attending paediatrician remarked on the eartags and also asked if she had an umbilical hernia at birth.(which she didn't) Has anyone else had ear variations associated with kidney cancers? Sue She is undergoing a nephrectomy within the week; the cancer is a stage 1 and fully encapsulated; prognosis is good at this point. ---End Message---
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi Marilyn and Jenny, Well said Marilyn. I know that there isn't a different 'scope of practice' here in Australia for midwives practising out of hospital, but I do accept that a manual removal is and can be life saving in some situations. Two of the bleeds I have managed were about an hour from the nearest hospital - again I can hear the criticism - but that's the reality of working in rural settings. I also think there is quite a defined difference between a bleed from a placenta accreta and one from a placenta that is just stuck on some scar tissue or whatever. This has been my observation anyway. The accreta bleed is more insipid and insidious. Not the full blown free bleed that we all don't want to witness, but a slower, steadier expulsion of blood. The bleed which is fast and furious and must be dealt with there and then, is usually from a placenta that is just hanging on somewhere and so usually comes away with CCT, but if not ... perhaps a manual removal if appropriate to the circumstances. Anyone else witnessed the different types of bleeds?? Sue Jenny: I know that what you say is Australian practice and if i were attending homebirths here I would always transfer rather than do a manual removal of either a partially detached placenta or retained products however it wasn't considered outside of a midwife's scope of practice in the USA where I practised (california and washington state), in fact it was required by state law that i be capable of carrying out this procedure. The exact procedure is detailed in Varney's Midwifery third edition, p. 843, Chap 68. Most certaily considered part of the midwife's scope of practice. I would suggest that any birth attendant practicing in an out of hospital setting should at least know what to do and have practiced the procedure just in case which is what Sue was saying is her situation. I have never actually done the procedure myself but was knowledgeable of it, tested on it with simulation (as it is NOT something you practice on someone) and aware when it is necessary. Definetely quite different than removing a placenta trapped in the vaginal vault, the os, or lower segment. marilyn - Original Message - From: Jenny Cameron [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 27, 2005 9:00 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Manual removal of a separated placenta is different to manual removal of a placenta still attached to the uterine wall. Removing a separated placenta from the os or lower segment is not difficult but it is uncomfortable for the woman. Manually detaching a placenta from the uterine wall is barbaric and traumatic and should not be carried out unless under adequate anaesthetic and fluid replacement. Granted a partially separated placenta is a high risk situation as bleeding will continue until separation. Although this is an emergency we would better to summon help and use bi-manual compression to slow/stop the bleeding until assistance arrives. If you are performing true manual removal of the placenta and membranes (ie partially separated placenta ) as a midwife you are practising outside your scope of practice. Jenny Jennifer Cameron FRCNA FACM ProMid Professional Midwifery Education Service 0419 528 717 - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, February 28, 2005 7:31 AM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi Sue, I was taught that if doing a manual removal would effectively save the woman's life, then that was the best option. Obviously a risk vs benefit type of situation. The doctor I trained with did the occasional manual removal at home rather than the time challenging option of transferring, and always with the woman's cooperation. I work rurally, and sometimes the speed of the bleed and the distance from hospital would equal real damage to the woman. As I said in my posting, I have not had to perform a manual removal, but I can and would if it was a life saving procedure. I thought the hospital acted very dangerously by delaying many aspects of their management of the PPH I witnessed last year, and that all up, a manual removal there and then would have been the quickest and safest option. Instead the woman went on to lose much more blood over another 40 minutes or so until in theatre, and then faced the choice of transfusion. I found that management very scary. I have witnessed one manual removal in a hospital on the delivery bed after the cord tugging GP/Obs broke the cord whilst trying to extract the placenta (after a forceps delivery). He simply went straight in after the placenta and delivered it quite quickly. The woman was not too perturbed!! (and hadn't had any drugs either). So I guess it's a matter of training, attitude, access and appropriateness - all
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi Sue, I was taught that if doing a manual removal would effectively save the woman's life, then that was the best option. Obviously a risk vs benefit type of situation. The doctor I trained with did the occasional manual removal at home rather than the time challenging option of transferring, and always with the woman's cooperation. I work rurally, and sometimes the speed of the bleed and the distance from hospital would equal real damage to the woman. As I said in my posting, I have not had to perform a manual removal, but I can and would if it was a life saving procedure. I thought the hospital acted very dangerously by delaying many aspects of their management of the PPH I witnessed last year, and that all up, a manual removal there and then would have been the quickest and safest option. Instead the woman went on to lose much more blood over another 40 minutes or so until in theatre, and then faced the choice of transfusion. I found that management very scary. I have witnessed one manual removal in a hospital on the delivery bed after the cord tugging GP/Obs broke the cord whilst trying to extract the placenta (after a forceps delivery). He simply went straight in after the placenta and delivered it quite quickly. The woman was not too perturbed!! (and hadn't had any drugs either). So I guess it's a matter of training, attitude, access and appropriateness - all to be assessed in a very short time frame if a real bleed is occurring. Sue I am a bit confused here - can you please explain how you do manual removal in the home situation? Surely this is too dangerous a procedure to do at home? Thanks Sue - Original Message - *From:* Marilyn Kleidon mailto:[EMAIL PROTECTED] *To:* ozmidwifery@acegraphics.com.au mailto:ozmidwifery@acegraphics.com.au *Sent:* Monday, February 28, 2005 1:34 PM *Subject:* Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Totally agree Sue. I was taught manual removal too and exactly the same re when to apply gentle but firm CCT. However, for a manual removal at home you do need maternal cooperation and did have one incidence in Seattle where we had to transfer for prolonged moderate/heavy blood loss that just would not settle and uterus that kept getting boggy. Para 3 with several years between each of the births, third birth being precipitous, placenta delivered easily (dirty duncan if you know what I mean) physiologically but bleeding would not subside and mum kept soaking a pad in an hour, could not stand a hand going past the introitus and was happy to go to the hospital. Estimated blood loss was 1600mL including theatre, a pin head size piece of membrane was all they could find. Mum declined transfusion and was home the next day tired but happy. marilyn -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Re: Breech
Hi Helen, Babies are often breech at 32 weeks, even up to 35/36 weeks, so I'd tend to try to relax a bit. I do understand your anxiety, particularly in today's breech-scared environment. My second baby was born breech vaginally and I know how tough the emotional journey can be. The doctor I learnt through would recommend trying to turn your baby by external version - should be done with people who can listen to the baby's heart rate, and done without force, but even he would say wait a few more weeks until you begin this.These days , the drs who are happy to do external versions generally want you to take a relaxant as well - valium or whatever. I would want to avoid that as well. Other things which help babies turn, like acupuncture, homeopathics, acupressure and the tilting process can all be done anytime, but I'd suggest you also trust that the baby will turn, or if he/she can't turn then there's a good reason for this (my baby had her cord tangled over her shoulder and between her legs..I told her she dansed into the world...). By the way, the tilting process has 3 steps to it - not just the on your back bottom in the air one.I have to go to work now,but if noone else has posted the 3 step breech tilt by this evening, I'll try to find it. (It was a posting by Lieve a year or so ago) Take a deep breath Helen, Sue I'd probably leave the pulsatilla until after 35 weeks too - any of the energy changing modalities may invite early births too, so take care that baby is old enough when you use them. Hello everyone! I am in need of some help!!! I am 32 weeks pregnant and the baby is in a breech position. I have been doing breech tilts 2-3 times a day for the past week with no success. I am having acupuncture next week. I am particularly interested in some information on the use of pulsatilla. Any ideas will be much appreciated!! Thanks Helen -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi, I would definitely treat this woman like all others and assume physiological 3rd stage is sufficient. I have never actively managed a 3rd stage, and have given syntometrine 3 times only after placentas were born - all in my early days of homebirth. I always prefer to; a) make sure women are well hydrated going into 2nd stage so they can tolerate volume loss b) if bleeding is serious go into deliver placenta mode I always catch and therefore can measure blood loss at a glance I engage the mother first and tell her she's bleeding and that I need her to focus and deliver her placenta I always give herbs as a first line of attack- shepherd's purse has always been my first choice I would rub up a ctxn, add an ice pack to her uterus if one available Then with her assistance pushing I would apply cord traction and see if the placenta would come Repeat this maybe twice Then contemplate manual removal if necessary (not had to yet...) I have managed 5 large haemorrhages (over 1.5 litres measured) in this manner and have not had to transfer anyone yet.(I have a haemoglobinometer with which I can measure Hbs on the spot over the next few weeks if necessary..) This management regime was taught to me by John Stevenson and always seems to work.Up until very recently, I have always worked alone. Isn't it interesting all the different ways we'd handle this depending on our personal experiences? By the way, late last year I witnessed the worst PPH I'd ever seen - mainly because of the management in the hospital (it was a hospital support not a homebirth), and with all the hands you could ever imagine -I'd say too many - the woman was severley depleted. Drips in etc etc but too much too late. A cord pulling midwife, and then no acknowledgement of when she needed help (irrespective of my pleas) plus she underestimated the blood loss by more than 100% (she thought 600ml, and it was measured by weight (? accuracy) to be more like 1400ml) and then the woman was taken to theatre - more time, more blood, why not a manual removal then and there?? Aaaah. Expect no PPH but stay on your toes ...always my motto. Sue - Original Message - From: leanne wynne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 24, 2005 2:43 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Hi All, I would be interested to hear from any experienced homebirth midwives how they would care for a woman who is a G10P9 if she chose to birth at home. She has had all normal, quick births so far. Would you use active management of third stage because she is a grand multip or would you still encourage a physiological third stage?? Leanne. From: Marilyn Kleidon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Date: Thu, 24 Feb 2005 16:55:56 -0800 Excellent point. I do think the 500mL definition for PPH is spurious. Having been educated by a homebirth midwifery school I have to say we were not concerned when the blood loss was less than 1000mL as most of our 3rd stages were physiological. Very occassionally we did use oxytocin for management of 3rd stage usually when the woman had a history of PPH greater than 1000mL or retained products etc.. However we were well versed in the Cochrane studies and aware of that evidence so we had a high degree of caution shall I say. We did carry 40 units of pitocin and also ergometrine both vials and tabs to births as well as herbal remedies. Syntometrine does not seem to be available in the USA at least not where I was. That being said from what i have seen here postnatally, active management really decreases the postpartum blood loss in most women. I am currently doing the extended midwifery service and visiting women in their home during the first 1 to 10 days and most seem to have almost finished bleeding by day 5, for most of the homebirth women I visited in the USA just from memory I would say they were almost finished by day 10. Both the American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA) have been collecting stats for 5 to 10 years at least and must have good stats on this topic. I know it isn't Australian data but itmight be helpful. marilyn - Original Message - From: Jenny Cameron To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 23, 2005 3:51 PM Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT Good point Michelle. If we used 1000ml as PPH definition the stats would not look so appealing for active mgmt. Also as someone stated women having a physiological 3 stage tend to lose more in the first few hours after birth than those having active mgmt. As far as I am aware no-one has researched total postpartum (say in the first week) blood loss. Hb or Hct estimation is the best way of
Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi Abby, You'd have to be quick and really believe this will work in the case of a true and fast PPH. I have seen a woman taste her placental blood whilst having a trickle bleed after the placenta was born and the blood loss stopped , but I can't recall if that was after she got up, in which case she may have dislodged a clot which is the most likely cause for this type of trickle bleeding. More usually, the placenta is sliced up and frozen, in situarions where the woman is scared of/has history of PND. Birthing the placenta is very definitely the mode of action for any PPH, in my poinion. Sue Has anyone had any experience with women eating a chunk of raw placenta to stop pph? I have read a few things about it and was just wondering if anyone had experience with this. Thanks Love Abby Add FUN to your email - CLICK HERE! http://www.incredimail.com/index.asp?id=54475 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] active management of third stage
Hi Nicole, Could you give some more details about where to go - I found the directive but not the actual document. Thanks, Sue To those who are interested I am a new grad midwife (6 months out) and we were taught about active and physiological management. I work in a tertiary referral hospital and our policy follows the NSW Health recommendations for active management to prevent PPH. This policy guideline is explicit and defines active management and Im sure you will find all the answers to your questions if you look into it. The website for NSW Health is www.health.nsw.gov.au http://www.health.nsw.gov.au/ and if you search under postpartum haemorrhage it will lead you to the policy. It also describes not only active management, but guidelines for ppH, recommendation on how long to leave a placenta in situ etc Nicole -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RE CHoices to VBAC
Hi Jenny, (and others), Just interested in Robyn Turnbull's reply to you re the Caboolture woman's 'medical condition' that was not disclosed in the newspaper coverage. Do you have any idea what that was - and also I've been contacted by the Vacc Awareness Group who believed the woman had planned a homebirth. The Courier Mail story alludes to that ... was this really what it was about?? Reporting to DOCS etc seems to be the new way to control ... all of us. Two of my women have been reported in the last 2 years for their choices ... This new 'best practice' cry is also very handy for those wishing to not support our rights to make choice - it was used in this case, and also for a woman who was transferred out of a low key hospital to a higher level one at full dilation to a c/section when it was discovered her baby was breech... even though the drs in both hospitals were competent with breech. Sounds like 'best practice' overrides safety and evidence based information to me. What a strange world we have created. Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Doppler advice
Hi, Am looking for the SA contact for dopplers and the name of the doppler that was recommended some time back on this list. Hope someone can help, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Uni SA B(Mid) problems
Hi all, Just thought I'd update those others of you who may have enrolled to do the external BMid course through Uni SA. I guess I'd been feeling that there was something uncertain around the course, and today I received a letter from the uni saying that in future, all clinical placements for this course have to happen in SA (whereas to date students have found placements wherever they've resided). Reason cited was due to pressure on clinical places from within those states (any state apart from SA)... makes you laugh since only Vic and SA have BMid programs. I know the huge Base Hospital near me (1300 births p/a) only has 2 places for midwifery students which are allocated to the students from Sturt Uni at Wagga Wagga. Oh dear. I'm yet to determine whether the clinical placements can be done in blocks, in which case one could fly to SA for a few weeks here and there as required .. just another hurdle on the pathway... Any of you currently doing this course having problems now with your clinical placements? Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Routine Observations in labour and post partum
Title: Re: [ozmidwifery] Routine Observations in labour and post partum Hi Tania, Have to agree with you - I don't 'routinely' do much except listen to baby's heart rate, more so in 2nd stage or if any worrying fluctuations in 1st stage. I don't do BP's unless there has been a problem during the pregnancy and I guess my main belief is in trusting the woman as I know her. to tell me of any physical deviations. I have worked now for over 20 years following this philosophy, and have not had any problems. There seems to be a huge gap between normal physiological birth and medicalised management of birth. Forgive me if I am wrong... This also follows for postnatal care - I only do BP's or temps if I or or the mother think there is a problem ... I would tend to do more maternal pulses whilst waiting for third stage but this and other worries would translate to maybe 5 % of the births I attend, and mostly there are no problems... healthy mums and healthy babes... Sue I am finding this whole thread really interesting, and quite horrifying all at once! If I were a labouring woman, I'd be blowed if I'd be standing still to let someone monitor my pulse and resps every 1/2 an hour! And for what? I can't believe that all of us don't truthfully expect a pulse rate to be higher than normal when in active labour, or that a woman labouring well in a warm pool might have a slightly raised temp. The way I see it, there are plenty of women having babies who manage to stay at home until labour is well established, before they enter a hospital or birth centre, or call their midwife to attend them at home, and these women are not having any of that damaging neo-cortex stimulation from someone wanting to observe and document their vital signs. Whilst I know a baseline is important, should we not be assuming that in the absence of any other signs, a healthy woman in labour is just that? Is it just the fear of litigation that drives us to do half hourly obs? Or is it truly justified from a research based perspective? I like to think that as a midwife, I approach the whole idea of pregnancy and birth from a wellness perspective, that a woman is healthy and well, and has the ability to gestate and birth under her own steam until I'm proven otherwise. This philosophy carries on in labour too, so why are so many of us suddenly treating women like they are an accident waiting to happen when they are in labour? Maybe there's that thought that a birth is safe and successful only in retrospect, I dunno... Working independently with normal healthy women, who expect to be treated as such, we do a baseline bp in labour when we arrive, or when the opportunity arises, (feeling their skin to do the bp gives you a good indication of whether they are hot or not, and pulse is heard through the steth during the bp reading) and if all's well, and their pregnancy has been uneventful from that point of view (no hx of raised bp for example) then it doesn't factor into it again, unless labour becomes prolonged, or we're thinking about transfer into hospital. I don't feel that I'm taking any chances in not doing these obs constantly, and the vast majority of the women we birth with get on with it and birth, undisturbed by us clanking around with a sphygmo etc. We check the water temp regularly, but this is non invasive, and also listen to baby quite frequently, depending on what the mum is comfortable with. Those who don't want any doppler are always most obliging to let us know that baby is moving frequently. Stretches the comfort level a bit I know, but when it all comes down to it, it's their birth. Anyway, just my 2 bob's worth... Tania - Original Message - From: Ken WArd mailto:[EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, December 08, 2004 5:53 PM Subject: RE: [ozmidwifery] Routine Observations in labour All these obs in labour. distracting for the woman and annoying for the midwife. We do 15/60 fhr, although I do it 30/60 early labour, and when I can in active labour, 15-30/60 if all has been well. Any concerns I'll listen from cont. to cont. If I'm really worried I'd do a ctg. 2nd stage 5/60 until hov then following every cont. I try and slip obs in as I can. Temp 4/60, bp2-4/24conts continuously, pulse 30/60. Ve's I don't tend to do on multis unless they ask. Primips 6/24 from active labour., no real hard and fast rules on ve's. As long as abdom. descent can be detected and mum and bub ok there is no pressure.Observation of iquor, what the woman is saying, how she is managing the conts, fluid intake and output. If all has been well I do not interfere or interrupt the woman, but take my chance as it comes. MS -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Anglodutch NTL Account Sent: Tuesday, 7 December 2004 5:22 PM To: [EMAIL PROTECTED] Subject: RE: [ozmidwifery] Routine Observations in labour Oops, BP should be hourly of course, not 4 hourly! Claudia
Re: [ozmidwifery] Incidence of meconium
Thanks Leanne, Is there any way I can access that article or acquire a copy of it - I don't have a membership to MIDIRS. There are certainly lots of articles now that don't support routine suctioning of mec-stained babies at head birth, and yet it is still common practice up here in the Northern Rivers Area hospitals. Any feedback from anyone about changing practices in hospital care? Thanks, Sue Hi Sue, An excellent article in MIDIRS Midwifery Digest 14:1 2004 by a midwife cites Houlihan and Knuppel (1994) as showing that meconium is normally passed by the foetus in 3% of cases @ 36 weeks gestation, 13% @ 36 -39 weeks gestation, 19% @ 40 -41 weeks gestation and 23% @ 41 weeks gestation. This does not cause a problem unless the foetus becomes hypoxic. Leanne. From: Sue Cookson [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: [ozmidwifery] Incidence of meconium Date: Fri, 03 Dec 2004 10:30:36 +1100 Hi everyone, Just wondering if anyone has information on the incidence of meconium during labour? Anecdotally, I would say around 20%, but wonder if other's practices agree with this figure and if there are any statistics showing a reliable figure? Thanks, Sue Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Incidence of meconium
Hi Leanne, Thanks for the offer to send me a copy - probably ordinary mail would be the easiest. My address is: Sue Cookson, 200The Pocket Road, The Pocket NSW 2483 Thanks again, Sue Cookson Hi Sue, It really is a terrific article about birthing in the caul. I'm sure I also have an article somewhere about how suctioning the baby on the peri actually stimulates the baby to take a breath and thus meconium is drawn into the lungs whereas if the baby is not touched just the pressure exerted on the baby's chest by maternal contractions will empty the lungs ... I will do some searching ... I can fax articles to you if you wish or send them by snail mail if that is more convenient - let me know. I will now go and hunt through my filing cabinet for those articles before my next client arrives. Leanne. From: Sue Cookson [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Incidence of meconium Date: Mon, 06 Dec 2004 12:33:30 +1100 Thanks Leanne, Is there any way I can access that article or acquire a copy of it - I don't have a membership to MIDIRS. There are certainly lots of articles now that don't support routine suctioning of mec-stained babies at head birth, and yet it is still common practice up here in the Northern Rivers Area hospitals. Any feedback from anyone about changing practices in hospital care? Thanks, Sue Hi Sue, An excellent article in MIDIRS Midwifery Digest 14:1 2004 by a midwife cites Houlihan and Knuppel (1994) as showing that meconium is normally passed by the foetus in 3% of cases @ 36 weeks gestation, 13% @ 36 -39 weeks gestation, 19% @ 40 -41 weeks gestation and 23% @ 41 weeks gestation. This does not cause a problem unless the foetus becomes hypoxic. Leanne. From: Sue Cookson [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: [ozmidwifery] Incidence of meconium Date: Fri, 03 Dec 2004 10:30:36 +1100 Hi everyone, Just wondering if anyone has information on the incidence of meconium during labour? Anecdotally, I would say around 20%, but wonder if other's practices agree with this figure and if there are any statistics showing a reliable figure? Thanks, Sue Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Leanne Wynne Midwife in charge of Women's Business Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Incidence of meconium
Title: Incidence of meconium Hi everyone, Just wondering if anyone has information on the incidence of meconium during labour? Anecdotally, I would say around 20%, but wonder if other's practices agree with this figure and if there are any statistics showing a reliable figure? Thanks, Sue
Re: [ozmidwifery] Arthritis in pregnancy
Title: Re: [ozmidwifery] Arthritis in pregnancy Hi Sheena, I have just been researching the Rhogam thread and came across a discussion on the Midwifery Today forum about a woman who came down with degenerative arthritis about 3 months after receiving her Rhogam shot. This was linked possibly to her mercury level after a Rhogam injection. Do you know if there is a vaccination history with your friend's cousin? Just a thought, Sue Have a friend whose 30 yr old cousin has developed arthritis, she is six months pregnant and confined to a wheelchair. This has only happened since she was pregnant, does anyone have any experience or has anyone heard of this before. I believe she is consulting a rheumatologist, but they are looking for any info out there. Thanks Sheena Johnson
[ozmidwifery] External Bmidders from UniSA
Hi, Just wondering if any of you out there who are doing the external B(Mid) from Uni SA have had any trouble with your clinical placements? I'm in northern NSW and have been told that there are very few local clinical placements available, but do not want to end up doing placements in nursing homes as was mentioned by someone on the list recently (not neccessarily doing a Uni SA course). Thanks, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
