RE: [ozmidwifery] NZ stats

[Lisa Gierke]

Title: Message



Brenda 
you make some interesting points; so is what we aspire to in high rates of 
mdiwfery care caused by an inability by women to get other options in care - 
this is outrageous, no different really to the system we have now where womens 
choices are limited. 
There 
seems to be huge issues with a lack of understanding between different health 
professioanls in who is repsonsible for what when a midwife admits a woman to a 
hospital. In some of the reports I have read about adverse outcomes,lack of 
role understanding coupled with a lack of collaboration and 
communication can play big roles when things go pear shaped. Scary stuff really! 
Lisa

  
  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of 
  brendamanningSent: Friday, 7 July 2006 8:54 AMTo: 
  ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] NZ 
  stats
  BEWARE: 
  REALITY CHECK:I don't want to disillusion alot of you but 
  a reality check is way overdue about what's going on across the 
  Tasman.The saying: 'Be careful what you wish 
  for.' is very applicable here.What MW have 
  gained in autonomy, they have lost in the respect of their professional 
  colleagues, the community & women generally. The whole maternity system 
  has an 'uncomfortable feeling'.I've thought alot before writing this 
  all down, not wanting to 'upset' people, & of course it grieves me because 
  it's my home & I'd love to be there !! SO here goes: this is looking 
  at the situation without the 'rose tinted spectacles'. But of course it's 
  generalising in some aspects.As a Kiwi who spends time every year in 
  NZ & came through the changes seeing the system evolve there, I feel I 
  really need to say that Aust would not be doing it's women a service to 
  emulate the system EXACTLY as it is implemented there. It may appear idyllic 
  but it isn't, and not a day goes by that there's not an article in some 
  newspaper there decrying Midwives (they are NOT popular politically & 
  have created alot of emnity & alienated health professionals with whom we 
  would much rather have collaborative practice) . There is a national midwifery 
  shortage, the same as here & because of the way the system is set up there 
  large areas of the country have women with reduced choices in pregnancy 
  care, not enhanced.I specifically went to the Manawatu, Wairarapa 
  & Horewhenua districts looking to relocate there 6 months ago. I go every 
  year with the same intention ie checking out the system & the situation. 
  This year I spoke to all Pg women I saw, esp around Carterton, Greytown for 
  those of you that know the area (because my elderly parents live in Upper Hutt 
  & I wanted to be close).
  In Martinborough alone, (a small rural town), I saw 6 Pg women in the 
  street over the space of an hour & each one was birthing either in Levin 
  or Hutt Hospital (ie 1 hour drive North, or South through the Rimutuka ranges, 
  ie narrow & windy as hell, icy & sometimes closed in winter ! ). 
  There was no MW in their community, they were totally horrified at the 
  thought of birth at home & they had reduced options because the GPs have 
  been 'squeezed' out of providing maternity care. I spoke with a group of IP in 
  Levin & they are overwhelmed & understaffed, travelling alot of 
  mileage over narrow windy roads to clinic. The majority of their births are in 
  hospital & they (the IPs) are turning women away because they are 
  overbooked. 
  One woman in Wellington tried 13 MW before she found 1 as her LMC ! 
  I was offered 10 jobs in 1 week ! 
  There are few private maternity hospitals there.
  I also have a very close friend in the outer Auckland region who 
  keeps me up to date with cuttings, emails etc. There is alot of general 
  dissatisfaction there with the whole system too.There are alot of IPs 
  who have 'burned out' & returned to the hospital system over the last 4 
  years overwhelmed by work & commitment to on call 24/7 because the women 
  have no other options for local care !The system is not one to emulate 
  here.Surely we want more choice for women, not 
  less, and we certainly don't want to alienate our 
  professional colleagues who we need to be working WITH, not AGAINST.I 
  really believe that Aust MW need to look more closely at the system in NZ 
  before holding it up as a model of care they aspire to. It needs alot of 
  'tweaking' to make it ideal.  I love NZ, but in this arena it's not 
  perfect & I think MW need to look very closely at the big 
  picture.Off the soapbox now !!With kind 
  regardsBrenda Manning www.themidwife.com.au- Original 
  Message - From: "Andrea Robertson" 
  <[EMAIL PROTECTED]>To: 
  Sent: Friday, July 07, 2006 12:15 
  AMSubject: Re: [ozmidwifery] NZ stats> Hi Pauline,> 
  > As I understand it, those that don't go to a midwife end up with a 
  > doctor (usually an obstetrician) and the 

RE: [ozmidwifery] homebirth enquiry

[jo]

Thanks Janet - had given that no: apparently a no go!

Jo 

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 11:48 AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] homebirth enquiry

Noeline Lang Orange 026321462
- Original Message - 
From: "jo" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, July 06, 2006 10:56 PM
Subject: [ozmidwifery] homebirth enquiry


> 
> Hi all,
> 
> Have had an enquiry from a woman in Orange (NSW) wanting a homebirth -
> anyone know of any willing midwives?
> 
> Jo Hunter
> 
> 
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[ozmidwifery] Low liquor was Trial of scar

[Lisa Gierke]

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological!
Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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RE: [ozmidwifery] Low liquor was Trial of scar

[Penny Withers]

  Haven't posted before and have only recently started reading here.  So
thanks for all of your interesting comments on a range of issues and
subjects.  I'm interested particularly in this one..I had
oligohydramnios diagnosed at 34 weeks.  An AFI of 2 is not normal in my
experience and three weeks later still no baby ...other measures of fetal
wellbeing all ok.  Had my baby been cephalic I would have accepted
induction.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 6:33 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Low liquor was Trial of scar

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological!
Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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RE: [ozmidwifery] Low liquor was Trial of scar

[Penny Withers]

I got it Lisa the second time  :)

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 6:33 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Low liquor was Trial of scar

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological!
Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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Re: [ozmidwifery] NZ stats

[sally tracy]

Dear Brenda, dear Ozmids
Great to have a discussion about the cross Tasman midwifery situation 
- but I must confess i want to weigh into the debate to set just a
couple of little facts straight. Whilst it is never a good thing to
transplant a system of care from one cultural/political/social context
to another without first assessing its relevance and its
appropriateness  - that alone should be the reason for not looking more
closely at what is happening in New Zealand.  

Fact 1. In NEW ZEALAND  - all  women are supported  (by
legislation through government funding and the reform of the 1990
Nurses Act and five other substantive legislative changes) to give
birth with whomever they feel is the right choice. This means that
hypothetically there is NO barrier to a woman being able to have a home
birth , a birth in a primary hospital or a teaching hospital with a
midwife, a GP or an obstetrician.  In reality this is difficult for
many women  - mainly due to the shortage of midwives NOT the lack of
recofgnition of midwifery practice,(entirely different situation in
this country).
             In AUSTRALIA  - women do not have this same opportunity to
access the caregiver of their choice OR to give birth where they think
is the most appropriate place for them and with a midwife, a GP or an
obstetrician. There are some ways that this can be achieved  - i.e. the
family pay for the services of an IPM and negotiate (often at
extraordinary lengths) access agreements and a transfer arrangement
with the local hospital should the woman want to move from home to
hospital  -  if the need should arise. Similarly they may be lucky
enough to have heard about a one-to-one midwifery group practice and be
able to book in and traverse the maize of risk assessment etc. etc. 

Fact 2.   In NEW ZEALAND, GPs declared at the time of the
parliamentary inquiry into maternity services (held in 1990 before the
legislative change) that they had no intention of offering maternity
care any more  - there were apparently about 6 GPs who still wanted to
practice. Going to the Wairarapa  - which was also my old stomping
ground) one of the most outstanding midwives who emerged following the
law change used to work completely collaboratively with the local GPs
and obstetricians. She was a model for collaborative practice and a
true inspiration in the way trust and respect can work when each
professional values the others' contribution. Sadly, Jane died a couple
of years ago and as is the case in Australia, the midwifery shortages
have meant that there are very few midwives left on the ground to take
up the service where she and others have left off.
            In AUSTRALIA  - there are similar cases of midwives working
well with GPs  - but the basic framework  - to honour and remunerate
professionals for equal work means that GPs and obstetricians ALONE are
supported by the governments (both state and federal) to provide a
service to women. There is no space for collaboration or working
together  - except on some very rare occasions where both the midwives
and the GPs are exceptional.  

Fact 3.   In NEW ZEALAND and AUSTRALIA there are chronic shortages
of midwives - neither government has recognised the true worth of the
profession enough to fund the necessary educational requirements of the
profession. New Zealand, at least is trying to redress this with a huge
injection of funding for the education of midwives being considered at
least. In Australia the situation is exacerbated because we have so
many good midwives frustrated and giving up that they will ever be
recognised to offer their full scope of practice. How many rural areas
are there out there where midwives would give their 'eye tooth' to be
able to hang their shingle and offer antenatal/birth/postnatal care to
the women in their communities?

Fact 4.  neither New Zealand nor Australia have an idyllic system 
- there is not a system that is without the need for some improvement.
The the basic problem in Australia is that there is no legislation to
support women to find the caregiver of their choice for childbirth, and
in New Zealand there is that very real opportunity. Without similar
foresight and vision Australian women will never be in the position to
have this choice.
I think the real difference is perfectly illustrated in the words of
Helen Clark (as Minister for Health) when she introduced the
legislation into the new Zealand parliament  - and the fact that every
women crossed the floor to vote in favour.. she stated ...[from the Forward in the Information
for Health Providers called "Nurses
Amendment Act 1990", Wellington 1990, Department of Health, New
Zealand.]
" The implementation of the Nurses Amendment Act 1990 should
increase the choices available to women and their families in
childbirth services. The Act restores autonomy to midwives, who were
previously limited by legislation which allowed medical practitioners
only to take full responsibility f

RE: [ozmidwifery] Low liquor was Trial of scar

[Lisa Gierke]

Hi Penny
Out of interest idi your babe have IUGR? 
Lisa

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Penny Withers
Sent: Friday, 7 July 2006 7:11 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar


  Haven't posted before and have only recently started reading here.  So
thanks for all of your interesting comments on a range of issues and
subjects.  I'm interested particularly in this one..I had
oligohydramnios diagnosed at 34 weeks.  An AFI of 2 is not normal in my
experience and three weeks later still no baby ...other measures of fetal
wellbeing all ok.  Had my baby been cephalic I would have accepted
induction.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 6:33 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Low liquor was Trial of scar

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological! Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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RE: [ozmidwifery] Low liquor was Trial of scar

[Lisa Gierke]

Apologies for my terrible spelling!! Lack of sleep due to sick toddler
certainly can affect the brain and the fingers!!!

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 7:19 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar


Hi Penny
Out of interest idi your babe have IUGR? 
Lisa

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Penny Withers
Sent: Friday, 7 July 2006 7:11 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar


  Haven't posted before and have only recently started reading here.  So
thanks for all of your interesting comments on a range of issues and
subjects.  I'm interested particularly in this one..I had
oligohydramnios diagnosed at 34 weeks.  An AFI of 2 is not normal in my
experience and three weeks later still no baby ...other measures of fetal
wellbeing all ok.  Had my baby been cephalic I would have accepted
induction.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 6:33 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Low liquor was Trial of scar

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological! Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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Re: [ozmidwifery] NZ stats

[Janet Fraser]

> Midwifery is under a lot of stress everywhere and clearly in danger
> of being suborned by the medical model unless we are very careful.


Yes, yes, yes Andrea! Too true. MWs need to be the ones making the
decisions, not in a subordinate position to surgeons!
: )
J
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RE: [ozmidwifery] Low liquor was Trial of scar

[Penny Withers]

Frank breech 37 weeks--3045g ( so a midwife caring for me said very loudly
THAT'S NOT IUGR).
Bilateral hip dyplasia--braced for three weeks and pavlick harness for 8
weeks.  No family history of ddh.  She was squished.
Looking at my tummy was scary it was really little and looked "dry" 

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 7:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar

Apologies for my terrible spelling!! Lack of sleep due to sick toddler
certainly can affect the brain and the fingers!!!

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 7:19 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar


Hi Penny
Out of interest idi your babe have IUGR? 
Lisa

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Penny Withers
Sent: Friday, 7 July 2006 7:11 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Low liquor was Trial of scar


  Haven't posted before and have only recently started reading here.  So
thanks for all of your interesting comments on a range of issues and
subjects.  I'm interested particularly in this one..I had
oligohydramnios diagnosed at 34 weeks.  An AFI of 2 is not normal in my
experience and three weeks later still no baby ...other measures of fetal
wellbeing all ok.  Had my baby been cephalic I would have accepted
induction.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Gierke
Sent: Friday, 7 July 2006 6:33 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Low liquor was Trial of scar

Am resending this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological! Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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Re: [ozmidwifery] Low liquor was Trial of scar

[Janet Fraser]

Lower liquor (and 
remember we measure VERY imperfectly) is normal at term - this 
is different from earlier in pregnancy.
Biophysical profiling is supposed to 
give this kind of information but is deeply flawed. To whit:
Suspect Diagnoses Come with 
Biophysical Profilinghttp://www.midwiferytoday.com/articles/biophysical.asp
- Original Message - 
From: "Lisa Gierke" <[EMAIL PROTECTED]>
To: 
Sent: Friday, July 07, 2006 6:32 
PM
Subject: [ozmidwifery] Low liquor was 
Trial of scar
Am resending this as didn't come thru" on my 
email. lisaJanet could you please provide us with some references on 
the low liquorthing? My understanding and experience is that in some cases 
of severegrowth restriction, low liquor is concerning, obviously this would 
beassessed along with other measures of fetal wellbeing. But if one has a 
IUGRfetus who has placental insufficieny, poor growth and low liqour 
volumes;you have a baby that is at risk of adverse perinatal outcomes such 
as IUFDetc.A decsion needs to be made between IOL and further inutero 
monitoring.We need to be careful we are not normalising the 
pathological!Lisa-Original Message-From: [EMAIL PROTECTED][mailto:[EMAIL PROTECTED] On 
Behalf Of Janet FraserSent: Friday, 7 July 2006 1:22 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Trial of 
ScarIt just stands to reason, doesn't it, that a muscle that 
stretches so far inpregnancy wouldn't be as thick as it is when empty! And 
yes, like everyonesays, if those women weren't being carved up no one could 
come out with thatcrap. It's a bit like the "We have to induce for low 
liquor" rubbish wheneveryone who's read anything of worth knows that low 
liquor means bubs is onthe way shortly... Pathologising the utterly normal, 
again!: )J--This mailing list is sponsored by ACE 
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RE: [ozmidwifery] Low liquor was Trial of scar

[Penny Withers]

Thank-you Janet for that link.

 









From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Janet Fraser
Sent: Friday, 7 July 2006 7:30 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Low
liquor was Trial of scar



 



Lower liquor (and remember we measure VERY imperfectly) is normal at term
- this is different from earlier in pregnancy.





Biophysical
profiling is supposed to give this kind of information but is deeply flawed. To
whit:





Suspect
Diagnoses Come with Biophysical Profiling
http://www.midwiferytoday.com/articles/biophysical.asp





- Original
Message - 



From: "Lisa
Gierke" <[EMAIL PROTECTED]>





To: 





Sent: Friday,
July 07, 2006 6:32 PM





Subject:
[ozmidwifery] Low liquor was Trial of scar







 



Am resending
this as didn't come thru" on my email. lisa


Janet could you please provide us with some references on the low liquor
thing? My understanding and experience is that in some cases of severe
growth restriction, low liquor is concerning, obviously this would be
assessed along with other measures of fetal wellbeing. But if one has a IUGR
fetus who has placental insufficieny, poor growth and low liqour volumes;
you have a baby that is at risk of adverse perinatal outcomes such as IUFD
etc.A decsion needs to be made between IOL and further inutero monitoring.
We need to be careful we are not normalising the pathological!
Lisa
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet
Fraser
Sent: Friday, 7 July 2006 1:22 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Trial of Scar


It just stands to reason, doesn't it, that a muscle that stretches so far in
pregnancy wouldn't be as thick as it is when empty! And yes, like everyone
says, if those women weren't being carved up no one could come out with that
crap. It's a bit like the "We have to induce for low liquor" rubbish
when
everyone who's read anything of worth knows that low liquor means bubs is on
the way shortly... Pathologising the utterly normal, again!
: )
J


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Re: [ozmidwifery] Fw: online journals

[meg]

Thanks Barbara, and everyone else who replied.
Megan

- Original Message - 
From: "Dr Barbara Vernon" <[EMAIL PROTECTED]>

To: 
Sent: Friday, July 07, 2006 2:03 PM
Subject: RE: [ozmidwifery] Fw: online journals



Hi Megan



I'm pleased to say that the Australian College of Midwives now has an 
online

Journal: Women and Birth.



The first issue of this year can be accessed by all by visiting the

http://www.sciencedirect.com/science/journal/18715192



In the future it will be possible for members and subscribers to access 
all

the past and present content of the journal at
 http://www.sciencedirect.com/wombi



Members of the ACM are also able to access a greatly discounted price for
the international Journal called Midwifery which is also available on line
to subscribers.  We're in the process of setting up this option for our
members, hope to have it available by August.



Kind regards, Barb.



Dr Barbara Vernon
Executive Officer
Australian College of Midwives
1/97 Northbourne Ave, TURNER ACT
Ph +61 2 6230 7333





From: Rebecca Gaiewski <[EMAIL PROTECTED]>

Date: 30 June 2006 2:21:40 PM

To: ozmidwifery@acegraphics.com.au

Subject: Re: [ozmidwifery] Fw: online journals

Reply-To: ozmidwifery@acegraphics.com.au



Hi Megan,

I am at Uni, so I have access through them but the

Australian Health Review is free and you have access via there web site:

http://www.aushealthreview.com.au/publications/articles/

also

http://informit.com.au/index.asp

has Australasian online journals as a trial but later to purchase, I am 
not

sure of the prices.

Journals such as Birth @ http://www.blackwell-synergy.com/toc/bir/33/2

will sometime have free articles, you can have the 'table of contents'
e-mailed.

Another good one is the Cochrane Review @
http://www.mrw.interscience.wiley.com/cochrane/cochrane_clsysrev_crglist_fs.
html

Hope these help.

Cheers

Rebecca Gaiewski

[EMAIL PROTECTED]







On 30/06/2006, at 7:48 AM, meg wrote:





Thanks Andrea, I was begining to think it was me!

megan

- Original Message -

From:   Andrea Quanchi

To:   
ozmidwifery@acegraphics.com.au


Sent: Thursday, June 29, 2006 5:32 PM

Subject: Re: [ozmidwifery] Fw: online journals



This is always an issue unless you

1. are studying and thus have access through the uni.

2. are employed at a hospital Most hospitals have access through the 
library
and a government website but I can never remember what it is. If you work 
at

a hospital check with the IT department or library.

3. ANF members can access AJAN via ANF website

I am yet to find a way to access some journals even with all of the above 
(

Birth, Practicing Midwife just two off the top of my head).

Andrea Quanchi

On 29/06/2006, at 4:50 PM, meg wrote:





- Original Message -

From:   meg

To:   
ozmidwifery@acegraphics.com.au


Sent: Wednesday, June 28, 2006 4:57 PM

Subject: online journals



Can anyone tell me where they access online journals that are able to be
downloaded or emailed. I have access to midirs but you can only get 
articles

mailed out and they cost a fair bit.

Megan


















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Re: [ozmidwifery] Trial of Scar

[Sue Cookson]

I recall a woman in Canberra about 6 years ago who had her 8th baby at
home after 7 c/sections.
Take heart,
Sue




  
  

  
  My sister had a lscs for pih /
failed induction (don't ask) and then went on to have a failed attempt
at a VBAC (same Dr) he noted a thin lower segment. I agree with the
natural state theory and discussed this thought with my sister, as the
dr advised her not to have any more children suggesting that she was at
risk of uterine rupture. 
  She has since moved to Brisbane, had
another lscs, and the OB never mentioned anything unusual with her
uterus.
   
  She is now trying to fall pregnant
with her 4th.
   
  megan

Re: [ozmidwifery] Trial of Scar

[Janet Fraser]

Woohoo 7! I read the stories of a US 
woman online the other day who has had 11 c-secs - so far. No thoughts of 
anything else after the initial surgery. Rather sad and dangerous, I 
thought.
J

  - Original Message - 
  From: 
  Sue 
  Cookson 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, August 06, 2006 8:13 
  PM
  Subject: Re: [ozmidwifery] Trial of 
  Scar
  I recall a woman in Canberra about 6 years ago who had her 8th 
  baby at home after 7 c/sections.Take heart,Sue
  



My sister had a lscs for pih / failed induction 
(don't ask) and then went on to have a failed attempt at a VBAC (same Dr) he 
noted a thin lower segment. I agree with the natural state theory and 
discussed this thought with my sister, as the dr advised her not to have any 
more children suggesting that she was at risk of uterine rupture. 

She has since moved to Brisbane, had another 
lscs, and the OB never mentioned anything unusual with her 
uterus.
 
She is now trying to fall pregnant with her 
4th.
 
megan

[ozmidwifery] All vaccines at birth

[abby_toby]

http://news.bbc.co.uk/2/hi/health/4939996.stm

This article creates scary images to me. I think it's bad enough that hep B is 
given at birth... though why do people jab newborns if their immature 
immune system can't respond effectively to vaccines??.. another idiocy 
of "birth" culture. But this is insane, just what a newborn needs, first being 
drugged to the eyeballs with pain relief cocktails, taken away from mum and 
jabbed with a chemical cocktail and synthetic molecules, sounds completely 
rational to me for protecting bubbas at risk. Let's overload their tiny bodies 
at a vulnerable time, sure that would be protcting them. 

What baffles me is, why doesn't all the $$ going into researching ways to 
create artificial substances and vaccines go into raising breastfeeding and 
gentle birth practices, or into feeding under nourished pregnant women or 
creating community gardens and good health and hygeine. These are the things 
that will change infant mortality, not injecting tiny, vulnerable bodies with 
dangerous chemicals.  

Sometimes the rationale of people has me completely stumped!

Abby xo
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RE: Fw: [ozmidwifery] Blood pressure...

[Kelly @ BellyBelly]

Great news - mum relaxed, all is now normal and fine with every aspect of
her monitoring. I had a feeling it was only anxiety. And thank goodness it
was good old white coat syndrome... we can all breathe now.

Best Regards,

Kelly Zantey
Creator, BellyBelly.com.au 
Gentle Solutions From Conception to Parenthood
BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Thursday, 6 July 2006 5:55 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: Fw: [ozmidwifery] Blood pressure...


  By obtaining information from an internet
> list and offering this in opposition to the care the woman receives from
the
> hospital can have a potentially damaging effect on her trust of the carers
> at the hospital that she has chosen.

I'm afraid I see trust as something to be earned and trusting professionals
because they're professionals is unwise. No one suggests we trust other
professionals uncritically so why are midwives and doctors different? A
second opinion is always recommended in other medical situations. Offering a
woman genuine evidence that saves her and her baby from unnecessary
intervention may not enhance her relationship with those she has employed
but it might just save her life! Why should she uncritically trust
everything she's told just because it's in a hospital?


 The woman should take her birthing
> plan and her queries regarding the blood pressure to the people at the
> hospital, where she can discuss what an induction means and why she may or
> may not need this.

No, this woman should seek outside sources to confirm for herself what she
feels comfortable with, not ask the people who want to intervene. What will
their response be? "Oh sure, we just offered induction because our time and
motion issues and surgeons' timetables mean we prefer to induce women to our
needs not theirs." Or will it be, "Yes, you're deathly ill and if we don't
induce you your baby might die." I know the latter response is the one I
hear most reported back from consumers.

> My defense over the interference in hospitals stands only on this- that
> people interfere when they are concerned of the potential risk to the
mother
> and baby, if we did nothing we are also putting them at risk.

No, people interfere when the nexus of commerce, misogyny and ignorance
around what birth really is comes together. We all know that rates of
intervention in hospitals are way out of control and overservicing is the
name of the game. You can't possibly be saying that primary c-sec rates are
appropriate in this country and that all interventions are performed with
pure hearts and women's lives in the balance? Birth isn't inherently
dangerous but if you look at the outcomes in this country clearly birth in
institutions is a risky business.

There are no excuses for our outrageous rates of intervention but every
reason for our concomitantly poor outcomes. As WHO says, when all women are
treated in high tech units as if they are high risk, outcomes are crap. Too
true!

J
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Re: [ozmidwifery] All vaccines at birth

[Michelle Windsor]

I often hear women initially say they want their baby to have whatever they need 'to keep them healthy'.  When you tell them that about 90% of Hep B is spread by sexual contact it raises some questions!!     Cheers  Michelle[EMAIL PROTECTED] wrote:  http://news.bbc.co.uk/2/hi/health/4939996.stmThis article creates scary images to me. I think it's bad enough that hep B is given at birth... though why do people jab newborns if their immature immune system can't respond effectively to vaccines??.. another idiocy of "birth" culture. But this is insane, just what a newborn needs, first being drugged to the eyeballs with pain relief cocktails, taken away from mum and jabbed with a chemical cocktail and synthetic molecules, sounds completely rational to me for protecting bubbas
 at risk. Let's overload their tiny bodies at a vulnerable time, sure that would be protcting them. What baffles me is, why doesn't all the $$ going into researching ways to create artificial substances and vaccines go into raising breastfeeding and gentle birth practices, or into feeding under nourished pregnant women or creating community gardens and good health and hygeine. These are the things that will change infant mortality, not injecting tiny, vulnerable bodies with dangerous chemicals. Sometimes the rationale of people has me completely stumped!Abby xo--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe. 
		On Yahoo!7  
 
360°: Your own space to share what you want with who you want!

[ozmidwifery] Fw: on the side

[Stephen & Felicity]

Forwarding on to the list for Heidi, who said she sent it herself but it 
didn't work (I couldn't see it).


- Original Message - 
From: "heidi crisp" <[EMAIL PROTECTED]>

To: <[EMAIL PROTECTED]>
Sent: Thursday, July 06, 2006 1:40 PM
Subject: on the side


I'm sending this off list- I replied on list, maybe that didn't work? I 
did find yours.


The emphasis was on 'little' knowledge being dangerous, however 'alot' of 
knowledge is a fabulous idea.  Especially balanced, well researched 
knowledge.  The fear I wrote of that is not required in labour is that of 
ill informed/ scary stories from friends (such as the baby in OP and the 
cascade of events) and the other fear that is never required in labour is 
misunderstandings from health care staff.  Women deserve absolutely to 
know all that is happening to them, but if women do choose a service such 
as the hospital there needs to be a balance of appreciation of the medical 
background and this woman really needs to be asking her health 
professionals to adequately explain the reasons for their concerns. 
There was certainly no indication that women are either infants (!?) or 
undeserving of any information- we as health professionals are taught to 
use evidence based -well researched information and I would expect people 
to be passing on this information to the women they care for.


Her description of her induction needs to be adressed by the staff going 
to care for her (if that arises) before the birthday not on it.



I'm intrigued as to your sharp criticism- all it's made me do is to 
unsubscribe from the list after dealing with the wrath of letters such as 
yourself.  It's interesting the condolence of hospital criticism; and yet 
a reply to a suggestion to a doula gets absolutely trodden into the 
ground.  Many, many wonderful midwives work within a hospital system and 
yes most of us will try to expand our small group of midwives offering one 
to one care, but until then a little confidence in the system wouldn't go 
astray out there.  I encourage all the women I care for to ask questions 
and when I do an induction I'm always conscious of getting consent again 
and discussing what's going to happen on the day, if at any time the woman 
wants to change her mind I let her know that i'll support her choices.





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[ozmidwifery] FW: [ozbirthing] Too many caesars

[Kelly @ BellyBelly]

Leslie - I
wonder if this has something to do with what you mentioned at Choices last
night (the Ob was sued in the US for something like 1.3 million for performing
a caesarean which was 'uninformed consent') Maybe they are deciding it might be
a good idea to think differently and thought they better say something quick
smart?

 





Best Regards,

Kelly Zantey
Creator, BellyBelly.com.au 
Gentle Solutions From Conception to Parenthood
BellyBelly Birth Support
- http://www.bellybelly.com.au/birth-support













From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Saturday, 8 July 2006 1:46
PM
To: [EMAIL PROTECTED]
Subject: [ozbirthing] Too many
caesars



 

Too many caesars
Experts are calling for a rethink on the readiness of Australian 
women to have caesareans. Kellie Bisset reports
The Australian 
July 08, 2006
IN doctors' rooms around the country pregnant women are walking in 
and asking for their babies to be surgically removed. They're not the 
majority, but evidence shows their numbers are increasing.
Some of them are paralysed by the fear of giving birth, others want 
to remain in control of where and when they have their baby, and 
still others think caesarean section is a less risky option than 
leaving delivery up to Mother Nature. 

Add to these the women advised by their obstetricians to have a 
caesarean section before, or during, labour and you get a national 
caesarean rate of nearly 29 per cent.

Midwives have loudly criticised the rapid growth of surgical 
deliveries over the past decade, and now doctors are joining them.

More obstetricians are worried that the looming possibility of one in 
three babies checking in to the world via the spartan surrounds of an 
operating theatre is too high a number. And important new research 
published last month in the US
journal Obstetrics & Gynecology 
(2006;107:1226-1232) gives us an idea as to why.

The study of more than 30,000 women showed the more caesareans they 
had, the greater the risk of complications including hysterectomy, 
bowel and bladder injury, admission to intensive care and blood 
transfusions. Risks for some complications more than doubled between 
the first and the third caesar.

Given that more than 80 per cent of Australian mothers who've had one 
caesar go on to have another, the US results are particularly 
relevant to us.

"In the desire to do good we have actually started to do some harm, 
and this paper illustrates that well," says David Ellwood, professor 
of obstetrics and gynaecology at the Australian
 National University.

Ellwood says we need to think carefully about getting the balance 
right between what's excessive and a safe level of intervention to 
avoid harm. "I really think at the moment we have swung too far the 
other way. We perhaps overestimate the size of the impact on outcomes 
for babies and underestimate the risks (to the mother)."

Senior vice-president of the Royal Australian and New Zealand College 
of Obstetricians and Gynaecologists Dr Chris Tippett agrees.

She says too many women are getting biased or selective information 
on the pros and cons of caesarean section, which is now seen by many 
doctors and their patients as the preferred option.

"Caesarean section is a significant intervention . . . there are 
concerns about whether or not we are leaving a legacy of problems."

Until now, studies looking at the question of repeat caesarean risk 
have reported mixed results, but many doctors and midwives have long 
suspected the caesarean story is not a completely rosy one.

Experts say that while this study confirms what they've been 
thinking, it's significant because of its sheer size and conclusive 
results, which can now be used to give women a better picture of what 
they're up against. 

It showed one in 155 women needed a hysterectomy after their first 
caesar, but that risk rises to nearly one in 40 for those having 
their fourth – figures Ellwood describes as "surprisingly
high".

Another major complication was placenta accreta, an abnormally firm 
attachment of the placenta to the wall of the uterus, which hampers 
control of bleeding after the baby is born. In many cases of placenta 
accreta, severe bleeding leads to the need for a blood transfusion or 
hysterectomy. 

According to the study the risk of placenta accreta more than doubled 
for those women having their third caesar (one in 175) compared with 
those having their first (one in 413).

By the fourth caesar, the risk was one in 46.

Tippett says she now sees a case of placenta accreta every three to 
four weeks, a huge jump from when she started her obstetrics training 
in the early 80s.

"This study is good evidence – it says to women that caesarean 
section is generally a safe procedure, but if you are planning on 
having a family of three to four children, think very carefully 
before you go down the caesarean section pathway."

Ellwood thinks we've lost sight of the bigger picture.

"It is the third c