Re: [ozmidwifery] prison birthing
We used to have the women from Mulawa gaol in Sydney come to us. I never work in the clinics so I am not sure about their antenatal care but they always came to us when in labour- or of antenatal problems. Depending on their offence ( which, naturally, was not divulged to us), they had one or two prison officers with them who remained outside the room. I never saw or heard of anyone chained to a bed. There were very occasionally women who were handcuffed because they had a history of absconding or because their offences and gaol history were so dire they were considered to be a physical threat to staff. In that case they were required to have a female prison officer within the room in order to assure the midwives' safety. I must emphasise that that was very rare- maybe two or three cases in the ten years I have been in this delivery suite. They had the same length of stay in hospital as anyone else (approx 3 days postpartum) then mother went back to prison and baby was cared for according to the arrangements sorted out before the birth, sometimes family members, sometimes foster care. Is this what you were after? Some time last year pregnant women were moved to another facility (? near Windsor) so we don't see them anymore. Monica - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 08, 2006 1:21 PM Subject: [ozmidwifery] prison birthing Do any of you midwives out there know how birth happens for pregnant women in Australian prisons? Are they transferred to hospital or are they required to stay in the prison health service. I have been reading an Amnesty report of the abuses of pregnant and laboring women in the US (it is available through Sheila Kitzinger’s website for anyone who is interested). I am keen to know what similarities exist for Australian women. I thought fetal monitoring and a drip was bad enough-try giving birth being chained to a bed-not knowing how long you can cuddle your baby for before she is removed! That breaks my heart. Amy _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Emily Sent: Wednesday, February 08, 2006 8:10 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] yoga video hi everyone funny photo attached that shows what happens if your baby doesnt get enough food ! i found this while looking for photos for an infant nutrition seminar im doing for uni next week. does anyone still have that short movie of the yoga mum where the baby crawls up and has a feed while shes upside down?? id love to include that :) if anyone has it they can send it direct to me at [EMAIL PROTECTED] thanks emily _ Brings words and photos together (easily) with HYPERLINK http://us.rd.yahoo.com/mail_us/taglines/PMDEF3/*http:/photomail.mail.yahoo. comPhotoMail - it's free and works with Yahoo! Mail. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.375 / Virus Database: 267.15.2/252 - Release Date: 2/6/2006 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.375 / Virus Database: 267.15.2/253 - Release Date: 2/7/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] prison birthing
women who have come into my work have a guard standing outside the room and the woman chained to the bed. (I work in a large tertiary instiutuion).if they are in labour then the guard does not stay in the room otherwise it is the guards job to stay in the room with these women at all times. after the birth they are allowed minimal time with their child before the child is taken away and all rights relinquished depended upon what the woman was in for and if she is giving up her baby. regards - Original Message - From: adamnamy To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 08, 2006 12:51 PM Subject: [ozmidwifery] prison birthing Do any of you midwives out there know how birth happens for pregnant women in Australian prisons? Are they transferred to hospital or are they required to stay in the prison health service. I have been reading an Amnesty report of the abuses of pregnant and laboring women in the US (it is available through Sheila Kitzinger’s website for anyone who is interested). I am keen to know what similarities exist for Australian women. I thought fetal monitoring and a drip was bad enough-try giving birth being chained to a bed-not knowing how long you can cuddle your baby for before she is removed! That breaks my heart. Amy From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of EmilySent: Wednesday, February 08, 2006 8:10 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] yoga video hi everyone funny photo attached that shows what happens if your baby doesnt get enough food ! i found this while looking for photos for an infant nutrition seminar im doing for uni next week. does anyone still have that short movie of the yoga mum where the baby crawls up and has a feed while shes upside down?? id love to include that :) if anyone has it they can send it direct to me at [EMAIL PROTECTED] thanks emily Brings words and photos together (easily) withPhotoMail - it's free and works with Yahoo! Mail. --No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.15.2/252 - Release Date: 2/6/2006 --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.15.2/253 - Release Date: 2/7/2006
RE: [ozmidwifery] prison birthing
Hi Amy, The women who birth at our hospital from the local minimum security prison are not guarded. They are visited once a day, and have to sign a form. Some of them love being in hospital, because it is a more normal environment for their children to visit. Some will try to stay longer for this reason. I find the whole thing heartbreaking. They can keep children with them up until age four. They are usually housed with other women who have children in the prison. Regards, Nicole. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of adamnamySent: Wednesday, February 08, 2006 1:22 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] prison birthing Do any of you midwives out there know how birth happens for pregnant women in Australian prisons? Are they transferred to hospital or are they required to stay in the prison health service. I have been reading an Amnesty report of the abuses of pregnant and laboring women in the US (it is available through Sheila Kitzinger’s website for anyone who is interested). I am keen to know what similarities exist for Australian women. I thought fetal monitoring and a drip was bad enough-try giving birth being chained to a bed-not knowing how long you can cuddle your baby for before she is removed! That breaks my heart. Amy From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of EmilySent: Wednesday, February 08, 2006 8:10 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] yoga video hi everyone funny photo attached that shows what happens if your baby doesnt get enough food ! i found this while looking for photos for an infant nutrition seminar im doing for uni next week. does anyone still have that short movie of the yoga mum where the baby crawls up and has a feed while shes upside down?? id love to include that :) if anyone has it they can send it direct to me at [EMAIL PROTECTED] thanks emily Brings words and photos together (easily) withPhotoMail - it's free and works with Yahoo! Mail. --No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.15.2/252 - Release Date: 2/6/2006 --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.15.2/253 - Release Date: 2/7/2006
[ozmidwifery] St. George's Hospital Kogarah Homebirth Service up and running!
From The Age newspaper - I have been waiting to hear how this program is going.sounds great! Helen Cahill http://www.theage.com.au/news/health-and-fitness/special-delivery-for-mums/2 006/02/01/1138590559473.html# Special delivery for mums By Danielle Teutsch February 2, 2006 Something radical is happening at St George Hospital in Kogarah. The hospital is offering homebirth as an option for expectant mums. Not only does NSW Health approve, it is footing the bill for insurance. For the past decade, homebirth has been depicted as unsafe hippie nonsense, and the numbers of women doing it have fallen accordingly. The 2003 Mothers and Babies report found 0.2 per cent of women gave birth at home, and overall numbers had fallen from 182 to 132 in a five-year period. The number is miniscule, admits Associate Professor Nicky Leap, area director of midwifery practice. It has had an alternative image, associated with an alternative lifestyle, she says. There is still a small but significant group of women who want to give birth without medical intervention, she says. Until now, their options have been limited unless they were prepared to pay up to $5000 for a private midwife. Some women were also reported to be freebirthing - having babies at home without medical support. Independent midwives the world over are not able to get insurance, she says. But homebirth with hospital back-up should be an option for all low-risk women. The homebirth outreach program at St George is the culmination of a decade of lobbying by the hospital and midwifery groups - the NSW Government was finally convinced that the program would satisfy safety standards. The program started taking bookings in May last year and has had its first birth. About three women each month are using the service, says St George Hospital's head of women's and children's health, Dr Greg Davis - and the number is expected to rise. The program has not been introduced at St George by accident. Unlike in some other maternity wards, where turf wars have been conducted between midwives and obstetricians, the two groups work in harmony at St George. Davis, who also works in private obstetrics, says he cannot understand why his fellow obstetricians make such a fuss about homebirth. My colleagues are very suspicious of this, he says. They are worried about safety, but midwifery-led care at home is the same as having a baby in a birth centre. Davis says fears about homebirth, such as increased risk of perinatal death and neonatal respiratory difficulty, have been overstated. Obstetricians worry about unavoidable complications that may be life threatening such as prolapse and post-partum hemorrhaging. But if you take that argument to its logical conclusion, it means someone can only deliver in a tertiary unit with intensive care - which is totally impractical, he says. He points to a US study, published in the British Medical Journal, the largest to date on homebirth, which found it was no less safe than giving birth in a hospital. Only 12 per cent of women in the study were moved to hospital, with a quarter of the cases for urgent reasons, and the rest for non-urgent reasons such as fatigue and lack of progress. Professor Caroline Homer, director of the Centre for Midwifery and Family Health at UTS, says women are carefully screened before they are admitted to the homebirth program to make sure they are low-risk patients, according to guidelines developed by the Australian College of Midwives. Each birth is attended by two midwives equipped to deal with medical emergencies; and there are protocols for transferring to a hospital if necessary. KITCHEN BIRTH TOASTED WITH CHAMPERS AND CAKE For her first pregnancy, Narelle Batterham, 34, went to a private hospital with an obstetrician. Her doctor was on holidays when she delivered so another obstetrician was brought in, who insisted she give birth while on her back. It was not a position I would have chosen, Batterham says. In hindsight, I could have said no, but not being confident, I just let it go. When she became pregnant again, her obstetrician's fees had doubled, so she booked into the birth centre at St George Hospital. I liked the idea I would be seen by the same midwives all the way through, so I wouldn't have a stranger when I gave birth. I had a water birth there and it was an excellent experience. For her third child she decided to have a homebirth, as part of the St George Hospital outreach program, confident that the hospital was nearby if there was an emergency. It's been a natural progression. In my head I was treating it as if I was in a birth centre, Batterham says. She planned to use her spa bath at home during labour. But her labour progressed so quickly that she gave birth on a mattress in an open area near the kitchen, assisted by two midwives who arrived just in time. It was so hot, and that was an area that was air-conditioned, she says. Her daughters, Jacinda, aged 2, and Brianna, 5, were there
Fw: [ozmidwifery] Re: Post cs support
I've sent this twice now without it appearing. I hope it arrives this time! J From: Janet Fraser [mailto:[EMAIL PROTECTED] Sent: Tuesday, 7 February 2006 1:57 PMTo: Helen and GrahamSubject: Fw: [ozmidwifery] Re: Post cs support Hi Helen, I've sent this to ozmid twice now and it hasn't appeared! Here's a personal one instead. Best, J - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Tuesday, February 07, 2006 10:10 AM Subject: Fw: [ozmidwifery] Re: Post cs support - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Monday, February 06, 2006 7:27 PM Subject: Re: [ozmidwifery] Re: Post cs support Hi Helen, I'm so glad you're looking at this issue. You will save lives, I guarantee it. Debriefing within 72 hours is not going to be very useful for women although it would be helpful if it were offered and then open ended about coming back later. (Plus those other huge reasons you listed!)PTSD usually starts 4-6 months after the event and those early days, particularly in a hospital setting where women trust the word of the surgeons, most are in the grateful stage. It's a bit like Stockhom Syndrome, I think, so that even women who have had emergency hysterectomies because of poor clinical decisions are often grateful to have birthed in a hospital where their life has been saved, or so they see it at the time. Counsellors who are skilled in debriefing from birth are very rare. As I said in my previous email on this very subject, too many have bought into our wider myths around birth and simply see "birth" as naturally traumatic, which of course, it isn't in most cases. As the midwife who gets to know women, you are indeed in an important position. Some things which women have said to me about what they would have liked from a CP in your kind of position are: * I would have liked to be able to talk about what happened without defensiveness. I wasn't seeking to blame, I just really needed to share my feelings with someone else who had been present. * I would have really appreciated being able to follow up in the later months when my PTSD kicked in and I couldn't get anyone in the hospital to talk to me. * I wanted someone to validate my fear and distress and not brush it aside telling me I should just be grateful for my healthy baby. * I really wanted proper breastfeeding support so I could at least get something right about how I parented. When I speak to a woman who has had a very recent birth, regardless of what she's expressing at the time, I always validate what that is and add something like, "You've been through such a huge journey, and it's really normal that you're feeling [insert emotion here]. What I've found is that over time women's emotions can really change about their births, regardless of how they feel immediately after so don't forget that I'll be there to offer you support when that happens." That leaves open all possibilities for where her emotional state may go without inserting your own feelings about her birthing experience. You can also encourage her to write her birth story down "while it's fresh, so you don't lose the details" - again, not loaded one way or the other about how she feels but often very helpful in later processing. Records of a birth like photosor video can be great for this too soyou may wish to encourage that during pregnancy.Once women do start to feel like crap and look for help it's really hard to find any but knowing that you are a potential starting place is great. There are lots of consumer groups to which you can refer women (if your workplace is ok with that?) and a small number of appropriate counsellors in capital cities. I can probablyhelp you with contacts for your local area. To be honest, most women I know who've dealt with hospy social workers have not come away feeling good. Of course there are exceptions but as active participants in the hospy setting, they tend to underestimate the power of "a day at the office" for staff which is the wreck of a woman's life.Many also view interventions as normal and necessary and can't therefore grasp why a woman would feel distressed about them. In my own experience, every time I said I felt distressed by something which had occurred, a staff member would look at me with a puzzled _expression_ and say, "But it happens to everyone!" Well, it might but each woman is not "everyone" and so that doesn't make me feel any better about finding out weeks later about things which were done to my body, and drugs I was given,without my knowledge or consent, if you get my drift. As my sister said to me the other day (survivor of the Friday night c-sec so staff could go home), hospital staff might spend all day poking vaginas but women don't normally spend all day being poked. I truly thank you deeplyfor
Re: [ozmidwifery] prison birthing
I spent two months in prison here in B.C., Canada where midwifery is very suppressed. What an education. I spent my first week in maximum security C Unit and I'm sure the C stood for crazy. What a group of women. One of the women on our unit was pregnant and it was quite bizarre because she was the husband of one of the other inmates. That was a first for me! Apparently, she was only gay when incarcerated (which was a lot) but when she was on the outside she was straight and that's where the pregnancy came from. Hm. Anyway, I spent most of my time in prison doing what I do on the outside, talking to women about their births and their dreams for their kids. One day, this woman told me that she was 26 weeks preg and she had not felt the baby kick. I was, of course, very alarmed to hear this and asked her when the last time was that she had seen a doctor. It had been a couple of months and no one was in a hurry to book another appt. I told her that she should insist on having an u/s and find out what was going on. She went to health care and the baby was fine. The reason there was no movement was that she was on methadone and apparently the baby in utero is completely stoned on that---another first for me. I could write a book on all the things I learned in there that I didn't know before. Maybe one day I will--it was quite an adventure. The really harsh thing for prisoners is the terrible nutrition. Pregnant women got the same bland, starchy, cheap diet that everyone else got plus an orange and a piece of cheese every day. Often they would trade the orange and cheese for some junky food off someone else's tray. Poor little babies. Gloria Mh wrote: We used to have the women from Mulawa gaol in Sydney come to us. I never work in the clinics so I am not sure about their antenatal care but they always came to us when in labour- or of antenatal problems. Depending on their offence ( which, naturally, was not divulged to us), they had one or two prison officers with them who remained outside the room. I never saw or heard of anyone chained to a bed. There were very occasionally women who were handcuffed because they had a history of absconding or because their offences and gaol history were so dire they were considered to be a physical threat to staff. In that case they were required to have a female prison officer within the room in order to assure the midwives' safety. I must emphasise that that was very rare- maybe two or three cases in the ten years I have been in this delivery suite. They had the same length of stay in hospital as anyone else (approx 3 days postpartum) then mother went back to prison and baby was cared for according to the arrangements sorted out before the birth, sometimes family members, sometimes foster care. Is this what you were after? Some time last year pregnant women were moved to another facility (? near Windsor) so we don't see them anymore. Monica - Original Message - From: adamnamy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, February 08, 2006 1:21 PM Subject: [ozmidwifery] prison birthing Do any of you midwives out there know how birth happens for pregnant women in Australian prisons? Are they transferred to hospital or are they required to stay in the prison health service. I have been reading an Amnesty report of the abuses of pregnant and laboring women in the US (it is available through Sheila Kitzinger’s website for anyone who is interested). I am keen to know what similarities exist for Australian women. I thought fetal monitoring and a drip was bad enough-try giving birth being chained to a bed-not knowing how long you can cuddle your baby for before she is removed! That breaks my heart. Amy _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Emily Sent: Wednesday, February 08, 2006 8:10 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] yoga video hi everyone funny photo attached that shows what happens if your baby doesnt get enough food ! i found this while looking for photos for an infant nutrition seminar im doing for uni next week. does anyone still have that short movie of the yoga mum where the baby crawls up and has a feed while shes upside down?? id love to include that :) if anyone has it they can send it direct to me at [EMAIL PROTECTED] thanks emily _ Brings words and photos together (easily) with HYPERLINK http://us.rd.yahoo.com/mail_us/taglines/PMDEF3/*http:/photomail.mail.yahoo. comPhotoMail - it's free and works with Yahoo! Mail. -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.375 / Virus Database: 267.15.2/252 - Release Date: 2/6/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Cystotomy in Hysterectomy after c/s
Published in the American Journal of Obstetrics and Gynecology, January 2006 *Helpful terms to read this research paper:* *Cystotomy* : surgical cut of the urinary bladder; called also vesicotomy. *TVH:* total vaginal hysterectomy *TAH:* total abdominal hysterectomy *LAVH:* laparoscopically-assisted vaginal hysterectomy In summary, when all hysterectomies were considered together, 17 of the 51 ( 33.3%) cases of incidental cystotomy had a history of previous cesarean section, while only 25 of the 153 (16.3%) controls had a history of previous cesarean delivery. This difference was significant. Is previous cesarean section a risk for incidental cystotomy at the time of hysterectomy?: A case-controlled study Christopher M. Rooney, MD, a,* Adam T. Crawford, MD, a Brett J. Vassallo, MD,a,b Steven D. Kleeman, MD, a Mickey M. Karram, MD a Department of Urogynecology and Pelvic Reconstruction, Good Samaritan Hospital, a Cincinnati, OH; Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, b Park Ridge, IL Received for publication January 13, 2005; revised June 23, 2005; accepted July 27, 2005 KEY WORDS Hysterectomy Cystotomy Cesarean section Objective: The purpose of this study was to determine if previous cesarean section is an independent risk factor for incidental cystotomy at the time of hysterectomy. Study design: This is a case-controlled study that evaluated all cases of incidental cystotomy at the time of hysterectomy between January 1998 and December 2001. Five thousand and ninety-two hysterectomies were performed in the time period mentioned above, and 51 cases of incidental cystotomy were identified. Each case of incidental cystotomy was then matched to 3 controls with similar patient characteristics, medical histories, and surgical histories, as well as the absence of incidental cystotomy at the time of hysterectomy. Results: Overall, 5092 hysterectomies were performed during the study period (total abdominal hysterectomy [TAH] 3140 [ 61.7%], total vaginal hysterectomy [TVH] 1519 [ 29.8%], laparoscopically- assisted vaginal hysterectomy [LAVH] 433 [ 8.5%]). Fifty-one cases of incidental cystotomy were identified (TAH: 24 [ 47.1%], TVH: 19 [37.3%], LAVH: 8 [15.7%]). The overall incidence of cystotomy was 1.0%. When considering TAH, there were 24/3141 ( 0.76%) cases of incidental cystotomy, with 8 (33%) of these patients with a history of previous cesarean section. During TVH, we encountered 19/1519 (1.3%) cases of incidental cystotomy, with 4 (21%) of these women having undergone a previous cesarean. Finally, during LAVH, there were 8/433 ( 1.8%) cases of incidental cystotomy. Five ( 62.5%) of these patients had a previous history of cesarean section. In comparison, 19/72 (26.4% ) TAH controls had a previous history of cesarean. Four out of 57 (7.0%) TVH controls had a history of cesarean section. Finally, 2/24 ( 8.3%) LAVH controls had a history of previous cesarean. Conclusion: Previous cesarean section is indeed a significant risk factor for damage to the lower urinary tract at the time of hysterectomy (odds ratio [OR] 2.04; 95%CI 1.2-3.5). When analyzed separately, the OR of incidental cystotomy at the time of TAH, TVH, and LAVH in a woman with a history of previous cesarean was 1.26, 3.00, and 7.50, respectively. Only the value for LAVH was statistically significant ( P Z .005; 95%CI 1.8-31.4). _ 2005 Mosby, Inc. All rights reserved. Presented at the 31st Annual Meeting of the Society of Gynecologic Surgeons, April 4–6, 2005, Rancho Mirage, CA. * Reprint requests: Christopher M. Rooney, MD, Good Samaritan Hospital, 375 Dixmyth Ave, Seton Center; 8th Floor, Cincinnati, OH 45220. E-mail: [EMAIL PROTECTED] 0002-9378/$ - see front matter _ 2005 Mosby, Inc. All rights reserved. doi:10.1016/j.ajog.2005.07.090 American Journal of Obstetrics and Gynecology (2005) 193, 2041–4 www.ajog.org In the United States, hysterectomy is the most commonly performed gynecologic procedure, with over 600,000 performed annually. 1 The rate of bladder injury during hysterectomy has been reported to range from 0.37 to 2%. 2-4 More recent reports have placed the incidence consistently between 1% to 2%. 5 The reason for the increase in reported incidence is unknown, but some have speculated that it is secondary to the ever increasing rate of cesarean section. 5 Cesarean section is the most commonly performed surgery on women, with rates at an all-time high of 20% to 30% of all deliveries. With up to 20% of these women likely requiring a hysterectomy by the age of 55, adherence of the bladder to the lower uterine segment will make dissection at the time of hysterectomy more difficult. 6,7 While statistical analysis has been applied to several series of hysterectomies in an attempt to define risk factors associated with incidental cystotomy; a value for the risk attributable to previous cesarean section alone has not been
