Re: [ozmidwifery] Brow presentations

[Lynne Staff]

If you drew an upside down "3" on the mother's abdomen, with the small part
of the 3 over her pelvis, you get the picture? Hard to describe if you are
visual!
- Original Message -
From: "Belinda Maier" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, December 16, 2003 1:22 PM
Subject: Re: [ozmidwifery] Brow presentations


> I had a very similar experience recently with a friend.Her history was
that
> her 5 sisters all had private obst, induction's epidurals 4 sections and
one
> forceps. So this woman was really keen for a vaginal birth with no
> intervention but all of this head work to do. She saw a great anesthetist
> who did hypnosis on her to stimulate her labour when she was 3days srom no
> labour. This worked as did the relaxation stuff and she laboured very well
> over the day with synto. (after 24 hours spurious labour) I used
> intermittent monitoring to enable her to be more mobile and because with
her
> very large tummy it was too difficult to get a good trace without all our
> attention being on achieving that. She was in the bath rocking etc and got
> to 7cm in about 6hours. I hadn't palped her because  of the large abdomen
> and don't think I ould have picked up a brow because of that. Brows are
very
> difficult to palpate and you don't thankfully get them very often. I have
> felt a brow on palp before by feeling the position, then when you push
with
> your fingers to feel the head the first part you feel on an OA position is
> the side opposite to the back, a brow generally what you feel first is on
> the side of the babys  back. military you tend to feel both at once. I
wish
> I could draw it I am not sure I am being clear. My friend ended up with a
> section as he was an acynclitic brow presentation (the first eye I have
ever
> felt, not a pleasant surprise!!). She had laboured with no drugs for pain
> relief. As soon as the synto was turned off the contractions stopped which
> is indicative of malpresentation as was the early srom no labour.
> Unfortunately at section her baby was very flat and extremely bruised with
> his jaw wide open which made resus difficult and he ended up in NICU for
the
> night. She is quite devastated at this and of course wonders if she should
> have gone for a section straight away and not tried for natural birth
(which
> in her family is not common). She is coming to terms with it all, even if
we
> knew it was a brow we would have tried to se if contractions would turn
him
> to a face so he could birth. Your woman needed to try coz it may have
turned
> more to a face which could have birthed but everything is easy in
hindsight.
> It is interesting that my friend at 7cm looked at me and said what happens
> if her is stuck? I knew then oh oh, women who labour well no drugs who say
> that to me flag bigs signs of knowing something is not right
instinctively.
> My friend is breastfeeding well now and has lots of worries which is her
> nature anyway. Maybe next time?
> Belinda
> - Original Message -
> From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Wednesday, December 17, 2003 2:07 AM
> Subject: [ozmidwifery] Brow presentations
>
>
> > What do you all know about brow presentations? I was with a lovely woman
> > yesterday who wanted a natural birth and so i spent the morning with her
> and
> > her partner on the floor, in the shower and she dilated to fully within
4
> > hrs, just lovely and I am sure (so sure) I palped a posterior fontanelle
> > such that baby was direct OA, but almost military poition; I was trying
so
> > hard to follow her through a physiological 2nd stage but after an hour
and
> a
> > half with no sign of baby's head I did another VE and she had pushed
down
> a
> > small anterior lip, which obligingly slipped back but now there was a
> > central anterior fontanelle with caput just inferior to the fontanelle,
so
> > consultant called in and an emergency c/s due to brow presentation(not
> > emergent emergent, baby was just fine and mum was exhausted but not
> > physiologically compromised). Baby had great apgars, which is good as I
> had
> > not identified any fetal distress, I just want to know if there is
> anything
> > we could have done differently. Mum spent most of her labour and 2nd
stage
> > on all fours on the floor over a bean bag, with regular partner dancing,
> > pelvic rocking ie very active and effective first stage after 4cm. She
had
> > had a prolonged early first stage with  a significant hind leak and
> > intermittent contractions for almost 24 hrs before presenting to to
birth
> > suite yesterday for IOL and antibiotics. She was then 4cm dilated and
ARM
> of
> > forwaters to induce baby ROL at this time (this happened before my shift
> > thankfully as I have a hard time supporting ARM and just hate that
> > compromised feeling). Anyway she moved rapidly into an effective active
> > first stage as described above.
> >
> > I am wondering if anyone thinks preserving those for

Re: [ozmidwifery] Brow presentations

[Lynne Staff]

I tend to agree with Marilyn. Rupturing the membranes may have contributed
to the babe coming down deep into the woman's pelvis in a deflexed position,
also making it more difficult for it to flex and rotate with no
'cushioning'. An hour in the tub with some oblique pelvic stretches and
front to back rocking - don't ususally see this in labour, but it may help
in times like this - may also have assisted with flexion and rotation.

- Original Message -
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, December 17, 2003 6:01 AM
Subject: Re: [ozmidwifery] Brow presentations


> Yes, Denise: I wonder if an hour in the tub would have helped?? There was
no
> synto augmentation involved 4cm to fully in 4 hrs seemed like a lovely
> active birth was about to happen. Yes also: those Midwifery Today
> suggestions are great to try in a homebirth situation/independent practice
> but please tell me if there are any of you out there who would push a baby
> gently out of the pelvis and try to rotate and flex the head in a hospital
> birth suite? Also once I called in the consultant it became her call,
> however to be honest I kind of felt if I had said I was prepared to try to
> use my fingers to deflex the head she just might have let me(in the OT of
> course). I must admit I am a tad intimidated in the hospital but also I
have
> never encountered a brow presentation before: it has all been academic.
So,
> I await your wise counsel.
>
> marilyn
>
> - Original Message -
> From: "Denise Hynd" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Monday, December 15, 2003 6:13 PM
> Subject: Re: [ozmidwifery] Brow presentations
>
>
> > Dear Marilyn
> > Thank you for sharing your reflections and cogitations.
> >
> > This is my beleif, experience that midwives do reflect on all that
inputs
> > into a labour and the possible interplay rather than jumpimg to blame,
> > denouncement  of specific action of another or the woman and baby like
an
> > edict of an all knowing being !!
> >
> > In this particular insistance or similar I also wonder about the ramming
> (?)
> > effect of ARM and maybe other things that may have startled the mother
or
> > baby in the hospital??
> >
> > I take it there was no synto also pushing the hole along?
> > .
> > I understand and have seen floating in tubs to  help unstick some
> asynclitic
> > babies I wonder if it would help relax a non rigid brow back to a face
or
> > vertex??
> >
> > Also Midwifery Today & other midwifery texts talk of pushing stuck
babies
> > back and other maneovers trying to unstick them but that would be easier
> > with intact membranes?
> >
> > Denise
> > - Original Message -
> > From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
> > To: <[EMAIL PROTECTED]>
> > Sent: Tuesday, December 16, 2003 11:37 PM
> > Subject: [ozmidwifery] Brow presentations
> >
> >
> > > What do you all know about brow presentations? I was with a lovely
woman
> > > yesterday who wanted a natural birth and so i spent the morning with
her
> > and
> > > her partner on the floor, in the shower and she dilated to fully
within
> 4
> > > hrs, just lovely and I am sure (so sure) I palped a posterior
fontanelle
> > > such that baby was direct OA, but almost military poition; I was
trying
> so
> > > hard to follow her through a physiological 2nd stage but after an hour
> and
> > a
> > > half with no sign of baby's head I did another VE and she had pushed
> down
> > a
> > > small anterior lip, which obligingly slipped back but now there was a
> > > central anterior fontanelle with caput just inferior to the
fontanelle,
> so
> > > consultant called in and an emergency c/s due to brow presentation(not
> > > emergent emergent, baby was just fine and mum was exhausted but not
> > > physiologically compromised). Baby had great apgars, which is good as
I
> > had
> > > not identified any fetal distress, I just want to know if there is
> > anything
> > > we could have done differently. Mum spent most of her labour and 2nd
> stage
> > > on all fours on the floor over a bean bag, with regular partner
dancing,
> > > pelvic rocking ie very active and effective first stage after 4cm. She
> had
> > > had a prolonged early first stage with  a significant hind leak and
> > > intermittent contractions for almost 24 hrs before presenting to to
> birth
> > > suite yesterday for IOL and antibiotics. She was then 4cm dilated and
> ARM
> > of
> > > forwaters to induce baby ROL at this time (this happened before my
shift
> > > thankfully as I have a hard time supporting ARM and just hate that
> > > compromised feeling). Anyway she moved rapidly into an effective
active
> > > first stage as described above.
> > >
> > > I am wondering if anyone thinks preserving those forewaters might had
> > > avoided the malpresentation. Also should I have re-examined her
earlier?
> > Do
> > > you think I mistook the posterior fontanelle for the anterior one on
my
> > > first 2nd stage VE? I was so co

Re: [ozmidwifery] Brow presentations

[Marilyn Kleidon]

Yes, Denise: I wonder if an hour in the tub would have helped?? There was no
synto augmentation involved 4cm to fully in 4 hrs seemed like a lovely
active birth was about to happen. Yes also: those Midwifery Today
suggestions are great to try in a homebirth situation/independent practice
but please tell me if there are any of you out there who would push a baby
gently out of the pelvis and try to rotate and flex the head in a hospital
birth suite? Also once I called in the consultant it became her call,
however to be honest I kind of felt if I had said I was prepared to try to
use my fingers to deflex the head she just might have let me(in the OT of
course). I must admit I am a tad intimidated in the hospital but also I have
never encountered a brow presentation before: it has all been academic. So,
I await your wise counsel.

marilyn

- Original Message - 
From: "Denise Hynd" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, December 15, 2003 6:13 PM
Subject: Re: [ozmidwifery] Brow presentations


> Dear Marilyn
> Thank you for sharing your reflections and cogitations.
>
> This is my beleif, experience that midwives do reflect on all that inputs
> into a labour and the possible interplay rather than jumpimg to blame,
> denouncement  of specific action of another or the woman and baby like an
> edict of an all knowing being !!
>
> In this particular insistance or similar I also wonder about the ramming
(?)
> effect of ARM and maybe other things that may have startled the mother or
> baby in the hospital??
>
> I take it there was no synto also pushing the hole along?
> .
> I understand and have seen floating in tubs to  help unstick some
asynclitic
> babies I wonder if it would help relax a non rigid brow back to a face or
> vertex??
>
> Also Midwifery Today & other midwifery texts talk of pushing stuck babies
> back and other maneovers trying to unstick them but that would be easier
> with intact membranes?
>
> Denise
> - Original Message -
> From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Tuesday, December 16, 2003 11:37 PM
> Subject: [ozmidwifery] Brow presentations
>
>
> > What do you all know about brow presentations? I was with a lovely woman
> > yesterday who wanted a natural birth and so i spent the morning with her
> and
> > her partner on the floor, in the shower and she dilated to fully within
4
> > hrs, just lovely and I am sure (so sure) I palped a posterior fontanelle
> > such that baby was direct OA, but almost military poition; I was trying
so
> > hard to follow her through a physiological 2nd stage but after an hour
and
> a
> > half with no sign of baby's head I did another VE and she had pushed
down
> a
> > small anterior lip, which obligingly slipped back but now there was a
> > central anterior fontanelle with caput just inferior to the fontanelle,
so
> > consultant called in and an emergency c/s due to brow presentation(not
> > emergent emergent, baby was just fine and mum was exhausted but not
> > physiologically compromised). Baby had great apgars, which is good as I
> had
> > not identified any fetal distress, I just want to know if there is
> anything
> > we could have done differently. Mum spent most of her labour and 2nd
stage
> > on all fours on the floor over a bean bag, with regular partner dancing,
> > pelvic rocking ie very active and effective first stage after 4cm. She
had
> > had a prolonged early first stage with  a significant hind leak and
> > intermittent contractions for almost 24 hrs before presenting to to
birth
> > suite yesterday for IOL and antibiotics. She was then 4cm dilated and
ARM
> of
> > forwaters to induce baby ROL at this time (this happened before my shift
> > thankfully as I have a hard time supporting ARM and just hate that
> > compromised feeling). Anyway she moved rapidly into an effective active
> > first stage as described above.
> >
> > I am wondering if anyone thinks preserving those forewaters might had
> > avoided the malpresentation. Also should I have re-examined her earlier?
> Do
> > you think I mistook the posterior fontanelle for the anterior one on my
> > first 2nd stage VE? I was so convinced, I mean it felt like a text book
> > palp.I just hate to think I encouraged this woman to work so hard for
one
> > and half hours when I could have saved her that exhaustion. And I don't
> mean
> > "saved" in any metaphysical sense, just can't think of a better word. I
> know
> > hindsight is often 20/20 and am not beating myself up, just trying to
> > understand. There was some veiled criticism from the ob regarding not
> having
> > "effective analgesia" on board: however it was realised when the woman
> > elected to have a GA that having an epidural or narcotics was never part
> of
> > her plan.
> >
> > I have looked up all of my texts and am pretty satisfied that a c/s for
> > brow presentation is the best alternative, but would welcome other
ideas.
> >
> > thanks
> > marilyn
> >
> >
> > --
>

Re: [ozmidwifery] High heads/ pain free ???

[Lynne Staff]

Hi Maria - lovely to see you 'on-line'. The book is Pregnancy - the Inside
Story, by Joan Raphael-Leff, published by Karnac Books: London & New York
(1993)
Here is the acrostic with which she begins the book. Enjoy.

Wheels within wheels, wombs within wombs,
Oscillating figure/ground perspective turns:
Mother-daughter-me: cord-links on a chain.
Each uniquely storied
Nestling Russian-doll - dowried
Sorrow-sweet fruition cursed with Eden-pain.

Clocking lunar cycles of bloodshed or gestation
Ova ripen, surge and burst
In firstfruit tithe.
Narrowing, womb-cone of past generation
Awaits procreation beyond our grasp.
Glistening seeds of Eve's sun-honeyed fig -
Eternal fractals on the female tree of life.

- Original Message -
From: "Nick Ryan" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, November 01, 2003 10:39 PM
Subject: Re: [ozmidwifery] High heads/ pain free ???


> This is my first time on this list, however I to have experienced the
> situation of the midwives clinic (Lynne Staff) and the truly petrified
> women. The other place I have met these women when they book in at my
> hospital where the allocation of time is half an hour, (cant procure any
> more funded time from my boss) however by the time these particular women
> attempt to debrief from the previous birthing experience and unresolved
> breastfeeding experiences, more than their allocated time is gone. All
that
> happens is,  I feel as though I too have let these women down because  at
> the end of my day I am left  with a wad of paperwork to refer women on and
> the feeling of frustration. Why cant we meet these somewhere in their
lives
> between babies so they have psychological healing time?
>
> Lynne, May I have some more info on the book you are reading Pregnancy -
the
> inside story?
>
> Cheers
> Maria Ryan
>
> - Original Message -
> From: "Lynne Staff" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Thursday, October 30, 2003 1:46 PM
> Subject: Re: [ozmidwifery] High heads/ pain free ???
>
>
> > Yes it does(the fringe), Sue, and so do the skills which midwives and
> > doctors (dare I say it) used to have in being with women who have been
> > categorised, standardised, legalised
> > It does for the women experiencing it too - I am reading an amazing book
> at
> > the moment called Pregnancy - the Inside Story, and some of the things I
> > read in that open my eyes but also break my heart with the fear - no -
the
> > absolute horror with which more women than we can imagine view their
> > pregnancies and their impending (I use the word impending intentionally)
> > births and motherhood. Every week in Midwives clinic I sit with at least
> two
> > women who are still so overcome with horror at the thought of giving
> birth,
> > it interferes with everything they do and think. And when they describe
to
> > me what happened to them last time, or what they have heard to make them
> > feel that way, I get a sense of something huge that has to be overcome -
> > something much bigger than interventions, because it is something that
is
> in
> > women themselves often that keeps the momentum so that all of these
things
> > which are happening in birth today keep happening.
> >
> > I remember the wonder and satisfaction I felt when I attended my first
> > homebirth where the woman was a primigravida with a 'high head' at term,
> and
> > how much she taught me. The wonder at her strength - for she had to work
> > HARD, the satisfaction that I had come across something (for me) new and
> > wondrous - I had never seen it before ( I have seen the longest newborn
> > heads at home, and the biggest smiles from women who give birth to these
> > babies though!) - women like this one were talked into caesareans even
> then,
> > and I am talking 20 years ago. The fear that was instilled into them of
a
> > long hard and very painful labour, ending in a caesarean, when it (the
> > labour bit) could be avoided. There are many women who would consider it
a
> > practical decision to make too.
> >
> > The lessons I learned at home I could never have learned how and where I
> was
> > working. The responsibility for my learning and change did not rest just
> > with the system, or where I was working, but with me as a midwife.
> >
> > One of the problems is though, that as midwives, many never get to see
> women
> > with these unique situations actually giving birth. It's taken away from
> > them (women), before they even come close to it.
> >
> > When I think of the number of Students and Midwives who have never seen
> > vaginal breech birth, I am amazed, and frustrated and angry at the fact
> that
> > they probably never will, unless they go to out of the way places or
> > countries, or find the few here that will still "allow" women to birth
> > breech babies vaginally, or  women, midwives and doctors who know and
feel
> > comfortable with it.
> > A penny for our thoughts
> >
> > - Original Message -
> > From: "Su

Re: [ozmidwifery] Brow presentations

[Belinda Maier]

I had a very similar experience recently with a friend.Her history was that
her 5 sisters all had private obst, induction's epidurals 4 sections and one
forceps. So this woman was really keen for a vaginal birth with no
intervention but all of this head work to do. She saw a great anesthetist
who did hypnosis on her to stimulate her labour when she was 3days srom no
labour. This worked as did the relaxation stuff and she laboured very well
over the day with synto. (after 24 hours spurious labour) I used
intermittent monitoring to enable her to be more mobile and because with her
very large tummy it was too difficult to get a good trace without all our
attention being on achieving that. She was in the bath rocking etc and got
to 7cm in about 6hours. I hadn't palped her because  of the large abdomen
and don't think I ould have picked up a brow because of that. Brows are very
difficult to palpate and you don't thankfully get them very often. I have
felt a brow on palp before by feeling the position, then when you push with
your fingers to feel the head the first part you feel on an OA position is
the side opposite to the back, a brow generally what you feel first is on
the side of the babys  back. military you tend to feel both at once. I wish
I could draw it I am not sure I am being clear. My friend ended up with a
section as he was an acynclitic brow presentation (the first eye I have ever
felt, not a pleasant surprise!!). She had laboured with no drugs for pain
relief. As soon as the synto was turned off the contractions stopped which
is indicative of malpresentation as was the early srom no labour.
Unfortunately at section her baby was very flat and extremely bruised with
his jaw wide open which made resus difficult and he ended up in NICU for the
night. She is quite devastated at this and of course wonders if she should
have gone for a section straight away and not tried for natural birth (which
in her family is not common). She is coming to terms with it all, even if we
knew it was a brow we would have tried to se if contractions would turn him
to a face so he could birth. Your woman needed to try coz it may have turned
more to a face which could have birthed but everything is easy in hindsight.
It is interesting that my friend at 7cm looked at me and said what happens
if her is stuck? I knew then oh oh, women who labour well no drugs who say
that to me flag bigs signs of knowing something is not right instinctively.
My friend is breastfeeding well now and has lots of worries which is her
nature anyway. Maybe next time?
Belinda
- Original Message -
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, December 17, 2003 2:07 AM
Subject: [ozmidwifery] Brow presentations


> What do you all know about brow presentations? I was with a lovely woman
> yesterday who wanted a natural birth and so i spent the morning with her
and
> her partner on the floor, in the shower and she dilated to fully within 4
> hrs, just lovely and I am sure (so sure) I palped a posterior fontanelle
> such that baby was direct OA, but almost military poition; I was trying so
> hard to follow her through a physiological 2nd stage but after an hour and
a
> half with no sign of baby's head I did another VE and she had pushed down
a
> small anterior lip, which obligingly slipped back but now there was a
> central anterior fontanelle with caput just inferior to the fontanelle, so
> consultant called in and an emergency c/s due to brow presentation(not
> emergent emergent, baby was just fine and mum was exhausted but not
> physiologically compromised). Baby had great apgars, which is good as I
had
> not identified any fetal distress, I just want to know if there is
anything
> we could have done differently. Mum spent most of her labour and 2nd stage
> on all fours on the floor over a bean bag, with regular partner dancing,
> pelvic rocking ie very active and effective first stage after 4cm. She had
> had a prolonged early first stage with  a significant hind leak and
> intermittent contractions for almost 24 hrs before presenting to to birth
> suite yesterday for IOL and antibiotics. She was then 4cm dilated and ARM
of
> forwaters to induce baby ROL at this time (this happened before my shift
> thankfully as I have a hard time supporting ARM and just hate that
> compromised feeling). Anyway she moved rapidly into an effective active
> first stage as described above.
>
> I am wondering if anyone thinks preserving those forewaters might had
> avoided the malpresentation. Also should I have re-examined her earlier?
Do
> you think I mistook the posterior fontanelle for the anterior one on my
> first 2nd stage VE? I was so convinced, I mean it felt like a text book
> palp.I just hate to think I encouraged this woman to work so hard for one
> and half hours when I could have saved her that exhaustion. And I don't
mean
> "saved" in any metaphysical sense, just can't think of a better word. I
know
> hindsight

Re: [ozmidwifery] Thanks

[Dierdre Bowman]

Hi Maureen,

I'm Dierdre Bowman and I'm with Maternity Coalition QLD.  I was wondering if
you could email me off list.

My email is [EMAIL PROTECTED]
Thanks
Dierdre.

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

Re: [ozmidwifery] Brow presentations

[Denise Hynd]

Dear Marilyn
Thank you for sharing your reflections and cogitations.

This is my beleif, experience that midwives do reflect on all that inputs
into a labour and the possible interplay rather than jumpimg to blame,
denouncement  of specific action of another or the woman and baby like an
edict of an all knowing being !!

In this particular insistance or similar I also wonder about the ramming (?)
effect of ARM and maybe other things that may have startled the mother or
baby in the hospital??

I take it there was no synto also pushing the hole along?
.
I understand and have seen floating in tubs to  help unstick some asynclitic
babies I wonder if it would help relax a non rigid brow back to a face or
vertex??

Also Midwifery Today & other midwifery texts talk of pushing stuck babies
back and other maneovers trying to unstick them but that would be easier
with intact membranes?

Denise
- Original Message -
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, December 16, 2003 11:37 PM
Subject: [ozmidwifery] Brow presentations


> What do you all know about brow presentations? I was with a lovely woman
> yesterday who wanted a natural birth and so i spent the morning with her
and
> her partner on the floor, in the shower and she dilated to fully within 4
> hrs, just lovely and I am sure (so sure) I palped a posterior fontanelle
> such that baby was direct OA, but almost military poition; I was trying so
> hard to follow her through a physiological 2nd stage but after an hour and
a
> half with no sign of baby's head I did another VE and she had pushed down
a
> small anterior lip, which obligingly slipped back but now there was a
> central anterior fontanelle with caput just inferior to the fontanelle, so
> consultant called in and an emergency c/s due to brow presentation(not
> emergent emergent, baby was just fine and mum was exhausted but not
> physiologically compromised). Baby had great apgars, which is good as I
had
> not identified any fetal distress, I just want to know if there is
anything
> we could have done differently. Mum spent most of her labour and 2nd stage
> on all fours on the floor over a bean bag, with regular partner dancing,
> pelvic rocking ie very active and effective first stage after 4cm. She had
> had a prolonged early first stage with  a significant hind leak and
> intermittent contractions for almost 24 hrs before presenting to to birth
> suite yesterday for IOL and antibiotics. She was then 4cm dilated and ARM
of
> forwaters to induce baby ROL at this time (this happened before my shift
> thankfully as I have a hard time supporting ARM and just hate that
> compromised feeling). Anyway she moved rapidly into an effective active
> first stage as described above.
>
> I am wondering if anyone thinks preserving those forewaters might had
> avoided the malpresentation. Also should I have re-examined her earlier?
Do
> you think I mistook the posterior fontanelle for the anterior one on my
> first 2nd stage VE? I was so convinced, I mean it felt like a text book
> palp.I just hate to think I encouraged this woman to work so hard for one
> and half hours when I could have saved her that exhaustion. And I don't
mean
> "saved" in any metaphysical sense, just can't think of a better word. I
know
> hindsight is often 20/20 and am not beating myself up, just trying to
> understand. There was some veiled criticism from the ob regarding not
having
> "effective analgesia" on board: however it was realised when the woman
> elected to have a GA that having an epidural or narcotics was never part
of
> her plan.
>
> I have looked up all of my texts and am pretty satisfied that a c/s for
> brow presentation is the best alternative, but would welcome other ideas.
>
> thanks
> marilyn
>
>
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[ozmidwifery] caesarean and stillbirth link

[Denise Hynd]

Title: FW: Live caesarean on channel 9 tomorrow--outraged responses needed!



 

 


This may help your 
response, Jenny
 
'Delivery by 
caesarean section in the first pregnancy could increase the risk of unexplained 
stillbirth in the 
second' 
Although caesarean section is known 
to be associated with an increased risk of disorders of placentation in 
subsequent pregnancies, effects on the rate of antepartum stillbirth are not 
known. Gordon Smith and 
colleagues looked at data for pregnancy discharge from the 
Scottish Morbidity Record and the Scottish Stillbirth and Infant Death Enquiry 
to estimate the relative risk of antepartum stillbirth in second pregnancies. 
The absolute risk of unexplained stillbirth at or after 39 
weeks' gestation, 
in women who had had a caesarean for their first child, was about twice that in 
women who had had a previous vaginal delivery. In a Commentary, Judith 
Lumley assesses the challenge of how to act in the face of 
these findings. She suggests that maternity hospitals with high rates of 
caesarean first births might think carefully about strategies to reduce the 
number of caesarean sections. 
 
Gordon C S Smith, Jill P Pell, 
Richard Dobbie 
Lancet 2003: 
362: 1779-84 

 
 
Jenny 
A Parratt
PhD 
candidate, University of 
Newcastle
Independent 
Midwife Consultant
P.O. 
Mandurang Vic 3551
Australia
0409 
393073
[EMAIL PROTECTED]
-Original 
Message-From: Bruce Teakle 
[mailto:[EMAIL PROTECTED]] Sent: Thursday, December 04, 2003 9:59 
AMTo: MC Committee; Rachael 
Smith; Toni Cannard; Ian Gittus; Melissa Bruijn; Jackie Doolan; Darren Sunn; 
Vicki Chan; Cesca Lejeune; Jenny Gamble; Therese 
O'Brien; 
Sarah Buckley; Molly Palmer; Deidrie Cullen; Helen Bremner; cheryl-anne Murphy; 
Cesca Lejeune - Peer Skills; Lynne Staff; Caroline McCullough; Nikky Campbell; 
Jodie Miller; Debbie Gould; Barbara Cook; Sandra Eales; Dierdre Bowman; Meredyth 
Sauer; Jacqui Dulieu; Janelle Pembroke; Judith Connolly; Sandiellen Black; 
Joanne Fisher; Claire Brassard; Lianne Schwartz; Kerry McGovern; Anne Clarke; 
Christine Kay; Carmon Martin; Cathy StylesSubject: [MCMgtCte] FW: Live caesarean on 
channel 9 tomorrow--outraged responses needed!
 
 
 
Dear Committee,Cas McCullough has contacted me 
(see below) having been enraged by this morning's channel 9 selling caesareans. 
It could be a good opportunity to pressure them into giving "balance" 
(which the media seems to be sensitive about). Perhaps equal time for people 
concerned about the harm caused by unnecessary CS?Caroline also made a 
very plausible suggestion that the obs are currently engaged in a PR campaign to 
normalise and sell CS. If true, it is a great credit to us that they feel the 
need.I've just heard that Andrea Robertson will be interviewed tomorrow, 
presumably just before the "live caesarean".Best wishes from 
Bruce.-Bruce TeakleLindsay RdMt Glorious 
4520Ph 07 3289 0231  0438 736 
740--From: 
"Wayne and Cas" <[EMAIL PROTECTED]>Date: Wed, 3 Dec 2003 12:05:10 
+1000To: "Bruce Teakle" <[EMAIL PROTECTED]>Subject: FW: [ozmidwifery] Live caesarean 
on channel 9 tomorrow--outraged responses needed!Please get in touch 
with Justine to provide a response to this asap.This needs to come from 
someone in Sydney. We also need comments bywomen who have had caesareans who 
feel horrified that their experiencesare being 
trivialised.Cheers,Cas.Cas, Wayne, Liam and Daniel 
McCullough[EMAIL PROTECTED]www.casmccullough.comemails 
can be sent to the Today show at [EMAIL PROTECTED] or you canvisit the 
Channel 9 comments & complaints page 
athttp://ninemsn.com.au/support/channel9.asp> I was disgusted 
to see an interview today on pros and cons of > c-section that was 
completely pro c-section on the Today Show on > Channel 9. Did anyone 
else see it? I feel physically sick that they > want to show a live 
caesearean birth on TV...what an insult to all > those women who have had 
horrible c-births.>> Very pissed off...>> 
Cas.>> Ps: Please write to Channel 9 and express your outrage 
Carolyn > D A response from you or Jackie Mawson would be 
good!To unsubscribe from this group, send an email 
to:[EMAIL PROTECTED]Your use of Yahoo! 
Groups is subject to the Yahoo! 
Terms of Service. To 
unsubscribe from this group, send an email 
to:[EMAIL PROTECTED]Your use 
of Yahoo! Groups is subject to the Yahoo! Terms of Service. 

[ozmidwifery] Brow presentations

[Marilyn Kleidon]

What do you all know about brow presentations? I was with a lovely woman
yesterday who wanted a natural birth and so i spent the morning with her and
her partner on the floor, in the shower and she dilated to fully within 4
hrs, just lovely and I am sure (so sure) I palped a posterior fontanelle
such that baby was direct OA, but almost military poition; I was trying so
hard to follow her through a physiological 2nd stage but after an hour and a
half with no sign of baby's head I did another VE and she had pushed down a
small anterior lip, which obligingly slipped back but now there was a
central anterior fontanelle with caput just inferior to the fontanelle, so
consultant called in and an emergency c/s due to brow presentation(not
emergent emergent, baby was just fine and mum was exhausted but not
physiologically compromised). Baby had great apgars, which is good as I had
not identified any fetal distress, I just want to know if there is anything
we could have done differently. Mum spent most of her labour and 2nd stage
on all fours on the floor over a bean bag, with regular partner dancing,
pelvic rocking ie very active and effective first stage after 4cm. She had
had a prolonged early first stage with  a significant hind leak and
intermittent contractions for almost 24 hrs before presenting to to birth
suite yesterday for IOL and antibiotics. She was then 4cm dilated and ARM of
forwaters to induce baby ROL at this time (this happened before my shift
thankfully as I have a hard time supporting ARM and just hate that
compromised feeling). Anyway she moved rapidly into an effective active
first stage as described above.

I am wondering if anyone thinks preserving those forewaters might had
avoided the malpresentation. Also should I have re-examined her earlier? Do
you think I mistook the posterior fontanelle for the anterior one on my
first 2nd stage VE? I was so convinced, I mean it felt like a text book
palp.I just hate to think I encouraged this woman to work so hard for one
and half hours when I could have saved her that exhaustion. And I don't mean
"saved" in any metaphysical sense, just can't think of a better word. I know
hindsight is often 20/20 and am not beating myself up, just trying to
understand. There was some veiled criticism from the ob regarding not having
"effective analgesia" on board: however it was realised when the woman
elected to have a GA that having an epidural or narcotics was never part of
her plan.

I have looked up all of my texts and am pretty satisfied that a c/s for
brow presentation is the best alternative, but would welcome other ideas.

thanks
marilyn


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[ozmidwifery] Removal from list

[Selangor Maternity Centre]

Could this email address please be removed from the mailing list.  Thank you


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[ozmidwifery] birth centres in Melbourne & suburbs

[jayne]

Is there a list of  birthcentres in Melbourne 
and suburbs?  Or could someone please let me know which ones they know are 
still open.
 
Thanks
 
Jayne
 
 

Re: [ozmidwifery] I've had a baby (long)

[Debbie Field]

I have the same response when people say i am brave 
having a homebirth. 
And I love telling my story to people in the 
hope that it may open their hearts to other possibilities. 
I do believe though that whatever people believe to 
be true, is perfectly true and right for them - as homebirthing was for me. And 
if a simple conversation about my birth can provide information to someone else 
so they are able to make a more informed choice...so be it. And then i respect 
their choice. 
 
deb
 

  - Original Message - 
  From: 
  Dierdre Bowman 
  To: [EMAIL PROTECTED] 
  
  Sent: Thursday, December 11, 2003 9:00 
  AM
  Subject: Re: [ozmidwifery] I've had a 
  baby (long)
  
  Jo I must be rude and bad mannered because I 
  often tell people in response to "you must be brave to have a homebirth" that 
  they must be brave to go to hospital. 
   
  Woops, never looked at it as being rude, I always 
  felt it was an appropriate way to start the conversation roling about birth. 
  Hope I haven't offended too many people.
   
  Dierdre B.

Re: [ozmidwifery] I've had a baby (long)

[Dierdre Bowman]

Jo I must be rude and bad mannered because I often 
tell people in response to "you must be brave to have a homebirth" that they 
must be brave to go to hospital. 
 
Woops, never looked at it as being rude, I always 
felt it was an appropriate way to start the conversation roling about birth. 
Hope I haven't offended too many people.
 
Dierdre B.

Re: [ozmidwifery] caesarean and stiilbirth

[Elissa and David]

You'll find the same topic covered at
http://news.bbc.co.uk/1/hi/health/3244410.stm
if thats any use .Alternatively if you want the original Lancet article , I
can email you a copy.
Cheers,
   David
- Original Message -
From: "Larry & Megan" <[EMAIL PROTECTED]>
To: "ozmidwifery" <[EMAIL PROTECTED]>
Sent: Monday, December 15, 2003 3:02 PM
Subject: [ozmidwifery] caesarean and stiilbirth


> Hi all,
> did anyone save a copy of the article that was posted on 28-11-03 on the
> link of caesarean and stillbirth URL
> http://news.independent.co.uk/uk/health/story.jsp?story=467949 it is no
> longer available without paying?
>
> If so could they please email it to me on [EMAIL PROTECTED], we wish to
> put it in our birth newsletter
>
> thanks
> Megan
>
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[ozmidwifery] Media influence on birth expectations

[Belinda Maier]

I thought this may interest you all, I love that she talks of the awful
things you do , it would scare anyone I should imagine, but to then tell you
to video it all??

What no one tells you about childbirth
>From Parents Expecting 2002 ( an information ((?)) mag for parents)


Vomiting due to low B/P after epidural also in labour without sometimes

you make nasty noises

you may have a bowel movement right on the delivery table.

You act like a lunatic - especially if you haven't been given any pain
medication.

Throwing off your clothes simply a common reaction to pain and exhaustion.If
you do lose it, don't feel bad. Doctors and nurses are used to reactions
such as these. (Still it wouldn't hurt to apologise afterward).

Your mind goes blank


This litany of horrors you should know about ends with... "You're also
likely to forget many details of the birth itself, so be sure your partner
takes plenty of photos or captures it all on
videotape
Also to finish off (and this is classic to show that this is all about the
reporter).

It's not love at first sight. Don't feel bad if your first reaction to
holding your newborn isn't overwhelming joy. You've just been through an
exhausting experience and need time to recover. You can try breastfeeding -
then let a nurse take your child so you can get some rest. That's what I did
after 17 hours labour and a c section. But after an hour, I had them bring
back my baby girl and I was immediately smitten.

Wow I would love to do a study on the journalists who publish these stories
as a catharsis to their own experiences! You know my birth was crap so all
of you should expect crap births!



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