Re: [ozmidwifery] Midwifery troubles in NZ

[Katrina Flora]

Title: Message



I agree Maureen, seems like when a baby dies under 
the care of an Ob then it's the danger of birth or women's faulty bodies, but 
when it's under the care of a Midwife it's the midwife's fault (or b/c they 
didn't have a dr, ironic)
 
Katrina

  - Original Message - 
  From: 
  Ken 
  Ward 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, March 21, 2006 1:11 
  PM
  Subject: RE: [ozmidwifery] Midwifery 
  troubles in NZ
  
  I 
  would like to see a list of babies dying in medical care. It is awful, but 
  things do happen.  We had a case where a young mum was told it would be 
  better for her breech baby to born by C/S.  The baby died. So C/S need 
  not 'save' the baby.  Also, if that's the total number of incidents in 
  that time frame, then surely the stats aren't too bad. What else was involved 
  in the cases? Why aren't Drs errors published?   
  Maureen
  
-Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of B & 
GSent: Monday, 20 March 2006 9:31 PMTo: 
ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Midwifery 
troubles in NZ


  
  


  FYI, just 
  when we are hoping for reform here there is this tragic report from 
  NZ. Barb
   
   
   
  This article is owned by, or has been licensed 
  to, the New Zealand Herald. You may not reproduce, publish, 
  electronically archive or transmit this article in any manner without 
  the prior written consent of the New Zealand Herald. To make a 
  copyright clearance inquiry, please click here.
 

  
  

   
  
 

  


  

  Pete 
Hodgson
   Hodgson argues against review of maternity services 
  
   20.03.06 
  4.20pm
   Health 
  Minister Pete Hodgson says a review of maternity services would only 
  delay improvements being made in the sector. National Party 
  health spokesman Tony Royal today renewed his call for an independent 
  audit of maternity services following a report of another baby's death 
  being blamed on midwife care. The parents of the child born at 
  Auckland's Middlemore Hospital in an emergency caesarean operation 
  were reportedly told midwives had misread a fetal heart rate monitor. 
  The child died seven hours after the caesarean. The 
  case follows criticism of health workers following reports on the 
  deaths of three other babies -- two by a coroner and one by Health and 
  Disability Commissioner Ron Paterson. The child's parents -- 
  Heather and Alan Phillips -- are now calling for an inquiry into 
  maternity and midwifery care. Mr Ryall said the problem was 
  not going to go away and Mr Hodgson needed to get the review started 
  so problems could be fixed. "Every month there are more 
  frightening incidents coming to light, and more professional groups 
  calling for change." Mr Hodgson said a review of maternity 
  services would delay improvements being developed by professionals. 
  "It would be easy for all involved -- including me -- to call 
  for a review and take some of the political heat out of the maternity 
  issue," he said. "But while it would be easy it would also be 
  counter-productive." The Health Ministry was talking with 
  professional bodies in maternity service including midwives, doctors 
  and nurses focusing on improving services through better coordination 
  between Leader Maternity Care and hospital services. "The 
  ministry and the maternity sector are taking this approach because 
  they know action is needed now -- not after a drawn-out review 
  process." Mr Hodgson pointed out that National MP Paul 
  Hutchison had previously been reported saying he did not think a 
  review was necessary. Dr Hutchison told NZPA that he agreed 
  with Mr Ryall but wanted the Government to act on the 1999 maternity 
  review which he said had been ignored. "Due to the increasing 
  concerns about maternity care I would agree with Tony that a full 
  review is undertaken now -- but great note should be taken of that 
  report from 1999." The hospital involved in the latest case is 
  waiting until the Accident Compensation Corporation has reported its 
  decision before commenting. The New Zealand Herald newspaper 
  reported key failures in the baby's death were midwives' miss-reading 
  of a fetal heart rate monitor and a fetal blood-acidity test was 
  unnecessary in the circumstances and w

[ozmidwifery] Re: Misoprostol

[Joy Cocks]

Dear All,
Thanks so much for your responses re Misoprostol.  There's certainly some
food for thought in what I've read so far.
Thanks again,
Joy

Joy Cocks RN (Div 1) RM CBE IBCLC
BRIGHT Vic 3741
email:[EMAIL PROTECTED]


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RE: [ozmidwifery] Midwifery troubles in NZ

[Ken Ward]

Title: Message



I 
would like to see a list of babies dying in medical care. It is awful, but 
things do happen.  We had a case where a young mum was told it would be 
better for her breech baby to born by C/S.  The baby died. So C/S need not 
'save' the baby.  Also, if that's the total number of incidents in that 
time frame, then surely the stats aren't too bad. What else was involved in the 
cases? Why aren't Drs errors published?   Maureen

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of B & 
  GSent: Monday, 20 March 2006 9:31 PMTo: 
  ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Midwifery 
  troubles in NZ
  
  


  
  
FYI, just 
when we are hoping for reform here there is this tragic report from NZ. 
Barb
 
 
 
This article is owned by, or has been licensed to, 
the New Zealand Herald. You may not reproduce, publish, electronically 
archive or transmit this article in any manner without the prior written 
consent of the New Zealand Herald. To make a copyright clearance 
inquiry, please click here.
   
  


  
 

   
  

  
  

  
Pete 
  Hodgson
 Hodgson argues against review of 
maternity services 
 20.03.06 
4.20pm
 Health 
Minister Pete Hodgson says a review of maternity services would only 
delay improvements being made in the sector. National Party 
health spokesman Tony Royal today renewed his call for an independent 
audit of maternity services following a report of another baby's death 
being blamed on midwife care. The parents of the child born at 
Auckland's Middlemore Hospital in an emergency caesarean operation were 
reportedly told midwives had misread a fetal heart rate monitor. 
The child died seven hours after the caesarean. The case 
follows criticism of health workers following reports on the deaths of 
three other babies -- two by a coroner and one by Health and Disability 
Commissioner Ron Paterson. The child's parents -- Heather and 
Alan Phillips -- are now calling for an inquiry into maternity and 
midwifery care. Mr Ryall said the problem was not going to go 
away and Mr Hodgson needed to get the review started so problems could 
be fixed. "Every month there are more frightening incidents 
coming to light, and more professional groups calling for change." 
Mr Hodgson said a review of maternity services would delay 
improvements being developed by professionals. "It would be easy 
for all involved -- including me -- to call for a review and take some 
of the political heat out of the maternity issue," he said. "But 
while it would be easy it would also be counter-productive." The 
Health Ministry was talking with professional bodies in maternity 
service including midwives, doctors and nurses focusing on improving 
services through better coordination between Leader Maternity Care and 
hospital services. "The ministry and the maternity sector are 
taking this approach because they know action is needed now -- not after 
a drawn-out review process." Mr Hodgson pointed out that 
National MP Paul Hutchison had previously been reported saying he did 
not think a review was necessary. Dr Hutchison told NZPA that he 
agreed with Mr Ryall but wanted the Government to act on the 1999 
maternity review which he said had been ignored. "Due to the 
increasing concerns about maternity care I would agree with Tony that a 
full review is undertaken now -- but great note should be taken of that 
report from 1999." The hospital involved in the latest case is 
waiting until the Accident Compensation Corporation has reported its 
decision before commenting. The New Zealand Herald newspaper 
reported key failures in the baby's death were midwives' miss-reading of 
a fetal heart rate monitor and a fetal blood-acidity test was 
unnecessary in the circumstances and wasted time. A hospital 
document described the events surrounding the birth and poor follow-up 
with the parents as a "multi-system failure". Other recent 
controversies involving midwife care included the death of a baby in 
February 2001 after an undiagnosed breech birth at home, another 
undiagnosed breech birth incident in February 2003 and a baby who died 
in November 2003 after emergency caesarean and mismanaged labour at 
North Shore Hospital. In Dunedin today a High Court jury was to 
be asked to decide whether midwife Jennifer Joan Crawshaw, 44, is guilty 
 

Re: [ozmidwifery] Larry

[Judy Chapman]

Speaking from Mareeba, we did ok, 40km north of the centre of the storm.   Bit scary going to work though at 0630.   Cheers  Judy  diane <[EMAIL PROTECTED]> wrote:  Hi,   Hope you gals up North managed to weather the storm without too much damage this morning. Any new little Larry's born in the storm?     I was thinking of you, as I will be moving to N.Q at the end of the year ( beachside too, I wonder if thats a wise decision!!!).      I suppose you are all busy with!
  the
 clean up and waiting for power, so when you do get to read this, just know we were thinking of you all in N.Q     Cheers,  Diane   
		On Yahoo!7 
 
Messenger: Make free PC-to-PC calls to your friends overseas. 

[ozmidwifery] article FYI

[leanne wynne]

Studies Short on Soy Formula Risks
Experts See Little Health Danger With Formula

By Todd Zwillich
WebMD Medical News

Reviewed By Louise Chang, MD
on Friday, March 17, 2006

March 17, 2006 -- There is not enough scientific data to determine whether 
or not soy formula consumed by millions of infants poses a health risk, a 
government panel concluded Friday.


Experts say they have little concern that an estrogen-like substance in soy 
-- known as genistein -- poses a developmental risk to infants who consume 
it or whose parents consumed it in soy-based foods.


Still, very few studies have looked at the long-term health effects of soy 
formula, which is used to feed an estimated 25% of all U.S. infants, the 
panel says.


Soy has raised concerns not only because of its exploding consumption by 
U.S. infants and adults but also because studies have shown that genistein 
can interfere with hormonal function in rats and their offspring.


A variety of toxic effects, including stunted growth, sexual organ 
abnormalities, and decreased fertilization, have all been observed in 
laboratory animals. All of the effects appear to be caused by genistein's 
ability to mimic the effects of natural estrogen. Some researchers also 
suspect soy of playing a role in reduced breast cancer rates in Japan, where 
soy consumption is very high.


The committee says it had "negligible" concern that usual intakes of 
genistein cause adverse health effects in newborns and infants who consume 
soy formula, though one expert -- Ruth Etze, MD -- dissented from the 
conclusion. Etzel, a pediatrician at the Alaska Native Medical Center in 
Anchorage, could not be reached for comment.


Human infants consume much lower genistein doses than laboratory animals, 
and most of the chemical is not absorbed into the human bloodstream, says 
Karl Rozman, PhD, a University of Kansas toxicologist who led NIH panel.


But at the same time, few studies have looked at soy's effects in a 
controlled way, he explains.


More Study Needed

"That means there are studies there, but they are not allowing us to come to 
a firm conclusion one way or another. But it also means that we do not see a 
problem," says Rozman.


One study pegged infant formula feeding as a risk factor for premature 
breast development in girls. Experts called for better research to determine 
if that and other potential health effects are real.


"Another case-control study to examine premature breast development in 
females following exposure to soy infant formula is needed," the committee 
concludes.


Panelist Jatinder Mhatia, MD, says soy formula has not shown "a blip on the 
radar screen" in terms of ill health consequences, despite use by an 
estimated 40 million total infants.


But Mhatia also says parents are up to 10 times more likely to give their 
infants soy formula in the U.S. than in Britain. Some countries, including 
Israel, have restricted formula use to prescription-only status for infants 
who cannot consume milk. But American doctors are quick to recommend formula 
for fussy infants, which parents are heavily encouraged by advertising to 
use, he says.


"Only in our country are we using [soy] in a free-for-all," Mhatia, a 
pediatrician at the Medical College of Georgia, tells WebMD. "Soy has a 
specific indication, and we tend to use and abuse in America."


"Why should you use soy unless there's an indication?" he says.




SOURCES: NTP-CERHR Expert Panel Report on the Reproductive and Developmental 
Toxicity of Genistein, Center for the Evaluation of Risks to Human 
Reproduction, National Institutes of Health, March 17, 2006. Karl Rozman, 
MD, University of Kansas. Jitander Mhatia, MD, department of pediatrics, 
Medical College of Georgia, Augusta.


© 2006 WebMD Inc. All rights reserved



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


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Re: [ozmidwifery] RE: night shift

[katnap076]

I remember reading something about peppermint 
either sucking onlollies or a couple of drops of oil rubbed on hands and inhaled 
can wake you up for a drive home, I"m lucky I can sleep well when not 
interrupted, i usually sleep for a few hours before my first night so i'm not 
running on empty.  Doing permenant nights I turn my nights into days, so 
i'll eat during the night and not int he day.  Good luck.
 
 
Kat  =^..^=

  - Original Message - 
  From: 
  Nicole 
  Carver 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, March 16, 2006 9:34 
  PM
  Subject: [ozmidwifery] RE: night 
  shift
  
  Hi 
  Tanya,
  The 
  worst night is usually the second night, and the worst time of night is 
  between 3am and 5.30 ish. It is a good idea to try to have a couple of hours 
  sleep late in the afternoon before the first night shift. Eat several small 
  nutritious meals a day when you are on night duty, including 3 during the 
  shift. Lay off the coffee or coke as much as you can. Take things to do like 
  craft or easy reading. If you take something to do you will usually not have 
  time to do it! Try not to sit down too much, go for a walk as often as you 
  can. When you are sitting down try to keep alert by talking to your 
  colleagues. Wear clothing that is loose around the middle (wind is a 
  problem!) Drink lots of water.
  Tell 
  your friends and family that you are not to be called or visited before 4pm at 
  the earliest. Take your phone off the hook when you are trying to sleep. Also 
  disconnect the door bell if possible. If you put a note on the door, be 
  careful not to make it obvious that there is a sleeping female home alone. 
  Maybe, "do not disturb, baby sleeping"! Ignore any one who does knock. If you 
  wake up early, have a snack and a drink, maybe read for a while and then try 
  again. If not at least have another lie down late in the afternoon. 
  
  Good 
  luck!
  Nicole Carver.
   
  
-Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of Tanya 
McPhailSent: Thursday, March 16, 2006 8:25 PMTo: 
ozmidwifery@acegraphics.com.auSubject: 
Hi all,
 
I am a newly graduated Midwife, who has her first lot of night shift (5 
shifts) coming up.
 
Does anyone have a tips for me? How to sleep best during the day, how 
to stay awake and alert during the night?
 
Thanks
 
 


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RE: [ozmidwifery] VBAC after 'tummy tuck'

[Lieve Huybrechts]

Title: VBAC after 'tummy tuck'








Hoi Justine,

 

Can you explain me what a
‘tummy tuck’ is? I am afraid my English is not that expert J

 

Lieve

 



Lieve Huybrechts

vroedvrouw

0477740853



 

-Oorspronkelijk
bericht-
Van:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Namens
Justine Caines
Verzonden: maandag 20 maart 2006
13:11
Aan: OzMid List
Onderwerp: [ozmidwifery] VBAC
after 'tummy tuck'

 

Dear Wise Women

In have a tragic message from a woman wanting a VBA2C also has had a
‘tummy tuck’.

So sad as she is one of the many who had a total number done on her.

But she recognises that so that’s positive.

Any ideas re the tummy tuck.  Knowing nothing I would think the tummy tuck
bit would not interact with the c/s scar?

Please advise!

Many Thanks

Justine 

[ozmidwifery] VBAC after 'tummy tuck'

[Justine Caines]

Title: VBAC after 'tummy tuck'



Dear Wise Women

In have a tragic message from a woman wanting a VBA2C also has had a ‘tummy tuck’.

So sad as she is one of the many who had a total number done on her.

But she recognises that so that’s positive.

Any ideas re the tummy tuck.  Knowing nothing I would think the tummy tuck bit would not interact with the c/s scar?

Please advise!

Many Thanks

Justine 

RE: [ozmidwifery] Recommendations?

[B & G]

Hi Julia,
The time is ripe with major maternity services reform happening in this
state at the moment. The Gold Coast Birth Centre is just awaiting (like
other new models of care) for the new negotiated industrial award to be
announced. I cannot tell you much more about that as negotiations are
continuing.
Going to Queensland Health home page -www.health.qld.gov.au would give
you general information and contact details for the hospitals you
mention. It is competitive and you really need to sell yourself but
there is plenty of work. Read the Re-birthing report would give you a
solid foundation for preparing for interviews.
I am Redcliffe- ~ 1200 births/year and Caboolture does ~ 1800
births/year part of Redcliffe-Caboolture District. Our rates have
increased by about 20% past the past year.
Cheers Barb


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Julia
Haythornthwaite
Sent: Monday, 20 March 2006 6:54 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Recommendations?


Hi

I am a little confused as to how this mailing list thing works, but ... 
here I am willing to give it a go!

Just wondered if there was anyone out there who could help me with a 
couple of questions I have? I am currently a 3rd-year midwifery student 
in New Zealand. My family and I have made the big decision to leave New 
Zealand's shores and live on the Gold Coast in January 2007. I 
ultimately would love to work in a birthing centre, but I hear the 
competition is pretty fierce (maybe even more so for a new graduate!), 
so I was wondering if there are any particular hospitals that anyone 
could recommend in the Gold Coast/Brisbane area? I have been in 
correspondence with a contact at Mater Mother's Hospital and have been 
given good information on the new graduate programme offered there 
which is great, but haven't heard anything from any of the other 
hospitals I have contacted (namely Ipswich, Caboolture, Redland and 
Logan hospitals). Any thoughts/ideas?

Thank you. Really looking forward to hearing from you.

Julia

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RE: [ozmidwifery] Recommendations?

[Sharon Dalton]

Hello Julia,
The best person to contact is Jocelyn Toohill, Midwifery Unit Manager of
Antenatal and Birthing at Gold Coast Hospital. We have a Birth Centre
just beginning and lots of other exciting possibilities in the works. Ph
07 55198325
Regards Sharon

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Julia
Haythornthwaite
Sent: Monday, March 20, 2006 6:54 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Recommendations?

Hi

I am a little confused as to how this mailing list thing works, but ... 
here I am willing to give it a go!

Just wondered if there was anyone out there who could help me with a 
couple of questions I have? I am currently a 3rd-year midwifery student 
in New Zealand. My family and I have made the big decision to leave New 
Zealand's shores and live on the Gold Coast in January 2007. I 
ultimately would love to work in a birthing centre, but I hear the 
competition is pretty fierce (maybe even more so for a new graduate!), 
so I was wondering if there are any particular hospitals that anyone 
could recommend in the Gold Coast/Brisbane area? I have been in 
correspondence with a contact at Mater Mother's Hospital and have been 
given good information on the new graduate programme offered there 
which is great, but haven't heard anything from any of the other 
hospitals I have contacted (namely Ipswich, Caboolture, Redland and 
Logan hospitals). Any thoughts/ideas?

Thank you. Really looking forward to hearing from you.

Julia

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[ozmidwifery] Midwifery troubles in NZ

[B & G]

Title: Message





  
  


  FYI, just when 
  we are hoping for reform here there is this tragic report from NZ. 
  Barb
   
   
   
  This article is owned by, or has been licensed to, 
  the New Zealand Herald. You may not reproduce, publish, electronically 
  archive or transmit this article in any manner without the prior written 
  consent of the New Zealand Herald. To make a copyright clearance inquiry, 
  please click here.
 

  
  

   
  
 

  


  

  Pete 
  Hodgson
   Hodgson argues against review of maternity 
  services 
   20.03.06 
  4.20pm
   Health 
  Minister Pete Hodgson says a review of maternity services would only delay 
  improvements being made in the sector. National Party health 
  spokesman Tony Royal today renewed his call for an independent audit of 
  maternity services following a report of another baby's death being blamed 
  on midwife care. The parents of the child born at Auckland's 
  Middlemore Hospital in an emergency caesarean operation were reportedly 
  told midwives had misread a fetal heart rate monitor. The child 
  died seven hours after the caesarean. The case follows criticism 
  of health workers following reports on the deaths of three other babies -- 
  two by a coroner and one by Health and Disability Commissioner Ron 
  Paterson. The child's parents -- Heather and Alan Phillips -- are 
  now calling for an inquiry into maternity and midwifery care. Mr 
  Ryall said the problem was not going to go away and Mr Hodgson needed to 
  get the review started so problems could be fixed. "Every month 
  there are more frightening incidents coming to light, and more 
  professional groups calling for change." Mr Hodgson said a review 
  of maternity services would delay improvements being developed by 
  professionals. "It would be easy for all involved -- including me 
  -- to call for a review and take some of the political heat out of the 
  maternity issue," he said. "But while it would be easy it would 
  also be counter-productive." The Health Ministry was talking with 
  professional bodies in maternity service including midwives, doctors and 
  nurses focusing on improving services through better coordination between 
  Leader Maternity Care and hospital services. "The ministry and the 
  maternity sector are taking this approach because they know action is 
  needed now -- not after a drawn-out review process." Mr Hodgson 
  pointed out that National MP Paul Hutchison had previously been reported 
  saying he did not think a review was necessary. Dr Hutchison told 
  NZPA that he agreed with Mr Ryall but wanted the Government to act on the 
  1999 maternity review which he said had been ignored. "Due to the 
  increasing concerns about maternity care I would agree with Tony that a 
  full review is undertaken now -- but great note should be taken of that 
  report from 1999." The hospital involved in the latest case is 
  waiting until the Accident Compensation Corporation has reported its 
  decision before commenting. The New Zealand Herald newspaper 
  reported key failures in the baby's death were midwives' miss-reading of a 
  fetal heart rate monitor and a fetal blood-acidity test was unnecessary in 
  the circumstances and wasted time. A hospital document described 
  the events surrounding the birth and poor follow-up with the parents as a 
  "multi-system failure". Other recent controversies involving 
  midwife care included the death of a baby in February 2001 after an 
  undiagnosed breech birth at home, another undiagnosed breech birth 
  incident in February 2003 and a baby who died in November 2003 after 
  emergency caesarean and mismanaged labour at North Shore Hospital. 
  In Dunedin today a High Court jury was to be asked to decide 
  whether midwife Jennifer Joan Crawshaw, 44, is guilty of the manslaughter 
  of a first-pregnancy breech baby born on March 14, 2004. Meanwhile 
  NZ First MP Barbara Stewart said she knew of another death but had been 
  asked not to publicise it. She wanted to hear what solutions Mr 
  Hodgson proposed and the latest case should ring alarm bells. - 
  NZPA   
   

  
  

  

  


  
  
 
Copyright © 2006, APN Holdings 
  NZ Ltd
 
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Use

[ozmidwifery] But there is Dr delay to the story from NZ

[B & G]

Title: Message





  
  

   
   
   

  Just read the 
  fuller details. Seems to me the midwives took her to hospital correctly 
  but a huge delay in being seen by the Dr! Seems to me there is 
  scaremongering going on. Love to know more about the Dr stats.  
  Barb
   
   
   
   
  This article is owned by, or has been licensed to, 
  the New Zealand Herald. You may not reproduce, publish, electronically 
  archive or transmit this article in any manner without the prior written 
  consent of the New Zealand Herald. To make a copyright clearance inquiry, 
  please click here.
 

  
  

   
  
 

  


  

  Alan and Heather Phillips place 
flowers at the grave site of their baby daughter Tyla in Awhitu. 
Picture / Kenny Rodger
   Baby died after hospital errors 
   20.03.06By 
  Martin Johnston
   Another baby 
  has died after a series of mistakes partly blamed on midwife care. 
  Tyla Phillips survived for only 7 hours after she was born at 
  Middlemore Hospital in an emergency caesarean operation last August. 
  A hospital specialist later told her parents, Heather and Alan 
  Phillips, that if the operation had been performed three hours earlier she 
  might have lived. The specialist said midwives misread a fetal 
  heart rate monitor. The couple now want an inquiry into maternity 
  and midwifery care because their case follows other newborn deaths with 
  similar themes. Middlemore is saying little publicly about Tyla's 
  birth until the Accident Compensation Corporation has reported its 
  decision to the hospital and Health and Disability Commissioner Ron 
  Paterson has investigated. The hospital says it may refer the 
  case, which had devastated the staff involved, to the commissioner, or 
  medical or midwifery bodies. However, hospital documents and a 
  tape recording the Phillips have of one of their meetings with senior 
  clinicians catalogue the mistakes that led to Tyla's death on August 18 
  and a follow-up internal review. A key failure was midwives' 
  mis-reading of a fetal heart rate monitor, according to the obstetric 
  consultant on call at the time, Dr Alec Ekeroma, on the tape. He 
  also indicated that the fetal blood-acidity test which led to the 
  caesarean decision - done after an obstetric registrar reviewed the heart 
  monitoring - was unnecessary in the circumstances and wasted time. 
  He said the 21-minute caesarean operation - Tyla was born at 
  5.53am - should have been done "probably two or three hours earlier". If 
  it had been, this "may have changed the outcome". Mrs Phillips was 
  several days overdue when she went to the Middlemore-allied Botany Downs 
  Maternity Unit, which was managing her pregnancy. The unit's midwives had 
  her transferred to Middlemore at 11.45pm on August 17. Her waters had 
  broken around 9pm, containing what her medical file says was "moderate 
  meconium" (faeces from the baby). Staff noticed thick meconium when she 
  arrived at the hospital. The presence of meconium can indicate a 
  distressed baby. Because of this, the Phillips expected a caesarean on 
  arrival at Middlemore. Mrs Phillips said she was not fully 
  assessed by an obstetric doctor until about 5am. Her medical file 
  states a registrar was asked to see her after her arrival but was busy in 
  theatre. At 5.32am the decision was made to deliver Tyla by 
  caesarean after the blood-acid test - which had consumed 20 minutes, after 
  one attempt at the test failed - confirmed her distress. A report 
  on Tyla's post-mortem says her lungs had suffered "massive meconium 
  inhalation" and extensive bleeding, and she had brain damage from oxygen 
  deprivation. A Middlemore document describes the events 
  surrounding the birth and poor follow-up with the parents as a 
  "multi-system failure". A letter to ACC by clinical director of 
  women's health Dr Keith Allenby lists 11 recommendations being considered 
  to address some of the issues the case has highlighted. These 
  include clarifying what should be done in response to abnormalities 
  revealed by fetal heart rate monitoring; regular training, for all 
  pregnancy-care staff, in interpreting the monitoring results; and 
  clarifying the chain of contact "if obstetric registrar busy (as new tier 
  of doctors now in place)". The Phillips have lost confidence in 
  New Zealand's midwife-dominated maternity system. "If I could do 
  it again," said 33-year-old Mrs Phillips, who had difficulty conceiving 
  Tyla, "I wouldn't go the midwife way. I would go to a doctor, a 
  specialist." Tyla's case follows crit

Re: [ozmidwifery] Misoprostol

[Lisa Barrett]

Hi Jo
I do concede that when fully informed the pros of some things ( including 
medications) outway the cons. However to have it as the drug of choice at a 
maternity unit on the say-so of a Dr with no discussion or investigation 
just doesn't seem right.  Also as we are seeing in this discussion things 
creep along from just one use to numerous uses just because it appears a 
good idea rather than it's be thoroughly tried and tested.


Medications are indeed complex and at a time of emergency what appears to 
work the best could be seen to be the way to go.  They used Thalidomide as 
the drug of choice and miracle cure for morning sickness.  I'm sure there 
are many women who wished that had been more thoroughly tested before being 
prescribed.


These discussions are just to make us all think (and thank god for that) 
there are very rarely clear cut right or wrongs.


Lisa

- Original Message - 
From: "Jo Bourne" <[EMAIL PROTECTED]>

To: 
Sent: Monday, March 20, 2006 7:31 PM
Subject: Re: [ozmidwifery] Misoprostol


From what I know of Misoprostol I can't imagine ever agreeing to take it. 
BUT in order to stay pregnant I am currently taking two kinds of drugs not 
recommended for pregnant women or women trying to get pregnant... When I 
was doing IVF almost all the drugs they gave me were clearly marked "not 
to be taken during pregnancy or when you may become pregnant". As a 
consumer it does seem to me that sometimes you do have to make complex 
choices about medications and there are times when taking drugs that 
aren't recommended or approved for pregnancy can be the better choice.


cheers
Jo

At 6:20 PM +1030 20/3/06, Lisa Barrett wrote:
it seems a little unethical to use an unlicensed drug on women unless we 
tell them.(Unlicenced to use on gravid women that is)  Is this the case in 
any of your units.  do you let women know that

a.the drug you are going to use is a. unlicensed for that use
b. contraindicated in pregnancy and lactation  (information freely 
available on the net)
c. if it's going to be used for induction the isn't really agreement about 
dose etc. etc.


I find it hard to believe that any woman would actually want the drug even 
if some god like dr thinks it has to be available.


Lisa
- Original Message - From: "Joy Cocks" <[EMAIL PROTECTED]>
To: "Ozmidwifery" 
Sent: Monday, March 20, 2006 2:58 PM
Subject: [ozmidwifery] Misoprostol


I work in a very small hospital, covering acute, aged care, emergency, as
well as midwifery.
One of our GP obstetricians has requested that we have Misoprostol in 
stock
(which we already have for acute patients) as "all the hospitals now use 
it
for post-partum bleeding".  I would be interested to know how common this 
is
as it is another off label use.  I'm also concerned that it will then be 
a

small step to use if for cervical ripening/IOL.
I notice in Hale that it is a category L3 (moderately safe) whereas
Ergometrine is L4 (possibly hazardous) in breastfeeding mothers.  I'm
remembering the "olden days" when Ergometrine tablets were used fairly
routinely for women with incomplete 3rd stage or were passing clots - I
don't remember the exact dose - but it was used over several days in
reducing doses (I even had it myself 30 yrs ago!).
Interested to hear any comments or research that anyone has regarding
Misoprostol and post-partum bleeding (I'm assuming he means haemorrhage, 
not

normal bleeding).
Thanks,
Joy

Joy Cocks RN (Div 1) RM CBE IBCLC
BRIGHT Vic 3741
email:[EMAIL PROTECTED]


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RE: [ozmidwifery] Misoprostol

[Nicole Carver]

I would hate to see Misoprostil used for induction in women whose baby is
alive, and actually haven't myself used it for induction when the baby has
unfortunately died. However, I have seen it work extremely well when a woman
is having a large PPH. The results are almost instantaneous.
Nicole.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Lisa Barrett
Sent: Monday, March 20, 2006 6:51 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Misoprostol


it seems a little unethical to use an unlicensed drug on women unless we
tell them.(Unlicenced to use on gravid women that is)  Is this the case in
any of your units.  do you let women know that
a.the drug you are going to use is a. unlicensed for that use
b. contraindicated in pregnancy and lactation  (information freely available
on the net)
c. if it's going to be used for induction the isn't really agreement about
dose etc. etc.

I find it hard to believe that any woman would actually want the drug even
if some god like dr thinks it has to be available.

Lisa
- Original Message -
From: "Joy Cocks" <[EMAIL PROTECTED]>
To: "Ozmidwifery" 
Sent: Monday, March 20, 2006 2:58 PM
Subject: [ozmidwifery] Misoprostol


>I work in a very small hospital, covering acute, aged care, emergency, as
> well as midwifery.
> One of our GP obstetricians has requested that we have Misoprostol in
> stock
> (which we already have for acute patients) as "all the hospitals now use
> it
> for post-partum bleeding".  I would be interested to know how common this
> is
> as it is another off label use.  I'm also concerned that it will then be a
> small step to use if for cervical ripening/IOL.
> I notice in Hale that it is a category L3 (moderately safe) whereas
> Ergometrine is L4 (possibly hazardous) in breastfeeding mothers.  I'm
> remembering the "olden days" when Ergometrine tablets were used fairly
> routinely for women with incomplete 3rd stage or were passing clots - I
> don't remember the exact dose - but it was used over several days in
> reducing doses (I even had it myself 30 yrs ago!).
> Interested to hear any comments or research that anyone has regarding
> Misoprostol and post-partum bleeding (I'm assuming he means haemorrhage,
> not
> normal bleeding).
> Thanks,
> Joy
>
> Joy Cocks RN (Div 1) RM CBE IBCLC
> BRIGHT Vic 3741
> email:[EMAIL PROTECTED]
>
>
> --
> This mailing list is sponsored by ACE Graphics.
> Visit  to subscribe or unsubscribe.
>


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Re: [ozmidwifery] Misoprostol

[Sadie]

We use 1000mg Misoprostal ( 5 tablets PR) for PPH, along with 30iu 
Syntocinon in 500 mls CSL, catheter for bladder, and of course 'rubbing up a 
contraction' by a midwife. This is all after IM syntometrine given with the 
anterior shoulder.

I have not seen misoprostol used for IOL, unless the woman has an FDIU.

Cheers,

Sadie 



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Re: [ozmidwifery] Misoprostol

[Jo Bourne]

>From what I know of Misoprostol I can't imagine ever agreeing to take it. BUT 
>in order to stay pregnant I am currently taking two kinds of drugs not 
>recommended for pregnant women or women trying to get pregnant... When I was 
>doing IVF almost all the drugs they gave me were clearly marked "not to be 
>taken during pregnancy or when you may become pregnant". As a consumer it does 
>seem to me that sometimes you do have to make complex choices about 
>medications and there are times when taking drugs that aren't recommended or 
>approved for pregnancy can be the better choice.

cheers
Jo

At 6:20 PM +1030 20/3/06, Lisa Barrett wrote:
>it seems a little unethical to use an unlicensed drug on women unless we tell 
>them.(Unlicenced to use on gravid women that is)  Is this the case in any of 
>your units.  do you let women know that
>a.the drug you are going to use is a. unlicensed for that use
>b. contraindicated in pregnancy and lactation  (information freely available 
>on the net)
>c. if it's going to be used for induction the isn't really agreement about 
>dose etc. etc.
>
>I find it hard to believe that any woman would actually want the drug even if 
>some god like dr thinks it has to be available.
>
>Lisa
>- Original Message - From: "Joy Cocks" <[EMAIL PROTECTED]>
>To: "Ozmidwifery" 
>Sent: Monday, March 20, 2006 2:58 PM
>Subject: [ozmidwifery] Misoprostol
>
>>I work in a very small hospital, covering acute, aged care, emergency, as
>>well as midwifery.
>>One of our GP obstetricians has requested that we have Misoprostol in stock
>>(which we already have for acute patients) as "all the hospitals now use it
>>for post-partum bleeding".  I would be interested to know how common this is
>>as it is another off label use.  I'm also concerned that it will then be a
>>small step to use if for cervical ripening/IOL.
>>I notice in Hale that it is a category L3 (moderately safe) whereas
>>Ergometrine is L4 (possibly hazardous) in breastfeeding mothers.  I'm
>>remembering the "olden days" when Ergometrine tablets were used fairly
>>routinely for women with incomplete 3rd stage or were passing clots - I
>>don't remember the exact dose - but it was used over several days in
>>reducing doses (I even had it myself 30 yrs ago!).
>>Interested to hear any comments or research that anyone has regarding
>>Misoprostol and post-partum bleeding (I'm assuming he means haemorrhage, not
>>normal bleeding).
>>Thanks,
>>Joy
>>
>>Joy Cocks RN (Div 1) RM CBE IBCLC
>>BRIGHT Vic 3741
>>email:[EMAIL PROTECTED]
>>
>>
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>>This mailing list is sponsored by ACE Graphics.
>>Visit  to subscribe or unsubscribe.
>>
>
>
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[ozmidwifery] Recommendations?

[Julia Haythornthwaite]

Hi

I am a little confused as to how this mailing list thing works, but ... 
here I am willing to give it a go!


Just wondered if there was anyone out there who could help me with a 
couple of questions I have? I am currently a 3rd-year midwifery student 
in New Zealand. My family and I have made the big decision to leave New 
Zealand's shores and live on the Gold Coast in January 2007. I 
ultimately would love to work in a birthing centre, but I hear the 
competition is pretty fierce (maybe even more so for a new graduate!), 
so I was wondering if there are any particular hospitals that anyone 
could recommend in the Gold Coast/Brisbane area? I have been in 
correspondence with a contact at Mater Mother's Hospital and have been 
given good information on the new graduate programme offered there 
which is great, but haven't heard anything from any of the other 
hospitals I have contacted (namely Ipswich, Caboolture, Redland and 
Logan hospitals). Any thoughts/ideas?


Thank you. Really looking forward to hearing from you.

Julia

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[ozmidwifery] question re funding

[Belinda]

Hi everyone, I have just found out I have an abstract accepted for the 
normal birth conference in June in Cumbria. I would be excited but need 
to look for funding to be able to get there. Can anyone give me 
suggestions where to look, i am a PhD student (nearly finished - final 
chapter on the go) and will look at the uni but am pretty sure time will 
be an issue. Any suggestions greatly accepted

Belinda




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