RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Thank you for this, Rachel. I am very interested in this subject because in Croatia, you become a midwife after graduating from a high school for midwives. There is no university-level education afterwards and I was under an impression that if we (women and midwives together) manage to convince our Ministry of Health to start educating midwives at that, higher level, a major step would be accomplished. Now I realize that there is much more to it. So midwives working in the public health system in Australia don't have the same autonomy as do independent midwives? How about training? Is it all self-study after graduating from college? Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of wump fish Sent: Wednesday, August 31, 2005 2:32 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Even if it is the same curriculum in Australia - it is set within a different context. Correct me if I am wrong (still getting to grips with the system here). A student midwife in Australia is 'mentored' by midwives working in the public health system. Because these midwives are limited in their autonomy and skills, the student will also be limited. Students are also subject to the cultural and social perceptions of midwifery where they train. If most people perceive midwives as nurses working in maternity - it is difficult to develop an identity as a midwife (I am struggling to maintain my own professional identity). In the UK the midwives I trained with were 'midwives', they did not also work as nurses, nor refer to themselves as nurses. Women in the UK called us midwives and had an understanding and respect for our role. During my practice as a team midwife - women would ring us to tell us they were pregnant. We would send a letter to their GP to let them know (out of courtesy), then provide all the woman's care until 6wks postnatal. Women refer to midwives as 'my midwife' and ask each other 'who is your midwife'. Are Australian students exposed to this kind of reciprocal relationship with women? Midwifery is not just about clinical skills - it is about philosophy, culture, experience, politics etc etc. Rachel From: Vedrana ValÄ?iÄ [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 15:13:18 +0200 This is the minimum of what European midwives have to learn, either in 3 years of practical and theoretical studies (after 10 years of general school education) or in 18 months (for qualified nurses responsible for general care): TRAINING PROGRAMME FOR MIDWIVES The training programme for obtaining a diploma, certificate or other evidence of formal qualifications in midwifery consists of the following two parts: A. THEORETICAL AND TECHNICAL INSTRUCTION (a) General subjects 1. Basic anatomy and physiology 2. Basic pathology 3. Basic bacteriology, virology and parasitology 4. Basic biophysics, biochemistry and radiology 5. Paediatrics, with particular reference to new-born infants 6. Hygiene, health education, preventive medicine, early diagnosis of diseases 7. Nutrition and dietetics, with particular reference to women, new-born and young babies 8. Basic sociology and socio-medical questions 9. Basic pharmacology 10. Psychology 11. Principles and methods of teaching 12. Health and social legislation and health organization 13. Professional ethics and professional legislation 14. Sex education and family planning 15. Legal protection of mother and infant (b) Subjects specific to the activities of midwives 1. Anatomy and physiology 2. Embryology and development of the foetus 3. Pregnancy, childbirth and puerperium 4. Gynaecological and obstetrical pathology 5. Preparation for childbirth and parenthood, including psychological aspects 6. Preparation for delivery (including knowledge and use of technical equipment in obstetrics) 7. Analgesia, anaesthesia and resuscitation 8. Physiology and pathology of the new-born infant 9. Care and supervision of the new-born infant 10. Psychological and social factors B. PRACTICAL AND CLINICAL TRAINING This training is to be dispensed under appropriate supervision: 1. Advising of pregnant women, involving at least 100 pre-natal examinations. 2. Supervision and care of at least 40 women in labour. 3. The student should personally carry out at least 40 deliveries; where this number cannot be reached owing to the lack of available women in labour, it may be reduced to a minimum of 30, provided that the student participates actively in 20 further deliveries. 4. Active participation with breech deliveries. Where this is not possible because of lack of breech deliveries practice may be in a simulated situation. 5. Performance of episiotomy and initiation
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
can you let us know how the c-section conference goes Rachel ? emilywump fish [EMAIL PROTECTED] wrote: Thanks Denise! What a lovely response.Moving to Australia has re-ignited my fighting spirit regarding women's birth rights. There is so much to fight for and so many motivated, strong midwives and birthing women. I am looking forward to what we can all achieve together for the future of childbirth in Australia.By the way, is anyone going to the Wesley Hospital (Qld) on Saturday for the 'C-section: the way of the future' conference? Should be interesting/infuriating.RachelFrom: "Denise Hynd" <[EMAIL PROTECTED]>Reply-To: ozmidwifery@acegraphics.com.auTo: <OZMIDWIFERY@ACEGRAPHICS.COM.AU>Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)Date: Tue, 30 Aug 2005 18:18:02 +0800Dear RachelI find your fe! dd back very perceptiveit seems that the obs are behavinglike threatened children.And previouslyRegarding the 3rd degree tear stats. I would be interested to know wherethis research is from. As far a I know no-one has researched physiologicalbirth and it's impact on the perineum - probably because so few womenexperience it.I hope all future midwives have half the abilities you have shown on this list in only 2 emailsYou have given me great cheer for the futre of midwifery!!Denise Hynd"Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled."- Linda Hes- Original Message - From: "wump fish" <[EMAIL PROTECTED]>To: <OZMIDWIFERY@ACEGRAPHICS.COM.AU>Sent: Tuesday, August 30, 2005 12:02 PMSubject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children.Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe.Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power?I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth.RachelFrom: "Sally-Anne Brown" <[EMAIL PROTECTED]>Reply-To: ozmidwifery@acegraphics.com.auTo: <OZMIDWIFERY@ACEGRAPHICS.COM.AU>Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralia! n.com.au report)Date: Tue, 30 Aug 2005 08:23:49 +1000- Original Message -From: SallyTo: Sally-Anne BrownSent: Tuesday, August 30, 2005 8:11 AMSubject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies! born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with "modest benefits". Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby group the National Association of Specialist Obstetricians and Gynaecologists - said the review, published late last year, also found babies born in home-like settings such as midwife-run centr! es ran an 85 per cent higher risk of death around the time of childbirth. However, the overall rate is still very low - about eight babies in 1000 live births in 2002, according to the Australian Bureau of Statistics. Dr Pesce also said studies that midwives sometimes used to back up their safety claims were scientifically inferior, usually because their subjects
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Obviously scary rubbish makes better news than truthful lovely births. I think you are SO right there. It seems to me that viewing birth as a disaster just waiting to happen, even if it is a normal birth, is Dr Giltrap's problem. Plus, I'm still trying to understand what he meant by: Dr Giltrap claimed Australian midwives were not as well trained as their European counterparts and Australian standards were often higher than those in Europe. There is a resolution by EU which states how many hours of what midwives have to have, and I doubt that it is more than you have in Australia. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, August 30, 2005 6:22 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Rachel (welcome btw!) I hear everything you're saying and I concur. It's so transparently about a professional monopoly but their own brilliant misinformation campaign is so entwined with our current cultural fears around normal physiological birth that very little gets into the media to contradict it. Of course what I really want is for them to have to answer how all the guff they spout really stands up against the research but the seven second soundbite only allows long enough for scare tactics, not evidence. It's interesting to me that in many years of writing letters to SMH and The Age, I have never had one published on birth issues. I've got quite a track record on political issues of other kinds, but not even the most benign letter on home birth or midwifery has made it into their publications. Obs and midwives get published a bit but very rarely consumers. I sent letters to every major paper plus regionals for Home Birth Awareness Week last year, and not one was published. That's a lot of editors making the same decision. Obviously scary rubbish makes better news than truthful lovely births. Food for thought! 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: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
I think there is a difference between the training and skills of Australian mw and UK mw. But, this largely exists due to the different maternity systems and the blocks placed on practice by the obs. Your mw training is reliant on the experiences you are able to access. For example, as a direct entry mw in the UK my training began in the community with a community midwife providing midwifery-led care with a family focus. By the end of our course we were expected to be able to provide total care for 'normal' women (including suturing). I realise that I have a limited viewpoint at present, but I have noticed that the mainstream perception of midwives is that we are nurses with a mid specialisation, and even refer to each other as nurses. People are getting a bit sick of me correcting them when they call me a nurse. Midwives are prevented from maintaining and developing skills by hospital systems. For example, I have been told I am not allowed to suture! Many mw do not rotate and will only work in one area eg. postnatal. I am working on an escape plan to get out of the maternity system as I can see my midwifery skills being worn away. I am sure that the independent mws and birth centre mws are more than able to provide total care for women. But, I wonder if mws who have been trained in the mainstream system and have only worked in this system would have the skills, experience or confidence to provide total care for women. If Dr Giltrap is correct, then the answer is not to leave birth the the obs, but to improve mw education and empower the mw profession. Rachel From: Vedrana Valèiæ [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:54:14 +0200 Obviously scary rubbish makes better news than truthful lovely births. I think you are SO right there. It seems to me that viewing birth as a disaster just waiting to happen, even if it is a normal birth, is Dr Giltrap's problem. Plus, I'm still trying to understand what he meant by: Dr Giltrap claimed Australian midwives were not as well trained as their European counterparts and Australian standards were often higher than those in Europe. There is a resolution by EU which states how many hours of what midwives have to have, and I doubt that it is more than you have in Australia. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, August 30, 2005 6:22 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Rachel (welcome btw!) I hear everything you're saying and I concur. It's so transparently about a professional monopoly but their own brilliant misinformation campaign is so entwined with our current cultural fears around normal physiological birth that very little gets into the media to contradict it. Of course what I really want is for them to have to answer how all the guff they spout really stands up against the research but the seven second soundbite only allows long enough for scare tactics, not evidence. It's interesting to me that in many years of writing letters to SMH and The Age, I have never had one published on birth issues. I've got quite a track record on political issues of other kinds, but not even the most benign letter on home birth or midwifery has made it into their publications. Obs and midwives get published a bit but very rarely consumers. I sent letters to every major paper plus regionals for Home Birth Awareness Week last year, and not one was published. That's a lot of editors making the same decision. Obviously scary rubbish makes better news than truthful lovely births. Food for thought! 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. _ Dont just search. Find. Check out the new MSN Search! http://search.msn.click-url.com/go/onm00200636ave/direct/01/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Once again, sent the last mail before it was finished, sorry. Obviously scary rubbish makes better news than truthful lovely births. I think you are SO right there. It seems to me that viewing birth as a disaster just waiting to happen, even if it is a normal birth, is Dr Giltrap's problem. Plus, I'm still trying to understand what he meant by: Dr Giltrap claimed Australian midwives were not as well trained as their European counterparts and Australian standards were often higher than those in Europe. There are a couple of directives by EU which address midwives, and I doubt that it is more than you have in Australia. Aah, but then higher standards come into effect, right? Anyway: Directive 80/154/EEC concerning the mutual recognition of diplomas, certificates and other evidence of formal qualifications in midwifery and including measures to facilitate the effective exercise of the right of establishment and freedom to provide services Directive 80/155/EEC concerning the coordination of provisions laid down by Law, Regulation or Administrative Action relating to the taking up and pursuit of the activities of midwives Decision 80/156/EEC setting up an Advisory Committee on the Training of Midwives Directive 89/594/EEC amending Directives 75/362/EEC, 77/452/EEC, 78/686/EEC, 78/1026/EEC and 80/154/EEC relating to the mutual recognition of diplomas, certificates and other evidence of formal qualifications as doctors, nurses responsible for general care, dental practitioners, veterinary surgeons and midwives, together with Directives 75/363/EEC, 78/1027/EEC and 80/155/EEC concerning the coordination of provisions laid down by Law, Regulation or Administrative Action relating to the activities of doctors, veterinary surgeons and midwives Directive 2001/19/EC amending Council Directives 77/452/EEC, 77/453/EEC, 78/686/EEC, 78/687/EEC, 78/1026/EEC, 78/1027/EEC, 80/154/EEC, 80/155/EEC, 85/384/EEC, 85/432/EEC, 85/433/EEC and 93/16/EEC As for dr Pesce, even if midwife care did offer just minimal benefits, I'm sure women would like to make the choice for themselves. And comparing lacerations with episiotomies, where everything, skin, muscles, nerves are cut, left me with my mouth open. As did the statement that there is a higher risk of perinatal deaths in birth centres. Vedrana -Original Message- From: Vedrana Valčić Sent: Tuesday, August 30, 2005 8:54 AM To: 'ozmidwifery@acegraphics.com.au' Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Obviously scary rubbish makes better news than truthful lovely births. I think you are SO right there. It seems to me that viewing birth as a disaster just waiting to happen, even if it is a normal birth, is Dr Giltrap's problem. Plus, I'm still trying to understand what he meant by: Dr Giltrap claimed Australian midwives were not as well trained as their European counterparts and Australian standards were often higher than those in Europe. There is a resolution by EU which states how many hours of what midwives have to have, and I doubt that it is more than you have in Australia. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, August 30, 2005 6:22 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Rachel (welcome btw!) I hear everything you're saying and I concur. It's so transparently about a professional monopoly but their own brilliant misinformation campaign is so entwined with our current cultural fears around normal physiological birth that very little gets into the media to contradict it. Of course what I really want is for them to have to answer how all the guff they spout really stands up against the research but the seven second soundbite only allows long enough for scare tactics, not evidence. It's interesting to me that in many years of writing letters to SMH and The Age, I have never had one published on birth issues. I've got quite a track record on political issues of other kinds, but not even the most benign letter on home birth or midwifery has made it into their publications. Obs and midwives get published a bit but very rarely consumers. I sent letters to every major paper plus regionals for Home Birth Awareness Week last year, and not one was published. That's a lot of editors making the same decision. Obviously scary rubbish makes better news than truthful lovely births. Food for thought! 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: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Dear Rachel I find your fedd back very perceptive it seems that the obs are behaving like threatened children. And previously Regarding the 3rd degree tear stats. I would be interested to know where this research is from. As far a I know no-one has researched physiological birth and it's impact on the perineum - probably because so few women experience it. I hope all future midwives have half the abilities you have shown on this list in only 2 emails You have given me great cheer for the futre of midwifery!! Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 30, 2005 12:02 PM Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with modest benefits. Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby group the National Association of Specialist Obstetricians and Gynaecologists - said the review, published late last year, also found babies born in home-like settings such as midwife-run centres ran an 85 per cent higher risk of death around the time of childbirth. However, the overall rate is still very low - about eight babies in 1000 live births in 2002, according to the Australian Bureau of Statistics. Dr Pesce also said studies that midwives sometimes used to back up their safety claims were scientifically inferior, usually because their subjects were not randomised - an accepted technique to remove bias. Everybody says it's been shown to be safe - but it's not. It's been shown to be reasonably safe, but without question there's a worry about increased risk of perinatal mortality, he said. There's a positive effect (of birthing centres), but it's a lot lower than you would be led to believe by people who advocate this model. Kathleen Fahy, professor of midwifery at the University of Newcastle, said Dr Pesce was using the Cochrane deaths data to imply that something is significant when it isn't. What's going on here is a desire to prevent midwives from practising their profession, and using safety to do so
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Thank God there are some who support us, they are just not vocal enough. Without the support of the Cairns OB's Mareeba would be history. Cheers Judy --- wump fish [EMAIL PROTECTED] wrote: As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with modest benefits. Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby group the National Association of Specialist Obstetricians and Gynaecologists - said the review, published late last year, also found babies born in home-like settings such as midwife-run centres ran an 85 per cent higher risk of death around the time of childbirth. However, the overall rate is still very low - about eight babies in 1000 live births in 2002, according to the Australian Bureau of Statistics. Dr Pesce also said studies that midwives sometimes used to back up their safety claims were scientifically inferior, usually because their subjects were not randomised - an accepted technique to remove bias. Everybody says it's been shown to be safe - but it's not. It's been shown to be reasonably safe, but without question there's a worry about increased risk of perinatal mortality, he said. There's a positive effect (of birthing centres), but it's a lot lower than you would be led to believe by people who advocate this model. Kathleen Fahy, professor of midwifery at the University of Newcastle, said Dr Pesce was using the Cochrane deaths data to imply that something is significant when it isn't. What's going on here is a desire to prevent midwives from practising their profession, and using safety to do so, she said. Sally Tracy, associate professor of midwifery practice development at the University of Technology Sydney, said she had recently finalised a study using data from more than 1million Australian births, which would be published shortly in a major medical journal. Although prevented under medical journal requirements from discussing the findings before publication, she said the results were positive for midwife centres. In an article to be published next month in NASOG's newsletter, Dr Pesce - who also represents obstetricians and gynaecologists on the Australian Medical
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
You are so right about many Australian Midwives being prevented from gaining the full spectrum of skills necessary for total care of well women. As you said the answer is to give midwives the opportunity to learn what they should not just want OB's want them to learn. Those midwives who work independently, in birth centres and some in hospitals have had to actively chase the knowledge and experience necessary to do their work properly. It is hard work sometimes. All worth it though when you have a satisfying birth with a woman who you have developed a relationship with antenatally. Cheers Judy --- wump fish [EMAIL PROTECTED] wrote: I think there is a difference between the training and skills of Australian mw and UK mw. But, this largely exists due to the different maternity systems and the blocks placed on practice by the obs. Your mw training is reliant on the experiences you are able to access. For example, as a direct entry mw in the UK my training began in the community with a community midwife providing midwifery-led care with a family focus. By the end of our course we were expected to be able to provide total care for 'normal' women (including suturing). I realise that I have a limited viewpoint at present, but I have noticed that the mainstream perception of midwives is that we are nurses with a mid specialisation, and even refer to each other as nurses. People are getting a bit sick of me correcting them when they call me a nurse. Midwives are prevented from maintaining and developing skills by hospital systems. For example, I have been told I am not allowed to suture! Many mw do not rotate and will only work in one area eg. postnatal. I am working on an escape plan to get out of the maternity system as I can see my midwifery skills being worn away. I am sure that the independent mws and birth centre mws are more than able to provide total care for women. But, I wonder if mws who have been trained in the mainstream system and have only worked in this system would have the skills, experience or confidence to provide total care for women. If Dr Giltrap is correct, then the answer is not to leave birth the the obs, but to improve mw education and empower the mw profession. Rachel From: Vedrana Valèiæ [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:54:14 +0200 Obviously scary rubbish makes better news than truthful lovely births. I think you are SO right there. It seems to me that viewing birth as a disaster just waiting to happen, even if it is a normal birth, is Dr Giltrap's problem. Plus, I'm still trying to understand what he meant by: Dr Giltrap claimed Australian midwives were not as well trained as their European counterparts and Australian standards were often higher than those in Europe. There is a resolution by EU which states how many hours of what midwives have to have, and I doubt that it is more than you have in Australia. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, August 30, 2005 6:22 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Rachel (welcome btw!) I hear everything you're saying and I concur. It's so transparently about a professional monopoly but their own brilliant misinformation campaign is so entwined with our current cultural fears around normal physiological birth that very little gets into the media to contradict it. Of course what I really want is for them to have to answer how all the guff they spout really stands up against the research but the seven second soundbite only allows long enough for scare tactics, not evidence. It's interesting to me that in many years of writing letters to SMH and The Age, I have never had one published on birth issues. I've got quite a track record on political issues of other kinds, but not even the most benign letter on home birth or midwifery has made it into their publications. Obs and midwives get published a bit but very rarely consumers. I sent letters to every major paper plus regionals for Home Birth Awareness Week last year, and not one was published. That's a lot of editors making the same decision. Obviously scary rubbish makes better news than truthful lovely births. Food for thought! 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. _ Dont just search. Find
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
This is the minimum of what European midwives have to learn, either in 3 years of practical and theoretical studies (after 10 years of general school education) or in 18 months (for qualified nurses responsible for general care): TRAINING PROGRAMME FOR MIDWIVES The training programme for obtaining a diploma, certificate or other evidence of formal qualifications in midwifery consists of the following two parts: A. THEORETICAL AND TECHNICAL INSTRUCTION (a) General subjects 1. Basic anatomy and physiology 2. Basic pathology 3. Basic bacteriology, virology and parasitology 4. Basic biophysics, biochemistry and radiology 5. Paediatrics, with particular reference to new-born infants 6. Hygiene, health education, preventive medicine, early diagnosis of diseases 7. Nutrition and dietetics, with particular reference to women, new-born and young babies 8. Basic sociology and socio-medical questions 9. Basic pharmacology 10. Psychology 11. Principles and methods of teaching 12. Health and social legislation and health organization 13. Professional ethics and professional legislation 14. Sex education and family planning 15. Legal protection of mother and infant (b) Subjects specific to the activities of midwives 1. Anatomy and physiology 2. Embryology and development of the foetus 3. Pregnancy, childbirth and puerperium 4. Gynaecological and obstetrical pathology 5. Preparation for childbirth and parenthood, including psychological aspects 6. Preparation for delivery (including knowledge and use of technical equipment in obstetrics) 7. Analgesia, anaesthesia and resuscitation 8. Physiology and pathology of the new-born infant 9. Care and supervision of the new-born infant 10. Psychological and social factors B. PRACTICAL AND CLINICAL TRAINING This training is to be dispensed under appropriate supervision: 1. Advising of pregnant women, involving at least 100 pre-natal examinations. 2. Supervision and care of at least 40 women in labour. 3. The student should personally carry out at least 40 deliveries; where this number cannot be reached owing to the lack of available women in labour, it may be reduced to a minimum of 30, provided that the student participates actively in 20 further deliveries. 4. Active participation with breech deliveries. Where this is not possible because of lack of breech deliveries practice may be in a simulated situation. 5. Performance of episiotomy and initiation into suturing. Initiation shall include theoretical instruction and clinical practice. The practice of suturing includes suturing of the wound following an episiotomy and a simple perineal laceration. This may be in a simulated situation if absolutely necessary. 6. Supervision and care of 40 women at risk in pregnancy, or labour or postnatal period. 7. Supervision and care (including examination) of at least 100 post-natal women and healthy new-born infants. 8. Observation and care of the new-born requiring special care including those born pre-term, post-term, underweight or ill. 9. Care of women with pathological conditions in the fields of gynaecology and obstetrics. 10. Initiation into care in the field of medicine and surgery. Initiation shall include theoretical instruction and clinical practice. Is it different in Australia? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Judy Chapman Sent: Tuesday, August 30, 2005 2:14 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) You are so right about many Australian Midwives being prevented from gaining the full spectrum of skills necessary for total care of well women. As you said the answer is to give midwives the opportunity to learn what they should not just want OB's want them to learn. Those midwives who work independently, in birth centres and some in hospitals have had to actively chase the knowledge and experience necessary to do their work properly. It is hard work sometimes. All worth it though when you have a satisfying birth with a woman who you have developed a relationship with antenatally. Cheers Judy --- wump fish [EMAIL PROTECTED] wrote: I think there is a difference between the training and skills of Australian mw and UK mw. But, this largely exists due to the different maternity systems and the blocks placed on practice by the obs. Your mw training is reliant on the experiences you are able to access. For example, as a direct entry mw in the UK my training began in the community with a community midwife providing midwifery-led care with a family focus. By the end of our course we were expected to be able to provide total care for 'normal' women (including suturing). I realise that I have a limited viewpoint at present, but I have noticed that the mainstream perception of midwives is that we are nurses with a mid specialisation, and even refer to each other as nurses. People are getting
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Thanks Denise! What a lovely response. Moving to Australia has re-ignited my fighting spirit regarding women's birth rights. There is so much to fight for and so many motivated, strong midwives and birthing women. I am looking forward to what we can all achieve together for the future of childbirth in Australia. By the way, is anyone going to the Wesley Hospital (Qld) on Saturday for the 'C-section: the way of the future' conference? Should be interesting/infuriating. Rachel From: Denise Hynd [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 18:18:02 +0800 Dear Rachel I find your fedd back very perceptive it seems that the obs are behaving like threatened children. And previously Regarding the 3rd degree tear stats. I would be interested to know where this research is from. As far a I know no-one has researched physiological birth and it's impact on the perineum - probably because so few women experience it. I hope all future midwives have half the abilities you have shown on this list in only 2 emails You have given me great cheer for the futre of midwifery!! Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 30, 2005 12:02 PM Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with modest benefits. Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby group the National Association of Specialist Obstetricians and Gynaecologists - said the review, published late last year, also found babies born in home-like settings such as midwife-run centres ran an 85 per cent higher risk of death around the time of childbirth. However, the overall rate is still very low - about eight babies in 1000 live births in 2002, according to the Australian Bureau of Statistics. Dr Pesce also said studies that midwives sometimes used to back up their safety claims were scientifically inferior, usually because
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Rachel is that the Wesley Hospital in Townsville? Knowing the rates of C-section up here it does not surprise me. I think their rate is around 50%. (Although they seem to be the better of the two Private Hospitals) h the way of the future??? Honey - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, August 31, 2005 9:29 AM Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Thanks Denise! What a lovely response. Moving to Australia has re-ignited my fighting spirit regarding women's birth rights. There is so much to fight for and so many motivated, strong midwives and birthing women. I am looking forward to what we can all achieve together for the future of childbirth in Australia. By the way, is anyone going to the Wesley Hospital (Qld) on Saturday for the 'C-section: the way of the future' conference? Should be interesting/infuriating. Rachel From: Denise Hynd [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 18:18:02 +0800 Dear Rachel I find your fedd back very perceptive it seems that the obs are behaving like threatened children. And previously Regarding the 3rd degree tear stats. I would be interested to know where this research is from. As far a I know no-one has researched physiological birth and it's impact on the perineum - probably because so few women experience it. I hope all future midwives have half the abilities you have shown on this list in only 2 emails You have given me great cheer for the futre of midwifery!! Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 30, 2005 12:02 PM Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with modest benefits. Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
No, it's the one in Brisbane. There is one midwife booked to speak - Denis Walsh. There is a uro-gynea dr talking about childbirth and the pelvic floor. I will with-hold judgement until I have attended and listened - h. In the UK the arguement of pelvic floor damage was often used in discussions regarding second stage. I told the cons. that I would change my practice if he could show me the supposed evidence - he couldn't. This led to a review of second stage research by a multi-disciplinary group (including myself) and surprise surprise no-one could find any evidence. So, the unit I worked in was in the process of changing the guidelines and auditing outcomes when I left for oz. Rachel From: Honey Acharya [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Wed, 31 Aug 2005 10:29:16 +1000 Rachel is that the Wesley Hospital in Townsville? Knowing the rates of C-section up here it does not surprise me. I think their rate is around 50%. (Although they seem to be the better of the two Private Hospitals) h the way of the future??? Honey - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, August 31, 2005 9:29 AM Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Thanks Denise! What a lovely response. Moving to Australia has re-ignited my fighting spirit regarding women's birth rights. There is so much to fight for and so many motivated, strong midwives and birthing women. I am looking forward to what we can all achieve together for the future of childbirth in Australia. By the way, is anyone going to the Wesley Hospital (Qld) on Saturday for the 'C-section: the way of the future' conference? Should be interesting/infuriating. Rachel From: Denise Hynd [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 18:18:02 +0800 Dear Rachel I find your fedd back very perceptive it seems that the obs are behaving like threatened children. And previously Regarding the 3rd degree tear stats. I would be interested to know where this research is from. As far a I know no-one has researched physiological birth and it's impact on the perineum - probably because so few women experience it. I hope all future midwives have half the abilities you have shown on this list in only 2 emails You have given me great cheer for the futre of midwifery!! Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, August 30, 2005 12:02 PM Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http
RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
As a newcomer to Australia from the UK - it seems that the obs are behaving like threatened children. Firstly, their stats can flawed. Other developed countries have also looked at the evidence and concluded that midwife-led, community-based care is effective, efficient and safe. For example, the UK is moving towards a midwifery-led birth centre model based on research about what women want and what is safe. Secondly, even if midwifery-led birth is unsafe (which it is not). Surely women's right to choose this option should be maintained. Women should be able to access a wide range of birth options from independent mws to elective c-section. Interesting that a woman's right to opt for an elective c-section/induction is upheld by the obs despite the wealth of research demonstrating it is not the safest choice for mother or baby. However, they want to block a woman's right to choose midwifery-led care based on safety claims. Is this about safety or power? I am deeply disturbed by the amount of hostility directed at mws by obs. We should be working together - mw being the experts in physiological birth, and obs being the experts in complicated birth. Rachel From: Sally-Anne Brown [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Date: Tue, 30 Aug 2005 08:23:49 +1000 - Original Message - From: Sally To: Sally-Anne Brown Sent: Tuesday, August 30, 2005 8:11 AM Subject: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Sally ([EMAIL PROTECTED]) suggested you might be interested in this http://theaustralian.com.au report. 'Higher risk' in midwife deliveries Adam Cresswell, Health editor 30 August 2005 THE safety of midwife-led birthing units has been doubted and the most reliable evidence suggests babies born in such centres are 85 per cent more likely to die during or shortly after birth, compared with babies born in major hospitals. Leading obstetrician Andrew Pesce said yesterday that a review by the international Cochrane Collaboration - considered the best source of evidence for medical claims - found that home-like settings for births were associated with modest benefits. Dr Pesce said these benefits included higher rates of breastfeeding, more satisfied mothers and slightly higher rates of spontaneous vaginal childbirth (as opposed to surgical deliveries). However, the Sydney-based Dr Pesce - who is also secretary of the industrial lobby group the National Association of Specialist Obstetricians and Gynaecologists - said the review, published late last year, also found babies born in home-like settings such as midwife-run centres ran an 85 per cent higher risk of death around the time of childbirth. However, the overall rate is still very low - about eight babies in 1000 live births in 2002, according to the Australian Bureau of Statistics. Dr Pesce also said studies that midwives sometimes used to back up their safety claims were scientifically inferior, usually because their subjects were not randomised - an accepted technique to remove bias. Everybody says it's been shown to be safe - but it's not. It's been shown to be reasonably safe, but without question there's a worry about increased risk of perinatal mortality, he said. There's a positive effect (of birthing centres), but it's a lot lower than you would be led to believe by people who advocate this model. Kathleen Fahy, professor of midwifery at the University of Newcastle, said Dr Pesce was using the Cochrane deaths data to imply that something is significant when it isn't. What's going on here is a desire to prevent midwives from practising their profession, and using safety to do so, she said. Sally Tracy, associate professor of midwifery practice development at the University of Technology Sydney, said she had recently finalised a study using data from more than 1million Australian births, which would be published shortly in a major medical journal. Although prevented under medical journal requirements from discussing the findings before publication, she said the results were positive for midwife centres. In an article to be published next month in NASOG's newsletter, Dr Pesce - who also represents obstetricians and gynaecologists on the Australian Medical Association's federal council - said the Cochrane review looked at the results of six different trials, together involving 8677 women. The review found birth centre care was associated with modest reductions in some medical interventions, such as episiotomies - where a cut is made in the perineum to assist birth and prevent
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Rachel (welcome btw!) I hear everything you're saying and I concur. It's so transparently about a professional monopoly but their own brilliant misinformation campaign is so entwined with our current cultural fears around normal physiological birth that very little gets into the media to contradict it. Of course what I really want is for them to have to answer how all the guff they spout really stands up against the research but the seven second soundbite only allows long enough for scare tactics, not evidence. It's interesting to me that in many years of writing letters to SMH and The Age, I have never had one published on birth issues. I've got quite a track record on political issues of other kinds, but not even the most benign letter on home birth or midwifery has made it into their publications. Obs and midwives get published a bit but very rarely consumers. I sent letters to every major paper plus regionals for Home Birth Awareness Week last year, and not one was published. That's a lot of editors making the same decision. Obviously scary rubbish makes better news than truthful lovely births. Food for thought! J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Hi All Janet consumer letters are published quite regularly (well MC members seem to be). I had a corker refuting Pieter Mourik's assertion re homebirth safety where I called him 'factually impotent' Letters to the Ed are hard to crack. I have a 50/50 success rate. After a while you adapt to a style (I can write 200 very cutting words these days to span the myriad of issues but it has TAKEN A LOT OF PRACTICE!) Remember you will never get published if you go over word count. I would congratulate Adam Cresswell for naming Obstetricians groups as Industrial lobby groups! I love it. Also let's ask Dr Pesche about his evidence on Australian safety re midwife models (we know he hasn't got it!!) E-mail is always best (but most do that these days I know). Some allow 250 words but I seem to stay on 200! They rather individuals not orgs (so unless I am correcting a wrong of an article I have been in and one usually gets right of reply) I go as an individual. Keep up the great work Kind regards Justine Caines -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report)
Like I said, Justine, I've been published a lot in SMH and the Age, just never on birth, so I obviously have the style etc for those other topics. I'll look out for some of those consumer letters from MC. J - Original Message - From: Justine Caines [EMAIL PROTECTED] To: OzMid List ozmidwifery@acegraphics.com.au Sent: Tuesday, August 30, 2005 3:01 PM Subject: Re: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries (http://theaustralian.com.au report) Hi All Janet consumer letters are published quite regularly (well MC members seem to be). I had a corker refuting Pieter Mourik's assertion re homebirth safety where I called him 'factually impotent' Letters to the Ed are hard to crack. I have a 50/50 success rate. After a while you adapt to a style (I can write 200 very cutting words these days to span the myriad of issues but it has TAKEN A LOT OF PRACTICE!) Remember you will never get published if you go over word count. I would congratulate Adam Cresswell for naming Obstetricians groups as Industrial lobby groups! I love it. Also let's ask Dr Pesche about his evidence on Australian safety re midwife models (we know he hasn't got it!!) E-mail is always best (but most do that these days I know). Some allow 250 words but I seem to stay on 200! They rather individuals not orgs (so unless I am correcting a wrong of an article I have been in and one usually gets right of reply) I go as an individual. Keep up the great work Kind regards Justine Caines -- 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.
