RE: [ozmidwifery] Oblique presentation?
Good idea. Some good contractions will see that bub's head down in the pelvis.[proper ably]. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Honey AcharyaSent: Thursday, 12 October 2006 2:57 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Oblique presentation? Any suggestions for a woman who is 39 weeks pregnant just had doctors appointment where she was told baby is now not OP but oblique (head on right side) and he suggested that they admit her to hospital right away (worried about cord prolapse) and wait and look at inducing her. She declined that offer and said she would go away and give it some more time.
Re: [ozmidwifery] Breastfeeding
Hi, I wonder if some talking through, some info and the importance of skin to skin contact after birth could help here. This may be related to previous sexual abuse, but then again, maybe not. Many survivors of sexual abuse find that breastfeeding can be extremely healing, and a way of reclaiming back their bodies. Men handling my breasts doesn't make me feel ill as such, but I hate the sensation. It gives me the fingernails scraped on the chalkboard feeling. In some cultures (apparently) men are considered imature and unmanly if they want to play with breasts. On theother hand, I have breastfed 4 children beautifully for over 13 years. They can suck, knead and cuddle to their heart's content - I love it! (though nipple twiddling is rather annoying) So there may be many reasons for not liking your breasts being touched and it may help to know other women feel the same and still go on to breastfeed. Barb - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:42 AM Subject: Re: [ozmidwifery] Breastfeeding I've seen this before and it was indeed related to sexual abuse. Fortunately the woman involved was keen that her issues didn't end up impacting negatively on the life of her baby so she went for counselling and was able to work through her stuff enough to bf.How sad that our abusers are able to reach through us to our children like this. J - Original Message - From: Andrea Bilcliff To: Ozmidwifery Sent: Thursday, October 12, 2006 11:05 AM Subject: [ozmidwifery] Breastfeeding I'm posting this on behalf of a birth attendant who has contacted me. She will be supporting a womansoon who has for want of a better term, 'breast issues'. The woman really wants to breastfeed but thethought of itmakes her feel ill. She hates it when her partner touches her breasts. The birth attendant is not sure whether this is related toprevious sexual abuse or not. I've never come across this situation before and wondered if others had experience of this and what helped the women? Thanks, Andrea Bilcliff
Re: [ozmidwifery] Oblique presentation?
would probably think of offering the same advice as breech. Moxa, visualisation , gentle massage in the right direction, squatting. Placenta and uterus all normal? Definite need for concern if membranes release if there is nothing in the pelvis. Would talk about knee chest position and self checking for cord if this happens and emergency transport. Is she close to hospy? Cheers Di - Original Message - From: Honey Acharya To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 2:57 PM Subject: [ozmidwifery] Oblique presentation? Any suggestions for a woman who is 39 weeks pregnant just had doctors appointment where she was told baby is now not OP but oblique (head on right side) and he suggested that they admit her to hospital right away (worried about cord prolapse) and wait and look at inducing her. She declined that offer and said she would go away and give it some more time.
RE: [ozmidwifery] term breech trial - ECV option
Title: Re: [ozmidwifery] Fwd: term breech trial further to supporting ECV is osteotherapy. My osteopath recently shared with me her experience of treating a client with a breech baby who was being forced into having a c/s. Her Dr's were very synical of the idea. Working with both, the woman had scans etc but also had a treatment before (not sure how long) the ECV. Osteo can treat both Mum and baby, creating a nice spacious environment and perhaps addressing some fears the baby has etc. In this case, bubs turned beautifully, much to the astonishment of the medical Dr's. I have personally experienced an Osteo treatment with my 3rd baby who was very much responding to the hands on my belly. I could feel him hidingand eventually he came to her and it was incredibly clear to me what was going on. After, the osteo who was also my friend, was able to express some very interesting stuff about my baby that made sense. as said, if an ECV is a womans only option for a breech lay then supporting it is important. cheers Megan From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of nunyaraSent: Thursday, 12 October 2006 9:12 AMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] term breech trial - ECV option Hi all! Most of you probably already know that acupuncture can help turn a breech baby. I know of some mothers who have used Moxa (a Chinese herb Mugwort in a rolled form which is lit and applied to a specific acupuncture point Bladder 67) successfully to turn a breech bub and for others it has not worked. However, I would recommend that professional acupuncture treatment be sought as acupuncturists use Moxa as well. I have recently read an article in the Journal of Complementary Medicine (which is a journal for doctors and pharmacists who are trying to get in on natural therapies) which covered a scientific trial in the use of acupuncture to turn breech babies. Of the group who had acupuncture treatment, most of those babies turned but out of the group who received no treatment, only a couple of the bubs turned. The outcome of the trial was that acupuncture was successful with breech presentations. I am madly trying to find which Journal this article was in but I have safely put it away (which means that I probably wont ever be able to find it again!) I am a Bowen therapist as well and have used bowen a couple of times with breech and the bubs have turned. I think trying acupuncture and/or Bowen though is preferable to doing nothing and ending up with a C/S. Cheers, Ramona Lane Nunyara, Bargara Beach, Qld. From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Honey AcharyaSent: Wednesday, 11 October 2006 2:18 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] term breech trial - ECV option Here in Townsville Qld some of the Ob's in the Townsville Hospital perform ECV's. David Watson is particulary successful at this and I have seen him perform a few and he seems to have the right touch and technique, the women who had other Ob's try on them firstand then himsaid he was much more gentle and it looked that way too. He has the woman lie on her side slightly and rests his knee behind their back, and using ultrasound on and off to monitor baby's position, then pushes the baby around getting them to either do a forward somersault or backward one. The private Ob's here refuse to do it all together. I noticed they are also performing the EECV trial (EarlyECV) around 33-34 weeks? One of the women I was with was being offerred this optionbut declined preferring to give her baby further time to turn and then at 37-38 weeks when baby was still in the breech position had a successful ECV and went on to have a straightforward normal vaginal birth at 41 weeks. Honey - Original Message - From: Helen and Graham To: ozmidwifery@acegraphics.com.au Sent: Wednesday, October 11, 2006 12:52 PM Subject: [ozmidwifery] term breech trial - ECV option I think it would be good to get a list of providers in each state who are performing External Cephalic Version ECV. I know, having just been to Box Hill Maternity for an inservice, they have one or two progressive obstetricians who have a regularECV clinic. They have theatre on standby if needed. I am sure plenty of women would be prepared to travel far and wide if they knew this option existed and could possibly avoid the need for LUSCS. I know this is not optimal, but at least some women may avoid LUSCS if ECV is offered. I think it is performed at 37 weeks to be the most successful. I would also be interested in other units offering this service to tell the women in my care if anyone knows of them. Thanks Helen Cahill - Original Message - From:
Re: [ozmidwifery] Oblique presentation?
Hi Honey What's the problem? OP / oblique? Let her go into normal labour encourage her in an upright position, leaning forward and all 4s. Ask her doctor if this practice is evidence basedNo inductionNo cord prolapseNo panicChris On 12/10/2006, at 2:57 PM, Honey Acharya wrote:Any suggestions for a woman who is 39 weeks pregnant just had doctors appointment where she was told baby is now not OP but oblique (head on right side) and he suggested that they admit her to hospital right away (worried about cord prolapse) and wait and look at inducing her.She declined that offer and said she would go away and give it some more time.
Re: [ozmidwifery] Launceston query
Dear Michelle, Thanks for that , have sent the info on. Katy - Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Thursday, October 12, 2006 9:54 AM Subject: [ozmidwifery] Launceston query Hi, Last week there was a query regarding midwives etc around Launceston. This is the web site of the midwives there who do homebirth as well as run a free standing birth centre. www.birthcentre.org.au Cheers Michelle On Yahoo!7Men's Health: What music do you want to hear on Men's Health Radio?
[ozmidwifery] Interesting article
British Journal oi Obstetrics and Gynaecology April 1993, Vol. 100, pp. 303-306 COMMENTARIES In Australia, approximately 50% of women carry some form of private health insurance for childbirth, with some variation between States. This gives them access to an obstetrician of their choice and to either private hospital accommodation or to a private bed in a public hospital as an intermediate patient. The obstetrician (or in a rural setting, a general practitioner/obstetrician) is remunerated on a fee-for-service basis by the Federal Government, receiving a global schedule fee for obstetric care regardless of complications of pregnancy or the type of delivery. The obstetric specialists fee currently amounts to $AU600. The patient is responsible for meeting any difference between the private obstetricians fee and the schedule fee. This extra fee varies between obstetricians and may be as high as an extra $AU600 but on average is an extra $AU110 (Deeble 1991). The average fee-forservice payment to private obstetricians and gynaecologists in Australia in 1991 was $AU291 600 which does not include income from extra billing (OReilly 1992). The other 50% of Australian women who do not carry private health insurance have their medical and hospital charges covered by a compulsory levy applied to all income earning Australians (1.25% of gross salary); there are no direct charges for public health services. This gives obstetric patients access to a public hospital where care is provided by salaried doctors and midwives. Almost no private obstetric hospitals in Australia produce annual clinical reports and most mixed hospitals produce information in which public and private data are combined. However, in those hospitals from which data are available an approximate doubling of caesarean section and instrumental delivery rates is seen for private births compared to public births with caesarean section rates for private patients often in the range of 30 to 35%. A similar doubling of intervention rates for private patients has been observed in the United Kingdom with 10.4% caesarean section rates for NHS patients compared to 22.5% for patients in pay beds (Macfarlane 1988). It is probable that these higher intervention rates are not due to the biological or medical differences between private and public obstetric patients. If anything, private patients are, in general, better nourished, better educated and better prepared for birth; they might be expected to require (and wish for) less intervention in childbirth. Not surprisingly, there is no evidence to show that these higher intervention rates confer any improvement in outcome for the mother or her baby (Cary 1990). When testing the strength of an association between two variables, a doselresponse relationship increases the likelihood of a causal effect. The data from Australia and the USA indicate such a dose/response relationship in the association of private insurance and high intervention Obstetric intervention and the economic imperative
[ozmidwifery] interesting article 2
CLINICAL OPINION American Journal of Obstetrics and Gynecology (2006) 194, 9326 Myth of the ideal cesarean section rate: Commentary and historic perspective Ronald M. Cyr, MD* Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI Received for publication July 10, 2005; revised September 12, 2005; accepted October 8, 2005 KEY WORDS Cesarean section rate Myth History of cesarean section John Whitridge Williams Evidence-based medicine Attempts to define, or enforce, an ideal cesarean section rate are futile, and should be abandoned. The cesarean rate is a consequence of individual value-laden clinical decisions, and is not amenable to the methods of evidence-based medicine. The influence of academic authority figures on the cesarean rate in the US is placed in historic context. Like other population health indices, the cesarean section rate is an indirect result of American public policy during the last century. Without major changes in the way health and maternity care are delivered in the US, the rate will continue to increase without improving population outcomes. _ 2006 Mosby, Inc. All rights reserved. Since the earliest days of the modern cesarean sectiondthe 1880sdthere has raged within the profession a debate about the appropriate indications for this operation.1,2 For several decades after the availability of antibiotics and blood banking, the cesarean section rate in the US remained in the 4% to 6% range. Between 1968 and 1978, the rate tripled to 15.2%, and discussion of cesarean section moved permanently into the public domain. A 1981 report commissioned by the National Institutes of Health (NIH) expressed concern about the rising rate, and its recommendations for reducing cesareans included qualified support for VBAC.3 By the 1990s, individual hospital cesarean section and VBAC rates were being published, and interpreted by consumer groups as indicators of obstetric care quality. In 1991, the Healthy People 2000 initiative advocated a 15% cesarean rate as a US health promotion objective by the year 2000.4 Despite expert and lay opinion that many cesareans are unnecessary, the rate continues to increase in the USdexceeding 27% in 2004dand shows no sign of abating.5,6 Indeed, there is growing discussion and acceptance of patient-choice cesarean section as a legitimate birth option.7,8 A recent editorial opined that Its time to target a new cesarean delivery rate.9 It is the premise of this essay that attempts to define, or enforce, an ideal cesarean section rate are futile, and should be abandoned. It will be argued that the cesarean rate is a consequence of individual value-laden clinical decisions, and that it is not amenable to the methods of evidence-based medicine. The influence of academic authority figures on the cesarean rate in the US will be placed in historic context. Like other population health indices, the cesarean section rate is an indirect result of American public policy during the last century. Without Dr Cyr is the 2003 ACOG/ORTHO-McNEIL Fellow in the History of American Obstetrics and Gynecology. * Reprint requests: Ronald M. Cyr, MD, Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0276. E-mail: [EMAIL PROTECTED] 0002-9378/$ - see front matter _ 2006 Mosby, Inc. All rights reserved. doi:10.1016/j.ajog.2005.10.199
[ozmidwifery] WV Based med rejected
This is part of the text of the last article. Isnt it amazing that individualization is O.K for obstetricians, but not for women wanting normal births? MM The recent emphasis on evidence-based medicine has tended to overshadow the need for individualization in obstetrics. RCTs provide information about populations, but cannot replace clinical judgment. Even if it is true, for example, that cesarean section is generally safer for babies in breech presentation, neither mother nor child would be well served by emergency surgery performed when the breech is on the perineum. Although RCTs provide the highest level of evidence, their external validity is often limited by small sample size and the recruitment biases inherent to the research process. Furthermore, investigators are not a random sample of providers. In the statistical spirit of our time, it is probably fair to say that clinical judgment and technical ability are normally distributed within the profession. These attributes are not often equally developed in the same individual, nor is there any evidence that academic achievement correlates positively with clinical excellence. In light of such confounding factors, it is prudent to maintain a degree of skepticism about the conclusions of any study. The future of cesarean section .we have all regretted that we have not done a cesarean in certain cases, but I have yet to regret one that I have done.23 Few obstetricians would disagree with this sentiment, expressed by a prominent New York obstetrician in 1920. Given this attitude, is there an upper limit to the cesarean rate? As the obstetric population becomes older, heavier, and increasingly primiparous, the cesarean rate in the US will continue to rise. This trend will be accentuated by the reluctance, or inability, of obstetricians to perform 934 Cyr
Re: [ozmidwifery] WV Based med rejected
Makes me shudder to read this stuff. I love how it's always OUR fault we get carved up because: As the obstetric population becomes older, heavier, and increasingly primiparous, the cesarean rate in the US will continue to rise. J - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 7:29 PM Subject: [ozmidwifery] WV Based med rejected This is part of the text of the last article. Isnt it amazing that individualization is O.K for obstetricians, but not for women wanting normal births? MM The recent emphasis on evidence-based medicine has tended to overshadow the need for individualization in obstetrics. RCTs provide information about populations, but cannot replace clinical judgment. Even if it is true, for example, that cesarean section is generally safer for babies in breech presentation, neither mother nor child would be well served by emergency surgery performed when the breech is on the perineum. Although RCTs provide the highest level of evidence, their external validity is often limited by small sample size and the recruitment biases inherent to the research process. Furthermore, investigators are not a random sample of providers. In the statistical spirit of our time, it is probably fair to say that clinical judgment and technical ability are normally distributed within the profession. These attributes are not often equally developed in the same individual, nor is there any evidence that academic achievement correlates positively with clinical excellence. In light of such confounding factors, it is prudent to maintain a degree of skepticism about the conclusions of any study. The future of cesarean section .we have all regretted that we have not done a cesarean in certain cases, but I have yet to regret one that I have done.23 Few obstetricians would disagree with this sentiment, expressed by a prominent New York obstetrician in 1920. Given this attitude, is there an upper limit to the cesarean rate? As the obstetric population becomes older, heavier, and increasingly primiparous, the cesarean rate in the US will continue to rise. This trend will be accentuated by the reluctance, or inability, of obstetricians to perform 934 Cyr
[ozmidwifery] asthma in labour
Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED]
RE: [ozmidwifery] asthma in labour
Yes, it has been used in a different delivery method, but definitely has been and probably still is, for calming contractions. I am sure some one who is familiar with it will reply. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Janet Fraser Sent: Thursday, 12 October 2006 6:29 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to: Joyous Birth Australian home birth network and forums. http://www.joyousbirth.info/ Or email: [EMAIL PROTECTED]
Re: [ozmidwifery] term breech trial - ECV option
Title: Re: [ozmidwifery] term breech trial - ECV option As a British midwife I have experienced lots of breeches but this was the first time in the water. It was amazing as the water stopped that hang and the pressure that the cord is sometimes under. Apart from dropping my trousers there was no contact with the woman and her baby, just whispers and encouragement. She did it totally unassisted complete hand off the breech. I feel so proud to be involved with women who have such confidence in their birthing ability. That's half the problems we are facing here. Both women and lots of midwives are scared and don't trust birth. As a midwife we should be highly skilled and knowledgeable, but knowing when to get involved and when to just watch is the greatest skill of all. Lisa Barrett Hi Lisa, Mary and All What a great story! My 2nd twin was breech and was also born into water (untouched until the very end). I had caught twin 1 but wasnt as quick with twin 2 so as she slid out one of our wonderful midwives lightly pushed the babe back towards the front so she would not bob up behind me and instead floated to the front and was essentially caught by me. My babe was footling breech (single). First I knew was our midwife said theres a foot. I remember thinking as her body slid out, brace yourself for the head but it was really quite easy (yes I had just birthed another babe I know!!). She had apgars of 9 and 9. The only discernable difference between her cephalic sister and her was she was a teeny bit shocked and had a wee cry. I am going to try and upload the photos somehow as quite a few people have contacted me (out of interest re twins) JC
Re: [ozmidwifery] term breech trial - ECV option
Justine I would LOVE to see these !!JoOn 12/10/2006, at 9:49 PM, Justine Caines wrote: As a British midwife I have experienced lots of breeches but this was the first time in the water. It was amazing as the water stopped that hang and the pressure that the cord is sometimes under. Apart from dropping my trousers there was no contact with the woman and her baby, just whispers and encouragement. She did it totally unassisted complete hand off the breech.I feel so proud to be involved with women who have such confidence in their birthing ability. That's half the problems we are facing here. Both women and lots of midwives are scared and don't trust birth. As a midwife we should be highly skilled and knowledgeable, but knowing when to get involved and when to just watch is the greatest skill of all. Lisa Barrett Hi Lisa, Mary and All What a great story! My 2nd twin was breech and was also born into water (untouched until the very end). I had caught twin 1 but wasn’t as quick with twin 2 so as she slid out one of our wonderful midwives lightly pushed the babe back towards the front so she would not bob up behind me and instead floated to the front and was essentially caught by me. My babe was footling breech (single). First I knew was our midwife said there’s a foot. I remember thinking as her body slid out, brace yourself for the head but it was really quite easy (yes I had just birthed another babe I know!!). She had apgars of 9 and 9. The only discernable difference between her cephalic sister and her was she was a teeny bit ‘shocked’ and had a wee cry. I am going to try and upload the photos somehow as quite a few people have contacted me (out of interest re twins) JC
[ozmidwifery] Midwives in Finland??
Title: Midwives in Finland?? Do we have any Finnish midwives on list? If not does anyone know of any? An Australian woman in Finland is looking for a Homebirth midwife. She was horrified by the following I just want to quote to you the section of the information booklet I received called 'we're having a baby'. This section is titled 'admission routines' and it says: 'The following procedures will be carried out on admission. First you will be weighed and washed and asked to change into hospital clothes. You will then be given an enema, as an empty bowel gives the baby more room. Your pubic hair may be shaved off. Your blood pressure and pulse will be taken and your urine tested for protein and glucose. An external and internal examination will be made to determine the baby's size, the size of your pelvis and how far the cervix is dilated'. Ta JC
Re: [ozmidwifery] Midwives in Finland??
Title: Midwives in Finland?? Hi Justine, I don't think there are any midwifes from Finland here, unless they are just lurking... But I can probably help this woman in what ever degree is possible. I am a childbirth educator and work together with the Aktive Birth Association in Finland. They will have the best contacts for homebirth midwives. Sad thing is, that there are only couple of them and it depends greatly where she is living. There are no birth centres and most hospitals are fairly medicalized. I have all the statistics for each hospital and have a pretty good idea of the different choices if she is living in the southern Finland. The booklet she received sounds pretty bad. I don't think enemas and shaves are routines anymore, but rest of it is probably true. What I find most disturbing in our hospitals is, that many of the midwives seem to have lost the trust in normal natural labour, and since you can'tchoose the midwife in advance you just have to cross your fingers and hope to get mached with a midwife, whoenjoys and knows howto support a woman in natural labor. But I guess this is the problem everywhere. Please ask her to contact me by email [EMAIL PROTECTED]. I have also lived in Australia myself, so would love to help her out. Päivi - Original Message - From: Justine Caines To: OzMid List Sent: Thursday, October 12, 2006 6:30 PM Subject: [ozmidwifery] Midwives in Finland?? Do we have any Finnish midwives on list?If not does anyone know of any?An Australian woman in Finland is looking for a Homebirth midwife.She was horrified by the following I just want to quote to you the section of the information booklet I received called 'we're having a baby'.This section is titled 'admission routines' and it says:'The following procedures will be carried out on admission. First you will be weighed and washed and asked to change into hospital clothes. You will then be given an enema, as an empty bowel gives the baby more room. Your pubic hair may be shaved off. Your blood pressure and pulse will be taken and your urine tested for protein and glucose. An external and internal examination will be made to determine the baby's size, the size of your pelvis and how far the cervix is dilated'. TaJC
Re: [ozmidwifery] Oblique presentation?
Hi Honey, Years ago (15?, 20?), I had a couple in my prenatal classes whose baby was lying like this. They wanted a natural birth but had prepared themselves mentally for a caesarean if the baby hadn't turned head down at the start of labour. I gave them the information about Moxa sticks and this had appeal (the mother was Australian, the father Malaysian of Chinese origin). At 39 weeks, they bought some Moxa sticks and gave it a try one evening. Within an hour some contractions had started quite strongly, so they went to the hospital. On admission the baby was still in an oblique position so the woman was prepped for the caesarean and an epidural inserted. As she was being wheeled to the theatre, she kept telling the staff that she could feel something happening. Oh no you can't, she was told, you have an epidural in place. She was lifted onto the table in theatre, draped and swabbed ready for the first incision. Please take a look under the sheet she begged. They did look and there was the baby's legs and body, already born (breech). Forceps were then used to ease the baby out. They called their baby Kai-ren (?spelling) which I was told means victory man in Chinese. This mother felt that the baby had saved her from the knife, and was very happy. I don't know if it was the Moxa or the labour (which was four hours in total) that turned the baby, but turn it did, in this case to a breech. These days, this may not save a woman from a caesarean of course, but at least it suggests that the baby may still turn, given a chance. I think that if she can stay out of hospital, she will have a better chance of getting the baby to turn (more exercise etc) and she will less vulnerable to scare stories and anxieties promoted by the staff. I hope she does well. Andrea At 02:57 PM 12/10/2006, you wrote: Any suggestions for a woman who is 39 weeks pregnant just had doctors appointment where she was told baby is now not OP but oblique (head on right side) and he suggested that they admit her to hospital right away (worried about cord prolapse) and wait and look at inducing her. She declined that offer and said she would go away and give it some more time. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] interesting article 2
Hi Mary, Yes it is an interesting article of opinion; it makes me feel sick that there is not one word about safety, outcomes, maternal morbidity, maternal mortality And then the statement: the cesarean rate is a consequence of individual value-laden clinical decisions, and that it is not amenable to the methods of evidence-based medicine. Is reflective of the lack of professional accountability within the obstetric field they are unable and unwilling to perform to recommended standards, particularly when the rewards are financial and legal security. It worries me that an opinion paper can be published in a journal of strong influence and yet omit these serious and important details. What is also interesting is that many lay people are quite aware, even before they attend classes, of the above concerns. In a group situation, there is always an interesting mix of people from all sorts of different backgrounds, and once they start talking specifically about medical interventions, within minutes the above issues emerge, so in my opinion unethical Obstetricians and their unethical supporters, can avoid the truth of the matter as much as they like, but it will only serve in the long term to completely undermine the respect that the community has had for them in the past and replace it with distrust. Warm hug Julie www.julieclarke.com.au From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Mary Murphy Sent: Thursday, 12 October 2006 7:26 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] interesting article 2 CLINICAL OPINION American Journal of Obstetrics and Gynecology (2006) 194, 9326 Myth of the ideal cesarean section rate: Commentary and historic perspective Ronald M. Cyr, MD* Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI Received for publication July 10, 2005; revised September 12, 2005; accepted October 8, 2005 KEY WORDS Cesarean section rate Myth History of cesarean section John Whitridge Williams Evidence-based medicine Attempts to define, or enforce, an ideal cesarean section rate are futile, and should be abandoned. The cesarean rate is a consequence of individual value-laden clinical decisions, and is not amenable to the methods of evidence-based medicine. The influence of academic authority figures on the cesarean rate in the US is placed in historic context. Like other population health indices, the cesarean section rate is an indirect result of American public policy during the last century. Without major changes in the way health and maternity care are delivered in the US, the rate will continue to increase without improving population outcomes. _ 2006 Mosby, Inc. All rights reserved. Since the earliest days of the modern cesarean sectiondthe 1880sdthere has raged within the profession a debate about the appropriate indications for this operation.1,2 For several decades after the availability of antibiotics and blood banking, the cesarean section rate in the US remained in the 4% to 6% range. Between 1968 and 1978, the rate tripled to 15.2%, and discussion of cesarean section moved permanently into the public domain. A 1981 report commissioned by the National Institutes of Health (NIH) expressed concern about the rising rate, and its recommendations for reducing cesareans included qualified support for VBAC.3 By the 1990s, individual hospital cesarean section and VBAC rates were being published, and interpreted by consumer groups as indicators of obstetric care quality. In 1991, the Healthy People 2000 initiative advocated a 15% cesarean rate as a US health promotion objective by the year 2000.4 Despite expert and lay opinion that many cesareans are unnecessary, the rate continues to increase in the USdexceeding 27% in 2004dand shows no sign of abating.5,6 Indeed, there is growing discussion and acceptance of patient-choice cesarean section as a legitimate birth option.7,8 A recent editorial opined that Its time to target a new cesarean delivery rate.9 It is the premise of this essay that attempts to define, or enforce, an ideal cesarean section rate are futile, and should be abandoned. It will be argued that the cesarean rate is a consequence of individual value-laden clinical decisions, and that it is not amenable to the methods of evidence-based medicine. The influence of academic authority figures on the cesarean rate in the US will be placed in historic context. Like other population health indices, the cesarean section rate is an indirect result of American public policy during the last century. Without Dr Cyr is the 2003 ACOG/ORTHO-McNEIL Fellow in the History of American Obstetrics and Gynecology. * Reprint requests: Ronald M. Cyr, MD, Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0276. E-mail: [EMAIL PROTECTED]
Re: [ozmidwifery] asthma in labour
They give injected ventolin before performing someECV's to relax a uterus do they not? But perhaps intramuscular or intravenous is different to inhaled??? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 8:58 PM Subject: RE: [ozmidwifery] asthma in labour Yes, it has been used in a different delivery method, but definitely has been and probably still is, for calming contractions. I am sure some one who is familiar with it will reply. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Janet FraserSent: Thursday, 12 October 2006 6:29 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED]
Re: [ozmidwifery] Breastfeeding
I would assume that a hands off approach to assisting this woman with breastfeeding would be of benefit. What techniques do others use in the early postnatal period to assist with attachment, positioning etc without manhandling? (excuse the pun) What methods Can be used antenatally to prepare her. Spending time with another breastfeeding woman springs to mind. rgds mikeOn 10/12/06, Barbara Glare Chris Bright [EMAIL PROTECTED] wrote: Hi, I wonder if some talking through, some info and the importance of skin to skin contact after birth could help here. This may be related to previous sexual abuse, but then again, maybe not. Many survivors of sexual abuse find that breastfeeding can be extremely healing, and a way of reclaiming back their bodies. Men handling my breasts doesn't make me feel ill as such, but I hate the sensation. It gives me the fingernails scraped on the chalkboard feeling. In some cultures (apparently) men are considered imature and unmanly if they want to play with breasts. On theother hand, I have breastfed 4 children beautifully for over 13 years. They can suck, knead and cuddle to their heart's content - I love it! (though nipple twiddling is rather annoying) So there may be many reasons for not liking your breasts being touched and it may help to know other women feel the same and still go on to breastfeed. Barb - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:42 AM Subject: Re: [ozmidwifery] Breastfeeding I've seen this before and it was indeed related to sexual abuse. Fortunately the woman involved was keen that her issues didn't end up impacting negatively on the life of her baby so she went for counselling and was able to work through her stuff enough to bf.How sad that our abusers are able to reach through us to our children like this. J - Original Message - From: Andrea Bilcliff To: Ozmidwifery Sent: Thursday, October 12, 2006 11:05 AM Subject: [ozmidwifery] Breastfeeding I'm posting this on behalf of a birth attendant who has contacted me. She will be supporting a womansoon who has for want of a better term, 'breast issues'. The woman really wants to breastfeed but thethought of itmakes her feel ill. She hates it when her partner touches her breasts. The birth attendant is not sure whether this is related toprevious sexual abuse or not. I've never come across this situation before and wondered if others had experience of this and what helped the women? Thanks, Andrea Bilcliff -- My photos online @ http://community.webshots.com/user/mike1962nzMy Group online @ http://groups.yahoo.com/group/PSP_for_PhotographersNew Photo site@Mike - http://mikelinz.dotphoto.comLindsay - Http://likeminz.dotphoto.com Life is a sexually transmitted condition with 100% mortality and birth is as safe as it gets. Unknown
RE: [ozmidwifery] Breastfeeding
Mike I use a doll and sometimes a knitted breast to demonstrate along with Rebecca Glovers pamphlet The Key to Successful Breastfeeding which gives mothers another visual image. Rebeccas DVD Follow Me Mum - is also fantastic because you can pause it anywhere you want to get a really closer look. If you are with her you can stop it and explain details or watch a section again. I very rarely feel that I need to do it for the mother. Antenatally the mothers can use dolls not quite like a real baby but the best we can do J Spending time with another breastfeeding woman seems to be a good idea and might be really useful perhaps a few ABA meetings antenatally. Barb I think your idea of lots of skin to skin contact if she is open to this would be a fantastic start for her if she feels she can cope with the closeness. Take care Shaughn From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Mike Lindsay Kennedy Sent: Friday, 13 October 2006 6:18 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Breastfeeding I would assume that a hands off approach to assisting this woman with breastfeeding would be of benefit. What techniques do others use in the early postnatal period to assist with attachment, positioning etc without manhandling? (excuse the pun) What methods Can be used antenatally to prepare her. Spending time with another breastfeeding woman springs to mind. rgds mike On 10/12/06, Barbara Glare Chris Bright [EMAIL PROTECTED] wrote: Hi, I wonder if some talking through, some info and the importance of skin to skin contact after birth could help here. This may be related to previous sexual abuse, but then again, maybe not. Many survivors of sexual abuse find that breastfeeding can be extremely healing, and a way of reclaiming back their bodies. Men handling my breasts doesn't make me feel ill as such, but I hate the sensation. It gives me the fingernails scraped on the chalkboard feeling. In some cultures (apparently) men are considered imature and unmanly if they want to play with breasts. On theother hand, I have breastfed 4 children beautifully for over 13 years. They can suck, knead and cuddle to their heart's content - I love it! (though nipple twiddling is rather annoying) So there may be many reasons for not liking your breasts being touched and it may help to know other women feel the same and still go on to breastfeed. Barb - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 11:42 AM Subject: Re: [ozmidwifery] Breastfeeding I've seen this before and it was indeed related to sexual abuse. Fortunately the woman involved was keen that her issues didn't end up impacting negatively on the life of her baby so she went for counselling and was able to work through her stuff enough to bf.How sad that our abusers are able to reach through us to our children like this. J - Original Message - From: Andrea Bilcliff To: Ozmidwifery Sent: Thursday, October 12, 2006 11:05 AM Subject: [ozmidwifery] Breastfeeding I'm posting this on behalf of a birth attendant who has contacted me. She will be supporting a womansoon who has for want of a better term, 'breast issues'. The woman really wants to breastfeed but thethought of itmakes her feel ill. She hates it when her partner touches her breasts. The birth attendant is not sure whether this is related toprevious sexual abuse or not. I've never come across this situation before and wondered if others had experience of this and what helped the women? Thanks, Andrea Bilcliff -- My photos online @ http://community.webshots.com/user/mike1962nz My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers New Photo site@ Mike - http://mikelinz.dotphoto.com Lindsay - Http://likeminz.dotphoto.com Life is a sexually transmitted condition with 100% mortality and birth is as safe as it gets. Unknown
Re: [ozmidwifery] asthma in labour
Thanks, Mary and Honey. I've learnt that it's via IV in large doses. A woman was told by her hb MW she couldn't birth at home and have ventolin via nebuliser as it would stall/halt labour. I can now reassure her that it's not the case. : ) J - Original Message - From: Honey Acharya To: ozmidwifery@acegraphics.com.au Sent: Friday, October 13, 2006 8:11 AM Subject: Re: [ozmidwifery] asthma in labour They give injected ventolin before performing someECV's to relax a uterus do they not? But perhaps intramuscular or intravenous is different to inhaled??? - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 8:58 PM Subject: RE: [ozmidwifery] asthma in labour Yes, it has been used in a different delivery method, but definitely has been and probably still is, for calming contractions. I am sure some one who is familiar with it will reply. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Janet FraserSent: Thursday, 12 October 2006 6:29 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] asthma in labour Hi all, can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect? TIA. J For home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED]
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Re: [ozmidwifery] asthma in labour
Hi Janet,I remember one woman who would go outside for a smoke, come back inside and have a couple of ventolin puffs throughout her labour! Her labour kept going though. On the other hand there are two women I can think of that didn't go into labour until they cut back on their Ventolin and they felt this was connected.Cheers MichelleJanet Fraser [EMAIL PROTECTED] wrote: Thanks, Mary and Honey. I've learnt that it's via IV in large doses. A woman was told by her hb MW she couldn't birth at home and have ventolin via nebuliser as it would stall/halt labour. I can now reassure her that it's not the case. : ) J- Original Message - From: Honey Acharya To: ozmidwifery@acegraphics.com.au Sent: Friday, October 13, 2006 8:11 AM Subject: Re: [ozmidwifery] asthma in labourThey give injected ventolin before performing someECV's to relax a uterus do they not? But perhaps intramuscular or intravenous is different to inhaled???- Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, October 12, 2006 8:58 PM Subject: RE: [ozmidwifery] asthma in labour Yes, it has been used in a different delivery method, but definitely has been and probably still is, for calming contractions. I am sure some one who is familiar with it will reply. MMFrom: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Janet FraserSent: Thursday, 12 October 2006 6:29 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] asthma in labour Hi all,can bronchodilators, particularly ventolin, for severe asthmacause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect?TIA.JFor home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED] On Yahoo!7 PS Trixi: Check back weekly for Trixi's latest update
