Dear Edwina there is evidence that it is safe to await labour from
Effective Care in Pregnancy & Childbirth & A large study also by
Hannah,M.et al in April 1996 "Induction of labour compared with expectant
management for prelabour rupture of the membranes at term" The New England
Journal of Medicine. 334:1005 -1010. If you rang 81617828 in office hours
the lovelly delivery suite ward clerk can fax your hospital the WCH protocol
and check list for ruptured membranes not in labour. This protocol is based
on the results of the Hannah study which found the rates of infection were
not significantly different in the expectant or active management group.
However they do say women were more likely to view induction of labour more
positively!! However I remember when this research was undertaken & the
women in the expectant group were admitted to hopital for the 3 days they
could wait for spontaneous onset of labour! Of course in practise women go
home & the birthing centre women seem to view this positively. If you tell
women the stats that 80% of them will be in labour in 24 -48 hours they are
much keener to await labour than choose intervention.
Regards jan Prider
----------
From: Leigh Evans[SMTP:[EMAIL PROTECTED]
Sent: Sunday, 7 September 2003 19:33
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Re: induction/augmentation following
SROM
Edwina, There is interesting info on theNational Institute for
Clinical Excellence (NICE) site. I think this is like our NHMRC but in the
UK. Leigh
----- Original Message -----
From: Vance & Edwina
To: [EMAIL PROTECTED]
Sent: Friday, September 05, 2003 6:46 PM
Subject: [ozmidwifery] Re: induction/augmentation following
SROM
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
--
This mailing list is sponsored by ACE Graphics.
Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
