Re: [ozmidwifery] How long before synto is used?

[Emily]

i guess all you can do is educate each woman about how it is protocol to use CTG but tell her about the evidence that shows it to be of no benefit while increasing c/s and instrumental delivery rates and how it will reduce her mobility, positions possible, water usage, comfort etc etc and then ask for her decision on what type of monitoring she would like. then it is quite legitimate to record in the notes that they have refused consent for CTG.

Bowman Family <[EMAIL PROTECTED]> wrote:

Our Syntocinon procedure has been updated to include routine EFM. this has
apparently been routine in major hospitals for a long time and accepted by
midwives in these units as being the best practice.
I have unfortunately accepted this practice too - but feel saddened with the
risk for midwives losing valuable skills by relying on CTG's instead of
truly being With Woman". and assessing the labour with sonicaid and
palpation of contractions and of course observing the woman.
There is an increased risk of busy midwives assessing a woman's labour by
CTG alone - not having the time to truly know the whole picture a bit
scary!!.
In our unit where we have caseload midwifery we have the time to stay with
women in labour and be tuned into the progress of labour and the baby's
wellbeing. I really still do not see the need in these situations to have to
rely on CTG, I would rather any day to rely on a good midwivery care/skills.
If there is any concern about the FH sure then use EFM
Also woman will no longer have freedom of movement, and baths, but this will
no longer be the case with compulsory continuous EFM for all Syntocinon
Inductions. I can see Caesarians yet further on the increase at our
hospital.

Linda

----- Original Message -----
From: "Janet Fraser"
To:
Sent: Thursday, June 15, 2006 1:05 PM
Subject: Re: [ozmidwifery] How long before synto is used?


> Amy your story is truly appalling and also totally normal in the system.
How
> anyone can "refuse" your requests is disgusting! EFM does NOT save lives,
it
> just increases c-sec rates. How about birthing with evidence based care at
> home if you have another baby? As Diana Korte says, if you don't want
> interventions, don't go where they're done ; )
> I hope you recover well from your awful brush with the drug pushing and
> unnecessary intervention. I wish it were not the norm but it clearly is!
> J
> ----- Original Message -----
> From: "adamnamy"
> To:
> Sent: Thursday, June 15, 2006 11:49 AM
> Subject: RE: [ozmidwifery] How long before synto is used?
>
>
> >
> > This is really pertinent thread for us mothers on the list...it seems an
> > issue about which there are no clear guidelines which makes it really
hard
> > for women who are attempting to be in charge of their own labors. They
> > don't even know what sort of time frame they will have in which to relax
> > into labor without pressure and threat of synto. I recently gave birth
in
> > our major hospital, by ARM (2nd birth, Hx of fast labor, 2cms dilated,
36
> > weeks but with cholestasis and very worried about that). I was
extremely
> > keen to avoid synto/EFM and all the other nasty possibilities.
> >
> > I asked over and over for some clear indication of how long they would
> give
> > me to progress into labor with out synto but was not given one. Within
an
> > hour of ARM I was being asked very regularly if I had contractions, with
> > frowns and talk about synto every time I said "not much happening". I
> > wonder how it might have panned out had I not been hassled every step of
> the
> > way...It only served to increase my anxiety 20 fold. We managed to hold
> > them off for 6 hours before it went up and the flogging of the body
began.
> > It is just a revolting drug that should be avoided unless strictly
> > necessary. The labor was nothing short of torturous and degrading (I am
> > sure you have all seen it in action).
> >
> > I also wonder if it was the unrelenting intensity of the contractions
that
> > forced my bub into a posterior, deflexed position within an hour of
> > established labor. Being hooked up to EFM doesn't help with keeping
> mobile
> > either. I am not a midwife-Could there be any truth in that idea?
> >
> > Anyway...I thought I had negotiated to switch it off once labor had
begun
> > but lo and behold...a change of shift and the next midwife refused. I
> ended
> > up switching it off myself-to her utter bewilderment. This was an act
of
> > desperation which left me quite compromised with her because our
> > relationship became quite frosty and unpleasant after this. I felt like
I
> > lost her support when I took the reigns and bucked against hospital
> > protocol. It was like I had offended her...that she felt compromised by
> me
> > asserting myself.
> >
> > If I ever needed to follow the same course of action I would have the
ARM
> > and then get myself home ASAP for labor to start itself. I feel as
though
> > getting my baby out and the room prepped for the "next customer" was as
> much
> > of a priority as my wishes to keep my labor and birth low key...I don't
> > know, am I an eternal cynic? Bub calls, I have to go...
> >
> > Amy
> >
> >
> >
> > -----Original Message-----
> > From: [EMAIL PROTECTED]
> > [mailto:[EMAIL PROTECTED] On Behalf Of diane
> > Sent: Thursday, June 15, 2006 8:54 AM
> > To: ozmidwifery@acegraphics.com.au
> > Subject: Re: [ozmidwifery] How long before synto is used?
> >
> > We sometimes have some confusion over whether the women should have oral
> > AB's cover if they are on home management of SROM. The policy doesnt
call
> > for it, but some doctor's recommend this. When in established labour and
> > membranes are broken for more than 18hrs, then IV AB's are used. I
guess
> > that confirms that you are at more risk in Hospital!!
> >
> > What do other units do?
> >
> > Cheers,
> > Diane
> > ----- Original Message -----
> > From: "brendamanning"
> > To:
> > Sent: Thursday, June 15, 2006 8:51 AM
> > Subject: Re: [ozmidwifery] How long before synto is used?
> >
> >
> > "The UK's NICE guidelines inherited from the UK's Royal College of Obs
and
> > Gynea suggest that it is fine to leave pre-labour rupture of membranes
up
> to
> > 96 hours before induction of labour - "
> >
> > This is the policy at Rosebud.
> >
> > If doing ARM for IOL then waiting 4 hours is common & reducing the synto
> > once the labour is established is recognised as 'best practice".
> >
> > The recent research which associates IOL with syntocinon & an increase
in
> > PPHs is acknowledged there.
> >
> > With kind regards
> > Brenda Manning
> > www.themidwife.com.au
> >
> > ----- Original Message -----
> > From: Debbie Slater
> > To: ozmidwifery@acegraphics.com.au
> > Sent: Thursday, June 15, 2006 12:04 AM
> > Subject: RE: [ozmidwifery] How long before synto is used?
> >
> >
> > The UK's NICE guidelines inherited from the UK's Royal College of Obs
and
> > Gynea suggest that it is fine to leave pre-labour rupture of membranes
up
> to
> >
> > 96 hours before induction of labour - see
> > http://www.nice.org.uk/page.aspx?o=17381
> >
> >
> > Debbie Slater
> > Perth, WA
> >
> >
> >
> > From: [EMAIL PROTECTED]
> > [mailto:[EMAIL PROTECTED] On Behalf Of Kelly @
> > BellyBelly
> > Sent: Wednesday, 14 June 2006 8:48 PM
> > To: ozmidwifery@acegraphics.com.au
> > Subject: [ozmidwifery] How long before synto is used?
> >
> > For those who work in maternity units, I am just wondering what the
policy
> > is in your unit in regards to how long a woman can continue after her
> waters
> >
> > have broken before having synto put up? There seems to be such pressure
to
> > put it up fairly quickly (after you ask to at least wait at all!), with
an
> > average of about 1 hour before the woman gets the pressure to speed
things
> > up.
> > Best Regards,
> >
> > Kelly Zantey
> > Creator, BellyBelly.com.au
> > Gentle Solutions From Conception to Parenthood
> > BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support
> >
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