Re: [ozmidwifery] How long before synto is used?
Women aren't doing their
own Inductions and Caesareans... Very
true, but they are all too frequently choosing
them
Alesa
Alesa KoziolClinical Midwifery EducatorMelbourne
- Original Message -
From:
Stephen
Felicity
To: ozmidwifery@acegraphics.com.au
Sent: Sunday, June 18, 2006 5:36 PM
Subject: Re: [ozmidwifery] How long
before synto is used?
Interesting, Megan.
The thing that is alarming to mein this scenario is not
thepossiblecash motivation, but the fact that "scheduling" and
"delaying" birth is considered to be something we as human beings have a right
to do as a normal part of our birthing processes. Also the "tsk tsk for
shame" in this article seems to be solely directed at the birthing women, and
not the professionals willing to intervene in the birth process to suit a
timetable. Women aren't doing their own Inductions and
Caesareans.
- Original Message -
From:
Megan
Larry
To: ozmidwifery@acegraphics.com.au
Sent: Sunday, June 18, 2006 3:31
PM
Subject: RE: [ozmidwifery] How long
before synto is used?
We talk about choices, but look what we will do for
free cash ???
Megan (whose 4th was bornon
histiming2 weeks before the magic date)
Baby bonus creates
hospital havoc18jun06
THE introduction of the baby bonus on July 1, 2004,
caused more than 1000 scheduled births to be delayed, a new study
shows.In its May 2004 Budget, the Federal Government announced a
maternity payment $3,000 for every baby born on or after July 1.
Research by Melbourne Business School economist Professor Joshua Gans and
Australian National University economist Dr Andrew Leigh has shown there
were more births on July 1, 2004, than on any other single date in the past
30 years.
"We estimate that around 700 births were shifted from the last week of
June 2004 into the first week of July 2004," Dr Leigh said.
"But more troublingly, we found that around 300 births were moved by more
than two weeks."
The researchers also found that the share of births that were induced or
delivered by caesarean section was high in July 2004.
Dr Leigh said hospitals needed to plan for July 1 this year, when the
bonus rises from $3,000 to $4,000.
"Maternity hospitals should expect fewer babies in the last week of June
and more in the first week of July," Dr Leigh said.
Re: [ozmidwifery] How long before synto is used?
Interesting, Megan. The thing that is alarming to mein this scenario is not thepossiblecash motivation, but the fact that "scheduling" and "delaying" birth is considered to be something we as human beings have a right to do as a normal part of our birthing processes. Also the "tsk tsk for shame" in this article seems to be solely directed at the birthing women, and not the professionals willing to intervene in the birth process to suit a timetable. Women aren't doing their own Inductions and Caesareans. - Original Message - From: Megan Larry To: ozmidwifery@acegraphics.com.au Sent: Sunday, June 18, 2006 3:31 PM Subject: RE: [ozmidwifery] How long before synto is used? We talk about choices, but look what we will do for free cash ??? Megan (whose 4th was bornon histiming2 weeks before the magic date) Baby bonus creates hospital havoc18jun06 THE introduction of the baby bonus on July 1, 2004, caused more than 1000 scheduled births to be delayed, a new study shows.In its May 2004 Budget, the Federal Government announced a maternity payment $3,000 for every baby born on or after July 1. Research by Melbourne Business School economist Professor Joshua Gans and Australian National University economist Dr Andrew Leigh has shown there were more births on July 1, 2004, than on any other single date in the past 30 years. "We estimate that around 700 births were shifted from the last week of June 2004 into the first week of July 2004," Dr Leigh said. "But more troublingly, we found that around 300 births were moved by more than two weeks." The researchers also found that the share of births that were induced or delivered by caesarean section was high in July 2004. Dr Leigh said hospitals needed to plan for July 1 this year, when the bonus rises from $3,000 to $4,000. "Maternity hospitals should expect fewer babies in the last week of June and more in the first week of July," Dr Leigh said.
Re: [ozmidwifery] How long before synto is used?
Hi, As you say it will always depend on the hospital policy.However, Iimagine the best way to gain an independent answer might be to review the evidence - A guide to effective evidence in pregnancy childbirth (Enkin et al) may be helpful, though it may also be slightly outdated. Alternatively, go to the Cochrane database on-line.Then at least you've got the evidence to change the hospital policy (you've got to have goals!!) Best wishes. On 6/14/06, Kelly @ BellyBelly [EMAIL PROTECTED] wrote: For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
RE: Re: [ozmidwifery] How long before synto is used?
Sally, It is up to wonderful women midwives like you to keep women's chances alive - don't give up! What hope will we have if the best chance we have at choice no longer wish to work in the system? We need to infiltrate the system to get anywhere. Don't underestimate the power and ability you have to change things, along with all of us sticking together. Power in numbers, power in beliefs. 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 sally @ home Sent: Saturday, 17 June 2006 1:56 PM To: ozmidwifery@acegraphics.com.au Subject: Re: Re: [ozmidwifery] How long before synto is used? You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. I so relate to what you have said Sally. It is hard to work in the system and maintain your integrity as a midwife. Considering the vast majority of midwives do work 'in the system' most of us do our best to provide the best we can within whatever restrictions we have to toe the line to. The system needs midwives like you who know how to challenge, and how to help your sisters challenge, so that in time we can change it. Please don't give it up. Sue - Original Message - From: sally @ home [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 11:56 AM Subject: Re: Re: [ozmidwifery] How long before synto is used? You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
We talk about choices, but look what we will do for free cash ??? Megan (whose 4th was bornon histiming2 weeks before the magic date) Baby bonus creates hospital havoc18jun06 THE introduction of the baby bonus on July 1, 2004, caused more than 1000 scheduled births to be delayed, a new study shows.In its May 2004 Budget, the Federal Government announced a maternity payment $3,000 for every baby born on or after July 1. Research by Melbourne Business School economist Professor Joshua Gans and Australian National University economist Dr Andrew Leigh has shown there were more births on July 1, 2004, than on any other single date in the past 30 years. "We estimate that around 700 births were shifted from the last week of June 2004 into the first week of July 2004," Dr Leigh said. "But more troublingly, we found that around 300 births were moved by more than two weeks." The researchers also found that the share of births that were induced or delivered by caesarean section was high in July 2004. Dr Leigh said hospitals needed to plan for July 1 this year, when the bonus rises from $3,000 to $4,000. "Maternity hospitals should expect fewer babies in the last week of June and more in the first week of July," Dr Leigh said.
Re: Re: [ozmidwifery] How long before synto is used?
but this will no longer be the case with compulsory continuous EFM for all Syntocinon Inductions. I can see Caesarians yet further on the increase at our hospital. Linda Hi, I find the whole idea of a procedure being compulsory as absolutely ludicrous!! You can't make a medical procedure compulsory, unless a patient is deemed not able to make his or her own decisions. From my understanding, mostly this happens with involuntary hospitalization of people with psychiatric disorders. Surely, by agreeing to use these procedures and abide by 'policy' that treats women this way, is basically agreeing that women are incapable of being in control of their own labouring and treating birthing women as involuntary psych patients. Even if, say, that birthing women were 'patients' in need of medical attention, they should definitely not be treated on par with people deemed mentally ill. I think it is atrocious. Hospitals seem to set women up for failure during labour and birth and abiding by the rules and regulations imposed on women in these institutions, midwives are also helping set them up for failure. All options should be offered to all women regardless of how informed or misinformed they are. It is for the woman to decide not the 'care providers' who assume control. Someone who claims to be 'with woman', should be making every effort to support women in making educated decisions, not leading them into hospital policy. If a woman feels safer in hospital to birth, then they should be treated the same as a woman choosing to birth at home. No woman should be treated differently because of her choice of birth place, in fact, that is discrimination. We, in western society, come from broken birth lines. We are afraid, uneducated and willingly pass over control of our births. It is not the birthing womans fault, for the power has been taken away. If midwives could spend more time empowering women during their pregnancy, maybe women would not be pouring water down their legs, what drove this woman to such an act? Fear??!! As care providers we need to support birthing women in taking back their power. This means supporting and providing true education, bucking against a system that sets women up for failure, standing up for what is right when seeing birthing women being treated wrongly, offering alternatives and suggestions, not treating women as involuntary patients but as strong, capable, powerful women. I feel so strongly about this because again and again I see the impact of modern 'birthing'( if you can call it that) practices. Women are damaged and traumatised and angry. Women should not have to fight for their rights as a woman or as a 'patient' ( if you want to see them like that). It is the only time that in hospitals, that I know of, that the 'patient' is not respected. If 'care providers' treated any other 'patient' with the amount of disrespect and disregard as birthing mums are treated with, they would be in big trouble with all kinds of authorities. But, birthing women are trested badly and with a total lack of regard so often. I believe this is shown just even in the whole policy situation. I could rave on for ages, but basically I think it SUCKS that women are treated this way, with rules and regulations aka policy and procedures. Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
Therein lies the problem with management of birth...all women, babies and births are not the same, so if everyone caring for the woman and baby does the same thing, how can this possibly be considered appropriate evidence based care? That is such and excellent and valid point. Also, please someone correct me if I am wrong, but hasn't continuos EFM been proven to not affect outcomes in a positive way. If we are talking about policies written with evidence based care in mind, surely the policy should reflect evidence based care. ( whatever evidence based is!) Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] How long before synto is used?
- Original Message - From: Lisa Barrett To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 4:21 PM Subject: Re: [ozmidwifery] How long before synto is used? Oh Jo, I forgot to say that the lovely Ob also said if you are not going to cooperate then you may as well stay at home!! Just what we wanted to hear Lisa
Re: [ozmidwifery] How long before synto is used?
- Original Message - From: Lisa Barrett To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 4:16 PM Subject: Re: [ozmidwifery] How long before synto is used? Hi Jo, Policies are apparently to make the midwife feel better and to get everyone to support you and be on your side. I heard this comment made just yesterday by an Ob ( one that we both know and like) to one of my clients who is having an ebac. He wasn't as it happens talking about ruptured membranes but continuous monitoring, but the underlying thought was the same. The best way to get a birth is to shut up and put up and everything will be just dandy. Policies are to make the professional feel in control no thought at all is given to the fact that the body and the baby belong to a woman and absolutely no credence is given to evidence based practice when it doesn't suite. As Brenda said the evidence says 96 hours is a reasonable time to watch and wait with ruptured membranesthe figures behind that (available on the nice web site) are 94% of women are in labour by that time. and thereafter it is still open to discussion in keeping with the woman's wishes. All the crap about gbs antibiotics etc etc is mainly rhetoric to add the scare factor into the scenario so women are unable to make any other choice than the one the system offers. Don't let the eye roll put you off. It's only people like us that stop the system doing exactly what they want. Disempowering the women they claim to be helping. Lisa
Re: Re: [ozmidwifery] How long before synto is used?
Abby, I agree with you, the proceedure should not be compulsory and I will take this up with colleagues, women should be given the right to choose if they want this, and I suppose the best way to go is what Emily has suggested and explain to the mother and write it in their notes if they choose to not have EFM.. I find this whole policy/proceedure thing often very difficult to work with, but hospitals do have to work within the safety of policies and guidelines to protect not only the mother and baby, but the hospital and staff themselves. In a court of law they will have to show that they followed proceedure. and have risk management in place. I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? Our policy is still at the updating stage and has room for change (hopefully) Thank you also Emily for you advise. Linda -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: Re: [ozmidwifery] How long before synto is used?
A friend of mine gave birth in a popular private Sydney hospital a few weeks ago, was induced (her choice, against OBs preference, amazingly he doesn't like to induce before 41w) - 2 doses of gel, ARM, synto. The only EFM was one trace at the start of the process. The midiwife caring for her asked her a number of times for a further trace, which she refused, usually by saying she wanted a shower now or to go to the toilet and that was that. She had discussed this plan with her OB in advance and knew she had his support, so she was fully prepared to send the midwife off to sort it out with him if the midwife had tried to bully her about it but it did not come to that. So there are hospitals around where it is possible. At 7:03 AM +1000 17/6/06, Kelly @ BellyBelly wrote: I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? From my perspective only, it seems to be all of them at the induced / augmented births I have been attending. I attend usually one but sometimes two births a month and it seems it's all part and parcel to be strapped down with Synto AND EFM in the bigger hospitals. Haven't been to a birth that's otherwise anyway. We work very hard to fob off any synt-happy midwives and doctors, especially where the membranes are ruptured even if it's only been an hour or two (yes I'm afraid there's pressure from midwives too, one was in a 'Know Your Midwife' program and thank goodness we were able to say no enough times as she did establish contractions on her own after the ARM). It's such a big effort sometimes that you can see how a woman without good support is going to be more likely to accept this as what's needed or feel overpowered, but you do it because you know you not only get synt you get continuous monitoring too. Say no and you get an entourage of doctors sometimes! Another challenge too is not only letting them have that choice, but choice without having an inappropriate comment made after she makes a choice alluding to the health of the baby, e.g. '... but if you keep labouring without the monitoring, I can't tell you / guarantee that everything will be okay for your baby down the track...' or mentioning the 's' word... (stillbirth). I don't know how many times one poor woman struggling to get the confidence to say no was spoken down too, not in a nasty way, but with lots of little dug in comments, she had to fight to say no to antibiotics, no to synto sooner after only an hour or two, EF monitoring, a drip for her baby in case he had strep b, which he didn't, the list goes on. 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 Bowman Family Sent: Thursday, 21 September 2006 4:35 AM To: ozmidwifery@acegraphics.com.au Subject: Re: Re: [ozmidwifery] How long before synto is used? Abby, I agree with you, the proceedure should not be compulsory and I will take this up with colleagues, women should be given the right to choose if they want this, and I suppose the best way to go is what Emily has suggested and explain to the mother and write it in their notes if they choose to not have EFM.. I find this whole policy/proceedure thing often very difficult to work with, but hospitals do have to work within the safety of policies and guidelines to protect not only the mother and baby, but the hospital and staff themselves. In a court of law they will have to show that they followed proceedure. and have risk management in place. I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? Our policy is still at the updating stage and has room for change (hopefully) Thank you also Emily for you advise. Linda -- 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. -- Jo Bourne Virtual Artists Pty Ltd -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
Yes EFMs are shown to cause c-secs and not protect even vulnerable babies against brain damage - the purported reason for using them in the first place! The solution is not to train staff more in using them because that is based on an entirely false premise but that's what RANZCOG promotes - see their website. The solution is to dump the technology because it not only fails to improve outcomes but has a deleterious effect on them. More machines does not equal more safety for women or babies, it means more lifethreatening and unnecessary surgery. J - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 7:37 PM Subject: Re: Re: [ozmidwifery] How long before synto is used? Therein lies the problem with management of birth...all women, babies and births are not the same, so if everyone caring for the woman and baby does the same thing, how can this possibly be considered appropriate evidence based care? That is such and excellent and valid point. Also, please someone correct me if I am wrong, but hasn't continuos EFM been proven to not affect outcomes in a positive way. If we are talking about policies written with evidence based care in mind, surely the policy should reflect evidence based care. ( whatever evidence based is!) Love Abby -- 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: Re: [ozmidwifery] How long before synto is used?
So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
It's true, there is a lot of pot luck involved for consumers, it is certainly what scares me about hospitals. But in this case I am pretty sure that the only policy was for an initial trace because the midwife was fairly clearly out of her comfort zone and didn't pull out the it's policy argument. At 12:19 PM +1000 17/6/06, Janet Fraser wrote: So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Jo Bourne Virtual Artists Pty Ltd -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
That birthing experiences vary so drastically as a result of individual staff is reason to advocate for returning the power and control of birth to birthing women. This, not policy, will help ensure that all women and babies have the best chance for a truly great birth. But it's institutions as well as individual staff that influence women's birthing experiences since each hospital has its own culture that filters through to the individuals working within it. At 12:19 PM +1000 17/6/06, Janet Fraser wrote: So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. J -- 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: Re: [ozmidwifery] How long before synto is used?
You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
Hi Sally, I'm sorry if you feel offended or upset by any discussion on this forum, I'm sure no-one intentionally does that because part of the joy of it is we are all able to talk without prejudice. Thank god there are midwives like you working your butts off to help women get the best birth in a totally awful system. And that is the truth the system isn't woman centred or well informed and in the main practice isn't evidence based. That doesn't mean everyone working in it is the same. If however everyone was as great as you there wouldn't be this sort of discussion happening. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. If any unit was perfect no-one would feel like they were bucking the system or bending the rules. Policies and procedures are guildlines they are not Australian law each woman should have equal choice. In or out of hospital. I for one know (As I have been there myself) how frustrating it is to keep knocking against a brick wall but if we don't all stand up and be counted and shout loudly about the ridiculous nature of our hospital obstetric system how will we change it. If every midwife working at the hospital said look we are not doing continuous monitoring (for example) because it's not evidence based then what would happen. They would have to change. Why don't we do this. Mainly because half of the midwives feel safer with it on regardless. It might sound like I'm talking people down and I'm sorry about that but it is true. Don't give up on midwifery because birthing women need midwives who feel passionately and practice well. Lisa Independent midwife -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
Have a look at the SA Perinatal Protocols which seem reasonable, there are many chapters to view you need to look at the guidelines in chapter 8 and 10. http://www.health.sa.gov.au/ppg/Default.aspx?tabid=113 Regards Christine -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Debbie Slater Sent: 14 June 2006 23:35 To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used? The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
RE: [ozmidwifery] How long before synto is used?
I always find it amazing that what is happening to a womans body (i.e SROM) is not believed and that she has to go in for confirmation. Surely the woman would know and wouldnt need it confirmed - so the hosp needs evidence because women cant be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldnt deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days constant water trickling 37 +1 labour started 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, its all a load of rubbish. Jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ home Sent: Thursday, 15 June 2006 11:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the induced labour be more likely to stress baby? And the fact mum couldnt cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie Slater Sent: Thursday, 15 June 2006 12:05 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used? The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support No virus found in this incoming message. Checked by AVG Free Edition
Re: [ozmidwifery] How long before synto is used?
Our Syntocinon procedure has been updated to include routine EFM. this has apparently been routine in major hospitals for a long time and accepted by midwives in these units as being the best practice. I have unfortunately accepted this practice too - but feel saddened with the risk for midwives losing valuable skills by relying on CTG's instead of truly being With Woman. and assessing the labour with sonicaid and palpation of contractions and of course observing the woman. There is an increased risk of busy midwives assessing a woman's labour by CTG alone - not having the time to truly know the whole picture a bit scary!!. In our unit where we have caseload midwifery we have the time to stay with women in labour and be tuned into the progress of labour and the baby's wellbeing. I really still do not see the need in these situations to have to rely on CTG, I would rather any day to rely on a good midwivery care/skills. If there is any concern about the FH sure then use EFM Also woman will no longer have freedom of movement, and baths, but this will no longer be the case with compulsory continuous EFM for all Syntocinon Inductions. I can see Caesarians yet further on the increase at our hospital. Linda - Original Message - From: Janet Fraser [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 1:05 PM Subject: Re: [ozmidwifery] How long before synto is used? Amy your story is truly appalling and also totally normal in the system. How anyone can refuse your requests is disgusting! EFM does NOT save lives, it just increases c-sec rates. How about birthing with evidence based care at home if you have another baby? As Diana Korte says, if you don't want interventions, don't go where they're done ; ) I hope you recover well from your awful brush with the drug pushing and unnecessary intervention. I wish it were not the norm but it clearly is! J - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:49 AM Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover
Re: RE: [ozmidwifery] How long before synto is used?
I agree completely Jo. I have been reading this whole thread and feel really frustrated. So many things have gone through my head about what to write, but I feel so disheartened at the moment by all the horror stories I have been reading and hearing. One thing I find so frustrating is the whole being 'allowed' to do this and the hospital 'letting' the woman do that. It's like we're on detention at school and we're the naughty girls that don't know anything. Surely, if as much time and effort went into building up women's confidence in themselves and their ability to birth and know their bodies, as goes into 'policy' and 'protocol' writing, then there would not be a need for this conversation. I think we, as women, need to take back the power and start saying, we are 'allowing' you to do this to MY body, I am 'letting' you do that to my baby, I will decide when the time is right for any procedure I so admire women like Amy that do take back the power, for women only lose it because hey give it away. On that note, Amy, you wrote, I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. ~ but I think the reality is that you never had her support and she shouldn't have been offended as SHE was the one causing the offence against you. She was comprimising you, your baby and your birth by not listening and supporting you, you being the true expert. When women take back their power and 'care providers' realise that they are not the true experts, then that will be the time when birth becomes more empowered, safer and peaceful with a lot less serious and endangering outcomes. Love Abby Surely the woman would know and wouldn't need it confirmed - so the hosp needs evidence because women can't be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldn't deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days - constant water trickling - 37 +1 labour started - 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, it's all a load of rubbish. Jo -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: RE: [ozmidwifery] How long before synto is used?
I agree completely Jo. I have been reading this whole thread and feel really frustrated. So many things have gone through my head about what to write, but I feel so disheartened at the moment by all the horror stories I have been reading and hearing. One thing I find so frustrating is the whole being 'allowed' to do this and the hospital 'letting' the woman do that. It's like we're on detention at school and we're the naughty girls that don't know anything. Surely, if as much time and effort went into building up women's confidence in themselves and their ability to birth and know their bodies, as goes into 'policy' and 'protocol' writing, then there would not be a need for this conversation. I think we, as women, need to take back the power and start saying, we are 'allowing' you to do this to MY body, I am 'letting' you do that to my baby, I will decide when the time is right for any procedure I so admire women like Amy that do take back the power, for women only lose it because hey give it away. On that note, Amy, you wrote, I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. ~ but I think the reality is that you never had her support and she shouldn't have been offended as SHE was the one causing the offence against you. She was comprimising you, your baby and your birth by not listening and supporting you, you being the true expert. When women take back their power and 'care providers' realise that they are not the true experts, then that will be the time when birth becomes more empowered, safer and peaceful with a lot less serious and endangering outcomes. Love Abby Surely the woman would know and wouldn't need it confirmed - so the hosp needs evidence because women can't be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldn't deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days - constant water trickling - 37 +1 labour started - 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, it's all a load of rubbish. Jo -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] How long before synto is used?
We have a system whereby women MUST be admitted to the ward after confirmed SROM. In passing I may say, of women who come in with ?SRM, fewer than half do have ROM so it isn't reasonable to expect Mum's opinion to be Gospel. After admission we have an ongoing battle with the medical staff to allow mums time to labour on their own. Durig the week it's not such a problem because the induction book is usually full (max 3 per day) but on the W/E (no booked IOL) the pressure is on to induce any who are sitting upstairs. We give them the option then but most of our clientele are crying out for induction and jump at the opportunity. We are supposed to be introducing a protocol where women may go home with term ROM to await labour but the Director has avowadly made it as difficult as possible in the hope that the midwives will cave and do immediate IOL. As a side note, I have recently been appointed acting CMC for Delivery Suite in our tertiary centre. I want to try to implement a caseload model during my tenure. Anyone who runs such a model, I would be very interested in learning the nitty gritty of how it is organised. Many thanks, Monica - Original Message - From: jo [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:26 PM Subject: RE: [ozmidwifery] How long before synto is used? I always find it amazing that what is happening to a woman's body (i.e SROM) is not believed and that she has to go in for 'confirmation'. Surely the woman would know and wouldn't need it confirmed - so the hosp needs evidence because women can't be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldn't deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days - constant water trickling - 37 +1 labour started - 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, it's all a load of rubbish. Jo _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of sally @ home Sent: Thursday, 15 June 2006 11:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ mailto:[EMAIL PROTECTED] BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! It's a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you don't have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just don't understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour - wouldn't the induced labour be more likely to stress baby? And the fact mum couldn't cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards, Kelly Zantey Creator, http://www.bellybelly.com.au/ BellyBelly.com.au Gentle Solutions From Conception to Parenthood http://www.bellybelly.com.au/birth-support http://www.bellybelly.com.au/birth-support BellyBelly Birth Support - http
RE: [ozmidwifery] How long before synto is used?
u would think so but ive actually seen quite a few women in my limited experience come in saying they 'thought' their waters had broken and it turned out to be just a bit of extra vaginal discharge.. the one i hate is 'are you sure you havent wet yourself?' i actually saw an ob ask a woman this during 2nd stage, while pushing!! her waters broke with a huge pop and sprayed all over me in my position across the room as i walked past and the ob said 'do you think you might be doing a wee?' err no! i think the difference is women who come in and say 'my waters have broken' they usually have, but if they havent women arent always sure and are more likely to say 'i think they might have, im not sure i just wanted to come in to make sure' and things like that if that makes sense :)I always find it amazing that what is happening to a womans body (i.e SROM) is not believed and that she has to go in for confirmation. Surely the woman would know and wouldnt need it confirmed - so the hosp needs evidence because women cant be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets.I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldnt deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days constant water trickling 37 +1 labour started 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, its all a load of rubbish.JoFrom: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ home Sent: Thursday, 15 June 2006 11:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used?We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion.Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AMSubject: RE: [ozmidwifery] How long before synto is used?How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the induced labour be more likely to stress baby? And the fact mum couldnt cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards,Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-supportFrom: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie Slater Sent: Thursday, 15 June 2006 12:05 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used?The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture
Re: [ozmidwifery] How long before synto is used?
i guess all you can do is educate each woman about how it is protocol to use CTG but tell her about the evidence that shows it to be of no benefit while increasing c/s and instrumental delivery rates and how it will reduce her mobility, positions possible, water usage, comfort etc etc and then ask for her decision on what type of monitoring she would like. then it is quite legitimate to record in the notes that they have refused consent for CTG. Bowman Family [EMAIL PROTECTED] wrote: Our Syntocinon procedure has been updated to include routine EFM. this hasapparently been routine in major hospitals for a long time and accepted bymidwives in these units as being the best practice.I have unfortunately accepted this practice too - but feel saddened with therisk for midwives losing valuable skills by relying on CTG's instead oftruly being With Woman". and assessing the labour with sonicaid andpalpation of contractions and of course observing the woman.There is an increased risk of busy midwives assessing a woman's labour byCTG alone - not having the time to truly know the whole picture a bitscary!!.In our unit where we have caseload midwifery we have the time to stay withwomen in labour and be tuned into the progress of labour and the baby'swellbeing. I really still do not see the need in these situations to have torely on CTG, I would rather any day to rely on a good midwivery care/skills.If there is any concern about the FH sure then use EFMAlso woman will no longer have freedom of movement, and baths, but this willno longer be the case with compulsory continuous EFM for all SyntocinonInductions. I can see Caesarians yet further on the increase at ourhospital.Linda- Original Message - From: "Janet Fraser" To: Sent: Thursday, June 15, 2006 1:05 PMSubject: Re: [ozmidwifery] How long before synto is used? Amy your story is truly appalling and also totally normal in the system.How anyone can "refuse" your requests is disgusting! EFM does NOT save lives,it just increases c-sec rates. How about birthing with evidence based care at home if you have another baby? As Diana Korte says, if you don't want interventions, don't go where they're done ; ) I hope you recover well from your awful brush with the drug pushing and unnecessary intervention. I wish it were not the norm but it clearly is! J - Original Message - From: "adamnamy" To: Sent: Thursday, June 15, 2006 11:49 AM Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it reallyhard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birthin our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated,36 weeks but with cholestasis and very worried about that). I wasextremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Withinan hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said "not much happening". I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the bodybegan. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractionsthat forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor hadbegun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an actof desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt likeI lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have theARM and then get myself home ASAP for labor to start itself. I feel asthough getting my baby out and the room prepped for the "next customer" was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cyni
Re: [ozmidwifery] How long before synto is used?
I haveto say that, unfortunately, many women are not in tune enough with their bodies to know whether theyhave ruptured their membranes or not. this is evidenced by what they say on the phone...eg " I'm not sure if I have broken my waters or not". And we have had incidences of women desperate to be induced tipping a glass of water down their pants to make it look like they have!! Policies and guidelines are not necessarily 'a load of rubbish' either, they are not just a bunch of words written down at the whim of an individual person. Believe me, having been on a guidelines development committee, with everyone from the Director of Obstetrics to midwives from the birth centre. It has taken over 18 months to review and rewrite only a handful of guidelines. Unfortunately, we need these so that we all do the same thing.There is enough confliciting adveice dished out by midwives as it is. Not all of these guidelines are restrictive and if women know enough to challenge them then I see that as good for the system. I just wish there were more women out there who would challenge the system. However, whilst I was practicing as an independent midwife...I treated the women I wasworking with the respect and honour that they deserved and would definately watch and wait in cases like this. Sally - Original Message - From: jo To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:26 PM Subject: RE: [ozmidwifery] How long before synto is used? I always find it amazing that what is happening to a womans body (i.e SROM) is not believed and that she has to go in for confirmation. Surely the woman would know and wouldnt need it confirmed - so the hosp needs evidence because women cant be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldnt deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days constant water trickling 37 +1 labour started 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, its all a load of rubbish. Jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ homeSent: Thursday, 15 June 2006 11:10 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] How long before synto is used? We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour
RE: [ozmidwifery] How long before synto is used?
I understand that there is a need for policies etc in the system. Your last line However, whilst I was practicing as an independent midwife...I treated the women I wasworking with the respect and honour that they deserved and would definately watch and wait in cases like this. Why cant women choosing to birth in hospital receive the same respect and support? This is exactly the problem and issue I have with policies, they are not individual based and do not take into account individual womens needs. When a woman says I'm not sure if I have broken my waters or not. Why cant those women be assured that if there was just a trickle its probably a hind water leak and if there was a pop and gush then they have more than likely broken, what do you think has happened, what is your feeling on it? Give it back to her and therefore give her back the power exactly where it should be. This is not a personal issue with you Sally, simply trying to understand why the policies are so strict with little room to move for individuals. When women do want to do something that is different to what the policies say they are labeled as being difficult simply because they are informed. Ive been attending 2 births a month for the past 3 years as a doula and have seen women treated like this over and over again and the eyes roll (not always) when I walk in as her doula. Is it because she is empowering herself with support and knowledge? I really dont understand! Thanks for listening Jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ home Sent: Friday, 16 June 2006 2:14 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? I haveto say that, unfortunately, many women are not in tune enough with their bodies to know whether theyhave ruptured their membranes or not. this is evidenced by what they say on the phone... And we have had incidences of women desperate to be induced tipping a glass of water down their pants to make it look like they have!! Policies and guidelines are not necessarily 'a load of rubbish' either, they are not just a bunch of words written down at the whim of an individual person. Believe me, having been on a guidelines development committee, with everyone from the Director of Obstetrics to midwives from the birth centre. It has taken over 18 months to review and rewrite only a handful of guidelines. Unfortunately, we need these so that we all do the same thing.There is enough confliciting adveice dished out by midwives as it is. Not all of these guidelines are restrictive and if women know enough to challenge them then I see that as good for the system. I just wish there were more women out there who would challenge the system. However, whilst I was practicing as an independent midwife...I treated the women I wasworking with the respect and honour that they deserved and would definately watch and wait in cases like this. Sally - Original Message - From: jo To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:26 PM Subject: RE: [ozmidwifery] How long before synto is used? I always find it amazing that what is happening to a womans body (i.e SROM) is not believed and that she has to go in for confirmation. Surely the woman would know and wouldnt need it confirmed - so the hosp needs evidence because women cant be trusted to tell the truth. Gggrr! The more I read about this the more frustrating it gets. I supported at a homebirth last year where SROM occurred at 36 weeks, mum new that midwife wouldnt deliver at home before 37 weeks. Got checked at hosp, signed herself out (they wanted her to stay until labour started and to birth there) bed rest for 8 days constant water trickling 37 +1 labour started 4 hours, beautiful healthy baby born in lounge room. Times, clocks, protocols, policies, its all a load of rubbish. Jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of sally @ home Sent: Thursday, 15 June 2006 11:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used
[ozmidwifery] How long before synto is used?
For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: [ozmidwifery] How long before synto is used?
They like to have a baby within 24 hours of # membranes so will augment with synto within 12 hours usually, although a lot depends upon the time of day and acuity i.e. reluctant to start synto at night due to smallish unit and lack of on site theatre staff/anaesthetists etc at night. Also if labour ward busy the woman with # membranes might have to wait a bit longer than otherwise, which is often not a bad thing :-). We don't have a 'fixed' time limit, factors such as GBS +ve or medical indications might hasten the decision to augment, otherwise 6-12 hours wait is about average. If SROM happens in the evening they are usually left until morning before synto started. Occasionally multips are induced by ARM alone and given 4-6 hours to establish before synto is commenced, which can be nicer for the woman and is sometimes requested by some more informed ladies. Often works very well, especially for ladies with history of quick labours. Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 14, 2006 8:48 PM Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.8.4/363 - Release Date: 13/06/2006
Re: [ozmidwifery] How long before synto is used?
Kelly In the maternity unit I worked in Northern Ireland we tend to leave women at term who had spontaneous rupture of members up to 48 hours to see if they go into labour before interveningWomen who have their members artifically rupturedas part of the induction of labour proceduretend to be left two hour to see if contractionsestablishBriege"Kelly @ BellyBelly" [EMAIL PROTECTED] wrote:For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support Send instant messages to your online friends http://uk.messenger.yahoo.com
RE: [ozmidwifery] How long before synto is used?
The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
RE: [ozmidwifery] How long before synto is used?
How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the induced labour be more likely to stress baby? And the fact mum couldnt cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie Slater Sent: Thursday, 15 June 2006 12:05 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used? The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: [ozmidwifery] How long before synto is used?
Hi Kelly, I think most places differentiate between spontaneous release of the waters or artificial rupture, in regards to potential for infection and other issues. Our area policy is after SROM they can do home management after initial confirmation of SROM by speculum exam and amnicator and ferning test of the fluid (when it drys on a microscope slide, it creates a ferning pattern), they have a CTG and if head is not high they can go home for 24 hrs, return for another CTG, then home again for another 24 if they choose. I work in a low risk unit that doesnt induce, so Im not really up on the practice at our referral hospy, but, I belive they dont really wait to put up Synto, nor do they reduce the Synto once woman is contracting well(which is what I was taught should happen!). Maybe because ARM is an intervention, where they not only risk starting off the cascade, but they have done VE which (theoretically)increases risk of infection (any more so than a speculum???). OR maybe it is because THEY are misogynist, control freaks Diane. - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 14, 2006 10:48 PM Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
RE: [ozmidwifery] How long before synto is used?
Heheheh J I was actually quite surprised that for the very first time, at this last birth at the Mercy in Melbourne, they did turn down the drip when asked mum coped so much better and the word epidural wasnt yelled out again after that! They started it at 40 (that was a very mini dose according to the doctor and would likely kick things along being a multi) and they later turned it down to 20 she was having strong frequent contractions and while they appeared to slow down and were less intense but were still regular and strong, I asked if there was a chance it could be turned off altogether as I could see mum getting quite distressed, which was answered with, well were thinking of turning it up. After a protest and only 1.5 hours since last VE, mum was found to be 8cms, surprise, surprise. They let her have the synt off and out as too the EFM. Never before seen it in my life!!! Its always a big no everywhere else. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of diane Sent: Thursday, 15 June 2006 7:53 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? Hi Kelly, I think most places differentiate between spontaneous release of the waters or artificial rupture, in regards to potential for infection and other issues. Our area policy is after SROM they can do home management after initial confirmation of SROM by speculum exam and amnicator and ferning test of the fluid (when it drys on a microscope slide, it creates a ferning pattern), they have a CTG and if head is not high they can go home for 24 hrs, return for another CTG, then home again for another 24 if they choose. I work in a low risk unit that doesnt induce, so Im not really up on the practice at our referral hospy, but, I belive they dont really wait to put up Synto, nor do they reduce the Synto once woman is contracting well(which is what I was taught should happen!). Maybe because ARM is an intervention, where they not only risk starting off the cascade, but they have done VE which (theoretically)increases risk of infection (any more so than a speculum???). OR maybe it is because THEY are misogynist, control freaks Diane. - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 14, 2006 10:48 PM Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: [ozmidwifery] How long before synto is used?
The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
Interesting you mention that bit about PPH Brenda, they estimated a 600ml loss but had to do horrifically painful things to her after the birth as she was trickling and they finally found a few small pea-sized (from memory) clots on the cervix, which they said would keep bleeding if they didn't get it. She said it was more painful than labour, I could tell though, she was screaming! Bubs was born with his hand to his head, but no tear, no graze etc. I'll have to put those guidelines on my site for all to read I think :) 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 brendamanning Sent: Thursday, 15 June 2006 8:52 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- 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] How long before synto is used?
We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- 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] How long before synto is used?
Oh mum didn't have strep b swap done (they forgot to do it) so they wanted her to be on ab's too as policy assumed she was positive. She ended up saying no after they sent in a barrage of people trying to tell her to have ab's. 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 diane Sent: Thursday, 15 June 2006 10:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- 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] How long before synto is used?
We wait up to 96 hours. If a woman rings with ?pre-labour SROM, we ask them to attend the unit for confirmation, either by history (checking pads) or spec if it looks inconclusive. We do an abdo palp, CTG then send her home with antibiotics to be commenced 18 hours after ROM. We ask to attend the unit daily for CTG. Usually the women will go into spontaneous labour but if they haven't by the 96 hours they come in for synt infusion. Sally - Original Message - From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 7:28 AM Subject: RE: [ozmidwifery] How long before synto is used? How frustrating then, that of the births I have been to, when there has been an ARM to induce labour, mum gets pressure for the drip after an hour, then they keep coming back in at periodic intervals of 30mins-1hr with more pressure for synto! Its a fight to keep them away! So would it be fair for a mum having an ARM to ask to have her waters broken and then go home, or will they not allow this? I get the impression that they want to keep you in, as I have asked many times if we can get out for a walk and the only thing you can do is walk the ward, and not leave it. Very frustrating if you are trying to get things going, as mum ends anxious about the whole thing especially when you have such an unrealistic time frame to get things going! Obviously some cases are different; I have seen ARM for things like post-dates baby, twins, and the recent one where there was cholestasis involved, which of course makes it different but frustrating when you dont have much info about, I think I need a good midwifery text or something similar as even on the internet mum found it hard to get any good information. She was only borderline for cholestasis, but the doctors were scaring her about what *could* happen and how they just dont understand the condition well enough. She had the drip up after only 2 hours despite regular 30 second contractions that were progressing. Just an assumption, but if they are worried about baby getting stressed from the labour wouldnt the induced labour be more likely to stress baby? And the fact mum couldnt cope with the contractions as well and then had peth? The labour went quite quickly and it was all over in a few hours. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Debbie SlaterSent: Thursday, 15 June 2006 12:05 AMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] How long before synto is used? The UKs NICE guidelines inherited from the UKs Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBellySent: Wednesday, 14 June 2006 8:48 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.8.3/360 - Release Date: 9/06/2006
Re: [ozmidwifery] How long before synto is used?
We swab on SROM assessment as we dont routinely swab, but unless confirmed positive wont start IVAB until 18 hrs. Confirmed GBS aren't considered to be candidates for home management. Di - Original Message - From: Kelly @ BellyBelly [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:10 AM Subject: RE: [ozmidwifery] How long before synto is used? Oh mum didn't have strep b swap done (they forgot to do it) so they wanted her to be on ab's too as policy assumed she was positive. She ended up saying no after they sent in a barrage of people trying to tell her to have ab's. 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 diane Sent: Thursday, 15 June 2006 10:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
They did a swab just before ARM but also said that it takes 2 days for the cultures to grow. 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 diane Sent: Thursday, 15 June 2006 11:18 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We swab on SROM assessment as we dont routinely swab, but unless confirmed positive wont start IVAB until 18 hrs. Confirmed GBS aren't considered to be candidates for home management. Di - Original Message - From: Kelly @ BellyBelly [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:10 AM Subject: RE: [ozmidwifery] How long before synto is used? Oh mum didn't have strep b swap done (they forgot to do it) so they wanted her to be on ab's too as policy assumed she was positive. She ended up saying no after they sent in a barrage of people trying to tell her to have ab's. 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 diane Sent: Thursday, 15 June 2006 10:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -- 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.
RE: [ozmidwifery] How long before synto is used?
This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth, WA From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @ BellyBelly Sent: Wednesday, 14 June 2006 8:48 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] How long before synto is used? For those who work in maternity units, I am just wondering what the policy is in your unit in regards to how long a woman can continue after her waters have broken before having synto put up? There seems to be such pressure to put it up fairly quickly (after you ask to at least wait at all!), with an average of about 1 hour before the woman gets the pressure to speed things up. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http
Re: [ozmidwifery] How long before synto is used?
I ended up switching it off myself-to her utter bewilderment. YAY! Amy, I wish more women would know enough to exercise their choice. Shame about the midwife though, process focussed rather than woman centred? I don't know, am I an eternal cynic? The sad fact is that this cynicism (from which I also suffer) is bred from reality. This is the impetus for change if we can get through that 'stepford wives' type mentality, the one where society is so accepting of all that is fed to them from those in authority, like polititians and doctors! Keep talking to anyone who will listen. A tiny spark in the right environment will have great results in changing local culture. Think Globally, Act locally applies here too. Cheers, Di - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:49 AM Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs
Re: [ozmidwifery] How long before synto is used?
Amy your story is truly appalling and also totally normal in the system. How anyone can refuse your requests is disgusting! EFM does NOT save lives, it just increases c-sec rates. How about birthing with evidence based care at home if you have another baby? As Diana Korte says, if you don't want interventions, don't go where they're done ; ) I hope you recover well from your awful brush with the drug pushing and unnecessary intervention. I wish it were not the norm but it clearly is! J - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:49 AM Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour is established is recognised as 'best practice. The recent research which associates IOL with syntocinon an increase in PPHs is acknowledged there. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Debbie Slater To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 12:04 AM Subject: RE: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - see http://www.nice.org.uk/page.aspx?o=17381 Debbie Slater Perth
RE: [ozmidwifery] How long before synto is used?
The woman I supported Tuesday had cholestasis and was given only 2-3 hours before the pressure was too great! I am sure if she was given at least 6 hours like yourself and was not hounded that her labour would have been more established - she was progressing. But they kept sending more and more doctors in, I think they eventually sent in the consultant or someone in charge who told her, 'I'm here to give you a gentle nudge that we are worried about this baby, I'm here looking after all the women today and it's my job to make sure all the babies are okay. You are here being induced today because of the condition (which was not at a serious level mind you not to mention the hours we waited for a bed!) and we don't know enough about it to let it go. I can't say that if you laboured without it, the baby would have complications and there is the chance of stillbirth; babies with this condition appear well then all of a sudden go downhill...' yada yada yada... you get the picture. Instead she had an excruciating labour, almost ended up with an epidural but thank god they turned it down. She went to 8cms quickly, because of the peth baby was not very responsive and poor mum was a mess. Argh it's so cruel. 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 adamnamy Sent: Thursday, 15 June 2006 11:50 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest
Re: [ozmidwifery] How long before synto is used?
iI had an induction with my second baby ( post dates and GDM ). My private obs only induces at night as he feels women labour better at this time. He did an ARM at 7.30pm and said he would see me in the morning if nothing happened. We had also negotiated a midwife delivery ( regardless of if he was there or not ). My sisters ob did exactly the same for her both times. all our babies were born at night, beautiful midwife births ( 3 out of 4 in the private system ). zoe - Original Message - From: Janet Fraser [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:05 AM Subject: Re: [ozmidwifery] How long before synto is used? Amy your story is truly appalling and also totally normal in the system. How anyone can refuse your requests is disgusting! EFM does NOT save lives, it just increases c-sec rates. How about birthing with evidence based care at home if you have another baby? As Diana Korte says, if you don't want interventions, don't go where they're done ; ) I hope you recover well from your awful brush with the drug pushing and unnecessary intervention. I wish it were not the norm but it clearly is! J - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 11:49 AM Subject: RE: [ozmidwifery] How long before synto is used? This is really pertinent thread for us mothers on the list...it seems an issue about which there are no clear guidelines which makes it really hard for women who are attempting to be in charge of their own labors. They don't even know what sort of time frame they will have in which to relax into labor without pressure and threat of synto. I recently gave birth in our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated, 36 weeks but with cholestasis and very worried about that). I was extremely keen to avoid synto/EFM and all the other nasty possibilities. I asked over and over for some clear indication of how long they would give me to progress into labor with out synto but was not given one. Within an hour of ARM I was being asked very regularly if I had contractions, with frowns and talk about synto every time I said not much happening. I wonder how it might have panned out had I not been hassled every step of the way...It only served to increase my anxiety 20 fold. We managed to hold them off for 6 hours before it went up and the flogging of the body began. It is just a revolting drug that should be avoided unless strictly necessary. The labor was nothing short of torturous and degrading (I am sure you have all seen it in action). I also wonder if it was the unrelenting intensity of the contractions that forced my bub into a posterior, deflexed position within an hour of established labor. Being hooked up to EFM doesn't help with keeping mobile either. I am not a midwife-Could there be any truth in that idea? Anyway...I thought I had negotiated to switch it off once labor had begun but lo and behold...a change of shift and the next midwife refused. I ended up switching it off myself-to her utter bewilderment. This was an act of desperation which left me quite compromised with her because our relationship became quite frosty and unpleasant after this. I felt like I lost her support when I took the reigns and bucked against hospital protocol. It was like I had offended her...that she felt compromised by me asserting myself. If I ever needed to follow the same course of action I would have the ARM and then get myself home ASAP for labor to start itself. I feel as though getting my baby out and the room prepped for the next customer was as much of a priority as my wishes to keep my labor and birth low key...I don't know, am I an eternal cynic? Bub calls, I have to go... Amy -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of diane Sent: Thursday, June 15, 2006 8:54 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] How long before synto is used? We sometimes have some confusion over whether the women should have oral AB's cover if they are on home management of SROM. The policy doesnt call for it, but some doctor's recommend this. When in established labour and membranes are broken for more than 18hrs, then IV AB's are used. I guess that confirms that you are at more risk in Hospital!! What do other units do? Cheers, Diane - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 15, 2006 8:51 AM Subject: Re: [ozmidwifery] How long before synto is used? The UK's NICE guidelines inherited from the UK's Royal College of Obs and Gynea suggest that it is fine to leave pre-labour rupture of membranes up to 96 hours before induction of labour - This is the policy at Rosebud. If doing ARM for IOL then waiting 4 hours is common reducing the synto once the labour
RE: [ozmidwifery] How long before synto is used?
I supported a woman a few months back who had a SROM but no labour for a day or two. She was a birth centre mum but didn’t tell me or them abut the ROM. We went in and they said she would have to birth in labour ward now as it had been 48 hours. This wonderful gorgeous first time mum said I will go home if you don’t let me stay in the birth centre. I 'played mediator' and requested that they give us a few hours and see how things went before making such choices. Every time the midwife came in -which to her credit was few- we said she was doing fine. By lunch time (we had gone in at 6am) there was no real labour to speak of and for some reason her hubby started t tell jokes and I asked how they had met which turned out to be a very funny story. We laughed -really laughed for almost 30mins and low and behold on came labour. She birthed beautifully about 5 hours later. Bring on those love and laugh hormones! Perhaps people should suggest that before synto? Jo -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.8.3/361 - Release Date: 6/11/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
