RE: [ozmidwifery] Request for information on current models of midwifery led care
A bit of clarification on the NZ perspective from Kiwi midwife Kim Stead: My two cents worth...(with permission to share). NZ midwives can and are sued. That is why they have indemnity insurance, which is included in the NZCOM mebership. You pay $600 membership per year which includes the PI. The laws are different in NZ than here but basically, for someone to get compensation from the government, someone was be held responsible for the injury/neglect/malpractice etc. Often the midwife is the first point of blame. Cases can be brought against a midwife years after the alleged incident. The NZCOM (NZ college of midwives) employ two lawyers to represent midwives in such cases. Obviously there is a need for these lawyers. --- B G [EMAIL PROTECTED] wrote: Helen, From my limited knowledge as an ex-kiwi there is no opportunity to sue. I hope others will correct me if I have got it wrong. If an adverse event occurs the injured person have the right to be supported or as long as it takes for recovery or for comfort by the ACC. This was set up in the early '70's people pay for this from their taxes. Effectively this is a universal insurance scheme, no lawyers (boy did they scream loud then) and no fault access. Things were further refined about 5 years ago. I made a claim about 1978 when I was belted by a cow I was milking smashed glasses and crook back. I was paid ACC instead of a wage, had my glasses replaced and all was right. I can reactivate my claim if anything further happens although I think this aspect was changed recently. Cheers Barb Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] the UK unit that owered it's cs rate
DeB Do you have a referenced article about the govt backing for national/collaborative action in the UK to lower their C/S rates?? Denise Hynd "Never believe that a few caring people can't change the world. For, indeed, they are the only ones who ever have." Margaret Mead - Original Message - From: Debbie Slater To: [EMAIL PROTECTED] Sent: Tuesday, August 03, 2004 11:01 PM Subject: Re: [ozmidwifery] the UK unit that owered it's cs rate Jo It was the North Hants Hospital in Basingstoke. Below is the message that was sent to the NCT list that I amon which. The person who told us about it is a member of the Maternity services comittee there. St George's in Tooting, London have also reduced their rate from 24 to 18 percent. Debbie The North Hampshire Hospital, Basingstoke, has halved its caesarean sectionrate!The Head of the Labour Ward (Carol) is behind it, supported by the LeadObstetrician (Claire). Carol was at the last Rising Caesarean RateConference in January and expressed her frustration that it was all very wellbut what *exactly* had to happen to get the rate down. The Maternity Forum met last week, and since we have just lost ouradministrative support goodness knows when we'll get any minutes so whatfollows is from my memory: The graph showed that the csr peaked in Dec/Jan at around 28-30%. Therewas lots of talk about how they could get the rate down. From May there hasbeen a steady decline in the rate reaching 15% in October, and 13% over thefirst couple of weeks in November. They are hoping to be able to maintainthis. They are really excited by their success, but it was clear they wantedto maintain it for a few more months before they feel confident to startshouting about it. The year end csr won't show the dramatic improvementalthough they are expecting it to end up at around 20% overall as opposed to25% last year. So, how have they done it. Well it is multifactorial. 1. Feb/March saw the annual change of registrars. Two female registrarsjoined who are very pro vaginal birth. 2. VBAC - women with a history of caesarean section are encouraged tolabour. 3. Breech - Despite results of the Term Breech Trial, they are stillsupporting those women who wish to give birth vaginally to breech presentingbabies to do so. In 1991 3% of breech babies were born vaginally, currently15% of breech babies are born vaginally. 4. CTG training package - Last year they had a doctor who was veryinterested in this and who put together a very good training package for themidwives resulting in better interpretation of EFM traces. 5. Carol was given a small amount of money to spend on improving things forwomen. She decided the beds in the labour rooms looked very clinical andspent the money on nice duvet covers and pillow cases (no, wait, keepreading). She then moved the beds so they are along the wall, with a chairin front of bed. Male partners are encouraged to sit on bed with thelabouring woman using the chair. Women then generally stand up and move forcontractions, the more upright position being better for labour. She has hadto fight to keep those beds along the walls. Auxillary staff keep movingthem back to the middle and it sounded like she has had a bit of a set towith them. Her and Claire have had to be very persistent in moving the bedsback! But she has won. 6. Induction - There has been a change of induction procedure. Epiduralsare no longer fitted before induction but are available afterwards if andwhen needed. Women are finding that they can cope with induced labour andmidwives are gaining confidence that women can cope. More inductions arebeing carried out since it is now policy to induce at 10 days (due to NICEguidelines) rather than 12 days as previously, but more are resulting inspontaneous vaginal deliveries. 7. Midwife ventouse practitioners - Basingstoke now have four midwivestrained to do ventouse deliveries. In 55% of cases where a midwife is calledto carry out a ventouse delivery, a spontaneous vaginal birth is achieved.But more important are the opportunities this gives for experienced midwivesto pass on their skills to less experienced midwives. What these measures have succeeded in doing is changing the attitude ofthe unit as a whole. It is early days yet, but they have high hopes of beingable to sustain the change. They have recently taken on a new obs and Carolsays she made it very clear to him at their first meeting that this is howthings are going to be run and that he will have to fit in. There was another graph too. Just in case anyone thinks they are doingless cs and more forceps/ventouse that is not the case. The forceps/ventousedeliveries have remained unchanged. The number of caesareans has gone downand the number of svd's has gone up. I
Re: [ozmidwifery] Midwives in NT and elsewhere need YourHelp
Dear tania I trust she has personally complained to her local members (both state and federal and the candidates standing her federal seat!! Denise Hynd "Never believe that a few caring people can't change the world. For, indeed, they are the only ones who ever have." Margaret Mead - Original Message - From: Tania Smallwood To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 6:56 AM Subject: Re: [ozmidwifery] Midwives in NT and elsewhere need YourHelp Denise, I am currently providing care to a lovely young woman from Darwin, who has temporarily relocated to Adelaide to birth 'at home' for this very reason. She has been active in trying to get something happening in Darwin, and I'm thinking, would love to be involved in this campaign. Let me know if there is anything else we can do aside from sending the letters on, in which I will, of course, outline her story and the ridiulous lengths she has had to go to in order to obtain the care she requires, desires and deserves. Tania - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 12:23 AM Subject: [ozmidwifery] Midwives in NT and elsewhere need YourHelp The Maternity Coalition (MC) and the AustralianCollege of Midwives Incorporated (ACMI) are calling onMothers, Midwives and families of Australia to supporta national action. In May the NT Government passed the Health Professionals Actthat requires all health professionals to haveProfessional Indemnity Insurance (PI). For the last 3 years theNT government has known that PI has been unavailableto midwives on the global insurance market.The Northern Territory Government has removed allrights of women to access midwifery care in their community/homeattended by anexperienced and registered midwife. In May this year the NT Nursing Board applied thislegislation, and to date have refused 2 midwivesregistration in the Northern Territory and taken 1 midwife off the register because they are unable to obtain PI. The MC and the ACMI have decided enough is enough! We must ensure all Australian women have choice and access to fair and reasonable cost effective midwifery care and that midwives can rightfully practice their skills in any setting according to the World Health Organisation definition of a Midwife, supported by International Colleges of Midwives. The National leaders of MC and ACMI are meeting with the Federal Health Minister Tony Abbott and Shadow Health Minister Julia Gillard on Wednesday 4th and Thursday 5th August, 2004 in Canberra. They will inform the Government of the dangerous position in which they have placed women and midwives by restricting practice under this new legislation.Women are already birthing at home alone because they cannot obtain the services of an experienced midwife. A groundswell of people around the nation is embarking on a major campaign to bring this unfair and discriminatory issue to the attention of federal leaders. A campaign to demonstrate the effects of legislation applied only to those midwives unable to purchase PI. Please help ensure that our federal representativesreceive our message that women and midwives are unitedin wanting the Howard Government to take immediatesteps in obtaining PI insurance for midwives, so thatAustralian women have access to fair and reasonablecost effective midwifery care. THE PLAN Template Letters can be downloaded from the ACMI and MC websites www.maternitycoalition.org.au - campaign kitwww.acmi.org.au/text/whois/representingyou.htm If posting six (6) letters should be individually signed with your return address details. If faxing send the same letter to the following fax numbers. Send the first letter to: The Hon. Tony Abbott MPPhone (02) 6277 7220 Fax (02) 6273 4146 Parliament House, Canberra ACT 2600 The Second letter to: Your Federal Representative check the website addresses below for mail details Then another four letters to: one to each of the following MPs The Hon John Howard MP Prime Minister Phone (02) 6277 7700 Fax (02) 6273 4100 House of RepresentativesParliament House, Canberra ACT 2600 Mr Mark Latham MP Leader of the Opposition Phone (02) 6277 4022 Fax (02) 6277 8495 House of Representatives Parliament House, Canberra ACT 2600 Bob Brown Senator for Tasmania (Greens) Phone (02) 6277 3170 Fax (02) 6277 3185 Electorate Office9th Floor, Marine Board Building1 Franklin
[ozmidwifery] midwifery heritage
For your interest. Recently received from the chronicler of family history. The plaque spoken of is very plain doesn't mention midwifery. "Hello Cousin Mary.. thank you for mutual interest in our forebare Mary Carroll/King the question as to your mothers and my great grand mother being a woman who assisted many women during child birth... the answer would lie in the story passed on the generations that came after her as told by some of her own children namely my grandfather Daniel his sister Julia and so on ..also a mr Horace Oakley who seemed to have pride in announcing to any interested King family member that it was mammy King who put the first flannel on his back.. HoraceI believe as a child was practally brought up by the King family as his mother had died and rumour has it she walked into the sea near Portland and drowned .. [I have never checked his mother's story so I don't know if this is fact or fiction... ]Horace being considerably younger than other members of Mary's family would [if available ]accompany her carrying a light of some description during night times as she walked and sometimes a fair distance in all kinds of weather.. Was Mary a registered nurse ???...I would think not because when she arrived in this country she was barely 18 years old could read only and at 19 she was married and pregant.. during her child bearing life she gave birth to 12 children.. with these considered it highly unlikely but on the other hand she must have been indeed very experienced and by all accounts very popular..It would seem some women had talent for that sort of thing [perhaps God gifted] My guess if birth certificates of those children born in and around Portland between years 1860-1900 could be looked at more than likely we would find Mary's name as present at it's birth ...I have one such certificate in my possession which states just that ...See the attachments re a llittle on Mary and a plaque that we had made and placed on the commemoration wall which depicts the immigrants that first stepped foot on soil at Portland after leaving their native land.."
Re: [ozmidwifery] Midwives in NT and elsewhere need YourHelp
Tania, I am a student midwife in Darwin and would love to introduce the young woman you are talking about to some of the "political" goins on with midwifery care up here. My email address is [EMAIL PROTECTED] Kirsten Start life with a midwife - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 6:53 PM Subject: Re: [ozmidwifery] Midwives in NT and elsewhere need YourHelp Dear tania I trust she has personally complained to her local members (both state and federal and the candidates standing her federal seat!! Denise Hynd "Never believe that a few caring people can't change the world. For, indeed, they are the only ones who ever have." Margaret Mead - Original Message - From: Tania Smallwood To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 6:56 AM Subject: Re: [ozmidwifery] Midwives in NT and elsewhere need YourHelp Denise, I am currently providing care to a lovely young woman from Darwin, who has temporarily relocated to Adelaide to birth 'at home' for this very reason. She has been active in trying to get something happening in Darwin, and I'm thinking, would love to be involved in this campaign. Let me know if there is anything else we can do aside from sending the letters on, in which I will, of course, outline her story and the ridiulous lengths she has had to go to in order to obtain the care she requires, desires and deserves. Tania - Original Message - From: Denise Hynd To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 12:23 AM Subject: [ozmidwifery] Midwives in NT and elsewhere need YourHelp The Maternity Coalition (MC) and the AustralianCollege of Midwives Incorporated (ACMI) are calling onMothers, Midwives and families of Australia to supporta national action. In May the NT Government passed the Health Professionals Actthat requires all health professionals to haveProfessional Indemnity Insurance (PI). For the last 3 years theNT government has known that PI has been unavailableto midwives on the global insurance market.The Northern Territory Government has removed allrights of women to access midwifery care in their community/homeattended by anexperienced and registered midwife. In May this year the NT Nursing Board applied thislegislation, and to date have refused 2 midwivesregistration in the Northern Territory and taken 1 midwife off the register because they are unable to obtain PI. The MC and the ACMI have decided enough is enough! We must ensure all Australian women have choice and access to fair and reasonable cost effective midwifery care and that midwives can rightfully practice their skills in any setting according to the World Health Organisation definition of a Midwife, supported by International Colleges of Midwives. The National leaders of MC and ACMI are meeting with the Federal Health Minister Tony Abbott and Shadow Health Minister Julia Gillard on Wednesday 4th and Thursday 5th August, 2004 in Canberra. They will inform the Government of the dangerous position in which they have placed women and midwives by restricting practice under this new legislation.Women are already birthing at home alone because they cannot obtain the services of an experienced midwife. A groundswell of people around the nation is embarking on a major campaign to bring this unfair and discriminatory issue to the attention of federal leaders. A campaign to demonstrate the effects of legislation applied only to those midwives unable to purchase PI. Please help ensure that our federal representativesreceive our message that women and midwives are unitedin wanting the Howard Government to take immediatesteps in obtaining PI insurance for midwives, so thatAustralian women have access to fair and reasonablecost effective midwifery care. THE PLAN Template Letters can be downloaded from the ACMI and MC websites www.maternitycoalition.org.au - campaign kitwww.acmi.org.au/text/whois/representingyou.htm If posting six (6) letters should be individually signed with your return address details. If faxing send the same letter to the following fax numbers. Send the first letter to: The Hon. Tony Abbott MPPhone (02) 6277 7220 Fax (02) 6273 4146 Parliament House, Canberra ACT 2600 The Second letter to: Your Federal Representative check the website addresses below for mail details Then another four letters to: one to each of the following
[ozmidwifery] MC ACMI National Action
Dear All, Apologies for cross posting... The Maternity Coalition (MC) and the Australian College of Midwives Incorporated (ACMI) are calling on Mothers, Midwives and families of Australia to support a national action. In May the NT Government passed the Health Professionals Act that requires all health professionals to have Professional Indemnity Insurance (PI). For the last 3 years the NT government has known that PI has been unavailable to midwives on the global insurance market. The Northern Territory Government has removed all rights of women to access midwifery care in their community/home attended by an experienced and registered midwife. In May this year the NT Nursing Board applied this legislation, and to date have refused 2 midwives registration in the Northern Territory and taken 1 midwife off the register because they are unable to obtain PI. The MC and the ACMI have decided enough is enough! We must ensure all Australian women have choice and access to fair and reasonable cost effective midwifery care and that midwives can rightfully practice their skills in any setting according to the definition of a Midwife, established by the International Confederation of Midwives, and endorsed by World Health Organisation and the International Federation of Gynaecologists and Obstetricians. The National leaders of MC and ACMI are meeting with the Federal Health Minister Tony Abbott and Shadow Health Minister Julia Gillard on Wednesday 4th and Thursday 5th August, 2004 in Canberra. They will inform the Government of the dangerous position in which they have placed women and midwives by restricting practice under this new legislation. Women are already birthing at home without a professional attendant because they cannot obtain the services of an experienced midwife. A groundswell of people around the nation is embarking on a major campaign to bring this unfair and discriminatory issue to the attention of federal leaders. A campaign to demonstrate the effects of legislation applied only to those midwives unable to purchase PI. Please help ensure that our federal representatives receive our message that women and midwives are united in wanting the Howard Government to take immediate steps in obtaining PI insurance for midwives, so that Australian women have access to fair and reasonable cost effective midwifery care. Visit: http://www.maternitycoalition.org.au/NT_action.htmlfor more information on the plan of action and a sample letter to send to the politicians.
Fw: [ozmidwifery] Request for information on current models of midwifery led care
Dear Anne Thanks a lot for the taking the time to answer my questions. Would love a copy of your stats. Are there any plans to increase the staff to cater for the obviously high demand? One of the reasons I wanted to know if a doctor has to "admit" a labouring woman is because I feel when they do, they inevitably do a VE on admission which I feel is totally unnecessary 99% of the time and seems to set the woman up for the old "failure to progress" line and then on to a caesar. This is where the doctors go wrong if you ask me. There are so many other ways to see if a woman is progressing in labour but once you have that cervical dilatation timeline it seems to influence all decisions from then on. So if the midwife is the primary care attendant I suspectadmission VEs aren't done routinely in labourcorrect me if I'm wrong Anyway, that's my vent for the day. Helen Cahill - Original Message - From: Anne Clarke To: [EMAIL PROTECTED] Sent: Wednesday, August 04, 2004 3:45 PM Subject: Re: [ozmidwifery] Request for information on current models of midwifery led care Dear Helen, I work at the Birth Centre, RWH Brisbane and we are the primary carers, however, we also see ourselves as a team and refer when appropriate, but this does not mean we give up caring for our client. The comments that are put forward are quite inflammatory and they can be sued if they are not careful. However, the best ammunition is our statistics and cost effectiveness and consumer satisfaction. They can never argue about that! You are quite right comparing the Obs and GP senario, again they cannot argue with that. 1. Medical indemnity status of midwives working in New Zealand - my understanding of it is that they work under the control of the health department and Yes 2. If anyone gets sued it is the hospital/health service. Is this correct? Yes. However, if you have acted negligently they will sue you too. 3. If the hospital is successfully sued, where does the money come from if a huge payout is granted. My understanding is that taxpayers all contribute somehow to a government fund for such purposes. Yes 4. Do all the women see a doctor at the beginning of pregnancy to be screened as low or high risk or does the midwife screen them and refer them on if needed. At the Birth Centre, women go on a ballot drawn about 7mths before their due date e.g. we will be doing the ballot for April 2004 next month. Meanwhile the women book into the hospital and see the consultant/registrar to be 'passed' by them. I tell the women not to leave the room until the doctor has written somewhere in their notes that they are OK to come to the Birth Centre unless there is a specific medical reason for not coming. They do not have to wait for an USS (as some of our mother's decline any USS's). The women in the ballot are sent a letter either offering a place (on proviso they are passed by the doc) if they were unsuccessful in the ballot they are still to be passed by the doc to come to the Birth Centre as some women may miscarry or change their mind (this is not often) and an opening may occur and then those on the waiting list from the ballot can be offered a place a little later down the track. Meanwhile the women who do not have a place can either share care with their GP or they can be cared for by the Phoenix project. The Phoenix is a team of 4-6 Midwives who can look after low and high risk in the ANC and one of them is on call per shift to look after her in labour ward. Many women who do not come to the Brith Centre for a myriad of reasons like the option of the Phoenix. 5. Do all women see a doctor in labour on admission or do the midwives totally provide the support/care with medicos only being called if there is a problem. We only include the medicos if there is a problem - but we still look after the woman. We order any tests (blood, MSU, USS etc) as needed. 6. What are the comparisons between perinatal mortality and caesarian rates between countries with midwifery led care and Australia - I've heard they are lower but don't have any research to back my claims. Our stats are outstanding. If you want a copy of the stats I do not have them on email but can snail mail them to you if you like. Email me back with your address if you want these stats. It also costs approximately $1,800 per woman for her care with us. It costs twice as much through the 'regular' system for a healthy singleton pregnancy. Again you cannot argue with this. Regards, Anne Clarke
[ozmidwifery] unrecognised pregnancy
Am I right in thinking I heard on national TV(Today Tonight) that the21 yr old girl who didn't know she was pregnant gave birth to a baby girl in the toilet, said "she came bum first fell in the toilet"? How's that for a successful natural breech birth without forceps to the after coming head? MMl
[ozmidwifery] Great story in the SMH today
Hi everyone, This story in page 3 of the Herald is terrific - the picture takes up about 1/3 of the page and the quotes from Sally and Justine are excellent. Rather than give you the transcript which would have omitted the pic, here is the URL for the page itself, so you can enjoy the full story. http://www.smh.com.au/articles/2004/08/04/1091557922616.html?oneclick=true Congratulations Justine and Sally - great publicity! 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.
[ozmidwifery] TV show
for those interested, ABC TV's Compass, Sun 10.15pm [check your guide]is showing a UK doco on abortion, I think its called My Foetus. I believe it includes the footage of an abortion and shows images of foetus at various ages. I heard that 'the powers that be' tried to prevent it being aired. Megan This message was sent through MyMail http://www.mymail.com.au -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Request for information on current models of midwifery led care
Hi again Anne No you didn't give me the wrong answer on doctors seeing a labouring woman - I was just having a vent about my thoughts on why they shouldn't routinely see them. Thanks again Helen - Original Message - From: Anne Clarke To: Graham and Helen Sent: Wednesday, August 04, 2004 9:52 PM Subject: Re: [ozmidwifery] Request for information on current models of midwifery led care Dear Helen, Thanks a lot for the taking the time to answer my questions. Would love a copy of your stats. Are there any plans to increase the staff to cater for the obviously high demand? Unfortunately no, as we have limited beds too in the Birth Centre (4 rooms). I will send you the stats ASAP, but I still need a snail mail address (postal) as I cannot send you them over the email. One of the reasons I wanted to know if a doctor has to "admit" a labouring woman is because I feel when they do, they inevitably do a VE on admission which I feel is totally unnecessary 99% of the time and seems to set the woman up for the old "failure to progress" line and then on to a caesar. This is where the doctors go wrong if you ask me. There are so many other ways to see if a woman is progressing in labour but once you have that cervical dilatation timeline it seems to influence all decisions from then on. So if the midwife is the primary care attendant I suspectadmission VEs aren't done routinely in labourcorrect me if I'm wrong Must have given you the wrong answer to this one as no, a doc does not admit or discharge any of our women in labour etc. A consultant/registrar only has to pass them to come to the Birth Centre as low risk and that is generally the only time they see the doc unless we refer them on for some reason. Regards, Anne
