If only all the women, their families and the children born were of the same mind then we wouldn't have to consider any defensive practice, unfortunately this is not the case and I do not see anything wrong with midwives looking after them selves providing they are not causing problems to mother and baby. It is not just that you can't get struck off for bad practice it is the stress and despair as you spend the time (and money) defending yourself.
I am well aware about the information that says not to cut a cord on a compromised baby but it many situations it can be impossible to do this depending on the whereabouts of the woman and baby and the resus needed e.g. intubation. Could you please send the references about not needing to put blood for cord gases on ice and the length of time before cord gas results deteriorate as I must admit I have not looked at this myself but merely followed our labs advice. Sadie, it has become hospital policy then your choice is to continue to do this or change the policy, ignoring the policy will only make your life too stressful to practice at your best, I do sympathise with your predicament just gather all the information and keep plugging away. Christine -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Sadie Sent: 13 October 2006 22:27 To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] cord blood gases Just wondering where you work Lisa? You sound incredibly sarcastic and dismissive of what is a working fact for me. Sadie ----- Original Message ----- From: "Lisa Barrett" <[EMAIL PROTECTED]> To: <ozmidwifery@acegraphics.com.au> Sent: Friday, October 13, 2006 8:41 PM Subject: Re: [ozmidwifery] cord blood gases > > > >> Unfortunately Lisa, it is our hospital policy. Believe me, it is a pretty >> serious issue for any midwife that does not obtain cord gases. > > I'm sure that makes it ok then Sadie. Hospital policies are of course > the ultmate deterant against making people think for themselves. Quite > honestly if you don't do it and can back up why there is nothing to be > afraid of. You can't be struck off for good practice. > > On the point of putting it in ice. Just to make sure I wasn't talking > through my arse I have spent the evening reading up on blood gases. They > do not change significantly within the first hour and the reading is still > accurate at room temperature. > > Lisa Barrett > > > > . > > > > is a defensive issue and indeed I have found that the results often >>>> support your actions during labour i.e. in not intervening sooner and I >>>> try >>>> and do them if I think there may be a problem of some sort, sorry this >>>> is >>>> vague. If you are busy a good trick is to use two clamps on the cord >>>> to >>>> hold the blood in the cord and if you take it within 30 mins and get it >>>> in >>>> ice and to the labs the results are still OK to use. Of course you >>>> cannot >>>> do this with a physiological 3rd stage but I can't think you would need >>>> cord >>>> gases if all was well enough for a physiological 3rd stage. >>>> >>> >>> It is a defensive issue to do them at all. It is only ever to cover >>> yourself even if it's to back up not intervening. >>> Why would you suspect fetal compromise in labour that wasn't proven by >>> fetal compromise at birth and then what would a gas achieve. Either you >>> were right or wrong. >>> >>> If you are busy a good trick is to get someone else to care for the >>> other women at the time of birth so you don't have to put the cord blood >>> on ice. Better still don't do one. >>> >>> If all doesn't go well and you have a baby needing resus, all the >>> research tells us not to cut the cord, the way that a compromised baby >>> still is getting oxygen. >>> >>> To do a procedure you should have evidence to back up it's necessity. >>> There is none for blood gas. Just as there is none for continuous >>> monitoring. It's practice in fear and no good to anybody. >>> >>> Lisa Barrett >>> >>> >>> >>>> I am not a supporter of doing them at every birth as it is another >>> >>> >>> >>> >>>> distraction from caring for the mother and baby but it is helpful to >>>> support >>>> your care and the results can influence the treatment/care of a baby >>>> making >>>> the care more appropriate. >>>> >>>> Christine >>>> >>>> >>>> -----Original Message----- >>>> From: [EMAIL PROTECTED] >>>> [mailto:[EMAIL PROTECTED] Behalf Of Naomi Wilkin >>>> Sent: 13 October 2006 17:37 >>>> To: ozmidwifery@acegraphics.com.au >>>> Subject: [ozmidwifery] cord blood gases >>>> >>>> Hi all, >>>> Just wondering how common it is for cord blood gases to be done in >>>> maternity units. I work in a small metro. hospital with a very busy >>>> maternity unit and our medical 'powers that be' are pushing for them >>>> to be done at every birth. Something we, the midwives, are very, >>>> very reluctant to do. >>>> I was also wondering if anyone knows of any research that may help us >>>> to prevent this from becoming a routine thing. >>>> >>>> Thanks >>>> Naomi. >>>> >>>> >>>> -- >>>> This mailing list is sponsored by ACE Graphics. >>>> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. >>>> -- >>>> This mailing list is sponsored by ACE Graphics. >>>> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. >>>> >>> >>> -- >>> This mailing list is sponsored by ACE Graphics. >>> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. >>> >> >> >> -- >> This mailing list is sponsored by ACE Graphics. >> Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. >> > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
