Title: Message
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Hi
Edwina,
The
book by Henci Goer "The Thinking Woman's Guide to a Better Birth" has excellent
research-based info on induction/augmentation and SROM. It was my bible when
dealing with my obstetrician. It also explains the rationale behind why doctors
prefer to augment (the Irish school of Birth Management) and limit labours to a
certain time frame. Personally, I find this practice disgusting! It just adds
more pressure to perform when women need to be inside themselves and not worried
about pleasing someone else.
Hope
this helps.
Cheers,
Cas
McCullough
Dear Listers,
Can anyone refer me to any research arguing
against inducing women who have not gone into labour within hours of
SROM. I looked after a lady today who had SROM at 0755 but had not
experienced any contractions. At 0830 the doctor decided (without either
of us having as yet reviewed the lady - she was still at home) that if she was
not in labour by lunchtime then she would need induction. I was polite
but obvious in my disapproval and the doctor acknowledged my disapproval but
stated that we had to give the woman the option.
I gave the woman the option but added that any
interference with nature increased the risks of further intervention. I
told the woman not to make a decision yet but to think about it and then sent
her home! When the doctor asked about her I told her that I thought she
would establish better at home where she would be more relaxed (I didn't say
"and away from prying hands" but I thought it!!!). The doctor extended
her time limit to 1400 (generous eh?). The woman returned in established
labour at 1345!!!!!
It is really hard as in our unit the women have
been seeing the same doctor throughout pregnancy and so have developed a trust
in them. We (midwives) are strangers that don't always agree with their
trusted GP! Because of this the doctors often get their way (not
necessarily the woman centered way). If I can circulate some literature
recommending at least 24 hours after SROM before interfering perhaps I may
change some ideas. It is only one particular doctor and she says she
doesn't want the women labouring on too long as they will get tired and won't
be able to push. I think she (the doctor) wants to be sure of sleep that
night!
Any ideas? Cheers,
Edwina
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