Dear listers,
I am seeking some answers to queries about the (NSW) Obstetric Data Base Format
Having come from another state (WA) where there was only a Midwives Birth Notification form and that I was aware midwives can suggest changes to!.
1) Does any one know who determines what goes into the Obs Data Base or what questions are asked on these forms which are filled out after a birth in a NSW Public hospital?
2) Are they only completed in NSW public hospitals or are other states using them?
3) Are any private hospitals doing them?
4) Are the same questions asked at every hospital across the state or only across a health area?
I am concerned as there are implications on the reflection, thinking and practice of midwives and doctors.
For example asking the practitioner completing the form not only was there Shoulder Dystocia but to also to grade SD as either "Mild, moderate or severe."
Similarly is the list of ante natal testing for each woman going to increase or decrease depending on outcomes or if not supported by EBP?
For example as we find more "abnormal OGCT" when evveryone is tested etc or will the test results and costs be reviewed as recommended in the Cocherane Dat base which now all NSW hospitals can access? Such that this test becomes routine only for women who have symptoms or other risk factors?
Mind you the Midwives Birth notification form also have some implications on the practitioner also, for example the use of obstetric language re-enforces the obstetric thinking and approach about practice so most midwives deliver rather than birth women!
Thus I am wondering who reviews the format of the Obs Database forms?
And what formal use is made of this data, for example will NSW see a rise in the rates, concerns and looking for Shoulder Dystocia, GDM such that obs are going to dispute the current low stats about these problems?
I have always been concerned at the amount of inservice there is in hospitals, obstetric and midwifery journals and the like about the statistically rare obstetric emergencies PARTICULARLY WHEN COMPARED TO THE AMOUNT OF RESOURCES DEDICATED TO education about SUPPORTING AND ENHANCING NORMAL BIRTH in hospitals etc. Though it is understandable when every midwife is asked such pointed and dubious questions and Not asked was the care given evidence based practice let alone woman centred!?
Denise Hynd
Dear Denise
The form is reviewed every few years and the research question down the left bottom corner changed.
There used to be a consultatory process about this and midwives were included. You would need to contact Margie Pym the project officer and ask her how you go about getting a question in there.
I would personally like to see one related to POSITION for SECOND STAGE, BIRTH and THIRD STAGE and then we can take a look at how that affects overall outcomes for mother and baby.
Would also like to see a research question related to WATER BIRTHS.
Of course the ultimate data collection would include a different coloured form for PRIVATE AND PUBLIC women.
Go for it now Denise, the induction/augmentation information was included long ago and can surely be included elsewhere in the middle column.
Margie can be contacted at the Dept of Health 9391 9199
Let us know the outcome.
Jan
