Re: Twin policies.

[Rhonda]

Title: Re: Twin policies.

Robin,   Good Luck!      You are not only standing up for what you believe is right but for the many women who will surely suffer without your strength to protect them.  Best wishes to you and know that whatever the outcome you have done what is right. You obviously have him worried as if his only come back is to attack you personally then he is not being very professional.  Try to point that fact out -  if he had enough solid evidence then he would welcome challenge and defend it with facts.        Rhonda.     ----- Original Message ----- From: Robin Moon To: Jan Robinson Cc: [EMAIL PROTECTED] Sent: Friday, August 17, 2001 9:23 PM Subject: Re: Twin policies. Thank you Jan, for that input.   Unfortunately,  he is still pushing for it to be made policy. I pity the poor women of the North Shore when he becomes a VMO next year.   Can I just clarify that this sentence; -   'No offsetting advantages in terms of decreased fetal or neonatal morbidity or mortality were found."   implies that whether the 2nd twin was delivered by emergency c/section or by podalic version etc, there was no difference in the(neonatal) outcome?( I dont have my hands on this book until Monday, which is when I am mediating on the issue) This of course is the crux of his argument, that the 2nd twin is always in peril and intervention must be instigated ahead of time to offset it. *sigh*. I wonder where the word 'skill' comes in?   Sorry to keep on about this, but I feel so strongly for the women on this issue.His indignant letter of complaint resulting from me challenging his actions contained so much slander about me that I feel it necessary to bring legal representation with me as support for mediation.  I just want to be sure of my facts before I face him.   Robin   ----- Original Message ----- From: Jan Robinson To: Robin Moon Cc: [EMAIL PROTECTED] Sent: Monday, August 13, 2001 2:17 PM Subject: Re: Twin policies. Dear Robin There are no teaching hospitals in Sydney that have such a policy ... Women with multiple pregnancies and no obvious complications should be able to formulate birth plans which request minimal intervention ... (that does not include a trip to theatre for delivery!) Most dizygotic twins births are perfectly staightforward as long as the woman remains upright and is able to assist. From 3rd Ed Guide to effective care in pregnancy and childbirth ... p.146 "Virtually no data from controlled trails are available to help determine the choice between vaginal birth and cesarean section for women with multiple pregnancy. A single trial has assessed the effect of cesarean section for delivery when the second twin was in a non-vertex presentation. As would be expected, maternal febrile morbidity and need for general anesthesia was increased with cesarean section. No offsetting advantages in terms of decreased fetal or neonatal morbidity or mortality were found." Jan Robinson -- __________________________________________________________________________  Jan Robinson                                      Phone/fax: 011+ 61+ 2+ 9546 4350  Independent Midwife Practitioner                       e-mail: <[EMAIL PROTECTED]>  8 Robin Crescent                                       www:   midwiferyeducation.com.au  South Hurstville  NSW  2221                    National Coordinator, ASIM __________________________________________________________________________