Re: Re: [ozmidwifery] How long before synto is used?
but this will no longer be the case with compulsory continuous EFM for all Syntocinon Inductions. I can see Caesarians yet further on the increase at our hospital. Linda Hi, I find the whole idea of a procedure being compulsory as absolutely ludicrous!! You can't make a medical procedure compulsory, unless a patient is deemed not able to make his or her own decisions. From my understanding, mostly this happens with involuntary hospitalization of people with psychiatric disorders. Surely, by agreeing to use these procedures and abide by 'policy' that treats women this way, is basically agreeing that women are incapable of being in control of their own labouring and treating birthing women as involuntary psych patients. Even if, say, that birthing women were 'patients' in need of medical attention, they should definitely not be treated on par with people deemed mentally ill. I think it is atrocious. Hospitals seem to set women up for failure during labour and birth and abiding by the rules and regulations imposed on women in these institutions, midwives are also helping set them up for failure. All options should be offered to all women regardless of how informed or misinformed they are. It is for the woman to decide not the 'care providers' who assume control. Someone who claims to be 'with woman', should be making every effort to support women in making educated decisions, not leading them into hospital policy. If a woman feels safer in hospital to birth, then they should be treated the same as a woman choosing to birth at home. No woman should be treated differently because of her choice of birth place, in fact, that is discrimination. We, in western society, come from broken birth lines. We are afraid, uneducated and willingly pass over control of our births. It is not the birthing womans fault, for the power has been taken away. If midwives could spend more time empowering women during their pregnancy, maybe women would not be pouring water down their legs, what drove this woman to such an act? Fear??!! As care providers we need to support birthing women in taking back their power. This means supporting and providing true education, bucking against a system that sets women up for failure, standing up for what is right when seeing birthing women being treated wrongly, offering alternatives and suggestions, not treating women as involuntary patients but as strong, capable, powerful women. I feel so strongly about this because again and again I see the impact of modern 'birthing'( if you can call it that) practices. Women are damaged and traumatised and angry. Women should not have to fight for their rights as a woman or as a 'patient' ( if you want to see them like that). It is the only time that in hospitals, that I know of, that the 'patient' is not respected. If 'care providers' treated any other 'patient' with the amount of disrespect and disregard as birthing mums are treated with, they would be in big trouble with all kinds of authorities. But, birthing women are trested badly and with a total lack of regard so often. I believe this is shown just even in the whole policy situation. I could rave on for ages, but basically I think it SUCKS that women are treated this way, with rules and regulations aka policy and procedures. Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Food for thought......
The use of involuntary hospitalization or any other form of forced treatment is perhaps the most controversial issue in the wider mental health community, pitting family members, citizen advocacy groups, professionals and consumers against one another on the subject. In addition, legal advocates and the courts take very seriously the denial of a person's liberty. Involuntary hospitalization is one of the most extreme examples of denial of liberty in a democratic society To me, making women fight for their rights is a way of forcing treatment, administering a 'compulsory' procedure against a womans wishes is forced treatment, refusing to stop a procedure is forced treatment, forcing women to stay in hospital or making them sign an AMA form are both forms of involuntary hospitalization. Birthing women are being treated in a similiar fashion to people described as ~ .a person is imminently dangerous to self or others; is gravely disabled; or clearly needs immediate care and treatment surely this is not how we see women???!!! Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
Therein lies the problem with management of birth...all women, babies and births are not the same, so if everyone caring for the woman and baby does the same thing, how can this possibly be considered appropriate evidence based care? That is such and excellent and valid point. Also, please someone correct me if I am wrong, but hasn't continuos EFM been proven to not affect outcomes in a positive way. If we are talking about policies written with evidence based care in mind, surely the policy should reflect evidence based care. ( whatever evidence based is!) Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] How long before synto is used?
- Original Message - From: Lisa Barrett To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 4:21 PM Subject: Re: [ozmidwifery] How long before synto is used? Oh Jo, I forgot to say that the lovely Ob also said if you are not going to cooperate then you may as well stay at home!! Just what we wanted to hear Lisa
Re: [ozmidwifery] How long before synto is used?
- Original Message - From: Lisa Barrett To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 4:16 PM Subject: Re: [ozmidwifery] How long before synto is used? Hi Jo, Policies are apparently to make the midwife feel better and to get everyone to support you and be on your side. I heard this comment made just yesterday by an Ob ( one that we both know and like) to one of my clients who is having an ebac. He wasn't as it happens talking about ruptured membranes but continuous monitoring, but the underlying thought was the same. The best way to get a birth is to shut up and put up and everything will be just dandy. Policies are to make the professional feel in control no thought at all is given to the fact that the body and the baby belong to a woman and absolutely no credence is given to evidence based practice when it doesn't suite. As Brenda said the evidence says 96 hours is a reasonable time to watch and wait with ruptured membranesthe figures behind that (available on the nice web site) are 94% of women are in labour by that time. and thereafter it is still open to discussion in keeping with the woman's wishes. All the crap about gbs antibiotics etc etc is mainly rhetoric to add the scare factor into the scenario so women are unable to make any other choice than the one the system offers. Don't let the eye roll put you off. It's only people like us that stop the system doing exactly what they want. Disempowering the women they claim to be helping. Lisa
Re: Re: [ozmidwifery] How long before synto is used?
Abby, I agree with you, the proceedure should not be compulsory and I will take this up with colleagues, women should be given the right to choose if they want this, and I suppose the best way to go is what Emily has suggested and explain to the mother and write it in their notes if they choose to not have EFM.. I find this whole policy/proceedure thing often very difficult to work with, but hospitals do have to work within the safety of policies and guidelines to protect not only the mother and baby, but the hospital and staff themselves. In a court of law they will have to show that they followed proceedure. and have risk management in place. I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? Our policy is still at the updating stage and has room for change (hopefully) Thank you also Emily for you advise. Linda -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] using a baby sling after C-section
Hi, I was asked by a woman if she can wear a babysling two weeks after her c-section. She was told not to carry anything hevier, than the child for six weeks and has asked me since we sold the hug-a-bub baby sling for her earlier. Before I answer her, I thought I'd ask you midwives first. To me it would make sense to carry the baby in a sling, but since I don't know too much about surgery, don't want to give wrong advise. Päivi Childbirth educator Finland
Re: [ozmidwifery] using a baby sling after C-section
I would say that would be the best way to carry the baby, as the load will be closest to her body, therefore the lightest.HTHJoOn 17/06/2006, at 4:27 AM, Päivi Laukkanen wrote:Hi, I was asked by a woman if she can wear a babysling two weeks after her c-section. She was told not to carry anything hevier, than the child for six weeks and has asked me since we sold the hug-a-bub baby sling for her earlier. Before I answer her, I thought I'd ask you midwives first. To me it would make sense to carry the baby in a sling, but since I don't know too much about surgery, don't want to give wrong advise. PäiviChildbirth educatorFinland
RE: Re: [ozmidwifery] How long before synto is used?
A friend of mine gave birth in a popular private Sydney hospital a few weeks ago, was induced (her choice, against OBs preference, amazingly he doesn't like to induce before 41w) - 2 doses of gel, ARM, synto. The only EFM was one trace at the start of the process. The midiwife caring for her asked her a number of times for a further trace, which she refused, usually by saying she wanted a shower now or to go to the toilet and that was that. She had discussed this plan with her OB in advance and knew she had his support, so she was fully prepared to send the midwife off to sort it out with him if the midwife had tried to bully her about it but it did not come to that. So there are hospitals around where it is possible. At 7:03 AM +1000 17/6/06, Kelly @ BellyBelly wrote: I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? From my perspective only, it seems to be all of them at the induced / augmented births I have been attending. I attend usually one but sometimes two births a month and it seems it's all part and parcel to be strapped down with Synto AND EFM in the bigger hospitals. Haven't been to a birth that's otherwise anyway. We work very hard to fob off any synt-happy midwives and doctors, especially where the membranes are ruptured even if it's only been an hour or two (yes I'm afraid there's pressure from midwives too, one was in a 'Know Your Midwife' program and thank goodness we were able to say no enough times as she did establish contractions on her own after the ARM). It's such a big effort sometimes that you can see how a woman without good support is going to be more likely to accept this as what's needed or feel overpowered, but you do it because you know you not only get synt you get continuous monitoring too. Say no and you get an entourage of doctors sometimes! Another challenge too is not only letting them have that choice, but choice without having an inappropriate comment made after she makes a choice alluding to the health of the baby, e.g. '... but if you keep labouring without the monitoring, I can't tell you / guarantee that everything will be okay for your baby down the track...' or mentioning the 's' word... (stillbirth). I don't know how many times one poor woman struggling to get the confidence to say no was spoken down too, not in a nasty way, but with lots of little dug in comments, she had to fight to say no to antibiotics, no to synto sooner after only an hour or two, EF monitoring, a drip for her baby in case he had strep b, which he didn't, the list goes on. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Bowman Family Sent: Thursday, 21 September 2006 4:35 AM To: ozmidwifery@acegraphics.com.au Subject: Re: Re: [ozmidwifery] How long before synto is used? Abby, I agree with you, the proceedure should not be compulsory and I will take this up with colleagues, women should be given the right to choose if they want this, and I suppose the best way to go is what Emily has suggested and explain to the mother and write it in their notes if they choose to not have EFM.. I find this whole policy/proceedure thing often very difficult to work with, but hospitals do have to work within the safety of policies and guidelines to protect not only the mother and baby, but the hospital and staff themselves. In a court of law they will have to show that they followed proceedure. and have risk management in place. I would love to hear what other hospitals are doing with Syntocinon Inductions. Is it policy to use continuous CTG's throughout labour? Our policy is still at the updating stage and has room for change (hopefully) Thank you also Emily for you advise. Linda -- 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. -- Jo Bourne Virtual Artists Pty Ltd -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] How long before synto is used?
Yes EFMs are shown to cause c-secs and not protect even vulnerable babies against brain damage - the purported reason for using them in the first place! The solution is not to train staff more in using them because that is based on an entirely false premise but that's what RANZCOG promotes - see their website. The solution is to dump the technology because it not only fails to improve outcomes but has a deleterious effect on them. More machines does not equal more safety for women or babies, it means more lifethreatening and unnecessary surgery. J - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, June 16, 2006 7:37 PM Subject: Re: Re: [ozmidwifery] How long before synto is used? Therein lies the problem with management of birth...all women, babies and births are not the same, so if everyone caring for the woman and baby does the same thing, how can this possibly be considered appropriate evidence based care? That is such and excellent and valid point. Also, please someone correct me if I am wrong, but hasn't continuos EFM been proven to not affect outcomes in a positive way. If we are talking about policies written with evidence based care in mind, surely the policy should reflect evidence based care. ( whatever evidence based is!) Love Abby -- 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: Re: [ozmidwifery] ctg stuff
hi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only collective inertia and fear that has led to everyone still using it. the fact that it has sneakily become the best practice standard. in the big cochrane review on the subject the only benefit seen was a reduction in neonatal seizures seen in the CTG group. this was used as evidence that it may reduce the incidence of cerebral palsy in this group also. actually, there was follow up studies done on all the studies included in the review some years later and it actually showed no difference in cerebral palsy rates in most studies. one study amazingly actually showed a higher rate of cerebral palsy in the CTG group !! this has been conveniently forgotten. CTGs are still sold to women as being a safety net to prevent cerebral palsy despite the fact that there is absolutely no evidence whatesoever of this being the case all that remains to be the benefit of CTGs is for care providers. it makes many people feel safe to have a neat little print off documenting what has been happening. the other thing is that apparently in the court system, parents can only be 'compensated' if a no fault verdict is made and that requires a CTG. anyway i wrote a huge article about this titled 'the irony of obstetric risk analysis' and handed it in with my end of term work. i am waiting with bated breath to hear the feedback and whether i will fail for being so blatently anti-obstetrics to my obstetric supervisors!!! but i figured theres less harm saying it all now, on my way out :) the reason im writing this is that the (good) obstetrician wants me to put together my views on social inductions and social elective caesars and how we should respond to women who sometimes demand these things and whether it is ethical to refuse. im really struggling with it because if we all always say inform and then follow the mothers wishes, what right do we have to refuse this? it is often for what i see as ridiculous reasons (ie the woman recently who demanded an induction so she wouldnt birth on 6/6/06 and threatened to kill herself if we didnt) but who am i to judge women's choices like others judge non-interventionalist choices? id love to know everyones thoughts on this onelove emily Do you Yahoo!? Everyone is raving about the all-new Yahoo! Mail Beta.
RE: Re: [ozmidwifery] ctg stuff
It would be good if we could change the ordinary persons thinking from intervention is necessary to save lives and prevent bad outcomes- and that the trade- offs are minimal to the truth about how dangerous and ineffective they can be and how choosing one often means setting yourself up for the whole gamut of intervention. I think women who choose such interventions for non medical reasons in part do so because when they are done for medical reasons we are told that they are safe and in fact necessary to ensure a good outcome. There is an attitude that because it is so frighteningly common it must be safethe path most traveledmust be safe! We all know that it is not actually the case, women and their babies fare so much better, emotionally and physically when empowered to birth under their own steam. It is not about judging women but changing the climate so to speakchanging the common assumption that hospital birthing with its vast array of aids and interventions is the be all and end all of safe birthing, this is obviously a harder task. In the mean timewomen will still want to birth in a multitude of ways... It just seems strange that it is easier to persuade the docs to intervene than to not interfere. Amy From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Emily Sent: Saturday, June 17, 2006 8:49 AM To: ozmidwifery@acegraphics.com.au Subject: Re: Re: [ozmidwifery] ctg stuff hi all i have just finished the 'obstetrics' term of my course and over the 9 weeks i repetitively brought up my disgust with the use of CTGs against all the very high quality evidence that is out there against them, that noone refutes they just ignore. the wonderful obstetrician who was my supervisor (only one ive ever met that i like) agreed and said it is only collective inertia and fear that has led to everyone still using it. the fact that it has sneakily become the best practice standard. in the big cochrane review on the subject the only benefit seen was a reduction in neonatal seizures seen in the CTG group. this was used as evidence that it may reduce the incidence of cerebral palsy in this group also. actually, there was follow up studies done on all the studies included in the review some years later and it actually showed no difference in cerebral palsy rates in most studies. one study amazingly actually showed a higher rate of cerebral palsy in the CTG group !! this has been conveniently forgotten. CTGs are still sold to women as being a safety net to prevent cerebral palsy despite the fact that there is absolutely no evidence whatesoever of this being the case all that remains to be the benefit of CTGs is for care providers. it makes many people feel safe to have a neat little print off documenting what has been happening. the other thing is that apparently in the court system, parents can only be 'compensated' if a no fault verdict is made and that requires a CTG. anyway i wrote a huge article about this titled 'the irony of obstetric risk analysis' and handed it in with my end of term work. i am waiting with bated breath to hear the feedback and whether i will fail for being so blatently anti-obstetrics to my obstetric supervisors!!! but i figured theres less harm saying it all now, on my way out :) the reason im writing this is that the (good) obstetrician wants me to put together my views on social inductions and social elective caesars and how we should respond to women who sometimes demand these things and whether it is ethical to refuse. im really struggling with it because if we all always say inform and then follow the mothers wishes, what right do we have to refuse this? it is often for what i see as ridiculous reasons (ie the woman recently who demanded an induction so she wouldnt birth on 6/6/06 and threatened to kill herself if we didnt) but who am i to judge women's choices like others judge non-interventionalist choices? id love to know everyones thoughts on this one love emily Do you Yahoo!? Everyone is raving about the all-new Yahoo! Mail Beta.
Re: Re: [ozmidwifery] How long before synto is used?
So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] ctg stuff
I'd love a copy of that for the JB website, Emily, if you'd like to share and I'd love all your refs What you're describing in terms of "maternal choice" really needs a feminist critique to allow us to manage those "choices" in ways which are not harmful to women. Since induction and elec. c-secs are innately harmful, causing physical and emotional trauma to previously healthy women, we need to stop ranking all these "choices" as somehow equal. Surgery for no reason is no more healthy than formula feeding for no reason yet most of us struggle to work out what to do with cases where women request interventions with no medical need. I cannot support choices which are at heart harmful to women and babies in exactly the same way as I cannot support women to lie down in the middle of the highway despite it being their "choice" so to do. If surgeons weren't setting the agenda, we wouldn't perceive these interventions as normal and healthy. (Thecrap that so many Obs talk to make VB sound like a risky, dangerous, illinformed choice!)Lots of work to do there! You'd really benefit in this from the recent MASSIVE discussions on JB around choice and what many of us feel is more important still - maternal control. J
Re: Re: [ozmidwifery] How long before synto is used?
It's true, there is a lot of pot luck involved for consumers, it is certainly what scares me about hospitals. But in this case I am pretty sure that the only policy was for an initial trace because the midwife was fairly clearly out of her comfort zone and didn't pull out the it's policy argument. At 12:19 PM +1000 17/6/06, Janet Fraser wrote: So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Jo Bourne Virtual Artists Pty Ltd -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] How long before synto is used?
That birthing experiences vary so drastically as a result of individual staff is reason to advocate for returning the power and control of birth to birthing women. This, not policy, will help ensure that all women and babies have the best chance for a truly great birth. But it's institutions as well as individual staff that influence women's birthing experiences since each hospital has its own culture that filters through to the individuals working within it. At 12:19 PM +1000 17/6/06, Janet Fraser wrote: So there are hospitals around where it is possible. I think in most cases it's that there are individual staff, nothing to do with the institutions. Some women have great births in some hospitals and for others the same place is a bloodbath. It's the staff you fluke on the day that have the biggest impact on your experience. 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: Re: [ozmidwifery] How long before synto is used?
You know, a lot of the time I feel trapped between a rock and hard place!! I know that what has been said is not a personal attack, but working in the system (and how bad am I for succumbing to that?) makes me, by default, part of the problem. This I find very hard. I worked for 14 years as an independent midwife, it was hard yakka but extremely rewarding in all regards...I loved it. However, I was bearly able to keep food on the table, and paying bills was a nightmare.My belief was to keep my bookings manageable so that I could be there for all the women I worked with. In that time I never missed a birth. I believed I was working truly 'with woman'. In 2000 I went from homebirthing into a Level 3 referral hospital, because it was my misguided belief that I may learn something. (I had never worked with women with high risk pregnancies) and I really needed some financial stability in my life. The culture shock was immense and I spent the first few months wondering what the heck I had done. The midwives I worked with worked under the most horrendous conditions and time and time again I saw them raw with grief because they felt they were unable to give the care these women needed and were entitled to. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. Considering the hard work and effort we go to to work with and enable women to achieve the experience that is their right, I find some of what has been said quite insulting. Sure, there are midwives out there that are more medical model than midwives in the true sense, but this can be said for all people from all walks of life, and yes some policies etc are frustrating to work within, but unfortunately we can't work without them. Working in 'the system' is hard enough, it is a constant battle and an exhausting one at that. I am saddened by what I am reading and it just fuels my belief that midwifery is not where I want to be anymore. Sally -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: Re: [ozmidwifery] ctg stuff
www.joyousbirth.info Susan Cudlipp [EMAIL PROTECTED] wrote: What is the JB website please? Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Saturday, June 17, 2006 10:26 AMSubject: Re: Re: [ozmidwifery] ctg stuffI'd love a copy of that for the JB website, Emily, if you'd like to share and I'd love all your refsWhat you're describing in terms of "maternal choice" really needs a feminist critique to allow us to manage those "choices" in ways which are not harmful to women. Since induction and elec. c-secs are innately harmful, causing physical and emotional trauma to previously healthy women, we need to stop ranking all these "choices" as somehow equal. Surgery for no reason is no more healthy than formula feeding for no reason yet most of us struggle to work out what to do with cases where women request interventions with no medical need. I cannot support choices which are at heart harmful to women and babies in exactly the same way as I cannot support women to lie down in the middle of the highway despite it being their "choice" so to do. If surgeons weren't setting the agenda, we wouldn't perceive these interventions as normal and healthy. (Thecrap that so many Obs talk to make VB sound like a risky, dangerous, illinformed choice!)Lots of work to do there! You'd really benefit in this from the recent MASSIVE discussions on JB around choice and what many of us feel is more important still - maternal control.J No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006 Yahoo! Sports Fantasy Football 06 - Go with the leader. Start your league today!
Re: Re: [ozmidwifery] How long before synto is used?
Hi Sally, I'm sorry if you feel offended or upset by any discussion on this forum, I'm sure no-one intentionally does that because part of the joy of it is we are all able to talk without prejudice. Thank god there are midwives like you working your butts off to help women get the best birth in a totally awful system. And that is the truth the system isn't woman centred or well informed and in the main practice isn't evidence based. That doesn't mean everyone working in it is the same. If however everyone was as great as you there wouldn't be this sort of discussion happening. Last year I started work at a brand new hospital in Berwick. A 'low risk' midwifery led unit...we endeavor to work with women in the true sense, we buck the system as much as we are able, which is often, and we bend the rules constantly, however,it is hard given that the medical profession, especially anaesthetists, have us over a barrel...this is where the rock and the hard place come in. We buck the system and we are hauled over the coals by the 'programme' and the medical establishment, we tow the line and we are shot down in flames by people who regard anything to do with hospitals as anti birthing women. If any unit was perfect no-one would feel like they were bucking the system or bending the rules. Policies and procedures are guildlines they are not Australian law each woman should have equal choice. In or out of hospital. I for one know (As I have been there myself) how frustrating it is to keep knocking against a brick wall but if we don't all stand up and be counted and shout loudly about the ridiculous nature of our hospital obstetric system how will we change it. If every midwife working at the hospital said look we are not doing continuous monitoring (for example) because it's not evidence based then what would happen. They would have to change. Why don't we do this. Mainly because half of the midwives feel safer with it on regardless. It might sound like I'm talking people down and I'm sorry about that but it is true. Don't give up on midwifery because birthing women need midwives who feel passionately and practice well. Lisa Independent midwife -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
