Re: [ozmidwifery] Abby's Birth Announcement

[Sonja & Barry]

Congratulations Abby,
How wonderful and empowering for you.
Sonja
- Original Message - 
From: "Abby and Toby" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>; ;
<[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>;
<[EMAIL PROTECTED]>
Sent: Friday, November 04, 2005 9:38 PM
Subject: [ozmidwifery] Abby's Birth Announcement


> HI,
>
> Sorry for the x-post, but thought I would share that thismorning at 3:46am
I
> gave birth to a beautiful little girl, Runah. After a couple of days of
> crazy prelabour and 5 hours of active labour she was birthed in warm
water,
> in my own home, into my friends hands with just her daddy, mummy and two
> friends there.
> After having a very traumatic c-section with my first daughter, this was
> truly amazing!!
> I am sore, tired and truly EMPOWERED!!
>
> Love Abby
>
> --
> This mailing list is sponsored by ACE Graphics.
> Visit  to subscribe or unsubscribe.
>

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Re: [ozmidwifery] Strep B screening

[Sonja & Barry]

Title: Message



Nicola,
Have you asked whether you could have the 
antibiotics given via a butterfly needle rather than have a cannula, we give 
women this choice if they choose to have antibiotics.  We also give women 
the choice of reswabbing if they want as strep b is transient and may not be 
around at the time of birth.  Most women are just happy to go with the 
antibiotics and not make a choice.  It is lovely to hear you asking 
questions and challenging the system.
Sonja

  - Original Message - 
  From: 
  Nicola 
  Morley 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, November 08, 2005 3:17 
  PM
  Subject: RE: [ozmidwifery] Strep B 
  screening
  
  Can 
  I ask a personal question on this one? Last birth (January 2003, Gosford 
  Hospital Community Midwives) I was given intravenous antibiotics 
  automatically because I had been StrpB positive in the previous pregnancy. I 
  wasn't retested. I am pregnant again - will I be automatically assumed to have 
  Strep B again? will I be tested again? Is it even possible to be clear now 
  even if I have been Strep B positive in the past or am I hoping in vain to 
  avoid the treatment? It only bothers me because I like to spend a LOT of 
  labour on my hands and knees and I found the drip in my hand very 
  uncomfortable. If it is inevitable to have them again, what is the best plan 
  of action? To stay home as long as possible? To ask for the drip in my forearm 
  instead of the back of my hand? Any other suggestions. I will of course talk 
  about it with the midwives when I book in next week, but just wondering in the 
  meantime, seeing the topic has come up here!
   
  Nicola Morley
  Trainee Doula
   
  

-Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Jenny 
CameronSent: Tuesday, November 08, 2005 12:23 PMTo: 
ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Strep B 
screening
Current recommendations in Vic are to offer 
screening at 35-37 weeks per the CDC evidence. It does appear to be the best 
available evidence, far better than the risk-based approach of administering 
IV ABS to a select group of women considered to be 'at-risk'. Women 
are unlikely to change their status within a month, therefore with screening 
only those women who test GBS +ve will be offered IV ABs intrapartum to 
prevent early onset (within the first week of life) GBS pneumonia in the 
neonate. Also surface swabbing and collection of gastric asp on neonates is 
a waste of time, the baby will be sick with GBS well before the results of 
any swabs are available. Many years ago I saw a baby become ill & 
subsequently die of GBS pneumonia. The baby was term & perfectly welll 
at birth, within an hour of birth started having apnoeic attacks and four 
hours later was shocked & gravely ill. The Vic guidelines are currently 
under review but you can check the site below:
 
http://www.3centres.com.au/
 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  diane 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, November 07, 2005 8:17 
  PM
  Subject: Re: [ozmidwifery] Strep B 
  screening
  
  With respect Jenny,
  Im not sure that too many of the 
  recommendations out of the good old U.S of A could be described as 'best 
  practice'.
  Here is the NSW directive, it does however, 
  also refer to the CDC guidelines
   
  http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf
   
  At our unit we do not routinely swab, we take 
  the risk factor approach,but if it appears in MSU or on a swab done for 
  other reasons we then require our women to birth at Gosford where there 
  are paediatricians they can transfer back after 24-48 hrs
  Cheers
  Di
  
- Original Message - 
From: 
Jenny 
Cameron 
To: ozmidwifery@acegraphics.com.au 

Sent: Sunday, November 06, 2005 
4:52 PM
Subject: Re: [ozmidwifery] Strep B 
screening

Curent best practice is to offer screening 
for GBS at 35-37 weeks. See site below:
 
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm
 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Mary Murphy 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, November 04, 2005 
  6:47 PM
  Subject: [ozmidwifery] Strep B 
  screening
  
  
  I hav

Re: [ozmidwifery] Strep B screening

[Mh]

Nicola wrote:


Can I ask a personal question on this one? Last birth (January 2003,
Gosford Hospital Community Midwives) I was given intravenous antibiotics
automatically because I had been StrpB positive in the previous
pregnancy. I wasn't retested. I am pregnant again - will I be
automatically assumed to have Strep B again? will I be tested again? Is
it even possible to be clear now even if I have been Strep B positive in
the past or am I hoping in vain to avoid the treatment? It only bothers
me because I like to spend a LOT of labour on my hands and knees and I
found the drip in my hand very uncomfortable. If it is inevitable to
have them again, what is the best plan of action? To stay home as long
as possible? To ask for the drip in my forearm instead of the back of my
hand? Any other suggestions. I will of course talk about it with the
midwives when I book in next week, but just wondering in the meantime,
seeing the topic has come up here!


When you were GBS positive, was it a uninary or vaginal infection? Urinary 
is more serious because it is a systemic infection while vaginal 
colonisation can be  transient.  If it was vaginal you would be within your 
rights to request re testing before treatment. Of course you can decline 
testing and treatment if you want to.
If IV antibiotics are recommended and you're OK with it you could specify 
that you want to cannula in your forearm rather than the back of your hand 
and have it bunged and covered so it's less likely to catch on stuff. You 
shouldn't need a fluid line as benzyl penicillin (AB of choice) can be given 
by IV push.



Jenny wrote:

 Many years ago I saw a baby become ill &
subsequently die of GBS pneumonia. The baby was term & perfectly welll
at birth, within an hour of birth started having apnoeic attacks and
four hours later was shocked & gravely ill.


I have seen the same, perfectly well breast feeding baby, dead six hours 
later from fulminating GBS meningitis. It is sobering to realise what can 
happen.

Monica


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Re: [ozmidwifery] Strep B screening

[Lisa Barrett]

Title: Message




Hi,  
This is a great question.  There are choices for 
you here.  
You could ask for a further vaginal swab for GBS to 
check your status at the end of your pregnancy.  And if you test positive 
you could decide whether or not you wanted antibiotics at all.  They can 
only insert an IV and administer antibiotics if you let them.   
OR
you could decide that you don't really want to know 
your status and refuse antibiotics. OR
you could just take the antibiotics on your previous 
positive result.
The main thing is you do actually have a choice in 
this. Your body your baby your birth.
All the guidelines for antibiotics are made up from 
the current available evidence.  Below is taken from the Cochrane report, a 
review of available information.  As you can see at best it is quite ropey 
and even though they saw a reduction in infection there was no change in 
neonatal mortality.
I am a British midwife and until I came here to work 
I didn't see anyone tested for GBS or an infected baby.(I have been a midwife 
since 1988)
The best thing you could do is check the evidence for 
yourself.  Not the guidelines but the evidence that the guidelines are made 
up of then make a decision of how you want your labour to be.
Lisa
COCHRANE REPORT
Five trials were included. Overall quality was poor, with potential selection 
bias in all the identified studies. Intrapartum antibiotic treatment reduced the 
rate of infant colonization (odds ratio 0.10, 95% confidence interval 0.07 to 
0.14) and early onset neonatal infection with group B streptococcus (odds ratio 
0.17, 95% confidence interval 0.07 to 0.39). A difference in neonatal mortality 
was not seen (odds ratio 0.12, 95% confidence interval 0.01 to 2.00).

Authors' conclusions
Intrapartum antibiotic treatment of women colonized with group B 
streptococcus appears to reduce neonatal infection. Effective strategies to 
detect maternal colonization with group B streptococcus and better data on 
maternal risk factors for neonatal group B streptococcus infection in different 
populations are required.

   

RE: [ozmidwifery] Strep B screening

[Mary Murphy]

Title: Message








The international guidelines (Center of Disease
control, USA)
say that each pregnancy is to be treated separately unless you previously had a
strep B positive baby. Even then, while it is in the guidelines, it is bit of
guesswork as to whether you will be positive in the present pregnancy. So, test
each pregnancy and if neg, no need to have IV Ab’s. MM 

 









From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Nicola Morley
Sent: Tuesday, 8 November 2005
12:17 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Strep B
screening



 



Can I ask a personal question on this one?
Last birth (January 2003, Gosford Hospital Community Midwives) I was given
intravenous antibiotics automatically because I had been StrpB positive in the
previous pregnancy. I wasn't retested. I am pregnant again - will I be
automatically assumed to have Strep B again? will I be tested again? Is it even
possible to be clear now even if I have been Strep B positive in the past or am
I hoping in vain to avoid the treatment? It only bothers me because I like to
spend a LOT of labour on my hands and knees and I found the drip in my hand
very uncomfortable. If it is inevitable to have them again, what is the best
plan of action? To stay home as long as possible? To ask for the drip in my forearm
instead of the back of my hand? Any other suggestions. I will of course talk
about it with the midwives when I book in next week, but just wondering in the
meantime, seeing the topic has come up here!





 





Nicola Morley





Trainee Doula





 





-Original Message-
From: owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au]
On Behalf Of Jenny Cameron
Sent: Tuesday, November 08, 2005
12:23 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Strep B
screening



Current recommendations in Vic are to offer screening at
35-37 weeks per the CDC evidence. It does appear to be the best available
evidence, far better than the risk-based approach of administering IV ABS to a
select group of women considered
to be 'at-risk'. Women are unlikely to change their status within a month,
therefore with screening only those women who test GBS +ve will be offered IV
ABs intrapartum to prevent early onset (within the first week of life) GBS
pneumonia in the neonate. Also surface swabbing and collection of gastric asp
on neonates is a waste of time, the baby will be sick with GBS well before the
results of any swabs are available. Many years ago I saw a baby become ill
& subsequently die of GBS pneumonia. The baby was term & perfectly
welll at birth, within an hour of birth started having apnoeic attacks and four
hours later was shocked & gravely ill. The Vic guidelines are currently
under review but you can check the site below:





 





http://www.3centres.com.au/





 





Jenny





Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717





 





 







- Original Message - 





From: diane 





To: ozmidwifery@acegraphics.com.au 





Sent: Monday, November
07, 2005 8:17 PM





Subject: Re: [ozmidwifery]
Strep B screening





 





With respect Jenny,





Im not sure that too many of the recommendations out of the
good old U.S of A could be described as 'best practice'.





Here is the NSW directive, it does however, also refer to
the CDC guidelines





 





http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf





 





At our unit we do not routinely swab, we take the risk
factor approach,but if it appears in MSU or on a swab done for other reasons we
then require our women to birth at Gosford where there are paediatricians they
can transfer back after 24-48 hrs





Cheers





Di







- Original Message - 





From: Jenny Cameron






To: ozmidwifery@acegraphics.com.au 





Sent: Sunday, November
06, 2005 4:52 PM





Subject: Re: [ozmidwifery]
Strep B screening





 





Curent best practice is to offer screening for GBS at 35-37
weeks. See site below:





 





http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm





 





Jenny





Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717





 





 







- Original Message - 





From: Mary Murphy






To: ozmidwifery@acegraphics.com.au 





Sent: Friday, November
04, 2005 6:47 PM





Subject: [ozmidwifery]
Strep B screening





 



I have been told by a pregnant woman that she was reluctant
to have a strep B test at 35-37 weeks. She was informed by a doctor in the A/N
clinic of our public tertiary hospital, that if she went into labour with an
“unknown status” and attended the delivery suite , her baby would
have to be given IMI antibiotics until the baby’s screening swabs came
back 48hrs later.  She felt that to protect the baby, she had to consent
to A

RE: [ozmidwifery] Strep B screening

[leanne wynne]

Hi Nicola,
You just need to ask to have another low vaginal swab at around 36 weeks 
gestation. It is possible that you will be negative this time. Yes you could 
request that the doctor put the IV cannula somewhere less uncomfortable.
Also remember that you do have the option of refusing the antibiotics if you 
wish. Years ago all the midwives did, if Mum was GBS positive, was monitor 
the baby's temperature and then treat the baby symtomatically if necessary.

All the best,
Leanne.

Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health Service  Mob 0418 371862





From: "Nicola Morley" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: RE: [ozmidwifery] Strep B screening
Date: Tue, 8 Nov 2005 15:17:25 +1100

Can I ask a personal question on this one? Last birth (January 2003,
Gosford Hospital Community Midwives) I was given intravenous antibiotics
automatically because I had been StrpB positive in the previous
pregnancy. I wasn't retested. I am pregnant again - will I be
automatically assumed to have Strep B again? will I be tested again? Is
it even possible to be clear now even if I have been Strep B positive in
the past or am I hoping in vain to avoid the treatment? It only bothers
me because I like to spend a LOT of labour on my hands and knees and I
found the drip in my hand very uncomfortable. If it is inevitable to
have them again, what is the best plan of action? To stay home as long
as possible? To ask for the drip in my forearm instead of the back of my
hand? Any other suggestions. I will of course talk about it with the
midwives when I book in next week, but just wondering in the meantime,
seeing the topic has come up here!

Nicola Morley
Trainee Doula


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Jenny Cameron
Sent: Tuesday, November 08, 2005 12:23 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Strep B screening


Current recommendations in Vic are to offer screening at 35-37 weeks per
the CDC evidence. It does appear to be the best available evidence, far
better than the risk-based approach of administering IV ABS to a select
group of women considered to be 'at-risk'. Women are unlikely to change
their status within a month, therefore with screening only those women
who test GBS +ve will be offered IV ABs intrapartum to prevent early
onset (within the first week of life) GBS pneumonia in the neonate. Also
surface swabbing and collection of gastric asp on neonates is a waste of
time, the baby will be sick with GBS well before the results of any
swabs are available. Many years ago I saw a baby become ill &
subsequently die of GBS pneumonia. The baby was term & perfectly welll
at birth, within an hour of birth started having apnoeic attacks and
four hours later was shocked & gravely ill. The Vic guidelines are
currently under review but you can check the site below:

http://www.3centres.com.au/

Jenny
Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717



- Original Message -
From: diane 
To: ozmidwifery@acegraphics.com.au
Sent: Monday, November 07, 2005 8:17 PM
Subject: Re: [ozmidwifery] Strep B screening

With respect Jenny,
Im not sure that too many of the recommendations out of the good old U.S
of A could be described as 'best practice'.
Here is the NSW directive, it does however, also refer to the CDC
guidelines

http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf

At our unit we do not routinely swab, we take the risk factor
approach,but if it appears in MSU or on a swab done for other reasons we
then require our women to birth at Gosford where there are
paediatricians they can transfer back after 24-48 hrs
Cheers
Di

- Original Message -
From: Jenny   Cameron
To: ozmidwifery@acegraphics.com.au
Sent: Sunday, November 06, 2005 4:52 PM
Subject: Re: [ozmidwifery] Strep B screening

Curent best practice is to offer screening for GBS at 35-37 weeks. See
site below:

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm

Jenny
Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717



- Original Message -
From: Mary   Murphy
To: ozmidwifery@acegraphics.com.au
Sent: Friday, November 04, 2005 6:47 PM
Subject: [ozmidwifery] Strep B screening


I have been told by a pregnant woman that she was reluctant to have a
strep B test at 35-37 weeks. She was informed by a doctor in the A/N
clinic of our public tertiary hospital, that if she went into labour
with an "unknown status" and attended the delivery suite , her baby
would have to be given IMI antibiotics until the baby's screening swabs
came back 48hrs later.  She felt that to protect the baby, she had to
consent to A/N screening.  Those who recognize the description of this
hospital, is that true?  

Re: [ozmidwifery] question from Year 10 student

[Andrea Quanchi]

I have searched through Maternal, Fetal and Neonatal Physiology 
(Blackburn & Loper) and cant find anything helpful

Andrea Q
On 08/11/2005, at 9:54 AM, wump fish wrote:

This made me laugh. It is just the kind of question my son (year 9) 
would come up with.


I haven't even thought about it! I would go with the fluid and equal 
pressure theory. Being upside down in water at an adult (try it) does 
not result in the same pressure as being upside down outside water. 
However, if we go with this theory - what happens when women rupture 
their membranes. We know it has a variety of effects on labour and the 
baby. But, does it also make it less comfortable for baby due to being 
upside down? Just thinking aloud.


I would love someone to find some evidence on this.

Rachel



From: "Bowman Family" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: [ozmidwifery] question from Year 10 student
Date: Mon, 7 Nov 2005 20:10:21 +1100

I am involved in the CoreOf Life Program for Year 10 students.  It is 
a fun and interactive program run over a double period and is about 
the journey through pregnancy, labour birth and parenting.
Last week when I was demonstrating positioning with doll & pelvis  
one of the boys asked  "how come the blood doesn't rush to the baby's 
head like it does for us if we are upside down"

I didn't know the correct answer and said I would get back to him.
It possibly is obvious but I have asked a few peers and no-one is 
definite they have the correct answer.  I thought I would throw it 
open to OzMidwifery for discussion.


Linda


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RE: [ozmidwifery] Strep B screening

[Nicola Morley]

Title: Message



Can I 
ask a personal question on this one? Last birth (January 2003, Gosford Hospital 
Community Midwives) I was given intravenous antibiotics automatically 
because I had been StrpB positive in the previous pregnancy. I wasn't retested. 
I am pregnant again - will I be automatically assumed to have Strep B again? 
will I be tested again? Is it even possible to be clear now even if I have been 
Strep B positive in the past or am I hoping in vain to avoid the treatment? It 
only bothers me because I like to spend a LOT of labour on my hands and knees 
and I found the drip in my hand very uncomfortable. If it is inevitable to have 
them again, what is the best plan of action? To stay home as long as possible? 
To ask for the drip in my forearm instead of the back of my hand? Any other 
suggestions. I will of course talk about it with the midwives when I book in 
next week, but just wondering in the meantime, seeing the topic has come up 
here!
 
Nicola 
Morley
Trainee Doula
 

  
  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Jenny 
  CameronSent: Tuesday, November 08, 2005 12:23 PMTo: 
  ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Strep B 
  screening
  Current recommendations in Vic are to offer 
  screening at 35-37 weeks per the CDC evidence. It does appear to be the best 
  available evidence, far better than the risk-based approach of administering 
  IV ABS to a select group of women considered to be 'at-risk'. Women 
  are unlikely to change their status within a month, therefore with screening 
  only those women who test GBS +ve will be offered IV ABs intrapartum to 
  prevent early onset (within the first week of life) GBS pneumonia in the 
  neonate. Also surface swabbing and collection of gastric asp on neonates is a 
  waste of time, the baby will be sick with GBS well before the results of any 
  swabs are available. Many years ago I saw a baby become ill & subsequently 
  die of GBS pneumonia. The baby was term & perfectly welll at birth, within 
  an hour of birth started having apnoeic attacks and four hours later was 
  shocked & gravely ill. The Vic guidelines are currently under review but 
  you can check the site below:
   
  http://www.3centres.com.au/
   
  Jenny
  Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
  1465Howard Springs NT 083508 8983 19260419 528 717
   
   
  
- Original Message - 
From: 
diane 

To: ozmidwifery@acegraphics.com.au 

Sent: Monday, November 07, 2005 8:17 
PM
Subject: Re: [ozmidwifery] Strep B 
screening

With respect Jenny,
Im not sure that too many of the 
recommendations out of the good old U.S of A could be described as 'best 
practice'.
Here is the NSW directive, it does however, 
also refer to the CDC guidelines
 
http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf
 
At our unit we do not routinely swab, we take 
the risk factor approach,but if it appears in MSU or on a swab done for 
other reasons we then require our women to birth at Gosford where there are 
paediatricians they can transfer back after 24-48 hrs
Cheers
Di

  - Original Message - 
  From: 
  Jenny 
  Cameron 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, November 06, 2005 4:52 
  PM
  Subject: Re: [ozmidwifery] Strep B 
  screening
  
  Curent best practice is to offer screening 
  for GBS at 35-37 weeks. See site below:
   
  http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm
   
  Jenny
  Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
  1465Howard Springs NT 083508 8983 19260419 528 717
   
   
  
- Original Message - 
From: 
Mary 
Murphy 
To: ozmidwifery@acegraphics.com.au 

Sent: Friday, November 04, 2005 
6:47 PM
Subject: [ozmidwifery] Strep B 
screening


I have been told by a 
pregnant woman that she was reluctant to have a strep B test at 35-37 
weeks. She was informed by a doctor in the A/N clinic of our public 
tertiary hospital, that if she went into labour with an “unknown status” 
and attended the delivery suite , her baby would have to be given IMI 
antibiotics until the baby’s screening swabs came back 48hrs 
later.  She felt that to protect the baby, she had to consent to 
A/N screening.  Those who recognize the description of this 
hospital, is that true?  Or has this lady been unintentionally 
misled?  Does this happen in any other hospitals?  Feel free 
to email me off line if you don’t want to “speak” publicly. Thanks, MM 




Internal Virus Database is out-of-date.Checked by AVG 
Anti-Virus

Re: [ozmidwifery] Strep B screening

[Jenny Cameron]

Current recommendations in Vic are to offer 
screening at 35-37 weeks per the CDC evidence. It does appear to be the best 
available evidence, far better than the risk-based approach of administering IV 
ABS to a select group of women considered to be 'at-risk'. Women are 
unlikely to change their status within a month, therefore with screening only 
those women who test GBS +ve will be offered IV ABs intrapartum to prevent early 
onset (within the first week of life) GBS pneumonia in the neonate. Also surface 
swabbing and collection of gastric asp on neonates is a waste of time, the baby 
will be sick with GBS well before the results of any swabs are available. Many 
years ago I saw a baby become ill & subsequently die of GBS pneumonia. The 
baby was term & perfectly welll at birth, within an hour of birth started 
having apnoeic attacks and four hours later was shocked & gravely ill. The 
Vic guidelines are currently under review but you can check the site 
below:
 
http://www.3centres.com.au/
 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  diane 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, November 07, 2005 8:17 
  PM
  Subject: Re: [ozmidwifery] Strep B 
  screening
  
  With respect Jenny,
  Im not sure that too many of the recommendations 
  out of the good old U.S of A could be described as 'best 
  practice'.
  Here is the NSW directive, it does however, also 
  refer to the CDC guidelines
   
  http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf
   
  At our unit we do not routinely swab, we take the 
  risk factor approach,but if it appears in MSU or on a swab done for other 
  reasons we then require our women to birth at Gosford where there are 
  paediatricians they can transfer back after 24-48 hrs
  Cheers
  Di
  
- Original Message - 
From: 
Jenny 
Cameron 
To: ozmidwifery@acegraphics.com.au 

Sent: Sunday, November 06, 2005 4:52 
PM
Subject: Re: [ozmidwifery] Strep B 
screening

Curent best practice is to offer screening for 
GBS at 35-37 weeks. See site below:
 
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm
 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, November 04, 2005 6:47 
  PM
  Subject: [ozmidwifery] Strep B 
  screening
  
  
  I have been told by a pregnant 
  woman that she was reluctant to have a strep B test at 35-37 weeks. She 
  was informed by a doctor in the A/N clinic of our public tertiary 
  hospital, that if she went into labour with an “unknown status” and 
  attended the delivery suite , her baby would have to be given IMI 
  antibiotics until the baby’s screening swabs came back 48hrs later.  
  She felt that to protect the baby, she had to consent to A/N 
  screening.  Those who recognize the description of this hospital, is 
  that true?  Or has this lady been unintentionally misled?  Does 
  this happen in any other hospitals?  Feel free to email me off line 
  if you don’t want to “speak” publicly. Thanks, MM 
  
  
  

  Internal Virus Database is out-of-date.Checked by AVG 
  Anti-Virus.Version: 7.0.344 / Virus Database: 267.11.9/70 - Release 
  Date: 29/09/2005
  
  

  Internal Virus Database is out-of-date.Checked by AVG 
  Anti-Virus.Version: 7.0.344 / Virus Database: 267.11.9/70 - Release Date: 
  29/09/2005

Re: [ozmidwifery] question from Year 10 student

[Jennifairy]

how about the fact that fetal circulatory system very different to 
mature (ie born already) system? & fetal haemoglobin also very different?

but yeah, I go with the 'upside down in water' theory!
jennifairy

wump fish wrote:

This made me laugh. It is just the kind of question my son (year 9) 
would come up with.


I haven't even thought about it! I would go with the fluid and equal 
pressure theory. Being upside down in water at an adult (try it) does 
not result in the same pressure as being upside down outside water. 
However, if we go with this theory - what happens when women rupture 
their membranes. We know it has a variety of effects on labour and the 
baby. But, does it also make it less comfortable for baby due to being 
upside down? Just thinking aloud.


I would love someone to find some evidence on this.

Rachel



From: "Bowman Family" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: [ozmidwifery] question from Year 10 student
Date: Mon, 7 Nov 2005 20:10:21 +1100

I am involved in the CoreOf Life Program for Year 10 students.  It is 
a fun and interactive program run over a double period and is about 
the journey through pregnancy, labour birth and parenting.
Last week when I was demonstrating positioning with doll & pelvis  
one of the boys asked  "how come the blood doesn't rush to the baby's 
head like it does for us if we are upside down"

I didn't know the correct answer and said I would get back to him.
It possibly is obvious but I have asked a few peers and no-one is 
definite they have the correct answer.  I thought I would throw it 
open to OzMidwifery for discussion.


Linda



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Re: [ozmidwifery] Active birth educators on the mid north coast?

[Janet Fraser]

How about contacting the Hunter Natural Birth Support Group which also works
in Newcastle?
J
- Original Message - 
From: "Andrea Robertson" <[EMAIL PROTECTED]>
To: 
Sent: Tuesday, November 08, 2005 7:07 AM
Subject: [ozmidwifery] Active birth educators on the mid north coast?


> Hi Listers,
>
> Am forwarding this message that I received. Please reply direct to Tracey
> if you can help.
> She is also asking about any weekend programs that might be available
> between Newcastle and Coffs Harbour.
>
> Andrea
>
> 
>
>
> I am a naturopath working on the midnorth coast (Port Macquarie) NSW. I
see
> many client who have no access to active birth education in this area. Do
> you have any contacts of private midwifes who teach classes on the mid
> north coast?
> Regards
> Tracey Lee Morley
>
> --
> Tracey Lee Naturopathic Centre
> Tracey Lee Morley N.D. D.B.M.
> 3 Alkina Ave/P.O. Box 5040
> Port Macquarie NSW 2444
> ph 0265 823424 mb 0429356093
> Email:  <[EMAIL PROTECTED]>
>
> -
> 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  to subscribe or unsubscribe.
>
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RE: [ozmidwifery] question from Year 10 student

[wump fish]

This made me laugh. It is just the kind of question my son (year 9) would 
come up with.


I haven't even thought about it! I would go with the fluid and equal 
pressure theory. Being upside down in water at an adult (try it) does not 
result in the same pressure as being upside down outside water. However, if 
we go with this theory - what happens when women rupture their membranes. We 
know it has a variety of effects on labour and the baby. But, does it also 
make it less comfortable for baby due to being upside down? Just thinking 
aloud.


I would love someone to find some evidence on this.

Rachel



From: "Bowman Family" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: [ozmidwifery] question from Year 10 student
Date: Mon, 7 Nov 2005 20:10:21 +1100

I am involved in the CoreOf Life Program for Year 10 students.  It is a fun 
and interactive program run over a double period and is about the journey 
through pregnancy, labour birth and parenting.
Last week when I was demonstrating positioning with doll & pelvis  one of 
the boys asked  "how come the blood doesn't rush to the baby's head like it 
does for us if we are upside down"

I didn't know the correct answer and said I would get back to him.
It possibly is obvious but I have asked a few peers and no-one is definite 
they have the correct answer.  I thought I would throw it open to 
OzMidwifery for discussion.


Linda


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[ozmidwifery] Active birth educators on the mid north coast?

[Andrea Robertson]

Hi Listers,

Am forwarding this message that I received. Please reply direct to Tracey 
if you can help.
She is also asking about any weekend programs that might be available 
between Newcastle and Coffs Harbour.


Andrea




I am a naturopath working on the midnorth coast (Port Macquarie) NSW. I see 
many client who have no access to active birth education in this area. Do 
you have any contacts of private midwifes who teach classes on the mid 
north coast?

Regards
Tracey Lee Morley

--
Tracey Lee Naturopathic Centre
Tracey Lee Morley N.D. D.B.M.
3 Alkina Ave/P.O. Box 5040
Port Macquarie NSW 2444
ph 0265 823424 mb 0429356093
Email:  <[EMAIL PROTECTED]>

-
Andrea Robertson
Birth International * ACE Graphics * Associates in Childbirth Education

e-mail: [EMAIL PROTECTED]
web: www.birthinternational.com


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[ozmidwifery] MWs in Geraldton?

[Janet Fraser]

A mama is asking me about hb 
in Geraldton. Any takers?
TIA,
J
Joyous Birth Home Birth 
Forum - a world first!http://www.joyousbirth.info/forums/
 
Accessing Artemis Birth 
Trauma Recoveryhttp://health.groups.yahoo.com/group/accessingartemis

Re: [ozmidwifery] question from Year 10 student

[Judy Chapman]

I would take a punt at the even pressure of the fluid filled
uterus along with the baby's blood pressure adjusting naturally
to that position. 
Cheers
Judy
--- Bowman Family <[EMAIL PROTECTED]> wrote:

> I am involved in the CoreOf Life Program for Year 10 students.
>  It is a fun and interactive program run over a double period
> and is about the journey through pregnancy, labour birth and
> parenting.
> Last week when I was demonstrating positioning with doll &
> pelvis  one of the boys asked  "how come the blood doesn't
> rush to the baby's head like it does for us if we are upside
> down" 
> I didn't know the correct answer and said I would get back to
> him.  
> It possibly is obvious but I have asked a few peers and no-one
> is definite they have the correct answer.  I thought I would
> throw it open to OzMidwifery for discussion.
> 
> Linda




 
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[ozmidwifery] Interesting article

[Helen and Graham]

FYI
Helen
 
http://www.msnbc.msn.com/id/8247179/
When Debbie Cargile became pregnant with her first child 
in 1999, she very much wanted a natural childbirth. After seeing a Seattle 
obstetrician for the first few months, she decided to switch to a midwife for 
the rest of her prenatal care to help ensure she got her wish.
She considered a home birth but 
ultimately opted for a birthing center. After three hard days in labor with her 
cervix still not fully dilated, though, Cargile wound up in the hospital and her 
daughter was delivered in a sterile operating room via Caesarean section. “I had 
a real, real hard time with that, the fact that I ended up with a C-section,” 
Cargile says. “It was so far away from what I wanted. I wanted something more 
warm and natural.”


So 
when she became pregnant with her son a couple years later, she decided to try 
again for a vaginal delivery. Doctors call it a VBAC, for vaginal birth after 
Caesarean, and it’s one of the most controversial issues in obstetrics. For 
years, the mantra was “Once a C-section, always a C-section." Then in the 1990s 
doctors pushed to lower the escalating C-section rate by encouraging more VBACs. 
Now, the pendulum seems to have swung the other way, with many doctors — and 
insurers — saying the safest approach, to avoid the risk of uterine rupture or 
other complications, is to do the repeat Caesarean.
Recent research in The New England 
Journal of Medicine shows the risks of a VBAC are only slightly higher than 
those of a repeat C-section. But the outcome can be very bad, including the 
death of the baby. Cargile studied up on VBACs and decided she could live with 
the small chance of problems. “Yes, there’s risk, but there’s risk with any 
childbirth,” she says. The medical community, in her opinion, is “a bit pro 
C-section. It’s the easy thing to do and there’s less liability on everyone’s 
part.”
Although she wanted to try for a 
VBAC at a birthing center, she says, her insurance company refused to cover her 
unless she delivered at a hospital. In the end, Cargile attempted a VBAC at a 
hospital but her placenta ruptured, likely a complication of her previous 
Caesarean, and she needed an emergency C-section.
Even though most women won't face 
this problem, it is experiences like this that have prompted some insurers to 
insist on repeat C-sections and hospital births. Still, Cargile bristled at 
being told where to have her baby.
Confusion all 
aroundCargile's case highlights some of the controversies, 
issues and frustrations that many pregnant women now face. Though women have 
been having babies for millennia, there's still no consensus on the best way to 
go about it. If anything, it seems to be getting more complicated.
"The doctors are confused and so 
are the women," says Dr. Sharon Phelan, an obstetrician at the University of New 
Mexico and a spokesperson for the American College of Obstetricians and 
Gynecologists.
Laura Fields, an Atlanta mother 
who gave birth a year ago, says she was overwhelmed with medical information 
when she became pregnant. She remembers thinking, "Wow, there's so many 
decisions and so many different opinions. There's a lot of controversy out 
there."
One of the most confusing issues 
for her was choosing which of the many prenatal tests to undergo.





There's also disagreement on a 
range of other issues, including whether to use pain drugs in labor and which 
ones, when to perform episiotomies (incisions to widen the birth canal), whether 
elective inductions or C-sections are a good idea, where women should have their 
babies (hospital, birthing center or at home), and what to do when a woman is 
overdue.
Doctors, midwives, nurses, 
insurers, hospital administrators and patients can all have different opinions 
on the best way to go about having a baby.
Take elective C-sections, for 
instance, which are gaining in popularity as busy women want to schedule their 
births rather than wait for nature to take its course. Aside from the 
convenience (for both patients and doctors), proponents claim that C-sections 
are better than vaginal births because they don't cause damage to pelvic tissue 
that may lead to urinary incontinence or sexual problems later in life.
Others, like many midwives and 
physicians such as Dr. Ann Honebrink of the University of Pennsylvania, point 
out that a C-section is major surgery that carries risks of bleeding and 
infection, and requires a longer recovery period. Honebrink also says there's no 
proof that elective C-sections help women avoid incontinence or sexual woes. 

"I think we'll look back [on 
elective C-sections] in 10 years and think that maybe this wasn't so good," 
Honebrink says. She notes that C-sections leave scar tissue and adhesions that 
may make it more difficult for a woman to get a proper colonoscopy or make it 
more likely she'll have complications if she needs additional surgery later in 
life, such as a hysterectomy. 
Honebrink says t

Re: [ozmidwifery] question from Year 10 student

[FIONA AND CRAIG RUMBLE]

Perhaps the pressure exerted on the 
baby's head by the contracting uterus aids venous return and keeps the 
blood from pooling in the brain?
Regards Fiona Rumble

  - Original Message - 
  From: 
  Bowman 
  Family 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, November 07, 2005 7:10 
  PM
  Subject: [ozmidwifery] question from Year 
  10 student
  
  I am involved in the CoreOf Life Program for Year 
  10 students.  It is a fun and interactive program run over a double 
  period and is about the journey through pregnancy, labour birth and 
  parenting.
  Last week when I was demonstrating positioning 
  with doll & pelvis  one of the boys asked  "how come the 
  blood doesn't rush to the baby's head like it does for us if we are upside 
  down" 
  I didn't know the correct answer and said I 
  would get back to him.  
  It possibly is obvious but I have asked a few 
  peers and no-one is definite they have the correct answer.  I 
  thought I would throw it open to OzMidwifery for discussion.
   
  Linda

Re: [ozmidwifery] Strep B screening

[diane]

With respect Jenny,
Im not sure that too many of the recommendations 
out of the good old U.S of A could be described as 'best practice'.
Here is the NSW directive, it does however, also 
refer to the CDC guidelines
 
http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_240.pdf
 
At our unit we do not routinely swab, we take the 
risk factor approach,but if it appears in MSU or on a swab done for other 
reasons we then require our women to birth at Gosford where there are 
paediatricians they can transfer back after 24-48 hrs
Cheers
Di

  - Original Message - 
  From: 
  Jenny 
  Cameron 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, November 06, 2005 4:52 
  PM
  Subject: Re: [ozmidwifery] Strep B 
  screening
  
  Curent best practice is to offer screening for 
  GBS at 35-37 weeks. See site below:
   
  http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm
   
  Jenny
  Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
  1465Howard Springs NT 083508 8983 19260419 528 717
   
   
  
- Original Message - 
From: 
Mary 
Murphy 
To: ozmidwifery@acegraphics.com.au 

Sent: Friday, November 04, 2005 6:47 
PM
Subject: [ozmidwifery] Strep B 
screening


I have been told by a pregnant 
woman that she was reluctant to have a strep B test at 35-37 weeks. She was 
informed by a doctor in the A/N clinic of our public tertiary hospital, that 
if she went into labour with an “unknown status” and attended the delivery 
suite , her baby would have to be given IMI antibiotics until the baby’s 
screening swabs came back 48hrs later.  She felt that to protect the 
baby, she had to consent to A/N screening.  Those who recognize the 
description of this hospital, is that true?  Or has this lady been 
unintentionally misled?  Does this happen in any other hospitals?  
Feel free to email me off line if you don’t want to “speak” publicly. 
Thanks, MM 



Internal Virus Database is out-of-date.Checked by AVG 
Anti-Virus.Version: 7.0.344 / Virus Database: 267.11.9/70 - Release 
Date: 29/09/2005

Re: [ozmidwifery] question from Year 10 student

[JoFromOz]

Mary Murphy wrote:

  
  


  
  
  
  I am sure
someone more knowledgeable will
have the precise answer, but it has t do with the fact that the uterus
is a
fluid filled vacuum with pressures equal all throughout.  Therefore
there is no
up or down like in the atmosphere.  Is that right?  MM.
   
  

Sounds good, but
surely the law of gravity still exists in utero?  Maybe it has
something to do with pressure in vessels, or the fact that the brain
needs more blood to it - but then what about breech presentation... 
That *is* a tough question! :)  MM you have my text books, you look it
up! ;)

Jo

RE: [ozmidwifery] question from Year 10 student

[Nicole Carver]

I 
think you are right Mary. But I think there is still some gravity, which 
explains why the heaviest part, the head, most commonly ends up at the lowest 
point.
Nicole.

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of Mary 
  MurphySent: Monday, November 07, 2005 8:47 PMTo: 
  ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] question 
  from Year 10 student
  
  I am sure someone 
  more knowledgeable will have the precise answer, but it has t do with the fact 
  that the uterus is a fluid filled vacuum with pressures equal all 
  throughout.  Therefore there is no up or down like in the 
  atmosphere.  Is that right?  MM.
   
  
  
  
  
  From: 
  owner-ozmidwifery@acegraphics.com.au 
  [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Bowman FamilySent: Monday, 7 November 2005 5:10 
  PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] question from Year 
  10 student
   
  
  I am involved in the CoreOf Life 
  Program for Year 10 students.  It is a fun and interactive program run 
  over a double period and is about the journey through pregnancy, labour birth 
  and parenting.
  
  Last week when I was demonstrating 
  positioning with doll & pelvis  one of the boys asked  "how 
  come the blood doesn't rush to the baby's head like it does for us if we are 
  upside down" 
  
  I didn't know the correct answer 
  and said I would get back to 
  him.  
  
  It possibly is obvious but I have 
  asked a few peers and no-one is definite they have the correct 
  answer.  I thought I would throw it open to OzMidwifery for 
  discussion.
  
   
  
  Linda

RE: [ozmidwifery] question from Year 10 student

[Mary Murphy]

I am sure someone more knowledgeable will
have the precise answer, but it has t do with the fact that the uterus is a
fluid filled vacuum with pressures equal all throughout.  Therefore there is no
up or down like in the atmosphere.  Is that right?  MM.

 









From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Bowman Family
Sent: Monday, 7 November 2005 5:10
PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] question
from Year 10 student



 



I am involved in the CoreOf Life Program for Year 10
students.  It is a fun and interactive program run over a double period
and is about the journey through pregnancy, labour birth and parenting.





Last week when I was demonstrating positioning with doll
& pelvis  one of the boys asked  "how come the blood
doesn't rush to the baby's head like it does for us if we are upside
down" 





I didn't know the correct answer and said I would get
back to him.  





It possibly is obvious but I have asked a few peers and no-one
is definite they have the correct answer.  I thought I would throw it open
to OzMidwifery for discussion.





 





Linda

[ozmidwifery] question from Year 10 student

[Bowman Family]

I am involved in the CoreOf Life Program for Year 
10 students.  It is a fun and interactive program run over a double period 
and is about the journey through pregnancy, labour birth and 
parenting.
Last week when I was demonstrating positioning with 
doll & pelvis  one of the boys asked  "how come the blood 
doesn't rush to the baby's head like it does for us if we are upside 
down" 
I didn't know the correct answer and said I 
would get back to him.  
It possibly is obvious but I have asked a few peers 
and no-one is definite they have the correct answer.  I thought I 
would throw it open to OzMidwifery for discussion.
 
Linda