RE: [ozmidwifery] FW: National Maternity Action Plan
Title: FW: National Maternity Action Plan Brilliant Justine! What a woman, Roll on NMAP! in solidarity (I REALLY like this sign off!) Carolyn Hastie -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Justine CainesSent: Monday, 16 September 2002 11:22 PMTo: OzMid ListSubject: [ozmidwifery] FW: National Maternity Action PlanDear Oz MiddersFYI, I posted the following reply on Ausfem-PolnetIn SolidarityJustine Caines -- Forwarded MessageFrom: Justine Caines [EMAIL PROTECTED]Date: Mon, 16 Sep 2002 23:20:07 +1000To: [EMAIL PROTECTED]Subject: National Maternity Action Plan Dear Barbara and AllIts pretty insulting to the great women across the country who have put many months into the development of this document to say you havent read it and then launch in with uninformed comment.The National Maternity Action Plan (NMAP) combines the plethora of evidence based research that determines midwives as the most appropriate and cost effective carers for the vast majority (80-85%) of women. NMAP is not about homebirth, NMAP is about all women being able to choose the care of a known midwife regardless of where they give birth.Less than 1% of Australian women can access the care of a known midwife. In NZ where women are able to choose their carer (legislation entitles a Midwife, GP and Obstetrician to be paid the same rate and women elect their carer and are funded by a birth payment) they have seen a rise in midwife care in 8 years from 14% to 72%. Women In Australia do not have equity of choice. In fact if a woman chooses to pursue a natural birth with a known midwife in the vast majority of cases she will have to fund the care herself (via an independent midwife). The cost of an independent midwife for the entire care from early pregnancy to 6 weeks post-natally including 1 on 1 care during the birth is less than a caesarean section alone. Please dont bandy choice when as a childbearing woman I can access an elective caesarean tomorrow without any medical indication that is considered 2-4 times more dangerous than a normal vaginal birth but I am actively discriminated against if I choose to access international best practice in maternity, the care of a known midwife.I see the choice of intervention for women in very safe hands, the medical lobby is very powerful and continues to claim interventionist practices as safer, despite an increase in the maternal death rate by 70% (The NHMRC Report revealed 46 direct maternal deaths showing an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium). http://www.nhmrc.gov.au/publications/pdf/wh32.pdfJustine CainesMum to Ruby, nearly 3, Clancy 18 months and Will 2 and a half monthsACT President The Maternity Coalition--- Barbara McGarity [EMAIL PROTECTED] wrote: Ihave not read the whole action plan, but I would be concerned if it led to an effort by government to push women out of maternity hospitals/wards because it would be cheaper for the government. Women should have choice, and there are many women who have successful home births, but women should not be coerced. (Sometimes women are coerced also into thinking there is something wrong or unwomanly with accepting pain reduction measures, and feel guilty when the birth comes and they need them.) Sometimes equipment is needed urgently when there is a glitch in the birth, and some women gain confidence from knowing that they have the hospital resources immediately available. Women need to be adequately informed about all options and risks before making a decision. I well remember when one grandchild was born and the mechanism that turns on babies' sugar absorption failed to kick in, which can result very quickly in death. Fortunately the doctor recognised the stress and put in a drip to save the baby (so quickly that he broke the baby's toe, which is better than a dead baby). I realise that this is not a very clinical description, but it was an emergency that needed the expertise and equipment very quickly. After a few days of the drip, the mechanism kicked in normally. Barbara -- End of Forwarded Message
Re: [ozmidwifery] FW: National Maternity Action Plan
Title: Re: [ozmidwifery] FW: National Maternity Action Plan Hi Marilyn You are right many of the cases the women had significant complications, and you would want to hope that it was women in severe distress that died, rather than healthy ones. The point the report very clearly makes is the link between c/s and post operative embolism. I still think we are within our rights to site the report as they warn of the link and increased risk and yet out there we still see it used consistently with none/little medical indication and in fact an increase reporting of c/s as the cosmetic and civilised way to give birth!! A little from the report During the triennium, there were approximately 150,000 Caesarean sections with four instances where the death was attributed primarily to the operation or to the anaesthetic. Although not taking into account any consideration of morbidity, the rate of one death per 37,500 cases is a useful index of the safety of Caesarean section in modern obstetric care. The known association between Caesarean section and postoperative thromboembolism should direct clinicians to assessing whether a patient undergoing Caesarean section is at increased risk, and in such circumstances to consider thromboprophylaxis. The 46 direct maternal deaths shows an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium. The reason for this increase is not clear and requires further investigation. The leading principal causes of direct maternal deaths remained pulmonary embolism (8; 17.4%), amniotic fluid embolism (8; 17.4%) and pre-eclampsia (6; 13.0%) (Table 8). There was one direct maternal death associated with a homebirth. Justine xx Hi Justine and all: Excellent reply Justine, go NMAP, I couldn't believe their response, it left me tongue tied and then you untied it. I do have a question on the maternal mortality stats: despite an increase in the maternal death rate by 70% (The NHMRC Report revealed 46 direct maternal deaths showing an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium). http://www.nhmrc.gov.au/publications/pdf/wh32.pdf I didn't access these just now, but I did read through them a month or so ago, and someone please correct me if I am wrong, but these women who died most if not all seemed really sick women, in other words pregnancy and childbirth compounded their illnesses and interventions didn't help but they all seemed very necessary. Desperate situations most if not all of them. I guess what I am saying is, that I really don't think increased interventions or obstetric care led to this increase in maternal deaths. Maybe there was an increase in severely ill women becoming pregnant, I don't know, it is being studied. I do not believe any of these women would have been candidates for midwifery led care unless the midwives were specialists in high risk obstetrics. I would really like to see another opinion on this as reading the cases quite honestly freaked me out. marilyn - Original Message - From: Justine Caines mailto:[EMAIL PROTECTED] To: OzMid List mailto:[EMAIL PROTECTED] Sent: Monday, September 16, 2002 6:22 AM Subject: [ozmidwifery] FW: National Maternity Action Plan Dear Oz Midders FYI, I posted the following reply on Ausfem-Polnet In Solidarity Justine Caines -- Forwarded Message From: Justine Caines [EMAIL PROTECTED] Date: Mon, 16 Sep 2002 23:20:07 +1000 To: [EMAIL PROTECTED] Subject: National Maternity Action Plan Dear Barbara and All Its pretty insulting to the great women across the country who have put many months into the development of this document to say you havent read it and then launch in with uninformed comment. The National Maternity Action Plan (NMAP) combines the plethora of evidence based research that determines midwives as the most appropriate and cost effective carers for the vast majority (80-85%) of women. NMAP is not about homebirth, NMAP is about all women being able to choose the care of a known midwife regardless of where they give birth. Less than 1% of Australian women can access the care of a known midwife. In NZ where women are able to choose their carer (legislation entitles a Midwife, GP and Obstetrician to be paid the same rate and women elect their carer and are funded by a birth payment) they have seen a rise in midwife care in 8 years from 14% to 72%. Women In Australia do not have equity of choice. In fact if a woman chooses to pursue a natural birth with a known midwife in the vast majority of cases she will have to fund the care herself (via an independent midwife). The cost of an independent midwife for the entire care from early pregnancy to 6 weeks post-natally including 1 on 1 care during the birth is less than a caesarean section
RE: [ozmidwifery] FW: National Maternity Action Plan
Title: Re: [ozmidwifery] FW: National Maternity Action Plan Hmm, my desire that it would... stir up the nest that is...sadly, I think all the hornets have left. :-) My idea of a joke. Actually, I think a lot of things people carry on about are a joke when the serious deep things of life like how mothers are treated in our society are left to flounder and i sure don't mean providing you beaut child care, although kibbutz style living would be a great idea! Our society is constantly getting things by the wrong end of the stick... anyway Kristy Ruddick has done us all proud hasn't she? As for in solidarity, I REALLY like it and I was a radical pinko once, theoretically that is, never joined the communist party, but certainly in my radical youth was a top far left socialist (still am :-) still a pure care for each other sort of person, but now, with insight on self responsibility but with the understanding that ignorance of universal laws leaves people incredibly disadvantaged. Ignorance is not bliss and hording the worlds wealth is not kind and imprisoning refugees is not just, so we keep the vision and keep on in solidarity :-) I won't be at Newcastle on the 12th. I'm off to NZ :-) I'm sorry to miss you. I admire you heaps. love, Carolyn -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Justine CainesSent: Tuesday, 17 September 2002 10:16 PMTo: OzMid ListSubject: Re: [ozmidwifery] FW: National Maternity Action Plan Hey Carolyn,Let me know if I stirred up a hornets nest on Ausfem. I am no longer a subscriber.As for the In Solidarity I sincerely mean it, a left over of the union movement, where most didnt mean it!!! But dont worry I wont call you Comrade!! Look forward to catching up in Newcastle on the 12thJustineBrilliant Justine! What a woman, Roll on NMAP!in solidarity (I REALLY like this sign off!)Carolyn Hastie -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Justine CainesSent: Monday, 16 September 2002 11:22 PMTo: OzMid ListSubject: [ozmidwifery] FW: National Maternity Action PlanDear Oz MiddersFYI, I posted the following reply on Ausfem-PolnetIn SolidarityJustine Caines -- Forwarded MessageFrom: Justine Caines [EMAIL PROTECTED]Date: Mon, 16 Sep 2002 23:20:07 +1000To: [EMAIL PROTECTED]Subject: National Maternity Action PlanDear Barbara and AllIts pretty insulting to the great women across the country who have put many months into the development of this document to say you havent read it and then launch in with uninformed comment.The National Maternity Action Plan (NMAP) combines the plethora of evidence based research that determines midwives as the most appropriate and cost effective carers for the vast majority (80-85%) of women. NMAP is not about homebirth, NMAP is about all women being able to choose the care of a known midwife regardless of where they give birth.Less than 1% of Australian women can access the care of a known midwife. In NZ where women are able to choose their carer (legislation entitles a Midwife, GP and Obstetrician to be paid the same rate and women elect their carer and are funded by a birth payment) they have seen a rise in midwife care in 8 years from 14% to 72%. Women In Australia do not have equity of choice. In fact if a woman chooses to pursue a natural birth with a known midwife in the vast majority of cases she will have to fund the care herself (via an independent midwife). The cost of an independent midwife for the entire care from early pregnancy to 6 weeks post-natally including 1 on 1 care during the birth is less than a caesarean section alone. Please dont bandy choice when as a childbearing woman I can access an elective caesarean tomorrow without any medical indication that is considered 2-4 times more dangerous than a normal vaginal birth but I am actively discriminated against if I choose to access international best practice in maternity, the care of a known midwife.I see the choice of intervention for women in very safe hands, the medical lobby is very powerful and continues to claim interventionist practices as safer, despite an increase in the maternal death rate by 70% (The NHMRC Report revealed 46 direct maternal deaths showing an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium). http://www.nhmrc.gov.au/publications/pdf/wh32.pdfJustine CainesMum
Re: [ozmidwifery] FW: National Maternity Action Plan
Dear Justine, I have just read your posting to Ausfem, you are doing a great job. I gather from your later comments it wasn't well received. If we are failing to reach feminists then I am worried. What were there issues or concerns? Kathleen --Kathleen FahyProfessor of MidwiferyHead of School of Nursing and MidwiferyFaculty of HealthThe University of NewcastleUniversity Drive,Callaghan, 2308 Ph 02 49215966 Fax 02 49216981 [EMAIL PROTECTED] 09/17/02 10:16pm Hey Carolyn,Let me know if I stirred up a hornets nest on Ausfem. I am no longer a subscriber.As for the In Solidarity I sincerely mean it, a left over of the union movement, where most didnt mean it!!! But dont worry I wont call you Comrade!! Look forward to catching up in Newcastle on the 12thJustineBrilliant Justine! What a woman, Roll on NMAP!in solidarity (I REALLY like this sign off!)Carolyn Hastie -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Justine CainesSent: Monday, 16 September 2002 11:22 PMTo: OzMid ListSubject: [ozmidwifery] FW: National Maternity Action PlanDear Oz MiddersFYI, I posted the following reply on Ausfem-PolnetIn SolidarityJustine Caines -- Forwarded MessageFrom: Justine Caines [EMAIL PROTECTED]Date: Mon, 16 Sep 2002 23:20:07 +1000To: [EMAIL PROTECTED]Subject: National Maternity Action PlanDear Barbara and AllIts pretty insulting to the great women across the country who have put many months into the development of this document to say you havent read it and then launch in with uninformed comment.The National Maternity Action Plan (NMAP) combines the plethora of evidence based research that determines midwives as the most appropriate and cost effective carers for the vast majority (80-85%) of women. NMAP is not about homebirth, NMAP is about all women being able to choose the care of a known midwife regardless of where they give birth.Less than 1% of Australian women can access the care of a known midwife. In NZ where women are able to choose their carer (legislation entitles a Midwife, GP and Obstetrician to be paid the same rate and women elect their carer and are funded by a birth payment) they have seen a rise in midwife care in 8 years from 14% to 72%. Women In Australia do not have equity of choice. In fact if a woman chooses to pursue a natural birth with a known midwife in the vast majority of cases she will have to fund the care herself (via an independent midwife). The cost of an independent midwife for the entire care from early pregnancy to 6 weeks post-natally including 1 on 1 care during the birth is less than a caesarean section alone. Please dont bandy choice when as a childbearing woman I can access an elective caesarean tomorrow without any medical indication that is considered 2-4 times more dangerous than a normal vaginal birth but I am actively discriminated against if I choose to access international best practice in maternity, the care of a known midwife.I see the choice of intervention for women in very safe hands, the medical lobby is very powerful and continues to claim interventionist practices as safer, despite an increase in the maternal death rate by 70% (The NHMRC Report revealed 46 direct maternal deaths showing an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium). http://www.nhmrc.gov.au/publications/pdf/wh32.pdfJustine CainesMum to Ruby, nearly 3, Clancy 18 months and Will 2 and a half monthsACT President The Maternity Coalition--- Barbara McGarity [EMAIL PROTECTED] wrote: Ihave not read the whole action plan, but I would be concerned if it led to an effort by government to push women out of maternity hospitals/wards because it would be cheaper for the government. Women should have choice, and there are many women who have successful home births, but women should not be coerced. (Sometimes women are coerced also into thinking there is something wrong or unwomanly with accepting pain reduction measures, and feel guilty when the birth comes and they need them.) Sometimes equipment is needed urgently when there is a glitch in the birth, and some women gain confidence from knowing that they have the hospital resources immediately available. Women need to be adequately informed about all options and risks before making a decision. I well remember when one grandchild was born and the mechanism that turns on
Re: [ozmidwifery] FW: National Maternity Action Plan
Title: FW: National Maternity Action Plan Dear Justine, This is a great response. I am sitting here listening to Radio National as they read out letters from listners. You should send them this in the hope they will read it out. Jackie - Original Message - From: Justine Caines To: OzMid List Sent: Monday, September 16, 2002 10:52 PM Subject: [ozmidwifery] FW: National Maternity Action Plan Dear Oz MiddersFYI, I posted the following reply on Ausfem-PolnetIn SolidarityJustine Caines -- Forwarded MessageFrom: Justine Caines [EMAIL PROTECTED]Date: Mon, 16 Sep 2002 23:20:07 +1000To: [EMAIL PROTECTED]Subject: National Maternity Action Plan Dear Barbara and AllIts pretty insulting to the great women across the country who have put many months into the development of this document to say you havent read it and then launch in with uninformed comment.The National Maternity Action Plan (NMAP) combines the plethora of evidence based research that determines midwives as the most appropriate and cost effective carers for the vast majority (80-85%) of women. NMAP is not about homebirth, NMAP is about all women being able to choose the care of a known midwife regardless of where they give birth.Less than 1% of Australian women can access the care of a known midwife. In NZ where women are able to choose their carer (legislation entitles a Midwife, GP and Obstetrician to be paid the same rate and women elect their carer and are funded by a birth payment) they have seen a rise in midwife care in 8 years from 14% to 72%. Women In Australia do not have equity of choice. In fact if a woman chooses to pursue a natural birth with a known midwife in the vast majority of cases she will have to fund the care herself (via an independent midwife). The cost of an independent midwife for the entire care from early pregnancy to 6 weeks post-natally including 1 on 1 care during the birth is less than a caesarean section alone. Please dont bandy choice when as a childbearing woman I can access an elective caesarean tomorrow without any medical indication that is considered 2-4 times more dangerous than a normal vaginal birth but I am actively discriminated against if I choose to access international best practice in maternity, the care of a known midwife.I see the choice of intervention for women in very safe hands, the medical lobby is very powerful and continues to claim interventionist practices as safer, despite an increase in the maternal death rate by 70% (The NHMRC Report revealed 46 direct maternal deaths showing an increase of 19 direct maternal deaths when compared to the 27 recorded in the previous triennium. This is the highest number of direct deaths reported since the 197981 triennium). http://www.nhmrc.gov.au/publications/pdf/wh32.pdfJustine CainesMum to Ruby, nearly 3, Clancy 18 months and Will 2 and a half monthsACT President The Maternity Coalition--- Barbara McGarity [EMAIL PROTECTED] wrote: Ihave not read the whole action plan, but I would be concerned if it led to an effort by government to push women out of maternity hospitals/wards because it would be cheaper for the government. Women should have choice, and there are many women who have successful home births, but women should not be coerced. (Sometimes women are coerced also into thinking there is something wrong or unwomanly with accepting pain reduction measures, and feel guilty when the birth comes and they need them.) Sometimes equipment is needed urgently when there is a glitch in the birth, and some women gain confidence from knowing that they have the hospital resources immediately available. Women need to be adequately informed about all options and risks before making a decision. I well remember when one grandchild was born and the mechanism that turns on babies' sugar absorption failed to kick in, which can result very quickly in death. Fortunately the doctor recognised the stress and put in a drip to save the baby (so quickly that he broke the baby's toe, which is better than a dead baby). I realise that this is not a very clinical description, but it was an emergency that needed the expertise and equipment very quickly. After a few days of the drip, the mechanism kicked in normally. Barbara -- End of Forwarded Message
