Enkin et al. in A Guide to Effective Care in Pregnancy & Childbirth state:
"Routine [postnatal] Observations: Making & recording regular measurements of Temp, pulse, bp, fundal height, lochia & the various wounds that a woman may sustain during birth, is still common practice in the days following birth. The intensity of this screening activity varies arbitrarily and depnds more on the hospital in which a mother happens to give birth, and on the legnth of time she spends in it, than on her individual needs. While it is prudent to observe women in this way when they are known to be at increased risk of either infection or hemorrhage, it is difficult to justifythis as a routine for all women." Chapter 45, p.432 This book is available online, free, in PDF format from www.maternitywise.org/guide Also, have a look at WHO: Care in Normal Labour & Birth online http://www.who.int/reproductive-health/publications/MSM_96_24/MSM_96_24_table_of_contents.en.html Has the OB that wants the change provided any evidence to support his/her demands? Jen --- cummins <[EMAIL PROTECTED]> wrote: > Dear List > > Sorry to go back over old ground (message sent by > Mel Dunstan 17/11/04), but I really need your help > in a Obs V Midwives battle against doing postnatal > observations. About 4 years ago we ceased doing > postnatal observations on all 'normal birth' > postnatal women. Our postnatal unit has run > perfectly since this time without incident relating > to the postnatal care of wellbeing of the women we > care for. We use a pathway for signing off the > education and the wellbeing of mother and child. > > Recently we have had a visiting registrar who > required postnatal observations on women. This > request has gone to our DON who demanded that our > practice be immediately updated and that we do at > least one set of obs per day on every woman. > In our unit,we do not gain a numerical value from > any machine, however, we ask the woman how she is > feeling, we observe behaviour, we listen to the > woman, we educate and spend time with mother and > baby, we are 'with woman'!! and if there is anything > deviating from the normal then we investigate > further, often by doing observations, however, if > there is no indication to do the observations, then > I do not believe that they need to be done. > Four years ago, our unit progressed from being task > orientated and medicalised, to caring for the > individual and empowering the woman to care for > herself. A woman with child is not a medical > emergency and removing routine observations is > normalising this situation. > I have no doubt the woman I cared for last night > (day3, engorged breasts, tears, etc) would have an > elevated temp, high heart rate and probably an > elevated BP but I was already dealing with the > problems and a set of obs would have proven NOTHING. > > > I am so very angry and frustrated that I am now > faced with a situation where I need to find some > recent evidence based practice to support the fact > that we do not do routine observations. We are > having to re-invent a wheel that has been rolling > perfectly well for so many years (until it ran over > an obstetric nail). > > If there is anyone out there who can help, please > alert me to web sites, publications, anything!! > > Thanks in advance > > Felicity Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
