RE: [ozmidwifery] OP babies

[Ken Ward]

It is 
suppose to be our life style. Too much sitting around.  My last baby was ol 
to oa and rotated around to op during labour and got stuck.. Awful feeling, as 
if I had a piece of 4x2 up there.  Anyway a gentle keillands rotation, and 
she just about fell out.  Where I did my mid the obests. would often do a 
rotation and then let the babies birth naturally.  I don't think it's my 
pelvis 'cause the boys were oa,s.  But no. 1, another girl, was also an op.--Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]]On Behalf Of Jo & Dean 
BainbridgeSent: Tuesday, August 13, 2002 9:04 PMTo: 
[EMAIL PROTECTED]Subject: [ozmidwifery] OP 
babies

  I have a question that will probably be seen as a 
  silly one to some (but remember I am a consumer so it is my right to ask silly 
  questions!)  If one of the main reasons for cs is failure to progress and 
  fetal malpresentation AND a common factor with both these 'reasons' is a baby 
  that is persistently in OP ... why doesn't anyone do anything to correct this 
  before labour?  I know a large portion of bubs are OP then turn during 
  labour; but it seems like we have found that it is easier to deal with it by 
  cs or forceps rotation...why is it we don't try to avoid the situation 
  altogether?
  Very few women I have encountered were even aware 
  of the term OP or what the whole OP presentation involves (longer labours more 
  interventions etc). Why do we pregnant mums not get told during ante-natal 
  check ups what position bubs in?  Why doesn't anyone check when labour 
  commences?  
  I am aware of the optimal presentation booklet 
  and now try to encourage all women I come across to be aware of their posture 
  and to try swimming and sitting in positions as well as vertical positioning 
  during labour that will encourage bub to be OA but this is AFTER I 
  had a cs for failure to progress (8cm and stalled for 2 hours no fetal 
  distress- due to having a monitor on and being made to be supine...no wonder 
  bub did not turn himself!)
  I am curious why this seems to be something that 
  is ignored by mainstream but something that plays a major role in how birth 
  results as cs or ivd??
  can anyone shed some light??   
  
  Jo Bainbridgefounding member CARES 
  SAemail: [EMAIL PROTECTED]phone: 08 
  8388 6918birth with trust, faith & 
love...

Re: [ozmidwifery] Achieving Midwifery Models in Hunter

[Kathleen Fahy]

Dear Terry,
 
Thank you so much for this very useful piece of information.
 
I'll follow up.
 
Best wishes,
 
Kathleen
 
--Kathleen 
FahyProfessor of MidwiferyHead of School of Nursing and 
MidwiferyFaculty of HealthThe University of NewcastleUniversity 
Drive,Callaghan, 2308
 
Ph 02 49215966
 
Fax 02 49216981>>> [EMAIL PROTECTED] 08/15/02 10:56am 
>>>
Hi Kathleen,
Sorry for my mix-up, and good luck on the day, I hope you 
get lots of people with many ideas.
I presented one of our members with an idea, and she has 
taken it on board to write up a proposal for us.
Community midwifery care where by a group of midwives will 
take on a case load of women and birth them in the setting of their choice or 
appropriate to them. Home or hospital. This should be paid for by the health 
system, we are still working on the proposals to take to the numerous committees 
to be considered, may be your group can help us, as we may be able to help you. 

The name of the person writing up our proposal is 

Sonia Anderson Phone 03 
62636706
88 Tongatabu Rd
Dromedary 7030
Tasmania
 
Terry Stockdale Independent Midwife

  - Original Message - 
  From: 
  Kathleen Fahy 
  To: [EMAIL PROTECTED] 
  
  Cc: [EMAIL PROTECTED] 
  Sent: Tuesday, August 13, 2002 5:07 
  PM
  Subject: Re: [ozmidwifery] Achieving 
  Midwifery Models in Hunter
  
  Dear Terry,
   
  I am sorry if you posting confused you.  I am taking responsibility 
  for planning the day.  I have invited Justine as our guest to use her 
  well know facilitation and activist skills to help the day move forward in a 
  really dynamic way.
   
  I did attach the details to the last e-mail as a flyer.  Do you have 
  specifc questions?
   
  Kathleen
   
  --Kathleen 
  FahyProfessor of MidwiferyHead of School of Nursing and 
  MidwiferyFaculty of HealthThe University of NewcastleUniversity 
  Drive,Callaghan, 2308
   
  Ph 02 49215966
   
  Fax 02 49216981>>> [EMAIL PROTECTED] 08/13/02 
  10:44am >>>
  
Hi,
Can Justin Caines email me re info that maybe 
of help.
Terry Stockdale
[EMAIL PROTECTED]
 
- Original Message - 
From: 
Kathleen Fahy 
To: [EMAIL PROTECTED] 

Cc: [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; Anne Saxton 
Sent: Monday, August 12, 2002 5:27 
PM
Subject: [ozmidwifery] Achieving 
Midwifery Models in Hunter

Dear All,
 
I am attaching a flyer advertising our workshop to find ways to bring 
about publically funded midwifery models (including homebirths) here in the 
Hunter Valley.  Anne Saxton (Midwife and Service Manager has a 
vision to reactivate and revitalise midwifery models for 
which the John Hunter Hospital was once famous). 
 
We will be coordinating our efforts in line with the National Maternity 
Action Plan.  The day will be facilitated by Justine Cain a 
mother of 3 under 3 and a birth activist with Maternity Coalition.  

 
If you would like to join us for the day your energy would be most 
welcome.  There is no cost (except if you want us to provide lunch and 
morning tea but you are free to bring your own).
 
Please RSVP to Nadyne Smith (my PA) 02 49217873
 
 
 
 
--Kathleen 
FahyProfessor of MidwiferyHead of School of Nursing and 
MidwiferyFaculty of HealthThe University of NewcastleUniversity 
Drive,Callaghan, 2308
 
Ph 02 49215966
 
Fax 02 49216981

Re: [ozmidwifery] OFP

[JoFromOz]

Hi Eliza, not sure if you caught my other post... just wanted 
to say Hi ... I was in the same mid course as you :) How are you 
finding your first year out?  I am finding things  A LOT different to 
what I expected... where I am working, everybody is very 'scissor happy" 
:(  I am learning who to keep my mouth shut around, and who I can confide 
in about different little things.
 
Well, hope you are enjoying finally being a midwife 
:)
 
Jo

  - Original Message - 
  From: 
  henk / eliza merbis 
  To: [EMAIL PROTECTED] 
  
  Sent: Thursday, August 15, 2002 4:48 
  AM
  Subject: [ozmidwifery] OFP
  
  Dear Larissa,
   
  Being new to 'the business', I couldn't help but 
  pick up on your email about how you feel about OFP and how you are going to 
  include it in your CBE classes. I would be very interested in a rundown on 
  this interesting topic as we really didn't cover it in our course (Post Grad. 
  Dip Midwifery). Surprise! Surprise!
  Would you have any info you could perhaps send 
  me/email me??
   
  Eliza 
   

[ozmidwifery] Re:

[Lynne Staff]

Judy - what a situation. Have to step back and look at some strategies. We
are not public, but have 1-2-1 care in birth suite. For references, ask her
to look at the government investigations into maternity care  since 1990,
and the recommendations from those investigations. Plain as the nose on your
face to keep the birth centre going, to encourage more, and for more women-
friendly services (our best "risk management" tool). Got to go but will
write more fully later - regards, Lynne
- Original Message -
From: "Judy Chapman" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, August 15, 2002 10:50 AM


>
>
> Hi All
>
> Assistance is needed urgently.
> We have a relatively new DON in Mackay and yesterday we were told by one
of
> the nurse managers that she is not in favour of midwives. Apparently we
all
> think ourselves too good and she wants us to be good little nursies and go
> back to doing what the doctors tell us to do.
>
> She has given our NPC (ex Birth Centre and homebirth midwife) till next
> Fricay to justify every position in the unit.
> Wants to get rid of midwife antenatal clinic, 7 day EMS, Antenatal classes
> etc. The Birth Centre has to justify its existance (thank God they have a
> strong consumer support group).
>
> I need references to easily obtained evidence to assist in our case.
>
> As well I need a leaflet to be able to give out to women and the community
> on the role and responsabilites of a midwfe. We need community support.
>
> Also need to find out the midwife:Client ratio in Birthing suites,
> especially Qld Health Facilities.
>
> Thanks in advance
> Judy
>
> _
> MSN Photos is the easiest way to share and print your photos:
> http://photos.msn.com/support/worldwide.aspx
>
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> This mailing list is sponsored by ACE Graphics.
> Visit  to subscribe or unsubscribe.

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[ozmidwifery] Re:

[Kathleen Fahy]

Dear Judy,
 
Your first step for info is the Maternity Coalition National Maternity 
Action Plan.
 
Contact [EMAIL PROTECTED]
 
Next step, inform consumers now so that they can respond to the media and 
politicians.
 
Finally, protect yourself.  Be aware that people monitor this list, 
print off your positng and give it to yor boss.
 
Best wishes,
 
Kathleen
 
--Kathleen 
FahyProfessor of MidwiferyHead of School of Nursing and 
MidwiferyFaculty of HealthThe University of NewcastleUniversity 
Drive,Callaghan, 2308
 
Ph 02 49215966
 
Fax 02 49216981>>> [EMAIL PROTECTED] 08/15/02 10:50am 
>>>Hi AllAssistance is needed urgently.We have 
a relatively new DON in Mackay and yesterday we were told by one of the 
nurse managers that she is not in favour of midwives. Apparently we all 
think ourselves too good and she wants us to be good little nursies and go 
back to doing what the doctors tell us to do.She has given our NPC 
(ex Birth Centre and homebirth midwife) till next Fricay to justify every 
position in the unit.Wants to get rid of midwife antenatal clinic, 7 day 
EMS, Antenatal classes etc. The Birth Centre has to justify its existance 
(thank God they have a strong consumer support group).I need 
references to easily obtained evidence to assist in our case.As well I 
need a leaflet to be able to give out to women and the community on the role 
and responsabilites of a midwfe. We need community support.Also need to 
find out the midwife:Client ratio in Birthing suites, especially Qld Health 
Facilities.Thanks in 
advanceJudy_MSN 
Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx--This 
mailing list is sponsored by ACE Graphics.Visit  to 
subscribe or unsubscribe.

Re: [ozmidwifery] Achieving Midwifery Models in Hunter

[Child Birth Information Service]

Hi Kathleen,
Sorry for my mix-up, and good luck on the day, I hope you 
get lots of people with many ideas.
I presented one of our members with an idea, and she has 
taken it on board to write up a proposal for us.
Community midwifery care where by a group of midwives will 
take on a case load of women and birth them in the setting of their choice or 
appropriate to them. Home or hospital. This should be paid for by the health 
system, we are still working on the proposals to take to the numerous committees 
to be considered, may be your group can help us, as we may be able to help you. 

The name of the person writing up our proposal is 

Sonia Anderson Phone 03 
62636706
88 Tongatabu Rd
Dromedary 7030
Tasmania
 
Terry Stockdale Independent Midwife

  - Original Message - 
  From: 
  Kathleen Fahy 
  To: [EMAIL PROTECTED] 
  
  Cc: [EMAIL PROTECTED] 
  Sent: Tuesday, August 13, 2002 5:07 
  PM
  Subject: Re: [ozmidwifery] Achieving 
  Midwifery Models in Hunter
  
  Dear Terry,
   
  I am sorry if you posting confused you.  I am taking responsibility 
  for planning the day.  I have invited Justine as our guest to use her 
  well know facilitation and activist skills to help the day move forward in a 
  really dynamic way.
   
  I did attach the details to the last e-mail as a flyer.  Do you have 
  specifc questions?
   
  Kathleen
   
  --Kathleen 
  FahyProfessor of MidwiferyHead of School of Nursing and 
  MidwiferyFaculty of HealthThe University of NewcastleUniversity 
  Drive,Callaghan, 2308
   
  Ph 02 49215966
   
  Fax 02 49216981>>> [EMAIL PROTECTED] 08/13/02 
  10:44am >>>
  
Hi,
Can Justin Caines email me re info that maybe 
of help.
Terry Stockdale
[EMAIL PROTECTED]
 
- Original Message - 
From: 
Kathleen Fahy 
To: [EMAIL PROTECTED] 

Cc: [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; Anne Saxton 
Sent: Monday, August 12, 2002 5:27 
PM
Subject: [ozmidwifery] Achieving 
Midwifery Models in Hunter

Dear All,
 
I am attaching a flyer advertising our workshop to find ways to bring 
about publically funded midwifery models (including homebirths) here in the 
Hunter Valley.  Anne Saxton (Midwife and Service Manager has a 
vision to reactivate and revitalise midwifery models for 
which the John Hunter Hospital was once famous). 
 
We will be coordinating our efforts in line with the National Maternity 
Action Plan.  The day will be facilitated by Justine Cain a 
mother of 3 under 3 and a birth activist with Maternity Coalition.  

 
If you would like to join us for the day your energy would be most 
welcome.  There is no cost (except if you want us to provide lunch and 
morning tea but you are free to bring your own).
 
Please RSVP to Nadyne Smith (my PA) 02 49217873
 
 
 
 
--Kathleen 
FahyProfessor of MidwiferyHead of School of Nursing and 
MidwiferyFaculty of HealthThe University of NewcastleUniversity 
Drive,Callaghan, 2308
 
Ph 02 49215966
 
Fax 02 49216981

[no subject]

[Judy Chapman]

Hi All

Assistance is needed urgently.
We have a relatively new DON in Mackay and yesterday we were told by one of 
the nurse managers that she is not in favour of midwives. Apparently we all 
think ourselves too good and she wants us to be good little nursies and go 
back to doing what the doctors tell us to do.

She has given our NPC (ex Birth Centre and homebirth midwife) till next 
Fricay to justify every position in the unit.
Wants to get rid of midwife antenatal clinic, 7 day EMS, Antenatal classes 
etc. The Birth Centre has to justify its existance (thank God they have a 
strong consumer support group).

I need references to easily obtained evidence to assist in our case.

As well I need a leaflet to be able to give out to women and the community 
on the role and responsabilites of a midwfe. We need community support.

Also need to find out the midwife:Client ratio in Birthing suites, 
especially Qld Health Facilities.

Thanks in advance
Judy

_
MSN Photos is the easiest way to share and print your photos: 
http://photos.msn.com/support/worldwide.aspx

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RE: [ozmidwifery] Midwifery model of care in hospitals

[Ken Ward]

Thanks Jen, but I work at Box Hill. Believe me, it is not midwifery-led.  We do
routine CTG.s, Four hour VE {usually by RMO's, for practice] use of epidurals
is high, very reluctant to have VBACS.  Need I go on?   The unit is doctor
controlled. Women are almost forced to have repeat c/s.  It got so bad I
started doubting my ability as a midwife, my belief that women's bodies can
birth.  KYM programme is okay, but they are still 'overseen' by the medical
staff. The midwives involved are not necessarily 'active'. They are basically
very good support.  Thanks anyway.  Maureen.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]On Behalf Of Jen Semple
Sent: Tuesday, August 13, 2002 10:11 AM
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Midwifery model of care in hospitals


Re: Melbourne

I don't have any experience w/ the hospitals, but from
what I've heard... both Monash & the Women's have
birth centres which are mid-led, Birralee @ Box Hill
has a KYM (Know Your Midwife) program which is
caseload mid, & Sunshine has just revamped their
program to be more mid-led.

Hope this gives you some ideas.

Jen

 --- Ken Ward <[EMAIL PROTECTED]> wrote: > Does
anyone know of a midwifery-led unit in Melbourne?


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RE: [ozmidwifery] Colic/osteopathy

[Ken Ward]

Sounds 
like lactose intolerance., or over-supply. Should be self-limiting. Get mum off 
the dairy foods for several days and see if that helps.  But don't try and 
foolow everyone's advice. It gets far too complicated and confusing.. Off dairy, 
reduce lactose to baby, end of green poos and hopefully the colic..  Took 
no. 2 child to the chiro./ oesto at nine months. Best thing we ever 
did.

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]]On Behalf Of Sheena 
  JohnsonSent: Tuesday, August 13, 2002 4:41 PMTo: 
  [EMAIL PROTECTED]Subject: Re: [ozmidwifery] 
  Colic/osteopathy
  Stephanie
   
  The birth was a ventouse after a spinal and a 
  prolonged first stage, head in posterior, turned manually by the obstetrician 
  when doing a VE.
   
  We live in Warracknabeal and the closest 
  osteopath is Ballarat, 2 1/2 hours away. We have been to the chiropracter this 
  a'noon who did his masters in childhood conditions, and I got some NATREN 
  powder someone else suggested. The stomach sleeping didn't continue very long, 
  but the explosive green/yellow poo's have. We have sent a sample to path just 
  incase. However she is gaining weight, 8oz last week and 3oz this week. We 
  will get there in the end. they all grow up eventually!!!
   
  Sheena Johnson
  [EMAIL PROTECTED]

[ozmidwifery] OPs , POPs and the need for CS.

[Jan Robinson]

Dear Jo, Liz, Andrea, Lynne and list

It is non-informed consent to your management not to tell a woman she has an
OP position during pregnancy ... Just as it is negligent not to tell her all
of the possible ways she can deal with changing it during pregnancy and
labour.

There is almost always a way a fetal OP position can be changed - dependent
on where the challenge to it's turning presents.
Jean Sutton  has presented these ways very well in her "Optimal Fetal
Positioning"  book.

If the challenge is ABOVE the brim and external to the uterus eg.  strong
abdominal muscles holding the baby tight against the mother's spinal column
.. Then there is every likelyhood of the occiput turning towards the front
once it hits the pelvic floor.  (No problems except usually more lower back
pain experienced during labour)  The majority of posterior positions in
primigravidas are due to their wonderful muscle tone.

However,  if the problem is above the brim and INTERNAL eg. Low lying
anterior placenta the baby has a more difficult time gaining access to the
pelvis and usually has to rock into it using an asynclitic mechanism. These
babies usually present with very bruised scalp tissue and horrendous upward
moulding (if they remain in the posterior position and deliver that way) and
with backward moulding (similar to a brow if the placenta was low and to one
side) and they had to spend a lot of time getting through the brim and then
turned once they reached the level of the ischial spines.

I had an example of the latter early yesterday morning with a client having
her third baby. (The first two had birthed with normal mechanisms.)

Kathryn commenced a labour that was sporadic all day Tuesday, and did not
establish properly until late Tuesday night with the help of cualiphylum.
She progressed slowly throughout the night, wanting to push prematurely and
ending with a thick anterior lip that wouldn't budge for some hours despite
side lying and trying just about every other position to open up her outlet.
Her major complaint throughout was "my hips, my hips,"

Although abdominal examination revealed the occiput had finally disappeared
into the brim just before sunrise, a repeat vaginal  examination revealed
lip still  present and caput ++ with head still above the spines. The
thought of an epidural was tempting  as we were all sleep deprived at this
time. There was a large fecal mass now evident in the rectum (not present
earlier) so the advice was to try and sit on the toilet and evacuate it with
the hope that it would provide a new space for the occiput to descend and
rotate ... and after a few sips of warm lemon cordial and water to restore
energy, a few pushes with contractions that evacuated the faecal mass,the
head quickly followed.  Oh, what a feeling!!! and not just for the mother!

I also had another experience with a posterior (that remained that way) at
home  some years ago  due to a low-lying anterior placenta. It was the
second pregnancy. (First baby no problems, in fact a very easy birth).

Linda's labour progressed slowly throughout the day,  into the night and the
next morning as well. Despite the pain, she persevered with her persistently
posterior position, using the bath, the birthing ball, eventually reclining
upright on a beanbag with exhaustion .. because of the knowledge of what
would happen  to her if we transferred to hospital (she was a midwife!).
Linda's pain management skills were so powerful, she could literally rise
above her contractions. She insisted that when the head finally crowned that
she REST to recover the strength she knew she needed to let that huge
presenting mass out.
My trust in her almost wavered at that stage,  but she reminded me that the
FHS were still OK and that she knew what she was doing.  In hindsight,  she
was allowing her external  genitalia to stretch to adequately accommodate
the  diameters of that huge POP head.
Eventually she got up on all fours and let her baby out slowly (no tearing
at all) and I have never been so in awe of anyone as I was that morning
Linda let her little baby boy out so gently.

The upward moulding on that baby's head was so grotesque that he initially
looked like an dwarf to me ... His swollen scalp and upwardly moulded head
just looked so large in proportion to the rest of his body!

Linda later went on to have a lovely birth in the water with her third baby,
delivered her herself with her mother assisting the 'catch'.

However, Linda had nightmares about pain for weeks when she viewed the video
of her POP birth. 

I'll make a teaching package about posteriors with her and Kathryn soon and
and I'll include their births in it  ... before examples of successful
posterior outcomes are lost  the the students of tomorrow.

Midwives will need to be stronger advocates for  women as we move into an
age where OP gets added to the list of reasons  for doing an elective C/S.
As midwives they need to be aware that they must be proficient in pickin

RE: [ozmidwifery] OP labours (long)

[sally]

I’m
with Jacki and Vicki.

 

It’s
not such a big deal given time, space and support. 

 

In peace and joy

 

Sally
Westbury

 

 

Re: [ozmidwifery] OP babies

[elizabeth mcalpine]

One response I heard recently.."if we tell the 
mothers that their baby is OP,  we will cause anxiety".
 
Personally, I think it is important to avoid this 
position, and tell them, and believe that women should be 
told. 
It does indeed cause many problems as you 
mentioned. 
I also tell them what to do to try to correct it, 
prior to labour, from 34 weeks primip, 37 - 38 multi as Sutton & Scott 
advise.  They suggest that the following happens; early SROM, inco-ordinate 
contractions, post maturity, induction, augmentation, increased pain, longer 
labour, medical complications etc.  
 
If its during labour, its off the bed, 
upright, movement - rocking, climbing, birth ball, hands and knees etc.  

 
Liz

  - Original Message - 
  From: 
  Jo 
  & Dean Bainbridge 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 9:03 
  PM
  Subject: [ozmidwifery] OP babies
  
  I have a question that will probably be seen as a 
  silly one to some (but remember I am a consumer so it is my right to ask silly 
  questions!)  If one of the main reasons for cs is failure to progress and 
  fetal malpresentation AND a common factor with both these 'reasons' is a baby 
  that is persistently in OP ... why doesn't anyone do anything to correct this 
  before labour?  I know a large portion of bubs are OP then turn during 
  labour; but it seems like we have found that it is easier to deal with it by 
  cs or forceps rotation...why is it we don't try to avoid the situation 
  altogether?
  Very few women I have encountered were even aware 
  of the term OP or what the whole OP presentation involves (longer labours more 
  interventions etc). Why do we pregnant mums not get told during ante-natal 
  check ups what position bubs in?  Why doesn't anyone check when labour 
  commences?  
  I am aware of the optimal presentation booklet 
  and now try to encourage all women I come across to be aware of their posture 
  and to try swimming and sitting in positions as well as vertical positioning 
  during labour that will encourage bub to be OA but this is AFTER I 
  had a cs for failure to progress (8cm and stalled for 2 hours no fetal 
  distress- due to having a monitor on and being made to be supine...no wonder 
  bub did not turn himself!)
  I am curious why this seems to be something that 
  is ignored by mainstream but something that plays a major role in how birth 
  results as cs or ivd??
  can anyone shed some light??   
  
  Jo Bainbridgefounding member CARES 
  SAemail: [EMAIL PROTECTED]phone: 08 
  8388 6918birth with trust, faith & 
love...

RE: [ozmidwifery] OP labours (long)

[Vicki Chan]

Title: Message



I'm 
inclined to agree, Jackie!
 
My own 
babies love that direct op posi. They've all been quick, the 
last 4.5kg and still manage to come out within the hour! No back 
pain.Must be my HUGE childbearing hips! (says she putting the belt on the size 8 
pants cause they just fell down)
 
Too 
much fussin can cause more dramas than we started with.
I do 
talk to my clients about optimal fetal positioning...in a relaxed way...going 
back to the days of old and showing the differences in general posture with 
digging for yams and washing clothes in the river, compared to drving in 
the car and watching TV.
If the 
babies are persistantly OP I just smile and say, ''some babies just like it that 
way...they work it out along the way''
And 
they do!
 
Vicki 


  
  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]] On Behalf Of Jackie 
  KitschkeSent: Wednesday, August 14, 2002 12:25 PMTo: 
  [EMAIL PROTECTED]Subject: [ozmidwifery] OP labours 
  (long)
  Dear Jo and all,
  I find the whole idea about optimal fetal positioning an 
  interseting one. I have attended in the past, a session with Jean Sutton 
  discussing it and found it very interesting and indeed sometimes use the 
  positions she suggests to suggest to women in labour. The interesting and 
  amazing thing about midwifery practice is that it is the women who teach you 
  so much. So many women I have been with in labour will adopt these positions 
  themselves ie put one foot up and rock into the side the baby needs to rotate 
  into, sit on the loo, rock etc as long as they are given the space to do it. 
  They do what their body's tell them to do.
  I understand Jo the logic of wanting to know or be told 
  about this but I fear that we are turning another part of normal childbirth 
  into an abnormality and if not careful in years to come these women will not 
  be allowed to birth with midwives as they are high risk (I know I sound 
  paranoid but I am sure if midwives or hundreds of years ago were now told that 
  breech and twins were considered high risk they would laugh at us). So many 
  women now come into the antenatal clinic and look worriedly at you as you 
  palpate there tummies and ask if the baby is in the right position. Some of 
  these women are only 28 weeks. I have looked after women in labour with OP 
  babies and thought that this will be a long hard labour and the next minute 
  the woman wants to push. And conversly the baby who is the "perfcet position" 
  what ever that is has a baby that takes forever or comes out face to pubes and 
  you wonder how that happened.
  In the last MIDIRS there is and article titled "Malpositions 
  and malpresentations of the occiput: current research and practice tips" that 
  discusses the research around this.  It states that a "Gardberg and 
  colleagues research into op found that 68% of babies presenting as persistant 
  op at birth had developed from a malrotation during labour from an initial oa 
  position. Only 32% of persistant op cases were op at the start of labour". 
  This confirmed for me some of the things I have experienced. I just fear that 
  we are putting fear into women antenatally and blaming them and/or their 
  babies when perhaps this is not true. It is like when someone says to a woman 
  antenatally that her baby is too big to fit through. It is more difficult to 
  work with that woman when she is having a long labour as she doesn't trust her 
  body.
  My sister (the one I sent that champagne charged email about 
  in December) started her labour in op. She niggled and contracted at home for 
  3 days and when she finally came to the BC in established labour she was 3 cms 
  at 3am and gave birth to her boy at 0930am. Now I would have thought with the 
  start she had not to expect a baby at best till the afternoon. So I think this 
  is another example that we just have to trust the process and inspire in women 
  the confidence to birth their babies. 
  We can only learn from women if we give them the space to do 
  their best work. THis can only happen within midwifery models of care. Working 
  with women having an OP labour usually means a slow start and getting them 
  through that is the key but you only see that when you work in a midwifery 
  model. Keeping those women at home until the active part of labout starts is 
  vital and then supporting them with encouragement, privacy and time. The more 
  you care for women the more you learn about the amazing things they do and it 
  is this experience that helps you with the next birth and also gives you the 
  stories to relay to women when they are concerned.
  Sorry this is so long
  Jackie
   
   

[ozmidwifery] OFP

[henk / eliza merbis]

Dear Larissa,
 
Being new to 'the business', I couldn't help but 
pick up on your email about how you feel about OFP and how you are going to 
include it in your CBE classes. I would be very interested in a rundown on this 
interesting topic as we really didn't cover it in our course (Post Grad. Dip 
Midwifery). Surprise! Surprise!
Would you have any info you could perhaps send 
me/email me??
 
Eliza 
 

Re: [ozmidwifery] OP babies

[Lois Wattis]

RCT stands for Random Controlled Trial (ie research). Regards, Lois Wattis


- Original Message - 
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, August 14, 2002 5:38 PM
Subject: [ozmidwifery] OP babies


--- Lynne Staff <[EMAIL PROTECTED]> wrote: > 
What does RCT stand for (2nd paragraph below)?

Thanks, Jen
 
>There are many lifelstyle factors which could
> contribute to the number of OP positions seen. In my
> mid education, we were told it was 10% of women. I
> think it is more common than this, and talk about
> changing the way we do our daily activites, which
> can encourage a little one to settle itself into an
> anterior position.
> 
> It seems to help, and while I have not done
> await for itRCT.women tell me it helps
> and the fact that they are also upright and active
> in labour with no routine ARM is something they
> appreciate too
> 
> Regards, Lynne

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[ozmidwifery] OP babies

[Jen Semple]

 --- Lynne Staff <[EMAIL PROTECTED]> wrote: > 
What does RCT stand for (2nd paragraph below)?

Thanks, Jen
 
>There are many lifelstyle factors which could
> contribute to the number of OP positions seen. In my
> mid education, we were told it was 10% of women. I
> think it is more common than this, and talk about
> changing the way we do our daily activites, which
> can encourage a little one to settle itself into an
> anterior position.
> 
> It seems to help, and while I have not done
> await for itRCT.women tell me it helps
> and the fact that they are also upright and active
> in labour with no routine ARM is something they
> appreciate too
> 
> Regards, Lynne

__
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Everything you'll ever need on one web page
from News and Sport to Email and Music Charts
http://uk.my.yahoo.com
--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

[ozmidwifery] OP babies research

[Grant and Louise]

  I don't know if it has been published yet, but was on either page 1 
  or 3 of the Saturday Sydney Morning Herald a while ago, with photo of 
  mother, midwife and Swiss ball.
   
  LOUISE
  [EMAIL PROTECTED]





	
	
	
	
	
	
	




  IncrediMail - Email has finally evolved - 
Click 
Here

Re: [ozmidwifery] OP babies

[Andrea Quanchi]

Do you know if the results of marie Chamebrlains study have been published yet???
Andrea Quanchi
On Tuesday, August 13, 2002, at 10:45  PM, Robin Moon wrote:

 

- Original Message -
From: Jo & Dean Bainbridge
To: [EMAIL PROTECTED]
Sent: Tuesday, August 13, 2002 9:03 PM
Subject: [ozmidwifery] OP babies

I have a question that will probably be seen as a silly one to some (but remember I am a consumer so it is my right to ask silly questions!)  If one of the main reasons for cs is failure to progress and fetal malpresentation AND a common factor with both these 'reasons' is a baby that is persistently in OP ... why doesn't anyone do anything to correct this before labour? 
 
Jo, there was a large research study conducted in Sydney recently on OP positions. It concentrated on ante-natal exercises to see if they could 'move' babies into a more optimal position prior to labour. The results were a dismal failure
 
 I know a large portion of bubs are OP then turn during labour; but it seems like we have found that it is easier to deal with it by cs or forceps rotation...why is it we don't try to avoid the situation altogether?
 
Usually we need to wait to see if the force of the contractions and the shape of the woman's pelvis will help the baby to rotate. That's what we're looking for prior to c/s or forceps. To give the woman's body every chance.
 
Very few women I have encountered were even aware of the term OP or what the whole OP presentation involves (longer labours more interventions etc). Why do we pregnant mums not get told during ante-natal check ups what position bubs in?  Why doesn't anyone check when labour commences? 
 
On your antenatal card there is spot for 'presentation'. Usually it has hieroglyphics for the lay person in it in the form of  'OA'. or ÓT' or 'OP" ( or LOA, LOT,LOP, ROA, ROT,ROP). That is the position of the baby. Most practitioners start documenting it from about 30 weeks. 
 
A competent midwife/doctor will always check the position of the baby when labour commences ( unless you come in very late in the labour and it's all too difficult!). We need it to tell us lots of things. Suggested length of labour, readiness of the baby, potential problems.
 
I am aware of the optimal presentation booklet and now try to encourage all women I come across to be aware of their posture and to try swimming and sitting in positions as well as vertical positioning during labour that will encourage bub to be OA but this is AFTER I had a cs for failure to progress (8cm and stalled for 2 hours no fetal distress- due to having a monitor on and being made to be supine...no wonder bub did not turn himself!)
 
Good for you, keep trying, it's better than doing nothing, and many midwives are able to offer other practical ways of turning babies that are sometimes helpful.  And I agree wholeheartedly, flat on your back is the worst position to labour effectively in. :-(
 
Remember this, the shape of a woman's pelvis will influence her labour. a VERY rough triangle shape where the pubic bone is at the apex, will allow the baby to rotate to the anterior nicely. If she is shaped more like a man where the pelvis is more oval shaped the baby will not rotate anteriorly too easily.
 
I am curious why this seems to be something that is ignored by mainstream but something that plays a major role in how birth results as cs or ivd??
can anyone shed some light?? 
 
I hope I've been able to help you a little. I'm getting a little rusty now and others may have other ideas to contribute I'm sure.
 
Cheers,
Robin.
 
Jo Bainbridge
founding member CARES SA
email: [EMAIL PROTECTED]
phone: 08 8388 6918
birth with trust, faith & love...

[ozmidwifery] for those attending the ACMI SA Branch AGM

[Jackie Kitschke]

To those attending the ACMI SA Branch AGM on Friday the 16th 
of August.
The address of "The Wakefield Hotel" is
76 Wakefield Street Adelaide, between Pultney and King William 
Streets. The address on the flyer is for "The Astor Hotel" which was last year's 
venue.
See you all then
Jackie

[ozmidwifery] OP labours (long)

[Jackie Kitschke]

Dear Jo and all,
I find the whole idea about optimal fetal positioning an 
interseting one. I have attended in the past, a session with Jean Sutton 
discussing it and found it very interesting and indeed sometimes use the 
positions she suggests to suggest to women in labour. The interesting and 
amazing thing about midwifery practice is that it is the women who teach you so 
much. So many women I have been with in labour will adopt these positions 
themselves ie put one foot up and rock into the side the baby needs to rotate 
into, sit on the loo, rock etc as long as they are given the space to do it. 
They do what their body's tell them to do.
I understand Jo the logic of wanting to know or be told about 
this but I fear that we are turning another part of normal childbirth into an 
abnormality and if not careful in years to come these women will not be allowed 
to birth with midwives as they are high risk (I know I sound paranoid but I am 
sure if midwives or hundreds of years ago were now told that breech and twins 
were considered high risk they would laugh at us). So many women now come into 
the antenatal clinic and look worriedly at you as you palpate there tummies and 
ask if the baby is in the right position. Some of these women are only 28 weeks. 
I have looked after women in labour with OP babies and thought that this will be 
a long hard labour and the next minute the woman wants to push. And conversly 
the baby who is the "perfcet position" what ever that is has a baby that takes 
forever or comes out face to pubes and you wonder how that 
happened.
In the last MIDIRS there is and article titled "Malpositions 
and malpresentations of the occiput: current research and practice tips" that 
discusses the research around this.  It states that a "Gardberg and 
colleagues research into op found that 68% of babies presenting as persistant op 
at birth had developed from a malrotation during labour from an initial oa 
position. Only 32% of persistant op cases were op at the start of labour". This 
confirmed for me some of the things I have experienced. I just fear that we are 
putting fear into women antenatally and blaming them and/or their babies when 
perhaps this is not true. It is like when someone says to a woman antenatally 
that her baby is too big to fit through. It is more difficult to work with that 
woman when she is having a long labour as she doesn't trust her 
body.
My sister (the one I sent that champagne charged email about 
in December) started her labour in op. She niggled and contracted at home for 3 
days and when she finally came to the BC in established labour she was 3 cms at 
3am and gave birth to her boy at 0930am. Now I would have thought with the start 
she had not to expect a baby at best till the afternoon. So I think this is 
another example that we just have to trust the process and inspire in women the 
confidence to birth their babies. 
We can only learn from women if we give them the space to do 
their best work. THis can only happen within midwifery models of care. Working 
with women having an OP labour usually means a slow start and getting them 
through that is the key but you only see that when you work in a midwifery 
model. Keeping those women at home until the active part of labout starts is 
vital and then supporting them with encouragement, privacy and time. The more 
you care for women the more you learn about the amazing things they do and it is 
this experience that helps you with the next birth and also gives you the 
stories to relay to women when they are concerned.
Sorry this is so long
Jackie