RE: [ozmidwifery] Cervical dystocia
1. immersion in water tub 2. remove her from water tub 3. ask her what's your biggest fear right now? and really listen. 4. hot compresses on her sacrum 5. lying down on side with upper leg well supported on pillows 6. clear the room of people, give her complete privacy Quoting Dorothy Thomas [EMAIL PROTECTED]: There is no time frame discussed all the question states is that after examination it was fourn that the woman has a degree of cervical dystocia and what are the practical steps that the midwife can take to ease the discomfort of this condition. Regards Dot -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Nikki Macfarlane Sent: Monday, 8 August 2005 3:56 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Cervical dystocia The definitions you have found for cervical dystocia are interesting Dorothy. Cervical dystocia just means that the cervix has stopped dilating. The explanation of dystocia that you came across assumes that no period of waiting would make any difference. Dystocia is a pretty random assessment. Within what time frame does the midwife make the prognosis that cervix has stopped dilating? What if it stops for an hour? Or two hours? Or five hours? What if she just waits? I woudl say the most imprtant thing is to determine the well being of the mother and baby. If the mother is comfortable with a wait appraoch, and the baby is not showing any signs of distress, why does any action need to be taken? OIf the baby is rotating into a better position for delivery then slowing down of cervial progress is pretty common. If the mother is happy, and the baby is happy, then why not just sit it out? Why does the midwife need to intervene in any way whatsoever? Just because the chart says the motehr is not progressing to time, so what? I woudl say this is the time that the midwife begins asking what the mother wants and where and how she is most comfortable. Taking any action just because she is not progressing as per a chart is no different that any other form of obstetric active management. Nikki Macfarlane www.childbirthinternational.com - Original Message - From: Dorothy Thomas [EMAIL PROTECTED] To: [EMAIL PROTECTED] Com. Au ozmidwifery@acegraphics.com.au Sent: Monday, August 08, 2005 1:32 AM Subject: [ozmidwifery] Cervical dystocia I have a queation as a student midwife, I have a case study that asks the question if a woman has a degree of cervical dystocia in internal examination what practical steps could the midwife take to ease the discomfort from this, the definitions I found for cervical dystocia all say that normal delivery is not able to be achieved and this necesitates ceasarian section. I can't seem to find any thing on comfort measures. I would condider may be placing the women on her side to stop pressue on the cx. But can't seem to think of anything else. Any suggestions would be greatly appreciated. Regards Dorothy Thomas PO Box 1616 Mount Isa Qld 4825 Ph: 0747436750 (home) Ph: 0403404538 (mobile) E-mail: [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Cervical dystocia
Dot, The question you are being asked seems very odd. Cervical dystocia per se would not necessarily cause any discomfort to the mother - it just means that the cervix is not dilating. If there was a cervical lip and the caregivers were requesting the mother not to push, this may cause discomfort. But I cannot understand why the cervix taking a rest would cause any discomfort. The only discomfort I can think if is the discomfort of regular vaginal examinations to measure whether or not there is any progress or the mental distress by being told that she is not making progress. If a midwife is focusing on the mother and her needs, and she is comfortable and content with taking a break, why would the cervix slowing in dilatation cause any discomfort? This question sounds like they are focusing on the need to continually progress at a fixed rate which is obstetric active management not expectant woman centred care. There is no discomfort just because the cervix is not dilating. There is discomfort when caregivers constantly do VE's to diagnose dystocia. And there is mental anguish when a woman is told she is not keeping up with the required timeframes and may require intervention to do so. Following a woman and baby's cues does not, on its own, cause discomfort. If vaginal examinations were not carried out, there would be no way of assessing this so called dystocia. It certainly is not a requirement for caesarean section. It is an indication that the mother needs some space, privacy and the opportunity to find her own rhythm to get on with the hard work of having a baby rather than meeting some abstract and arbritrary time limits imposed by those who do not understand that the unique dance that every labor requires to find its own time to get going. Some women progress regularly through each stage of labor. Others take rest periods for the woman to catch her breath, rest and refind her focus. How about coming to the answers from a totally midiwfery and woman centered approach, recognizing the need to be woman centred rather than repeating some textbook solution? Nikki Macfarlane Childbirth International www.childbirthinternational.com - Original Message - From: Dorothy Thomas [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, August 08, 2005 7:52 AM Subject: RE: [ozmidwifery] Cervical dystocia There is no time frame discussed all the question states is that after examination it was fourn that the woman has a degree of cervical dystocia and what are the practical steps that the midwife can take to ease the discomfort of this condition. Regards Dot -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Cervical dystocia
i think they may be wanting you to look at the things that cause cervical dystocia mostly related to fear. Phx sexual abuse Phx birth trauma Unknown birth attendants Fear of doctors / hospitals/ pain Since the question is relating to labour specifically the measures are those that can be taken at this time but could include a statement that prevention is better than cure, known midiwife, familiarity with birth environment prior to labour. In labour, privacy, reduced lighting, presence of midwife, sign on door asking people to knock and wait before entering. bath, food rest Get a hold of childbirth without fear (Grantly Dick Read) recently re leased and available from Birth International but should be in the uni library all off the top of my head in the middle of the night anyone want to add anything Andrea On 08/08/2005, at 3:32 AM, Dorothy Thomas wrote: I have a queation as a student midwife, I have a case study that asks the question if a woman has a degree of cervical dystocia in internal examination what practical steps could the midwife take to ease the discomfort from this, the definitions I found for cervical dystocia all say that normal delivery is not able to be achieved and this necesitates ceasarian section. I can't seem to find any thing on comfort measures. I would condider may be placing the women on her side to stop pressue on the cx. But can't seem to think of anything else. Any suggestions would be greatly appreciated. Regards Dorothy Thomas PO Box 1616 Mount Isa Qld 4825 Ph: 0747436750 (home) Ph: 0403404538 (mobile) E-mail: [EMAIL PROTECTED] winmail.dat -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Cervical dystocia
I have a queation as a student midwife, I have a case study that asks the question if a woman has a degree of cervical dystocia in internal examination what practical steps could the midwife take to ease the discomfort from this, the definitions I found for cervical dystocia all say that normal delivery is not able to be achieved and this necesitates ceasarian section. I can't seem to find any thing on comfort measures. I would condider may be placing the women on her side to stop pressue on the cx. But can't seem to think of anything else. Any suggestions would be greatly appreciated. Regards Dorothy Thomas PO Box 1616 Mount Isa Qld 4825 Ph: 0747436750 (home) Ph: 0403404538 (mobile) E-mail: [EMAIL PROTECTED] attachment: winmail.dat
RE: [ozmidwifery] Cervical dystocia
There is no time frame discussed all the question states is that after examination it was fourn that the woman has a degree of cervical dystocia and what are the practical steps that the midwife can take to ease the discomfort of this condition. Regards Dot -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Nikki Macfarlane Sent: Monday, 8 August 2005 3:56 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Cervical dystocia The definitions you have found for cervical dystocia are interesting Dorothy. Cervical dystocia just means that the cervix has stopped dilating. The explanation of dystocia that you came across assumes that no period of waiting would make any difference. Dystocia is a pretty random assessment. Within what time frame does the midwife make the prognosis that cervix has stopped dilating? What if it stops for an hour? Or two hours? Or five hours? What if she just waits? I woudl say the most imprtant thing is to determine the well being of the mother and baby. If the mother is comfortable with a wait appraoch, and the baby is not showing any signs of distress, why does any action need to be taken? OIf the baby is rotating into a better position for delivery then slowing down of cervial progress is pretty common. If the mother is happy, and the baby is happy, then why not just sit it out? Why does the midwife need to intervene in any way whatsoever? Just because the chart says the motehr is not progressing to time, so what? I woudl say this is the time that the midwife begins asking what the mother wants and where and how she is most comfortable. Taking any action just because she is not progressing as per a chart is no different that any other form of obstetric active management. Nikki Macfarlane www.childbirthinternational.com - Original Message - From: Dorothy Thomas [EMAIL PROTECTED] To: [EMAIL PROTECTED] Com. Au ozmidwifery@acegraphics.com.au Sent: Monday, August 08, 2005 1:32 AM Subject: [ozmidwifery] Cervical dystocia I have a queation as a student midwife, I have a case study that asks the question if a woman has a degree of cervical dystocia in internal examination what practical steps could the midwife take to ease the discomfort from this, the definitions I found for cervical dystocia all say that normal delivery is not able to be achieved and this necesitates ceasarian section. I can't seem to find any thing on comfort measures. I would condider may be placing the women on her side to stop pressue on the cx. But can't seem to think of anything else. Any suggestions would be greatly appreciated. Regards Dorothy Thomas PO Box 1616 Mount Isa Qld 4825 Ph: 0747436750 (home) Ph: 0403404538 (mobile) E-mail: [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
