re my story

[Jackie Kitschke]

I sent that story to the list as evidence that there are good 
stories around in hospitals and that we as midwives are as responsible for 
birth  outcomes as the doctors are. I do not want to use a public forum to 
judge who is good and who is not (by exculsion) as you can have the most wfo in 
the world but if they are working in systems that aren't women friendly their 
practice may change and who I think is good someone else may not. 
Jackie

Contact for Carolyn Hastie

[STEPHEN FLINT]

Please can Carolyn Hastie email Denise 
Hynd
Or some one else give me her email
Thank you Denise Hynd

Re: URGENT - 23 April national PI Summit

[STEPHEN FLINT]

Dear Barb and others,
Would it not be worthwhile asking the federal Labour and Democrat health
spokesperson to encourage  with Kay Patterson to acknowledge midwives and
maternity consumers have the current highest interest in the PI situation by
having them at this summit??
This can be simply done by a CC on the bottom of letters with copies to the
relevant MP/Senators.
Denise
PS
I will send an email  and add that by not having midwives and maternity
consumers at the summit this government is anti-competeitve and not
suppotive of consumer choice.
- Original Message -
From: "Vernon at Stringybark" <[EMAIL PROTECTED]>
To: "ozmid" <[EMAIL PROTECTED]>
Sent: Tuesday, April 09, 2002 9:18 PM
Subject: URGENT - 23 April national PI Summit


Dear List,

Maternity Coalition has been advised by someone working closely with
government on the PI issue that midwives are not being considered as part of
the AHMAC Working Group on PI report for the next Health minister's meeting
(due in May 2002).  This is despite the referral of this issue to the
Working Group by the September 2001 Health Minister's meeting in Adelaide.

We are also unsure whether or not the 23 April National Summit on PI
insurance to be hosted by fed health minister Kay Patterson includes
consideration of the effects of this issue on midwives.  At the moment we
have been unable to get a clear commitment that it will.

I have written and sent the following letter today.  I would urge all
interested organizations and individuals to send similar letters to the
federal health minister ASAP.  MC is seeking consumer representation at the
meeting.  We've probably got bucklies but it is important to try and to
stress the importance of maternity consumers' interests being considered!!

yours in midwife-led birthing,

Barb Vernon.




The Hon. Senator Kay Patterson
Minister for Health & Ageing
Parliament House
CANBERRA  ACT  2600

Dear Minister,

Re National summit on health professional indemnity insurance

I am writing to seek your urgent assurance that professional indemnity (PI)
insurance for midwives will be included on the agenda for the National
Summit on PI Insurance to be held on 23 April 2002 in Canberra.

The Maternity Coalition is a national non-profit umbrella organisation
committed to improving maternity care for women during pregnancy, birth and
the postnatal period, through women having greater access to one-on-one care
from an expert midwife.

Midwives are currently the only health professionals who have been forced to
cease practice altogether due to the lack of PI insurance.  The withdrawal
of this service affects more than 7,000 thousand Australian women and their
families each year.  The loss of this care is contrary to leading obstetric
research which shows that midwife-led care is both cost-effective and world
best-practice care for pregnant women.

The Australian Health Ministers acknowledged the importance of this issue
last September when they referred the problem of PI insurance for midwives
to the AHMAC Medical Indemnity Working Group.  Yet, extraordinarily, we have
information that suggests the Working Group has not considered the issue of
PI for midwives in the report it is preparing for the May Health Ministers¹
meeting.

The Maternity Coalition strongly urges you to include access for midwives to
affordable Professional Indemnity insurance on the agenda for the 23 April
Summit and to find workable solutions to restore private midwifery services.
This is particularly crucial in regional areas where childbirth services are
rapidly being shut down and women have no option but to travel long
distances to have their babies.

In addition to seeking your commitment to address the lack of PI insurance
for midwives, the Maternity Coalition is keen to represent consumers of
maternity services at the Summit.  We look forward to receiving an
invitation.

Yours sincerely,



Dr Barbara Vernon
National President
8 April 2002

--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

Re: 'turning' breech presentations.

[Kleimar]

Joy you raised some very interesting questions. Firstly the numbers of women 
included in the trial were actually quite small (130 in each arm), so the 
percentages translate to even smaller numbers (the 75% of moxa treated women 
with cepalic fetuses at term reprsents 98 women and the 62.3% of women in the 
control group with option of ECV represented 81 women with fetuses in 
cephalic presentation. The stats given for these numbers were P=.02;RR 1.21; 
95% CI, 1.02-1.43. 

Second was the timing of the moxa. My comment here is I think we are all 
reluctant to change our traditions. According to this paper, the standard of 
care for breech babies in China (or at least the hospitals were the trial 
took place) is moxa early in the 3rd trimester followed by ECV around 36-37 
weeks. In the introduction the authors present research on the probability of 
breech fetuses of primips, multips with prior breech, and multips with no 
prior breech turning spontaneously before 33 weeks, 35 weeks, etc..  They 
then decide to do the moxa treatment trial in the 33-35 week window ( which 
is not surprising to me because this is when it is done anyway). They appear 
to believe that spontaneous turning of a primip breech after 35 weeks in 
unlikely and so they want to use the moxa to enhance the likelihood of 
spontaneous turning (they give a figure of 15.5% for spontaneous correction 
of breech in primiparous women based on and article by Gottlicher and 
Madjaric, which is in a German publication (if anyone wants the name of it I 
will copy it later).  

Since moxa is traditionally done relatively early in the 3rd trimester, there 
is actually nothing in the literature to suggest that it is better than doing 
nothing at all later in the third trimester. Even though it is a procedure 
that the woman can do at home, it takes a lot of time and preparation to do 
right (or at least in the way it is done in the trial: 2 half hour 
stimulation per day for one to two weeks or until the baby is confirmed 
cephalic presentation). I realise that women who are making there own herbal 
preparations etc. may have no trouble with this but, I have worked with women 
who found it difficult to tolerate the smoke etc., not to mention the 
considerable irritation on their toes, and one client whose husband did not 
realise he had to extinguish the moxa stick and created a small fire in the 
kitchen. I don't know (because I have never offered it before 36 weeks) but I 
tend to think the discomforts would be more tolerable at 33 weeks than 37 
weeks. Then ECV is your back up. 


I have only worked with 4 clients who had breech presentations. 2 turned with 
ECV and were born vaginally and 2 were born vaginally in breech presentation. 
Of the 2 breeches at birth, one was undetected until labor and was born at 
home, the other refused to turn with 2 attempted ECV's [plus moxa daily from 
37 weeks and was born in the hospital with a necessary forceps lift out. The 
home birth was a multip, the hospital birth was a primip. My second daughter 
was breech (24 yrs ago and the dx was not made until 37 weeks, after which I 
had to change care providers (since my GP was recommending a c/s), get u/s, 
educate myself, and run around in a flap without appearing to be in a flap). 
I would have preferred to know earlier I think with full disclosure of all 
options, I don't know. I think it should be the woman's choice ultimately. 
But how can she choose if she doesn't have all of the information. 

Oh! The awareness of increased fetal movement: the paper admits it doesn't 
know how it (moxa) works, but they assume since increased awareness of fetal 
movement occured in the moxa subjects then that is related to how it works. 
They call for further investigation.  The paper states: "since moxabustion 
and ECV must be performed at different gestational ages, we may regard them 
as completmentary therapies to be used in succession".

Interestingly enough both of the groups in the trial had a high c/s rate even 
amongst babies cephalic at term. In the treatment group the c/s rate was 
35.4% (26 for breech at term) and in the control group 36.2% were c/s, again 
26 for breech at term. And this was apparently at hospitals wher the routine 
for breech birth was vaginal delivery.

Sorry this is so long. Marilyn
--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

moxibustion

[Meaghan Moon]

Hello Oz midders,
I have been following the thread of turning breeches with moxibustion with 
interest.  Recently we had a woman in our practice with a frank breech at 
33 weeks.  I tried moxibustion at 36 weeks.  Baby didn't turn and she had a 
c-section.  This was the first time I had tried moxibustion.  I was not 
prepared for how much smoke these sticks gave off.  I gave the first 
treatment our clinic and it stunk the place up for days.  It was a strange 
one to explain to clients coming in after the event.  One client became 
very ill shortly after her exposure to the smoke.  The parents took the 
moxa home with them and did it in the bathroom with the exhaust fan on but 
it was so smokey that it discouraged them from using it.  Anyway, in Canada 
where we cannot open doors and windows at any time of year or expose bare 
toes in the outdoors this presents a problem.  Anyone got a creative solution?

Meaghan


--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

the story of butterfly that didn't make it

[Malavisi, Pete]

a friend sent this to me she had come across it, yours in midwifery pete
malavisi

The Struggle Inside The Cocoon

I thought I'd share a wonderful little story with you today...

"A young man was attending a university, studying to become a naturalist.
One lovely spring day during his first year, when he was really feeling
burned out by studying, he decided to take a break and go for a stroll in
the nearby woods.

As he walked through the woods with warm sunlight streaming through the
fresh green leaves, he saw a twig with a cocoon attached to it that was
literally vibrating with
life.

He observed the cocoon for a few minutes, pondering the life and struggle
taking place inside of it.

Then, partly out of curiosity, partly out of misguided sympathy,  the young
man pulled a pocket knife out of his pocket. Then, he carefully-so as not to
hurt the creature inside - slit the cocoon from one end to the other and
stepped back to see what would happen.

In a few moments there emerged the crumpled wings of a beautiful monarch
butterfly. The butterfly tried to fly, but it fluttered and fell to the
ground.

The butterfly tried to fly once more and once more it fell to the ground.
Then it became very still, and the young man saw that- much to his horror-
the beautiful butterfly was dead.

Later, when it was too late, he learned that it is the struggle inside the
cocoon that builds strength in the wings and body of the creature inside so
that at the appropriate time it can emerge on its own and survive as an
adult in the world.

--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

URGENT - 23 April national PI Summit

[Vernon at Stringybark]

Dear List,

Maternity Coalition has been advised by someone working closely with
government on the PI issue that midwives are not being considered as part of
the AHMAC Working Group on PI report for the next Health minister's meeting
(due in May 2002).  This is despite the referral of this issue to the
Working Group by the September 2001 Health Minister's meeting in Adelaide.

We are also unsure whether or not the 23 April National Summit on PI
insurance to be hosted by fed health minister Kay Patterson includes
consideration of the effects of this issue on midwives.  At the moment we
have been unable to get a clear commitment that it will.

I have written and sent the following letter today.  I would urge all
interested organizations and individuals to send similar letters to the
federal health minister ASAP.  MC is seeking consumer representation at the
meeting.  We've probably got bucklies but it is important to try and to
stress the importance of maternity consumers' interests being considered!!

yours in midwife-led birthing,

Barb Vernon.  




The Hon. Senator Kay Patterson
Minister for Health & Ageing
Parliament House
CANBERRA  ACT  2600

Dear Minister,

Re National summit on health professional indemnity insurance

I am writing to seek your urgent assurance that professional indemnity (PI)
insurance for midwives will be included on the agenda for the National
Summit on PI Insurance to be held on 23 April 2002 in Canberra.

The Maternity Coalition is a national non-profit umbrella organisation
committed to improving maternity care for women during pregnancy, birth and
the postnatal period, through women having greater access to one-on-one care
from an expert midwife.

Midwives are currently the only health professionals who have been forced to
cease practice altogether due to the lack of PI insurance.  The withdrawal
of this service affects more than 7,000 thousand Australian women and their
families each year.  The loss of this care is contrary to leading obstetric
research which shows that midwife-led care is both cost-effective and world
best-practice care for pregnant women.

The Australian Health Ministers acknowledged the importance of this issue
last September when they referred the problem of PI insurance for midwives
to the AHMAC Medical Indemnity Working Group.  Yet, extraordinarily, we have
information that suggests the Working Group has not considered the issue of
PI for midwives in the report it is preparing for the May Health Ministers¹
meeting.  

The Maternity Coalition strongly urges you to include access for midwives to
affordable Professional Indemnity insurance on the agenda for the 23 April
Summit and to find workable solutions to restore private midwifery services.
This is particularly crucial in regional areas where childbirth services are
rapidly being shut down and women have no option but to travel long
distances to have their babies.

In addition to seeking your commitment to address the lack of PI insurance
for midwives, the Maternity Coalition is keen to represent consumers of
maternity services at the Summit.  We look forward to receiving an
invitation. 

Yours sincerely,



Dr Barbara Vernon
National President
8 April 2002

--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

Fw: 'turning' breech presentations.

[Darren Sunn]

> From a plain midwife who is very reluctant to interfere with the natural
> > process.
> > Joy Johnston
> >
> I guess the problem is that if we leave it to the babies to turn if they
> choose and they don't, most women are left with a very unnatural pathway. ie
> C/S.   MM
> 
>Babies can, and have been born breeched (naturally ie. NO intervention and at home). 
>It is not a foregone conclusion that a breech "should" be C/S, nor does it logically 
>follow that left up to nature it will be successful birth. What is important is that 
>good information is presented, researched and discussed so that the mother can make 
>an informed choice.

Darren Sunn.

--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

re: lasinoh

[Steve & Bronni McGrath]

Then my visitor to the class arrived - a new mum and her gorgeous 
  8 week oldbaby - and took out her tube of Lansino and told them that it 
  was essentialand that it had saved her nipples and she used it all the 
time
I have used it and for me it wasn't much help.  I had the joy of 
nipple vasospasm and no amount of cream would help.  I was disappointed as 
i had heard other's swear by it.  A great product for the right person, i 
did have lots of love and support and that got me through both times, and am 
still feeding my 17 month old and love it.
Regards Bronni