"I have found that midwifery in hospitals has gone backwards. " Oh. how true. Sadly. During one of my classes at uni this semester one the lecturers wanted us Master's students to outline ways in which nursing has gone forward in the past decade. I almost snorted into my coffee, for I am of the firm belief that midwifery has not gone forward. It's gone backwards. How many other nursing factions can say this?
I guess the good in this is that our consciousness's ( ?sp) have gone forward, to the point where midwives are so determined to make changes. My depth of experience only extends to 15 years or so, but would it be right to think that the efforts to liberate midwives from their medical shackles is a relatively new concept? Or was it like this back in the 70's also? Robin ----- Original Message ----- From: "Lina Davern" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, October 05, 2002 11:49 AM Subject: Re: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!) > hi I am lina and I went back to nursing after an 18 year break. I decided > to go back to midwifery. So two and a half years ago I did a refresher > course. I chose to go and work in a privae hospital because I knew the num > and I thought that she would keep an eye on me. Each time I reflect on the > situation I can not remember why I chose midwifery. Any way this year my > num has decided that I work in the birthing unit. So ctg's have been one of > my biggest night mares, I think you need a degree to read them to start off > with. I even did an inservice lecture on ctg's but that was not enough. I > have found that experience is the best teacher in reading ctg'd. Today I do > not worry about early decels above 110bpm but I still report them because > the obstetrician is the first to say that "I was not informed". > I have found that midwifery in hospitals has gone backwards. We do an > initial ctg on all admission, if it has a sleep trace, like reduced > varibility we try and wake the baby up and leave the monitor on until it > wakes up. Any one that is induced goes on continous monitoring. Noone is > game enought not to monitor. When I worked in the public system 20 years > ago we listened to the fetal heart rates half hourly and then when pushing > inbetween contractions. Our caesarean rates I am sure were not as high as > what they are today. > Even so I doubt that I would have the courage to be a midwifery practtioner > like what of yee girls are on the list. Even though I am in the opposition > to you I admire yee and I have learnt heaps from reading the list. Good > luck and keep up the great work and say a prayer for me. > Love Lina. > > > >From: "YOLANDE WILLIAMS" <[EMAIL PROTECTED]> > >Reply-To: [EMAIL PROTECTED] > >To: <[EMAIL PROTECTED]> > >Subject: Re: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!) > >Date: Thu, 3 Oct 2002 16:27:23 +1000 > > > >Jo, Did you report(incident report) the doctor and encourage your patient > >to make a complaint against the doctor(give her the patient feed back > >form)? This is how these rude & unprofessional people need to be delt > >with. Never let thier lack of respect upset you. Your support of that > >woman is admirable I hope you can look past the bad and see the good that > >you can do? > >keep it up! > >Yolande. > > > >To: [EMAIL PROTECTED] > > Sent: Thursday, October 03, 2002 10:35 AM > > Subject: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!) > > > > > > I worked in birth suite last night, and had a not-so-nice shift... > > > > This woman was due to be induced on saturday, and came in for routine > >CTG monitoring (as she was post dates by about 5 or so days), and the CTG > >was very flat... variability 1-5, but a reactive trace. Eventually the > >decision was made to induce there and then. She had an ARM around 3pm, and > >was 2cm dilated. Clear liquor. Since this was her second baby, they > >decided to leave her for an hour to see if she went into labour > >'spontaneously'. She felt some niggles, that's all. So after SEVEN > >attempts to get an IV into her (and 2 hours after the ARM) syntocinon was > >commenced. > > > > For most of that time after the ARM I was told to leave the CTG on > >because they (the doctors) were not happy with it. And, of course when the > >syntocinon went up, the CTG was there to stay. Because the woman was > >mobilising well, on the ball, on the loo, walking, sitting, etc, the trace > >wasn't very clear. So, I sat with her the whole time, listening to the > >baby's heart, often getting the maternal pulse showing up on the monitor > >(low-lying placenta), but always hearing the baby's heart rate in the > >backround, assuring me of the baby's well-being. After about an hour of > >sketchy tracing, I told the woman and her husband that the doctor might > >want to put a FSE on because they wouldn't be sure of how the baby was from > >the printout. I showed them the device, and explained to them everything > >that would happen. They asked whether it would hurt the baby. I can't > >lie... a wire being screwed into a baby's head would hurt anyone. I said > >it would probably hurt the baby, but chances are it won't harm the baby. > >They were not happy with that, really, and the husband said that he has > >been sitting with me the whole time, listening to the baby's heart with me, > >and he was happy that the baby was fine if I was. Just then, I heard the > >first decelleration. I watched and heard it go down to about 80 at the > >onset of the contraction, then return to the baseline of about 135 as the > >contraction was letting up. An early decelleration. I listened in > >carefully during the next contraction, and the same thing happened. > > > > I went out to tell the doctor, and she came in, all stressed out, saying > >she had to put a FSE on. The father explained their concerns, and the > >woman was getting all stressed out too. I tried calming her, just > >whispering, 'just ignore the talking, you've been doing really well > >concentrating on your breathing, just keep doing that', etc... Eventually > >they agreed to see how dilated the cervix was before deciding on the FSE. > >If she was almost fully, they didn't want it. > > > > Unfortunately, it was time for doctor's change of shift. The new doctor > >to come on is one I've had altercations with before: he's rude, unwoman > >friendly and spiteful. He came in loudly proclaiming her need for and FSE, > >so they had to explain all over again to him why they didn't want one. The > >woman was contracting, and wanted silence, and even said, "shut up!" and he > >just kept talking, explaining why they needed it. So he did a VE. 4cm. > >After 3 hours of good contractions on a multi, who was feeling bowel > >pressure... 4cm. I had my doubts, but what can you do? Then she needed to > >void, before the FSE was applied. So we got her up to the toilet, and > >while she was sitting, the midwife in charge barged in, saying we need her > >back in bed, on her left side with oxygen. She's in the toilet... yes, > >well she needs to get back in bed as quickly as possible, the baby's in > >distress. The woman, in desperation, in the middle of a contraction, said, > >"don't tell me that!!" She turned to me, and said, "why are they scaring > >me like that??" I didn't know what to say :( > > > > We got her back to bed, on her left side, and applied oxygen. The FSE > >was attached, and showed the same early decellerations with most > >contractions down to about 80 or so. All the woman wanted to do was sit up > >on the ball... oh no, that wasn't allowed. The baby is distressed, you > >have to stay there. > > > > Just as a theatre was being prepared for a c/s, she had an urge to push, > >and there was head on view. Baby was born within 10 min, with the heart > >rate at some points only 50bpm. That was scary. When the baby came out, > >she had the cord tightly around her neck 4 times, and around her body once. > > She came out screaming, with apgars of 9 and 10. > > > > I just felt like suddenly my evening was out of control. Sorry it was > >so long... any comments? > > > > Jo (new midwife) > > > > Babies are Born... Pizzas are Delivered. > > > > > > > _________________________________________________________________ > Chat with friends online, try MSN Messenger: http://messenger.msn.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.
