Fw: 'educated' women
- Original Message - From: S.J.F.ELECTRICAL. To: [EMAIL PROTECTED] ; Lynne Staff Sent: Wednesday, May 15, 2002 8:00 AM Subject: Re: 'educated' women Dear Lynn I was wondering if Selangor's website was up and if so what is the address??As on Monday at a function for international nurses midwives days at Sydney private hospital I asked the DCS/DON had she contemplated offering a midwifery option of care for at least the client's of some understanding/knowledgeable obs at this hospital (Phillip Coocks Andrew Pesce were cited as possibiles). She has and will look at it again!!So all you midwives in Private hospitals do not loose heart!! All of you everywhere make a suggestion at least once a year, month, week toward a midwfery form/option of care!Or join Maternity Coalition ACMI and get pushing through them Denise in - Original Message - From: Lynne Staff To: Debby M Cc: [EMAIL PROTECTED] Sent: Friday, May 14, 2010 8:53 AM Subject: Re: 'educated' women Dear Debbie - I was saddened to read your posting but also so pleased you turned your experience into a positive learning one for yourself and others, as you shared with this list. Some years ago I had to do an assignment for uniwhere we had to choose a group of disadvantaged women and prepare a resource package for them, to make available for them in order to "maximise" their chances of a good birth (that means so many things to different people doesn't it?). Anyway, I chose privately insured women as a disadvantaged group andbased my arguments on the high operative outcomes, that cannot be explained away by 'risk', and strengthened that argument using the way in which , and what information is provided to women by obstetricians (as women with Private Health insurance would get the majority of their information from their ob with that ever pervasive medical perspective). I would love to talk to you more about this if you would be willing. Also I do agree that we (in Oz) need, as you say, some leaflets like the informed choice leaflets thatare available in the UK. However, I was looking through them againh, the other day, and thinking that there are still some of the brochures which subtly (and some not-so-subtly) lead a woman 'that' way, and lead them away from listening to, believing in and acting on theirown bodily knowledgeand what it tells them at this time. Just my two cents worth - regards, Lynne - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 7:32 PM Subject: Re: 'educated' women I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice. My first birth was the classic cascade of intervention leading to a csec and I was led down that path by my obstetrician. It wasn't until some months after the birth and a lot of reading, that I discovered there were many many aspects of the decisions made by myself that were far from informed. On almost every aspect related to my "care" my obstetrician presented me with advice and information that could only lead me to conclude and agree that his advice for the recommended intervention was right. I later found there were a whole range of risks and options that I was not told about and on one piece of intervention he actually out and out lied to me. I can only presume that he thought he was doing the right thing, but I also get the feeling that often we, the woman, are only told what our carer wants us to hear. Whilst we may think we are informed at the time it is not until we get our noses into some good medical research papers and text books that we discover how much wider the risks and options are. This in itself presents a couple of problems. The first being time, and what do you teach women? There is obviously a lot to learn or obstetric and midwifery training wouldn't take so long. Some of the concepts I have read about I have had to bounce of my husband (a radiographer) to fully grasp what is being discussed and its implications, indicating that those with a lesser education than I may have even more difficulty in grasping some of the risks or benefits of different ideas related to labour management. I am very pro informing the woman. I think one of the best ways this could be done would be to have a series of little brochures that talk in simplified terms that most women could understand what the causes, treatments and consequences of the myriad of bi
Re: 'educated' women
Dear Debbie - I was saddened to read your posting but also so pleased you turned your experience into a positive learning one for yourself and others, as you shared with this list. Some years ago I had to do an assignment for uniwhere we had to choose a group of disadvantaged women and prepare a resource package for them, to make available for them in order to "maximise" their chances of a good birth (that means so many things to different people doesn't it?). Anyway, I chose privately insured women as a disadvantaged group andbased my arguments on the high operative outcomes, that cannot be explained away by 'risk', and strengthened that argument using the way in which , and what information is provided to women by obstetricians (as women with Private Health insurance would get the majority of their information from their ob with that ever pervasive medical perspective). I would love to talk to you more about this if you would be willing. Also I do agree that we (in Oz) need, as you say, some leaflets like the informed choice leaflets thatare available in the UK. However, I was looking through them againh, the other day, and thinking that there are still some of the brochures which subtly (and some not-so-subtly) lead a woman 'that' way, and lead them away from listening to, believing in and acting on theirown bodily knowledgeand what it tells them at this time. Just my two cents worth - regards, Lynne - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 7:32 PM Subject: Re: 'educated' women I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice. My first birth was the classic cascade of intervention leading to a csec and I was led down that path by my obstetrician. It wasn't until some months after the birth and a lot of reading, that I discovered there were many many aspects of the decisions made by myself that were far from informed. On almost every aspect related to my "care" my obstetrician presented me with advice and information that could only lead me to conclude and agree that his advice for the recommended intervention was right. I later found there were a whole range of risks and options that I was not told about and on one piece of intervention he actually out and out lied to me. I can only presume that he thought he was doing the right thing, but I also get the feeling that often we, the woman, are only told what our carer wants us to hear. Whilst we may think we are informed at the time it is not until we get our noses into some good medical research papers and text books that we discover how much wider the risks and options are. This in itself presents a couple of problems. The first being time, and what do you teach women? There is obviously a lot to learn or obstetric and midwifery training wouldn't take so long. Some of the concepts I have read about I have had to bounce of my husband (a radiographer) to fully grasp what is being discussed and its implications, indicating that those with a lesser education than I may have even more difficulty in grasping some of the risks or benefits of different ideas related to labour management. I am very pro informing the woman. I think one of the best ways this could be done would be to have a series of little brochures that talk in simplified terms that most women could understand what the causes, treatments and consequences of the myriad of birth related problems and procedures are, eg. Understanding Fetal Distress 1. Join the worlds largest e-mail service with MSN Hotmail. Click Here-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: 'educated' women
Lynne Interesting that you cite the (I presume) MIDIRS Informed Choice leaflets. I Mavis Kirkham's attended presentationat the ICM Congress in Vienna regarding the analysis of the effectiveness of the leaflets. Very big study. From memory the results have been published in the BMJ . Unfortunately, once again the findings were not positive as the analysis indicated that women continue to believe the MO rather than evidence based leaflets. Mavis concludesthat auhtorative knowledge ( that is the dominant ideology) is all and thatdecisions are made in a climate ofblame manipulation and control fear. This is not to say don't use them, develop your own etc. Just to be aware that they are not necessarily going to be as influencing on decision making as we may think ( or hope)! Liz McCall - Original Message - From: Lynne Staff To: Debby M Cc: [EMAIL PROTECTED] Sent: Friday, May 14, 2010 8:53 AM Subject: Re: 'educated' women Dear Debbie - I was saddened to read your posting but also so pleased you turned your experience into a positive learning one for yourself and others, as you shared with this list. Some years ago I had to do an assignment for uniwhere we had to choose a group of disadvantaged women and prepare a resource package for them, to make available for them in order to "maximise" their chances of a good birth (that means so many things to different people doesn't it?). Anyway, I chose privately insured women as a disadvantaged group andbased my arguments on the high operative outcomes, that cannot be explained away by 'risk', and strengthened that argument using the way in which , and what information is provided to women by obstetricians (as women with Private Health insurance would get the majority of their information from their ob with that ever pervasive medical perspective). I would love to talk to you more about this if you would be willing. Also I do agree that we (in Oz) need, as you say, some leaflets like the informed choice leaflets thatare available in the UK. However, I was looking through them againh, the other day, and thinking that there are still some of the brochures which subtly (and some not-so-subtly) lead a woman 'that' way, and lead them away from listening to, believing in and acting on theirown bodily knowledgeand what it tells them at this time. Just my two cents worth - regards, Lynne - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 7:32 PM Subject: Re: 'educated' women I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice. My first birth was the classic cascade of intervention leading to a csec and I was led down that path by my obstetrician. It wasn't until some months after the birth and a lot of reading, that I discovered there were many many aspects of the decisions made by myself that were far from informed. On almost every aspect related to my "care" my obstetrician presented me with advice and information that could only lead me to conclude and agree that his advice for the recommended intervention was right. I later found there were a whole range of risks and options that I was not told about and on one piece of intervention he actually out and out lied to me. I can only presume that he thought he was doing the right thing, but I also get the feeling that often we, the woman, are only told what our carer wants us to hear. Whilst we may think we are informed at the time it is not until we get our noses into some good medical research papers and text books that we discover how much wider the risks and options are. This in itself presents a couple of problems. The first being time, and what do you teach women? There is obviously a lot to learn or obstetric and midwifery training wouldn't take so long. Some of the concepts I have read about I have had to bounce of my husband (a radiographer) to fully grasp what is being discussed and its implications, indicating that those with a lesser education than I may have even more difficulty in grasping some of the risks or benefits of different ideas related to labour management. I am very pro informing the woman. I think one of the best ways this could be done would be to have a series of little brochures that talk in simplified terms that most women could understand what the causes, treatments and consequences of the myriad of birth related problems and procedures are, eg. Understa
Re: 'educated' women
Hi Liz Kirkham Mavis gave the Oration at the ACMI Fellows Investiture last year, and I enjoyed her presentation thoroughly. I would love a copy of her full paper, so must peruse BMJ. No, I was thinking about the way in which the leaflets were put together, not only in actual terminolgy used but in the way some of the sentences were construced as well. The messages still come through in some of them (even though they are evidence based),that birthis a potential disaster.Yes, lurking on the fringes, and it is these veiled meanings, I guess you could call them, that I was particularly referring to. I do think it is wonderful the leafletsareavailable (and wasn't it about time, too) and they are a positive step for women, and I know Rome wasn't built in a day (but these leaflets do lay a good foundation).These are just somethoughts I have after reflecting a bit on them. (and I am sure there are many midwives out there who are ready to throttle me for my posting to Debby and the list!! But, as I said,the comment is meant to be a constructive one, and not destructive, and based on my own musings/observations - whatever you like to call them.) This is entirely separate from what Mavis Kirkham's study is about. I interpreted the content of her orationas meaningthe way in which midwives used the leaflets, and in the ways midwivesprovided women with"packages of dense information" without actually ascertaining what women's individual information needs were, or hearing what the women were telling them their needs were. I am truely an academic novice, and haven't got the words to say what I mean yet,but I have this thing about information and the ways in which it is provided (not hard to pick THAT!!! I wonder if it is obsessive compulsive disorder, and what I should do with it!!). By the way, I love Kirkham and Perkins' "Reflections on Midwifery" Recommended reading for all midwives, GPs and obstetricians involved in maternity care. Regards, Lynne - Original Message - From: Ms Elizabeth McCall To: [EMAIL PROTECTED] Sent: Tuesday, May 14, 2002 10:23 AM Subject: Re: 'educated' women Lynne Interesting that you cite the (I presume) MIDIRS Informed Choice leaflets. I Mavis Kirkham's attended presentationat the ICM Congress in Vienna regarding the analysis of the effectiveness of the leaflets. Very big study. From memory the results have been published in the BMJ . Unfortunately, once again the findings were not positive as the analysis indicated that women continue to believe the MO rather than evidence based leaflets. Mavis concludesthat auhtorative knowledge ( that is the dominant ideology) is all and thatdecisions are made in a climate ofblame manipulation and control fear. This is not to say don't use them, develop your own etc. Just to be aware that they are not necessarily going to be as influencing on decision making as we may think ( or hope)! Liz McCall - Original Message - From: Lynne Staff To: Debby M Cc: [EMAIL PROTECTED] Sent: Friday, May 14, 2010 8:53 AM Subject: Re: 'educated' women Dear Debbie - I was saddened to read your posting but also so pleased you turned your experience into a positive learning one for yourself and others, as you shared with this list. Some years ago I had to do an assignment for uniwhere we had to choose a group of disadvantaged women and prepare a resource package for them, to make available for them in order to "maximise" their chances of a good birth (that means so many things to different people doesn't it?). Anyway, I chose privately insured women as a disadvantaged group andbased my arguments on the high operative outcomes, that cannot be explained away by 'risk', and strengthened that argument using the way in which , and what information is provided to women by obstetricians (as women with Private Health insurance would get the majority of their information from their ob with that ever pervasive medical perspective). I would love to talk to you more about this if you would be willing. Also I do agree that we (in Oz) need, as you say, some leaflets like the informed choice leaflets thatare available in the UK. However, I was looking through them againh, the other day, and thinking that there are still some of the brochures which subtly (and some not-so-subtly) lead a woman 'that' way, and lead them away from listening to, believing in and acting on theirown bodily knowledgeand what it tells them at this time. Just my two cents worth - regards, Lynne - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 7:32 PM Subject: Re: 'educated' wome
Re: 'educated' women
I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice. My first birth was the classic cascade of intervention leading to a csec and I was led down that path by my obstetrician. It wasn't until some months after the birth and a lot of reading, that I discovered there were many many aspects of the decisions made by myself that were far from informed. On almost every aspect related to my "care" my obstetrician presented me with advice and information that could only lead me to conclude and agree that his advice for the recommended intervention was right. I later found there were a whole range of risks and options that I was not told about and on one piece of intervention he actually out and out lied to me. I can only presume that he thought he was doing the right thing, but I also get the feeling that often we, the woman, are only told what our carer wants us to hear. Whilst we may think we are informed at the time it is not until we get our noses into some good medical research papers and text books that we discover how much wider the risks and options are. This in itself presents a couple of problems. The first being time, and what do you teach women? There is obviously a lot to learn or obstetric and midwifery training wouldn't take so long. Some of the concepts I have read about I have had to bounce of my husband (a radiographer) to fully grasp what is being discussed and its implications, indicating that those with a lesser education than I may have even more difficulty in grasping some of the risks or benefits of different ideas related to labour management. I am very pro informing the woman. I think one of the best ways this could be done would be to have a series of little brochures that talk in simplified terms that most women could understand what the causes, treatments and consequences of the myriad of birth related problems and procedures are, eg. Understanding Fetal Distress 1. What is fetal distress 2. Some examples of what can cause it 3. How is it diagnosed - intermittent, continuous, fetal scalp monitoring, fetal ph testing, fetal stimulation test- pros and cons of these (maybe referring to another brochure for the monitoring) 3. Alleviating fetal distress by - changing positions, oxygen, turning of interventions (oxytocin, epidurals etc), operative delivery (referring to another brochure), csec (referring to another brochure) - pros and cons of these. As you can see even a simple approach can prove complex - there would be a lot of different brochures - and unfortunately most women will take the "it will never happen to me" approach, and being in labour is probably not the best time to be reading a document - although having such information available would mean that at least the support person would be aware if the woman had been given all the options. I don't know that there is a solution to this. Whilst early birth education may be useful there will always be the problem of information retention as women wait for longer and longer after finishing school to have their babies. The only way I can see to help women is to make the information as widely available as possible, it is then up to them if they choose to absorb the facts or if they choose to rely on other people for the information - which of course carries the risk I encountered during my first delivery of being told what they want you to hear. Debby MillerChat with friends online, try MSN Messenger: Click Here -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: 'educated' women
Debby, You rightly point out one of the dilemnas of childbirth education - how much do we teach and what perspective do we teach from? How on earth to get across the myriad of information so women can make truly informed choices? If we tried to teach even a tenth of all the possible things that could happen in their pregnancy, labour, birth, postpartum or with breastfeeding, it would take hundreds of hours of childbirth education or piles and piles of brochures. Then the problem that all women you are working with have a different knowledge base to start with, a different level of interest and motivation, and a different capacity to absorb and understand the information. So how do we tackle it at all? I work at this from two perspectives. Firstly, teach NORMAL pregnancy, NORMAL birth, NORMAL neonatal issues, NORMAL breastfeeding. For example, I don't talk about pain relief options. Why not? Because my clients do not need me to cover anything they can read for themselves in a pregnancy book or a women's magazine. We talk about pain. How pain is normal. Why labour hurts. What it is telling us. How will it benefit the woman and her baby. How she has everything within her capacity to deal with it. How her body will utilise amazing hormones to work with her pain. How she has so many options available to her to help her deal with it. Pain is normal. Labour will hurt. I don't try and talk about ways to make it go away. I do the same with normal labour. I don't talk about fetal distress. Only one women in twenty that I teach might even experience this problem. So how do I make sure that if she is the one in twenty that she has some way of making informed choices? This is the second aspect of my classes. I teach her skills that she can utilise in ANY situation where labour does not take the path she had deemed the most optimal one. Decision making tools. Questioning and communication tools. Techniques for determining the type of caregiver she had chosen and how to go about exploring other options if she decides she has the wrong one for her needs. These skills are not only helpful for gaining further information when a doctor tells her he thinks her baby is in distress. They will also help her to explore her options if she has gestational diabetes diagnosed. Or her membranes rupture before the onset of contractions. Or if her labour is not progressing as quickly as her caregiver would like. Or her baby is thought to have jaundice and the caregiver has suggested testing. Or if she is experiencing problems with breastfeeding. Or even 5 years later when she is trying to resolve a problem with her son or daughter related to their school classroom. TRhese are life skills. They are not unique to labour. They do not require a massive accumulation of knowledge on every single possibility. Teach simple tools that develop skills for communication, decision making and questioning. Teach effective listening techniques by example. Teach assertiveness by example. Really beieve in what you teach and then practice it yourself. Your clients will follow your lead - not every time but for those who are in a place on their own journeys where they are ready to do so, they will see your example of "walking your talk" and develop those same skills themselves. A long way to not say very much I think! Nikki Macfarlane Singapore - Original Message - From: Debby M To: [EMAIL PROTECTED] Sent: Sunday, May 12, 2002 5:40 PM Subject: Re: 'educated' women I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice.
Re: 'educated' women
yes, those too. marilyn
educated women
I believe it is absolutely vital that birthing education is given in schools as it is during these years that most of your values and beliefs are instilled. Recently I was talking to one of our GP/Obs who is Dutch. She was discussing the system in Holland (which I so envy) where only midwives or Obstetricians partake in pregnancy and birth. She herself had three beautiful homebirths and it was so lovely to see her face light up and the absolute joy she experienced with her own births.She discussed the normality of this whole process over there and how frustrating she finds our present system within the hospitals-as does many of us. The Dutch are raised believing birth to besuch a normal event in life and don't get bogged down in the "pain issue" as appears to be a major crux in our society does. I truly believe for things to really change in Australia is must begin with the education of our children, the birthing parents of the future. Lets get to it! Tracy
Re: 'educated' women
I too have thought for sometime that perhaps the education on birth should begin in school - it seems to often be too late once a woman is pregnant! For some women though there must be emotional issues I think. I have also wondered whether evolutionary theory has led to the belief that we can further improve on nature - that our bodies have a fault that has to be bypassed by an abdominal incision!
'educated' women
I have always thought that education on birth would be very beneficial at senior high school and universities.I think I have said it before, we should really educate the women doing feminist studies, gender studies and so forth. The ones who believe strongly in their rights over their bodies. I know that one private hospital that EVERYONE wants to go to here in Adelaide offers 'pre-birth' education to couples planning babies...and knowing that the cs rate at this hospital is up around the 60%, then I am sure this 'education' contains all the benefits and pros of safe easy surgeryone comment was overheard "the spinal in at 9am, the baby born at 9.15 and the champagne flows at 10am" (this was said by a client, not staff). vacating the soap box once more Jo Bainbridgefounding member CARES SAemail: [EMAIL PROTECTED]phone: 08 8365 7059birth with trust, faith love...
Re: 'educated' women
In a message dated 5/10/02 8:05:56 PM W. Australia Standard Time, [EMAIL PROTECTED] writes: I have always thought that education on birth would be very beneficial at senior high school and universities. Here in Perth we have the Birthplace Support group which give school talks about childbirth. I cannot tell you much more about the results of their work, as I have no direct experience, but I am sure that it is very effective. I have volunteered to help out, and will tell you more when I have more information. Debbie Slater Perth, WA
Re: 'educated' women
so long as we also play pre op tapes to people having breast reduction, breast enhancements, face lift, tummy tucks...etc etc. Kirsten - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, May 10, 2002 7:36 AM Subject: Re: 'educated' women I really think all women considering elective cesareans should be shown graphic videos of the operation and exactly what will be done to their body. As a midwifery student I was quite interested to witness my first c/s and it was nothing at all like the pre-op videos I had seen in CBE classes or at school and certainly not at all like the birthday TV shows. Also, since there is quite a lot of variety in the length of time to perform the surgery etc., I think several such videos should be shown to those requesting elective c/s for non obstetric/medical reasons. I think this would be true informed consent. Having been with a few friends lately who have had necessary surgeries for a variety of conditions, I was shocked at how the body trauma of the surgery was minimised to these women. I was also shocked at the response I received when I tried to inform one family of the help their mum would need after such a major operation (she nee! ! ded a complete hysterectomy after torsion of her fallopian tube and her ovary becoming a 5 pound mass). The surgeons had really minimised the post-op recovery etc.. presumably to get my friend to have the surgery, which incidently I totally agreed she needed. Anyway, I think people need reality checks every now and again. marilyn
