Re: [ozmidwifery] Mum Gives Birth In Toilet - Monash Medical Centre
Well actually for my first and only labour and birth (so far) I took two panadol when I thought I could not stand it any longer!! (P.S I had no other drugs!) - Original Message - From: Kylie Carberry To: ozmidwifery@acegraphics.com.au Sent: Wednesday, January 24, 2007 1:11 PM Subject: RE: [ozmidwifery] Mum Gives Birth In Toilet - Monash Medical Centre I can obviously see why this mum's distressed, but I can help ask why she was surprised no one offered her Panadol. Having been in labour my fair share of times, never has it been offered and I think I would have laughed if it had been! Kylie From: Kelly Zantey [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Mum Gives Birth In Toilet - Monash Medical Centre Date: Wed, 24 Jan 2007 14:33:54 +1100 Mum gives birth in toilet Jane Metlikovec January 24, 2007 12:00am A MOTHER says her baby daughter was born in a hospital toilet bowl and had to be rescued after staff ignored her screams for help. Kay, 24, was in the final stages of labour when she was rushed by ambulance to Monash Medical Centre on Tuesday last week. In a statement to the Herald Sun yesterday, the hospital said it regretted the birth did not go according to plan. At the hospital, the Mt Waverley mother of two was told to wait in a standard share room instead of being directed to a birthing suite, despite having contractions fewer than two minutes apart. A midwife saw me when I came in and pressed on my stomach once. Nobody checked if I was dilated. I didn't even get offered a Panadol, Kay said. An hour after arriving, distressed and screaming in agony, she went to the toilet, where she gave birth to a girl. Her husband Michael, who had become frantic, had hit an emergency buzzer in panic to try to get help, but he said none came in time so he kicked down the locked door and ran in, pulling the infant from the toilet bowl. Kay said she was terrified her daughter could have died, and described the ordeal as horrific. I thought she could have been seriously hurt, or worse. If it wasn't for Michael coming to my aid, I don't know what the result would have been, Kay said. It was the most traumatic thing we have had to go through. I would have thought it would have been one of the happiest times of our lives, but it was terrible. Kay said Michael pressed the emergency buzzer three times, but no one responded until after a nearby caterer alerted medical staff. When someone finally came, Michael asked why it took so long and they told him the buzzer didn't work, Kay said. I was completely shocked. It is an emergency buzzer. This was an emergency. But the director of nursing at Monash Medical Centre, Kym Forrest, said in a statement to the Herald Sun: The buzzers were checked and both were working. The obstetrician and midwives were in fact alerted to the baby's arrival by the buzzer being sounded from Kay's room. Ms Forrest also denied the door had been kicked in. It is a dual lock which can be opened from both sides and this was the way access was achieved, she said. But Kay said the toilet cubicle, complete with broken door, looked like a murder scene. There was blood everywhere. I was screaming. It was just horrible, she said. The couple are seeking a formal apology, but Ms Forrest said they had not lodged a formal complaint with the hospital. We regret that Kay did not have the birth experience our midwives strive to provide to all the mums in their care, Ms Forrest said. We are as disappointed as Kay and Michael that the birth of their second child did not go according to plan, but babies have a mind of their own sometimes. Opposition health spokeswoman Helen Shardey called for the Government to investigate: It is just lucky the baby was not seriously injured in this fiasco. A spokeswoman for Health Minister Bronwyn Pike said it was an operational matter for the hospital to deal with. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Conception, Pregnancy, Birth and Baby BellyBelly Birth Support -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] vbac didn't happen
Me too! Sick and tired of it all, I wish that people would take time to think... 'does she have any other signs of second stage?' Melissa - Original Message - From: cath nolan To: ozmidwifery@acegraphics.com.au Sent: Saturday, December 30, 2006 10:26 AM Subject: [ozmidwifery] vbac didn't happen Hi everyone, My friend had a baby boy last night by c.s. I have spoken with her this morning. After being seen by a wonderful midwife from this list, she rang and cancelled the caeser booking for yesterday morning and went into what sounds good labour after a sweep. . She couldn't talk much about details , but sounded happy with her baby boy called Riley, who was 8lb1 and 54 cms. He has breastfed beautifully, thank goodness. By the gist of the short story , was examined and told to push and wasn't fully. AH. Then told to breathe through etc etc, re examined hours later 6cm. I'm so over women being put through this crap. God I wish people would learn to trust womens bodies and stop fiddling. Why can't they wait until pushy signs happen!! Of course I have n't said anything to her just venting here about this.She sounded tired and a bit spaced out, having regular peth and will talk more when she is out of hospital. She is pleased that she laboured and had no analgesia throughout. It's just a damn pity that she needed the section in the end. I'm off to work a late shift, wish me luck, Cath
Re: [ozmidwifery] waterbirth
Sue, I asked the 'powers to be' again as to why we can't use the bath. The response was that it is very dangerous What a uphill battle everything always is!! I also asked why we then don't have a policy on how to have a shower in labour. The response was walking off in a huff! Melissa P.S We only got the bath because we wrote a letter to Jim McGinty, which we got in trouble for, and interestingly enough when he came for a tour of the ward renovations last week the sign on the door which says do not use until further notice was gone. I also asked about this. Maybe Mr McGinty needs to know that the bath that he instructed to be installed is still not in use! - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Thursday, December 21, 2006 9:55 PM Subject: Re: [ozmidwifery] waterbirth Mary, you may also be interested to know that our brand new bath (where I work) is yet to be used because we -apparently - have to have a policy in place before women are allowed to use it for labour! Even though no other hospital seems to have seen this as a necessary requirement. Births in this pristine piece of porcelain are verbotten, but we will utilise the KEMH policy for 'unplanned' waterbirths. However we are still wondering when the powers that be will actually risk letting our labouring women get into the bath. It's been sitting there unused for some months now!! Merry Christmas to you too, and to all on the list Sue - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, December 21, 2006 8:33 PM Subject: [ozmidwifery] waterbirth Thank you all for your swift replies. I am supporting midwife who, as a midwife in homebirth, did lots of water births and was recently present at a water birth in a hospital where SHE supported the midwife who supported a woman's wishes for a water birth. As we have only 'accidental' water birth policies in WA hospitals, these midwives are being 'hauled over the coals' for not making the woman get out of the water to birth. Lots of intimidation going on. This will all help. Thanks and Merry Christmas, Mary M Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.5.432 / Virus Database: 268.15.15/581 - Release Date: 9/12/2006 3:41 PM
Re: [ozmidwifery] paed burn cream
SSD is silvazine. It comes (well used to anyway) in black tubes or big tubs. It had to be kept in the fridge and was a prescription drug. When a burn patient arrived in ED. The wound was cleaned then SSD applied, non stick dressing then bandage. We used to leave it for 24 -48 hrs, then take the dressing down, debride and reapply if necessary. It was used on adults as well as children. Hope that helps Melissa - Original Message - From: Kristin Beckedahl To: ozmidwifery@acegraphics.com.au Sent: Friday, December 08, 2006 7:22 PM Subject: RE: [ozmidwifery] paed burn cream I'm not sure..what is SSD cream? From: Rene and Tiffany [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] paed burn cream Date: Fri, 8 Dec 2006 19:55:04 +1000 Are you referring to SSD cream? René Tiff From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kristin Beckedahl Sent: Friday, 8 December 2006 4:37 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] paed burn cream I'm trying to find out the name of the burn cream used in paed (and maybe others) wards for childrens burns - apparently been around for years and really helps to rapidly heal the wounds?? Any idea? Thanks, Kristin Advertisement: Fresh jobs daily. Stop waiting for the newspaper. Search Now! www.seek.com.au -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. image001.jpg -- Join the millions of Australians using Live Search. Try live.com.au -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] getting synto etc
Hi Jo, I think it is not licenced for use for induction of labour with live babies in australia. It's ok for stillbirth induction and pph. Melissa - Original Message - From: Jo Watson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, November 15, 2006 5:33 PM Subject: Re: [ozmidwifery] getting synto etc From what I've heard, it is a drug not licensed for use in obstetrics (but it is used, obviously) ... I can't remember it's primary function though. And I can't be bothered googling right now. Jo On 15/11/2006, at 5:02 PM, meg wrote: I work at a major tertiary hospital-we stock misoprostil and use it with pph's so I think it is licenced. Meg - Original Message - From: Lisa Barrett [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, November 15, 2006 4:48 PM Subject: Re: [ozmidwifery] getting synto etc misoprostal isn't licenced here is Australia. I wouldn't be prescribing it if I were a GP. When I was Working at a private Hospital the Obs kept it in their own possesion. It isn't licenced to be kept at the hospital as far as I know. The pharmacy at the hospital wouldn't touch it. It's not the sort of drug you should have at a homebirth anyway. Lisa Barrett - Original Message - From: Philippa Scott [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, November 15, 2006 3:55 PM Subject: RE: [ozmidwifery] getting synto etc I am hoping to get a script for Misoprostal (sp) for my homebirth. Any ideas. Should I just ask a GP? What are they liable for if they do prescribe it. Cheers Philippa Scott Birth Buddies - Doula Assisting women and their families in the preparation towards childbirth and labour. President of Friends of the Birth Centre Townsville -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Robyn Dempsey Sent: Wednesday, 15 November 2006 12:10 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] getting synto etc Yes, the synto is about $100 a box. So what I do, is buy/pay for one box, which lasts for the next women ( does that make sense?), I only use Synto about once a year! ( and then there are the years you need it 3 times in a row!) Robyn D - Original Message - From: Jennifairy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, November 15, 2006 8:47 AM Subject: Re: [ozmidwifery] getting synto etc I have a few births at home coming up and was wondering about synto and other drugs in my kit. How do others purchase them? Do I have to have a script from a doctor? The other issue that I do find difficult is the issue of cost for homebirth.Others I have been involved in have been for friends and colleagues. Does anyone have a schedule of payment and cost that they use? I am meeting with a couple on Monday and would love to have a bit more idea. Any feedback will be greatly appreciated, Thanks Cath Had a client recently who I sent to her GP for a script for synt. She got the script, went to the chemist to fill it found it was going to cost her around $80 to get it - they only sold it in the boxes of five vials. I ended up asking around my MIPP friends managed to find some that way (dint need it anyway so its still in my fridge). If you give me your postal address Im happy to post some to you - my understanding is that its ok to keep it out of the fridge for a time. cheers -- Jennifairy Gillett RM Midwife in Private Practice Women's Health Teaching Associate ITShare volunteer - Santos Project Co-ordinator ITShare SA Inc - http://itshare.org.au/ ITShare SA provides computer systems to individuals groups, created from donated hardware and opensource software -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. __ NOD32 1866 (20061114) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Blood gasses( Long)
Thanks Mary for all your effort in finding these refs. Very useful. Melissa - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, October 24, 2006 8:06 PM Subject: [ozmidwifery] Blood gasses( Long) This Technical report covers fetal monitoring in a really comprehensive way. www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.section.700 Re blood gases, I promise not to bother you again, but still having difficulties finding recent studies. This first one appears to explain the process and meanings better than any other I have read. I excerpted some interesting points from the articles I read. MM 1. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 101:1054-1063, 1994 Umbilical Cord Blood Gas Analysis at Delivery: A Time for Quality Data. Jennifer A. Westgate, Jonathan M. Garibaldi, Keith R. Greene 2, Postpartum Determination of Umbilical Artery Blood Gases: Effect of Time and Temperature Moshe Manor, Isaac Blicksteina, Ynon Hazan, Orna Flidel-Rimon1, and Zion J. Hagay 1 Depts. of Obstet. and Gynecol. and Neonatol., Kaplan Hosp., 76100 Rehovot, Israel (affiliated with Hadassah-Hebrew Univ. School of Med., Jerusalem);a author for correspondence: fax 972-8-9411944, e-mail [EMAIL PROTECTED] Determination of cord blood gases and pH is recommended in all neonates with low Apgar scores to distinguish metabolic acidosis from hypoxemia or from other causes that might result in low Apgar scores (1). Although the metabolic acidosis found in cord blood is a poor predictor of long-term neurological injury (2), assessment of umbilical cord blood gas is helpful to exclude intrapartum or birth events that cause acidosis and serves as legal evidence against any alleged association with poor outcome (3). 3. Obstet Gynecol Clin North Am. 1999 Dec;26(4):695-709. Related Articles, Links Umbilical cord blood gas analysis. Thorp JA, Rushing RS. St. Luke's Hospital of Kansas City, Missouri, USA.Umbilical cord blood gas and pH values should always be obtained in the high-risk delivery and whenever newborn depression occurs. This practice is important because umbilical cord blood gas analysis may assist with clinical management and excludes the diagnosis of birth asphyxia in approximately 80% of depressed newborns at term. The most useful umbilical cord blood parameter is arterial pH. Sampling umbilical venous blood alone is not recommended because arterial blood is more representative of the fetal metabolic condition and because arterial acidemia may occur with a normal venous pH. A complete blood gas analysis may provide important information regarding the type and cause of acidemia and sampling the artery and vein may provide a more clear assessment. The sampling technique is simple and easily mastered by any treatment person in the delivery room. Preheparinized syringes ensure a consistent dose and amount of heparin. Depending on how normality is defined and on the population studied, normal ranges for umbilical cord blood gas values vary (see Table 1). In general, the lower range for normal arterial pH extends to at least 7.10 and that for venous pH to at least 7.20. Many different factors during pregnancy, labor, and delivery can affect cord blood gases. Umbilical blood sampling for acid-base status at all deliveries cannot be universally recommended because many facilities do not have the capabilities to support such a practice and in doing so may impose an excessive financial burden. Considering the costs, the accumulated published data, and the nonspecificity of electronic fetal monitoring in the evaluation of fetal oxygenation, it may be more rational to implement universal cord blood gas analysis. Care providers and institutions with the logistical capabilities in place should consider the cost efficacy of routine cord blood gas analysis because it is the gold standard assessment of uteroplacental function and fetal oxygenation/acid-base status at birth. 4. Umbilical Cord Blood Gas Analysis at DeliveryS F Loh, A Woodworth, G S H Yeo (research carried out in 1994. MM) Umbilical cord blood gas values reflect the last moment of fetal oxygenation and acid base balance prior to delivery. Severe fetal acidemia is associated with increased perinatal mortality and increased risk of subsequent impaired neurological develop In acute hypoxic insult of short duration, fetal and placental blood may not have sufficient time to equilibrate and this may be reflected in a large arterial-venous difference in BDecf. However, in long-standing hypoxic insult, lactic acid produced by the baby was given time to be removed across the
Re: [ozmidwifery] cord blood gases
Hi Shelley, I recently attended a advanced fetal assessment course at our tertiary hospital and all the pros for cord blood gases were presented. CTG's were discussed with pros and cons such as 80% show some abnormality but 80% of babies are not sick or acidotic. It was presented as one of certain diagnostic tools for fetal acidosis and therefore useful for litigation. You mentioned the results are inaccurate. I'd be very interested in hearing why they are inaccurate. We don't do them and I don't agree with routinely doing them so any more information would be helpful. Thanks Melissa - Original Message - From: michelle gascoigne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 10:39 PM Subject: Re: [ozmidwifery] cord blood gases Naomi In England we have seen in increase in 'fear' of litigation. Obstetrics in this country has always taken a huge chunk of the litigation for most hospitals . We now have in our country CNST (clinical neglegence scheme for trusts). Trusts are what groups of health care organisations are called. CNST is an insurance that Trusts pay into so that litigation claims can be paid when won. The CNST set out standards for trusts and depending on how well you achieve the standards determines the insurance premiums, which you can imagine are huge figures. The trouble is that CNST requirements for the standards to be met are not always sensible or in the best interests of women. Some standards like (cord blood sampling for ph post birth) are simply taken to record results in the notes which may protect against litigation in the future. I have a million issues with this practice! We had a university supervised professional debate about this issue in the Trust where I worked when it first became an issue. The midwives against and the Obs. for. We won the debate but the CNST requirements meant that we could save the Trust loads of money if we did them so they were introduced. Some of us still refused to do them. I would only do them if it was explained in full to the mother and father and they agreed. I gave it to them warts and all (like the obs openly admit that it is just to defend them in cases of litigation.). I did not make the decision the parents did. Needless to say when you tell them how inaccurate the results are and that neither they nor the baby will benfit from the results. Many choose not to have it done. I will search out my references and post them seperately. Our debate was published in a midwifery mag here! Shelly Midwife - Original Message - From: Naomi Wilkin [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 13, 2006 9:07 AM Subject: [ozmidwifery] cord blood gases Hi all, Just wondering how common it is for cord blood gases to be done in maternity units. I work in a small metro. hospital with a very busy maternity unit and our medical 'powers that be' are pushing for them to be done at every birth. Something we, the midwives, are very, very reluctant to do. I was also wondering if anyone knows of any research that may help us to prevent this from becoming a routine thing. Thanks Naomi. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.12.12/461 - Release Date: 02/10/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] doubles
I just seem to get two of Lisa's Melissa - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 14, 2006 4:16 PM Subject: [ozmidwifery] doubles I am receiving 2 of everyones emails. Is this happening to others or just me? MM
Re: [ozmidwifery] GBS and Staph
I thought group b strep and staph aureaus are different organisms? Staph infections on vaginal swab require no treatment or preventative abs in labour. Staph seems to have no effects on baby (that they haven't found out yet!) and it is a normal colonisation of the skin only becoming a issue in the sick, and immunocompromised. I not 100% sure and am getting ready for work so no time to look it up yet. (p.s sharon, where i work we use benzpennicillin 1.2grams then 600mg every four hours.) Regards Melissa - Original Message - From: sharon To: ozmidwifery@acegraphics.com.au Sent: Friday, October 06, 2006 6:35 PM Subject: RE: [ozmidwifery] GBS and Staph Thats right gbs is group b streph which is found on vaginal swab at 36 weeks treated with benzpennicillin during labour every 4 hours commencing with a loading dose of 3 gms then 1.2 gm every four hours while in active labour. Regards sharon From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ceri KatrinaSent: Friday, 6 October 2006 7:32 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] GBS and Staph Isn't GBS a staph infection??? Been awhile since I was at work, relishing in the time off work with little munchkin who is now 3 and bit months old.katrinaOn 06/10/2006, at 7:06 PM, Kelly @ BellyBelly wrote: One of the women on my site has just found out she has both of these things. She said she has googled for hours and cant find anything on Staph specifically. Can someone pass on some knowledge on what this is going to mean? I have never heard of someone having both before . Shes almost 38wks Best Regards,Kelly ZanteyCreator,BellyBelly.com.auConception, Pregnancy, Birth and BabyBellyBelly Birth Support
Re: [ozmidwifery] No Contractions
Hi all, I've just gotten home from work and I feel jinxed! I was caring for a very motivated primip who presented before I arrived at 1930hrs. She previously had phoned and presented earlier in the morning in early labour. When she came she was examined by the midwife and was contracting 4-5/60, palp LOP and 1/5 above brim. VE 6 cm and at spines. I arrived at 2130hrs and the obstetrician came to see her before he went to bed and he palped her and agreed and wanted a ARM. Anyway all was going well and she wanted Pethidine at 2330hrs(he told her you'd be stupid not to have pethidine as a first timer and the baby needs it as well because his head gets squashed! so the idea was firmly implanted) I examined her on the birth stool where she was labouring quietly and she was 7 cm, well applied, station +1, no moulding. We discussed ARM as ordered and she consented to it after the pethidine had taken effect. At 2400hrs contractions had slowed to 6-7/60 and she wanted the ARM at that time. ARM at 0030hrs. Her contractions became weak to moderate 6-7mins, and she was enjoying the rest so I let her be for 3hrs. At 0330hrs no pick up of contractions so I discussed with the doctor ?synto and he said no and her contractions will pick up eventually. I was thinking maybe but the longer she goes the higher the chances the following obstetrician at 0700 will do a C/S plus a few other warning signs! She was happy to following my suggestions and mobilise but she could only do it for short periods due to sheer exhaustion. When standing/ stool she had strong contractions with involuntary pushing, anal pouting etc, but back on the bed they virtually stopped. Due to the recent thread on this list I watched her fluid intake very carefully. At 0400hrs she had a total of 1800mls of H2O and lemonade. I even gave her a spoonful of honey! She was voiding well and no palpable bladder. Pushing became uncontrollable, show, anal dilation etc. I decided to recheck her cervix and she was still 8cm at 0500hrs, LOP and station +2-+3. I was faced with the dilemma of leaving her on the stool where she was having strong contractions but uncontrollable pushing or back for a lie down where the contractions would virtually stop. Anyway she was desperate for a rest and wanted to lie down. At this stage she was totally spent, physically and emotionally. Dr still wouldn't come to see her. New doc came on and examined her and said that the vertex was +3 but it was only moulding and the actual head was still5/5 abovebrim!! With a anterior lip no less (I don't know how with everyone independently agreeing that it was 1/5above in early labour) Down the corridor she went for a C/S for 'CPD and always to be a C/S' I feel strongly that she would have birthed beautifully with good contractions if something had been done earlier in the shift,when she had the strength, energy and motivation.I could find no cause for her stop/start labour and there were no signs of obstruction, no moulding etc. Sorry its so long but any thoughts? Melissa - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Friday, October 06, 2006 9:30 PM Subject: Re: [ozmidwifery] No Contractions I wanted to respond also about how sad I feel as a consumer that the hospital midwives must do the lesser of two evils. Sad for the midwives who have to practice this way as it must be so hard. Also sad for the families that use this system that they often dont get evidence based care or an expectant management approach because they dont have enough information to say actually I am not going to have either option, I want something different. If only they knew to ask is that really necessary? Why? Another reason to have a professional support person I suppose or a private midwife. What a terrible state of affairs we are in. I truly feel for all who are involved in this type of scenario as no-one gets to experience that birth in the way it was meant to be. Absolutely Philippa - this is the truth of the matter, women don't know that there IS another option, and we are caught between the rock and the hard place in trying to care for them. Sue PS - will try both the sugar water and the honey next time I have a slow labour :-) - Original Message - From: Philippa Scott To: ozmidwifery@acegraphics.com.au Sent: Friday, October 06, 2006 8:52 PM Subject: RE: [ozmidwifery] No Contractions I had a Sudanese client a while back whose other support person (another Sudanese woman) gave the client hot water with about 10 sugars in it. Traditionally they use a slightly different hot mixture she said, but boy did it pick up her contractions. This was her 3rd baby and third labour for this baby in 2 weeks. Fear played a big part in two labours
Re: [ozmidwifery] FYI news article
Yes, I liked the phrase "needed a caesarean". Just like the common one post NELUSC 'lucky we did that because the uterus was starting to thin' or 'very lucky because the cord was around the neck' ... u and? Sometime I worry that this culture that had been adopted of women 'unable' to birth and obstetric intervention has gone to far to stop or reverse. It is very depressing. Also I wonder if we have turned into a third world country with malnourished women who have rickets in their pelvises because of all the C/S for CPD, obstructed labour etc!!! Maybe I'm feeling particularly jaded because I did night duty last night and haven't slept, but I go to work prepared for battle! Melissa - Original Message - From: Tania Smallwood To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 20, 2006 11:30 AM Subject: RE: [ozmidwifery] FYI news article Hi Louise and others, No eating alive to be done from here J but I did want to comment on this one…the thing I think I find most offensive about all of this is that it just carries on the charade that the women are paying for, and therefore getting the ‘best’ care. Women have been conned into thinking that if they pay the highest fees for the PHI, and then pay the biggest gap payment for the ‘best’ obstetrician, go to the ‘best’ hospital, they will have the best, and therefore the safest birth. This plan just carries that little lie on, by drawing more women into the system, and into this one hospital in particular, when the cold hard reality is that less than one in three of them is going to give birth to their babies through their vagina anyway, and of those one in three, how many are going to be straightforward? My sources tell me that the c/s rate for primips is up around 70%...so how many women are going to be conned into thinking that they will get this great hotel stay, and then just be glad they were in the hospital to start with, because they ‘needed’ a caesarean… Just makes me sad Tania --No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.405 / Virus Database: 268.12.5/451 - Release Date: 19/09/2006 --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.405 / Virus Database: 268.12.5/451 - Release Date: 19/09/2006
Re: [ozmidwifery] midwives supporting homebirth being attacked
At the hospital I work at you have to write to and receive permission from the DON before undertaking employment outside the hospital!! Good grief, are we two and need permission to go outside and play? The notion that our lives outside of the hospital need to be sanctioned by a DON is appalling! Needless to say I have never written to the DON but many off the staff do Melissa - Original Message - From: Andrea Quanchi [EMAIL PROTECTED] To: ozmidwifery ozmidwifery@acegraphics.com.au; Maternity Coalition [EMAIL PROTECTED] Sent: Wednesday, July 12, 2006 6:33 AM Subject: [ozmidwifery] midwives supporting homebirth being attacked The last two days I have been trying to support one of our colleagues who is under attack. Anne Smith, whom many of you will know, had moved from Mildura where she had worked for many years at the hospital and attending home births, to Wangaratta to work in their community midwifery program which offers continuity of care to women so long as the give birth at the hospital. She has continued to attend home births since she moved. Last week one of the women who was attending the program decided she wanted to birth at home and so Anne documented this in her notes and informed the woman that she would no longer be eligible to attend the program for ante natal care as this is the accepted practice there. Subsequently Anne has been called to task by management because they felt that as she had agreed to attend the home birth for a woman who she had previously seen in the community midwife program there was a conflict of interest/. Yesterday she was presented with an ultimatum 1. resign, 2. be dismissed immediately or 3. promise not attend the home birth Anne felt she had no option but to resign and honour her commitment to the woman to be with her where she chooses to birth. Anne has now sacrificed he major source of income and the women of wangaratta wanting to attend the community midwife program a very experienced and passionate midwife. I know this email will be read by people who already get it so its a little like preaching to the converted but this will have an imapct, Most midwives in private practice dont have enough clients to do this as their sole source of income. Most country towns only have one hospital and if I could not supplement my income by working at the local hospital then I would probably have to move and this would deny homebirth with a midwife to women in the large geographical area that I cover. Wangaratta si no different and if midwives cant who offer home birthing as an option to women cant work at the hospital it is unlikely they will remain there fro long. The other thing they were suggesting is that once a woman attends the community midwifery program and meets the midwives she is bo longer able to choose to birth at home. When asked to sign a code of conduct at the hospital where you work make sure you read it. I did and refused to sign mine until they changed it as it said I had to ask permission from the DON before undertaking other employment. They tried to tell me that this didnt mean that I was reading too much into it and making a fuss over nothing but they eventually removed the clause from my document before I signed it but I know many of my colleagues weren't even aware that that clause was in there when they signed it. This was one thing that was put to Anne that the document she signed said she had to notify(might not be the right word) the hospital board were she undertaking other employment so read your appropriate document carefully as they are all derivatives of the same thing. IWe all think we are allowed to work where we want but it seems hospitals dont have the same opinion on this that we do. Of course it you want to work at another hosital that seems to be OK its only if you are doing something they dont want you to do that they will bring this up against you. Is this what the next round is about? Will other hospitals that employ midwives who also work outside the hospital try this one next. I suspect so. Be prepared. Andrea Quanchi -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Low liquor was Trial of scar
Title: Message I didn't think Lisa was dismissive of Gloria, and I thought she made a valid and well stated point, which has encouraged debate, discussion and further thought. Thanks Lisa - Original Message - From: Stephen Felicity To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 11, 2006 10:12 AM Subject: Re: [ozmidwifery] Low liquor was Trial of scar Lisa, "such a broad unsupported statement could lead a woman to believe that the current management of her pregnancy is incorrect because she read on this list of very experienced midwives and doulas that decreased liqour was only due to imminent labour." Well, since women aren't morons, and pregnancy is not really an issue of "management" but rather CARE and SUPPORT, I don't think we need to fear that a woman reading research, evidence and opinion and making her own decisionswill trulybe endangered by "a little bit of knowledge" - if she is able to enjoy true control of her own pregnancy and birth and receive true care and support. Besides which I personally find no flaw in Janet's reasoning and statement; it's accurate. And this is a consumer list as much as it is a Midwife and Doula list. "Mary I was not 'dismissing" the opinions of Gloria Lemay, and I am aware of her background." Gloria Lemay's wisdom, experience and evidence based knowledge is not "the opinion of an American Doula" (I don't know of many women with more claim to the title of MIDWIFE than Gloria!) - besides which, I'm intrigued as to why an American Doula's contributions would hold little weight anyway? If you ARE in fact aware of her background (as well as the fact that she can see and post on this list), I would have thought you would have at leastphrased your dismissal more respectfully. I also feel sad that wisdom, intuition, instinct and common senseare rejected and that Midwives will disregard the hard won wisdom of their own (Gloria made some colossal personal sacrifices in honour of TRULY being with woman and providing REAL support and care). Where is our respect for our real crones and our birthing women's innate wisdom? And I wouldn't "shoot an opinion from an Obstetrician down in flames" if that opinion was accurate, fair, woman-centered, evidence-based,and reasonable.
Re: [ozmidwifery] CTG stillbirth
Hi Michelle, CTG's have been proven to be very inaccurate, for various reason such as interpretation etc. In fact 80% of all CTG's will show some abnormality, which is staggering considering it is such a widely spread and heavily relied on tool. Why is it used?, because in most hospital's it is the best available. That is why some places are moving from CTG alone towards biophysical profiles in birth suite which is far more accurate. Often a suspicious CTG will be shown ok with BPP and the women is left alone without further interference and vice vera. Very sad.. - Original Message - From: Sadie To: ozmidwifery@acegraphics.com.au Sent: Saturday, May 27, 2006 5:38 PM Subject: Re: [ozmidwifery] CTG stillbirth CTG's can only reveal what is happening at that moment and are subjective to interpretation.Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is. Just my thoughts having been through a similar situation.. Sadie - Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Saturday, May 27, 2006 5:15 PM Subject: [ozmidwifery] CTG stillbirth Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal. To me it just proves again the unreliability of CTG's. Just interested in what others think. Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want!
Re: [ozmidwifery] RE:
Hi Amanda, I have worked places where they don't give Vit K until mum and baby have returned to the ward. They changed their practice so babies are not given any routine medication at all in birth suite (unless for resus) because their have been a few instances where baby inadvertently and tragically was given the mothers syntocinon. A way in this could happen is someone else prepared the synto, accidentally leaves it on the resus trolley. The primary midwife is unaware and gets her own synto and the second midwife thinks she is giving Vik K. Regards, Melissa - Original Message - From: Nicole Carver [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, May 26, 2006 6:35 AM Subject: [ozmidwifery] RE: Hi Amanda, Why not delay the Vit K and do both on day 1? We have just stopped giving vit K and weighing the babe in the birth suite so that there is less interruption to the early time between babe and parent/s and first breast feed. We generally give Hep B on day 2 or 3 if the parents want the babe to have it. Regards, Nicole. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Amanda W Sent: Thursday, May 25, 2006 8:11 PM To: ozmidwifery@acegraphics.com.au Subject: Hi all, I have just started working at a new health facility that tends to give hep B injections on day 2 or 3. I have come from a facility that gives hep B at birth when vitamin k is given. Can anyone shed some light as to why the might do it this way. Any articles. They seem to not know why they do it. I just want to change practice so that can be done at the same time as the vitamin k. Thanks. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] weight loss
Hi Sue, This particular lady had me stumped too! Good luck and let me what the outcome. Melissa - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, May 24, 2006 9:44 PM Subject: [ozmidwifery] weight loss Dear wise women I have been following a client on early discharge whose baby is losing weight. Now about 2 weeks old, I readmitted her on day 5 as bub was lethargic, had not had a bowel movement and had lost weight. She expressed, fed and topped up, bub 'woke up' and put on weight, started opening bowels and generally improved all round, went home again fully breast feeding, seems to have plenty of milk, plenty of wet nappies but again - no poo's, and on last 2 visits had lost weight, 50g then another 40g. Has not regained birth weight yet and does not seem satisfied despite frequent b/f. I will be seeing her again tomorrow and am frankly puzzled by this scenario. She is on medication herself for epilepsy (low dose Tegretol and another that I can't remember) and has been taking Motilium to boost supply. Any suggestions/comments? TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke
Re: [ozmidwifery] allergies and vaginal , c/section birth
I can't put my hands on it now but i know it does exist! I have read about increased risk of asthma and allergy with C/S, and also spoken with a paediatric allergist who also concurs. So it's out there! Perhaps a google search? Melissa - Original Message - From: islips To: ozmidwifery@acegraphics.com.au Sent: Tuesday, May 23, 2006 12:09 PM Subject: [ozmidwifery] allergies and vaginal , c/section birth Hi Everyone, I wonder if anyone has come across any research that looks at the mode of delivery and the incidence of severe allergies / asthma in these children. Thanks in advance Zoe
[no subject]
Hi all wise women, I know this is something already widely discussed, but at work this morning we were discussing redeveloping our breastfeeding policy. A hot debate occurred in relation to timing of the first breastfeed. In particular if the baby does not show interest in feeding in the first few hours, length of time before we start interfering. 6 hours was being tossed around before doing BSL's, NGT feeding, gastric lavage etc. I was wondering if anyone had any links or references at hand to support allowing the healthy term baby to go longer and to have his first breastfeed when he is ready. Thanks Melissa
Re: [ozmidwifery] working in a private hospital ?
Sorry Julie, having worked in a variety of private hospitals while doing agency work when I first moved to Perth I cannot give abalanced view. I work in a fairly midwifery orientated public hospital. Melissa - Original Message - From: Julie Garratt To: ozmidwifery@acegraphics.com.au Sent: Thursday, May 11, 2006 3:31 PM Subject: [ozmidwifery] working in a private hospital ? Dearwise women, I'm wanting to get an idea on what the disadvantages and benefits are to working in a private hospital . I must admit, as a direct entry midwife, I probably have a less than positive view of the private system having been told by lecturers that doing clinical placement there would be a waste of time. ( You become very "birth centric"' when you have to catch 40 babies to register). Ithink I'm asking for a balanced view here if one exists. Julie, longtime daily lurker :)
Re: [ozmidwifery] any benefit to teaching women self examination?
Hi Sue, I too have seen many transitional women at 3 or 4cm who birthed within in the hour! Melissa - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Wednesday, April 05, 2006 8:10 PM Subject: Re: [ozmidwifery] any benefit to teaching women self examination? I have long thought that transition phase has nothing to do with how many centimetres dilated a woman is, have been laughed at several times for suggesting that a woman was transitional at only 3cms, only to have a birth within 1/2 hour. Ihave known even very experienced midwives get VE's wrong - one memorable one was a woman who was supposed to be 'fully' and in reality had a posterior closed os, which had not been reached - the midwife was feeling the head stretching the anterior vag wall and had not felt back far enough to reach the os. Mistook the bulging anterior wall for an open cervix. Another who self-examined and got the stage correct (5cms) but entirely missed the fact that it was an undiagnosed breech! She just thought the baby was bald :-) Melissa - I agree that your own assessment at home was probably correct and can only assume that the admitting midwife made an error, but you own behaviour at that time was surely transitional! (still, a good story to dine out on !! :-)) For myself I found self examination quite easy but did not do it prior to going in- was most disappointed to be told I was only 5cms and not thinking that my labour was strong and that I was transitional - delivered 1 hour later, after self-checking and finding an anterior lip. I don't know how women not used to feeling their own bodies would fare - as student midwives we all found this to be one of the hardest skills to learn and it took many VE's before it clicked for me. Ina May Gaskin, and others also speak of cervix's actually 'going backwards' and I have seen this occasionally. Interesting thoughts Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Maxine Wilson To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 04, 2006 12:35 PM Subject: RE: [ozmidwifery] any benefit to teaching women self examination? Oh what a stressful experience I had something similar happen for my first vaginal birth (and labour) when I was examined I was only 3 but I thought I must have been 8 and felt really panicky and then within about 20 mins I was pushing and 15 minutes later my baby was born. But it was very disheartening thinking I didnt know where my body was at. I believe my VE was correct I was just having transitional type contractions with my cervix not far behind! It just reinforces the question of how useful is a VE? Maxine From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Melissa SingerSent: Tuesday, 4 April 2006 2:04 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] any benefit to teaching women self examination? Hi Maxine, This is my own personal experience with self examination. I'm a midwife of ten years working in a hospital setting (ie have done plenty of V.E's!!) and when I had my first baby just over a year ago I laboured at home from 11am until midnight when I did my own examination and I could have sworn I felt a 5 cm dilated cervix with bulging membranes. From there I decided to go to the birth centre which was 45min away. I had strong regular contractions but coping fairly well at home in the shower. My husband was asleep - typical! When I arrived the midwife examined me (I didn't tell her I had performed my own) and she said I had a posterior closed and uneffaced cervix. I was baffled aboutthe discrepancyand absolutely mortified I, as a midwife, had arrived to the birth centre so early. She suggested we go home so I did. I screamed all the way home, stayed there for 1/2hr anddecided if I had to go another 12hrs with this intense pain I needed drugs and drove the 45 mins back fighting the urge to go to the loo for a poo. Arrived and jumped in the bath a screamed out a baby girl. Much to the midwife's surprise! My husband told her the head was out. Anyway, I'm still not convinced her examination was right looking at the time line of events, but I was coping so well at home and when I was told I hadn't even started to efface yet I lost the plot! When I arrived back the midwife must have thought I still had ages to go because I didn't received one word from her, let alone reassuring, that
Re: [ozmidwifery] any benefit to teaching women self examination?
Hi Maxine, This is my own personal experience with self examination. I'm a midwife of ten years working in a hospital setting (ie have done plenty of V.E's!!) and when I had my first baby just over a year ago I laboured at home from 11am until midnight when I did my own examination and I could have sworn I felt a 5 cm dilated cervix with bulging membranes. From there I decided to go to the birth centre which was 45min away. I had strong regular contractions but coping fairly well at home in the shower. My husband was asleep - typical! When I arrived the midwife examined me (I didn't tell her I had performed my own) and she said I had a posterior closed and uneffaced cervix. I was baffled aboutthe discrepancyand absolutely mortified I, as a midwife, had arrived to the birth centre so early. She suggested we go home so I did. I screamed all the way home, stayed there for 1/2hr anddecided if I had to go another 12hrs with this intense pain I needed drugs and drove the 45 mins back fighting the urge to go to the loo for a poo. Arrived and jumped in the bath a screamed out a baby girl. Much to the midwife's surprise! My husband told her the head was out. Anyway, I'm still not convinced her examination was right looking at the time line of events, but I was coping so well at home and when I was told I hadn't even started to efface yet I lost the plot! When I arrived back the midwife must have thought I still had ages to go because I didn't received one word from her, let alone reassuring, that it was all O.K and I was nearing the end. Melissa - Original Message - From: Maxine Wilson To: ozmidwifery@acegraphics.com.au Sent: Tuesday, April 04, 2006 8:00 AM Subject: RE: [ozmidwifery] any benefit to teaching women self examination? Hi Julie an interesting concept and I have actually had this discussion before- Was it with you? I think as a student midwife that vaginal exams were one of the most difficult clinical skills to learn, because initially everything felt the same soft and squishy and it took a bit of experience to start to discern the different textures and landmarks. This may be different for other midwives though I may have been a slow learner!! Though it did seem pretty universal at the time I trained for it to be a skill that took some practice for us students ( oh poor women in teaching hospitals). Maybe teaching methods are different/better now. So my initial response is it may be hard for a woman to feel how dilated she is but the descent of the head may be easier for her to feel but not necessarily relevant if she was in early labour. I was a support person at a clients birth the other night and she spontaneously (ie noone suggested it) put her finger inside her vagina to feel where her baby was, she was in a bath and had slow progress when pushing so actually checked her own progress (descent of the head) and gave the midwife feedback. I am interested to see what others think. Maxine From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Julie ClarkeSent: Tuesday, 4 April 2006 6:51 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] any benefit to teaching women self examination? Hello. It seems that women admitted to labour wards in the latent phase of labour are more likely to have interventions, and up to 80% of women presenting can have admission delayed (Lauzon Hodnett 2001). I have sought information on how to determine the transitionfrom latent to active phase and it seems that themain physiological marker used in diagnosis is the dilatation of the cervix. I am wondering if there would be any benefit to teaching women self examination as a method of delaying admission. I would appreciate any feedback, comments, opinions,experiences. Thank you, Julie
Re: [ozmidwifery] PPH C/S
Maybe the thinking is should she have another large PPH there is already direct access to the uterus to clamp hemorrhaging vessels? It seems Obs are always suggesting a C/S for one reason or another. I think it is OK for her to say no, there are protocols and procedures to follow for anyone with high risk of PPH and usually if they are followed and she is birthing in a place where there is 24hr theatre immediately available it should be reasonable. But that said I don't know how large her previous pph's were, if she was compromise etc Melissa - Original Message - From: Nicole Carver To: ozmidwifery@acegraphics.com.au Sent: Saturday, April 01, 2006 4:44 PM Subject: RE: [ozmidwifery] PPH C/S Women also have PPH's at caesarean. Not sure if c/s would be safer. Perhaps she should see another ob for a second opinion. Nicole. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Kelly @ BellyBellySent: Saturday, April 01, 2006 4:27 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] PPH C/S Hello all, A woman on my forums has had two normal births of big babies 11lb3oz and 13lb5oz and had a PPH with both. Her Ob is now recommending a c/s with her third bub and wants a scan at 34 weeks as a deciding factor of this. She wants a normal birth is it okay just for her to say no without too much risk with PPH? Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
Re: [ozmidwifery] Inducing labour
Hi Kim, Given that the baby has to come early, I'd be inclined to introduce non-pharmacological methods of cervical ripening first. For example, evening primrose oil, acupuncture, sexual intercourse plus many of the other herbal remedies. Evening primrose oil, in my opinion only, works wonderfully to ripen the cervix. Most importantly I would ask her to examine her feelings towards birth, natural versus caesarian and help her resolve any fears and anxieties. She also really needs to ask herself is she ready emotionally for this baby to be born. I have seen this work wonders on post dates women who want to avoid induction. Often the big thing for them is fear of change in family dynamics which they have avoided but once they face them and resolve that fearthey start labouring!! But as I've stated that I have only used this method on term/post dates women. Hope this is helpful, Melissa - Original Message - From: Kim Hunter [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, March 29, 2006 1:29 PM Subject: [ozmidwifery] Inducing labour Hi everyone, I'd like to turn the tables and take off my List Admin hat and you all for a little assistance. I have a friend at college who is due to give birth to her second child in mid April. She has had a very bad time with all day sickness for the entire pregnancy and is at a point where all she wants is to get it out and has almost got to the point of booking a caesarean. Her first child was born by caesarean, so this idea doesn't seem to phase her, although I do get a sense that she'd like to have a natural birth this time round. The catch is it has to come early. Can anyone offer any suggestions or way to naturally bring on labour, so that a caesarean can be avoided. I have asked some of my lecturers about homoeopathics and herbal remedies and they have made the following suggestions that help only after labour has started. Cauloph 200 hourly to initiate labour if contractions are weak. or herbal partus preparation 2.5ml of this taken every hour during labour: raspberry leaf cramp bark motherwort sqaw vine wild yam Jasmine essential oil to the temples to give strong contractions. Jasmine, Clary Sage and Lavender essential oils to the temples on for pain relief. I am still looking into this but would appreciate any help you can offer. Warm regards Kim your friendly listadmin --- Kim Hunter List Administration Birth International ACE Graphics and Associates in Childbirth Education http://www.birthinternational.com/ [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] vasa previa
Hi Janet, I probably have seen about 10 unknown vasa previa post birth. All laboured without incident. Two of those werealso ARM's by doctors speeding up the birth process, and only realised oncethe placenta was delivered Very lucky doctors if you ask me! - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 20, 2005 1:26 PM Subject: Re: [ozmidwifery] vasa previa Thanks, Kate. It seemed extreme to me but it's really hard to find studies on. This is in the international foundation's website. They have forums too. http://ivpf.org/ J - Original Message - From: Kate Reynolds To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 20, 2005 4:07 PM Subject: RE: [ozmidwifery] vasa previa Hi Janet, Id be very surprised if the fatality rate is so high for undiagnosed vasa praevia. I have only ever seen one responsible for an FDIU at term when SROMd at home, and I have seen many placentae (?30 - 40) post-birth with massive vessels running through the membranes without incident. In many of those seen, the membranes tore all the way along side the edge of the vessel. I guess its a case of if we know about it, are we obliged to avoid any risk. I think the fatality stats are only relevant when the vessel actually tears but it would seem there are many that never rupture. I have also seen it successfully diagnosed once ruptured and saved by crash c/s on a couple of occasions (obviously in a tertiary referral delivery suite). Cheers, Kate
Re: [ozmidwifery] vasa previa
In one case where the doctor had performed a ARM, on checking the placenta the hole in the membranes was in between two vessels. The membrane was torn up to the vessels. http://pages.prodigy.net/nathanparis/vp.htm - Original Message - From: Ken WArd To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 20, 2005 6:23 PM Subject: RE: [ozmidwifery] vasa previa We are talking about blood vessels crossing in front of the baby's head, ie presenting. Blood vessels in the membranes aren't a big deal, but when they are presenting expect massive haemorrhage, as with placenta previa. Obliviously the cases cited were not vasa previa, or the vessel would have been torn -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Melissa SingerSent: Tuesday, 20 December 2005 8:18 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] vasa previa Hi Janet, I probably have seen about 10 unknown vasa previa post birth. All laboured without incident. Two of those werealso ARM's by doctors speeding up the birth process, and only realised oncethe placenta was delivered Very lucky doctors if you ask me! - Original Message - From: Janet Fraser To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 20, 2005 1:26 PM Subject: Re: [ozmidwifery] vasa previa Thanks, Kate. It seemed extreme to me but it's really hard to find studies on. This is in the international foundation's website. They have forums too. http://ivpf.org/ J - Original Message - From: Kate Reynolds To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 20, 2005 4:07 PM Subject: RE: [ozmidwifery] vasa previa Hi Janet, Id be very surprised if the fatality rate is so high for undiagnosed vasa praevia. I have only ever seen one responsible for an FDIU at term when SROMd at home, and I have seen many placentae (?30 - 40) post-birth with massive vessels running through the membranes without incident. In many of those seen, the membranes tore all the way along side the edge of the vessel. I guess its a case of if we know about it, are we obliged to avoid any risk. I think the fatality stats are only relevant when the vessel actually tears but it would seem there are many that never rupture. I have also seen it successfully diagnosed once ruptured and saved by crash c/s on a couple of occasions (obviously in a tertiary referral delivery suite). Cheers, Kate
Re: [ozmidwifery] level 2 midwives
Hi Alese, was referring to WA Melissa - Original Message - From: Judy Chapman [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, November 01, 2005 8:41 PM Subject: RE: [ozmidwifery] level 2 midwives As well, there are limited number of positions for NO2 so that many midwives who is able to care for complex care patients are restricted to NO1 positions purely because one does not get the position and hence pay, on ability but on the number of such positions avialable. Cheers Judy --- B G [EMAIL PROTECTED] wrote: Level 2 or Clinical Nurse (now known as Nursing Officer 2) midwives do not have to be shift coordinators. The position description (generic) primarily refers to a midwife (nurse) who is able to care for complex care clients. Unfortunately it is Queensland Health and managers who have added that aspect of co-ordinating shifts AND taking complex patient load AND having portfolio's as you describe. this is of course in your own time as there is never anytime allocated for off-line time to do these portfolio's If you look at the Nurses Award Qld and MX170 you will find full details of generic position descriptions. In our organisation NO1's co-ordinate as well even with a NO2 on the same shift. They actually get more money for it as it incorporates a 'in charge of shift allowance' NO2's don't get this. They also work in all areas you describe as these are not restricted to NO2's. I do not have on my name badge Clinical Nurse just Midwife. It is hoped with Peter Forster's review published 30/9 this whole workload and off-line time will be reviewed. Midwives who work in BC have their salary averaged (all penalties) and are paid at NO2 -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Alese Koziol Sent: Tuesday, 1 November 2005 5:20 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] level 2 midwives Thanks for the clarification Melissa, which state are you referring to? - Original Message - From: Melissa Singer mailto:[EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, November 01, 2005 4:37 PM Subject: Re: [ozmidwifery] level 2 midwives Hi Alese, Level 2 midwife (in a ward hospital setting) is the senior midwife on that shift who is responsible for the co-ordination of the shift as well as being a resource person for level 1 midwives. There is usually at least one on per shift. They also have portfolio's such as clinical indicators, best practice, equip etc. Other level 2 midwives are usually early discharge home visiting midwives, staff development midwives, midwives responsible for the co-ordination of ANC, childbirth classes and such. Midwives who work independently in birth centers here are also level 2's. Hope that helps Melissa - Original Message - From: Alese mailto:[EMAIL PROTECTED] Koziol To: ozmidwifery mailto:ozmidwifery@acegraphics.com.au Sent: Tuesday, November 01, 2005 12:47 PM Subject: [ozmidwifery] level 2 midwives Dear list Amongst the discussions recently there was mention of a 'level 2 midwife'. Could someone please enlighten me... which state was this terminology used for and what exactly is a level 2 midwife? Have a medico trying to bully us into using a policy which he has obviously 'borrowed' which also uses this terminology. It is not used in Victoria. Many thanks in anticipation Alesa Alesa Koziol Clinical Midwifery Educator Melbourne Do you Yahoo!? Find a local business fast with Yahoo! Local Search http://au.local.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] level 2 midwives
Hi Alese, Level 2 midwife (in a ward hospital setting) is the senior midwife on that shift who is responsible for the co-ordination of the shift as well as being a resource person for level 1 midwives. There is usually at least one on per shift. They also have portfolio's such as clinical indicators, best practice, equip etc. Other level 2 midwives are usually early discharge home visiting midwives, staff development midwives, midwives responsible for the co-ordination of ANC, childbirth classes and such. Midwives who work independently in birth centers here are also level 2's. Hope that helps Melissa - Original Message - From: Alese Koziol To: ozmidwifery Sent: Tuesday, November 01, 2005 12:47 PM Subject: [ozmidwifery] level 2 midwives Dear list Amongst the discussions recently there was mention of a 'level 2 midwife'. Could someone please enlighten me... which state was this terminology used for and what exactly is a level 2 midwife? Have a medico trying to bully us into using a policy which he has obviously 'borrowed' which also uses this terminology. It is not used in Victoria. Many thanks in anticipation Alesa Alesa KoziolClinical Midwifery EducatorMelbourne
Re: [ozmidwifery] Just a thought
I have the book on my shelf and it is interesting reading. I agree everyone should have a copy. Melissa - Original Message - From: Vedrana Valčić [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, September 10, 2005 1:18 PM Subject: RE: [ozmidwifery] Just a thought Thank you, Andrea! Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Robertson Sent: Saturday, September 10, 2005 6:11 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Just a thought Hello Vedrana, Marsden has written many articles -we have some on our website that you will find interesting. His book Pursuing the Birth Machine describes how the WHO came around to thinking that the obstetric model of care needed to be changed and the consensus meeting that established the standards of care set down by the WHO. His conversion to midwifery came about primarily through personal contact with midwives, mainly in Europe. As an epidemiologist he could see the sense in what they were saying and he set out to prove this through research etc. It is a great read, and has all the references etc that underpin the recommendations. As the publisher of Pursuing the Birth Machine (it is 10 years old now) we have a few copies left at a very good price. it is a book that everyone should have on their shelf, not only because of its now historical importance but also because the arguments are very eloquently put - a good example of how to tackle these arguments yourselves. More details are available here: http://www.acegraphics.com.au/product/ace/bk200.html Regards, Andrea At 07:52 PM 9/09/2005, you wrote: Marsden Wagner talks convincingly about his conversion. Where can I read about that? Vedrana - 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. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[no subject]
Hi all, I thought I'd share with you a ridiculous scenerio which happened at my work today. A woman who was having her fourth baby, three previous being vaginal births and one of which was a uncomplicated vaginal breech birth was booked for her first ELUSC for breech at 38 weeks. Upon looking through the notes the only options that were documented as being offered to her were C/S or "risky ECV". This baby was previously cephalic until 33/40, with only her last two visits showing a non engaged breech presentation. I surely hope they palpated her before performing the C/S today. Whats evenmore ridiculous is that she had her previous babies at our hospital under the same obstetricians as today. Our obstetricians are very experienced and in the past routinely did vaginal breech births, with a couple still doing them. This poor lady had simply gone to the wrong clinic day and seen the wrong obstetrician for her! Her other three babies were all born within the last five years! Times are changing fast!
Re: [ozmidwifery] Re:
Hi Sue,
Couldn't but wonder what would of happened if she
went to Dr W clinic day?
- Original Message -
From:
Susan
Cudlipp
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, August 31, 2005 8:38
PM
Subject: [ozmidwifery] Re:
Hi Melissa (only just worked out the surname
:-))
Yes, happened today - how sad.
Also today we saw a multi 10 wks post partum with
RPOC post emergency C/S for breech at 36 weeks. This particular lady had
vaginal breech with no.1, I delivered no 2 (SVD), and then, as you say - came
into labour on 'the wrong day' with no 3!
There have been several incidents of what would 5
years ago been considered to be 'good' breech presentations in multis, being
rushed off to theatre in established labour, ( I remember one who was at least
7cms) justified by that accursed so-called breech trial! Really
sad how the skills to deliver well positioned breech births are no longer
taught or used.
Did anyone else catch the 7 news last night? A
small story on a 23 week bub who had done very well, however they did state
that she had been one of twins, the other having died (or been terminated??
due to complications - sorry, a bit vague on that bit, kids making noise at
the time)
BUT the bit I did catch was that she had had to
have a C/S at 23 weeks because the 'placenta was growing through a previous
C/S scar'
I find it very interesting to read the recent
VBAC recommendations and guidelines given to women -states
clearlythat VBAC is in many cases preferable to repeat C/S - so why are
they so keen to do the C/S in the first place
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"Edmund Burke
- Original Message -
From:
Melissa Singer
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, August 31, 2005 5:22
PM
Hi all,
I thought I'd share with you a ridiculous
scenerio which happened at my work today. A woman who was having her
fourth baby, three previous being vaginal births and one of which was a
uncomplicated vaginal breech birth was booked for her first ELUSC for breech
at 38 weeks. Upon looking through the notes the only options that were
documented as being offered to her were C/S or "risky ECV".
This baby was previously cephalic until 33/40,
with only her last two visits showing a non engaged breech
presentation. I surely hope they palpated her before performing the
C/S today.
Whats evenmore ridiculous is that she had
her previous babies at our hospital under the same obstetricians as
today. Our obstetricians are very experienced and in the past
routinely did vaginal breech births, with a couple still doing them.
This poor lady had simply gone to the wrong clinic day and seen the wrong
obstetrician for her!
Her other three babies were all born within the
last five years!
Times are changing fast!
No virus found in this incoming message.Checked by AVG
Anti-Virus.Version: 7.0.344 / Virus Database: 267.10.17/85 - Release
Date: 30/08/2005
Re: [ozmidwifery] BF video
Judy, Can I have a copy too? [EMAIL PROTECTED] Thanks! - Original Message - From: Päivi [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, August 27, 2005 5:24 AM Subject: Re: [ozmidwifery] BF video Yes please, [EMAIL PROTECTED] Thank you : ) Any more takers for this one??? It will take a while for me on my slow line to upload. I will try to get on line about lunch time tomorrow to send to those who say. Cheers Judy --- Kate /or Nick [EMAIL PROTECTED] wrote: Ditto please Kate [EMAIL PROTECTED] - Original Message - From: Denise Hynd To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 25, 2005 6:15 PM Subject: Re: [ozmidwifery] BF video Judy can you send it to me? Thank you [EMAIL PROTECTED] Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: Judy Chapman To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 25, 2005 3:35 PM Subject: [ozmidwifery] BF video I have just been sent a hilarious video (2MB). Mum doing a yoga handstand, baby crawling and knows where the good stuff comes from... Need I say more. What a laugh. On a par with one of my bellydance mates who is still BF a 2 yr old. 10 min prior to performance it was a loud Titta, Mum, Titta and when side one was finished Other side Mum, other side. God love 'em. Cheers Judy --- - Do you Yahoo!? Messenger 7.0: Make free PC-to-PC calls to your friends overseas. You could win a holiday to see them! --- - No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.15/81 - Release Date: 24/08/2005 Do you Yahoo!? Make free PC-to-PC calls to your friends overseas. You could win a holiday to see them! http://au.docs.yahoo.com/promotions/messenger/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.15/81 - Release Date: 24/08/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Midwives clinic
I think midwives clinics (in hospitals) are invaluable in restoring women's confidence in midwives as the primary care-giver in labour and birth. Women (and their supports) who primarily see doctors in their pregnacy often are always asking when's the doctor coming? Unfortunately going to see a doctor is often associated with an abnormal event therefore pregnancy and birth is as well. Having midwives clinics, even if the caregiver's in labour are different, helps foster a sense of normalcy for the women. Were I work I have seen an enormous shift in this attitude with the women and their families as antenatal care who shifted from all obstetric care to a mixture of both with most antenatal care by the midwife. Melissa - Original Message - From: Ken WArd [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, August 07, 2005 4:58 PM Subject: RE: [ozmidwifery] Midwives clinic Even if they do see different midwives during the pregnancy, it still helps when they come in. Having worked in small units I know that there are only so many staff to meet. In my last position women could ask for a specific midwife to 'go on call' for them. Most of the women were happy to have who ever was on. Of course there was a few who requested NOT to have certain midwives, this also catered for. Our -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Andrea Quanchi Sent: Sunday, 7 August 2005 2:28 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Midwives clinic Alan are you offering continuity of carer or an alternative to the obs and then they still get a different midwife in labour. In Echuca they started a midwife clinic that offers shared care b/w the GP/obs and the midwife clinic but it in fact means that instead of having their antenatal care by one person they now have it by at least three. And then they just get who ever in labour as well. If you are offering continuity of carer then this is what you can sell and it will be attractive to the women. Otherwise sell the things you are offering that they dont get from the Ob. On time appointments, longer appointments etc. In the country the bush telegraph is still the best source of information so get women talking about it and a mail out to known pregnant women, notices or poters in child care centres, kindergartens etc saying 'Do you know someone who is pregnant tell them about the new choices that they have Good luck but keep pushing for a caseload if you dont have one its great ANdrea Quanchi On 07/08/2005, at 11:16 AM, Alan Rooney wrote: Advice needed I work in a small hospital in western NSW and we are about to start a Midwives clinic. The 2 obs in town are supporting us in this venture but I need some suggestions on how to inform the women of the town why they should choose the Midwives clinic and not visit the obs surgery, but I would like to do this without offending the obs. I would like to put this information in a pamphlet in all the Docs surgeries in the town. Any ideas would be appreciated. Also if anyone has research articles on this subject I would appreciate them. off list email [EMAIL PROTECTED] Thanks Alan. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Thrush Treatment
Hi Jo, I hae my first baby 11 months ago and had a easy time with breastfeeding - no cracked grazed nipples. She attached easily right from the first feed. After about two weeks I developed pain deep in my right breast. It woke me up at night with a hot stabbing pain. It felt like someone had shoved a fire poker in their and then twisted it around. I have never experienced this intensity of pain before. Still my nipples looked fine and unchanged. I started to get a feeling of glass shards passing through the ducts as my breast was filling and emptying. My baby also developed thrush in her mouth after I started experiencing this. I tried the dactarin gel for 3 weeks for myself and the baby with no improvement. I went to the GP as I wasn't sleeping very much due to the pain and of course the new bub. Fortunately she was very sympathetic and gave me a script for oral systemic Nilstat. This worked a treat! She said that the general consensus in the medical field was thrush in ducts was a myth but she was a bit dubious of this as she actually listened to what the women were telling her. My GP and myself are still in the dark as to how I got thrush in the ducts, but it must of been because the treatment was so effective. I hope this is helpful to you because I certainly couldn't have lived with it because it was so painful. Melissa - Original Message - From: JoFromOz [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, August 05, 2005 11:33 AM Subject: spam: [ozmidwifery] Thrush Treatment ... I still have thrush. We've been treating for the last 3 weeks, and it seems to have (?mostly) gone from my actual nipples, but it is still definitely in my ducts. I am having trouble getting a prescription for Fluconazole (Diflucan) as is recommended, as the drug isn't actually authorised for breastfeeding. It is needed on an authority script because it's hundreds of dollars. I got a breastmilk sample sent off the other day to try to culture the candida, but due to the properties in BM, I doubt it will show up anything. I read on Dr Hale's site that he doesn't actually believe in ductal thrush, and says this: Some of us in this field are wondering if this intense pain could be neuritis or neuopathic in origin, following nipple trauma of some sort. But no one really understands the origin of this pain. So, should I just suck it up and get on with it, or follow up on the diflucan? From what I've read, the symptoms I have are from thrush: Deep breast pain with onset towards the end of a feed or beginning after a feed and lasting up to an hour (or more at times); Worse at night; sometimes radiates into my sternum. One nipple is intact and has been for WEEKS now, but at night it does hurt to feed more. The other nipple that was almost missing has come back and is almost healed. It too, hurts more at night, sometimes burning after a feed (both of them) for a good 1/2 hour. Does anyone have any experience with this? MM sent me some info saying that Diflucan is the drug of choice for this, but if I can't get it prescribed because it's not authorised, is there any other choice apart from living with it? Thanks :) Jo (mum to Will, 10 weeks old today) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] intermittent auscultation
So true Sue!! - hung out to dry then burnt at the stake! - Original Message - From: Susan Cudlipp [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, July 30, 2005 7:23 PM Subject: Re: [ozmidwifery] intermittent auscultation This is so true. We constantly have to justify our belief in the natural process of birth and should a mishap happen in midwifery care, the midwife is all but burnt at the stake. By contrast, most hospitals have regular mortality meetings to discuss medical mishaps, these are in house and only for the purpose of medicos discussing amongst themselves. The results are not for sharing with midwives or any other interested parties. I often wonder why it is that so much utter stupidity becomes common practice - not only in medical circles - and yet the common sense approach is ignored, riduculed or just not taken seriously. Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, July 30, 2005 9:33 AM Subject: Re: [ozmidwifery] intermittent auscultation I notice that it is expected that Midwives base their practice on evidence research. It would appear on the other hand that the medical profession are able to practice on whatever they believe. They do not feel obliged to justify their preference or practice. Why is this so? Why are midwives always feeling they must justify themselves? Why do you allow it ? Who in fact are we accountable to in real life? Our clients, ourselves our peers only ? Or ..?? Brenda - Original Message - From: Mary Murphy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, July 30, 2005 11:15 AM Subject: RE: [ozmidwifery] intermittent auscultation Pete, the only problem is that the somebodies, in positions of power, have set a standard that a reasonable midwife has to adhere to, or suffer the consequences if there is an adverse outcome, ie, a dead or compromised baby. Also, when one is employed by the Govt. there is an expectation that the standard will be adhered to. There was not extensive trials or even large scale retrospective research to compare 1/2 hrly or 1/4 hrly to continuous EFM. Unfortunately, common sense does not prevail.When we don't have the midwifery research knowledge to back it up, we have no other choice. I wish it were otherwise, MM se- d-oes -n--Original Message- Sally I agree with what both you and Gloria are saying, with a low risk women term and all progressing well in labour where is the evidence to support any auscultation, I also believe that it can he horribly invasive and could easily be construed as intervention. Surely as professionals we can use our skills to make the call on whether auscultation is needed or not. I also believe that there can be a lot of angst built up over listening too often in what in most situations is the normal physiology of 2nd stage. yours in midwifery pete malavisi On Fri, 29 Jul 2005 16:24:32 +0800, Sally Westbury [EMAIL PROTECTED] said: OK. What the Nice Guideline have based the bulk of their guideline on are the following three studies. All of these studies have randomized high and low risk pregnancies. I would like to propose that the auscultation intervals set are reflective of a lack of risk screening. I would like to us think about is whether it is appropriate to try to translate these auscultation interval to a low risk client group?? What do other people thinks?? Efficacy and safety of intrapartum electronic fetal monitoring: an update SB Thacker, DF Stroup, and HB Peterson STUDY SELECTION: Our search identified 12 published RCTs addressing the efficacy and safety of EFM; no unpublished studies were found. The studies included 58,855 pregnant women and their 59,324 infants in both high- and low-risk pregnancies from ten clinical centers in the United States, Europe, Australia, and Africa. DATA Vintzileos, A. M. et al. 1993. A randomized trial of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation. Obstetrics Gynecology 81:899-907. METHODS: The study was conducted simultaneously at two university hospitals in Athens, Greece (Alexandra and Marika Iliadi Hospitals) from October 1, 1990 to June 30, 1991. All patients with singleton living fetuses and gestational ages of 26 weeks or greater were eligible for inclusion. The participants were assigned to continuous EFM or intermittent auscultation based on the flip of a coin. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit
Re: [ozmidwifery] triplet birth
Hi Wendy, I have onlybeen present at 26week triplet vaginal birth about 6 years ago. The triplets obviously needed nursery time and ventilation but no complicationsduringthe actual birth process. Surely some of the risks (cord involvementetc) with vaginal triplet birth are the same preterm or term? Thanks Melissa - Original Message - From: wendy hoey To: ozmidwifery@acegraphics.com.au Sent: Thursday, July 28, 2005 9:42 AM Subject: [ozmidwifery] triplet birth Hi all, have been lurking fora while, love the interesting discussions, thankyou.I'm a married mum of two and hospital midwife by convenience. Anyway, at work last week a woman came in at 32 weeks , triplets, in good labour at 7 cm, all head down, off to her c/s asplanned with a huge amount of fuss, mum stressed out to the max. Iunderstand all the risk factors and the reasons for a c/s ( prem as well)just wondered if anyone out there has been at a triplet vaginalbirth in Australia? Despite the risks I just had thisbig gut feeling that everything would have been all right. The babies were all fine except the third who needed a bit of CPAP once they got into the nursery. My Auntie had a vaginal birth of triplets in a community hospital in Perth in 1979, she's vague on the details but all was OK with the boys. thanks Wendy.
Re: [ozmidwifery] Things/g. Lemay
Gloria, No pulsating cord, HR 1, relex 1, colour 1? Active resuscitation commenced at birth. Melissa - Original Message - From: Gloria Lemay To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 19, 2005 3:11 PM Subject: Re: [ozmidwifery] Things/g. Lemay did you have a pulsing cord, Melissa? what did the baby get 3 for at one min? Gloria - Original Message - From: Melissa Singer To: ozmidwifery@acegraphics.com.au Sent: Monday, July 18, 2005 7:04 PM Subject: Re: [ozmidwifery] Things/g. Lemay Last week I attended a birth with mentum anterior (diagnosed on view). Head was born then 3 minutes later the rest of the baby. Apgars 3, 5, 7, 7. Wt 4.7kgs, peri intact. Why were the apgars at birth so low (no heart rate at all when born) and the fetal heart rate had been fine during her rapid labour and second sage and some baby's sit there for seven minutes without a problem? Melissa - Original Message - From: Tania Smallwood To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 19, 2005 5:53 AM Subject: RE: [ozmidwifery] Things/g. Lemay Well it must have been the moon then last Friday my colleague and I went to see a woman for an antenatal appt, all well at 39 weeks, and then 30 minutes later SROM while we were on our way to the next appt, 40 minutes of labour, hubby rushing through the door, no equipment, kids scissors boiling in a pot on the stove, cord ties thrown together with embroidery thread, baby born in the spa! Lovely, but what a rush for all! Tania x From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Gloria LemaySent: Tuesday, 19 July 2005 3:25 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Things/g. Lemay Congratulations, Mary! Last Thurs night I attended a face presentation where the little mentum anterior face/head just sat there turning purple for way longer than I needed. Same thing, tincture of time and it rotated and squooshed into Dad's hands with only 1/2 inch tear. That must have been some crazy midwife moon! Gloria - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Monday, July 18, 2005 5:24 AM Subject: [ozmidwifery] Things/g. Lemay Hi Gloria, remember I said I would ask the mother about posting her C/S Lotus Placenta on Midwifery Today? She said it is fine with her.// Re the delay with the head before birth of the body? Lieve said it might be the moon? A week ago I was 2nd midwife at a lovely home waterbirth and guess what? Babys head was born and 7 minutes later the body was born with the next available contraction. It did seem like a long time and the primary midwife and I had to hold our mouths shut so we wouldnt do the just give a little push instruction. All well. No need to do anything except talk to the baby. Cheers, MM
Re: [ozmidwifery] Things/g. Lemay
Last week I attended a birth with mentum anterior (diagnosed on view). Head was born then 3 minutes later the rest of the baby. Apgars 3, 5, 7, 7. Wt 4.7kgs, peri intact. Why were the apgars at birth so low (no heart rate at all when born) and the fetal heart rate had been fine during her rapid labour and second sage and some baby's sit there for seven minutes without a problem? Melissa - Original Message - From: Tania Smallwood To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 19, 2005 5:53 AM Subject: RE: [ozmidwifery] Things/g. Lemay Well it must have been the moon then last Friday my colleague and I went to see a woman for an antenatal appt, all well at 39 weeks, and then 30 minutes later SROM while we were on our way to the next appt, 40 minutes of labour, hubby rushing through the door, no equipment, kids scissors boiling in a pot on the stove, cord ties thrown together with embroidery thread, baby born in the spa! Lovely, but what a rush for all! Tania x From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Gloria LemaySent: Tuesday, 19 July 2005 3:25 AMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Things/g. Lemay Congratulations, Mary! Last Thurs night I attended a face presentation where the little mentum anterior face/head just sat there turning purple for way longer than I needed. Same thing, tincture of time and it rotated and squooshed into Dad's hands with only 1/2 inch tear. That must have been some crazy midwife moon! Gloria - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Monday, July 18, 2005 5:24 AM Subject: [ozmidwifery] Things/g. Lemay Hi Gloria, remember I said I would ask the mother about posting her C/S Lotus Placenta on Midwifery Today? She said it is fine with her.// Re the delay with the head before birth of the body? Lieve said it might be the moon? A week ago I was 2nd midwife at a lovely home waterbirth and guess what? Babys head was born and 7 minutes later the body was born with the next available contraction. It did seem like a long time and the primary midwife and I had to hold our mouths shut so we wouldnt do the just give a little push instruction. All well. No need to do anything except talk to the baby. Cheers, MM
