Naomi
That was one of the big issues for us too! Hence the debate. Women are supposed to be informed antenatally. I know that they are being taken but women are seldom asked and seldom know. How dreadful!
Shelly
----- Original Message ----- From: "Naomi Wilkin" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Monday, October 16, 2006 8:57 AM
Subject: Re: [ozmidwifery] cord blood gases



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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