Re: [ozmidwifery] 3rdStage Feedback
hi all, All of my clients choose not to have oxytocin unless bleeding. They read the AIMS booklet mostly. I have had 2 retained placentas, 1 with bleeding, 1 without and 1 pph out of 115 clients. Leigh - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Wednesday, December 10, 2003 11:50 PM Subject: Re: [ozmidwifery] 3rdStage Feedback At our hospital when a 3rd stage is 'actively managed' it means 30 units of synto in a 500ml bag of CSL is run through at 240ml/hr after the usual syntometrine jab in the leg. It has become such routine that syntometrine isn't really considered active management anymore. Jo Original Message From: Denise HyndTo: [EMAIL PROTECTED] ; listSent: Tuesday, December 09, 2003 12:52 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise-- Babies are Born... Pizzas are delivered.
RE: [ozmidwifery] 3rdStage Feedback
I talk to the women, give the balances info and comment that O prefer not to give it. I have found that it has only been when I have given synto that I have trouble with 3rd stage. Recently was with a woman, no blood loss at birth, I only recognised separation because the cord lengthened and the fundus rose. Placenta slipped out. On the other hand I have witnessed massive blood loss over 2500mls. Maureen -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kristy RobertsonSent: Wednesday, 10 December 2003 4:46 PMTo: [EMAIL PROTECTED]Subject: Re: [ozmidwifery] 3rdStage Feedback Hi Denise, I actually talked about this topic and informed choice in an essay for one of my subjects at the beginning of the year (for the Grad. Dip. of Mid.), in which i did quite well in. Where I have done my placements this year and will work next year as a grad (rural Victoria), the management of third stage is only touched upon in antenatal classes, and women are given a clear indication of which method is preferable. No detail is given as to what physiological third stage involves. When the time comes after the birth of the baby, consent is assumed rather than sought and the women are told 'here's a little injection i'm going to give in your leg now to help the placenta come away.' It seems as though it is presumed that women choose to have active management of third stage because they choose to have their baby in this hospital. The only cases i have witnessed where synt is not given is where the woman is well educated and informed and states on her birth plan, on arrival to the ward, and after the birth of her baby, that she does not want an active third stage. Regards Kristy -Original Message-From: Denise Hynd [EMAIL PROTECTED]To: [EMAIL PROTECTED] [EMAIL PROTECTED]; list [EMAIL PROTECTED]Date: Tuesday, December 09, 2003 3:00 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
At our hospital when a 3rd stage is 'actively managed' it means 30 units of synto in a 500ml bag of CSL is run through at 240ml/hr after the usual syntometrine jab in the leg. It has become such routine that syntometrine isn't really considered active management anymore. Jo Original Message From: Denise HyndTo: [EMAIL PROTECTED] ; listSent: Tuesday, December 09, 2003 12:52 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise-- Babies are Born... Pizzas are delivered.
Re: [ozmidwifery] 3rdStage Feedback
AAGH! "At our hospital when a 3rd stage is 'actively managed' it means 30 units of synto in a 500ml bag of CSL is run through at 240ml/hr after the usual syntometrine jab in the leg. It has become such routine that syntometrine isn't really considered active management anymore.Jo" Original Message From: Denise HyndTo: [EMAIL PROTECTED] ; listSent: Tuesday, December 09, 2003 12:52 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise-- Babies are Born... Pizzas are delivered.
Re: [ozmidwifery] 3rdStage Feedback
Wow Jo: what evidence is this based on?? marilyn - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Wednesday, December 10, 2003 5:50 AM Subject: Re: [ozmidwifery] 3rdStage Feedback At our hospital when a 3rd stage is 'actively managed' it means 30 units of synto in a 500ml bag of CSL is run through at 240ml/hr after the usual syntometrine jab in the leg. It has become such routine that syntometrine isn't really considered active management anymore. Jo Original Message From: Denise HyndTo: [EMAIL PROTECTED] ; listSent: Tuesday, December 09, 2003 12:52 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise-- Babies are Born... Pizzas are delivered.
Re: [ozmidwifery] 3rdStage Feedback
That is used for women who are grand multi's or history of PPH. HTH. Jo Original Message From: Marilyn KleidonTo: [EMAIL PROTECTED]Sent: Friday, December 12, 2003 12:43 AMSubject: Re: [ozmidwifery] 3rdStage Feedback Wow Jo: what evidence is this based on?? marilyn - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Wednesday, December 10, 2003 5:50 AM Subject: Re: [ozmidwifery] 3rdStage Feedback At our hospital when a 3rd stage is 'actively managed' it means 30 units of synto in a 500ml bag of CSL is run through at 240ml/hr after the usual syntometrine jab in the leg. It has become such routine that syntometrine isn't really considered active management anymore. Jo Original Message From: Denise Hynd To: [EMAIL PROTECTED] ; list Sent: Tuesday, December 09, 2003 12:52 PM Subject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise-- Babies are Born... Pizzas are delivered.
RE: [ozmidwifery] 3rdStage Feedback
Hi Denise, birthed first baby in level 3 public hospital in Adelaide with private obs, oxytocic given (Dr's practice), but at the same time we had asked for the cord to stop pulsating before cut. It was never expalined to me that my baby would receive so much of this drug due to our choice of waiting. Needless to say we wised up and birthed next two at home with a private midwife and had physiological third stage, waiting 11/2 hrs for the placenta to come away first time, baby still attached. Next time it took about 1/2 hr to come away, kept baby attached for about 3 hours. We were prepared to follow the rec of our midwife if medically indicated. I also found the AIMSpublication on third stage, name escapes me, very informative. A girlfriend recently birthed with private obs and insisted on physiological 3rd stage, Obs had never experienced one. My friend was well read and had spoken to my midwife to confirm her understandings of it all. I was fortunate enough to be at the birth and she did get her phys 3rd stage, but Obs didn't take her eyes off that vagina, waiting, watching, worrying and occaisionally touching the cord to see if anything was happening. Quite amusing for me to see, hopefully she is now more open minded in her practice. best wishes Megan Resch -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Denise HyndSent: Tuesday, 9 December 2003 3:23To: [EMAIL PROTECTED]; listSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
Where did that man get his statistics? If it applied to my practice I would have dead women all over the place! MM .'" He told me that 10-15% of women that don't have the injection die from PPH.. "
Re: [ozmidwifery] 3rdStage Feedback
Hi Denise I work in a private hospital where information regarding normal birth is shared in childbirth education classes. This is often the only time that the women hear about an alternative to active management. All the Obs practice active management unless challenged by their clients. We have close to 1000 births per year, but I could count on all my digits the number of women who opt for physiological third stage. I dont know what info the women recieve during their antenatal care in Obs rooms Cheers Alesa - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] ; list Sent: Tuesday, December 09, 2003 3:52 PM Subject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
Title: Re: [ozmidwifery] 3rdStage Feedback Hi Denise, Obviously in my practice in attendance at homebirths I offer normal physiological third stage. In over 200 homebirths I have given synto 3 times, with no maternal transfers for blood loss. At Mullumbimby Hospital, which is a level 1A hospital with 3 birth rooms, it is fairly standard that no routine oxytocin is administered, but the GP's tend to wait for the first separation bleed and then pull the placentas out with controlled cord traction - often 5-10 minutes after the birth. Some women are therefore transferred out to higher level hospital care for 3rd stage haemorrhages. In the larger hospitals near us, oxytocin is negotiable, but with varying degrees of bullying if the decision is made to birth without it. Hope this helps, Sue Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
In one hospital in Brisbane, not much is done to inform women before they are about to recieve oxytocics unless they happened to go to antenatal class where they are informed that it is given to help the placenta come away and that's that!!! However in the favour of some midwives I have been with, they try to tell the women what the drugs is for and ask if they would be ok about having it. Some midwives even avoid giving it unless haemorrhage occurs but they are far and few between. Women just think that it is necessary and say yes. So much for informed consent. Dierdre B
Re: [ozmidwifery] 3rdStage Feedback
Ditto Mary! On another tack, I have been tidying up my emails, and you asked me (a little while ago now, sorry) about the Side By Side conference, which went well, except for one presentation, and those who went will know what I am talking about(!). We don't have it on video, but there are copies of the CD with everyone's presentations (Powerpoint) on it. We would like to continue on witha conferenceevery two years - so much happening inmaternity care, and private sector care issues are challenging for midwives to say the least! Regards, Lynne - Original Message - From: Mary Murphy To: [EMAIL PROTECTED] Sent: Tuesday, December 09, 2003 7:19 PM Subject: Re: [ozmidwifery] 3rdStage Feedback Where did that man get his statistics? If it applied to my practice I would have dead women all over the place! MM .'" He told me that 10-15% of women that don't have the injection die from PPH.. "
Re: [ozmidwifery] 3rdStage Feedback
Hi Joy, You said: others just said something like, ' here's a little injection to help the placenta come away'! Another classic minifism!!! I challenge the assumption that just because the policy says that the woman must have oxytocics routinely that the midwife can give it without gaining informed consent. This would be another clear case of coercion, as is usually the case, the hospital's benefit (time saving). Cheers Andrea - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] 3rdStage Feedback
I was too overwhelmed to ask anything about where he got his info, I could only point out the greater chance of nothing happening. This is the same man who told me I would need a colostomy bag even if I didn't tear again.. From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary MurphySent: Tuesday, 9 December 2003 8:19 PMTo: [EMAIL PROTECTED]Subject: Re: [ozmidwifery] 3rdStage Feedback Where did that man get his statistics? If it applied to my practice I would have dead women all over the place! MM .'" He told me that 10-15% of women that don't have the injection die from PPH.. "
Re: [ozmidwifery] 3rdStage Feedback
Alesia Wrote: I dont know what info the women recieve during their antenatal care in Obs rooms 0.01 is the answer to your query Alesa. And that is where the problem lies. Pregnant? Come to my practice. I'm an Obstetrician . I'll look after you. I know what I'm doing. You sure as heck don't. Give me control over your body. I'll care for all your needs. I won't try and educate you. I don't really have the time. I am the specialist, I am a surgeon and you... you are merely pregnant. Does that feel familiar? Hugs, Sonia W.
Re: [ozmidwifery] 3rdStage Feedback
The same happens where I work. Cheers, Joanne. - Original Message - From: Alesa Koziol To: [EMAIL PROTECTED] Sent: Tuesday, December 09, 2003 7:44 PM Subject: Re: [ozmidwifery] 3rdStage Feedback Hi Denise I work in a private hospital where information regarding normal birth is shared in childbirth education classes. This is often the only time that the women hear about an alternative to active management. All the Obs practice active management unless challenged by their clients. We have close to 1000 births per year, but I could count on all my digits the number of women who opt for physiological third stage. I dont know what info the women recieve during their antenatal care in Obs rooms Cheers Alesa - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] ; list Sent: Tuesday, December 09, 2003 3:52 PM Subject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
because the policy says that the woman must have oxytocics routinely that the midwife can give it without gaining informed consent. This is how it was 20 years ago when I was a new midwife. Woe betide the woman who queried or refused it (no such thing as declining). - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Wednesday, December 10, 2003 7:57 AM Subject: Re: [ozmidwifery] 3rdStage Feedback Hi Joy, You said: others just said something like, ' here's a little injection to help the placenta come away'! Another classic minifism!!! I challenge the assumption that just because the policy says that the woman must have oxytocics routinely that the midwife can give it without gaining informed consent. This would be another clear case of coercion, as is usually the case, the hospital's benefit (time saving). Cheers Andrea - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- 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] 3rdStage Feedback
In response to a woman's question "You don't have to worry about that. I have done this hundreds of times before and this is your first time. I know what you need." - Original Message - From: *G and S* To: [EMAIL PROTECTED] Sent: Wednesday, December 10, 2003 8:40 AM Subject: Re: [ozmidwifery] 3rdStage Feedback Alesia Wrote: "I dont know what info the women recieve during their antenatal care in Obs rooms" 0.01 is the answer to your query Alesa. And that is where the problem lies. "Pregnant? Come to my practice. I'm an Obstetrician . I'll look after you. I know what I'm doing. You sure as heck don't. Give me control over your body. I'll care for all your needs. I won't try and educate you. I don't really have the time. I am the specialist, I am a surgeon and you... you are merely pregnant." Does that feel familiar? Hugs, Sonia W.
Re: [ozmidwifery] 3rdStage Feedback
Hi Denise, I actually talked about this topic and informed choice in an essay for one of my subjects at the beginning of the year (for the Grad. Dip. of Mid.), in which i did quite well in. Where I have done my placements this year and will work next year as a grad (rural Victoria), the management of third stage is only touched upon in antenatal classes, and women are given a clear indication of which method is preferable. No detail is given as to what physiological third stage involves. When the time comes after the birth of the baby, consent is assumed rather than sought and the women are told 'here's a little injection i'm going to give in your leg now to help the placenta come away.' It seems as though it is presumed that women choose to have active management of third stage because they choose to have their baby in this hospital. The only cases i have witnessed where synt is not given is where the woman is well educated and informed and states on her birth plan, on arrival to the ward, and after the birth of her baby, that she does not want an active third stage. Regards Kristy -Original Message-From: Denise Hynd [EMAIL PROTECTED]To: [EMAIL PROTECTED] [EMAIL PROTECTED]; list [EMAIL PROTECTED]Date: Tuesday, December 09, 2003 3:00 PMSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
Re: [ozmidwifery] 3rdStage Feedback
Hi Denise, At our small hospital (15 - 30 births a year), just recently it has become protocol that all women are to have the oxytocic for 3rd stage.This is a result of doctors' request. In the past, I think I was possibly the only midwife who spoke to them about whether or not they wanted it, others just said something like, ' here's a little injection to help the placenta come away'! Regards, Joy Joy Cocks RN (Div 1) RM CBE IBCLCBRIGHT Vic 3741 email:[EMAIL PROTECTED] - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] ; list Sent: Tuesday, December 09, 2003 15:52 PM Subject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
RE: [ozmidwifery] 3rdStage Feedback
At the hospital where I birthed my son, one of the questions on the birthplan list is 'Management of the afterbirth with an oxytocic injection is recommended. Do you have any thoughts about this?' My response was typed as this- 'I would like a physiological 3rd stage, unless medically indicated (increased/excessive bleeding)' When I handed my birthplan to the OB who I was 'allocated' to for my 36 week appointment, he proceeded to tell me that 'It was all well and good to deliver the placenta naturally, but its not very nice to die naturally from massive blood loss..' He told me that 10-15% of women that don't have the injection die from PPH.. I immediately pointed out that that meant that 90-85% of women don't die. He looked at me over his glasses and smiled, put my plan on the table and changed the topic.. As it was, after my sons birth, a midwife I didn't knowcame in with the injection, told me that she was just going to give it to me to help the placenta out. I immediately looked at my mum, then at my beautiful midwife Lynne. Lynne told this other woman that I didn't want it, that all was in hand.. I actually have a photo of this moment, I am smiling, holding my son, Lynne is busy talking to the other midwife with my mum looking over her shoulder, ready to speak up if needed :) My placenta came on its own, with no problems. It is still in my freezer now, waiting to be buried.. That is my experience.. From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Denise HyndSent: Tuesday, 9 December 2003 3:53 PMTo: [EMAIL PROTECTED]; listSubject: [ozmidwifery] 3rdStage Feedback Dear Ozmid list, I need to know or get some feedback about the prevelance of physiological third stage in Australia. That is are women being offered the option of birthing their placentas with out an oxytocic injection in Australain hospitals and is it standard practice to give women informed choice about this in homebirths (as I understand it) Personal expereinces of situations and protocols would be appreciated Thank you Denise
