Hi everyone. I agree with Marilyn but being 'newish midwife'.. I would have everything ready to go and cannula and fluids on hand as well. I'd also make a real effort to ensure she fully understood the situation should you have to intervene in a hurry. I have seen a grand multip b
Hi Leanne,
There is some evidence now (as per the ALSO course and other research) to suggest that contrary to what we were taught previously, it is the primips that are more likely to PPH not the multis and grandmultis. I can't claim alot of homebirth experience, but my feeling would be (like Ma
I would still use physiological management but have synto and syntometrine
on hand. I really think if you treat it as a problem before hand the you can
precipitate the problem, that is the problem with much medical management
they treat the potential problem before it is a problem and before you kn
I would make sure I had a good supply of oxytocics on hand even maybe have
the syntocinon drawn up but unless she has a hx of PPH etc. I would not
assume a PPH is destined to happen. Of course if the woman requested active
management then that would be fine too. If the woman was confident to wait
a
Fiona: I guess what I am meaning is the transition
time from lochia that is moderate rubra to light serosa type loss, so not active
fresh bleeding. I am also meaning the quality of the lochia in the second week.
I was more familiar with women having a moderate serosa (pinkish
brown) type los
Hi Leanne,
I would treat this women the same as any other. Physiological 3rd Stage
unless I need to intervene.
Here is a study to support this.
Is grand multiparity an independent predictor of pregnancy risk? A
retrospective observational study.
Humphrey MD.
Cairns Clinical School, School of M
Hi All,
I would be interested to hear from any experienced homebirth midwives how
they would care for a woman who is a G10P9 if she chose to birth at home.
She has had all normal, quick births so far. Would you use active management
of third stage because she is a grand multip or would you still
Marilyn, could you please clarify what you mean by
'bleeding' in the post-partum. Are you refering to fresh blood loss or ongoing
loss of lochia? I personally found no difference in the length of time I had a
vaginal loss (similar to a period) with all three of my children- the first,
defini
Excellent point. I do think the
500mL definition for PPH is spurious. Having been educated by a homebirth
midwifery school I have to say we were not concerned when the blood loss was
less than 1000mL as most of our 3rd stages were physiological. Very
occassionally we did use oxytocin for man
Great publicity Justine!
http://www.abc.net.au/health/thepulse/s1309861.htm
Helen Cahill
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