Re: [ozmidwifery] Obs first visits
In Mareeba the women are booked under the Midwife's name. I guess it takes a long time to change. We are not rocking the boat right now as what we are doing is very different to what most of the rest of Qld does and we are just too happy to still be alive. Working with the OB's in Cairns is one of the conditions of our survival. Cheers Judy --- wump fish [EMAIL PROTECTED] wrote: It is very depressing to hear that even when women have midwifery-led care they either have to see a dr or have their notes reviewed by a dr. As midwives we are the experts in normal and competent at identifying when things are high risk or becoming abnormal. Why the hell do the drs waste their time 'checking' notes incase we have missed something? Is it because the women are booked under their name, therefore they think they are responsible for a stuff-up? In the UK low risk women were booked under their mw's name unless there were problems. We would get into serious trouble if we had missed something and it resulted in a poor outcome (very very rarely happened). Responsibility goes hand in hand with autonomy. Rachel _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Do you Yahoo!? Yahoo! Photos: Now with unlimited storage http://au.photos.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Obs first visits
Where I worked (birth centre) the women saw a GP early on and was only referred for further visits if a problem developed or she went past 41 weeks. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Sonja BarrySent: Saturday, 22 October 2005 11:02 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Obs first visits Dear all, I am hoping for some information about midwifery/maternity units that don't require women to be seen by an obstetrician at any stagethroughout their pregnancy. Info I need is do the midwives listen for heart sounds etc, do they see a GP, or is this all quite irrelevant and thus no needs to do any of these checks? Some places call this a first visit, whilst others may use these checks to "allow" women access to birth centres etc. I hope this makes sense. Regards Sonja
RE: [ozmidwifery] Obs first visits
Not sure if this is relevant to your question. I worked ( both in-house and attached) to a large regional referral unit with 5000 births per year. Women would book in the community with the midwife or team at their local GPs. All care would be led by the midwives. Any problems and the women would be referred to the relevant specialist obs, eg. haematology, drug dependency etc. A low risk woman could get through her entire pregnancy and postnatal period without any contact with a dr. She would be offered an appt at 36wk with her GP. Often they didn't want it, so didn't make the appt. It worked the opposite way to Australia. Midwives were trusted to determine if a woman needed to see a dr - not the dr determining if she could have midwifery-led care. As for antenatal examinations and visit scheduling- we followed NICE guidelines, but adapted it to the individual woman. Women would often want to hear the FH - so we did it for her. Some women needed more visits for emotional support etc. So, it can be done. Where there is a will there is a way. I think in Australia you will find it very difficult to prise the drs fingers off the control button. We had a few problems with GPs. They got irritated that the women did'nt bother to see them at 36wks (it was up to the women to book the appt). The GPs liked to 'touch base' with them because they would be providing care for the new family in the future (fair point). But, the women obviously didn't feel they needed to 'touch base'. Rachel From: Sonja Barry [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Obs first visits Date: Sat, 22 Oct 2005 11:02:03 +1000 Dear all, I am hoping for some information about midwifery/maternity units that don't require women to be seen by an obstetrician at any stage throughout their pregnancy. Info I need is do the midwives listen for heart sounds etc, do they see a GP, or is this all quite irrelevant and thus no needs to do any of these checks? Some places call this a first visit, whilst others may use these checks to allow women access to birth centres etc. I hope this makes sense. Regards Sonja _ MSN Messenger 7.5 is now out. Download it for FREE here. http://messenger.msn.co.uk -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Obs first visits
At Mareeba the women are not seen by an OB. They are supposed to have just one visit sometime with a Dr to check they are normal healthy but that does not always happen. All charts are case conferenced with the supporting OB and suggestions for care are discussed if there is anything out of the ordinary in their history and it in then that they are classed as fit to birth with us or needing to go to Cairns. Cheers Judy --- Sonja Barry [EMAIL PROTECTED] wrote: Dear all, I am hoping for some information about midwifery/maternity units that don't require women to be seen by an obstetrician at any stage throughout their pregnancy. Info I need is do the midwives listen for heart sounds etc, do they see a GP, or is this all quite irrelevant and thus no needs to do any of these checks? Some places call this a first visit, whilst others may use these checks to allow women access to birth centres etc. I hope this makes sense. Regards Sonja Do you Yahoo!? The best of Hasselhoff on the web - Hoffice Attachments! http://au.news.yahoo.com/attachments/hoffice_attachments.html -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Obs first visits
Where I work women are booked in by midwives. There are about a thousand questions asked, covering physical, medical, gynaecological, obstetric, social and psychiatric history and a check of weight and height and BMI. Models of care are discussed at this appointment which is purely administrative. The choices are: midwives clinic, team midwifery programme, doctor's clinic, high risk doctor's clinic,GP shared care and private obstetric care. If the woman chooses (and there is room available) to go to the midwives clinic/ TMP they do not see a doctor unless the midwife identifies problems. All women not going to a private OB have a risk assessment file review within a couple of weeks of booking in but this involves the registrar looking over the file only. There is no listening to FHR at this appt. Women have previously been to GP to get a referral to book in. Many have had an early USS. They are offered a dating USS if haven't already had one, given forms for booking in bloods if not already done and as many of our women book in around 20 weeks they are offered morphology scans. The waiting list in house for these is many weeks so often they are advised to have them externally. If there is indication for Amnio or mother requests it that would be an indication for referral to obs. registrar or consultant to discuss. The regime for ANC has recently changed here and it is now, roughly: Book in about 12-14 weeks. Next visit (or book in) around 20 weeks. " " about 26 weeks. " " " 32 then 36 then 39/40 then 41 assess Cx at this visit, offer IOL from 41+3. This is probably way more information than you wanted! Hope it helps. Monica - Original Message - From: Sonja Barry To: ozmidwifery@acegraphics.com.au Sent: Saturday, October 22, 2005 11:02 AM Subject: [ozmidwifery] Obs first visits Dear all, I am hoping for some information about midwifery/maternity units that don't require women to be seen by an obstetrician at any stagethroughout their pregnancy. Info I need is do the midwives listen for heart sounds etc, do they see a GP, or is this all quite irrelevant and thus no needs to do any of these checks? Some places call this a first visit, whilst others may use these checks to "allow" women access to birth centres etc. I hope this makes sense. Regards Sonja
Re: [ozmidwifery] Obs first visits
It is very depressing to hear that even when women have midwifery-led care they either have to see a dr or have their notes reviewed by a dr. As midwives we are the experts in normal and competent at identifying when things are high risk or becoming abnormal. Why the hell do the drs waste their time 'checking' notes incase we have missed something? Is it because the women are booked under their name, therefore they think they are responsible for a stuff-up? In the UK low risk women were booked under their mw's name unless there were problems. We would get into serious trouble if we had missed something and it resulted in a poor outcome (very very rarely happened). Responsibility goes hand in hand with autonomy. Rachel _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Obs first visits
At King Edwards birth centre the GP/OB review the notes only at 36 weeks. Sally Westbury Homebirth Midwife Learn from mothers and babies; every one of them has a unique story to tell. Look for wisdom in the humblest places - that's usually where you'll find it. Lois Wilson
