Have a look at "Signposts for the Third
Stage Maze" on my website www.birthjourney.com for guidelines for
safe physiological third stage management and delayed cord clamping.
Cheers, Lois
----- Original Message -----
Sent: Thursday, July 15, 2004 8:02
AM
Subject: Re: [ozmidwifery] Birth summary
forms
Liz
As a mid student, I have also wondered about the
cervix closing before the placenta is birthed. With the birth of my third
child (at home) we opted for a physiological third stage and have since done
some research on the timing of cord clamping. It seems there is a lot of
supportive literature for delayed cord clamping with one of the few factors
against it being the fear of the cervix closing before birth of the
placenta.
Tania
----- Original Message -----
Sent: Wednesday, July 14, 2004 6:59
PM
Subject: Re: [ozmidwifery] Birth
summary forms
Hi Jan,
thanks so much for your
post. I too would love to work outside the hospital system however being a
recent graduate and having no-one to "apprentice" me, I lack the confidence
to do so. I feel my only option is to work overseas for a while (an
expensive option with 3 children and partner in tow). In the meantime I
embrace the wise-woman knowledge I encounter on this list. I have another
question too. The docs where I work have the fear that the cervix will close
before the placenta can birth. I think this is their reasoning for manual
removals if they are not out in the specified time frame. Is this because of
the syntocinon given for medically managed third stage, or is this a
realistic possibility also for physiological third stage? Once again,
forgive my ignorance.
blessings,
Liz.
----- Original Message -----
Sent: Sunday, July 11, 2004 6:42
AM
Subject: Re: [ozmidwifery] Birth
summary forms
Hi Liz
I'm lucky that I work outside the hospital system
so the guidelines used are safety and the mother's wishes. While ever
there is no bleeding I leave well enough alone. It is not good to meddle
when conducting a physiologic third stage. Although emergency drugs are in
the family fridge they are not used unless excessive bleeding necessitates
it.
In this particular case the woman had been vomiting towards the
end of a very long first labour so she was exhausted after giving birth.
After warm herbal tea for fluid replacement (and some home-made chocolate
brownie to restore her blood sugar levels) she put her newborn son to the
breast but after that she just wanted to close her eyes and sleep.
As
it was well past midnight, that was what I wanted as well,
I tucked my
client into her bed where she promptly fell asleep. I slept (very lightly)
on the floor beside her. When she awoke in the early hours of the morning
she emptied her bladder. I thought the placenta would come away then, but
it didn't, so as the baby was still asleep, tucked in with his father, we
had a cup of tea and went for a walk.
It was some walk, along the
northern end of Bondi Beach, climbed up Ben Buckler and walked another two
blocks over the top of the hill. She was ready to come home then as she
felt she wanted to empty her bowels. So we headed home and sat on the
toilet again and with a mighty push the placenta was expelled.
On
reflection, there was no obvious oedema in the lower birth canal, so I
assumed this was simply a case of a very fit woman, with very strong
abdominal and pelvic floor muscles that trapped the placenta temporarily.
We still look back on this experience and have a laugh at the memory
of the neighbours (also super-fit early morning walkers) out on Bondi
Beach congratulating my client on having the baby - not knowing that his
placenta was still in situ as we were talking!
I always get
satisfaction when completing the Perinatal Data forms for the Dept of
Health.
Although there are not a great number of homebirths recorded,
the long third stages that often occur at home must affect the state's
records of the average time taken.
Cheers
Jan
Jan
Robinson Independent Midwife Practitioner
National Coordinator
Australian Society of Independent Midwives
8 Robin Crescent South
Hurstville NSW 2221 Phone/Fax: 02 9546 4350
e-mail address:
<[EMAIL PROTECTED]> website: www.midwiferyeducation.com.au
On
10/07/2004, at 8:30 PM, Liz Newnham wrote:
Dear
Jan,
what
did you do in the situation about the placenta? Where I work at present
the doctors get twitchy if a placenta hasn't birthed within an hour, let
alone eight (mind you - labour ward - tertiary hospital, policy of
CCT). Forgive my ignorance.
Liz.
-----
Original Message -----
From:
Jan
Robinson
To:
[EMAIL PROTECTED]
Sent:Friday,
July 09, 2004 6:59 AM
Subject:Re:
[ozmidwifery] Birth summary
forms
Hi Sue
Not sure what birth
summary forms are, but my Birth Register is simply an excel spreadsheet
with all the details .. name address age etc. all the demographics. then
time membranes ruptured (if less than an hour before birth ... etc..)
number of vaginal examinations (i love entering zeros!) , length of each
stage position for each stage ... time of birth , date of birth lots of
stuff plus comments for anything interesting like placentas in situ for
eight hours , what we did about it , what type of sutures were used,
etc. The reason for it all being on a spreadsheet is so that I can
statistically analyse it to get the average age of my clients, average
duration of labour, first stage etc. It might be handy one day. I would
have to get m y daughter to help me with the analysis as I am not
brilliant using Excel, ... one of my clients set it up for me many years
ago ... It's easy enough to do if you understand Excel. I think Robyn
THompson sets hers up on some similiar type of spreadsheet.. she was
going to market it at one stage. Hilda Bastian also had a brilliant one
set up to go underd the HBA banner. It was the best idea I had ever seen
as it also had the facillity for anylisising social data as well. She
was going to get hers to a marketable stage too but then the homebirth
movement seemed to crumble temporarily and it has been lost to us. It
would be a great project for HBA to tackle, but we could also get the
NSWPD people to provide us with a template for their data sheet with add
ons. The USA midwives have one that Maralyn Kleidon would know about but
she is in the states at the moment. Perhaps we could put pressure on the
College to produce a workable one for all homebirth midwives that could
be used to collect research data for their IPM Accreditation program
that they are getting set up. Lots of possibilities
Did you get
the papers I sent you? We need to get the new forms from Centre Link
now.
Haven't got mine yet, they tell me they don't have anymore as
they had a printing mishap so I will have to go up to my local office to
get then.
Hope you and Arthur are both well. Give my love to
Penny.
Jan
Jan Robinson Independent Midwife
Practitioner
National Coordinator Australian Society of Independent
Midwives
8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02
9546 4350
e-mail address: <[EMAIL PROTECTED]> website:
www.midwiferyeducation.com.au
On 07/07/2004, at 5:12 PM, Sue Cookson
wrote:
Hi all,
Can anyone email me copies of their birth
summary forms please?
Am looking to rewrite my own, but would love
some of your inspiations and insights.
Many thanks,
Sue and
Penny
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