Re: [ozmidwifery] IOL and C/s...

[mh]

- Original Message - 
From: Sally-Anne Brown

To: ozmidwifery@acegraphics.com.au
Sent: Tuesday, September 13, 2005 7:37 AM
Subject: Re: [ozmidwifery] IOL and C/s...

-snip-
They have studied two groups a) IOL and b) spontaneous labour.  The results 
show a slight difference in the two groups of about 1.5% higher in the IOL 
group compared with the spont labour group. In both groups the results show 
(approx) 60% c/section rate - not the 30-50% c/section rate often spoken of.

-snip-

Have I understood this correctly? In this study, women who are induced *and 
have an EDB* have a 60% c/s rate?? I find this mind boggling.


I work in a tertiary hospital with many high risk pregnancies, in the 
Delivery Suite. Our statistics are (from memory, I don't have them at home) 
80% of primips overall(spontaneous and IOL) choose to have EDB. Overall, 60% 
normal birth, 29% LSCS, others instrumental, primips. This includes elective 
C/S for breech etc. That's not exactly correct but pretty close. I thought 
these figures were bad. How do they get such a high c/s rate just from EDB? 
Or have I misunderstood?

Monica


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RE: [ozmidwifery] IOL and C/s...

[Dean & Jo]

Tania, but you did hear BP say that there is no collection of cs rates
and failed inductions...remember it is considered the womans fault ie
FTP if an induction fails and results ina  cs...
Perhaps write to the pregnancy outcomes uinti and ask them for the data?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Tania
Smallwood
Sent: Monday, September 12, 2005 8:52 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] IOL and C/s...


Hi Belinda,
Is this stat published anywhere, or just anecdotal?  A 60% section rate
is twice the rate for the state, and I think twice the average for that
hospital too, and having just heard a leading obstetrician there tell
women that there is NO risk of an increase in c/s as a result of
induction, I'm trying to get my head around it...

Tania
x

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Belinda
Sent: Tuesday, 13 September 2005 12:06 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] IOL and C/s...

Tania, at the wch the stats are - for primip women indcued before 41 
weeks there is a 60% cs rate.
Belinda

Tania Smallwood wrote:

>  
>
> Just wondering if there are any good quality trials about IOL and
> increase of c/s?  Have just re-read Enkin, and it does state that IOL 
> is not associated with an increase in caesarean section rate (but 
> given that most states here are up around the 30% mark, you have to 
> wonder what they are comparing that to?), but I thought something came

> out of the Uk not long ago disputing this?
>
>  
>
> Anyone?
>
>  
>
> Tania
>
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Re: [ozmidwifery] IOL and C/s...

[Janet Fraser]

 BUT we can safely say to women now - two 
Australian studies have identified that whether you have IOL or not there is a 
60% chance of having a c/section with epidural block.
 
I would really love the details of both of 
these. I can wait for the yet to be released ; ) but do you have a link to the 
Tracy one?
 
TIA
J

RE: [ozmidwifery] IOL and C/s...

[Tania Smallwood]

Thank you all for your insightful comments
and information, it’s been a stomach churning time, just trying to digest
what we were told on the weekend, and trying to make some sense of it.  I
started to question whether what I thought I knew was just what I’ve been
told, or what I wanted to believe!  This list is such a treasure-trove of
information and support…thanks

 

Tania

x

 









From: owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au]
On Behalf Of Sally-Anne Brown
Sent: Tuesday, 13 September 2005
7:08 AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] IOL and
C/s...



 



Tania, 





Allison Shorten and Brett Shorten (University of Wollongong)
are about to publish an Australian study on the c/section rate with epidural
block. I do not have any info on demopgraphics etc as you would imagine all the
details are kept under wraps until publication (which is what we want -
publication !!).





 





They have studied two groups a) IOL and b) spontaneous
labour.  The results show a slight difference in the two groups of
about 1.5% higher in the IOL group compared with the spont labour
group. In both groups the results show (approx) 60% c/section rate -
not the 30-50% c/section rate often spoken of.





 





This study is in line with the results Sally Tracy found in
her research on EDB and c/section which also sits around 60%.





 





I would suggest IOL should be looked at in it's entirety
(the package deal).  I am not sure if either study looks at the numbers of
women having IOL.  BUT we can safely say to women now - two Australian
studies have identified that whether you have IOL or not there is a 60% chance
of having a c/section with epidural block.





 





SA





xo







- Original Message - 





From: Tania Smallwood






To: ozmidwifery@acegraphics.com.au 





Sent: Monday, September
12, 2005 6:11 PM





Subject: [ozmidwifery] IOL
and C/s...





 



 

Just wondering if there are any good quality trials about
IOL and increase of c/s?  Have just re-read Enkin, and it does state that
IOL is not associated with an increase in caesarean section rate (but given
that most states here are up around the 30% mark, you have to wonder what they
are comparing that to?), but I thought something came out of the Uk not long
ago disputing this?

 

Anyone?

 

Tania







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Re: [ozmidwifery] IOL and C/s...

[Sally-Anne Brown]

Tania, 
Allison Shorten and Brett Shorten (University of 
Wollongong) are about to publish an Australian study on the c/section rate with 
epidural block. I do not have any info on demopgraphics etc as you would imagine 
all the details are kept under wraps until publication (which is what we want - 
publication !!).
 
They have studied two groups a) IOL and b) 
spontaneous labour.  The results show a slight difference in the two 
groups of about 1.5% higher in the IOL group compared with the spont labour 
group. In both groups the results show (approx) 60% c/section rate - 
not the 30-50% c/section rate often spoken of.
 
This study is in line with the results Sally Tracy 
found in her research on EDB and c/section which also sits around 
60%.
 
I would suggest IOL should be looked at in it's 
entirety (the package deal).  I am not sure if either study looks at the 
numbers of women having IOL.  BUT we can safely say to women now - two 
Australian studies have identified that whether you have IOL or not there is a 
60% chance of having a c/section with epidural block.
 
SA
xo

  - Original Message - 
  From: 
  Tania 
  Smallwood 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, September 12, 2005 6:11 
  PM
  Subject: [ozmidwifery] IOL and 
  C/s...
  
  
   
  Just wondering if there are any 
  good quality trials about IOL and increase of c/s?  Have just re-read 
  Enkin, and it does state that IOL is not associated with an increase in 
  caesarean section rate (but given that most states here are up around the 30% 
  mark, you have to wonder what they are comparing that to?), but I thought 
  something came out of the Uk not long ago disputing 
  this?
   
  Anyone?
   
  Tania
  
  

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  5/09/2005
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Re: [ozmidwifery] IOL and C/s...

[Lisa Barrett]

Hi Tania

I too have been checking out the facts on inductions after listening to the 
same Obstetrician.  The Nice guidelines say that the mortality rate

is 1 in 3000 at 37 weeks 3 in 3000 at 41 weeks and 6 in 3000 at 43 weeks.
at 40wks 58% of women have delivered
at 41wks 74% of women have delivered
at 42wks 82% of women have delivered.

Due to all of the above the conclusion they make is induction prior to 41 
wks increases work load without significantly lowering perinatal mortality.

The whole document can be read on www.nice.org.uk

Also there are some interesting figures on the birthlove site below. These 
figures do show the risk for primip section is doubled with induction but 
the over all section rate doesn't seem to be altered.  Unless I've 
misinterpreted it.

http://www.birthlove.com/free/induction.html#first

Lisa Barrett



- Original Message - 
From: "Tania Smallwood" <[EMAIL PROTECTED]>

To: 
Sent: Monday, September 12, 2005 8:52 PM
Subject: RE: [ozmidwifery] IOL and C/s...



Hi Belinda,

Is this stat published anywhere, or just anecdotal?  A 60% section rate is
twice the rate for the state, and I think twice the average for that
hospital too, and having just heard a leading obstetrician there tell 
women

that there is NO risk of an increase in c/s as a result of induction, I'm
trying to get my head around it...

Tania
x

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Belinda
Sent: Tuesday, 13 September 2005 12:06 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] IOL and C/s...

Tania, at the wch the stats are - for primip women indcued before 41
weeks there is a 60% cs rate.
Belinda

Tania Smallwood wrote:




Just wondering if there are any good quality trials about IOL and
increase of c/s?  Have just re-read Enkin, and it does state that IOL
is not associated with an increase in caesarean section rate (but
given that most states here are up around the 30% mark, you have to
wonder what they are comparing that to?), but I thought something came
out of the Uk not long ago disputing this?



Anyone?



Tania


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Re: [ozmidwifery] IOL and C/s...

[Belinda]

Tania i will try to find out where I got  those stats, I know they are 
true but they are primips less than 41 weeks don't forget, my worry is 
that once a cs always a blah blah blah. At a recent class when they were 
all talking about inductions, epidural ... forceps etc I got frustrated 
and said,,, you don't have to have a crap first birth before thinking 
about having a great second one...they all looked at me and I was like 
oh did I say that out loud??? They all responded in great ways...I am 
getting so out there in my classes I am going to get into more trouble 
soon, like I have done in the past ( I seriously was complained about 
because MY women thought they had choices...I still can't believe 
midwives find that a problem enough to complain!!!), don't forget 
some hospital midwives are working  hard and getting sh or should i say 
BANNANAS, are your kids into Gwen??) it too love me


Tania Smallwood wrote:


Hi Belinda,

Is this stat published anywhere, or just anecdotal?  A 60% section rate is
twice the rate for the state, and I think twice the average for that
hospital too, and having just heard a leading obstetrician there tell women
that there is NO risk of an increase in c/s as a result of induction, I'm
trying to get my head around it...

Tania
x

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Belinda
Sent: Tuesday, 13 September 2005 12:06 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] IOL and C/s...

Tania, at the wch the stats are - for primip women indcued before 41 
weeks there is a 60% cs rate.

Belinda

Tania Smallwood wrote:

 




Just wondering if there are any good quality trials about IOL and 
increase of c/s?  Have just re-read Enkin, and it does state that IOL 
is not associated with an increase in caesarean section rate (but 
given that most states here are up around the 30% mark, you have to 
wonder what they are comparing that to?), but I thought something came 
out of the Uk not long ago disputing this?




Anyone?



Tania

   


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RE: [ozmidwifery] IOL and C/s...

[Tania Smallwood]

Hi Belinda,

Is this stat published anywhere, or just anecdotal?  A 60% section rate is
twice the rate for the state, and I think twice the average for that
hospital too, and having just heard a leading obstetrician there tell women
that there is NO risk of an increase in c/s as a result of induction, I'm
trying to get my head around it...

Tania
x

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Belinda
Sent: Tuesday, 13 September 2005 12:06 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] IOL and C/s...

Tania, at the wch the stats are - for primip women indcued before 41 
weeks there is a 60% cs rate.
Belinda

Tania Smallwood wrote:

>  
>
> Just wondering if there are any good quality trials about IOL and 
> increase of c/s?  Have just re-read Enkin, and it does state that IOL 
> is not associated with an increase in caesarean section rate (but 
> given that most states here are up around the 30% mark, you have to 
> wonder what they are comparing that to?), but I thought something came 
> out of the Uk not long ago disputing this?
>
>  
>
> Anyone?
>
>  
>
> Tania
>
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Re: [ozmidwifery] IOL and C/s...

[Belinda]

Tania, at the wch the stats are - for primip women indcued before 41 
weeks there is a 60% cs rate.

Belinda

Tania Smallwood wrote:

 

Just wondering if there are any good quality trials about IOL and 
increase of c/s?  Have just re-read Enkin, and it does state that IOL 
is not associated with an increase in caesarean section rate (but 
given that most states here are up around the 30% mark, you have to 
wonder what they are comparing that to?), but I thought something came 
out of the Uk not long ago disputing this?


 


Anyone?

 


Tania


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Re: [ozmidwifery] IOL and C/s...

[Janet Fraser]

Hi Tania,
I often use this article. It's 
not exactly what you're after but has an extensive bibliography. Where did the 
IOL in first time mamas has a 40% c-sec rate info come from. Jo???
J
http://wwwhencigoer.com/articles/elective_induction/

  - Original Message - 
  From: 
  Tania 
  Smallwood 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, September 12, 2005 6:11 
  PM
  Subject: [ozmidwifery] IOL and 
  C/s...
  
  
   
  Just wondering if there are any 
  good quality trials about IOL and increase of c/s?  Have just re-read 
  Enkin, and it does state that IOL is not associated with an increase in 
  caesarean section rate (but given that most states here are up around the 30% 
  mark, you have to wonder what they are comparing that to?), but I thought 
  something came out of the Uk not long ago disputing 
  this?
   
  Anyone?
   
  Tania