Thanks everyone for your responses so far re cord blood gases. It
will all be so helpful when we 'go into battle'.
Shelly, you commented about letting the parents make the
decision. This is one of our biggest areas of concern, as the
medicos have made no mention of how informed consent will be
obtained, and 'asking at the time', which was one response to this,
is so very inappropriate. I truly despair at the interpretation of
'informed consent' that I regularly see at my place of work. Your
references on this will be so useful.
Naomi
Naomi
In England we have seen in increase in 'fear' of litigation.
Obstetrics in this country has always taken a huge chunk of the
litigation for most hospitals . We now have in our country CNST
(clinical neglegence scheme for trusts). Trusts are what groups of
health care organisations are called. CNST is an insurance that
Trusts pay into so that litigation claims can be paid when won. The
CNST set out standards for trusts and depending on how well you
achieve the standards determines the insurance premiums, which you
can imagine are huge figures. The trouble is that CNST requirements
for the standards to be met are not always sensible or in the best
interests of women. Some standards like (cord blood sampling for ph
post birth) are simply taken to record results in the notes which
may protect against litigation in the future. I have a million
issues with this practice! We had a university supervised
professional debate about this issue in the Trust where I worked
when it first became an issue. The midwives against and the Obs.
for. We won the debate but the CNST requirements meant that we could
save the Trust loads of money if we did them so they were
introduced. Some of us still refused to do them. I would only do
them if it was explained in full to the mother and father and they
agreed. I gave it to them warts and all (like the obs openly admit
that it is just to defend them in cases of litigation.). I did not
make the decision the parents did. Needless to say when you tell
them how inaccurate the results are and that neither they nor the
baby will benfit from the results. Many choose not to have it done.
I will search out my references and post them seperately. Our debate
was published in a midwifery mag here!
Shelly
Midwife
----- Original Message ----- From: "Naomi Wilkin" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Friday, October 13, 2006 9:07 AM
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.
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