my recollection was that he said................. sort of........was...... if this programme (of having carers provide support in the home for new mums) were to reduce beastfeeding rates, then those things would follow (PPD & gastro etc). I thought the programme was poorly edited, in real terms the gent was trying to say that the particular intervention needed evaluation. Given the need for an evidence base in all aspects of maternity care (including midwifery) do we not agree? I think you should challenge the editors of ACA, if you want to see things more evenly presented. rosalee
>>> Jo & Dean Bainbridge <[EMAIL PROTECTED]> 04/17/02 10:23PM >>> Hi, just caught the quality viewing on ACA again tonight and thought I would write a little letter to Mudge for clarification on what he said regarding the early discharge and home help program offered by the Lyle Mac here in Adelaide. I have pasted it below if anyone is interested. this man has made some pretty out there comments before so I thought I would take him up on it this time. For those who missed it he said that it would be putting mothers at risk of PPD and babies at risk of gastro.....pretty poor arguments but he was very condescending to the program which I believe is unfounded. cheers Jo Dear Dr Mudge, I watched with interest your comments on A Current Affair last night regarding the early discharge program being trailed at the LMHS. Your criticism of the early discharge program included the risk of post partum depression, which caught my attention. I would be very grateful if you could explain your reasoning for listing this as a risk in the context of this program? You did not give clear reasoning as to why a healthy mother after a normal pregnancy and birth, with a healthy baby, being given the option to choose to go home early and have home help would be at increased risk of PPD. Surely the benefits of a support person whom offers a helping hand, some advice based on recent up to date study (if only a comprehensive 6 months), and peer support, coupled with visits from trained midwives, would in fact lower the risks of PPD? Could you explain to me the difference in a pilot program of this type and the home help offered to private patients through their insurance companies? Factors such as a caesarean birth; instrumental birth; the constant interruptions from well meaning staff within the public post natal wards; separation from partner and other children before leaving hospital are stressors that can have a negative psychological impact on some new mothers resulting in PPD. Contributing factors once going home include: isolation, sleep disruption, increased workload with older children and so forth. Almost all of these things can be elevated if not eliminated by early discharge and a support network. The option of early discharge is something that a growing number of women are seeking, and it is being catered for some with private health insurance, so why not those within the public sector. Those mothers whom are confident and competent to go home early should be supported in doing so. As Prof. Dekker stated, becoming a parent is NOT a medical illness. For some mothers there are problems, no doubt, but these are not the women under discussion. I feel that perhaps when making this public statement, you were not taking into account the socio-economic state of a large portion of women who birth at the LMHS. I feel that limited numbers of mothers would have access to the private health insurance benefits of home help. I agree that for those who are at greater risk of an adverse psychological state in the post partum that an early discharged program may not be suitable. However did you take into account that for those women who do births within the public system and stay for the three to five day period are often subjected to over worked staff and thus reduced quality of care? These women are at a possible greater risk of post partum depression for their emotional needs are sometimes overlooked, misunderstood or even ignored? The benefits of one on one contact, continuity of care, in this form of 'mother help' could include an earlier detection of depression or even avoidance of PPD. If my memory serves me correct, you voiced some reservations about the quality of service that the young women were offering? Can you state that the quality of care offered by insurance companies with the home help benefit is adequate? I understand that this was not the topic of discussion -types of home help care that is available- but I find it interesting the level of criticism you displayed towards this program? I am interested in what level of training in women's mental health that obstetrics includes? I have written to the RANZCOG for clarification on this. I would also be interested in what strategies the AMA, and indeed your own practice, have been implemented to lower the incident of PPD. I am shocked at how little is offered to women who are at risk of PPD and the limited knowledge that obstetricians have on those who are at greater risk. (I say this with confidence as I have been invited on more than one occasion to speak to the obstetric staff at Flinders Medical centre and this is a topic that is often discussed. I have also been an advisory to the Royal Women's Hospital in Melbourne on the emotional impact of caesarean birth and vbac.) This is not intended to be a personal attack on you. I am merely concerned that the arguments you stated in a public forum were not evidenced based and would like you to support what you said. I have forwarded this letter on to A Current Affair and Prof. Dekker and the AMA as I believe that they too would be interested in further understanding the basis for your criticism. Thank you for your time and look forward to reading the information you can no doubt supply to support your statement. Thank you. Jo Bainbridge founding member CARES SA email: [EMAIL PROTECTED] phone: 08 8365 7059 birth with trust, faith & love... ********************************************************************* This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health. ********************************************************************* -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
