Re: [ozmidwifery] 7.30 report
Dear all Pat Brodie mentioned last week will be on monday night as in tonight - but obviously will depend on other stuff like the devastation with Katrina. so check it out - may be on.. SA - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, September 05, 2005 11:57 AM Subject: [ozmidwifery] 7.30 report I have just heard from Denis Walsh that he and some others were filmed by the 7.30 Report (ABC) at the Conference last week. The program may go to air anytime this week, possibly Tuesday. All good stuff! Regards, 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. -- Internal Virus Database is out-of-date. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.17/84 - Release Date: 29/08/2005 -- Internal Virus Database is out-of-date. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.17/84 - Release Date: 29/08/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re: Breech Babies
We had a woman booked for elective C/S for breech - 2 previous svd's. On the table the obs felt that the baby was now cephalic. I asked later if she had thought about stopping at that point, response was, well, everyone was there and ready for the caesar, the paed was in a bad mood and wouldn't be impressed, and the woman was mentally prepped for C/S, also there was always the chance that it would turn again before labour began. She told the woman that the baby now felt cephalic but the woman did not ask to abandon the operation. How sad it is that major surgery can be performed for no better reason than to avoid inconveniencing the theatre staff and paediatrician. With regard to ECV - with my breech an attempt was made at 36 weeks, no preparation or uterine relaxants, it was very uncomfortable and not successful. I had also tried moxibustion for a week or so. With baby no 3 I felt she was breech at 28 weeks and again at 32 weeks, I turned her myself while relaxing in my own bed. It was quite spontaneous on my part and I did not 'force' anything or cause any discomfort, merely massaged my abdo and 'encouraged' her to turn around, I was amazed and very pleased when she did! I know this was early in gestation but no.1 had been breech from 28 weeks so it was in my mind that this one would too. Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Helen and Graham [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, September 04, 2005 4:54 PM Subject: Re: [ozmidwifery] Re: Breech Babies I had a friend about 8 years ago who was a primip breech and desperately wanted to give birth naturally. She managed to convince her ob to try cephalo-version on the operating table (on a weekday when all the staff were there anyway) so that if there had been a placental abruption or some other complication, she would have been able to have a caesar. It worked. Seems a bit dramatic but not as bad as just giving the nod to a caesar in the first place. Has anyone else had much to do with cephalo-version? Helen Cahill - Original Message - From: Judy Chapman [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, September 03, 2005 5:34 PM Subject: RE: [ozmidwifery] Re: Breech Babies I have just been surfing this site, some good stuff. I have a multi with a breech at 36+ wke at the moment and I dearly want her to be able to birth here. Cheers Judy --- Vedrana Valèiæ [EMAIL PROTECTED] wrote: A very interesting discussion on breech births and midwives: http://www.radmid.demon.co.uk/breech.htm Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Miriam Hannay Sent: Friday, September 02, 2005 6:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Re: Breech Babies I totally understand, Susan about the whole fear of breech birth. We have a couple of OBs who will 'let' women birth a breech babe vaginally, but fully managed, IOL, 16 gauge bores in both arms, hartmann's up, McRoberts, episi, full extraction. To me this seems torture. I am a second year Bmid student and intending to go into independent practice, so am availing myself of every extra learning opportunity available. A fellow student and I (my lovely partner in crime), attended Maggie Banks' emergency skills workshop in Melbourne recently which was SO valuable, and we feel much more comfortable about the possibility now. I have a dear friend whose first 'catch' as an RM was an undiagnosed breech at home, so it does happen. We need to be prepared and develop the skills to handle this situation. What a shame and potential danger it is if these skills fall by the way. Everyone who can should hear Maggie Banks speak, she dispells fears and demystifies like no-one else. Regards, Miriam (FUSA) --- Susan Cudlipp [EMAIL PROTECTED] wrote: Yes it was Brenda who wrote that, but I have also been a midwife long enough to have seen many breech births - back in the UK, and delivered a few myself. Not all good, mostly quite 'managed' but at least they were mostly seen as being manageable vaginally! My own elective C/S (nearly 21 years old now!) was for primip breech, although I was given the choice of vaginal birth, I knew just what that would entail within the large unit that I was obliged to attend - epidural, forceps, episiotomy, and I chose not to go there, however at that time there was no question that I would not be able to have VBAC with the next - nowadays that is not so. A year or so back we had a multi with a breech who was lucky enough to see a less interventionist OB (as you so rightly guessed Melissa :-)) and she chose to have a vaginal birth. Of course it had to be induced on the 'right' day, but was very straight forward. Apart from that we really don't see them anymore, and at least one of the few docs who does do them
[ozmidwifery] FW: Article re. caesars....
Subject: RE: [MCMgtCte] FW: Article re. caesars See: http://www.forensic-psych.com/articles/artMedMal.html A Plaintiff's Verdict: Meador v. Stahler and Gheridian -The $1.5 million award to a Massachusetts woman and her family in Meador v. Stahler and Gheridian3 made news as a rare instance of a malpractice judgment based on an allegedly unwanted and unnecessary cesarean section rather than a failure to perform such an operation. The plaintiff, Mary Meador, did not claim that the procedure was negligently performed or that the rare and disabling physical complications that resulted from it (which left her largely bedridden and unable to work or meet her family responsibilities for several years) were foreseeable. Instead, she claimed that the defendant obstetricians had misrepresented the risks of the alternative procedure (vaginal birth after prior cesarean) and ignored her persistent pleas for this alternative. Moreover, she alleged, they compelled her passive assent to the surgery in an emotionally coercive manner while she was progressing normally in labor, despite their having previously agreed to such a trial of labor. -Because the consequences of the cesarean were unforeseeable, and because Meador had signed a consent form for the surgery (to be used in case of emergency), this case did not meet the technical requirements specified under Massachusetts law4 for an action based on informed consent. Instead, the case was brought on the theory that the physicians' failure to obtain the patient's informed consent constituted substandard, negligent medical care. The forensic psychiatrist's expert testimony emphasized that the pro forma signing of a consent form did not constitute true informed consent, especially in light of the physicians' alleged disregard of the patient's expressed wishes and their inaccurate representation of the risks and benefits of the approach she preferred. - The psychiatrist also explained to the jury how Meador's life history left her vulnerable to experiencing the denial of informed consent as a highly traumatic event. Having coped since childhood with serious illnesses in her family, Meador had viewed doctors and nurses as nurturing figures who helped her gain control of potentially tragic situations. She had learned that choice was still possible even amidst illness and death. She had even been inspired to become a nurse herself and to teach this discipline to others. Thus, when she experienced a sudden loss of choice and control during childbirth, she reacted with intense fear and horror and felt she had been betrayed by health professionals, whom she now feared and mistrusted. In this way she lost her accustomed strategy for coping with life. Moreover, having helped hold her original family together in the face of tragic illness, Meador saw the family she had created torn apart by her sudden and devastating loss of control in a medical situation. The jury's recognition of the importance of the emotional facts of the case was highlighted by its awarding almost one-third of the total damages for loss of consortium. -Thus, it was not simply the physically disabling consequences of the surgery, but the loss of personal decision-making power concerning her body, her health, and the birth of her child, that caused Meador to suffer from Post-Traumatic Stress Disorder. Similarly, her husband's experience of loss of consortium was exacerbated by the physicians' failure to consult him to interpret his wife's wishes during labor. Instead of having participated in a true informed-consent process, he was left to feel powerless and helpless. In this way, forensic psychiatric testimony established a persuasive causal link between the lack of informed consent and the physical and emotional damages suffered by the patient and her family. Cheers, C Subject: [MCMgtCte] FW: Article re. caesars The Midwife Strikes Back This is timely with NCAD next weekend but Imust say Andrew P has his facts wrong. A woman sued an OB for an unnecessarycs in the US and this year won!Cheers,Subject: Article re. caesarshttp://www.news.com.au/story/0,10117,16490659-421,00.htmlOne third of Australian births to be caesarsBy Adam Cresswell05-09-2005From: The AustralianTHE number of women giving birth by caesarean section is rising fast, andcould soon hit a record of 32 per cent of deliveries - far higher than incountries such as Britain and New Zealand.There are more than 250,000 births a year nationwide, and emerging hospitaldata indicates the increase in caesarean rates since the mid-1990s may beaccelerating.Sally Tracy, associate professor of midwifery practice development at theUniversity of Technology Sydney, told The Australian yesterday thecalculations were based on trends in hospitals and the experiences ofmidwives in practice."Judging from the trends in tertiary hospitals, the caesarean rates are
[ozmidwifery] hep C and homebirth
Title: Bericht Hoi friends, Last week I send the question about hep C and homebirth. Since then I got a lot of information and I could decide that homebirth was not a problem with some precautions to protect ourselves. But I have a problem with my colleagues. We have a practice of three midwives and the other two refuse to help the mother, saying that they think the risc is to much to take. She was also a drugaddict, but clean now for several years. She had recent a partner with unsafe sexual behaviour (several partners). My colleagues say that she is responsible herself for what she got and take the consequences of it. I believe that everybody needs a second chance. They say, considering our teamwork that I have to refuse her too. They are angry at me. I feel that refusing her is some discimination. How should you handle this in your practice? warm greetings Lieve Lieve Huybrechts vroedvrouw 0477/740853 www.geboorte-infocentrum.be -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/89 - Release Date: 2/09/2005
[ozmidwifery] Pregnancy outcomes for Vic?
Jut wondering if someone can direct me to the website where the latest Victorian pregnancy outcomes are? Not an easy one to find Ive discovered Tania x
Re: [ozmidwifery] hep C and homebirth
Title: Bericht Lieve My heart goes out to you as it must be a painful and disappointing position to be in with your colleagues. I presume you have presented them with the evidence of the risks of infection and the appropriate measures to take. Do you have an ethics policy that you work by as midwives? To judge someone so harshly for their previous behaviour does not seem to be a compassionate way to care. I understand that you are probably in your own private practise and so there is no obligation to provide care. Do you think it is only because of the infection risks that they are upset or are their other issues such as her behaviour, personality etc that are being judged. You are in a difficult position and I guessthat you need to give them as much information as possible and also be able to discuss calmly with them about their fears. I would find it hard to stay calm and I guess you would be feeling pretty upset with them. Maybe you could also talk about why they are so angry - are they really that sure that you areputting their health at risk or do they not approve of this type of client, or maybe it hasto do with other issues in your practise that have not been dealt with. I and I think many Australian midwives would find this situationdifficult to understand asmost of us work in the public system and so haveno say about who our clients are. We care for whoever needs it. I think also that we identify strongly with the origins of midwife which is to be "with women". I understand that the literal meaningof vroedvrouw is wise woman (the best name for a midwife I have heard yet). Can you appeal to their wisdom? Ultimately you will make a decision. It is important to give them space to really listen to them and hear what they are also trying to tell you - is there something that they are concerned about that you haven't really heard? Also a bit of time can make the world of difference - perhaps giving them time to digest information before a final decision is made. If they will not provide care is there the option that you could care for her in a one to one manner? My best wishes to you. Maxine - Original Message - From: Lieve Huybrechts To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 06, 2005 12:26 AM Subject: [ozmidwifery] hep C and homebirth Hoi friends, Last week I send the question about hep C and homebirth. Since then I got a lot of information and I could decide that homebirth was not a problem with some precautions to protect ourselves. But I have a problem with my colleagues. We have a practice of three midwives and the other two refuse to help the mother, saying that they think the risc is to much to take. She was also a drugaddict, but clean now for several years. She had recent a partner with unsafe sexual behaviour (several partners). My colleagues say that she is responsible herself for what she got and take the consequences of it. I believe that everybody needs a second chance. They say, considering our teamwork that I have to refuse her too. They are angry at me. I feel that refusing her is some discimination. How should you handle this in your practice? warm greetings Lieve Lieve Huybrechts vroedvrouw 0477/740853 www.geboorte-infocentrum.be --No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.344 / Virus Database: 267.10.18/89 - Release Date: 2/09/2005
Re: [ozmidwifery] FW: Article re. caesars....
Probably should send this one to Pesce if you already have not. Judy --- Denise Hynd [EMAIL PROTECTED] wrote: Subject: RE: [MCMgtCte] FW: Article re. caesars See: http://www.forensic-psych.com/articles/artMedMal.html A Plaintiff's Verdict: Meador v. Stahler and Gheridian - The $1.5 million award to a Massachusetts woman and her family in Meador v. Stahler and Gheridian3 made news as a rare instance of a malpractice judgment based on an allegedly unwanted and unnecessary cesarean section rather than a failure to perform such an operation. The plaintiff, Mary Meador, did not claim that the procedure was negligently performed or that the rare and disabling physical complications that resulted from it (which left her largely bedridden and unable to work or meet her family responsibilities for several years) were foreseeable. Instead, she claimed that the defendant obstetricians had misrepresented the risks of the alternative procedure (vaginal birth after prior cesarean) and ignored her persistent pleas for this alternative. Moreover, she alleged, they compelled her passive assent to the surgery in an emotionally coercive manner while she was progressing normally in labor, despite their having previously agreed to such a trial of labor. - Because the consequences of the cesarean were unforeseeable, and because Meador had signed a consent form for the surgery (to be used in case of emergency), this case did not meet the technical requirements specified under Massachusetts law4 for an action based on informed consent. Instead, the case was brought on the theory that the physicians' failure to obtain the patient's informed consent constituted substandard, negligent medical care. The forensic psychiatrist's expert testimony emphasized that the pro forma signing of a consent form did not constitute true informed consent, especially in light of the physicians' alleged disregard of the patient's expressed wishes and their inaccurate representation of the risks and benefits of the approach she preferred. - The psychiatrist also explained to the jury how Meador's life history left her vulnerable to experiencing the denial of informed consent as a highly traumatic event. Having coped since childhood with serious illnesses in her family, Meador had viewed doctors and nurses as nurturing figures who helped her gain control of potentially tragic situations. She had learned that choice was still possible even amidst illness and death. She had even been inspired to become a nurse herself and to teach this discipline to others. Thus, when she experienced a sudden loss of choice and control during childbirth, she reacted with intense fear and horror and felt she had been betrayed by health professionals, whom she now feared and mistrusted. In this way she lost her accustomed strategy for coping with life. Moreover, having helped hold her original family together in the face of tragic illness, Meador saw the family she had created torn apart by her sudden and devastating loss of control in a medical situation. The jury's recognition of the importance of the emotional facts of the case was highlighted by its awarding almost one-third of the total damages for loss of consortium. - Thus, it was not simply the physically disabling consequences of the surgery, but the loss of personal decision-making power concerning her body, her health, and the birth of her child, that caused Meador to suffer from Post-Traumatic Stress Disorder. Similarly, her husband's experience of loss of consortium was exacerbated by the physicians' failure to consult him to interpret his wife's wishes during labor. Instead of having participated in a true informed-consent process, he was left to feel powerless and helpless. In this way, forensic psychiatric testimony established a persuasive causal link between the lack of informed consent and the physical and emotional damages suffered by the patient and her family. Cheers, C Subject: [MCMgtCte] FW: Article re. caesars The Midwife Strikes Back This is timely with NCAD next weekend but I must say Andrew P has his facts wrong. A woman sued an OB for an unnecessary cs in the US and this year won! Cheers, Subject: Article re. caesars http://www.news.com.au/story/0,10117,16490659-421,00.html One third of Australian births to be caesars By Adam Cresswell 05-09-2005 From: The Australian THE number of women giving birth by caesarean section is rising fast, and could soon hit a record of 32 per cent of deliveries - far higher than in countries such as Britain and New Zealand. There are more than 250,000 births a year nationwide, and emerging hospital data indicates the increase in caesarean rates since the mid-1990s may be accelerating. Sally Tracy, associate professor of
RE: [ozmidwifery] hep C and homebirth
Title: Bericht Hoi Lieve, Jammer dat u collegas zo denken. Het is niet onbekent, naatturlijk, maar het is niet leuk. Here in most nursing professions, sorry ladies I am including midwifery as nursing here, we are taught the concept of unconditional positive regard. Basically that everyone should be accepted for who they are and what they are without judgement. I understand there is a lot of misconception out in the community about Hep C and about Drug abuse and so forth, but as professionals we should be more aware of the underlying issues which have made this woman who she is, not judge her for the life she has led. If they would be faced with her in an emergency situation, where she was birthing in lift stuck on the fourth floor of a building would they just step back and let her birth alone. I am just a student and anyone feel free to put me back in my place, but I believe that your colleagues should have a hard look at their ethics before they take on anymore mothers, once you start to discriminate where does it end? My two bobs worth. Sterkte Lieve u bent een bezondere vrouw met een groote hart. Groetjes Melanie From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Lieve Huybrechts Sent: Tuesday, 6 September 2005 00:26 To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] hep C and homebirth Hoi friends, Last week I send the question about hep C and homebirth. Since then I got a lot of information and I could decide that homebirth was not a problem with some precautions to protect ourselves. But I have a problem with my colleagues. We have a practice of three midwives and the other two refuse to help the mother, saying that they think the risc is to much to take. She was also a drugaddict, but clean now for several years. She had recent a partner with unsafe sexual behaviour (several partners). My colleagues say that she is responsible herself for what she got and take the consequences of it. I believe that everybody needs a second chance. They say, considering our teamwork that I have to refuse her too. They are angry at me. I feel that refusing her is some discimination. How should you handle this in your practice? warm greetings Lieve Lieve Huybrechts vroedvrouw 0477/740853 www.geboorte-infocentrum.be -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/89 - Release Date: 2/09/2005
Re: [ozmidwifery] Pregnancy outcomes for Vic?
Hi Tania, Try http://www.health.vic.gov.au/perinatal/pubs.htm Hope that helps, Andrea Bilcliff - Original Message - From: Tania Smallwood To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 06, 2005 9:01 AM Subject: [ozmidwifery] Pregnancy outcomes for Vic? Jut wondering if someone can direct me to the website where the latest Victorian pregnancy outcomes are? Not an easy one to find Ive discovered Tania x
Re: [ozmidwifery] hep C and homebirth
Title: Bericht Hi Lieve It is a shame that your colleagues feel so strongly against supporting this woman, but in a group practice I understand how sometimes there could be conflict over clients. However I wonder if they would be asnegative about accepting someone with Hep B?? All the same precautions need to be considered for both the infant and midwives caring for the woman. On a another note, earlier this year we had a Hep C positive woman give birth to her premature infant. We therefore were handling her breastmilk for many weeks. This woman received Hep C from her mother at birth, so was infected through no fault of her own... does the route of infection really matter? I think not. Surely as clinical practitioners we are accountable for our care. This must be providedin a non judgmental manner to the woman despite where our personal prejudices might lie, afterall no one is perfect:) Cheers Alesa Alesa KoziolClinical Midwifery EducatorMelbourne - Original Message - From: Lieve Huybrechts To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 06, 2005 12:26 AM Subject: [ozmidwifery] hep C and homebirth Hoi friends, Last week I send the question about hep C and homebirth. Since then I got a lot of information and I could decide that homebirth was not a problem with some precautions to protect ourselves. But I have a problem with my colleagues. We have a practice of three midwives and the other two refuse to help the mother, saying that they think the risc is to much to take. She was also a drugaddict, but clean now for several years. She had recent a partner with unsafe sexual behaviour (several partners). My colleagues say that she is responsible herself for what she got and take the consequences of it. I believe that everybody needs a second chance. They say, considering our teamwork that I have to refuse her too. They are angry at me. I feel that refusing her is some discimination. How should you handle this in your practice? warm greetings Lieve Lieve Huybrechts vroedvrouw 0477/740853 www.geboorte-infocentrum.be --No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.344 / Virus Database: 267.10.18/89 - Release Date: 2/09/2005
Re: [ozmidwifery] Pregnancy outcomes for Vic?
the victorian perinatal data collection website x-tad-biggerwww.health.vic.gov.au//x-tad-biggerx-tad-biggerperinatal/x-tad-biggerx-tad-bigger/pdcu.htm /x-tad-bigger On 06/09/2005, at 9:01 AM, Tania Smallwood wrote: x-tad-biggerJut wondering if someone can direct me to the website where the latest Victorian pregnancy outcomes are? Not an easy one to find I’ve discovered…/x-tad-bigger x-tad-bigger /x-tad-bigger x-tad-biggerTania/x-tad-bigger x-tad-biggerx/x-tad-bigger
Re: [ozmidwifery] Pregnancy outcomes for Vic?
Tania try http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Births_in_Victoria_1999-2000?OpenDocument or do a search for perinatal statistics victoria Cheers, Katrina Tania Smallwood [EMAIL PROTECTED] wrote: Jut wondering if someone can direct me to the website where the latest Victorian pregnancy outcomes are? Not an easy one to find I've discovered. Tania x -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
