Re: [ozmidwifery] physiological 3rd stage

Tue, 21 Jun 2005 01:21:23 -0700

Thanks Mary, Denise and Janet for your interesting articles and web sites.
I have always had a special interest in the third stage of labour and it is depressing to realise how much good evidence there is 'out there' written by doctors but universally ignored by doctors.  One line in particular spoke to me "if you change physiology, you create pathology"
Now we have the added pressure of the insidious practice of cord blood gas analysis, which means depriving the babies of their cord blood as soon as is possible in order to send a section to the blood gas machine for immediate analysis to check their levels!  This is being done routinely at our tertiary hospital, and is only a matter of time before us smaller units follow suit.  I'm sure the litigation-fearful doctors will convince the hospital to buy an expensive machine for this too. ( they managed to spend $80,000 on a bladder scanner which is a bone of contention, apart from being very innacurate on post-partum women, due to fluid collection in the uterus, and quite useless over caesarean scars, it is eroding further the use of good clinical midwifery skills)
I also worry greatly about the new practice of collecting stem cells to be frozen for a possible future need.  To me it seems to be purely driven from a commercial point.  The parents are convinced that they should spend lots of money to protect their child from an unforseen future, when a little more attention to their physiological needs at birth might be a better insurance for future health.  If these cells are so valuable, why are we trapping them in the placenta and throwing them away, instead of letting the child benefit from them at birth as nature intended?
Why is it that only the 'bad' trials that 'prove' intervention is a good thing get accepted, when there is so much evidence against it? 
The discussion about possible links between early cord clamping and autism and other developmental disorders is very interesting too.  I have much interest in this, as disability is part of my life too, and have often wondered why we seem to have such an epidemic of ADD, Autism, Behavioral problems and so on.  It just seems so crazy to interfere with the process when it is obviously so poorly understood by so many 'experts' most of whom will not have ever even seen the process uninterfered with.
 
Has anyone done a study into long-term health issues of homebirth children and compared rates of disorders with hospital born children?
 
Regards, Sue
"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke
----- Original Message -----
Sent: Monday, June 20, 2005 8:35 PM
Subject: RE: [ozmidwifery] physiological 3rd stage

http://www.midwiferytoday.com/articles/bristol.asp        Try this link Sue. Cheers, MM

Thanks Mary - I'd like to see it - would you post or fax to me?  Fax no is 94545953 - if you don't have it on file.

Sue

 

Sue I have an article By Dr John Stevenson critiquing the Prendiville third stage trial.  The doctors wouldn’t take any notice as they deregistered him for supporting homebirth practices etc. I’m sure I have it somewhere if you want it for yourself,  cheers, MM

 

Hi Denise

I wanted some info that I could use in promoting physiological 3rd stage to doctors.  I am aware of recent studies which say that oxtocin should be routine for 3rd stage, and this seems to have been adopted almost completely in hospitals.  Where a woman chooses otherwise there is little to help support her choice within an obstetrically managed model of care.  If there are any studies out there that could present this arguement I would like to read them.

The post script to this birth was that she had an induction yesterday at T+ 4 for raised BP, had a quick labour and normal delivery, standing, oxytocin third stage, but with a sympathetic midwife who did not 'rush' this bit.  All is well and home today, quite happy with events.  I just think it's such a shame that her opinion was opposed, fairly aggressively,  I wish we saw more women take the trouble to inform themselves as this young lady did.

Thanks,Sue

"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke

----- Original Message -----

From: Denise Hynd

Sent: Friday, June 17, 2005 6:47 AM

Subject: Re: [ozmidwifery] physiological 3rd stage

 

Dear Sue

Who is it you want the evidence for woman or the Ob?

The women has accept the dr's scaremongering

 

I think  both need information on what is informed consent

And she needs to be reminded to trust her own god given body's ability to give birth which if she were in many other "undeveloped" countries would not be questioned

 

see the Health Consumer's Council pages and leaflets

 

and as you sad on the cascade of Intervention

 

I can hear it in operation from here!!

Denise Hynd

 

"Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled."

 

— Linda Hes

----- Original Message -----

Sent: Thursday, June 16, 2005 10:03 PM

Subject: [ozmidwifery] physiological 3rd stage

 

Dear list-wives

Have just had a frustrating 'discussion' with one of our obs. A woman has written a very clear birth plan stating that she wants no interventions unless absolutely necessary.  The 'problem' being that she is a JW and will not accept a transfusion under any circumstances.  The said obs was of the opinion that she should not be 'allowed' the choice of physiological 3rd stage in this case so as to prevent the risk of haemorrhage.

I wonder if any of you know of any studies into physiological 3rd stage that I can use here?  There is plenty of 'evidence' about the 'wisdom' of prophelactic use of oxytocics, but naturally the doctors, and sadly very few midwives, have any experience of expectant management of third stage. 

I am quite upset about the attitude displayed here that the woman's informed wishes are not being respected, but of course got no-where in trying to discuss this.  This girl is no more likely to bleed than any other person, but she has now been 'persuaded' to alter her birth plan. The trouble is she now has a raised BP at term and has been admitted. I can almost hear the 'cascade' starting! 

Any good evidence gratefully recieved.

Regards, Sue

"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke

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