Re: [ozmidwifery] NSW news
I don't have a problem with credentialing. What I do have a problem is, what additional, ongoing training or credentialing does an ob have to do. These are the people that save the babies! Just ask Andrew Pesce and Pieter Mourik!! Sonja - Original Message - From: G Lemay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 1:26 AM Subject: [ozmidwifery] NSW news New credentials give hope for birth centre EMMA SWAIN Tuesday, 30 August 2005 New credentials for midwives assisting in low risk births may pave the way for a midwifery-managed birthing model to be established in Maitland, a young mother has said. Maitland mother of two, Sarah-Jane Hazell, said news that midwives working under midwifery-managed birthing models in NSW would now be credentialed was a positive move forward for women's choice when it came to giving birth. I think this is just fantastic news and I believe it means Maitland has a real chance of having a midwifery-led birthing model like the one already established at Belmont, Ms Hazell, a member of the NSW Maternity Coalition, said. The Belmont Birthing Service opened in July for those Hunter women unlikely to experience complications during pregnancy, labour and birth. This is the first midwifery-led birthing service to be established in the Hunter area. Ms Hazell gave birth to her second child at home after experiencing a traumatic hospital birth with her first child. One to one midwifery care is a wonderful thing and women should have the choice of using this method if they want to, besides obstetricians are becoming more difficult to find and more expensive so a midwifery-managed model seems like the perfect alternative. NSW Health Minister John Hatzistergos said the new credentialling process, to be administered by the NSW Midwives Association, would be a first of its kind for Australia. This new system of credentialling for midwives is a quality control mechanism that will optimise safety for women who opt for midwifery-managed antenatal, birthing and postnatal care, Mr Hatzistergos said. In the rare instance that a problem develops during pregnancy, labour, birth or the post-natal period, midwives working as primary care givers will need to make important decisions about the need to seek medical attention. The credentialling process will provide a further set of checks and balances to ensure midwives are competent and confident in providing this care to women in low-risk settings. President of the NSW Midwives Association Dr Pat Brodie said this exciting new initiative would enable the public and care providers to have increased confidence in the range of services provided by midwives working in this way. For the first time, midwives have an opportunity to participate in a standardised quality process across the State, Mr Brodie said. http://maitland.yourguide.com.au/detail.asp?class=newssubclass=localcategory=general%20newsstory_id=419799y=2005m=8 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re:
Yeah, We have an expert GP (not) who wants all women to be assessed by a Dr on admission!!! This in Mareeba where the Dr has not been involved at all in normal birth for years and years. You can imagine our reaction. Our OB in Cairns is NOT impressed and has written to the appropriate place to say so. Cheers Judy --- Susan Cudlipp [EMAIL PROTECTED] wrote: Yes it was Brenda who wrote that, but I have also been a midwife long enough to have seen many breech births - back in the UK, and delivered a few myself. Not all good, mostly quite 'managed' but at least they were mostly seen as being manageable vaginally! My own elective C/S (nearly 21 years old now!) was for primip breech, although I was given the choice of vaginal birth, I knew just what that would entail within the large unit that I was obliged to attend - epidural, forceps, episiotomy, and I chose not to go there, however at that time there was no question that I would not be able to have VBAC with the next - nowadays that is not so. A year or so back we had a multi with a breech who was lucky enough to see a less interventionist OB (as you so rightly guessed Melissa :-)) and she chose to have a vaginal birth. Of course it had to be induced on the 'right' day, but was very straight forward. Apart from that we really don't see them anymore, and at least one of the few docs who does do them does such a horrendous job that I would personally prefer a C/S rather than submit to his handling.( you can probably guess that one too Mel!) It is sad that student midwives today will not learn these essential skills within the hospital system. Personally I feel confident that I can handle an unexpected breech, but cannot see how the next generation are going to cope with this, there is so much fear of what is really only a different variety of birth, in the same way that any 'different' presentation is. Anyone who has had the pleasure of hearing Maggie Banks speak, watched her video, or that of Michel Odent's work in Pithiers will know that this is true Rachel, I totally empathise with how you are feeling having just come to Australia from the UK (been here 15 years myself). It was a real shock to me to see how much all births are seen as being the doctor's property. One of my first births here was in a small hospital and I called the GP as per protocol. He arrived as I had the head in my hands and proceeded to rush in, without even washing his hands and virtually pushed me out of the way! I looked at him with horror and said quietly I think I may as well finish the job now don't you? He did step back and let me finish. Some years later he admitted that he had learned a few things from me - one of which was to wait for restitution before trying to deliver the shoulders! They were always in such a goddamn hurry to drag the baby out, it drove me mad. When they are faced with an 'expert' obstetrician (often a male authority figure) telling them their baby is in danger - they will chose to protect their child because as a mother that is their instinct. An example of this happened to me just this week - the head was well and truly crowned (primip, long labour, NO fetal distress) but OB insisted on listening to FH immediately ctx ended - it was about 100, and he took over from me to apply forceps. I was not concerned for the baby as I knew there had been no compromise throughout and that he would be born within minutes, but within the system I am obliged to defer to the doctor's judgement, whether or not I agree with it. Believe me, I know well what happens when one tries to argue!! I hope you maintain your own integrity and autonomy - it is very different here to what we knew in UK, but we do need to keep pushing for midwifery led care. I feel that much of the problem lies with how we are percieved and presented within this system. We are seen as being secondary and forced into a 'waitress' role, while doctors are glorified as being all-knowing experts. I have spent ages discussing things with couples only to have everything overturned by a 5 minute doctor appointment. Nice to have your input on the list Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: brendamanning [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Thursday, September 01, 2005 10:26 AM Subject: Re: [ozmidwifery] Re: Rachel, Actually that was me (Brenda)not Sue, who wrote about the physiological breeches, and I do realise now that experience is rare. When you speak about choice what you'd do if you had a breech baby yourself you are really limited because there are not many of us in PP who have experience with breeches. I would definitely not alter plans to birth at home if my baby was
Re: [ozmidwifery] Re: Breech Babies
Title: Re: [ozmidwifery] Re: Breech Babies Dear All This Obstetrician is Andrew Bissits from John Hunter in Newcastle. I heard he has cared for over 400 women birthing breech babies vaginally. He is the only Ob in Australia I would allow to touch me (lucky I live 2 and a half hrs away!) He didnt even baulk at my ranty presentation called myth busters (assessing what really happens inside the current system) Yesterday Andrew hosted a day on midwifery-led birth units that was VERY successful, partly due to an insane presentation by Pieter Mourik. 175 participants from several states and international speakers. Midwives were well represented with Kathleen Fahy, Sally Tracy, Anne Saxton, Nicky Leap, Pat Brodie, and Maralyn Rowley, 3 consumers, Dr Ric Gordon re the success of Bath in the UK The best part from me was speaking to a midwife I had never met who is working in a stand alone unit who had never previously been able to work her full scope who had recently witnessed her first waterbirth with a woman she had got to know . She said I did nothing I just watched this wonderful woman. This was a midwife who had previously been reluctant to work caseload in the stand-alone model. Theres a message in that for everyone who rejects caseload as too hard etc etc. We need so many more to embrace the change and make it work for midwives and women Viva la Revolution JC
[ozmidwifery] Pieter Mourik in The Australian
Title: Pieter Mourik in The Australian Dear all Here is the rant in the Oz today, I think he will assist us greatly! Interesting that re his insurance he has forgotten that taxpayers actually pay 80% of his premiums while midwives get no assistance! Also a copy of my letter to the Oz As a mother of 4, soon to be 6, I hold the safety of my children and myself dear. Dr Mourik's assessment of safety is little more than scare-mongering spin. Large Hospitals are not lined with medicos on hand for the 'what ifs' they are overstretched with competing interests. Private Hospitals and smaller units need to call in medical staff. Current services disregard the appropriate roles for midwives and doctors due to a complete stranglehold by the vested medical interests. The safety of midwifery is established. What is yet to be examined (due to a lack of medical accountability) is the safety and appropriateness of the routine care the majority of women are subjected to. In large centres women are herded like cattle and cared for with a clock and organisational management as a guide, rather than practices based on scientific evidence and women's choice. In rural areas it's generally a couple of hundred kilometres dodging kangaroos (due to no local service). I'm glad Dr Mourik has retired because his assertions that Drs can provide a safe service and emergency care in an instant need full scrutiny. Examination of current routine maternity care will reveal a sick system indeed. Midwives invaluable, but they must be in a hospital setting Peter Mourik September 03, 2005 IT was 8am and Sally - not her real name - had been in labour all night. She was tired but exhilarated; this was the moment she had waited for. This was her first baby, she was healthy and had been assessed as low risk, so she was confident. The labour was hard, but she received all the support she needed from her partner and the midwives, who had been wonderful. Her labour crossed three shifts of nurses. Now she had to push. Suddenly, even though her baby had been frequently listened to during her labour, the midwife found the baby's heart rate had dropped to a dangerous 60, and stayed at 60 despite rolling Sally over and giving oxygen. The midwife examined her and found the baby was not going to deliver quickly. The emergency alarm was rung. Within a minute, the visiting doctor, fortunately doing his rounds, arrived and conferred with the midwife, then rapidly delivered the baby with a vacuum. The umbilical cord was not only around the neck once, but five times. The baby was sleepy, but started breathing in one minute and was safe. This is a true story, and not uncommon; if this baby had been delivered in a free-standing midwife-only unit, or at home, it would not have survived the 30-minute transfer. Midwives cannot and should not do operative deliveries. They have not had the training that doctors have had. Midwives cannot provide their services in isolation from doctors, because they cannot guarantee to complete a safe delivery. To remove childbirth to free-standing midwife-only units, or worse, to a home, is simply taking unnecessary risks. Women who select themselves as healthy may be underestimating their risks. In Australia 30 per cent of women are obese, which increases all known complications. Women are leaving their childbearing until much older, which also increases the risk of complications. Over half the women having their first baby fail to have a normal delivery. Then there are other complications, like those where the baby is too big for a natural birth, or the cord may be around the baby's neck, strangling it during labour. The cord cannot be detected without monitoring during labour. The baby could be undersized or malnourished, which is difficult to detect clinically. Thirty per cent of these babies develop acute distress in labour, requiring immediate operative delivery. The baby's shoulders may become stuck during delivery, which although fortunately only happens in one in 500 births, is one of the most dangerous and difficult deliveries experienced, immediately needing the extra skills provided by an obstetrician. Even after normal delivery, 5 per cent of healthy women have a massive bleed, rising to 15 per cent if an injection to contract the uterus is refused. Can you imagine how dangerous this can be in a home environment? These complications are what we see in developing countries, and to advocate home deliveries or free-standing midwife-only units (with no immediate medical help close at hand) is like going backwards in time. Between 30 and 50 per cent of women who choose midwife-managed births have to be transferred to a doctor she has never met. If the woman delivers in a team model of care, immediate medical or surgical help is available and the same midwife is able to support the woman to the very end of delivery. Until now, Australia has led the world in safety in childbirth because midwives
Re: [ozmidwifery] More news on midwifery units
I hope the people of Mona Vale get behind the midwives and jump up and down, loud and long as they did in Mareeba. If they don't their service will be shelved for good. We certainly got somewhere with the help of the Hirst report and the support of the Cairns OB's. Cheers Judy --- Andrea Robertson [EMAIL PROTECTED] wrote: These two stories are in the Sydney Morning Herald today, along with a big colour photo, on page 3: Pregnant pause as birth program gets the push By Ruth Pollard, Health Reporter September 2, 2005 No continuity Lisa McLean, with son Luke, two, has lost her midwife. Photo: Peter Morris The NSW Government has abandoned a midwife project at Mona Vale and Manly hospitals, leaving up to 200 women - some of whom are due to give birth in the coming month - to scramble to find places at other hospitals. Just days before the project was to go ahead, the Northern Beaches Health Service decided to shelve it and undertake a review of maternity services in the area. Lisa McLean, who is due to give birth in eight weeks, has been affected by the change. She was attracted to the program because of the continuity of care it provided to expectant mothers, who were to have been allocated to one midwife for prenatal, birthing and postnatal care. Now, the women must choose to give birth at the unit without personalised midwives, or find obstetricians or birthing centres elsewhere. Mrs McLean will stay with the unit but has no idea which midwife will be caring for her and her baby. It was to become more of a personal, one-on-one experience; they are on call, they are there for the birth and the follow-up afterwards. That is the reason a lot of women go to obstetricians, even though they don't really need to, to have that continuity of care. AdvertisementAdvertisement The general manager of the Northern Beaches Health Service, Frank Bazik, said he was not prepared to give his final approval to the project before having all maternity services reviewed to determine which birthing model was appropriate for each hospital. Insisting that it had been deferred for only two to three months, Mr Bazik said there had been no safety concerns about the program. There have been some meetings with the obstetricians about this proposed model and they are supportive of it. However, the Herald understands that staff have been told that severe budget problems at the health service were a factor in the decision. Sally Tracy, an associate professor of midwifery practice development at the University of Technology, Sydney, said there was no reason to defer the program. I have no doubt that they have been bullied into not allowing this service to go ahead Clearly, there are people who have vested interests in this, who do not want to see a service where women go to midwives. --- Doctors irked at lack of say in midwifery talks September 2, 2005 A rift has emerged between the NSW Government and the Australian Medical Association, which says it has been shut out of consultations on the development of maternity services. So deep is the division that the association has begun a vigorous campaign to reclaim ground in the debate. Andrew Pesce, an obstetrician and senior member of the association, told the Herald that while a recent review of six international studies had found some modest benefits from midwife-assisted births, it had also found significant risks. It showed an 83 per cent increase in the risk of infant mortality, he said. Dr Pesce said NSW Health had made a policy decision to exclude the association from consultations, presumably because they know how we will respond. But Kathleen Fahy, the dean of midwifery at the University of Newcastle, and the co-author of the review, Denis Walsh, have disputed Dr Pesce's interpretation. AdvertisementAdvertisement The review, by the international non-profit group the Cochrane Collaboration, had not found a significant difference in baby deaths and it is less then honest of Dr Pesce to imply that it did, Professor Fahy said. After reviewing each of the studies included in the review she found 60 per cent of women who were supposed to give birth assisted by a midwife had been transferred to a hospital. Yet all the baby deaths were blamed on the birthing centres, even if the baby died hours, days or months after transfer to medical care. Most deaths were due to gross prematurity, gross abnormality or an unexplained stillbirth, she said. Their [the doctors'] fear is that midwives will get a Medicare number and set up in competition and women may choose midwives as their primary care providers rather than doctors. The association's NSW president, John Gullotta, said yesterday that he had also received no response to a request for a
Re: [ozmidwifery] Re-learning how to do breech births
Dear Andrea When will you add Perth to the this program?? Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 8:43 AM Subject: [ozmidwifery] Re-learning how to do breech births Hello listers, Yesterday I was talking to Maggie Banks about scheduling some more of her wonderful Birthspirit Intensive workshops for 2006. We hope to take in Adelaide and Brisbane as well as Sydney and Melbourne next year, given their enormous popularity (still a few places left in the December program: http://www.birthinternational.com/event/intensives2005/index.html Anyway, she mentioned that she now has a program designed to teach midwives how to manage breech births, that is in the process of being fully credentialled through the NZ College of Midwifery. She is now touring NZ offering this program so that midwives feel confident in facilitating this kind of birth, if it happens. Would there be enough interest in Australia for me to approach her to present some of these workshops here? It would make a very good alternative to the ALSO program, and is completely midwifery based. As far as I know, it is a one day program too. There has been quite a lot of discussion about breech births on the list and the loss of skills as a result of the swing towards C/Sec. This might be one way to help halt the slide. Please email me if you are interested. My email address is [EMAIL PROTECTED] Regards, - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/86 - Release Date: 31/08/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Re: Breech Babies
I have just been surfing this site, some good stuff. I have a multi with a breech at 36+ wke at the moment and I dearly want her to be able to birth here. Cheers Judy --- Vedrana Valèiæ [EMAIL PROTECTED] wrote: A very interesting discussion on breech births and midwives: http://www.radmid.demon.co.uk/breech.htm Vedrana -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Miriam Hannay Sent: Friday, September 02, 2005 6:10 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Re: Breech Babies I totally understand, Susan about the whole fear of breech birth. We have a couple of OBs who will 'let' women birth a breech babe vaginally, but fully managed, IOL, 16 gauge bores in both arms, hartmann's up, McRoberts, episi, full extraction. To me this seems torture. I am a second year Bmid student and intending to go into independent practice, so am availing myself of every extra learning opportunity available. A fellow student and I (my lovely partner in crime), attended Maggie Banks' emergency skills workshop in Melbourne recently which was SO valuable, and we feel much more comfortable about the possibility now. I have a dear friend whose first 'catch' as an RM was an undiagnosed breech at home, so it does happen. We need to be prepared and develop the skills to handle this situation. What a shame and potential danger it is if these skills fall by the way. Everyone who can should hear Maggie Banks speak, she dispells fears and demystifies like no-one else. Regards, Miriam (FUSA) --- Susan Cudlipp [EMAIL PROTECTED] wrote: Yes it was Brenda who wrote that, but I have also been a midwife long enough to have seen many breech births - back in the UK, and delivered a few myself. Not all good, mostly quite 'managed' but at least they were mostly seen as being manageable vaginally! My own elective C/S (nearly 21 years old now!) was for primip breech, although I was given the choice of vaginal birth, I knew just what that would entail within the large unit that I was obliged to attend - epidural, forceps, episiotomy, and I chose not to go there, however at that time there was no question that I would not be able to have VBAC with the next - nowadays that is not so. A year or so back we had a multi with a breech who was lucky enough to see a less interventionist OB (as you so rightly guessed Melissa :-)) and she chose to have a vaginal birth. Of course it had to be induced on the 'right' day, but was very straight forward. Apart from that we really don't see them anymore, and at least one of the few docs who does do them does such a horrendous job that I would personally prefer a C/S rather than submit to his handling.( you can probably guess that one too Mel!) It is sad that student midwives today will not learn these essential skills within the hospital system. Personally I feel confident that I can handle an unexpected breech, but cannot see how the next generation are going to cope with this, there is so much fear of what is really only a different variety of birth, in the same way that any 'different' presentation is. Anyone who has had the pleasure of hearing Maggie Banks speak, watched her video, or that of Michel Odent's work in Pithiers will know that this is true Rachel, I totally empathise with how you are feeling having just come to Australia from the UK (been here 15 years myself). It was a real shock to me to see how much all births are seen as being the doctor's property. One of my first births here was in a small hospital and I called the GP as per protocol. He arrived as I had the head in my hands and proceeded to rush in, without even washing his hands and virtually pushed me out of the way! I looked at him with horror and said quietly I think I may as well finish the job now don't you? He did step back and let me finish. Some years later he admitted that he had learned a few things from me - one of which was to wait for restitution before trying to deliver the shoulders! They were always in such a goddamn hurry to drag the baby out, it drove me mad. When they are faced with an 'expert' obstetrician (often a male authority figure) telling them their baby is in danger - they will chose to protect their child because as a mother that is their instinct. An example of this happened to me just this week - the head was well and truly crowned (primip, long labour, NO fetal distress) but OB insisted on listening to FH immediately ctx ended - it was about 100, and he took over from me to apply forceps. I was not concerned for the baby as I knew there had been no compromise throughout and that he would be born within minutes, but within the system I am obliged to defer to
[ozmidwifery] Weekend Australian...
http://www.theaustralian.news.com.au/common/story_page/0,5744,16475243%255E2702,00.html Birthing centres 'empower mothers' Clara Pirani, Medical reporter September 03, 2005 DOMINIQUE Alexander felt that only a midwife, not an obstetrician, would allow her to have any say in the way she gave birth. The 32-year-old mother of two gave birth to her daughters in a midwife-run unit within the Mercy Hospital for Women in Melbourne. The midwives listen to you. I wanted to have a natural childbirth without any pain relief, Mrs Alexander said. In the birthing centre, the midwives know that you want to have a natural birth so they prepare you and talk about different natural pain management, and I think they have a lot more faith in you, whereas I think obstetricians encourage you to have pain relief. Mrs Alexander disputes claims this week by the National Association of Specialist Obstetricians and Gynaecologists that babies born in home-like settings, such as midwife-run centres, have an 85per cent higher risk of death around the time of childbirth. Association secretary Andrew Pesce said studies that midwives used to back up their safety records were scientifically inferior. But Mrs Alexander said she felt completely safe giving birth without an obstetrician present. She was in labour for 16 hours with her first daughter and for five hours with her second, and did not use any medication during either birth. I had no problems and I was home the next day, she said. I would really disagree that birthing centres are more risky, and I don't believe that statistic. If you have a low-risk pregnancy, then why should you clog up the hospital system when you can use a birthing centre? I would have no hesitation going to a birthing centre again. Mrs Alexander said she had experienced no serious complications, other than some minor bleeding during her second pregnancy. A midwife had explained that if she developed any problems she would be transferred from the birthing unit to the hospital. If I had given birth more than two weeks early, or more than three weeks late, they would have induced me and I couldn't have had the girls in the birthing centre. That was all explained to me well in advance. She said hospitals could intimidate women, making them nervous about their ability to give birth. I think the birthing centre empowers women to give birth and allows them to feel confident and to know that we can do it, whereas in the hospital they talk about so many risks that they take the power away from you.
[ozmidwifery] another from the Australian...
http://www.theaustralian.news.com.au/common/story_page/0,5744,16475238%255E23289,00.html Midwife care gets seal of approval Adam Cresswell September 03, 2005 MIDWIVES could be blamed for just three of 51 deaths linked to birth centre care in an international review - an error rate so low it proves midwife-led care is safe, a leading expert has stated. An analysis of six studies included in the review found that, contrary to claims by leading obstetrician Andrew Pesce this week that the review showed midwife care increased baby death rates by 85 per cent, the outcomes were very good. Kathleen Fahy, professor of midwifery at the University of Newcastle, said the original data contained in the six trials included in the Cochrane review found that of the 51 deaths of babies born to the 7691 women booked into birth centres, 31 were stillbirths due largely to unavoidable factors such as congenital abnormalities or extreme prematurity. Of the remaining 20 deaths that occurred after babies had been born alive, eight were due to extreme prematurity, three to congenital abnormalities and six were either clinically unavoidable deaths or due to care that took place after the mother was transferred to hospital. Out of a total of 51 deaths among 7691 births, in six of them midwives were said to have made some level of error. Three of these happened after labour began, Professor Fahy told a midwives' conference in the NSW city of Newcastle yesterday. I think this is an absolutely fantastic outcome for midwife care. The Cochrane review was cited by Dr Pesce this week as evidence that midwifery-led birthing centres, two of which are operating in NSW, were unsafe. Many obstetricians are opposed to stand-alone midwife units, which do not offer specialist medical services on site, on the grounds that dangerous situations can arise unexpectedly, even among women previously assessed as being low-risk. In such situations, the life of the mother or baby can be at risk if transfer to a fully equipped hospitals takes too long. But Professor Fahy told the conference, organised by the division of obstetrics and gynecology at the city's John Hunter Hospital, that midwife units were being unfairly scrutinised and the safety of conventional hospital births was far from perfect. Medical care cannot deliver on its promise to make births safe, and I think we should be very careful not to make promises to the public we know we can't deliver on, she said. British obstetrician Richard Porter, director of maternity services at the Royal United Hospital in Bath, southern England, said midwife-led birthing services in his home town - some a 50-minute ambulance ride away from hospital facilities - were hugely popular and were not only proving safe but also reported much lower rates of surgical interventions. There's nothing second-rate about midwife-led units, he said. That's such an important message for communities - there's no need for anybody to be half-hearted about this. Dr Pesce, a consultant obstetrician at Sydney's Westmead Hospital, said an analysis of negligence claims filed with the doctors' insurer, United Medical Protection, showed a disproportionate rate of claims from women who had been cared for in rural hospitals. He warned midwives they would begin facing medical litigation, and urged doctors and midwives to lobby governments to introduce a long-term care scheme to pay for the care of babies born with brain damage.
[ozmidwifery] one more from the Aus...
http://www.theaustralian.news.com.au/common/story_page/0,5744,16470902%255E23289,00.html Infant formulas Adam Cresswell September 03, 2005 WOULD you entrust your pregnant pet to the care of a midwife? The question sounds absurd but, strange as it sounds, it seems not everybody would. One surgeon told a Sydney community newspaper last year he wouldn't let a cat have a baby at Australia's first midwife-led birth unit, at Ryde in the city's northwest, a startling claim considering that cats are the original home-birth enthusiasts. More alarming, because it was apparently factually unimpeachable, was the assertion by NSW obstetrician Andrew Pesce in The Australian this week that, according to an international study, women giving birth in birth centres had an 85 per cent higher risk of perinatal mortality overall. To the fury of midwives, Pesce hit the airwaves the following morning (by which time his statistic had fallen by two percentage points), telling breakfast television viewers the study found an 83 per cent increased risk of a baby dying during or immediately after childbirth. The claim was promptly contradicted by one of the study's co-authors, who pointed out the finding was only a trend and was not statistically significant. Midwifery groups, meanwhile, have their evidence: the most recent being a study published in the British Medical Journal in June. It found that among 5418 American women who had planned home births, there were lower rates of medical interventions and (contrary to Pesce's figures) rates of baby deaths similar to equivalent births in hospitals. A review of birth-centre outcomes in the British National Health Service in December last year found no reliable evidence about clear benefit or harm associated with birth-centre care compared with any other type. But as those attending yesterday's conference in Newcastle, NSW, on midwifery-led units were again reminded, some obstetricians continue to assert that babies will die unnecessarily if stand-alone midwife-led birth units continue and proliferate. So far there are two in NSW, at Ryde and Belmont, south of Newcastle. Some Sydney hospitals, such as Royal Prince Alfred Hospital at Camperdown and the Royal Hospital for Women at Randwick, have onsite units. A trial of a home-birth service run by midwives is to begin and two more services, at Shellharbour and Camden, are under consideration. Other states have midwifery-led care but are not expanding the stand-alone model as in NSW. Ryde and Belmont accept only low-risk women. Even high blood pressure during pregnancy is deemed significant enough to require transfer to a conventional hospital. Stand-alone units are not located within or on the same site as established tertiary hospitals. This means that no specialist obstetricians are on site, although they are on call. There are no anaesthetists, so no anaesthesia such as epidurals are offered; and there are no pediatricians immediately to hand. Some obstetricians claim all this is a recipe for potential disaster. But good medical practice is all about evidence, so what evidence is there that stand-alone midwifery is unsafe? Both sides trumpet studies that appear to back their case, so who should the public believe? It's important to first understand the terms of the debate. As the standards-setting body, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, makes clear, midwife care per se, or midwife units attached to large hospitals, are not the issue because in those cases back-up is available. The college opposes stand-alone units in metropolitan areas on the grounds that transfer by ambulance may take too long in an emergency. RANZCOG president Ken Clark says the college has no problem with women delivering in midwife-led units. If there are more midwife-led units in Australia, that's fine. The question is, where should they be? he tells Inquirer. We believe in metropolitan areas, primary care [birth] units, whether they be GP or midwife units, should be literally adjacent to a secondary care unit [fully equipped hospital]. Of course, whether that's the only issue for obstetricians is another matter: the then president of the Queensland branch of the Australian Medical Association, David Molloy, caused a storm in May when he said the midwife unit of a Brisbane hospital had been referred to by others as the killing fields, notwithstanding its hospital link. Molloy apologised for the comment, but many midwives took the remark as symptomatic of a deep-seated disregard for them among some doctors. It certainly fuelled a belief that the dispute is also about the two professions' attempts to win power over the other, a sensitive issue that was a subtext at yesterday's conference. And when it comes to looking at the evidence, two things are
Re: [ozmidwifery] Emailing: video05 you will like this
I got it, it was a email link for a video of a guy having a baby in a very medicalised setting. On 03/09/2005, at 3:51 AM, Gloria Lemay wrote: x-tad-smallermy virus scanner eliminated it. Gloria/x-tad-smallerx-tad-smaller- Original Message -/x-tad-smaller x-tad-smallerFrom:/x-tad-smallerx-tad-smaller /x-tad-smallerx-tad-smallerSusan Cudlipp/x-tad-smallerx-tad-smaller /x-tad-smaller x-tad-smallerTo:/x-tad-smallerx-tad-smaller /x-tad-smallerx-tad-smallerozmidwifery@acegraphics.com.au/x-tad-smallerx-tad-smaller /x-tad-smaller x-tad-smallerSent:/x-tad-smallerx-tad-smaller Friday, September 02, 2005 8:06 AM/x-tad-smaller x-tad-smallerSubject:/x-tad-smallerx-tad-smaller Re: [ozmidwifery] Emailing: video05 you will like this/x-tad-smaller x-tad-smallerIs this a genuine message or a virus?/x-tad-smallerx-tad-smallerI thought that attachments could not be sent to the list - please all be cautious and do not open unless it is verified/x-tad-smaller x-tad-smallerThe only thing necessary for the triumph of evil is for good men to do nothing/x-tad-smallerx-tad-smallerEdmund Burke/x-tad-smallerx-tad-smaller- Original Message -/x-tad-smaller x-tad-smallerFrom:/x-tad-smallerx-tad-smaller /x-tad-smallerx-tad-smallerlyn lyn/x-tad-smallerx-tad-smaller /x-tad-smaller x-tad-smallerTo:/x-tad-smallerx-tad-smaller /x-tad-smallerx-tad-smallerozmidwifery@acegraphics.com.au/x-tad-smallerx-tad-smaller /x-tad-smaller x-tad-smallerSent:/x-tad-smallerx-tad-smaller Friday, September 02, 2005 7:16 PM/x-tad-smaller x-tad-smallerSubject:/x-tad-smallerx-tad-smaller [ozmidwifery] Emailing: video05 you will like this/x-tad-smaller The message is ready to be sent with the following file or link attachments: Shortcut to: http://www.clubcultura.com/haymotivo/video05.htm Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/88 - Release Date: 1/09/2005
Re: [ozmidwifery] Re-learning how to do breech births
Hello Denise, There is a lot of interest in this workshop, but where and when we can get it organised will depend on Maggie's availability. She is keen to help Aussie midwives, and between us, we'll see what we can arrange. I know you are keen in Perth will keep you posted. Regards, Andrea At 04:53 PM 3/09/2005, you wrote: Dear Andrea When will you add Perth to the this program?? Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 8:43 AM Subject: [ozmidwifery] Re-learning how to do breech births Hello listers, Yesterday I was talking to Maggie Banks about scheduling some more of her wonderful Birthspirit Intensive workshops for 2006. We hope to take in Adelaide and Brisbane as well as Sydney and Melbourne next year, given their enormous popularity (still a few places left in the December program: http://www.birthinternational.com/event/intensives2005/index.html Anyway, she mentioned that she now has a program designed to teach midwives how to manage breech births, that is in the process of being fully credentialled through the NZ College of Midwifery. She is now touring NZ offering this program so that midwives feel confident in facilitating this kind of birth, if it happens. Would there be enough interest in Australia for me to approach her to present some of these workshops here? It would make a very good alternative to the ALSO program, and is completely midwifery based. As far as I know, it is a one day program too. There has been quite a lot of discussion about breech births on the list and the loss of skills as a result of the swing towards C/Sec. This might be one way to help halt the slide. Please email me if you are interested. My email address is [EMAIL PROTECTED] Regards, - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/86 - Release Date: 31/08/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Emailing: video05 you will like this
It's not bad, all in spanish but you get the drift with the acting and prior knowledge of what goes on. Cheers Judy --- Ceri Katrina [EMAIL PROTECTED] wrote: I got it, it was a email link for a video of a guy having a baby in a very medicalised setting. On 03/09/2005, at 3:51 AM, Gloria Lemay wrote: my virus scanner eliminated it. Gloria - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 8:06 AM Subject: Re: [ozmidwifery] Emailing: video05 you will like this Is this a genuine message or a virus? I thought that attachments could not be sent to the list - please all be cautious and do not open unless it is verified The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: lyn lyn To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 7:16 PM Subject: [ozmidwifery] Emailing: video05 you will like this The message is ready to be sent with the following file or link attachments: Shortcut to: http://www.clubcultura.com/haymotivo/video05.htm Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/88 - Release Date: 1/09/2005 Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Re-learning how to do breech births
We northerners really enjoyed the workshop in Townsville last year and I imagine there would be enough midwives to do another up north, maybe sunny Cairns this time? Cheers Judy --- Andrea Robertson [EMAIL PROTECTED] wrote: Hello Denise, There is a lot of interest in this workshop, but where and when we can get it organised will depend on Maggie's availability. She is keen to help Aussie midwives, and between us, we'll see what we can arrange. I know you are keen in Perth will keep you posted. Regards, Andrea At 04:53 PM 3/09/2005, you wrote: Dear Andrea When will you add Perth to the this program?? Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 8:43 AM Subject: [ozmidwifery] Re-learning how to do breech births Hello listers, Yesterday I was talking to Maggie Banks about scheduling some more of her wonderful Birthspirit Intensive workshops for 2006. We hope to take in Adelaide and Brisbane as well as Sydney and Melbourne next year, given their enormous popularity (still a few places left in the December program: http://www.birthinternational.com/event/intensives2005/index.html Anyway, she mentioned that she now has a program designed to teach midwives how to manage breech births, that is in the process of being fully credentialled through the NZ College of Midwifery. She is now touring NZ offering this program so that midwives feel confident in facilitating this kind of birth, if it happens. Would there be enough interest in Australia for me to approach her to present some of these workshops here? It would make a very good alternative to the ALSO program, and is completely midwifery based. As far as I know, it is a one day program too. There has been quite a lot of discussion about breech births on the list and the loss of skills as a result of the swing towards C/Sec. This might be one way to help halt the slide. Please email me if you are interested. My email address is [EMAIL PROTECTED] Regards, - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/86 - Release Date: 31/08/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. Do you Yahoo!? The New Yahoo! Movies: Check out the Latest Trailers, Premiere Photos and full Actor Database. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Emailing: video05 you will like this
Is it Portu Bien? I have this on DVD with subtitles. - Original Message - From: Judy Chapman [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, September 04, 2005 12:08 PM Subject: Re: [ozmidwifery] Emailing: video05 you will like this It's not bad, all in spanish but you get the drift with the acting and prior knowledge of what goes on. Cheers Judy --- Ceri Katrina [EMAIL PROTECTED] wrote: I got it, it was a email link for a video of a guy having a baby in a very medicalised setting. On 03/09/2005, at 3:51 AM, Gloria Lemay wrote: my virus scanner eliminated it. Gloria - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 8:06 AM Subject: Re: [ozmidwifery] Emailing: video05 you will like this Is this a genuine message or a virus? I thought that attachments could not be sent to the list - please all be cautious and do not open unless it is verified The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: lyn lyn To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 7:16 PM Subject: [ozmidwifery] Emailing: video05 you will like this The message is ready to be sent with the following file or link attachments: Shortcut to: http://www.clubcultura.com/haymotivo/video05.htm Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.10.18/88 - Release Date: 1/09/2005 Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Emailing: video05 you will like this
Try for yourself, cut and paste link into your browser http://www.clubcultura.com/haymotivo/video05.htm Regards Fiona Rumble
Re: [ozmidwifery] Pieter Mourik in The Australian
Title: Pieter Mourik in The Australian Here is a copy ofmine: I fail to understand why The Australian continues to publish the scare-mongering opinions of individuals who are quite clearly not aware of the current evidence (Midwives invaluable, but they must be in a hospital setting, September 03, 2005). I choose not to work in a hospital setting; however I do not provide midwifery services in isolation from doctors. I am very grateful for and value the small group of GP/Obs and Obstetricians who I can consult with if the need arises. The women who seek my services are looking for something that is not available to the majority of Australian women in the current health system, continuity of a known midwife. They are well informed and know that having a baby in hospital does NOT guarantee a safe delivery. I suggest Pieter Mourik look at the perinatal outcomes for the Inuit women in remote Inukjuak in Northern Quebec. They are an isolated, high risk population who are now cared for by the local midwives in their community. Their outcomes not only improved but put many of our Australian hospitals to shame. History is indeed their judge! Andrea Bilcliff Midwife - Original Message - From: Justine Caines To: OzMid List Sent: Saturday, September 03, 2005 4:47 PM Subject: [ozmidwifery] Pieter Mourik in The Australian Dear allHere is the rant in the Oz today, I think he will assist us greatly! Interesting that re his insurance he has forgotten that taxpayers actually pay 80% of his premiums while midwives get no assistance!Also a copy of my letter to the OzAs a mother of 4, soon to be 6, I hold the safety of my children and myself dear. Dr Mourik's assessment of safety is little more than scare-mongering spin.Large Hospitals are not lined with medicos on hand for the 'what ifs' they are overstretched with competing interests. Private Hospitals and smaller units need to call in medical staff. Current services disregard the appropriate roles for midwives and doctors due to a complete stranglehold by the vested medical interests. The safety of midwifery is established. What is yet to be examined (due to a lack of medical accountability) is the safety and appropriateness of the routine care the majority of women are subjected to. In large centres women are herded like cattle and cared for with a clock and organisational management as a guide, rather than practices based on scientific evidence and women's choice. In rural areas it's generally a couple of hundred kilometres dodging kangaroos (due to no local service). I'm glad Dr Mourik has retired because his assertions that Drs can provide a safe service and emergency care in an instant need full scrutiny. Examination of current routine maternity care will reveal a sick system indeed.Midwives invaluable, but they must be in a hospital settingPeter MourikSeptember 03, 2005IT was 8am and Sally - not her real name - had been in labour all night. She was tired but exhilarated; this was the moment she had waited for. This was her first baby, she was healthy and had been assessed as "low risk", so she was confident. The labour was hard, but she received all the support she needed from her partner and the midwives, who had been wonderful. Her labour crossed three shifts of nurses.Now she had to push. Suddenly, even though her baby had been frequently listened to during her labour, the midwife found the baby's heart rate had dropped to a dangerous 60, and stayed at 60 despite rolling Sally over and giving oxygen. The midwife examined her and found the baby was not going to deliver quickly. The emergency alarm was rung. Within a minute, the visiting doctor, fortunately doing his rounds, arrived and conferred with the midwife, then rapidly delivered the baby with a vacuum. The umbilical cord was not only around the neck once, but five times. The baby was sleepy, but started breathing in one minute and was safe. This is a true story, and not uncommon; if this baby had been delivered in a free-standing midwife-only unit, or at home, it would not have survived the 30-minute transfer. Midwives cannot and should not do operative deliveries. They have not had the training that doctors have had. Midwives cannot provide their services in isolation from doctors, because they cannot guarantee to complete a safe delivery. To remove childbirth to free-standing midwife-only units, or worse, to a home, is simply taking unnecessary risks. Women who select themselves as "healthy" may be underestimating their risks. In Australia 30 per cent of women are obese, which increases all known complications. Women are leaving their childbearing until much older, which also increases the risk of complications. Over half the women having their first baby fail to have a normal delivery.
Re: [ozmidwifery] Emailing: video05 you will like this
Hi all This is genuine email. did not know an attachment would go also. It is a great video of an add made in spain of a man giving birth. Take a look at the link you will all enjoy/. - Original Message - From: Susan Cudlipp To: ozmidwifery@acegraphics.com.au Sent: Saturday, September 03, 2005 1:06 AM Subject: Re: [ozmidwifery] Emailing: video05 you will like this Is this a genuine message or a virus? I thought that attachments could not be sent to the list - please all be cautious and do not open unless it is verified "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: lyn lyn To: ozmidwifery@acegraphics.com.au Sent: Friday, September 02, 2005 7:16 PM Subject: [ozmidwifery] Emailing: video05 you will like this The message is ready to be sent with the following file or link attachments:Shortcut to: http://www.clubcultura.com/haymotivo/video05.htmNote: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. No virus found in this incoming message.Checked by AVG Anti-Virus.Version: 7.0.344 / Virus Database: 267.10.18/88 - Release Date: 1/09/2005
