Re: [ozmidwifery] dive reflex

[Jenny Cameron]

The dive reflex is a term used to describe the 
newborns ability to close off peripheral circulation and redirect the majority 
of its blood supply to the brain, heart and adrenals. It is a protective 
mechanism to ensure the vital organs are kept functioning in times of critically 
low oxygen. It is called the 'seal diving reflex' because seals do it to survive 
the freezing waters when diving for food etc. It has nothing to do with inhaling 
water or other fluids. Cheers
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch 
ACMIPO Box 1465Howard Springs NT 083508 8983 19260419 528 
717
 
 

  - Original Message - 
  From: 
  Emily 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, January 23, 2006 5:38 
  PM
  Subject: RE: [ozmidwifery] dive 
  reflex
  
  
  
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Re: [ozmidwifery] Co sleeping

[Jenny Cameron]

Totally agree. I know lots of mums (colleagues, 
friends and women I have cared for) who had bub in bed as a matter of course. 
One couple who were up to no: 5 woke up to no babyhe was found peacefully 
sleeping between the mattress and the foot of the bed...perfectly healthy! 
Babies are built to survive and a healthy baby will free its 
airway.  Of course we should be careful if we are sedated etc. But 
that is common sense. Cheers
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch 
ACMIPO Box 1465Howard Springs NT 083508 8983 19260419 528 
717
 
 

  - Original Message - 
  From: 
  Kylie Carberry 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, January 06, 2006 9:53 
  AM
  Subject: Re: [ozmidwifery] Co 
  sleeping
  
  
  
  "There are always gonna be parents that have no interest in having 
  theirchild share a bed with them and expect them to sleep a minimum of 8 
  hours ina row each night"
  Just something on this comment...I have had four children and was never 
  really comfortable sharing a bed with my babies.  I tried but neither me 
  or hubby could sleep with them in there with 
  us. However, I never expected them to sleep 8 
  hours each night.  They had their own room close to ours, were fed on 
  demand, very loved, held and played with lots.  Thre were very content, 
  one wasn't and still isn't.  Just want to point out that mums who don't 
  want to share a bed shouldn't be criticised either.
  Kylie
  

From: "jesse/jayne" <[EMAIL PROTECTED]>Reply-To: 
ozmidwifery@acegraphics.com.auTo: 
Subject: Re: 
[ozmidwifery] Co sleepingDate: Fri, 6 Jan 2006 08:42:02 
+1100>I think this is a bigger deal in the US than here in 
Australia. I never>got anything like the reactions these women are 
describing when I had my>first child 14 years ago. In fact, a couple 
of the midwives where I birthed>my daughter matter of factly told me 
I should put her in the bed with me! I>remember hearing about 
'Ferberising' since the internet became commonplace>but 'controlled 
crying' had a bit of a hold here ever since I can remember.>There are 
always gonna be parents that have no interest in having their>child 
share a bed with them and expect them to sleep a minimum of 8 hours 
in>a row each nightI've noticed it's kind of a thing parents like 
to brag>about, just like early toilet training!>>My 
European mother in law didn't blink an eye when I did it (she did it 
with>all 9 of her children) and Aussie women my mother's age often 
confided that>they did it secretly and had the fear of God put into 
them that they would>suffocate their babies.>>It's sad 
that women can't listen to themselves and their babies to 
begin>with.>>Regards>>Jayne>- 
Original Message ->From: "Gloria Lemay" 
<[EMAIL PROTECTED]>>To: ; 
;>; 
; <@uniserve.com>>Sent: Friday, 
January 06, 2006 4:05 AM>Subject: [ozmidwifery] Co 
sleeping>>> > From Laura Shanley:> 
>> > Did you see the article in last week's Times about 
co-sleeping> > (12/29/05)? Not too bad! I'm enclosing it below. 
The last paragraph> > says it all! Love, Laura> 
>> 
>>http://www.nytimes.com/2005/12/29/fashion/thursdaystyles/29sleep.html?pagewanted=all> 
>> > And Baby Makes Three in One Bed> >> > 
By AMY HARMON> > Published: December 29, 2005> > 
JENNIFER JAKOVICH has spent most of her 5-month-old daughter's life> 
> dodging questions from friends, family and strangers about how and 
where> > Chloe sleeps. But since hearing that Dr. Richard Ferber, 
the country's> > most famous infant sleep expert, has relaxed his 
admonition against> > parents sleeping with their babies, she has 
taken a different tack.> >> > Jennifer and John Jakovich 
(with Chloe) consider themselves vindicated> > by the reversal of 
Dr. Richard Ferber, the infant sleep expert.> > "I now mention 
Ferber's new view while openly admitting to co-sleeping,"> > said 
Ms. Jakovich, an engineer in San Diego. She has broken the news to> 
> friends that Chloe sleeps in the same bed with her and her 
husband,> > John, a computer programmer. "I feel I have now been 
given the green> > light, that it's O.K."> >> 
> The Jackoviches are part of a growing group of American parents 
who> > share a bed with their baby, a common practice in the rest 
of the world,> > which had become nearly taboo in this country. A 
survey by the National> > Institute of Child Health and Human 
Development has found that about> > one-fifth of parents with 
infants up to eight months old said the baby> > usually shared a 
bed with them, more than triple the number of a decade> > 
ago.> >> > The trend appears to be driven largely by the 
increase in breastfeeding> > working mothers, who say it allows 
them to connect with their babies and> > still get some sleep. B

Re: [ozmidwifery] CF screening

[Jenny Cameron]

I agree. I have used this article in teaching 
midwifery. I ask the students to role play it and it really lifts out the 
message about prenatal testing. Better than me giving a whole lot of statistics. 
Cheers
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch 
ACMIPO Box 1465Howard Springs NT 083508 8983 19260419 528 
717
 
 

  - Original Message - 
  From: 
  Ken 
  WArd 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, December 04, 2005 4:11 
  PM
  Subject: RE: [ozmidwifery] CF 
  screening
  
   
  The 
  article is great, and I wish I'd had it for antenatal visits. So many women 
  think if they have all the tests they'll have a ok baby.  We pushed the 
  tests, even though we were supposed to be low intervention.  Have the 
  tests if you want, as Robyn says, it doesn't mean you have to terminate.  
  Can anyone tell us if there is pressure following a positive 
  result?
  
-Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of Judy 
ChapmanSent: Sunday, 4 December 2005 3:13 PMTo: 
ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] CF 
screening
This article on the birthinternational site is good for decisions re 
downs, I am sure it could be extrapolated to CF. 
http://www.birthinternational.com/articles/dietsch01.html
Cheers
JudyRobyn Dempsey 
<[EMAIL PROTECTED]> wrote:

  
  

  Who says that because testing is available, 
  that you have to terminate?
  The testing allows choice.
  My sister has made friends who have children 
  with CF, they knew they carried the gene and took the attitude " I know 
  what to do with CF kids, it doesn't bother me".
  On! ce again, I read judgment.
   
  Testing allows choice.the choice to 
  terminate, or the choice to prepare for a child with extra 
  needs.
   
  Robyn D



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Re: [ozmidwifery] RM birth announcement:)

[Jenny Cameron]

Congratulations Julie and welcome to the world of 
midwifery.
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Julie 
  Garratt 
  To: ozmidwifery@acegraphics.com.au 
  ; [EMAIL PROTECTED] 
  
  Sent: Monday, December 05, 2005 4:11 
  PM
  Subject: [ozmidwifery] RM birth 
  announcement:)
  
  Well I am happy to announce the safe arrival 
  of my university transcript closely followed by my registration and cute 
  little badge after a three year labour at Flinders university.
   Many thanks to the midwives, my fellow 
  students, lecturers and the BMid collective and Ozmid list for their help 
  and support.
   
  I start work on an early at Mt Barker Hospital 
  tomorrow and I cant wait. Yarho!
  Julie Garratt RM :)
   
   
  
  

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Re: [ozmidwifery] question

[Jenny Cameron]

Hello Mary
 
The turtle sign is the main sign but a long slow 
descent of the head is an indication or an alert sign. As is the need for 
mid-cavity forceps. 
 
References:
1) Baxley, E. Gobbo, R. 2004 Shoulder Dystocia Also 
series, Americal Family Physician, vol 68:7, pp 1707-14
 
2) Women's Hospitals Australasia. 2005, Shoulder 
Dystocia, Clinical Practice Guidelines. Available on-line 
 
Re the cord PaO2 levels. I have not found the 
original reference ( it will be in the shipping container with my lecture 
notes!) Haven't forgotten it. 

Cheers
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: Tuesday, November 29, 2005 8:44 
  PM
  Subject: RE: [ozmidwifery] question
  
  
  Jennifer Cameron 
  wrote “The signs of shoulder dystocia are 
  evident before the head is crowned and then the 'turtle' sign appears and 
  clinches the diagnosis so it is full steam ahead and get that baby born” My understanding is that the head 
  retraction on the perineum is the main sign. I realize that  a large baby 
  “could” be one, as is slow 2nd stage in the perineal phase, but 
  these accompany many normal births too.   .  Could you please 
  list the signs that are evident before the head is crowned and also the 
  reference?  Thanks, MM.  PS, a grandmultip client of mine recently 
  birthed a 5.3kg, HC 40cm, Length 60 cm, with no problems.  Had to stand 
  up to do it tho.
  
  
  
  
   
  
  Remember the placenta is beginning 
  to separate at the point of the head being born so the baby is dying of 
  hypoxia and acidosis. ALSO are probably correct on not waiting for 
  restitution.. You could wait all day for restitution and end up with a dead 
  baby. 
  
   
  
   
  
  

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Re: [ozmidwifery] rooming in

[Jenny Cameron]

Good for you Brenda. Mums don't get enough nurturing.
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: "brendamanning" <[EMAIL PROTECTED]>

To: 
Sent: Monday, November 21, 2005 9:57 AM
Subject: Re: [ozmidwifery] rooming in


I work some night duty in a small unit & if mothers ask me to 'mind' their 
babies & take them back for feeds overnight then I do, willingly.


I'm heavily into nurturing women, odd eh ??

The Mums know what they want, if they need to sleep, why would I say no ? 
I am being paid to stay awake & care for women & babies, that's what we do 
!
If they want us to mind their babies we do, it might be the only 
uninterrupted sleep they get for months. We don't ever 'take' the babies 
away, but always respond when asked unless we are flat out.

Are we wrong to help out when requested ?
When we take the babies back for feeds, we help with the nappy changing if 
needed, sit with the Mums,make them tea, provide analgesia or hotpacks & 
give them something to eat after feeds.
Isn't that just a huge basic part of 'caring for women' OR 'mothering the 
mother' ? Wouldn't our mothers do that for us if they were around for the 
feeds in the wee small hours ? Or would our support people shut the door & 
say "go for it, see you in the morning Welcome to motherhood" ! How 
supportive is that ?


Wrong again ???

With kind regards
Brenda Manning
www.themidwife.com.au

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

To: 
Sent: Monday, November 21, 2005 11:00 AM
Subject: Re: [ozmidwifery] rooming in


The obs dont like the idea of mucousy babies staying in the rooms with 
mums. However in most cases where the woman has had a c/s we get the 
fathers to stay the night to help out. There were other issues such as 
unwell mums etc. The women who complained were all multis and basic 
reason was that they were tierd. Last time i checked i was a midwife not 
a nanny  Since we implemented the rooming in policy our primips are 
BF better and going home so much more confident. It will be a shame if it 
goes back.

Zoe
- Original Message - 
From: "Cheryl LHK" <[EMAIL PROTECTED]>

To: 
Sent: Sunday, November 20, 2005 10:29 PM
Subject: RE: [ozmidwifery] rooming in


Just a query?  What are the obst's complaints based on - the same 3 
mothers complaints?  No doubt they were tired and wanted a bit of rest!! 
Welcome to motherhood.





From: "islips" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: [ozmidwifery] rooming in
Date: Sun, 20 Nov 2005 14:56:48 +0800

I wonder if someone can help me put together some stats regarding 
'rooming in' . I work at a large private hospital in Perth . We recently 
closed our night nursery and implemented a 'rooming in policy'. This has 
worked very well in enhancing BF , mothercrafting etc. However due to 3 
mothers and 3 obs complaining it looks as though we will have to change 
the policy. we have a meeting on tuesday and i would like to present 
some current research to the medical profession regarding the benefits 
of rooming in.

thanks
zoe
  - Original Message -
  From: Mary Murphy
  To: ozmidwifery@acegraphics.com.au
  Sent: Saturday, November 19, 2005 7:28 AM
  Subject: RE: [ozmidwifery] question


  Jenny, could you give us the reference please?  Thanks, MM




--

  ", one study demonstrated zero oxygen, because there is no longer any 
utero-placental circulation. This is part of the stimulation for the 
baby to breathe, but the baby is receiving some circulatory volume. "




  Jennifer Cameron FRCNA FACM





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Re: [ozmidwifery] question

[Jenny Cameron]

Cord pH's reflect circumstances intrauterine not 
postpartum When the cord blood is collected immediately at birth for pH 
estimation it is to gauge as accurately as possible the pH at the moment of 
birth where the baby receives its last lot of oxygentated blood via the 
utero-placental circulation. After birth the cord does still pulsate and the 
baby does receive some blood volume but the pH of this blood is probably 
acidotic and is poor in oxygen, one study demonstrated zero oxygen, because 
there is no longer any utero-placental circulation. This is part of the 
stimulation for the baby to breathe, but the baby is receiving some circulatory 
volume. 
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 083508 
8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Anne Clarke 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, November 17, 2005 7:24 
  AM
  Subject: Re: [ozmidwifery] question
  
  Dear Susan,
   
  You could say to them if this is so why do they 
  rely so much on cord ph's ?  One would think when the baby was born 
  and the pulsating cord was still not supplying the baby effectively the cord 
  blood (venous and arterial) was null and void to provide an estimation of 
  oxygenation for the babe.
   
  RegardsAnne ClarkeQueensland
  
- Original Message - 
From: 
Susan 
Cudlipp 
To: midwifery list 
Sent: Wednesday, November 16, 2005 9:30 
PM
Subject: [ozmidwifery] question

I have a question for you wise 
ozmidders.
I was having a discussion today with one of our 
obstetricians regarding cord clamping, and the benefits to the baby of 
delaying this until pulsations cease.  When I mentioned the benefit of 
the baby recieving oxygenated blood via the pulsating cord which could 
assist it's transition to independent respiration particularly if it was 
compromised (etc etc)  the obs was of the view that the pulsations 
could NOT be providing oxygenated blood because the uterus would have 
contracted down and the placenta could no longer be getting oxygen from 
mother's circulation.
Now I know that I have read reams on this and 
this is stated to be one of the benefits, but I could not answer that 
particular question physiologically and convincingly.
The point was also raised that in shoulder 
dystocia, babies die of asphyxiation, which (obs opinion) would not happen 
if they were recieving oxygen via the cord. 
I did print off George Morley's excellent 
papers for this Dr to read but would very much welcome anything that can 
show that the baby would still be receiving oxygenated blood post 
birth.
 
TIA
Sue
 
 
"The only thing necessary for the triumph of 
evil is for good men to do nothing"Edmund 
Burke__ NOD32 1.1289 (20051116) Information 
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Re: [ozmidwifery] question

[Jenny Cameron]

Remember the placenta is beginning to separate at 
the point of the head being born so the baby is dying of hypoxia and acidosis. 
ALSO are probably correct on not waiting for restitution. The signs of shoulder 
dystocia are evident before the head is crowned and then the 'turtle' sign 
appears and clinches the diagnosis so it is full steam ahead and get that baby 
born. You could wait all day for restitution and end up with a dead baby. 

 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Susan 
  Cudlipp 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, November 17, 2005 2:32 
  PM
  Subject: Re: [ozmidwifery] question
  
  Good point Anne!
   
  I did quite a thorough search last night and have 
  printed off some good articles which I will pass on.  However I could not 
  find the answer to why EXACTLY babies die in shoulder dystocia.  If it is 
  asphyxia, then (obs point of view) this proves that the cord is not sustaining 
  them. The ob said to me that if the cord WERE sustaining them there would 
  be no urgency to deliver the body, also quoted from the ALSO course that the 
  fetal Ph drops 0.04 (?)  per minute after delivery of head therefor we 
  should not be waiting for restitution but delivering body ASAP.  (I 
  didn't even go there!!)
  My feeling is that it is more to do with probable 
  cord compression, (although I cannot picture why this should necessarily be so 
  as the body and hence, presumably, the cord, would still be above the 
  pelvic brim) and trauma to the neck usually caused by mis-management (panic) 
  in trying to deliver the shoulders than asphyxia, but it is true that they 
  become asphyxiated within a short time if truly stuck.  Any answers on 
  that one?
  Thanks
  Sue
   
  "The only thing necessary for the triumph of evil is for good men to do 
  nothing"Edmund Burke
  
- Original Message - 
From: 
Anne 
Clarke 
To: ozmidwifery@acegraphics.com.au 

Sent: Thursday, November 17, 2005 5:54 
AM
Subject: Re: [ozmidwifery] 
question

Dear Susan,
 
You could say to them if this is so why do they 
rely so much on cord ph's ?  One would think when the baby was 
born and the pulsating cord was still not supplying the baby effectively the 
cord blood (venous and arterial) was null and void to provide an 
estimation of oxygenation for the babe.
 
RegardsAnne ClarkeQueensland

  - Original Message - 
  From: 
  Susan 
  Cudlipp 
  To: midwifery list 
  Sent: Wednesday, November 16, 2005 
  9:30 PM
  Subject: [ozmidwifery] question
  
  I have a question for you wise 
  ozmidders.
  I was having a discussion today with one of 
  our obstetricians regarding cord clamping, and the benefits to the baby of 
  delaying this until pulsations cease.  When I mentioned the benefit 
  of the baby recieving oxygenated blood via the pulsating cord which could 
  assist it's transition to independent respiration particularly if it was 
  compromised (etc etc)  the obs was of the view that the pulsations 
  could NOT be providing oxygenated blood because the uterus would have 
  contracted down and the placenta could no longer be getting oxygen from 
  mother's circulation.
  Now I know that I have read reams on this and 
  this is stated to be one of the benefits, but I could not answer that 
  particular question physiologically and convincingly.
  The point was also raised that in shoulder 
  dystocia, babies die of asphyxiation, which (obs opinion) would not happen 
  if they were recieving oxygen via the cord. 
  I did print off George Morley's excellent 
  papers for this Dr to read but would very much welcome anything that can 
  show that the baby would still be receiving oxygenated blood post 
  birth.
   
  TIA
  Sue
   
   
  "The only thing necessary for the triumph of 
  evil is for good men to do nothing"Edmund 
  Burke__ NOD32 1.1289 (20051116) Information 
  __This message was checked by NOD32 antivirus 
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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 
  
  
  

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Re: [ozmidwifery] Strep B screening

[Jenny Cameron]

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 
  
  

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[ozmidwifery] re medicalised birth etc

[Jenny Cameron]

A strategy I use in medicalised situations is to create or imagine a 
midwifery circle around me. As I look after a birthing woman (or a woman at any 
other phase in the childbirth journey) it is midwifery care that happens in that 
special space. So no matter how many 'pings' there she is in the care of a 
midwife and I am doing midwifery. Hope this makes sense. 
 
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

Re: [ozmidwifery] lizard - THIS IS HILARIOUS

[Jenny Cameron]

Helen
 
Don't feel silly, not all lizards lay eggs, some 
are live bearers and many reptiles have a bifid penis which could be mistaken 
for a tiny foot. Men are so heartless! However, women have better memories, just 
bide your time! Thanks for sharing this gem. Cheers
 
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch 
ACMIPO Box 1465Howard Springs NT 083508 8983 19260419 528 
717
 
 

  - Original Message - 
  From: 
  Helen and Graham 
  To: ozmidwifery 
  Sent: Thursday, October 27, 2005 7:40 
  PM
  Subject: [ozmidwifery] lizard - THIS IS 
  HILARIOUS
  
   
  Lizard Birthing 
  StoryIf you have 
  raised kids (or been one), and gone through the petsyndrome including 
  toilet-flush burials for dead goldfish, the story below will have you laughing 
  out LOUD!Overview: I had to take my son's lizard to the vet.Here's 
  what happened:Just after dinner one night, my son came up to tell me there 
  was"something wrong" with one of the two lizards he holds prisoner in his 
  room."He's just lying here looking sick," he told me."I'm serious, 
  Mom. Can you help?"I put my best lizard-healer statement on my face 
  and followed him into his bedroom. One of the little lizards was indeed 
  lying on his back, looking stressed. I immediately knew what to 
  do.>"Honey," I called, "come look at the lizard!"
  
  
  
  
  
  
  
  
  "Oh my gosh," my 
  husband diagnosed after a minute."She's having babies.""What?" my 
  son demanded. "But their names are Bert and Ernie, Dad!" I was equally 
  outraged. "Hey, how can that be? I thought we said we didn't want them to 
  reproduce," I accused my husband."Well, what do you want me to do, 
  post a sign in their cage?" heinquired.(I actually think he said this 
  sarcastically!)"No, but you were supposed to get two boys!" I reminded 
  him, (in mymost loving, calm, sweet voice, while gritting my teeth 
  together)."Yeah, Bert and Ernie!" my son agreed."Well, it's 
  just a little hard to tell on some guys, you know," Heinformed me. (Again 
  with the sarcasm, you think?)
  By now the rest of the family had gathered to see what 
  was going on. I shrugged, deciding to make the best of it. "Kids, this is 
  going to be a wondrous experience," I announced. "We're about to witness 
  the miracle of birth." OH, Gross!" they shrieked.Well, isn't 
  THAT just great! What are we going to do with a litter oftiny little 
  lizard babies?" my husband wanted to know. (I really do think he was being 
  snotty here, too, don't you?)We peered at the patient. After much 
  struggling, what looked like atiny foot would appear briefly, vanishing a 
  scant second later."We don't appear to be making much progress," I 
  noted."Its breech," my husband whispered, horrified."Do 
  something, Mom!" my son urged."Okay, okay." Squeamishly, I reached in 
  and grabbed the foot when it next appeared, giving it a gingerly tug. It 
  disappeared. I tried several more times with the same results."Should 
  I call 911?" my eldest son wanted to know."Maybe they could talk us 
  through the trauma." (You see a pattern here with the men in my 
  house?)"Let's get Ernie to the vet," I said grimly. We drove to the 
  vet withmy son holding the cage in his lap."Breathe, Ernie, 
  breathe," he urged."I don't think lizards do Lamaze," his father noted 
  to him. (Men can be so cruel to their own young. I mean what he does to me 
  is one thing, but this boy is of his loins, for God's sake.)The vet 
  took Ernie back to the examining room and peered at the little animal 
  through a magnifying glass."What do you think, Doc, a C-section?" I 
  suggested scientifically."Oh, very interesting," he murmured. "Mr and 
  Mrs. Cameron, may I speak to you privately for a moment?"I gulped, 
  nodding for my son to step outside."Is Ernie going to be okay?" my 
  husband asked."Oh, perfectly," the vet assured us. "This lizard is not 
  in labour. In fact, that isn't EVER going to happen...Ernie is a boy. You 
  see, Ernie is a young male. And occasionally, as they come into maturity, 
  like most male species, they umummasturbate.Just the way he 
  did, lying on his back. "He blushed, glancing at my husband. "Well, you 
  know what I'm saying, Mrs Cameron."We were silent, absorbing 
  this."So Ernie's just...just...Excited," my husband 
  offered."Exactly," the vet replied, relieved that we understood. 
  Moresilence.Then my vicious, cruel husband started to giggle. And 
  giggle. And then even laugh loudly."What's so funny?" I demanded 
  knowing, but not believing that the man I married would commit the upcoming 
  affront to my flawless femininity.Tears were now running down his 
  face."It's just...that...I'm picturing... you pulling on 
  it's...it's...teenylittle..." he gasped for more air to bellow in 
  laughter once more."That's enough," I warned.We thanked the 
  Veterinarian and hurriedly bundled the lizards and our son back into the car. 
  He was glad everything was going to be 

Re: [ozmidwifery] Lactation after ART

[Jenny Cameron]

Fair comment Jo. I realise infertility is a male & female issue, and the 
majority of women with PCOS will breastfeed successfully. I have been a 
midwife for a long time & I have never seen the low supply problems like I 
have lately. I strongly suspect one of the big reasons for the baby not 
feeding well ( which we also see a  lot of),  is doing elective LUSCS (which 
we also do a lot of) at 37 weeks and not the recommended 39-40 weeks.  Best 
wishes for a new baby soon. Cheers

Jenny

Jennifer Cameron FRCNA FACM

PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717


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

To: 
Sent: Monday, October 24, 2005 7:37 PM
Subject: Re: [ozmidwifery] Lactation after ART


I am currently undergoing IVF for secondary infertility. I have PCO, not 
PCOS, but my hormones are without a doubt whacky. However, I breastfed my 
daughter for 2.5 years. The first 3 months, particularly the first 8 weeks 
were utter hell, but not because of low supply. One thing I never had, at 
least early on, was low supply - though I pretty much never felt let down, 
had a late/slow letdown and more of a slow but steady flow than the raging 
torrents of milk some of my friends struggled not to drown their babies in.


Also, it's a big assumption that all these women with lactation problems 
did ART for their own reproductive issues, infertility is considered to be 
something like 30% female, 30% male, 30% both and 10% unexplained. Of the 
cases where the woman has the infertility problem they won't all be 
hormonal, there are lots of other reasons to do ART - she may have blocked 
tubes from previous surgery, carry an unfortunate gene combination that 
makes PGD necessary/preferable, we don't all have PCO/S or endo.


Personally I would say if you are seeing a lot of women with lactation 
problems post ART then the most common feature is likely to be post 
traumatic stress from the ART, shock that they have a live baby at all & 
if they were the one with the problem then also complete and utter loss of 
faith that any part of their reproductive system works at all. Neither 
infertility or ART end when you get pregnant and the pregnancy care that 
most women chose or are forced into through circumstance post ART is not 
likely to have helped them heal before the birth.


Just my two cents.

cheers
Jo

At 11:37 AM +0930 24/10/05, Jenny Cameron wrote:


Hi all

Does anyone have information on the effect on human lactation of assisted 
reproductive technology? I am noticing a lot of poor lactation among women 
who have had a baby by ART. A lot of women seem to be on Domperidone these 
days at the best of times?? Anyone else experiencing these phenomena? It 
does make sense that if the woman's hormonal milieau is such that 
reproduction needs hormonal assistance then lactation is likely to also??? 
Cheers


Jenny

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




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Re: [ozmidwifery] Lactation after ART

[Jenny Cameron]

Hi Barb
 
Can women who adopt without ever having been 
pregnant actually lactate? I thought pregnancy was a prerequisite for the breast 
changes that support lactation, particularly the appearance of secretory 
alveoli. I know women can put a baby on the breast and have bub feed from a 
lact-aid set-up. I would appreciate the references and the process/physiology 
for future teaching. Thanks . Cheers
Jenny
 
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 083508 
8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Barbara 
  Glare & Chris Bright 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, October 24, 2005 7:15 
  PM
  Subject: Re: [ozmidwifery] Lactation 
  after ART
  
  Hi,
   
  I think the answer is.possibly.  
  I tend to agree with Nicole that it's more likely to be birthing 
  interventionist birthing practices which get breastfeeding off to a poor 
  start,  followed up by scheduled breastfeeding which makes brestfeeding 
  successfully a near impossibility.  After all, women can breastfeed 
  past menopause, without ovaries, breastfeed adopted children without ever 
  having given birth.  I wouldn't assume that because a women has to be 
  assisted to get pregnant she won't be able to breastfeed.
   
  I recently helped a woman who had given 
  birth to twins @ 34 weeks.  They were concieved via IVF and the mother 
  had PCOS.  Most of the staff had written her off.  And when I first 
  saw her she was so disheartened because of the small drips of milk she was 
  getting, the babies were being comped and she had to go home 3/4 of an hr from 
  the hospital and leave her babies.  8 weeks later she was fully 
  breastfeeding and babies putting on 200 and 300 g per week each.
   
  Barb
  IBCLC
  
- Original Message - 
From: 
Michelle Windsor 
To: ozmidwifery@acegraphics.com.au 

Sent: Monday, October 24, 2005 7:05 
PM
Subject: Re: [ozmidwifery] Lactation 
after ART

Hi Jenny,
 
This is something that I noticed as well when working in a private 
hospital in Hobart.  The general consensus by the midwives there was 
that if a woman needed help to become pregnant then perhaps there was an 
underlying cause which would then interfere with lactation. The midwives 
there said they had noticed this quite often.
 
Cheers
MichelleJenny Cameron 
<[EMAIL PROTECTED]> wrote:

  

   
  
  Hi all
   
  Does anyone have information on the effect on human lactation of 
  assisted reproductive technology? I am noticing a lot of poor lactation 
  among women who have had a baby by ART. A lot of women seem to be on 
  Domperidone these days at the best of times?? Anyone else experiencing 
  these phenomena? It does make sense that if the woman's hormonal milieau 
  is such that reproduction needs hormonal assistance then lactation is 
  likely to also??? Cheers
   
  Jenny
   
  Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
  1465Howard Springs NT 083508 8983 19260419 528 717
   
   
  


Do you Yahoo!?The 
New Yahoo! Movies: Check out the Latest Trailers, Premiere Photos and full 
Actor Database.
  
  

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Re: [ozmidwifery] Lactation after ART

[Jenny Cameron]

Thank you for this Michelle. I work in a 
private hosp also and that is exactly what we midwives have suggested. Perhaps 
it is more noticeable in private hospitals because the women have more access to 
ART?? (Don't want to start a war there!!). Cheers
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Michelle Windsor 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, October 24, 2005 6:35 
  PM
  Subject: Re: [ozmidwifery] Lactation 
  after ART
  
  Hi Jenny,
   
  This is something that I noticed as well when working in a private 
  hospital in Hobart.  The general consensus by the midwives there was that 
  if a woman needed help to become pregnant then perhaps there was an underlying 
  cause which would then interfere with lactation. The midwives there said they 
  had noticed this quite often.
   
  Cheers
  MichelleJenny Cameron <[EMAIL PROTECTED]> 
  wrote:
  


 

Hi all
 
Does anyone have information on the effect on human lactation of 
assisted reproductive technology? I am noticing a lot of poor lactation 
among women who have had a baby by ART. A lot of women seem to be on 
Domperidone these days at the best of times?? Anyone else experiencing these 
phenomena? It does make sense that if the woman's hormonal milieau is such 
that reproduction needs hormonal assistance then lactation is likely to 
also??? Cheers
 
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  
  
  Do you Yahoo!?The 
  New Yahoo! Movies: Check out the Latest Trailers, Premiere Photos and full 
  Actor Database.
  
  

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[ozmidwifery] low milk & infertility

[Jenny Cameron]

A bit more. I tried searching under low supply & came up with some 
interesting info on PCOS (Polycystic ovary syndrome)and difficulty establishing 
a supply. I suspect a lot of our women who use ART have PCOS as it is a major 
cause of infertility. I'm sure these women are not given information on the link 
between PCOS and difficulty establishing a milk supply. Having this knowledge 
may prevent some of the disappointment and psychological distress these women go 
through trying to establish a supply. Not all women with PCOS will have a low 
supply but from one small study done (n=39) 33% had an insufficient supply and 
67% of the low supply group produced no milk at all. 
http://www.obgyn.net/pcos/articles/childers-chats.htm
Thanks for your input. Cheers
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

Re: [ozmidwifery] Lactation after ART

[Jenny Cameron]

This isn't one woman, there have been several. Even with Domperidone, not 
much milk results.



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


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

To: 
Sent: Tuesday, October 25, 2005 5:49 AM
Subject: Re: [ozmidwifery] Lactation after ART


I wonder if this woman has had reasonable breast growth as a teenager, if 
she was particularly skinny, dieted heaps etc or some sort of breast 
trauma?

Belinda

Jenny Cameron wrote:

Thanks Nicole. This is longer term lactation failure. ie week 4 after 
birth and still only 20 mls per feed or expression, if that! Very odd.

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

- Original Message -
*From:* Nicole Carver <mailto:[EMAIL PROTECTED]>
*To:* ozmidwifery@acegraphics.com.au
<mailto:ozmidwifery@acegraphics.com.au>
*Sent:* Monday, October 24, 2005 12:42 PM
*Subject:* RE: [ozmidwifery] Lactation after ART

Hi Jenny,
Is it that intervention is more common in the management of these
women, particularly if ART has resulted in a multiple pregnancy?
Intervention can interfere with the initiation of lactation for a
number of reasons, as you would be aware.
Nicole.

-Original Message-
*From:* [EMAIL PROTECTED]
<mailto:[EMAIL PROTECTED]>
[mailto:[EMAIL PROTECTED] Behalf Of
*Jenny Cameron
*Sent:* Monday, October 24, 2005 12:08 PM
*To:* ozmidwifery@acegraphics.com.au
*Subject:* [ozmidwifery] Lactation after ART

Hi all
 Does anyone have information on the effect on human lactation
of assisted reproductive technology? I am noticing a lot of
poor lactation among women who have had a baby by ART. A lot
of women seem to be on Domperidone these days at the best of
times?? Anyone else experiencing these phenomena? It does make
sense that if the woman's hormonal milieau is such that
reproduction needs hormonal assistance then lactation is
likely to also??? Cheers
 Jenny
 Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717


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Re: [ozmidwifery] Lactation after ART

[Jenny Cameron]

Thanks Nicole. This is longer term lactation 
failure. ie week 4 after birth and still only 20 mls per feed or _expression_, if 
that! Very odd. 
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Nicole 
  Carver 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, October 24, 2005 12:42 
  PM
  Subject: RE: [ozmidwifery] Lactation 
  after ART
  
  Hi Jenny,
  Is it that intervention is more common in 
  the management of these women, particularly if ART has resulted in a multiple 
  pregnancy? Intervention can interfere with the initiation of lactation for a 
  number of reasons, as you would be aware. 
  Nicole.
  
-Original Message-From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of Jenny 
CameronSent: Monday, October 24, 2005 12:08 PMTo: 
ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Lactation 
after ART 

Hi all
 
Does anyone have information on the effect on human lactation of 
assisted reproductive technology? I am noticing a lot of poor lactation 
among women who have had a baby by ART. A lot of women seem to be on 
Domperidone these days at the best of times?? Anyone else experiencing these 
phenomena? It does make sense that if the woman's hormonal milieau is such 
that reproduction needs hormonal assistance then lactation is likely to 
also??? Cheers
 
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  
  

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[ozmidwifery] Lactation after ART

[Jenny Cameron]

Hi all
 
Does anyone have information on the effect on human lactation of assisted 
reproductive technology? I am noticing a lot of poor lactation among women who 
have had a baby by ART. A lot of women seem to be on Domperidone these days at 
the best of times?? Anyone else experiencing these phenomena? It does make sense 
that if the woman's hormonal milieau is such that reproduction needs hormonal 
assistance then lactation is likely to also??? Cheers
 
Jenny
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

Re: [ozmidwifery] 'Breech birth woman wise'

[Jenny Cameron]

Fantastic Tina, a magic midwifery moment. Wish 
there were more.
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  Tina Pettigrew 
  To: [EMAIL PROTECTED] 
  
  Cc: ozmidwifery@acegraphics.com.au 
  
  Sent: Wednesday, October 19, 2005 5:45 
  PM
  Subject: [ozmidwifery] 'Breech birth 
  woman wise'
  
  
  
  Hi everyone,tis me againjust wanted to 
  share with you that last Friday while I was working in our family birthing 
  unit I had the most awesome of experiences.. being  midwife for a 
  woman with an undiagnosed breech birthWoo Hoo!!! Poor Janine and my fellow 
  midwives at Geelong have had to put up with me walking around with a smile too 
  big for my facesimply one of the most awesome births I have witnessed as 
  this strong and powerful woman birthed her breech baby in the standing 
  position.The baby, a frank breech, just birthed beautifully into my and the 
  woman's third year B Mid follow thru students handsIt was truly and all 
  BMid affair, with the birthing woman herself a 3rd year BMid 
  student!!!
   
  What also adds to the splendor of this birth was 
  that unbeknown to the BMid student and I, the consultant obstetrican did make 
  into the birth but just kept quiet and stood at the back of the room and 
  watched as we facilitated the birth (well we did nothing really as 'hands off 
  the breech' came flooding back from my midwifery education) we just 
  supported/reassured and held the space for the woman who stood strong and 
  powerful and breathed out her baby daughter.I can't stop smiling as on 
  reflection I can't believe that this OB got to witness 'breech birth woman 
  wise'a totally midwifery approach to breech birth!!
   
  The baby was born in good condition, Apgars of 6 
  at 1 and 9 at 5...a quick check over by the paed and she was straight back 
  into her mothers armsthe birth topped off with a wonderful physiological 
  third stage!! 
   
  For those of you close to me, you know that I 
  have had a rough trot the past few months with my midwiferybut such 
  experiences as this help to restore one's faith in the 'power of woman' and 
  reignite the spark that fuels the flame of my passion for midwifery and 
  woman's innate knowlege and wisdom to birth. Trusting in the process of birth, 
  women, and our skills as midwives has always been at the core of my midwifery 
  philosophy...to truly work in partnership with women and trust in their innate 
  abilities to birth safely and joyously is a totally empowering 
  experience...not just for the woman but also for the midwife!!! Maggie Bank's 
  book 'breech birth woman wise' has taken on a whole new meaning for meI 
  continue to be amazed at what woman teach us if we are just humble enough to 
  watch and listen.
   
  Yours in reforming midwifery,Tina 
  Pettigrew.
  
  

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[ozmidwifery] oops

[Jenny Cameron]

Sorry about the cordclamping site, it is no longer. Here are a few 
interesting links.
 
http://www.midwifeinfo.com/feature-cordclamping.php
http://www.who.int/reproductive-health/publications/MSM_98_4/MSM_98_4_chapter4.en.html
http://www.lotusbirth.com/doc/FEB2003Lotusbirth-191.htm
http://www.homebirth.org.uk/thirdstage.htm
http://www.whale.to/a/cord.html
 
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

Re: [ozmidwifery] Induction and third stage labour

[Jenny Cameron]

EDD is just that, an estimated date of delivery. 
Term is 38 to 42 weeks and there is reasonable evidence to offer  induction 
once a woman is 10 days past her EDD, provided it is accurate. Babies are born 
in better condition and there is less mec stained liquor. However it is a 
personal choice and second daily CTG is usually offered if the woman does not 
want induction. If women are induced it does increase the risk of C/S for the 
reasons Nicole outlined and certainly if the cervix is unfavorable.
 
A useful web-site is www.cordclamping.com
 
 Cheers
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box 
1465Howard Springs NT 083508 8983 19260419 528 717
 
 

  - Original Message - 
  From: 
  karen 
  shlegeris 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, October 04, 2005 10:51 
  AM
  Subject: [ozmidwifery] Induction and 
  third stage labour
  
  
  Dear 
  List,
  I’m a birth educator and prenatal 
  yoga teacher in Townsville.  I hope these questions are appropriate for 
  this list and would appreciate information from 
  you:
   
  
Induction.  
Andrea’s Preparing for Birth:Mothers book and the wall poster on cascade of 
intervention states that induction increases the risks of further 
intervention and ultimately caesarean, and that’s what I’ve always taught in 
my Active Birth classes.  However, when challenged for statistics by a 
client in a recent workshop, I looked up Enkin, Kierse etc. who stated that 
induction does not increase the risk of caesareans, recommending that 
induction is recommended soon after a women passes her EDD.  Can anyone 
clear this up for me? 
   
  
Third stage of 
labour.  I was under the belief that if active management of third 
stage was chosen, the cord had to be clamped and cut quickly to avoid an 
over-transfusion of blood from the placenta into the baby.  However, an 
OB recently told a client of mine that even 
if she had a Synto injection, the cord could be left until it stopped 
pulsing.  I’ve checked Myles textbook for midwives but it’s not clear 
on this.  
   
  I appreciate your 
  support.
   
  Best 
  wishes,
  Karen Shlegeris in 
  Townsville
  
  

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Re: [ozmidwifery] CPD

[Jenny Cameron]

 
CPD is certainly overdiagnosed. I believe it is a 
'diagnosis' used to cover a multitude of sins/excuses. One example; recently we 
had a primigravida have a planned C/S for CPD. She was a robust healthy woman 
with a smallish built husband. How one diagnoses CPD in a primigravida unless 
there is a grossly contracted/abnormal pelvis is a mystery to me. I did some 
digging & found out she was sick of herself at 39 weeks and requested a C/S! 
CPD was the reason supplied for the C/S. This is skewing the stats for CPD and 
is a misrepresentation of the real picture. She had a social C/S and that should 
have been recorded. 
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  brendamanning 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, September 20, 2005 3:18 
  PM
  Subject: [ozmidwifery] CPD
  
  Hi listers,
   
  A ?
  Do you think CPD is overdiagnosed ? If so how often would this 
  misdiagnosis occur do you think ? Plus how often is it wrong ?
   
  Any idea where I'd find this info ??
   
  Brenda
  www.themidwife.com.au  
  
  

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Re: [ozmidwifery] developmental hip dysplasia

[Jenny Cameron]

Midwives are capable of performing the test for hip 
dysplasia. It was always part of the routine examination at birth and is, or 
should be, taught to all students learning to be midwives. I think we have 
become a bit lazy with more paeds available now. Every baby should have a top to 
toe check at 4 - 7 days of age and this should include the hip check. This can 
be an important role for midwives. Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 
1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Kylie Carberry 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, September 17, 2005 8:03 
  AM
  Subject: [ozmidwifery] developmental hip 
  dysplasia
  
  
  Hi eveyone,
  I am just wondering if anyone can enlighten me a little on my 18 month old 
  daughter just-diagnosed developmental hip dysplasia.  I am still in 
  disbelief that this was not picked up when she was first born and my 
  paediatrician agreed.  To make things worse he told us that in Wollongong 
  Hospital (where she was born) they used to have a paediatrician who did a 
  routine check for DDH on all of the newborns and all were picked up.  To 
  cut costs the IAHS got rid of this service and according to my paed one or two 
  children are now overlooked.  What angers me is that even with treatment, 
  because she is older, my daughter will face the possibiliity of having ongoing 
  hip problems.  If anyone has any info on this condition (stories you've 
  heard etc) I would greatly appreciate it if you could get in touch with 
  me.  Also, what is the general procedure for the testing the hips and do 
  you guys think a paediatric examination should be routine?
  Thanks so much for having a read of my email,
  Kylie Carberry[EMAIL PROTECTED] 
  
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Re: [ozmidwifery] Friend with breach baby...told CS only options.

[Jenny Cameron]

Hi Debbie
 
Your friend may be interested in Maggie Banks web page. 
She is a NZ midwife specialising in breech birth. 
http://www.birthspirit.co.nz/index.php
 
Also go to the RANZCOG (Royal Australian & New Zealand 
College of Obs & Gyn) web page and check the position statements CObs -1 and 
C Obs -11. See link below. The College of O& G's do not rule out vag breech 
birth (see C 0bs 11)and there is also a statement about the responsibilities of 
O&G's. Best to use this info wisely. 
 
http://www.ranzcog.edu.au/publications/collegestatements.shtml
 

Best wishes
 
Jenny
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Debbie Field 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, September 09, 2005 8:22 
  AM
  Subject: [ozmidwifery] Friend with breach 
  baby...told CS only options.
  
  (i am a mum who had a home birth 3 yrs ago)
   
  Girls i would love some of your wisdom
   
  My friend is full term today and she has been carrying her baby in breach 
  for the last part of the pregnancy. 
  All along the Doctors have been telling her to book a CSin fact their 
  manner was quite demanding and accusing of abuse!
  My friend is a very grounded woman (28yrs) and wishes for a natural 
  birth. 
  She has been told that the baby will not turn.
  She has been told it is too dangerous to deliver breach as the cord can 
  get caught in the birth canal if the shoulders are out and the babies head is 
  in. And that if the chin is up it may suffocate. And they will not deliver 
  breach. Times have definitely changed.
  She requested the CS once contractions start to ensure the baby is 
  ready. 
  She has been advised that the baby is too big and CS must be monday. 
  
  (another friend of mine was told the same thingbaby too big, already 
  over 9lb, must have CS.she naturally delivered a 7.5lb healthy girl)
   
  I guess i would love any ideas, thoughts, suggestions, solutions, options 
  from you wise gals. 
   
  They have booked her CS for monday (NSW central coast)
   
  deb
  x
  
  

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Re: [ozmidwifery] x-rays and other nasties for a pregnant woman

[Jenny Cameron]

Hello All
 
What she may like to do is write to the CEO of the 
hospital in question and tell the story. This is appalling and should not happen 
in today's health care system. This woman is entitled to a full explanation of 
her procedure and given that her consent was obtained under less than adequate 
conditions and was not informed; I believe she warrants an apology as 
well. Women should not be frightened or intimidated to lodge a complaint; it her 
right as a health system user. The information she seeks should have been 
provided by the person ordering the test before the procedure was carried out. 

 
Jenny
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Janet 
  Fraser 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, September 01, 2005 10:24 
  PM
  Subject: [ozmidwifery] x-rays and other 
  nasties for a pregnant woman
  
  Can I please have some 
  thoughts on where to look for info on this? This young woman was admitted to 
  hospital with a suspected clot on the lung and suspected pneumonia. She is 
  really freaked out and I'd love to direct her somewhere specific for 
  information.
  This is direct from 
  her.
  Cheers,
  J
   
   
  "I was taken straight through again the 
  next morning for the other scan, which turned out to me like one of those CT 
  scan things, where you lay down and the machine goes all around you taking 
  photos. The man that did them was nice, but the doctor that came in to 
  'explain' everything was a real wench. She didn't look at me once, and just 
  said that she couldn't guarantee that there would be no risk to the baby, but 
  given that 'it's 20/40..' and she trailed off (wtf does that mean? that there 
  should be no problem? that they would be extra careful?) before shoving a 
  clipboard in my face and getting me to sign a disclaimer that she didn't give 
  me time to read. (That was my fault I know, but not being familiar with 
  hospitals and not having view of mum for reassurance I just signed  ) Anyway, halfway through (trapped under a wide plate that came a cm 
  from my nose) I was told to give them an arm, and was injected with what I now 
  know was the radiation stuff they use to monitor the blood pumping. I asked 
  what it was for, and wasn't answered until it was halfway into me. The whole 
  time I just lay there in tears thinking that I was doing something that was 
  really damaging to my baby, and no one was giving me any answers. 
  Afterwards I was told that there was no clot, but that oxygen wasn't 
  getting to my right lung properly and this meant pneumonia. I was given a 
  quick checkup and more tablets and sent on my way. What makes it worse 
  is that bubs has been very very active every single day since I could properly 
  feel kicks (around 16 weeks) and since Tuesday night I've hardly felt him at 
  all... Just a tiny tiny little bump maybe every couple of hours. That's two 
  days now and I'm really really worried that I've let him be harmed in some 
  way.. I have no idea what to do! Mum says to not worry about it because the 
  doctors wouldn't have given me anything that would hurt the baby, but I feel 
  like something is wrong." 
   
  Joyous Birth Home Birth 
  Forum - a world first!http://www.joyousbirth.info/forums/
   
  Accessing Artemis Birth 
  Trauma Recoveryhttp://health.groups.yahoo.com/group/accessingartemis
  
  

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Re: [ozmidwifery] Subchorionic Haematoma

[Jenny Cameron]

Hi Fiona
 
Sub-chorionic haematoma is the medical term for 
a collection of blood under the placenta, that is between the placenta and the 
wall of the womb. If it is small it won't interfere significantly with the 
function of the placenta and thus the growth of the baby. In my experience some 
women have what is called an edge-bleed from the placenta. For some reason the 
edge of the placenta lifts and continues to bleed on & off through the 
pregnancy. Generally it causes no long term problems for the mother or the baby. 
Occasionally the bleeding can be severe. I looked after a woman recently who 
bled on & off since early pregnancy then had a big bleed at 31 weeks, baby 
was born by emerg C/S and did well after a short period in the Neonatal 
Intensive Care Unit. Most women I have cared for with edge bleeding have carried 
to term. The bleeding has been more of a nuisance factor. Repeated light bleeds 
with admissions to hosp. The bleeding sometimes leaves no trace on ultrasound, 
others may leave a sub-chorionic haematoma. Your friend needs to obtain some 
more info from her Ob about why he thinks baby might come at 24 weeks. Hope this 
helps.
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs 
NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  D & F 
  Gorrel 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, August 18, 2005 12:44 
  PM
  Subject: [ozmidwifery] Subchorionic 
  Haematoma
  
  

  
Dear ozmidders
 
Would anyone have info re subchoroionic haemotoma?  My friend 
has bled since week 12 as is now at 20 weeks.  OB says she may 
make it 24-26 weeks.  Bub still growing beautifully at this 
stage. Any info would be appreciated.  Her biggest fear is a 
massive bleed leading to a hysterectomy.  Is this common? Is the 
condition common?  Will this be likely in any subsequent 
pregnancies.
 
With thanks
 
Fiona
 

  

  
  



  
  

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Re: [ozmidwifery] 5 steps of evidence based practice

[Jenny Cameron]

Hi Sonja
Lesley Page in "The New Midwifery. Science & 
Sensitivity in Practice' gives the 5 steps of evidence-based 
midwifery:
 
1) Finding out what is important to the woman & 
her family;
2) Using information from the clinical 
examination;
3) Seeking & assessing evidence to inform 
decisions;
4) Talking it through;
5) Reflecting on outcomes, feelings and 
consequences.
 
Cheers
Jenny
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Sonja 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, August 19, 2005 9:42 
  AM
  Subject: [ozmidwifery] 5 steps of 
  evidence based practice
  
  would any of you wise women know where I could 
  find information on the "5 steps of evidence based practice"?
  Thanks Sonja
  
  

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Re: [ozmidwifery] Doctor dystocia

[Jenny Cameron]

Julia, your comment at the end says it 
all...'so many women think that this is the best care available'. 
Midwives still have a big task in front of them to educate the public. 
I work in a private hospital and I have a 'smiley' name badge that says 
Jenny. Midwife. But most of our customers, both women and 
general patients still call me 'nurse'. I've have never referred to myself as a 
nurse at this hospital, nor do I have have nurse written anywhere on my I.D. I 
believe we need to get into the kinders and primary schools and teach the next 
generation of parents about healthy reproduction practices. Might be an 
interesting project for midwifery students to do? Introduce the concept of 
midwife to the kids. Cheers
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Julie 
  Garratt 
  To: Ozmidwifery 
  Sent: Wednesday, August 17, 2005 10:38 
  AM
  Subject: [ozmidwifery] Doctor 
  dystocia
  
  Doctor dystocia... Definition, when the private 
  obstetrician walks into the room, the baby can no longer fit through the 
  pelvis!
   
   Well that's what I feel after spending a 
  shift in one of Adelaide's "best' private hospitals over the weekend. Their 
  stats for the last 12 mths confirmed this, around a 50 to 55% caesarean 
  rate every month and shockingly  35 % of the women left had either 
  ventouse or forceps! Can someone please tell me why this is hapening? Lots of 
  epidurals? are the doctors in a hurry?
   
  No wonder ranzcog think childbirth is dangerous, 
  in some places it really is! Time to do some 
  media on the safety of obstetric care .?! Absolutely!
  I know that I'm preaching to the converted, buy 
  I'm horrified that so many women think that this is the best care 
  available.
  Julie, 3rd year BMid FUSA
   
  
  

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Re: [ozmidwifery] Clinical experiences

[Jenny Cameron]

Hi Lindsay

What about Mackay?

Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Lindsay Kennedy" <[EMAIL PROTECTED]>

To: 
Sent: Tuesday, August 16, 2005 11:47 AM
Subject: [ozmidwifery] Clinical experiences



Hi
For my Diploma of midwifery I need to do some hours of 'alternative
birthing'.  Originally I planned to go to Selangor in Nambour, but am
worried about the cost and practicality of this.  The other possibility is
Mareeba as it is closer... can anyone give me some input or ideas?  I live
in Townsville.  Ideally I am looking to do 2 weeks in October as I have
leave booked.
Thanks
Lindsay



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Re: [ozmidwifery] Midwifery refresher

[Jenny Cameron]

ACMI have an upskilling package. It was on sale at 
the recent ICM conference. It is a CD and a manual. Your friend will also need 
to arrange some supervised practice. The relevant State regulatory board should 
have the details of what is required.
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Michelle Windsor 
  To: Ozmidwifery 
  Sent: Monday, August 08, 2005 5:31 
  PM
  Subject: [ozmidwifery] Midwifery 
  refresher
  
  Hi,
   
  Have a query from a friend who has been out of mid for about 15 
  years.  She is wondering if anyone knows of any learning packages/modules 
  that she can do to up-date her knowledge and skills.  Would appreciate 
  any info that anyone has. 
   
  Thanks in advance
  Michelle
  
  
  Do you Yahoo!?Try 
  Yahoo! Photomail Beta: Send up to 300 photos in one email! 
  
  

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[ozmidwifery] PNMM

[Jenny Cameron]

Hello All
 
Perinatal mortality & morbidity meeting are for midwives, GP's & 
Obs. These meetings are an important risk management tool to identify practice 
issues. They should be conducted in the 'no fault' manner. The information 
shared in the meetings is protected by a section of law giving protection 
from FOI. Between section 32 and 47 in FOI Act are the exemptions to the Act. 
All healthcare institutions should have a process in place for review of 
practice and protection of the information disclosed in the meetings. Midwives 
should not be excluded from these meetings. Cheers and I'm still hearing those 
lovely tones of the Bittersweet symphony!!
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

Re: [ozmidwifery] Things/g. Lemay

[Jenny Cameron]

Melissa
Perhaps neck stretching due to the face presenting 
resulted in excess stimulation to the vagus nerve resulting in profound 
bradycardia. Baby probably did have a heart rate; just very slow and hard to 
hear or palpate. It is very unusual for cardiac arrest to occur in a neonate and 
when it does it is usually not possible to reuscitate the baby. It is a terminal 
event. 
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Melissa Singer 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, July 19, 2005 11:34 
  AM
  Subject: Re: [ozmidwifery] Things/g. 
  Lemay
  
  Last week I attended a birth with mentum anterior 
  (diagnosed on view).  Head was born then 3 minutes later the rest of the 
  baby.  Apgars 3, 5, 7, 7.  Wt 4.7kgs, peri intact.  Why were 
  the apgars at birth so low (no heart rate at all when born) and the fetal 
  heart rate had been fine during her rapid labour and second sage and some 
  baby's sit there for seven minutes without a problem?
   
  Melissa
  
- Original Message - 
From: 
Tania 
Smallwood 
To: ozmidwifery@acegraphics.com.au 

Sent: Tuesday, July 19, 2005 5:53 
AM
Subject: RE: [ozmidwifery] Things/g. 
Lemay


Well it must have 
been the moon then…last Friday my colleague and I went to see a woman for an 
antenatal appt, all well at 39 weeks, and then 30 minutes later SROM while 
we were on our way to the next appt, 40 minutes of labour, hubby rushing 
through the door, no equipment, kids scissors boiling in a pot on the stove, 
cord ties thrown together with embroidery thread, baby born in the 
spa!  Lovely, but what a rush for all!
 
Tania
x
 




From: 
owner-ozmidwifery@acegraphics.com.au 
[mailto:owner-ozmidwifery@acegraphics.com.au] 
On Behalf Of Gloria 
LemaySent: Tuesday, 19 
July 2005 3:25 AMTo: 
ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Things/g. 
Lemay
 

Congratulations, Mary!  
Last Thurs night I attended a face presentation where the little mentum 
anterior face/head just sat there turning purple for way longer than I 
needed.  Same thing, tincture of time and it rotated and squooshed into 
Dad's hands with only 1/2 inch tear.  That must have been some crazy 
midwife moon!  Gloria

  
  - Original Message - 
  
  
  From: Mary 
  Murphy 
  
  To: ozmidwifery@acegraphics.com.au 
  
  
  Sent: 
  Monday, July 18, 2005 5:24 AM
  
  Subject: 
  [ozmidwifery] Things/g. Lemay
  
   
  

  Hi Gloria, 
  remember I said I would ask the mother about posting her C/S Lotus 
  Placenta on Midwifery Today?  She said it is fine with her.// Re 
  the delay with the head before birth of the body?   Lieve 
  said it might be the moon?   A week ago I was 2nd 
  midwife at a lovely home waterbirth and guess what?  Baby’s head 
  was born and 7 minutes later the body was born with the next available 
  contraction.  It did seem like a long time and the primary 
  midwife and I had to hold our mouths shut so we wouldn’t do the “just 
  give a little push” instruction. All well. No  need to do 
  anything except talk to the baby. Cheers, 
  MM
  
  

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[ozmidwifery] Fw: Inspired

[Jenny Cameron]

FYI
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717
- Original Message - 
From: ACMI 
To: [EMAIL PROTECTED] 
Sent: Saturday, July 02, 2005 4:46 AM
Subject: FW: Inspired


Can I have some feedback on this request 
please
I wouldn’t know where to 
start
 

Regards 
Beth
Bethany 
Leditschke
Office 
manager
Australian College of 
Midwives
(02) 6230 
7333




 
Hello,
I am a mother of an 8 year old and 6 year 
old and am 36 years of age..   I have been reading some of your 
articles as I am very very interested in doing the Bachelor of Midwifery 
(applying to ACU).   I am a little daunted at 
the thought but also feel strongly about working in this area….  I teach 
Pre-Natal Yoga and love being with the Women (it always feels like such an 
honour) to be with them through the months but I feel I want to do and know more 
hence considering the work of a Midwife.  

 
I am wondering if anyone has the time to 
let me know what I am in for re hours per week of lectures and study time… I am 
of course going to attend the open day in August, but would love to hear from a 
student how they cope and if you know of any other mothers doing the 
degree.
 



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Re: [ozmidwifery] broken collar bone & subsequent birth

[Jenny Cameron]

Some resources for shoulder dystocia. A # clavicle is not a big issue in a 
neonate and doesn't necessarily mean excessive force was used. The neonates 
bones are pliable and the # is usually a 'greenstick' or partial break or 
bend in the bone and heals very well.


http://www.aafp.org/afp/20040401/1707.html
http://www.thefarm.org/midwives/dystocia.html
http://www.gentlebirth.org/archives/shoulderDystocia.html
http://www.who.int/reproductive-health/impac/Symptoms/Shoulder_dystocia_S83_S85.html

Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Nigel & Berni" <[EMAIL PROTECTED]>

To: 
Sent: Thursday, June 23, 2005 10:30 PM
Subject: [ozmidwifery] broken collar bone & subsequent birth



Hi folks,
I have posting below a message received on another list in case anyone 
here

would be so kind as to share some of their wisdom, and hopefully help this
woman with info for her second birth.

Any help would be greatly appreciated
Bernadine





Hi Everyone,
I don't normally write anything on TC Net - I am more of a silent

listener.

But I was actually wanting some advice (Not really regarding B/Feeding).
I am due to give birth to my 2nd baby in about 4 weeks and I have just

been

told I may have to have a caesarean - I know this is not a BAD thing but
from the minute I fell pregnant again I never questioned having another
natural labour.
The reason for the caesarean is because my first born was born with a

broken

collar bone. I was wondering if anyone else had experienced the same

thing,

and had a natural birth the 2nd time?
I am not overly concerned about the caesarean as my Gyno will perform the
operation - it is the weeks of healing that worries me.
Especially with a 2 year old!
I am looking so forward to being able to go through labour again,
knowing what I know now - that I didn't know back then. I really want to

try

No drugs (if I can) and breastfeed straightaway and do the things Sue Cox
suggests.
So if there is any suggestions or personal stories I would love to hear
them.

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Re: [ozmidwifery] Flat Spots

[Jenny Cameron]

 
This article may be useful re the flat 
spots.
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;112/1/199
 
Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Safetsleep 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, June 21, 2005 6:53 
PM
  Subject: Re: [ozmidwifery] Flat 
  Spots
  
  you may want to see  FAQ section ,Medical 
  Facts and Testimonials on www.safetsleep.com
   
  twelve years of collated data and wisdom there 
  you may find the published article in NZ Medical Journal of 
  interest?
   
  we have now worked  voluntarily with 54 
  families whose babies of various ages (eldest being 18 months) were considered 
  by cranio-facial plastic surgeons to require either helmet therapy or 
  surgery!! we managed to asist 53 of these babies to avoid these unpleasant and 
  unnatural interventions by working with the Hospital clinicaly tested product 
  Safe T Sleep Sleepwrap and the extra assistance mainly mentioned in Question s 
  4 and 5 of the FAQ section.
   
  it seems many cranio-facial plastic surgeons will 
  no longer accept these PWS (postional plagiocephaly without synostosis) 
  referrals as they are unable to copewe have been informed by a Canadian 
  cranio-facial plastic surgeon, Dr Tristan de Chalain that most NZ, Canadian 
  (not sure about Australian) cranio-facial plastic surgeons, are now forwarding 
  their referrals on to the SIDS Paediatricians. This of course as these 
  Paediatricians insist that there isn't a problem.; quoting technicaly 
  correctly that "most "babies heads return to a 'normal' shape. According to Dr 
  Tristan de Chalain globally well over 20% of babies heads never return to 
  'acceptable shape'the American Academy of Paediatrics considers it is at 
  least twice as high.
   
  happy researching!.and educating.we have 
  been very moved by the distress of affected parents and what some of the 
  babies have had to go through. 
   
  we are hoping to make it to the Brisbane 
  conference next monthi will try to ship across the relevant international 
  studies if people are interested...as it all costs, and so much of what we do 
  is voluntary
   
  do let us know
  truth, joy and godbless
  miriam
  educator/inventor
   
   
  
- Original Message - 
From: 
wendy hoey 

To: ozmidwifery@acegraphics.com.au 

Sent: Tuesday, June 21, 2005 8:14 
PM
Subject: Re: [ozmidwifery] Flat 
Spots

Kirsten,
   I have a 
friend who's baby developed not only a large flat spot but it was 
also asymmetrical, by the time she was sitting up it looked like 
someone had taken her head in two hands and squashed it on an angle if that 
sounds right!, it was very noticable and stressful for her mum. Her GP 
referred her to a paed/ortho spec. who sent her to a physio at the 
big children's hospital here. The physio made a foam pillow 
tailored to her head which she slept on, not sure for how long, and 
seemed to work. She's now 5 and stiil has a flattish but normal 
looking skull hidden under masses of hair. Her second child has had no 
problems at all, she did all the switching ends of cot with the first the 
same as the second. Maybe we all have different bone strength in our 
skulls!
cheers
Wendy.

  - Original Message - 
  From: 
  Diane Gardner 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, June 20, 2005 1:30 
  PM
  Subject: [ozmidwifery] Flat 
  Spots
  
  Kirsten
  Recommend your client to a gentle chiropractor or an 
  oesteopath, who treat babies, for an adjustment. Often the baby's neck is 
  out (especially in a difficult delivery) and they find 
  it uncomfortable to sleep in a different position. 
  
   
  I have found many feeding problems and also sleeping problems 
  are corrected because everything has settled back into the correct 
  position.
   
  Diane
  
  

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  6/06/2005

Re: [ozmidwifery] Midwifery in East Timor

[Jenny Cameron]

Hi Margaret
A couple of useful sites for maternal & child 
health education for midwives.
 
http://www.who.int/topics/maternal_health/en/
http://www.reproline.jhu.edu/index.htm
http://www.pepcourse.co.za/index.html
Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Margaret 
  Aggar 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, June 19, 2005 2:04 PM
  Subject: [ozmidwifery] Midwifery in East 
  Timor
  
  Dear All,
   
  I am a Midwife and Childbirth Educator working on the Central Coast of 
  NSW.  I went to East Timor in May, after hearing that their mortality 
  rate is 100 times that of Australia!  Only 10% of the women birth with a 
  trained professional present.  Many birth alone, or with an untrained 
  relative or friend.  There are village women who assist with births in 
  the remote villages.  One village I visited was a 9 hour bus trip 
  from Dili (just 180 kms away).  
   
  I have been asked to provide some training for these women in the remote 
  villages so that they are able to better care for these women and reduce the 
  poor outcomes, and to be able to recognise problems during the pregnancy so 
  that they can be moved into Dili before birth.
   
  I am working on a training package at present, which will need to be 
  translated into Tetum.  The training will take place at a Clinic in Dili 
  where there are about 60 births / month.  I also need to become more 
  fluent in their language - Tetum.  I will return to East Timor either 
  later this year, or early next year.  
   
  This is a voluntary venture, and the training will be provided free of 
  charge for the village women, with accomodation included.  I will be 
  looking for sponsorship for this as well as resources for these women to use 
  in their villages at the completion of the training.  It is anticipated 
  that this will be on-going, with maybe two trips / year to check and see how 
  they are going and provide more training.  There are 5 women interested 
  in the training at present.
   
  If there is anyone who may have an interest in assisting with this 
  training, or assisting in some way, or would like to know more, please contact 
  me via email.
   
  Regards,
   
  Margaret
  Send instant messages to your online friends http://au.messenger.yahoo.com 
  
  

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  6/06/2005

Re: [ozmidwifery] syntocinon crossing into the brain?

[Jenny Cameron]

Title: Re: [ozmidwifery] sexual abuse and labour



No, synthetic oxytocin does not cross the 
blood-brain barrier, or at least very little of it. Read Sarah Buckleys info. 

http://www.acegraphics.com.au/articles/sarah01.html
Cheers
Jenny

  - Original Message - 
  From: 
  Janet 
  Fraser 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, June 06, 2005 10:59 
AM
  Subject: [ozmidwifery] syntocinon 
  crossing into the brain?
  
  Can someone help me with a 
  question about this? There was a study done on nasal inhalation of syntocinon 
  acting a little like the real deal oxytocin and inducing a trusting emotional 
  state in the sniffer.
   
  Does syntocinon cross into 
  the brain? Obviously oxytocin originates there and affects the brain but can 
  IV syntocinon for augmentation/induction of labour have a similar 
  effect?
   
  I hope a pro can make sense 
  of this query!
   
  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
  
  

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  31/05/2005

Re: [ozmidwifery] Authors needed

[Jenny Cameron]

I think this is it plus a few 
others.
Jenny
 
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=15802414

  - Original 
  - 
  From: 
  Denise Hynd 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, June 05, 2005 11:03 
AM
  Subject: [ozmidwifery] Authors 
  needed
  
  
  Does any one have access to the Obs & Gyn Journal and can tell me the 
  authors of this article??
   
  ‘Readmission more likely after cesarean than vaginal birth.’ Obstetrics 
  & Gynecology 2005; 105: 836-42
  Thank you
   
  Denise Hynd
   
  "Let us support one another, not just in 
  philosophy but in action, for the sake of freedom for all women to choose 
  exactly how and by whom, if by anyone, our bodies will be 
  handled."
   
  — Linda Hes
  
  

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  31/05/2005

Re: [ozmidwifery] MidResearch

[Jenny Cameron]

The following link has relevant info. Instruction on how to take BP in preg. 
This is the consensus statement for Australia


http://www.racp.edu.au/asshp/news.htm

Jenny

- Original Message - 
From: "Ceri & Katrina" <[EMAIL PROTECTED]>

To: 
Sent: Wednesday, June 01, 2005 9:18 PM
Subject: Re: [ozmidwifery] MidResearch


On the topic of research, does anyone have any evidence on why we take BP 
on the right arm antenatally??  And any other guidelines or evidence on 
'how' to take the BP???


thanks

Katrina

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Re: [ozmidwifery] Pain relief resources

[Jenny Cameron]

The Maternitywise site from USA has some good info

http://www.maternitywise.org/mw/topics/pain/evidence.html

Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Kelly @ BellyBelly" <[EMAIL PROTECTED]>

To: 
Sent: Tuesday, May 24, 2005 9:40 AM
Subject: [ozmidwifery] Pain relief resources


Hello everyone!

I was wondering if someone could please point me to some recommended
accurate, up-to-date resources on pain relief in labour, as I am writing an
article on BellyBelly (to accompany the natural birth article I wrote for
this month) about the various forms of current pain relief and the real
risks for mother and baby. I already have Sarah Buckley's article on
Epidurals but I would like to cover all methods of pain relief in the one
article. There seems to be a great deal of out-dated information people are
getting hold of and discussing them across websites (particularly lots of
american info), so I would like to provide something more reliable and
hopefully local. I'd like to write about what medications are contained in
the forms of pain relief, side effects, any stats and general information on
how they are applied etc.

Any personal comments or experiences would be gladly accepted also.

Thank-you in advance!

Best Regards,

Kelly Zantey
Director, www.bellybelly.com.au & www.toys4tikes.com.au
Gentle Solutions For Conception, Pregnancy, Birth & Baby
Australian Little Tikes Specialists

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Re: [ozmidwifery] re epidural top ups and iv cannulation

[Jenny Cameron]

Agree Marilyn. I have seen a baby develop GBS. He was a normal birth at 
term, good Apgars. No prolonged ROM. Became ill very quickly (within one 
hour of birth), profound apneas & brady's, collapsed & died with 24 hours of 
birth. A big contributing factor to his death was delay in starting him on 
AB's. The tricky thing with newborns is that they don't always become 
febrile in response to infection, even a severe one. More likely a drop in 
temp. This case was many years ago & a baby presenting like that now would 
be given AB's immediately until proven otherwise. GBS has an incidence of 
1:1000 and good midwifery care will detect a sick or becoming sick infant. I 
wonder about the issue of antibiotic resistance, although this is less 
likely with Penicillin than the broad spectrums. WHO have big concerns about 
antibiotic resistance. 30% is a lot of women and babies.

Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>

To: 
Sent: Tuesday, May 24, 2005 3:09 PM
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation



What your describing is the risk based protocol vs the culture based one.
UNfortunately the recent evidence shows more babies were missed using the
risk based protocol that the culture based one. This is all covered on the
web sites posted. Whenever you practice prophylactic treatments you are
going to be treating some people unnecessarily it's the nature of the
beast!! We don't have the test(tests) to positively identify those mthers
who have a 100% chance of their babies becoming septic with GBS. And yes 
it

does become a pathogen again we don't know all the triggers that make it
change from being normal flora. Of course women refuse the antibiotics and 
I
personally have never known anyone who has had a baby become ill or die 
from

GBS disease. And I have attended births at home and in hospital with women
who have refused the antibiotics(after testing positive) or who birthed
before the iv could be set up and we simply watched the baby closely
especially taking temp's 4/24 for 48 hours and regularly for the first 
week.

However, if you read the web sites you must become aware that thinking you
can pick who will have a sick baby from health status of the mother can be
risky and erroneous. Though I have to say I would think babies in the
one-to-one continuity of care model would be much safer than those with
multiple providers and early discharge.

marilyn

- Original Message - 
From: "Ken WArd" <[EMAIL PROTECTED]>

To: 
Sent: Monday, May 23, 2005 3:14 AM
Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation



Do they really need iv ab's, or are we over treating as usual?  The vast
majority of these babies are fine. Maybe we should only be treating those
women with prom, not those in active labour, especially those with intact
membranes.  Another reason for leaving membranes intact i.e. no arm's.
as we all carry GBS can it be pathologic?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Jenny Cameron
Sent: Monday, 23 May 2005 10:34 AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation


I guess not if they need IV antibiotics.
Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message -
From: "Sally Westbury" <[EMAIL PROTECTED]>
To: 
Sent: Sunday, May 22, 2005 3:30 PM
Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation


> 30% of women are not normal???? Gosh.
>
> -Original Message-
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] On Behalf Of Jenny 
> Cameron

> Sent: Sunday, May 22, 2005 1:27 PM
> To: ozmidwifery@acegraphics.com.au
> Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation
>
> GBS is not normal. What is the cut-off point for midwifery care & scope
> of
> Px?
>
> Jennifer Cameron FRCNA FACM
> PO Box 1465
> Howard Springs NT 0835
>
> 0419 528 717
> - Original Message -
> From: "Ken WArd" <[EMAIL PROTECTED]>
> To: 
> Sent: Saturday, May 21, 2005 5:06 PM
> Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation
>
>
>> Why involve an obs for GBS? As long as correct procedure is followed,
>> there
>> is little chance of transmission. We give oral abs if prom iv in
> labour.
>> We
>> don't induce for 48hrs, rather just keep an eye on the woman's temp
> and
>> ctg
>> at 18hrs and and 24hrs following. We have never had a problem. Our drs
> rx
>> the abs, antenatally when the woman is diagnosed at 37/40.  A lot of
> our
>> women elect not to be swabbed, and again no probs

Re: [ozmidwifery] re epidural top ups and iv cannulation

[Jenny Cameron]

I guess not if they need IV antibiotics.
Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Sally Westbury" <[EMAIL PROTECTED]>

To: 
Sent: Sunday, May 22, 2005 3:30 PM
Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation



30% of women are not normal Gosh.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Jenny Cameron
Sent: Sunday, May 22, 2005 1:27 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation

GBS is not normal. What is the cut-off point for midwifery care & scope
of 
Px?


Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Ken WArd" <[EMAIL PROTECTED]>

To: 
Sent: Saturday, May 21, 2005 5:06 PM
Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation


Why involve an obs for GBS? As long as correct procedure is followed, 
there

is little chance of transmission. We give oral abs if prom iv in
labour. 

We
don't induce for 48hrs, rather just keep an eye on the woman's temp
and 

ctg
at 18hrs and and 24hrs following. We have never had a problem. Our drs

rx

the abs, antenatally when the woman is diagnosed at 37/40.  A lot of

our
women elect not to be swabbed, and again no probs. All babies are 
monitored

temp etc for 24hrs and parents aware of what to watch for.  Lets keep

drs

away from normal women having nice pregnancies and babies

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Jenny

Cameron

Sent: Saturday, 21 May 2005 12:39 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation


I take everyones point about it being useful and probably essential

for

midwives in rural areas to be able to cannulate but don't forget the

core

skills of midwifery practice during labour are support and assessment

of

progress and the ability to recognise potential problems. I don't feel
comfortable hearing that midwives are performing induction of labour
cannulations etc. Or inserting bungs for IV antis for GBS for that

matter,

If a woman is GBS pos then she should be referred and OBs involved.

Who

orders the antis??

Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message -
From: "Miriam Hannay" <[EMAIL PROTECTED]>
To: 
Sent: Saturday, May 21, 2005 7:43 AM
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation



From a student's perspective any discussion on what
constitutes a core midwifery skill really interests
me.

we have a template that needs to be completed and
signed off by supervising midwives regarding epidural
maintenance. we are supposed to witness a few and then
do the top ups ourselves and also remove the catheter
after the birth, document etc. This is obviously
regarded as an important midwifery skill by our
educators. However, I know of VERY few students who
have been given the opportunity to acquire cannulation
skills. In the tertiary hospital I am currently placed
in the RMOs do all the cannulation. Midwives can do it
but must do a course to become accredited. This course
is not available to students, and as far as i am
aware, you must have done a grad years in the hospital
to access the course. To me this seems ridiculous! I
have no intention of doing a GMP, instead intending to
apprentice in private practice before setting out my
own shingle. How on earth can I safely practice in the
private sector if i am not confident in establishing
iv access? to me this is a core midwifery skill that
while hopefully rarely utilised is of critical
importance when needed. It is a skill I would much
prefer to develop than doing maintenance and clean up
for our anaeshetists.

Also, on the thread of epidurals and instrumental
births...in my limited experience what Marilyn
mentions is borne out. I have been involved in several
births with epidural blocks and have only seen
instrumental birth needed when coached pushing was
utlised. In those cases where the power of the uterus
was allowed to facilitate descent until we had head on
view no assistance was required. The power of these
women's bodies birthed their babies despite the block
and it was marvellous to watch.

Miriam (2nd year Bachelor of Midwifery Flinders uni of
SA)


--- Marilyn Kleidon <[EMAIL PROTECTED]> wrote:

LOvely, Alesa that is exactly how I had experienced
epidurals being set up in the USA. However, I have
been told here that these large syringes that
require top ups are more innovative than the
infusion (pcea) pumps : I can't see how, even though
I can see (in some ways) that if this is the
technology we are using then midwives should be ofay
with it?? And yes I had never experienced the
epidural as being anything but turned off in 

Re: [ozmidwifery] GBS

[Jenny Cameron]

Thanks I am well aware of the guidelines.
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>

To: 
Sent: Monday, May 23, 2005 9:12 AM
Subject: Re: [ozmidwifery] GBS



Exactly 20to 30% of otherwise healthy women will test positive for GBS by
either urine culture or  lvs at 37/40 wks: we have no way of knowing which
GBS positive women will have a GBS septic baby and, in fact most GBS
positive women wont!! Somehow some women who are gbs positive transmit
immunity to their baby or themselves and others don't which is why the
antibiotics ordered are for GBS prophylaxis not illness. As Mary said we 
are

not treating an illness. Check out the GBS guidelines
at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5111a1.htm .
marilyn

- Original Message - 
From: "Mary Murphy" <[EMAIL PROTECTED]>

To: 
Sent: Saturday, May 21, 2005 11:29 PM
Subject: [ozmidwifery] GBS



GBS is part of the normal flora of a large number of women.  It causes

some

difficulty to some babies but not to all babies, even those that are
colonized.  Colonization does not mean illness.  MM

GBS is not normal. What is the cut-off point for midwifery care & scope 
of

Px?


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Re: [ozmidwifery] re epidural top ups and iv cannulation

[Jenny Cameron]

GBS is not normal. What is the cut-off point for midwifery care & scope of 
Px?


Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Ken WArd" <[EMAIL PROTECTED]>

To: 
Sent: Saturday, May 21, 2005 5:06 PM
Subject: RE: [ozmidwifery] re epidural top ups and iv cannulation


Why involve an obs for GBS? As long as correct procedure is followed, 
there
is little chance of transmission. We give oral abs if prom iv in labour. 
We
don't induce for 48hrs, rather just keep an eye on the woman's temp and 
ctg

at 18hrs and and 24hrs following. We have never had a problem. Our drs rx
the abs, antenatally when the woman is diagnosed at 37/40.  A lot of our
women elect not to be swabbed, and again no probs. All babies are 
monitored

temp etc for 24hrs and parents aware of what to watch for.  Lets keep drs
away from normal women having nice pregnancies and babies

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Jenny Cameron
Sent: Saturday, 21 May 2005 12:39 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation


I take everyones point about it being useful and probably essential for
midwives in rural areas to be able to cannulate but don't forget the core
skills of midwifery practice during labour are support and assessment of
progress and the ability to recognise potential problems. I don't feel
comfortable hearing that midwives are performing induction of labour
cannulations etc. Or inserting bungs for IV antis for GBS for that matter,
If a woman is GBS pos then she should be referred and OBs involved. Who
orders the antis??

Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message -
From: "Miriam Hannay" <[EMAIL PROTECTED]>
To: 
Sent: Saturday, May 21, 2005 7:43 AM
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation



From a student's perspective any discussion on what
constitutes a core midwifery skill really interests
me.

we have a template that needs to be completed and
signed off by supervising midwives regarding epidural
maintenance. we are supposed to witness a few and then
do the top ups ourselves and also remove the catheter
after the birth, document etc. This is obviously
regarded as an important midwifery skill by our
educators. However, I know of VERY few students who
have been given the opportunity to acquire cannulation
skills. In the tertiary hospital I am currently placed
in the RMOs do all the cannulation. Midwives can do it
but must do a course to become accredited. This course
is not available to students, and as far as i am
aware, you must have done a grad years in the hospital
to access the course. To me this seems ridiculous! I
have no intention of doing a GMP, instead intending to
apprentice in private practice before setting out my
own shingle. How on earth can I safely practice in the
private sector if i am not confident in establishing
iv access? to me this is a core midwifery skill that
while hopefully rarely utilised is of critical
importance when needed. It is a skill I would much
prefer to develop than doing maintenance and clean up
for our anaeshetists.

Also, on the thread of epidurals and instrumental
births...in my limited experience what Marilyn
mentions is borne out. I have been involved in several
births with epidural blocks and have only seen
instrumental birth needed when coached pushing was
utlised. In those cases where the power of the uterus
was allowed to facilitate descent until we had head on
view no assistance was required. The power of these
women's bodies birthed their babies despite the block
and it was marvellous to watch.

Miriam (2nd year Bachelor of Midwifery Flinders uni of
SA)


--- Marilyn Kleidon <[EMAIL PROTECTED]> wrote:

LOvely, Alesa that is exactly how I had experienced
epidurals being set up in the USA. However, I have
been told here that these large syringes that
require top ups are more innovative than the
infusion (pcea) pumps : I can't see how, even though
I can see (in some ways) that if this is the
technology we are using then midwives should be ofay
with it?? And yes I had never experienced the
epidural as being anything but turned off in second
stage in fact, at least until 2002 when i left it
was common practice to allow passive descent so that
active pushing did not commence until the head was
on view. With this practice I saw very few
instrumental births.  Can anyone give me the
justification for these syringe type epidurals
requiring top ups over the infusion pumps?

marilyn
  - Original Message -
  From: Alesa Koziol
  To: ozmidwifery
  Sent: Friday, May 20, 2005 6:17 AM
  Subject: [ozmidwifery] re epidural top ups


  Dear List
  Have read this thread with great interest. Not
wishing to get into the debate regarding whose skill
it is to p

Re: [ozmidwifery] re epidural top ups and iv cannulation

[Jenny Cameron]

I take everyones point about it being useful and probably essential for 
midwives in rural areas to be able to cannulate but don't forget the core 
skills of midwifery practice during labour are support and assessment of 
progress and the ability to recognise potential problems. I don't feel 
comfortable hearing that midwives are performing induction of labour 
cannulations etc. Or inserting bungs for IV antis for GBS for that matter, 
If a woman is GBS pos then she should be referred and OBs involved. Who 
orders the antis??

Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835
0419 528 717
- Original Message - 
From: "Miriam Hannay" <[EMAIL PROTECTED]>
To: 
Sent: Saturday, May 21, 2005 7:43 AM
Subject: Re: [ozmidwifery] re epidural top ups and iv cannulation


From a student's perspective any discussion on what
constitutes a core midwifery skill really interests
me.
we have a template that needs to be completed and
signed off by supervising midwives regarding epidural
maintenance. we are supposed to witness a few and then
do the top ups ourselves and also remove the catheter
after the birth, document etc. This is obviously
regarded as an important midwifery skill by our
educators. However, I know of VERY few students who
have been given the opportunity to acquire cannulation
skills. In the tertiary hospital I am currently placed
in the RMOs do all the cannulation. Midwives can do it
but must do a course to become accredited. This course
is not available to students, and as far as i am
aware, you must have done a grad years in the hospital
to access the course. To me this seems ridiculous! I
have no intention of doing a GMP, instead intending to
apprentice in private practice before setting out my
own shingle. How on earth can I safely practice in the
private sector if i am not confident in establishing
iv access? to me this is a core midwifery skill that
while hopefully rarely utilised is of critical
importance when needed. It is a skill I would much
prefer to develop than doing maintenance and clean up
for our anaeshetists.
Also, on the thread of epidurals and instrumental
births...in my limited experience what Marilyn
mentions is borne out. I have been involved in several
births with epidural blocks and have only seen
instrumental birth needed when coached pushing was
utlised. In those cases where the power of the uterus
was allowed to facilitate descent until we had head on
view no assistance was required. The power of these
women's bodies birthed their babies despite the block
and it was marvellous to watch.
Miriam (2nd year Bachelor of Midwifery Flinders uni of
SA)
--- Marilyn Kleidon <[EMAIL PROTECTED]> wrote:
LOvely, Alesa that is exactly how I had experienced
epidurals being set up in the USA. However, I have
been told here that these large syringes that
require top ups are more innovative than the
infusion (pcea) pumps : I can't see how, even though
I can see (in some ways) that if this is the
technology we are using then midwives should be ofay
with it?? And yes I had never experienced the
epidural as being anything but turned off in second
stage in fact, at least until 2002 when i left it
was common practice to allow passive descent so that
active pushing did not commence until the head was
on view. With this practice I saw very few
instrumental births.  Can anyone give me the
justification for these syringe type epidurals
requiring top ups over the infusion pumps?
marilyn
  - Original Message - 
  From: Alesa Koziol
  To: ozmidwifery
  Sent: Friday, May 20, 2005 6:17 AM
  Subject: [ozmidwifery] re epidural top ups

  Dear List
  Have read this thread with great interest. Not
wishing to get into the debate regarding whose skill
it is to perform this task I just wanted to share
our experience. The move away from an epidural that
required top ups in labour to infusion pumps came
about when the midwives refused to perform the
topups or push a bolus down the epidural line
manually. We insisted on the anaesthetists doing
this task as they were responsible for the integrity
of the line and most certainly for its placement.
Our anaesthetists got sick of returning again and
again to do this and researched an alternative for
themselves that we were happy to work with. In our
setting a midwife will assist the anaesthetist with
equipment required for epidural insertion, however
she never ever pushes any fluids down the line
manually. Priming the line is all done by the
anaesthetist, he/she connects all lines, filter and
tubing to a syringe and together they check the
settings on the syringe driver and turn it on. Works
for us, women have the analgesia they request,
midwives turn the pump off when second stage is
noted and many women push their infant actively-
although there is still a high number of
instrumental births
  Cheers
  Alesa
  Alesa Koziol
  Clinical Midwifery Educator
  Melbourne
Find local movie times and trailers on Yahoo! Movies.
http://au.movies.yahoo.com

Re: [ozmidwifery] re epidural top ups

[Jenny Cameron]

Where I work we have the epidural PCA with the 
syringe arrangement. They work very well. Good pain relief, mobility and the 
ability to push baby out. I was pleasantly surprised as the last place I worked 
in  the anaesthetists couldn't seem to get the mobility thing right. There 
we used infusions with boluses. 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Marilyn 
  Kleidon 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, May 21, 2005 11:46 
  PM
  Subject: Re: [ozmidwifery] re epidural 
  top ups
  
  LOvely, Alesa that is exactly how I had 
  experienced epidurals being set up in the USA. However, I have been told here 
  that these large syringes that require top ups are more innovative than the 
  infusion (pcea) pumps : I can't see how, even though I can see (in some 
  ways) that if this is the technology we are using then midwives should be ofay 
  with it?? And yes I had never experienced the epidural as being anything but 
  turned off in second stage in fact, at least until 2002 when i left it was 
  common practice to allow passive descent so that active pushing did not 
  commence until the head was on view. With this practice I saw very few 
  instrumental births.  Can anyone give me the justification for these 
  syringe type epidurals requiring top ups over the infusion pumps?
   
  marilyn
  
- Original Message - 
From: 
Alesa 
Koziol 
To: ozmidwifery 
Sent: Friday, May 20, 2005 6:17 
AM
Subject: [ozmidwifery] re epidural top 
ups

Dear List
Have read this thread with great interest. Not 
wishing to get into the debate regarding whose skill it is to perform this 
task I just wanted to share our experience. The move away from 
an epidural that required top ups in 
labour to infusion pumps came about when the midwives refused to perform the 
topups or push a bolus down the epidural line manually. We insisted on the 
anaesthetists doing this task as they were responsible for the integrity of 
the line and most certainly for its placement. Our anaesthetists got sick of 
returning again and again to do this and researched an alternative for 
themselves that we were happy to work with. In our setting a midwife will 
assist the anaesthetist with equipment required for epidural insertion, 
however she never ever pushes any fluids down the line manually. 
Priming the line is all done by the anaesthetist, he/she connects all lines, 
filter and tubing to a syringe and together they check the settings on 
the syringe driver and turn it on. Works for us, women have the analgesia 
they request, midwives turn the pump off when second stage is noted and many 
women push their infant actively- although there is still a high number of 
instrumental births
Cheers
Alesa
 
Alesa KoziolClinical Midwifery 
EducatorMelbourne
  
  

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Re: [ozmidwifery] Epidural top-up Policy

[Jenny Cameron]

Title: Re: [ozmidwifery] Epidural top-up Policy



Not where I worked .
J
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Marilyn 
  Kleidon 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, May 21, 2005 10:10 
  AM
  Subject: Re: [ozmidwifery] Epidural 
  top-up Policy
  
  I can't agree about the iv insertion either. How 
  can any midwife practice independently if she can't insert an iv. And it is 
  too a nursing skill in most of the world. If Australian nurses are not 
  inserting iv's now what were they doing 30 years ago? Definetly inserting 
  IV's.
   
  marilyn
  
- Original Message ----- 
From: 
    Jenny 
Cameron 
To: ozmidwifery@acegraphics.com.au 

Sent: Thursday, May 19, 2005 7:33 
PM
Subject: Re: [ozmidwifery] Epidural 
top-up Policy

Well said Justine
 
For the first 3-4 years of my midwifery 
experience epidurals were not an option for women where I worked. OK they 
are now but it is not the role of a midwife to top them up. I believe 
topping up is the job of the anaesthetist, the same as inserting IV's is not 
a midwifery role ( or a nursing one for that matter). This all about dumping 
the scut work on to women. Tasks like topping up are the housework of health 
care; too menial for docs to do, same with IV insertion. Prostaglandin gel 
insertion is now housework , the newness has faded so now the drudge 
(midwife) can do that. Am I too cynical...no, a midwife with both feet on 
the ground. Cheers, see you all in Brisbane.
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 
1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Justine Caines 
  To: OzMid List 
  Sent: Thursday, May 19, 2005 9:37 
  PM
  Subject: Re: [ozmidwifery] Epidural 
  top-up Policy
  Dear Lisa 
  and AllYou seem to have missed my point.  I did not advocate 
  against women choosing an epidural, I said the use of epidurals should 
  not be within a midwifery scope of practice and I stand by that. 
   I find it insane when a fraction of midwives actually work as 
  midwives and yet we yell and scram to keep supporting all the 
  obstetric who ha.  Don't worry all that stuff is very safe. 
   I agree every womanneeds a midwife, regardless (but topping up 
  the epidural is not being a midwife)As to who should do it, yes 
  let the Drs go for it, it's their domain!  If midwives determined 
  what was and wasn't midwifery then we would have real changein this 
  country NOW.We will never see midwifery practiced fully while 
  there is such support for an obstetric model with all its trappings. 
   The balance is so severely skewed it is time to get realand 
  establish what is midwifery and the right of healthy women to access 
  it exclusively.With less than .2 of 1% of women being able to be 
  cared for by a known midwifeand yet women being able to demand 
  epidurals, social inductions, and elec c/s I know where the work 
  needs to be done.As a woman I have paid $14,000 for homebirths, 
  with not a cent in return.  Yet I pay for the 30% rebate for 
  privately insured women to have the works.  Something has to 
  give.I really believe midwifery on the whole to be with well women 
  with only an emotional and supportive role for women accessing medical 
  care and intervention.Just because 80% of women currently receive 
  intervention and many blindly ask for it doesn’t mean it’s right, 
  or that they are informed.  Most women are told an epidural can’t 
  harm the baby!!  How can we say women really want/need an 
  epidural when 99% of them are forced to share their most intimate 
  moment with a stranger and nearly as many of them can’t even use warm 
  water immersion and they are in a system that sets them up for failure 
  (pelvis too small, big baby, unreal labour time frames etc 
  etc!).What we know is that where midwives form a relationship with 
  women the use of drugs is slashed.  In our local unitEpidurals 
  are hard to obtain and consequently 2 are done each year, what makes these 
  women different to the city womenwhere it is peddled??Hope 
  this clarifies Justine
  
  

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Re: [ozmidwifery] Epidural top-up Policy

[Jenny Cameron]

Title: Re: [ozmidwifery] Epidural top-up Policy



Well said Justine
 
For the first 3-4 years of my midwifery experience 
epidurals were not an option for women where I worked. OK they are now but it is 
not the role of a midwife to top them up. I believe topping up is the job of the 
anaesthetist, the same as inserting IV's is not a midwifery role ( or a nursing 
one for that matter). This all about dumping the scut work on to women. Tasks 
like topping up are the housework of health care; too menial for docs to do, 
same with IV insertion. Prostaglandin gel insertion is now housework , the 
newness has faded so now the drudge (midwife) can do that. Am I too 
cynical...no, a midwife with both feet on the ground. Cheers, see you all in 
Brisbane.
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 
1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Justine Caines 
  To: OzMid List 
  Sent: Thursday, May 19, 2005 9:37 
PM
  Subject: Re: [ozmidwifery] Epidural 
  top-up Policy
  Dear Lisa and 
  AllYou seem to have missed my point.  I did not advocate against 
  women choosing an epidural, I said the use of epidurals should not be 
  within a midwifery scope of practice and I stand by that.  I find it 
  insane when a fraction of midwives actually work as midwives and yet we 
  yell and scram to keep supporting all the obstetric who ha.  Don't 
  worry all that stuff is very safe.  I agree every womanneeds a 
  midwife, regardless (but topping up the epidural is not being a 
  midwife)As to who should do it, yes let the Drs go for it, it's their 
  domain!  If midwives determined what was and wasn't midwifery then we 
  would have real changein this country NOW.We will never see 
  midwifery practiced fully while there is such support for an obstetric model 
  with all its trappings.  The balance is so severely skewed it is time 
  to get realand establish what is midwifery and the right of healthy women 
  to access it exclusively.With less than .2 of 1% of women being able 
  to be cared for by a known midwifeand yet women being able to demand 
  epidurals, social inductions, and elec c/s I know where the work 
  needs to be done.As a woman I have paid $14,000 for homebirths, with 
  not a cent in return.  Yet I pay for the 30% rebate for 
  privately insured women to have the works.  Something has to 
  give.I really believe midwifery on the whole to be with well women 
  with only an emotional and supportive role for women accessing medical 
  care and intervention.Just because 80% of women currently receive 
  intervention and many blindly ask for it doesn’t mean it’s right, or 
  that they are informed.  Most women are told an epidural can’t harm the 
  baby!!  How can we say women really want/need an epidural when 99% of 
  them are forced to share their most intimate moment with a stranger and 
  nearly as many of them can’t even use warm water immersion and they are in a 
  system that sets them up for failure (pelvis too small, big baby, unreal 
  labour time frames etc etc!).What we know is that where midwives form 
  a relationship with women the use of drugs is slashed.  In our local 
  unitEpidurals are hard to obtain and consequently 2 are done each year, 
  what makes these women different to the city womenwhere it is 
  peddled??Hope this clarifies 
  Justine
  
  

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Re: [ozmidwifery] Iron infusion

[Jenny Cameron]

Without knowing her iron stores I would say avoid the iron infusion. A Hb of 
9 should correct well with a good diet with adequate red meat and regular 
exercise. It will be much slower if she does not eat red meat. If she feels 
well & milk supply is adequate I believe the risks of an iron infusion 
(anaphylaxis & death) do not outweigh the benefits in this case. A person 
having an iron infusion is cared for in a High Dependency unit whilst the 
infuion is in progress because of the risk of anaphylaxis. Iron is a highly 
toxic substance. Hope this helps. Cheers
Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Sue Cookson" <[EMAIL PROTECTED]>
To: 
Sent: Monday, May 16, 2005 6:19 PM
Subject: [ozmidwifery] Iron infusion


Hi,
Not too sure if this isn't part of the same thread about 'dramatic' 
women,.
What do any of you know about the risks/benefits of iron infusions after a 
PPH?
Hb @ 5 weeks is 91, but mother active, walking, good milk supply (always), 
happy...
Anyway, she's been advised by a medico to have an iron infusion and I can 
find very little in any of my Obs or midwifery texts.
Looking forward to your wise responses,

Sue
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Re: [ozmidwifery] Dramatic women

[Jenny Cameron]

It is a bit bewildering for women these days when 
there is so much to choose from and different levels of caregiver. It is the 
caregivers who make such a big deal of childbirth. The mere fact that we have 
set up & offer childbirth preparation classes says something. What are 
we really preparing women for ? Is is how to give birth or how to behave in 
the system we have constructed? Even the midwife-woman partnership is midwife 
constructed. Some women are choosing to have C/S because it is there and they 
want a predictable no labour pain birth; their caregiver hasn't even mentioned 
C/S. It is a complex social issue.
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Rachele 
  Meredith 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, May 15, 2005 12:01 PM
  Subject: Re: [ozmidwifery] Dramatic 
  women
  
  Mary,
   
  I have read Gloria's remark in the past and I 
  must say that I do not agree.  My observation is purely anecdotal and not 
  at all scientific, but from what I have observed, women end up with a high 
  rate of intervention because they are told they need it.
   
  When I was younger and poorer and myself and my 
  friends did not have private health insurance, we went to the public hospital 
  to have our babies.  We went through the midwives clinic and most of us 
  had straightforward births.  Very few c-secs, epidurals and 
  dramas.
   
  I now have a uni degree and a job that goes along 
  with it.  My colleagues have private health insurance and nearly every 
  one of them - several women at my work have had babies in the last two years - 
  has had a c-sec.  The *one* who had a vaginal birth had a long labour 
  with epidural and instrumental delivery, lots of stitches, a full term baby 
  who ended up in NICU for a week due to epidural fever which *could have* meant 
  an infection, prophylactic abx, breastfeeding issues, etc.  This woman is 
  so traumatised by her experience that she insists she will never have another 
  baby unless it is by c-sec.  Those that DID have c-secs had them because 
  they were told they were necessary.  Every one of those women planned a 
  "natural" birth and enrolled in birth classes with this in mind.
   
  The reasons they were given for *needing* a 
  c-sec?  One was 7 days past EDD ("very dangerous" said Dr) so she was 
  sectioned - not even induced!  One was told that her baby was way too big 
  to be born vaginally - bubs turned out to be the same size as the woman's 
  first baby!  Another was a failed induction, she was 7 days past EDD 
  and was told this is "very dangerous".  Her doctor also told her he had 
  never, in his decades of practice, seen an induction that didn't work.  
  Another was diagnosed with GD and told baby was too big and due to the GD the 
  birth could be complicated.  Another had pre-eclampsia and the babies 
  (twins) were delivered via c-sec at 28 weeks (she was told vaginal birth is 
  too risky for premmies).  Another was told she had to have a c-sec 
  because she was "high-risk" due to an incident of spotting in her tenth week 
  of pregnancy and the RSI in her wrists.  Another was sectioned because 
  the baby would be too big - bubs was 5lb 11oz.
   
  Incidentally, all but two of these women were in 
  their 20s when they had their babies.  Also, most of them were told after 
  the sugery that it was a good thing the c-sec had been done because the baby 
  was facing the wrong way and had the cord around its neck so it could not have 
  been born vaginally (or would have been stillborn).
   
  There are three women currently pregnant at my work, including 
  myself.  The other two are seeing private OBs and planning "natural" 
  births in the private hospital.  One has already been told that she may 
  have problems as she had such severe morning sickness it could mean something 
  is wrong.  The other is due around the same time as me (October) and told 
  me recently that she believes a doctor's advice NOT to read or research during 
  pregnancy is a good thing.  We talked about prenatal testing and she 
  feels that it is important to have all the tests (becuase her doctor siad 
  to)  and that she will trust him to act appropriately on the 
  results.  She will not do any research into any of this herself but trust 
  him to do his job.
   
  In my last pregnancy (my daughter is 21 months old) I had the scans and 
  tests I was told to have (until I changed my caregiver halfway through the 
  pregnancy).  Early bloods revealed high AFP levels which meant my baby 
  *could* have a neural tube defect.  The 18 week scan revealed my baby's 
  kidneys *may* be a bit on the small side which *could* mean a problem.  
  Also I had a low-lying placenta which *could* mean dramas at the birth.  
  Turned out bubs was normal, her kidneys are fine and the placenta was closer 
  to my ribs than my cervix by the time I was full 

Re: [ozmidwifery] research register?

[Jenny Cameron]

Sounds like something ACMI could 
administer.
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Dean 
  & Jo 
  To: ozmidwifery@acegraphics.com.au 
  
  Cc: [EMAIL PROTECTED] 
  
  Sent: Thursday, April 14, 2005 5:41 
  PM
  Subject: [ozmidwifery] research 
  register?
  
  
  Is there a kind of register of 
  what topics are being researched in midwifery circles?  
   
  Just 
  interested.  ;o)
   
  Jo
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Re: [ozmidwifery] Foetal positioning

[Jenny Cameron]

Hello all
 
These researchers would be better spending their 
research dollars on a copy of 'optimal fetal positioning' or 'the labour 
progress handbook'. It is the most redundant and wasteful piece of research I 
have seen. If it such an obstetric challenge then why not do some investigation 
into the effect of different positions in labour. There is a large study around 
that demonstrates that most posterior presentations happen during labour and not 
before. The title of their research should read 'Obstetric disposition and 
maternal malposition lengthens labour and .sorrycouldn't help 
it!
 
Still believing one day common sense will 
prevail..
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Sally Westbury 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Wednesday, April 13, 2005 7:59 
  PM
  Subject: [ozmidwifery] Foetal 
  positioning
  
  
  Foetal malposition 
  lengthens labour and poses maternal risksSource: Obstetrics 
  & Gynaecology 2005; 
  105: 763-72
  Assessing the 
  impact of foetal position at full dilatation on labour duration and indicators 
  of maternal morbidity. 
  
  Pregnant women 
  with occiput posterior or transverse position at full dilatation are at 
  increased risk of a prolonged second stage of labour and of maternal 
  morbidity, research shows. 
  "Since 
  Mauriceau's classical work was published in 1681, the occiput posterior and 
  transverse malpositions have remained an obstetric challenge," write Julie 
  Senecal (Laval 
  University, 
  Canada) and colleagues. 
  
  For the current 
  study, the team assessed the effect of such foetal positions on the duration 
  of the second stage of labour and on indicators of maternal morbidity, using 
  retrospective data for 210 women whose foetus was in the posterior position, 
  200 with it in a transverse position, and 1198 with an anteriorly positioned 
  foetus. 
  This revealed 
  that foetal malposition at full dilatation was associated with significant 
  maternal morbidity, including increased risks of instrumental delivery, 
  caesarean delivery, oxytocin administration, episiotomy, and blood loss 
  exceeding 500 ml. 
  In addition, the 
  duration of the second stage of labour with early or delayed pushing was 
  higher for transverse (3.6 hours and 2.5 hours, respectively) and posterior 
  (3.8 hours and 3.0 hours, respectively) positions than for the anteriorly 
  positioned group (3.1 hours and 2.2 hours, 
  respectively).
  "Guidelines that 
  propose norms for expected labour duration should take into consideration 
  position of the foetal head at full dilatation and the strategy of pushing," 
  conclude the researchers.
  Posted: 
  12 April 
  2005
   
   
  Sally 
  Westbury
  Homebirth 
  Midwife
   
  "It 
  takes courage to remain a true advocate for women, challenging authority and 
  sacrificing social and professional acceptance. It takes courage for a woman 
  to choose a caregiver who will truly advocate for and empower 
  her."    -Judy Slome Cohain
   
  
  

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Re: [ozmidwifery] Can anyone answer some questions from an English Student Midwife?

[Jenny Cameron]

Julie
 
You will need to check with the relevant state or 
teritory Nurses & Midwifery Board. Entry to practice in nursing in Australia 
is by studies at Degree level. Entry to practice in midwifery is at  
Bachelor degree level or Postgrad diploma. The Australian Nursing and Midwifery 
Council would be a good place to start as they have advice and links to the 
boards. 
 
http://www.anmc.org.au/
 
Good luck with your studies.
 
Jenny
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Julie Castle 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, April 12, 2005 4:04 
  AM
  Subject: [ozmidwifery] Can anyone answer 
  some questions from an English Student Midwife?
  
  Dear Listwives,
   
  If any of you can help with some of my queries it 
  would be much appreciated. First, some background.
   
  I am currently halfway through an Advanced 
  Diploma in Midwifery (Direct Entry) at Bournemouth University. We have been 
  given the option to convert to a degree in our final year (I qualify Sept 
  2006). My husband and I are visiting Perth this year in August with a view to 
  possibly relocating there when I have finished my training. Ok now the 
  questions!
   
  1) If i move to Australia to practise midwifery 
  do I need to have the degree or is the advanced diploma recognised. The reason 
  for this question is if I convert to degree in the final year my bursary will 
  be cut by about £300. 
   
  2) I read on one of the australian midwifery 
  sites that if you have the degree your starting salary is higher. Does anyone 
  know if this is true and does it only apply to Australian trained midwives? 
  
   
  3) If I move to Australia, will I be able to go 
  into caseload practice as a newly qualified midwife or will I be expected to 
  work in a hospital setting first?
   
  Your help and guidance is much 
  appreciated,
   
  Love Julie Castle
  
  

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[ozmidwifery] repairing fetal membranes

[Jenny Cameron]

It seems the platelet plugging technique is effective after amniocentesis 
rather that SROM. Link to abstract below.
 
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15590453
 
 
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

<><>

Re: [ozmidwifery] membranes and surgery

[Jenny Cameron]

Mary
I think that was the context of the article. I'd 
like to read it again.
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, April 09, 2005 6:10 
  PM
  Subject: Re: [ozmidwifery] membranes and 
  surgery
  
  Then why can't they repair very preterm ROM this way?  mm
  
- Original Message - 
From: 
Jenny 
    Cameron 
To: ozmidwifery@acegraphics.com.au 

Sent: Saturday, April 09, 2005 7:54 
AM
Subject: Re: [ozmidwifery] membranes 
and surgery

I read somewhere that fetal mambranes can be 
repaired with a mixture of maternal platelets and other bits. If I find the 
article I will post it to ozmid. Cheers
  
  

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Re: [ozmidwifery] membranes and surgery

[Jenny Cameron]

I read somewhere that fetal mambranes can be 
repaired with a mixture of maternal platelets and other bits. If I find the 
article I will post it to ozmid. Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  katnap076 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, April 08, 2005 5:41 
PM
  Subject: [ozmidwifery] membranes and 
  surgery
  
  Hello, 
  I am a studtent midwife and was looking at a 
  picture in a popular magazine at work and saw a picture of surgery being 
  performed in utero. just wondering how they repair the membranes?
   
   
  Kat
  
  

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Re: [ozmidwifery] PROM @ 35 weeks...

[Jenny Cameron]

http://www.obgmanagement.com/content/obg_featurexml.asp?file=2004/10/obg_1004_00024.xml
 
Hi Tania
Another bit of PPROM info.
J
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Tania Smallwood 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, April 07, 2005 8:11 
  AM
  Subject: [ozmidwifery] PROM @ 35 
  weeks...
  
  Hello wise women,
   
  Just wondering if anyone has handy anything recent on PROM 
  and expectant management vs induction of labour?  I've been reading my 
  ECPC (Enkin et al) but don't have the current one at my fingertips, having 
  lent it out a while ago.  Just wondering if it's still a bit ambiguous 
  regarding the pro's and con's of IOL in this case.  We have a woman just 
  over 35 weeks, who has had a small hind water leak.  No signs of 
  infection, has had U/S and bloods, as well as a great ctg.  She's keen to 
  rest and get to where she can birth at home.  I'm great with that, the 
  hospital is NOT.  Would just like to know I'm giving her good 
  information, as she's been told the old 'your baby might die' stuff at the 
  hospital before checking herself out.
   
  Thanks in advance
   
  Tania
  
  

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Re: [ozmidwifery] PROM @ 35 weeks...

[Jenny Cameron]

Tania ECPC is available on-line at
www.maternitywise.org
Also the Cochrane database has regular 
updates
Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Tania Smallwood 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, April 07, 2005 8:11 
  AM
  Subject: [ozmidwifery] PROM @ 35 
  weeks...
  
  Hello wise women,
   
  Just wondering if anyone has handy anything recent on PROM 
  and expectant management vs induction of labour?  I've been reading my 
  ECPC (Enkin et al) but don't have the current one at my fingertips, having 
  lent it out a while ago.  Just wondering if it's still a bit ambiguous 
  regarding the pro's and con's of IOL in this case.  We have a woman just 
  over 35 weeks, who has had a small hind water leak.  No signs of 
  infection, has had U/S and bloods, as well as a great ctg.  She's keen to 
  rest and get to where she can birth at home.  I'm great with that, the 
  hospital is NOT.  Would just like to know I'm giving her good 
  information, as she's been told the old 'your baby might die' stuff at the 
  hospital before checking herself out.
   
  Thanks in advance
   
  Tania
  
  

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  1/04/2005

Re: [ozmidwifery] Fw: [ababcnet] an article

[Jenny Cameron]

Oh dear.
Jennifer Cameron FRCNA FACMPO Box 
1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Katrina 
  Flora 
  To: ozmid 
  Sent: Tuesday, April 05, 2005 10:00 
  PM
  Subject: [ozmidwifery] Fw: [ababcnet] an 
  article
  
   
   This came through on lactnet 
  today, thought you would be interested, although, don't read if you are 
  prone to high blood pressure..http://www.sitnews.us/Columns/0405/040405_james_glassman.htmlTime 
  for Congress to get serious about WHO's excessesBy James K. 
  GlassmanScripps Howard News ServiceApril 04, 
  2005MondayPaul Volcker's report last week on the oil-for-food 
  scandal uncoveredshocking incompetence and venality at the United Nations. 
  But ifCongress really wants to reform the agency, the place to start is 
  theWorld Health Organization (WHO), which, in the latest absurdity, 
  hasembarked on a campaign to drive baby formula underground - 
  and,eventually, off the face of the earth. The big losers if the WHO 
  issuccessful will, of course, be the world's poor - the same victims 
  ofWHO blunders in fighting HIV/AIDS and malaria.With AIDS, the WHO 
  got a black eye for placing 18 Indian-made ripoffmedicines on its list of 
  approved drugs. Those medicines turned out tobe uncertified copies of the 
  patented HIV drugs from which they werecopied.With malaria, the 
  WHO has refused to encourage the use of DDT andother proven insecticides 
  and has engaged in what a group ofscientists, writing in The Lancet, 
  called "medical malpractice" in itsuse of a poor regime of anti-malarial 
  drugs.A U.N. agency that was set up in 1948, the WHO, more and more, 
  hascome under the influence of radical health and 
  environmentalactivists, who push a bitterly anti-enterprise 
  ideology.Congress should insist that the WHO stick to the basics. 
  Instead,having botched campaigns against the two worst epidemics in the 
  world,the WHO, incredibly, is focusing its attention on the 
  bottle-feedingof infants.You probably remember the infant-formula 
  imbroglio - a real blast fromthe left-wing past. Promoters of 
  breast-feeding managed to smear theuse of healthy formula to nourish 
  babies and discourage marketing ofbottle-feeding products.Now, 
  breasts are back.In January, the WHO recommended the adoption of an 
  extremeanti-bottle-feeding resolution at the 57th World Health Assembly - 
  theWHO's annual meeting, set for mid-May in Geneva. The 
  immediateobjective of the resolution is to force infant-formula packages 
  tocarry warning labels akin to those on cigarettes or liquor. 
  Theultimate goal is to scare mothers into abandoning 
  bottle-feeding.There's a deep irony here. The WHO wants to discourage 
  the use of babyformula, whose efficacy and safety have been established 
  over manydecades - while at the same time, the WHO has been approving 
  untestedanti-AIDS drugs.Certainly, there is no questioning the 
  benefits of breast-feeding. Butmany women lack the time or, in some cases, 
  the health to feed theirbabies from their own breasts. For them, infant 
  formula is anexcellent substitute.For example, if a woman wants to 
  pursue an active career outside thehome, breast-feeding is often 
  impractical. Infant formula provides thefreedom that many women want, and 
  deserve. Trying to make formulaanathema is to thrust such women back to 
  the Dark Ages.This question of choice for women is especially 
  compelling indeveloping nations, where economies are beginning to draw 
  females, aswell as males, into the work force in key positions.But 
  radicals advocate a double standard for the poor - in feedingbabies as 
  well as in HIV therapy.There's a correlation between high rates of 
  infant-formula use and lowrates of infant mortality. The reason is not 
  that infant formula isbetter than breast milk, but that, as a country 
  develops, infanthealth and nutrition improve, and the use of formula, at 
  the sametime, increases.Nestle sells more infant formula in a 
  healthy nation like Belgium thanit does in all of Africa, which has 60 
  times Belgium's population. Thebest way to boost good health in Africa is 
  to boost African economies.And time-saving technologies like infant 
  formula can help.This means that Africans should be able to choose, 
  and not to bescared or shamed into breast-feeding. Radicals and their 
  supporters atthe WHO, however, want to keep African women, in effect, 
  barefoot,denying them the choice, as they modernize, of a healthy, 
  convenientproduct.It's time for Congress to get serious about 
  reining in the excesses ofthe WHO. Defeat this silly resolution in May and 
  insist that theGeneva health bureaucrats concentrate on whipping AIDS and 
  malariawith proven medicines, not on pleasing the 
  ideologues.James K. Glassman is a fellow at the American 
  Enterprise Institute andhost of the Web site 
  TechCentralStation.com-- Merewyn JansonABA counsellor 
  

Re: [ozmidwifery] Midwifery program attracts Fed Government support and funding

[Jenny Cameron]

Well done to Tracy and Deb.
Fantastic. Cheers
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Tracy 
  Smith 
  To: [EMAIL PROTECTED] 
  Sent: Sunday, March 27, 2005 10:26 
  AM
  Subject: [ozmidwifery] Midwifery program 
  attracts Fed Government support and funding
  
  
  Hello fellow midwives, 
  My name is Tracy Smith. A colleague Deb Pattrick and I, developed and manage a 
  life education program called Core of Life. Some subscribers may have heard of 
  it before. This program educates adolescents about the reality of being 
  pregnant, giving birth and parenting a newborn. It is 
  always 
  co-presented with one of the presenters having a background in 
  midwifery and is an incredible opportunity to share midwifery knowledge and 
  normal childbirth with our parents of the future.
   
  This week it was 
  announced that Core of Life has been endorsed by the Australian government and 
  funded through Family and Community Services to expand Nationally over a three 
  year period. We are very excited and would like to thank all those midwives 
  who have encourage and supported us along this 5 year 
  journey.
  It is our endeavour to 
  enlighten all teenagers about the challenge and incredible journey they face 
  with becoming a parent and how midwives and midwifery care can assist and 
  empower them along the way.
  Cheers and Happy Easter 
  (I know mine is now!)
  Tracy 
  Smith
   

Re: [ozmidwifery] Re: implanon and breastfeeding

[Jenny Cameron]

Mmm. Glad I didn't know these vas facts when I was 
in my reproductive years! Cheers all.
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Melanie Gregory 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Tuesday, March 22, 2005 11:11 
  PM
  Subject: RE: [ozmidwifery] Re: implanon 
  and breastfeeding
  
  
  Yep 
  ..forget the vasectomy as foolproof..we have baby number six 9 years after the 
  vasectomyand a lovely little boy he is too !!
   
  
   
  Melanie 
  Gregory
  2 John 
  Street,
  Shenton Park
  Perth  6008
  WA
   home tel.(08) 
  93817970
   
  
  
  
  
  From: owner-ozmidwifery@acegraphics.com.au 
  [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Larissa InnsSent: Tuesday, March 22, 2005 1:49 
  PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Re: implanon and 
  breastfeeding
   
  
  Is there really a 10% risk of 
  uterine puncture? I've not seen that stat yet ( or did I have my eyes shut? 
  LOL).
  
   
  
  As for the vasectomy - nothing is 
  fool proof and I personally know 2 people who had failed vasectomies where 
  they magically regrew back together (the body is very 
  clever!).
  
   
  
  Hugs,Larissa
  

 the 
Mirena was recommended. But my gyn gave me a 10% risk of uterine puncture, 
which made me decide against it. Oral contraceptives are not an option for 
me, which is serously narrowing the choices. That vasectomy is looking 
good!

 

Kate

 

   

Re: Re: [ozmidwifery] First "birth"

[Jenny Cameron]

Public hospitals are there to serve the public. Hospital administrators can 
set all the policies and protocols they like but ultimately it is the 
woman's choice (as long as she is informed) to select her care. It is up to 
practitioners to document their recommendations and if the woman chooses not 
to follow these she does so at her own risk. It all hinges on informed 
consent. Public hospitals cannot throw people out or force them along a 
certain pathway. I know it is stressful and takes courage on the part of the 
midwife & the woman but the system can be 'beaten'. I have been told I am 
not to fit to practise by an Obs because I stood with a woman & supported 
her choice. So be it, I know differently. I have no regrets about my part of 
the decision making. Keep up with the latest evidence and stay strong. 
Cheers
Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: <[EMAIL PROTECTED]>
To: 
Sent: Tuesday, March 22, 2005 6:43 AM
Subject: Re: Re: [ozmidwifery] First "birth"


HI mary
I agree, I am currently on suspension because I tried to shortcut the 
"system" one by
seeing a woman and organising her ante natal required testing outside of 
the clinic and
two by telling her she had a choice, if she wants to have her baby in the 
hospital it
must be done by their protocols, her fears, expectations and wishes don't 
count. It is
just so frustrating
donna


Mary Murphy <[EMAIL PROTECTED]> wrote:
Lindsay wrote> women tell me that going to an Obstetrician means that
they
don't have to
> wait up at the hospital clinics for hours, and at least they see the
same
> person each visit.  I understand where they are coming from, it just
seems
> that, 'one person' they see, should be a Midwife.
Why is it that women have to wait so long at public clinics?  All the
women
I ask to attend a pub clinic for "homebirth backup" booking tell me the
same.  sometimes it is a factor in them not going for the visit and
refusing
to return at a later date.  The Obs has his receptionist and ? one
other?
why do we have so much support staff in hospital clinics and yet it can
take
all morning waiting for an "appointment" . It makes women feel as tho
they
are 2nd class citizens.  Is there an efficiency expert out there that
could
fix this?  MM
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Re: [ozmidwifery] First "birth"

[Jenny Cameron]

Because the Obs do not work their rosters out properly. The obs who is 
running the clinic is also 'on' for all public work...C/S, birth suite etc. 
This is so in at least one public hosp. Probably the bean counters being 
miserable.
Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835

0419 528 717
- Original Message - 
From: "Mary Murphy" <[EMAIL PROTECTED]>
To: 
Sent: Sunday, March 20, 2005 11:45 AM
Subject: Re: [ozmidwifery] First "birth"


Lindsay wrote> women tell me that going to an Obstetrician means that they
don't have to
wait up at the hospital clinics for hours, and at least they see the same
person each visit.  I understand where they are coming from, it just 
seems
that, 'one person' they see, should be a Midwife.
Why is it that women have to wait so long at public clinics?  All the 
women
I ask to attend a pub clinic for "homebirth backup" booking tell me the
same.  sometimes it is a factor in them not going for the visit and 
refusing
to return at a later date.  The Obs has his receptionist and ? one other?
why do we have so much support staff in hospital clinics and yet it can 
take
all morning waiting for an "appointment" . It makes women feel as tho they
are 2nd class citizens.  Is there an efficiency expert out there that 
could
fix this?  MM

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Re: [ozmidwifery] First "birth"

[Jenny Cameron]

Hello Lindsay
It is frustrating working in a pte hospital because the contract is between 
the woman and her practitioner. There isn't anything we can do when we 
finally meet the woman except give her our best care. What we need to do is 
enlighten the next generation. In particular, go into the kinders and 
primary schools and teach the public health benefits of midwifery care and 
normal birth. One of my survival tricks is to create a midwifery circle or 
space around the woman I am caring for and do whatever I can the midwifery 
way. Obs will usually leave BF management and other 'basic'cares up to the 
midwife. During labour we can help women with their pain management before 
resorting to an epidural. There are lots of little 'delaying ' techniques 
that can be implemented such as going to the toilet. This usually takes 
30-40 minutes when women are in good labour, which can mean another 
centimetre!! Hang in there, you will have more choice when you are finished 
your mid course and can work in other settings.
Cheers

Jenny
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835
0419 528 717
- Original Message - 
From: "Mike & Lindsay Kennedy" <[EMAIL PROTECTED]>
To: 
Sent: Saturday, March 19, 2005 10:21 PM
Subject: [ozmidwifery] First "birth"


I am studying to be a Midwife, doing a Diploma of Mid, here in Queensland.
Coming from NZ and having had my babies at home, I have a pretty 'normal'
view of birth, so have found Midwifery here somewhat surprising if not
shocking!  I had the pleasure of 'catching' my first baby last week.  I 
was
a little saddened that my first baby was born by Caesarean Section!!
I have spent the last week working in a private hospital, where it seems
nearly all babies are born by C/s.  It seems so tragic that these women 
who
are paying for the 'best' care are being cheated of what can be the most
rewarding and amazing experience of a woman' life.  I know that some women
need to have c/s, but the first c/s I witnessed was for Breech 
presentation,
imagine my surprise when the baby came out head first.  The next one was
because the baby was 'huge'.  I weighed that baby... just on 8lb.
It all seems distorted with women choosing Specialist care that seems to
make them at higher risk for any birth interventions, particularly c/s. 
Yet
women tell me that going to an Obstetrician means that they don't have to
wait up at the hospital clinics for hours, and at least they see the same
person each visit.  I understand where they are coming from, it just seems
that, that 'one person' they see, should be a Midwife.

Disillusioned:(
Lindsay
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Re: [ozmidwifery] PPH

[Jenny Cameron]

Hello Monica
 
As far as I know WHO call >500ml a PPH. They 
acknowledge that 1000mls is probably manageable physiologically in a healthy 
woman but their policy statements are global and the 500 mls is to take into 
account the many anaemic women in the world. Brucker (2001) states that the 
average woman loses < 500 mls in third stage. My own experience would agree 
with this. 
 
1000 mls is a considerable amount to lose, even for 
a healthy woman. It is a matter of knowing the woman's Hb prior to birth and if 
she is healthy and of average height and weight with a good Hb; 12  or 
above, she probably can withstand up to a litre, certainly 800 mls without going 
into shock. O.K. she won't go into shock but a big fluid loss could mean she 
will be slow to establish a good breastmilk supply or she may take a while to 
recover postbirth. 
 
A few thoughts. Hope it is helpful.
 
Brucker, M. 2001. Management of the third stage of 
labour: an evidence-based approach, Journal of Midwifery and Women's Health. Vol 
46:6.
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  Michelle Windsor 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, March 19, 2005 3:01 
  PM
  Subject: Re: [ozmidwifery] PPH
  
  Hi Monica,
   
  In the WHO guide to care in childbirth it says is that up to 1000 ml 
  blood loss may be physiological in healthy populations.  This WHO 
  guide was published in 1997 I think, and I haven't yet seen a more recent 
  edition.  You can purchase it through Birth International (www.birthinternational.com.au 
  )  Hope this helps.
   
  Cheers
  Michellemh <[EMAIL PROTECTED]> 
  wrote:
  Hi 
all,I sent this yesterday but it didn't come through to me at least so 
apologies if it's a repeat.There were some references a while 
ago about the WHO defininition of a PPH as being over 1000 mls. As we 
are now being required to go the most extreme lengths to treat "PPHs" of 
500mls or more, even if not causing any symptoms and bleeding is 
settling, I would love some evidence to suggest this is overkill. Can 
anyone point me to the WHO 
document?Thanks,Monica--This mailing list is 
sponsored by ACE Graphics.Visit to 
subscribe or unsubscribe.
  
  
  Find local movie times and trailers on Yahoo! Movies.

Re: [ozmidwifery] big baby

[Jenny Cameron]

Hello Belinda
Down Syndrome infants are usually smaller than average. If both she & her 
husband are tall a 4kg+ baby would not be considered unusual. AFP is 
affected by many factors and a woman's weight is one factor. This site might 
be useful as it states that most elevated maternal AFP levels have no 
identified cause.
http://www.dhmc.org/webpage.cfm?site_id=2&org_id=92&gsec_id=2016&sec_id=2016&item_id=2045

 High Risk Obstetrics
  Print this page

 Elevated Maternal Serum Alpha Feto Protein
   Description
 a.. Alpha fetoprotein (AFP) is a protein made by the fetal liver. 
If there is a break in the skin of the fetus due to a birth defect, it is 
found in very high levels in the amniotic cavity.
 b.. AFP also crosses the placenta and goes into the mothers blood 
stream.
 c.. Women are tested during pregnancy to determine how much AFP is 
in their blood.
 d.. The level of AFP in a woman’s blood increases as pregnancy 
progresses.
 e.. To determine if a woman has a normal amount of AFP in her 
blood, it is important to know the gestational age of the pregnancy.
 f.. High amounts of AFP in the blood may indicate a birth defect 
in the fetus which has caused a break in the skin.
 g.. Several birth defects are associated with increased amounts of 
AFP in the maternal blood stream:
 h.. Neural tube defects

   a.. Neural tube defects are a family of conditions including 
spina bifida and anencephaly.
   b.. Spina Bifida occurs when there is an opening in the bony 
part of the spine, causing the spinal cord to be exposed.

 a.. The severity of Spina Bifida depends on where the defects 
is in the spine, and how big it is. They can range from conditions that are 
very mild with very little effect to very severe conditions all depending on 
the size and location of an opening in the spine.
 b.. Small defects low in the spine may have little impact on a 
child’s life.
 c.. Children with large defects may not be able to walk, or 
control their bowels and bladder. Some of these children have problems from 
fluid build up in their brains (hydrocephaly).
 d.. Surgery is almost always needed to close the opening in 
the spinal cord.

   c.. Anencephaly is a lethal condition where the top of the skull 
did not close over the brain and the brain did not develop.

 a.. There are no survivors of anencephaly.
 b.. These fetuses lack most of the brain
   d.. There is an increased risk of chromosome abnormalities in 
fetuses with neural tube defects.
   e.. Other birth defects may also be present with neural tube 
defects.

 i.. Gastroschesis is a defect in the skin that covers the abdomen. 
Bowel comes out of the defect and sits in the amniotic cavity. There are 
usually no other birth defects found.

   a.. Fetuses with gastroschesis often have problems with proper 
growth(IUGR). This may neccessitate delivery of a baby early (preterm).
   b.. These children need repair of the defect immediately after 
delivery.
   c.. In 90% of cases, children survive without any problems.

 j.. There may be other less common birth defects that may cause 
elevated maternal AFP.

   Impact on Pregnancy
 a.. Elevated maternal serum AFP may cause anxiety in parents.
 b.. The first step in evaluating elevated maternal serum AFP is an 
ultrasound
 c.. The ultrasound will determine if the gestational age of the 
fetus is correct.
 d.. The ultrasound will also look for evidence of birth defects.

   a.. Less than 5% of fetuses will have a birth defect.
 e.. An amniocentesis is often offered to women to determine if the 
level of AFP is also increased in the amniotic fluid.

   a.. If the amniotic fluid AFP is normal, there is very little 
risk of the birth defects described above.
   b.. If the amniotic fluid AFP is high, a birth defect is very 
likely. Further ultrasound evaluation will be performed.

 f.. Most cases with elevated maternal AFP have no identified 
cause.
 g.. These pregnancies are at increased risk for slow growth, still 
birth, placental abruption, and preeclampsia.
 h.. An ultrasound is sometimes repeated at 32 weeks to see if the 
fetus is growing well.

   a.. If growth is normal, further testing is usually not needed.
   Resources:
 a.. Sidelines at 800-876-3151 or http://www.sidelines.org - for 
full listings of Resources for High-Risk Parents


 a.. Copyright © 2005 Dartmouth-Hitchcock Medical Center
Cheers.
Jennifer Cameron FRCNA FACM
PO Box 1465
Howard Springs NT 0835
0419 528 717
- Original Message - 
From: "Belinda Maier" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, March 17, 2005 9:52 AM
Subject: [ozmidwifery] big baby


Just looking for some ideas to help a woman in my ante

Re: [ozmidwifery] waterbirth

[Jenny Cameron]

Hi Jo
As long as the newly graduated BMId is are working 
with another experienced midwife and can be adequately supervised for at least 
twelve months. Definitely it is the best way to go but you need supervision. In 
the UK they have designated supervisors for all midwives.
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  jo 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, March 14, 2005 8:20 
PM
  Subject: RE: [ozmidwifery] 
  waterbirth
  
  Hi all,
   
  Once a student has completed the Bmid, is it feasible to 
  go straight into Independant Practice without working in a 
  hospital?
   
  Cheers
   
  Jo Hunter
  
  
  From: [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]Sent: 
  Monday, 14 March 2005 4:04 PMTo: ozmidwifery@acegraphics.com.auSubject: 
  Re: [ozmidwifery] waterbirth
  In a message dated 3/14/2005 3:30:31 PM AUS 
  Eastern Standard Time, [EMAIL PROTECTED] writes:
  i applaude you for doing what u want to. but however in the 
current climate bieng a bach of mid grad we are still un accepted by some 
midwives who have years of expereince or rather indocrination of working in 
hospitals. one day hopefully we can be accepted more by our collegues as 
being their equal. shift work can be frustrating but at the hospital where i 
am they gave us the choice of what we wanted to do ie 3 days to 5 days per 
week and all the interim. cheers  
sharonHi Sharon thanks for your comments...the 
  simple point I am trying to make is that the arguement I get from most 
  midwives re: caseloadand their unwillingness to participate, is that its 
  "too hard" "too demanding" "harder than shift work"having worked both ways 
  myself now, caseload while it can be more unpredicible than shift work in 
  terms of when you work and your availablity, I have found it FAR less tiring 
  and a great deal more flexible in how I choose to organise my day (and my 
  family) in partnership with the women in my care! When your rostered to work 
  on shiftwell that's it your rostered on and gone for upto 10 hours a 
  day.at least with caseload other than if I am with a birthing womanmy 
  day is my own, negotiated with the women concerned...and if I only feel like 
  working four hours today and 6 tomorrow.well, that's what I'll do! Much 
  more woman and midwife friendly!Cheers Tina P 

Re: [ozmidwifery] waterbirth

[Jenny Cameron]

Hello Tina
 
Bear in mind that our midwifery workforce is 
ageing, avg age is 48. I am 51 and if I was young and at the beginning of my mid 
career I would be into caseloading big time. I have just started a new job (in a 
mid hospital)  and it is hard making even that change to another hospital. 
Finding out where everything is etc. It is never easy & I have worked in 
many different institutions and it gets harder each time.  Also in 
this and most hospitals midwives are expected to look after general patients.I 
think this would be enough to swing midwives towards caseloading. I accept that 
most Australian midwives do not realise that caseloading is easier to manage 
than set shifts. I heard Caroline Flint talk on this issue and she clarified it 
well. I would like to do it in principle, but at the moment I want some time 
free for me after 35 years of busy caring. 
 
I believe things are changing but it is slow and we 
need to keep up our education of the public. In particular I think we (midwives) 
should be in the primary schools and kinders introducing the role of the midwife 
and talking about how to have a healthy society through healthy childbearing and 
parenting. Tina, hang in there, it is happening, albeit slowly. You will 
probably be writing all this up as part of the history of Australian midwifery 
one daya Masters project perhaps?!! Cheers
 
Jenny
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717
Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 0835
 
0419 528 717

  - Original Message - 
  From: 
  [EMAIL PROTECTED] 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, March 14, 2005 1:12 
PM
  Subject: Re: [ozmidwifery] 
  waterbirth
  In a message dated 3/14/2005 1:52:01 PM AUS 
  Eastern Standard Time, [EMAIL PROTECTED] 
  writes:
  It concerns me that Australian midwives are so slow to see the 
advantages in forming partnerships with women, listen to them and work 
with them to provide the types of birth services women want. It is 
difficult in many areas to convince midwives to even contemplate taking 
on their own caseload.Perhaps time will alleviate my concerns.  
I hope I see all Australian midwives working 'with women' before I 
die.JanHello Jan and everyone. Jan I couldn't 
  agree more!!As a recently graduated midwife, educated via a Bachelor of 
  Midwifery (predicated on continuity and woman-centred care) I am now working 
  fulltime shift-work across my scope of practice (rotating thu pregnancy, birth 
  and after birth care) and I can't believe that midwives feel that full-time 
  shift work is a wonderful way work!! Having just completed my midwifery 
  studies with full time uni and a caseload of between 10-15 women a year across 
  the 3 years of the B Mid...I was NO WHERE nearly as tired I am now with doing 
  the full-time shift work.it sucks big time!!!Where I work is a 
  large regional midwifery unit in Victoria, and the move is towards 
  implementing one-to-one midwifery care for women, with a known midwife 
  throughout their pregnancy, birthing and early parenting journey - caseload. 
  However, this move is being met with strenuous opposition from many of the 
  midwives who WILL NOT even contemplate that perhaps there is another way to be 
  'with woman' than the current fear based, institution focused, inflexible 
  rostered based system of maternity care. So like Jennifairy, I too am also 
  working with a MIPP to keep my skills up of supporting women in their on own 
  power to birth at home on a partime basis where I am sharing a small caseload 
  of women with another midwifery colleague, while continuing to work to educate 
  midwives on  the benefits of one-one midwifery care with known 
  womenwhilst continuing to practice the bulk of my midwifery in what now 
  seems like on planet Mars!!Yours in reforming midwiferyTina 
  Pettigrew. 

Re: [ozmidwifery] one umbilical artery

[Jenny Cameron]

http://www.adhb.govt.nz/newborn/Guidelines/Anomalies/SUA.htm
A bit of info on SUA.
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: list 
  Sent: Tuesday, March 08, 2005 9:53 
  PM
  Subject: [ozmidwifery] one umbilical 
  artery
  
  Does anyone have any experience with babies with one umbilical artery 
  & one vein?  I would appreciate stories and research.  thanks, 
  MM

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Hi Julie
This is fundus fiddling and may lead to incoordinate uterine action and 
partial separation. As long as there is no excessive bleeding it is safe to 
watch and wait.
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Julie Garratt" <[EMAIL PROTECTED]>
To: 
Sent: Monday, March 07, 2005 2:53 PM
Subject: RE: [ozmidwifery] MORE ACTIVE MANGAEMENT


Hi all,
When a placenta fails to birth in a reasonable amount of time??? Do you
"rub up a contraction or is this "fundus fiddling" going to interfere
with the process maybe leading to no contraction at all. I'm asking
because I've read both points of views and I'm a bit confused.
Julie, Student midwife.
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Mrs Joanne M
Fisher
Sent: 02 March 2005 21:57
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Hi Sue,
You mentioned adding "an ice pack to her uterus".  How does this work?
I'm
guessing it is meant to decrease the blood flow to that area, but how
does
this help the placenta birth?
Cheers, Joanne.
- Original Message - 
From: "Sue Cookson" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, February 24, 2005 11:59 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

> Hi,
> I would definitely treat this woman like all others and assume
> physiological 3rd stage is sufficient.
> I have never actively managed a 3rd stage, and have given
syntometrine 3
> times only after placentas were born - all in my early days of
homebirth.
> I always prefer to;
> a) make sure women are well hydrated going into 2nd stage so they
can
> tolerate volume loss
> b) if bleeding is serious go into "deliver placenta mode"
> I always catch and therefore can measure blood loss at a glance
> I engage the mother first and tell her she's bleeding and that I
need
> her to focus and deliver her placenta
> I always give herbs as a first line of attack- shepherd's purse has
> always been my first choice
> I would rub up a ctxn, add an ice pack to her uterus if one
available
> Then with her assistance pushing I would apply cord traction and see
if
> the placenta would come
> Repeat this maybe twice
> Then contemplate manual removal if necessary (not had to yet...)
>
> I have managed 5 large haemorrhages (over 1.5 litres measured) in
this
> manner and have not had to transfer anyone yet.(I have a
> haemoglobinometer with which I can measure Hbs on the spot over the
next
> few weeks if necessary..)
> This management regime was taught to me by John Stevenson and always
> seems to work.Up until very recently, I have always worked alone.
>
> Isn't it interesting all the different ways we'd handle this
depending
> on our personal experiences?
>
> By the way, late last year I witnessed the worst PPH I'd ever seen -
> mainly because of the management in the hospital (it was a hospital
> support not a homebirth), and with all the hands you could ever
imagine
> -I'd say too many - the woman was severley depleted. Drips in etc
etc
> but too much too late. A cord pulling midwife, and then no
> acknowledgement of when she needed help (irrespective of my pleas)
plus
> she underestimated the blood loss by more than 100% (she thought
600ml,
> and it was measured by weight (? accuracy) to be more like 1400ml)
and
> then the woman was taken to theatre - more time, more blood, why not
a
> manual removal then and there??
>
> Aaaah. Expect no PPH but stay on your toes ...always my motto.
>
> Sue

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Re: [ozmidwifery] NICE guidelines

[Jenny Cameron]

http://www.nice.org.uk/page.aspx?o=guidelines.completed
 
Try this Mary.
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: list 
  Sent: Monday, March 07, 2005 12:12 
  PM
  Subject: [ozmidwifery] NICE 
  guidelines
  
  Can someone post the website for the NICE guidelines in maternity care or 
  obstwetrics or similar, please.  I want to access the original 
  guidelines.  thanks, MM

Re: [ozmidwifery] newborn bath

[Jenny Cameron]

Re NB Bathing.
 
For midwives we need to bear in mind the baby is 
covered in body fluids until after a bath. It is recommended that we observe 
universal precautions unitil after the baby is bathed.
 
For parents. Safety first. Some parents do like a 
'step through'. It is good to ask first. Hospitals are intimidating and I have 
had mothers of 4 children ask me for a bath dem. What have we (society) done to 
these women? It is that general fear of 'doing it wrong', particularly in 
unfamiliar circumstances and on someone elses turf. I like emphasise that as 
long as it is safe there are no rules and regulations. 
 
Sometimes I think we have too many policies and 
procedures. Some hospitals have policies or guidelines on how to manage a normal 
birth. Come on, midwives are educated. Same for the general public, they know 
how to wash themselves and  ten year olds can bath younger sibs. It is all 
about attitude.
 
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Alesa 
  Koziol 
  To: ozmidwifery 
  Sent: Thursday, March 03, 2005 3:52 
  PM
  Subject: [ozmidwifery] newborn bath
  
  Dear List
  Updating policies at our workplace and seeking 
  any written policies that can be shared on bathing newborns. I doubt if there 
  is any but if anyone is aware of any written papers on this topic this would 
  also be gratefully received
  Cheers
  Alesa
   
  Alesa KoziolClinical Midwifery 
  EducatorMelbourne

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Thanks for the detailed insight Marilyn. My view is probably clouded by the 
stark memory I have of a GP performing a MROP on an unanaesthetised or 
analgesed woman when I was a student. I can still see the look of pain and 
terror on her face as she headed for the overbed light. I accept we can do 
these procedures as long as we are accredited. Cheers
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, March 03, 2005 12:35 AM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Needless to say the procedure is not done very often and always the
preferred place would be a hospital and under analgesia if not 
anaesthetic.
If it where done at home it would always be with the consultation of a
backup obstetrician by telephone. However as I said it was a required 
skill
at least in simulation for graduation. As in Sue's case many independent
midwives there do work in rural and remote locations where despite all
efforts actual transfer times can be greater than 1 hour usually due to
weather. This expectation has been around since at least the 1970's and in
some states such as Washington where midwifery never became illegal, since
1917. As always the procedure would only be done when the risks of not 
doing
it outweigh the risks of doing it in that particular location. A friend of
mine who has attended over 2,000 births in the Seattle area since 1981 has
performed the procedure once in that time, successfully with the mother 
and
baby being able to remain at home albeit with the midwife sleeping over.
Obviously litigation risks have also changed in the last 30 years and also
at least in Seattle so has the transfer transport facillitation. I have
heard several descriptions from midwives in the Washington-Oregon corridor
who have done the procedure at least once and successfully. As with Sue 
many
of these midwives were originally trained and educated by docs who were
still attending homebirths through the 1970's, consequently they were 
taught
many procedures that were not part of the hospital repertoire. Others have
taken placements in developing countries (from Jamaica to the Phillipines)
in charity hospitals where this (manual uterine exploration without
anaesthetic) unfortunately is standard procedure even after the placenta 
has
delivered, I am not sure but I actually think this was standard obstetric
practice in the USA through the 1970's and maybe why it was also included 
as
part of midwifery practice. Contrary to Australian perceptions of both
nursing and midwifery in the USA and Canada,  Nurses and Midwives there 
have
provided basic care in many frontier outposts for a long time, it isn't 
all
LA and NY though even there nurse practitioners and midwives practice.

To be honest Australia seems much more litigation minded than the USA at
least to me. Intervention is actually much more routine here and for 
public
hospitals the c/s rate is almost 10% higher, I am comparing Washington,
Oregon and California with Queensland. You also have to be aware that 
where
midwives work in the USA whether it is in or out of hospital they do work
with the authority of at least a nurse practitioner in Australia. An
obstetric nurse would never do an MROP but neither would she catch a baby, 
a
midwife would only do an MROP with consultation with an OB and would
certainly step aside if one were available where she was attending a 
woman.
Of course if a midwife performed the procedure inappropriately and
especially if the mother was harmed she could expect to have her licence
suspended if not revoked. Nurse Midwives in the USA can and do perform
procedures and have prescription priveleges that are certainly part of the
GP's scope of practice here.

I am surprised at the number of retained placentas I have become aware of
since working here and the associated extreme blood loss (approaching 2L),
what was a truly rare occurrence for me is actually quite common in a
hospital at least much more common that I expected. Since I didn't work in
the hospital there except on occassions of transfer, I can't really 
compare
the hospital systems, so their MROP rates in hospital may actually be
similar.

marilyn
- Original Message - 
From: "Jenny Cameron" <[EMAIL PROTECTED]>
To: 
Sent: Tuesday, March 01, 2005 4:59 AM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Hello Marilyn
I am surprised that litigation- mad America sanctioned midwives 
performing
MROP. If the placenta is difficult to remove manual removal may result in
death from shock as well as haemorrhage.
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: 
Sent: Tuesday, March 01, 2005 2:24 PM
Subject: Re: [ozmidwifery] M

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Hello Marilyn
I am surprised that litigation- mad America sanctioned midwives performing
MROP. If the placenta is difficult to remove manual removal may result in
death from shock as well as haemorrhage.
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
To: 
Sent: Tuesday, March 01, 2005 2:24 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Jenny:
I know that  what you say is Australian practice and if i were attending
homebirths here I would always transfer rather than do a manual removal of
either a partially detached placenta or retained products however it
wasn't
considered outside of a midwife's scope of practice in the USA where I
practised (california and washington state), in fact  it was required by
state law that i be capable of carrying out this procedure. The exact
procedure is detailed in Varney's Midwifery third edition, p. 843, Chap
68.
Most certaily considered part of the midwife's scope of practice. I would
suggest that any birth attendant practicing in an out of hospital  setting
should at least know what to do and have practiced the procedure just in
case which is what Sue was saying is her situation. I have never actually
done the procedure myself but was knowledgeable of it, tested on it with
simulation (as it is NOT something you practice on someone) and aware when
it is necessary. Definetely quite different than removing a placenta
trapped
in the vaginal vault, the os, or lower segment.
marilyn
- Original Message - 
From: "Jenny Cameron" <[EMAIL PROTECTED]>
To: 
Sent: Sunday, February 27, 2005 9:00 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Manual removal of a separated placenta is different to manual removal of
a
placenta still attached to the uterine wall. Removing a separated
placenta
from the os or lower segment is not difficult but it is uncomfortable for
the woman. Manually detaching a placenta from the uterine wall is
barbaric
and traumatic and should not be carried out unless under adequate
anaesthetic and fluid replacement. Granted a partially separated placenta
is
a high risk situation as bleeding will continue until separation.
Although
this is an emergency we would better to summon help and use bi-manual
compression to slow/stop the bleeding until assistance arrives. If you
are
performing true manual removal of the placenta and membranes (ie
partially
separated placenta ) as a midwife you are practising outside your scope
of
practice.
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Sue Cookson" <[EMAIL PROTECTED]>
To: 
Sent: Monday, February 28, 2005 7:31 AM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

> Hi Sue,
> I was taught that if doing a manual removal would effectively save the
> woman's life, then that was the best option. Obviously a risk vs
> benefit
> type of situation. The doctor I trained with did the occasional manual
> removal at home rather than the time challenging option of
> transferring,
> and always with the woman's cooperation. I work rurally, and sometimes
the
> speed of the bleed and the distance from hospital would equal real
damage
> to the woman. As I said in my posting, I have not had to perform a
manual
> removal, but I can and would if it was a life saving procedure.
>
> I thought the hospital acted very dangerously by delaying many aspects
of
> their management of the PPH I witnessed last year, and that all up, a
> manual removal there and then would have been the quickest and safest
> option. Instead the woman went on to lose much more blood over another
40
> minutes or so until in theatre, and then faced the choice of
transfusion.
> I found that management very scary.
>
> I have witnessed one manual removal in a hospital on the delivery bed
> after the cord tugging GP/Obs broke the cord whilst trying to extract
the
> placenta (after a forceps delivery). He simply went straight in after
the
> placenta and delivered it quite quickly. The woman was not too
perturbed!!
> (and hadn't had any drugs either).
>
> So I guess it's a matter of training, attitude, access and
> appropriateness - all to be assessed in a very short time frame if a
real
> bleed is occurring.
>
> Sue
>
>
>> I am a bit confused here - can you please explain how you do manual
>> removal in the home situation? Surely this is too dangerous a
>> procedure
>> to do at home? Thanks Sue
>>
>> - Original Message -
>> *From:* Marilyn Kleidon <mailto:[EMAIL PROTECTED]>
>> *To:* ozmidwifery@acegraphics.com.au
>> <mailto:ozmidwifery@acegraphics.com.au>
>> *Sent:* Monday, Fe

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Manual removal of a separated placenta is different to manual removal of a 
placenta still attached to the uterine wall. Removing a separated placenta 
from the os or lower segment is not difficult but it is uncomfortable for 
the woman. Manually detaching a placenta from the uterine wall is barbaric 
and traumatic and should not be carried out unless under adequate 
anaesthetic and fluid replacement. Granted a partially separated placenta is 
a high risk situation as bleeding will continue until separation. Although 
this is an emergency we would better to summon help and use bi-manual 
compression to slow/stop the bleeding until assistance arrives. If you are 
performing true manual removal of the placenta and membranes (ie partially 
separated placenta ) as a midwife you are practising outside your scope of 
practice.
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Sue Cookson" <[EMAIL PROTECTED]>
To: 
Sent: Monday, February 28, 2005 7:31 AM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Hi Sue,
I was taught that if doing a manual removal would effectively save the 
woman's life, then that was the best option. Obviously a risk vs benefit 
type of situation. The doctor I trained with did the occasional manual 
removal at home rather than the time challenging option of transferring, 
and always with the woman's cooperation. I work rurally, and sometimes the 
speed of the bleed and the distance from hospital would equal real damage 
to the woman. As I said in my posting, I have not had to perform a manual 
removal, but I can and would if it was a life saving procedure.

I thought the hospital acted very dangerously by delaying many aspects of 
their management of the PPH I witnessed last year, and that all up, a 
manual removal there and then would have been the quickest and safest 
option. Instead the woman went on to lose much more blood over another 40 
minutes or so until in theatre, and then faced the choice of transfusion. 
I found that management very scary.

I have witnessed one manual removal in a hospital on the delivery bed 
after the cord tugging GP/Obs broke the cord whilst trying to extract the 
placenta (after a forceps delivery). He simply went straight in after the 
placenta and delivered it quite quickly. The woman was not too perturbed!! 
(and hadn't had any drugs either).

So I guess it's a matter of training, attitude, access and 
appropriateness - all to be assessed in a very short time frame if a real 
bleed is occurring.

Sue

I am a bit confused here - can you please explain how you do manual 
removal in the home situation? Surely this is too dangerous a procedure 
to do at home? Thanks Sue

- Original Message -
*From:* Marilyn Kleidon 
*To:* ozmidwifery@acegraphics.com.au

*Sent:* Monday, February 28, 2005 1:34 PM
*Subject:* Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Totally agree Sue. I was taught manual removal too and exactly the
same re
when to apply gentle but firm CCT. However, for a manual removal
at home you
do need maternal cooperation and did have one incidence in Seattle
where we
had to transfer for prolonged moderate/heavy blood loss that just
would not
settle and uterus that kept getting boggy. Para 3 with several
years between
each of the births, third birth being precipitous, placenta
delivered easily
(dirty duncan if you know what I mean) physiologically but
bleeding would
not subside and mum kept soaking a pad in an hour, could not stand
a hand
going past the introitus and was happy to go to the hospital.
Estimated
blood loss was 1600mL including theatre, a pin head size piece of
membrane
was all they could find. Mum declined transfusion and was home the
next day
tired but happy.
marilyn
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Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Hello Leaane
Here is a link to an  article that may be useful re grand multi's and risk 
factors; and a link to a reply, just for another view.
http://www.mja.com.au/public/issues/179_06_150903/hum10036_fm.html
http://www.mja.com.au/public/issues/180_04_160204/letters_160204_fm-3.html
Cheers Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "leanne wynne" <[EMAIL PROTECTED]>
To: 
Sent: Friday, February 25, 2005 8:13 AM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT


Hi All,
I would be interested to hear from any experienced homebirth midwives how 
they would care for a woman who is a G10P9 if she chose to birth at home. 
She has had all normal, quick births so far. Would you use active 
management of third stage because she is a grand multip or would you still 
encourage a physiological third stage??
Leanne.

From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: 
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
Date: Thu, 24 Feb 2005 16:55:56 -0800
Excellent point. I do think the 500mL definition for PPH is spurious. 
Having been educated by a homebirth midwifery school I have to say we were 
not concerned when the blood loss was less than 1000mL as most of our 3rd 
stages were physiological. Very occassionally we did use oxytocin for 
management of 3rd stage usually when the woman had a history of PPH 
greater than 1000mL or retained products etc.. However we were well versed 
in the Cochrane studies and aware of that evidence so we had a high degree 
of caution shall I say. We did carry 40 units of pitocin and also 
ergometrine both vials and tabs to births as well as herbal remedies. 
Syntometrine does not seem to be available in the USA at least not where I 
was. That being said from what i have seen here postnatally, active 
management really decreases the postpartum blood loss in most women. I am 
currently doing the extended midwifery service and visiting women in their 
home during the first 1 to 10 days and most seem to have almost finished 
bleeding by day 5, for most of the homebirth women I visited in the USA 
just from memory I would say they were almost finished by day 10.  Both 
the American College of Nurse Midwives (ACNM) and the Midwives Alliance of 
North America (MANA) have been collecting stats for 5 to 10 years at least 
and must have good stats on this topic. I know it isn't Australian data 
but itmight be helpful.

marilyn
  - Original Message -
  From: Jenny Cameron
  To: ozmidwifery@acegraphics.com.au
  Sent: Wednesday, February 23, 2005 3:51 PM
  Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
  Good point Michelle. If we used 1000ml as PPH definition the stats 
would not look so appealing for active mgmt. Also as someone stated women 
having a physiological 3 stage tend to lose more in the first few hours 
after birth than those having active mgmt. As far as I am aware no-one 
has researched total postpartum (say in the first week) blood loss. Hb or 
Hct estimation is the best way of determining blood loss post partum but 
you need to have a pre-partum Hb/Hct  as well.

  Jenny
  Jennifer Cameron FRCNA FACM
  ProMid
  Professional Midwifery Education  Service
  0419 528 717
- Original Message -
From: Michelle Windsor
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, February 23, 2005 10:34 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT
I haven't heard of a study of this type beingb done.  I find it 
interesting that the NSW policy (similar to many others) of PPH is over 
500ml, and yet the WHO states that in healthy populations (ie not anaemic 
etc) up to 1000ml blood loss may be physiological.  It is often said that 
blood loss at birth is underestimated I wonder how many women have 
blood loss of over 500ml and are fine due to the increased circulating 
blood volume in pregnancy.

Cheers
Michelle
Fiona Rumble <[EMAIL PROTECTED]> wrote:
  WITH REGARDS TO THE RESEARCH THAT SUBSTANTIATES THE CLAIMS THAT 
ACTIVE MANAGEMENT IS SAFER THAN PHYSIOLOGICAL MANGAEMENT OF THIRD STAGE,
   DOES ANYONE KNOW IF THERE HAVE BEEN ANY STUDIES COMPARING 
PHYSIOLOGICAL WHOLE OF LABOUR AND BIRTH WITH ACTIVE MANAGEMENT OF THIRD 
STAGE FOLLOWING MANAGED LABOUR AND BIRTH I AM SURE THE RESULTS 
WOULD BE VERY DIFFERENT. JUST A THOUGHT. CHEERS FIONA



Find local movie times and trailers on Yahoo! Movies.

Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health Service  Mob 0418 371862
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Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Jenny Cameron]

Good point Michelle. If we used 1000ml as PPH 
definition the stats would not look so appealing for active mgmt. Also as 
someone stated women having a physiological 3 stage tend to lose more in the 
first few hours after birth than those having active mgmt. As far as I am aware 
no-one has researched total postpartum (say in the first week) blood loss. Hb or 
Hct estimation is the best way of determining blood loss post partum but you 
need to have a pre-partum Hb/Hct  as well. 
 
Jenny
 
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Michelle Windsor 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Wednesday, February 23, 2005 10:34 
  PM
  Subject: Re: [ozmidwifery] MORE ACTIVE 
  MANGAEMENT
  
  I haven't heard of a study of this type beingb done.  I 
  find it interesting that the NSW policy (similar to many others) of PPH is 
  over 500ml, and yet the WHO states that in healthy populations (ie not anaemic 
  etc) up to 1000ml blood loss may be physiological.  It is often said 
  that blood loss at birth is underestimated I wonder how many women have 
  blood loss of over 500ml and are fine due to the increased circulating 
  blood volume in pregnancy.  
   
  Cheers
  MichelleFiona Rumble 
  <[EMAIL PROTECTED]> wrote:
  




WITH REGARDS TO THE RESEARCH THAT SUBSTANTIATES 
THE CLAIMS THAT ACTIVE MANAGEMENT IS SAFER THAN PHYSIOLOGICAL MANGAEMENT OF 
THIRD STAGE,
 DOES ANYONE KNOW IF THERE HAVE BEEN ANY 
STUDIES COMPARING PHYSIOLOGICAL WHOLE OF LABOUR AND BIRTH WITH ACTIVE 
MANAGEMENT OF THIRD STAGE FOLLOWING MANAGED LABOUR AND BIRTH I AM 
SURE THE RESULTS WOULD BE VERY DIFFERENT. JUST A THOUGHT. CHEERS 
FIONA
  
  
  Find local movie times and trailers on Yahoo! Movies.

Re: [ozmidwifery] question

[Jenny Cameron]

A useful link re third stage management pros & 
cons.
 
http://www.emedicine.com/MED/topic3569.htm
 
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Jenny 
  Cameron 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, February 20, 2005 1:22 
  PM
  Subject: Re: [ozmidwifery] question
  
  Active management of third stage using controlled 
  cord traction.
  Beischer, N. Mackay, E. Purcal, N. 1989, 2nd 
  edition. Care of the pregnant woman and her baby, W.B.Saumders/Balliere & 
  Tindall, Sydney.
   
  1) Administer oxytocic, Syntocinon 10 units IMI 
  or IVI after the birth of the baby.
   
  2) Await signs of separation.
   
  3) The cord is reclamped near the vulva and 
  steadied with one hand while the other hand is used to gently push the uterine 
  fundus upwards. This will indicate if the placenta has separated since the 
  cord will not follow the upward movement of the uterus. If separation has 
  occurred, a combined movement is made of downward and backward traction on the 
  cord and upward displacement of the uterus, provided that the latter is 
  firmly contracted. 
   
  If the placenta does not advance there are 
  usually only 2 possibilities - it is still attached to the uterus or it has 
  become trapped in the tightly contracted uterus (unusual if using Syntocinon, 
  usually only occurs with Ergometrine). In such cases be patient and repeat the 
  procedure at intervals. Resist the temptation to massage the uterus unless 
  bleeding is excessive. If the umbilical cord 
  vessels are congested, remove the clamp and drain the cord blood out. This 
  will reduce the size of the placenta. 
   
  Once the placenta appears at the vulva you can 
  stop steadying the uterus and gently 'rock' the placenta out taking care not 
  to tear the membranes. If they begin to tear, the placenta should be rotated 
  to cause a bunching up of the membranes near the vulva; a wide clamp is then 
  applied and the membranes eased out with steady traction (pp 
  252-3).
   
  It is generally recommended to always use an 
  oxytocic with controlled cord traction, however it can performed without an 
  oxytocic as long as you await separation and ensure the uterus is firmly 
  contracted before applying any traction. Hope this helps. Cheers
  Jenny
  Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
  Education  Service0419 528 717
  
- Original Message - 
From: 
Ken 
WArd 
To: ozmidwifery@acegraphics.com.au 

Sent: Sunday, February 20, 2005 8:41 
AM
Subject: RE: [ozmidwifery] 
question

You must wait for placental separation, otherwise you risk inverting 
the uterus    Maureen

  -Original Message-From: [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of Susan 
  CudlippSent: Wednesday, 9 February 2005 2:55 AMTo: 
  ozmidwifery@acegraphics.com.auSubject: 
  [ozmidwifery] question
  Dear ozmid list-ners
  I have not been on the list for a while but 
  have a question that I would welcome your input on.
   
  When performing active management of the 
  third stage, is it routine practice to await signs of placental 
  separation before commencing CCT, or to simply ascertain that there is 
  uterine contraction?
   
  Also, what is the current recommendation for 
  management of retained placenta, or situations when the cord separates 
  during CCT?
   
  I know this may sound odd, and I know what I 
  was taught and have practiced, but I am in the midst of a "difference of 
  opinion" and I need to check what are the actual guidelines given.  I 
  have attempted to search this out myself but have not been able to find 
  much in the way of actual step-by-step instructions for active management 
  of the third stage.
   
  With respect, I do not need to 
  know people's preferred methods or  opinions on the rights and 
  wrongs of active management, simply the actual guidelines for active 
  management and when to commence CCT.  I would be grateful if anyone 
  can post this or lead me to it.  I have tried many sites on the net 
  without success and do not have easy access to up to date 
  manuals.
   
  Thank you in advance, I have been "off list" 
  for quite a while due to being very busy!  Looking forward to 
  listening in again now that life is a bit quieter.
   
  Susan  
  Cudlipp

Re: [ozmidwifery] question

[Jenny Cameron]

Active management of third stage using controlled 
cord traction.
Beischer, N. Mackay, E. Purcal, N. 1989, 2nd 
edition. Care of the pregnant woman and her baby, W.B.Saumders/Balliere & 
Tindall, Sydney.
 
1) Administer oxytocic, Syntocinon 10 units IMI or 
IVI after the birth of the baby.
 
2) Await signs of separation.
 
3) The cord is reclamped near the vulva and 
steadied with one hand while the other hand is used to gently push the uterine 
fundus upwards. This will indicate if the placenta has separated since the cord 
will not follow the upward movement of the uterus. If separation has occurred, a 
combined movement is made of downward and backward traction on the cord and 
upward displacement of the uterus, provided that the latter is firmly 
contracted. 
 
If the placenta does not advance there are usually 
only 2 possibilities - it is still attached to the uterus or it has become 
trapped in the tightly contracted uterus (unusual if using Syntocinon, usually 
only occurs with Ergometrine). In such cases be patient and repeat the procedure 
at intervals. Resist the temptation to massage the uterus unless bleeding is 
excessive. If the umbilical cord vessels are 
congested, remove the clamp and drain the cord blood out. This will reduce the 
size of the placenta. 
 
Once the placenta appears at the vulva you can stop 
steadying the uterus and gently 'rock' the placenta out taking care not to tear 
the membranes. If they begin to tear, the placenta should be rotated to cause a 
bunching up of the membranes near the vulva; a wide clamp is then applied and 
the membranes eased out with steady traction (pp 252-3).
 
It is generally recommended to always use an 
oxytocic with controlled cord traction, however it can performed without an 
oxytocic as long as you await separation and ensure the uterus is firmly 
contracted before applying any traction. Hope this helps. Cheers
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Ken 
  WArd 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Sunday, February 20, 2005 8:41 
  AM
  Subject: RE: [ozmidwifery] question
  
  You 
  must wait for placental separation, otherwise you risk inverting the 
  uterus    Maureen
  
-Original Message-From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of Susan 
CudlippSent: Wednesday, 9 February 2005 2:55 AMTo: ozmidwifery@acegraphics.com.auSubject: 
[ozmidwifery] question
Dear ozmid list-ners
I have not been on the list for a while but 
have a question that I would welcome your input on.
 
When performing active management of the third 
stage, is it routine practice to await signs of placental separation 
before commencing CCT, or to simply ascertain that there is uterine 
contraction?
 
Also, what is the current recommendation for 
management of retained placenta, or situations when the cord separates 
during CCT?
 
I know this may sound odd, and I know what I 
was taught and have practiced, but I am in the midst of a "difference of 
opinion" and I need to check what are the actual guidelines given.  I 
have attempted to search this out myself but have not been able to find much 
in the way of actual step-by-step instructions for active management of the 
third stage.
 
With respect, I do not need to 
know people's preferred methods or  opinions on the rights and 
wrongs of active management, simply the actual guidelines for active 
management and when to commence CCT.  I would be grateful if anyone can 
post this or lead me to it.  I have tried many sites on the net without 
success and do not have easy access to up to date manuals.
 
Thank you in advance, I have been "off list" 
for quite a while due to being very busy!  Looking forward to listening 
in again now that life is a bit quieter.
 
Susan  
Cudlipp

Re: [ozmidwifery] Castor oil

[Jenny Cameron]

Meconium stained liquor rarely causes a 
problem. Thick or particulate meconium can cause MAS. Until there is clearer 
research evidence I will be suctioning on the peri for thick mec. The issue is 
that if the baby in utero has been asphyxiated and passes meconium and then 
gasps, which he is likely to do if the asphyxia is severe. He may inhale mec at 
that point and nothing we do at or post birth will retrieve that meconium. 
The thorny issue is whether the baby passed the mec as a result 
of pathological hypoxaemia or did he open his bowels because he 
is mature and has a ready response to low oxygen levels however slight and 
transient.  Cord compression is common in all pregnancies and as the 
baby nears term the liquor production decreases slowly making cord compression 
more likely. A 42 weeker will pass mec very readily and a high % have MSL at the 
onset of labour. A quick check with a CTG is required. No evidence of 
hypoxaemia...fine, off with the monitor and on with the labour. Thanks for the 
reference. ECPC addresses this topic but it is about due for a new edition. 
Cheers
jenny
Jennifer Cameron FRCNA FACMProMid 
Professional Midwifery Education  Service0419 528 717

  - Original Message - 
  From: 
  Tania Smallwood 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Saturday, February 19, 2005 12:25 
  PM
  Subject: Re: [ozmidwifery] Castor 
  oil
  
   
   
  Sorry for butting in, but just found this quickly in my saved file, 
  thought it might clarify current findings...
   
  Tania
   
  Oropharyngeal and nasopharyngeal suctioning of meconium-stained 
  neonatesbefore delivery of their shoulders: multicentre, randomised 
  controlledrial  . ARTICLEThe Lancet, Volume 364, Issue 9434, 14 
  August 2004, Pages 597-602Nestor E Vain, Edgardo G Szyld, Luis M Prudent, 
  Thomas E Wiswell, Adriana MAguilar and Norma I 
  VivasAbstractBackgroundMeconium aspiration syndrome (MAS) 
  is a life-threatening respiratorydisorder in infants born through 
  meconium-stained amniotic fluid (MSAF).Although anecdotal data concerning 
  the efficacy of intrapartum oropharyngealand nasopharyngeal suctioning of 
  MSAF are conflicting, the procedure iswidely used. We aimed to assess the 
  effectiveness of intrapartum suctioningfor the prevention of 
  MAS.MethodsWe designed a randomised controlled trial in 11 
  hospitals in Argentina andone in the USA. 2514 patients with MSAF of any 
  consistency, gestational ageat least 37 weeks, and cephalic presentation 
  were randomly assigned tosuctioning of the oropharynx and nasopharynx 
  (including the hypopharynx)before delivery of the shoulders (n=1263), or 
  no suctioning before delivery(n=1251). Postnatal delivery-room management 
  followed Neonatal ResuscitationProgram guidelines. The primary outcome was 
  incidence of MAS. Cliniciansdiagnosing the syndrome and designating other 
  study outcomes were masked togroup assignment. An informed consent waiver 
  was used. Analysis was byintention to treat.Findings18 infants 
  in the suction group and 15 in the no suction group did not meetentry 
  criteria after random assignment. 87 in the suction group were 
  notsuctioned, and 26 in the no suction group were suctioned. No 
  significantdifference between treatment groups was seen in the incidence 
  of MAS (52[4%] suction vs 47 [4%] no suction; relative risk 0·9, 95% CI 
  0·6-1·3), needfor mechanical ventilation for MAS (24 [2%] vs 18 [1%]; 0·8, 
  0·4-1·4),mortality (9 [1%] vs 4 [0·3%]; 0·4, 0·1-1·5), or in the duration 
  ofventilation, oxygen treatment, and hospital 
  care.InterpretationRoutine intrapartum oropharyngeal and 
  nasopharyngeal suctioning ofterm-gestation infants born through MSAF does 
  not prevent MAS. Considerationshould be given to revision of present 
  recommendations
  
- Original Message - 
From: 
Marcia 
To: ozmidwifery@acegraphics.com.au 

Sent: Saturday, February 19, 2005 1:08 
PM
Subject: Re: [ozmidwifery] Castor 
oil

I have been watching this discussion re mec 
liquor and perineal suction. Anne, could you please give reference to your 
research that does not support this practice?
thank you.
marcia

  - Original Message - 
  From: 
  Anne 
  Clarke 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Friday, February 18, 2005 9:50 
  AM
  Subject: Re: [ozmidwifery] Castor 
  oil
  
  Dear Katrina,
   
  It seems that almost everyone does suction at 
  the peri with mec. liq. but the resarch does not support this routine 
  procedure.
   
  Regards,
  Anne Clarke
  Brisbane
  
- Original Message - 
From: 
Ceri & Katrina 
To: ozmidwifery@acegraphics.com.au 

Sent: Thursday, February 17, 2005 
3:23 PM
Subject: Re: [ozmidwifery] Castor 
oil
Hi AnneAre these articles on

Re: [ozmidwifery] epidural research

[Jenny Cameron]

Interesting article. You may need to register with 
Medscape to view this article but it is free and a useful site.
 
http://www.medscape.com/viewarticle/498489
 
Jenny
Jennifer Cameron FRCNA FACMProMid 
Professional Midwifery Education  Service0419 528 717

  - Original Message - 
  From: 
  Michelle Windsor 
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Thursday, February 17, 2005 10:56 
  PM
  Subject: RE: [ozmidwifery] epidural 
  research
  
  Dean and Jo wrote:  

  

I seriously 
question the validity of the research being done these 
days!
I know what you 
mean Jo, and I seriously question some of the interpretation of 
research.  Some of the medical profession take any study that 
suits them and quote it as evidence based practice.  Today I went to an 
inservice on CTG's and outcomes from a study done in Dublin were quoted 
-  apparently the largest ever study on outcomes of CTG monitoring 
versus intermittent, involving over ten thousand women.  I haven't 
heard of this study (has anyone else?) but it supported the use of 
continuous monitoring and supposedly didn't increase their caesar 
rate.  I find it hard to believe especially when they went on 
to talk about the 50%-70% false positives for fetal distress 
with CTG's.  
Michelle
 
-Original 
Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Kylie CarberrySent: Thursday, February 17, 2005 10:13 
AMTo: 
ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] epidural 
research
 

Hi everyone,
Just thought you all may be interested in a press 
release I found on the net and wanted to see what everyone thought.  I 
just gave my first-time pregnant sister-in-law a run down the risks of 
epidurals as she was very quick to say she will request one (of course her 
OB encouraged her, saying if I was a woman I'd have oneneedless to say 
this made me cringe), what can I tell her about this new 
research.
 
Early epidural does 
not raise c-section risk
Last Updated: 
2005-02-16 17:00:33 -0400 (Reuters 
Health)
NEW YORK 
(Reuters Health) - Women in labor who need early pain relief need not fear 
that an epidural makes it more likely that they'll have to have a 
cesarean.
Compared with intravenous 
narcotic pain control, new research shows, epidural pain control started in 
early labor does not increase the probability that women will undergo a 
c-section. 
Moreover, an early epidural 
seems to provide better pain control and may shorten the duration of labor. 

Previous reports have linked 
epidural analgesia with an elevated risk of cesarean delivery, but it is 
possible that this increased risk was due to related factors and not to the 
epidural per se, the researchers note in this week's New England Journal of 
Medicine. 
To determine if epidural pain 
control is an inherent risk factor for c-section, Dr. Cynthia A. Wong, from 
Northwestern 
University in Chicago, and 
colleagues assessed the outcomes of 750 pregnant women who received epidural 
pain control or intravenous hydromorphone started in the early stages of 
labor.
In contrast to previous reports, 
the c-section rate in the epidural group was actually slightly lower than 
that seen in the comparison group: 17.8 versus 20.7 
percent.
There was evidence that epidural 
pain control hastened delivery. The time from the start of pain control 
until delivery was significantly shorter in the epidural 
group.
In addition, epidural anesthesia 
was associated with significant improvements in pain and with better Apgar 
scores, the system used to evaluate infants in the first minutes of 
life.
In a related editorial, Dr. 
William Camann, from Brigham and Women's Hospital in Boston, comments that 
for women who experience severe pain in early labor and desire pain control, 
the new findings "make it clear that safe, effective pain relief with the 
use of (epidural pain control) should not be withheld simply because" they 
haven't passed some arbitrary stage.
SOURCE: New 
England Journal of Medicine, February 17, 2005.
Copyright © 2005 Reuters 
Limited. All rights reserved. Republication or redistribution of Reuters 
content, including by framing or similar means, is expressly prohibited 
without the prior written consent of Reuters. Reuters shall not be liable 
for any errors or delays in the content, or for any actions taken in 
reliance thereon. Reuters and the Reuters sphere logo are registered 
trademarks and trademarks of the Reuters group of companies around the 
world. 
 
 

Kylie 
Carberry
Freelance 
Journalist
p: 
02 42970115
m: 
0418 220 638
  

[ozmidwifery] BMids

[Jenny Cameron]

Hello all Bmids and all midwives.
 
It would be wise for hospitals to look closely at what really is value for 
their dollar. Jack of all trades and master of none is not the way to go. 
Multiskilling translates as deskilling. Also, if you are not an expert at 
anything hospitals can avoid paying you as a specialist. However, moving into 
the hospital system is not difficult in itself, don't be afraid of functioning 
in the hospital environment. A midwife is a midwife and wherever we are the same 
principles apply. Our codes of practice allow us to exercise our judgement and 
if we follow the principles of evidence-based practice, i.e. best available 
evidence combined with good clinical judgement and respect for the wishes of the 
'patient', we are doing good. We do not have to blindly follow hospital policy. 
It is up to the hospital to have evidence-based policies and for us to evaluate 
these policies critically. Stay strong and hang in there.
 
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

<><>

Re: [ozmidwifery] Bach Mid

[Jenny Cameron]

Hello Kim
 
You are not alone in your efforts to obtain employment. I have 
just moved to Darwin & I have had 4 'failed applications'. The last one 
being in a Community Care Centre desperate for midwivesbut only ones that 
can do assessments on the older person and other general nursing tasks. It is a 
fantastic centre but cannot afford to employ a midwife only. I am an RN but I do 
not profess to be up to date in that area, I am competent in my area of 
expertise. I am a midwife of 30 years experience, I am a qualified teacher (rare 
among many academics), have a Masters in Public Health (Women's Health), and I 
hold 2 Fellowships. So we will get there, good things are worth waiting for. 
Midwifery forever!! Cheers
 
Jenny
Jennifer Cameron FRCNA FACMProMid Professional 
Midwifery Education  Service0419 528 717

  - Original Message - 
  From: 
  Kim Stead 
  
  To: ozmidwifery@acegraphics.com.au 
  
  Sent: Monday, February 14, 2005 5:55 
  PM
  Subject: [ozmidwifery] Bach Mid
  
  

  
Hello again Marcia and others interested in this 
thread.
 
Thanks for your intro Marcia.  It's always nice 
to know who you are talking to.  I guess I have become a bit 
guarded regarding my midwifery qualification as it's been 
a torturous road to find a supportive environment in which to 
practice.  I live rurally - Gippsland to be precise.  DE 
midwives are virtually unheard of in the rural areas and many are at a 
loss as to 'what to do with us' since we can't be relocated to 
other wards - despite screaming out for midwifery staff.  
Some, like anything new, are very resistant to change - mostly 
their own insecurities from what I can make out.  
 
Anyway, I arrived in Australia 18mths ago and applied 
at two hospitals for work - both turned me down because 1. I could not 
be relocated and 2. because they were 'too busy' training medical 
staff.  I was also told that "I needed serious career advice if 
I thought I would ever be able to work in this country".  That 
was from one individual but someone in a position who should have known 
better!!!  You can imagine how that felt being a new, very 
enthusiastic graduate who had just sacrificed everything (family & 
finances included) to survive the 3 year 'full-on' 
degree!!  It was soul destroying to say the 
least and I now fully understand the term 'horizontal violence'!  
Fortunately for me - it just made me stronger and more determined!  
Why does this profession 'eat their young' instead of nuture them?  
I thought as midwives and as women - we were the nuturing types?  I 
know this is not true of all but the few that are like this leave a very 
bad taste in my mouth.   
 
Anyway... Since my 'failed applications', I 
had been working in the community 'with woman' the best way 
possible in the current environment but have just recently taken up an 
offer at one of the hospitals previously mentioned.  It is funny 
how things eventually have an about turn and how midwifery 
shortages don't change.  It seemed they 
were impressed by my work in the community and my dedication 
to 'midwifery philosophy' and keeping birth normal where possible.  
They wanted ME as part of their team...  It was a little hard to stomach at first and 
the concept of 'working in an obstetric model' is still very challenging 
each day when I drive to and from work.  I strive to work 
as
a midwife in a 'task orientated' environment where the 
focus is on the abnormal - either creating or correcting it.  It's 
no easy task or for the faint hearted!  I feel really sad that 
many midwives in this country are unable to practice to their full 
potential and see midwifery for what it really is - or should be.  
Perhaps we can stand united and fight for improvements for not only 
women but for ourselves?  We as women and midwives and 
mothers are a pretty strong force to be reckoned with!  Food 
for thought!
 
The hospital I am at are beginning to understand that 
Bach of Mid is here to stay and that we may well be the midwives of the 
future.  Many rural hospitals down this way are yet to take that on 
board.  I think that us 'new breed' of midwives have a lot to 
offer and lots of new ideas to share and vice versa.  I also 
believe that 'together' - all of us, can make a real difference and 
bring midwifery in this country into the 21st century - well at least 
inline with our other western sisters.  I live in hope. it's 
what keeps me going!  I hope my sharing some of my expe

Re: [ozmidwifery] Fw: Birthing Beds and recomendations/suggestions

[Jenny Cameron]

Hello Sue & All
I would not recommend a sofa bed for a woman to use post-birth. Buy a proper 
bed (Sealy etc' not a medical bed). Sofa beds are hideous to sleep on and 
are not physiologically safe for backs. Cheers
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Andrea Quanchi" <[EMAIL PROTECTED]>
To: 
Sent: Friday, February 11, 2005 7:38 AM
Subject: Re: [ozmidwifery] Fw: Birthing Beds and recomendations/suggestions


We used to have a lovely queen sized bed in our birth room that had plenty 
of room for three or more after the birth but someone in their wisdom 
bought a new double 'obstetric' bed with all the gizmos!  The mattress is 
like a rock and I would hate to have to sleep on it. While the automatic 
back rest is handy pillows always worked before, their is a little 
platform for stuff that pulls out at the bottom and foot rests so that you 
can position for suturing etc if needed bit we always imporvised before by 
sliding the mattress partway off the base and using the base to rest feet 
on and a little table for stuff. These beds are really expensive and not 
as woman friendly or condusive to use.  I find the woman view them as 
hospital beds and tend once on them want to adopt the submissive patient 
role rather than the normal bed which they treat more like their own.

Andrea Quanchi
On 06/02/2005, at 9:02 PM, scrosby wrote:
-- Forwarded Message ---
From: "scrosby" <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Tue, 1 Feb 2005 19:50:39 +1000
Subject: Birthing Beds and recomendations/suggestions
Hi everyone,
I work in a smallish midwifery unit in rural Victoria and we are looking 
at
purchasing some new beds for our newly developed birth rooms.
Has anyone suggestions,, we don't have a huge budget but I would love to 
hear
from other midwives as to what they are using and their comments etc.
One of our new rooms will be an active birth room that won't have a bed 
in
it, only a sofa bed for post birth recovery. One of our other rooms we 
will
use our current double bed however we would dearly like a couple of new 
beds.
I would love feedback about this.
Thanks in anticipation,

Sue Crosby
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Re: [ozmidwifery] Evidence based care for normal birth

[Jenny Cameron]

Hello Andrea,

Tuesday, December 14, 2004, 10:39:31 AM, you wrote:

AR> I have been approached By Denis Walsh, an Australian midwife who has been
AR> living and working in the UK for the last 20 years. He has just completed
AR> hi PhD on Birth Centres and is well known for his writing etc.

AR> His two day program on Evidence Based Care is very popular in the UK and he
AR> presented it in Melbourne and Brisbane on a previous trip. Denis is here
AR> until November next year and would like to present some further programs,
AR> while he continues his work for his UK University (writing etc). A series
AR> of workshops had been planned for most States, but the organiser has
AR> suddenly let him down and he has asked me if Birth International could help
AR> him. Having worked with Denis several times in the UK, I am naturally keen
AR> to help him out in the circumstance.

AR> If anyone is interested in having one of these events in their area, could
AR> they get in touch with me? We'll do the organising and advertising, but I
AR> need to gauge where the interest lies. We'll be offering some incentives to
AR> local organisers as well (free places in return for a venue and some other
AR> local support).

AR> I need to get these dates into our calendar very quickly, so that we can
AR> include the details in our next catalogue, which is due out at the end of
AR> January.

AR> Please either send a message to the list, or email me off line and we can
AR> talk more about the possibilities. These are programs that are well proven,
AR> motivating, exciting and useful who wants one in their area?

AR> Regards,

AR> Andrea

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

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

AR> --
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Hello to all
I am living in darwin now and it would be fantastic if denis could run
his workshop up here. Is there anyone from royal Darwin out there?? I
do not have access to my address book at the moment. Bev Turnbull is
the PG Mid coordinator at Charles D uni. Heres hoping.
Jenny

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[ozmidwifery] ParvoB19

[Jenny Cameron]

FYI
 
http://www.obgynworld.com/international/obgynworld/reference/pdf/cpg119.pdf
 
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

<><>

Re: [ozmidwifery] birthing a still baby

[Jenny Cameron]

Hello Jo
Women often say a dead baby feels cold inside of 
them. There are a few texts on women's experience of stillbirth. Jane Warland's 
The Midwife & the Bereaved Family is very good.Like all births each 
one is different, live or still. A woman's first birth is different to her 
second which is different to her third...and so on. Each birthing experience is 
unique and while there are principles that govern midwifery care in the instance 
of stillbirth, we have to approach each couple as unique each time. As well as 
experiencing birth, there is death to deal with. Physically birthing a dead baby 
is little different than a live baby. The baby undergoes the usual mechanisms in 
order to negotiate the birth canal. Depending on how long the baby has been 
dead, a dead baby is softer and more easily mouldable than a live baby therefore 
women rarely tear or require episiotomy. Also we need to be very gentle and 
careful handling a stillborn baby as the skin and underlying tissues may be very 
soft and fragile, macerated is the medical term. Hope this 
helps
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Dean 
  & Jo 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, November 21, 2004 7:08 
  PM
  Subject: [ozmidwifery] birthing a still 
  baby
  
  
  I am wondering if anyone knows of 
  some text, essay, or writing of some sort by women (or a woman) who has 
  birthed a live baby and a still baby and then written about the 
  differences.  I know that sounds 
  weird; but I was talking to someone who said she had heard from a woman who 
  had experienced this scenario and the woman had said there was a difference 
  between the two birth experiences –other than one baby had died.  I just don’t feel right in approaching 
  this person for confidentiality issues.
  The context of the conversation 
  was about how the child is an active participant in the birth process and 
  birthing a still baby would be different to birthing a live one.  Knowing how traumatic and/or personal 
  this is, I would not like to ask if anyone knows someone who has been there 
  and done this- rather just ask if anyone has read anything 
  before?
   
  Am I making sense??? I have run 
  out of coffee
   
  Cheers
  Jo
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Re: [ozmidwifery] niphedipine

[Jenny Cameron]

Apparently sub-lingual and gelcap Nifedipine was taken off the market a few 
years ago.
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "B & G" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Sunday, November 21, 2004 7:46 PM
Subject: RE: [ozmidwifery] niphedipine


There are two forms of nifedipine - one sub-lingual and the other 20mg
for oral ingestion. We use the 20mg oral ingestion every 20 minutes by 5
doses only. but I do know some places use the S/l dose but only 10mg.
One brand was the green gel capsule that one could aspirate the solution
and pop under the tongue - I haven't seen that for some time.
If using please warn the women the side effects which can be very
uncomfortable - flushing, heat, headache and sweats are the ones that
first come to mind. A very potent vasodilating agent that lowers end
diastolic pressures quickly.
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of ID & AC
Quanchi
Sent: Sunday, 21 November 2004 4:32 PM
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] niphedipine
we often have cause to use niphedipine for prem labour while awaiting
transfer to a tertiary centre and usually do so under advice from the
obstetric people at the receiving hospital which will be either RWH,
Monash
or Mercy ( in Victoria). They usually ask that the women chew the first
dose
to break open the enteric cover on the medication and allow it to be
absorbed quicker. (Because of the enteric coating even putting it under
the
tongue is low if you dont crush it first) A second dose can be swallowed
at
the same time which will be absorbed more slowly as the coating disolves
in
the GI tract. The subsequent doses are then swallowed. If time is not
important then swallowing all doses will be OK but I figure that when a
woman is suspected to be contracting then the aim is to stop it asap and
time from ingestion to absorption needs to be hastened for the first
dose.
Hope this helps but pharmacy at the big centres is always ready to help
if
you want to call them
Andrea Quanchi
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Re: [ozmidwifery] Labour and Birth - the 4 P's ????

[Jenny Cameron]

Hello Tania
You need to think a bit deeper. These are old terms and may not be found in 
recent textbooks. The passage is the pelvis, the passenger the 
baby...It's all about the mechanisms and the processes of labour which 
involves the psyche as well as the physical body; probably more than most 
women realise. Women can stop & start their labours. I witnessed a woman 
hold her baby at crowning until her husband retrieved their camera from in 
her case, where it was neatly tucked into a sock!! It was very funny but 
amazing control because it was important to her to get that 'photo having 
missed it first time around. Read 'Birthing From Within" by England & 
Horowitz for an interesting view of psyche issues. Good hunting!
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Tania & Laurie" <[EMAIL PROTECTED]>
To: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
Sent: Friday, November 19, 2004 12:10 PM
Subject: [ozmidwifery] Labour and Birth - the 4 P's 


Hi everybody
Does anybody out there have any information on the 4 P's of labour and 
birth
(passage, passenger, powers, psyche). I'm a BMidder at UniSA and we have
been asked to consider these in relation to the anatomy, physiology,
psychology, sociology and midwifery care surrounding normal labour and
birth. I'M STUCK!!!

I can't find any information in our texts so if anyone can help I'd really
appreciate it.
Cheers
Tania
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[ozmidwifery] Here 'tis!!

[Jenny Cameron]

http://www.nt.gov.au/health/news/2004/new_era_maternity_services.pdf
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

<><>

Re: [ozmidwifery] Great News for NT Women

[Jenny Cameron]

Title: Great News for NT Women



Brilliant and well done!!
Jenny
Jennifer Cameron FRCNA FACMProMid 
Professional Midwifery Education  Service0419 528 717

  - Original Message - 
  From: 
  Justine Caines 
  To: OzMid List ; MC NSW 
  Branch 
  Sent: Thursday, November 18, 2004 3:33 
  AM
  Subject: [ozmidwifery] Great News for NT 
  Women
  Dear AllIt seems 
  that Maternity Coalition women and midwives have done it!Today the NT 
  Health Minister, Toyne  launched a comprehensive package of reform for NT 
  maternity services and indemnity for Independent midwives (of which the NT 
  Gov will cover).  I can’t attach the release and it is not yet on the 
  website, but for those interested in looking later here is the 
  linkhttp://www.nt.gov.au/ocm/media_releases/A good day for MC,A great day for NT women and 
  midwives!!Thanks so much to Virginia Nock for a sterling effort of the 
  last 18 months, it was her wonderful experience of homebirth and a known 
  midwife that fuelled the passion.This is an example of how a national 
  organisation who has developed respect and has some clout can support a branch 
  to make great in-roads locally.Just shows when we tap all of our 
  talents what we can do together!!Also very positive for the rest of 
  the country, if Australia’s smallest jurisdiction can self insure private 
  midwives then why not VIC, NSW etc.Champers 
  tonight!JCJustine CainesNational President  Maternity 
  Coalition IncPO Box 105MERRIWA  NSW  2329Ph: (02) 
  65482248Fax: (02)65482902Mob: 0408 210273E-Mail: 
  [EMAIL PROTECTED]

Re: [ozmidwifery] seizure at birth

[Jenny Cameron]

Hello Jen
I would explain what is most likely to have happened and I would advise her 
to come in for a check ASAP. Common sense would say this was physiological 
and just the result of a long hot day's shopping and low BP. Remember the 
effect of increase in blood volume is at its peak at about this time 
(24-32/52), so BP is likely to be a bit lower than normal plus if she was 
hot she was probably vasodilated++.  It is impossible to categorically say 
there is nothing wrong in a telephone consult and as we are obliged to 
document all contacts with the women in our care, then we have little choice 
but to recommend she comes in for a check, or you go out & visit. Also if 
she freaked out the quick check will reassure her. If she doesn't want to 
come in or have a visit, then document what you recommended. Probably 20 
years ago I would have reassured her, but standards of risk management have 
altered the playing field. In my experience if it was 
pre-eclampsia/eclampsia then she would not recover, she would remain unwell. 
Always think, 'First do no harm'.

Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, November 17, 2004 8:45 PM
Subject: Re: [ozmidwifery] seizure at birth


Whew, that pretty much answers all of my  questions!
Thanks very much for taking the time to share your
knowledge & experience, Jenny.
Whoops, thought of another question!  Black outs
reminds me... I have a friend who had a black out when
she was about 30/40 during a long day of shopping.
She was having an uneventful pregnancy, normotensive,
etc.  Had lots of baby movements both before & after
the blackout.  But was understandably freaked out
after the blackout.
If you were her midwife & she rang you describing
this, what would you suggest to her?
She went on to have a gorgeous baby at term in a birth
centre.
Jen
--- Jenny Cameron <[EMAIL PROTECTED]> wrote:
Most unusual. Usual practice would assume eclampsia
until proven otherwise.
I once had a woman, normotensive, postdates &
multigravid  have a grand mal
seizure immediately following an ARM for induction
of labour. Fortunately
the Obs was just outside the door washing his hands.
On questioning she gave
a history of frequent blackouts during pregnancy.
Didn't think to report it!
Subsequently diagnosed as epileptic. The actual
seizure is not a problem for
the woman (we need to protect her from physical
injury). It is certainly a
problem if the baby is still in utero as he will be
anoxic for the period of
the seizure. The major morbidity for the woman
arises from the ischaemic
cerebral damage and possible stroke from the
hypertension. Never, ever
underestimate pre-eclampsia. Beware of the woman
with upper epigastric pain
and be very wary of the 'twitchy' woman. New grads
don't be afraid but be
vigilant. Women rarely become eclamptic without some
warning. Medical
science is very good at detecting pre-eclampsia. The
management of
pre-eclampsia has changed dramatically over the
period of time I have been a
midwife. It so much better now.
As far as midwifery responsibility, if a woman
seizures, you need to
1) Call for urgent medical help
2) Protect her from injury
3) Take BP.
4) Prepare for medication to lower hypertension..
5) Monitor the baby...N.B.mother takes priority. If
she is well oxygenated
the baby will be. Therefore sort her out first.
Happy midwifing
Jenny
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
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Re: [ozmidwifery] seizure at birth

[Jenny Cameron]

Most unusual. Usual practice would assume eclampsia until proven otherwise. 
I once had a woman, normotensive, postdates & multigravid  have a grand mal 
seizure immediately following an ARM for induction of labour. Fortunately 
the Obs was just outside the door washing his hands. On questioning she gave 
a history of frequent blackouts during pregnancy. Didn't think to report it! 
Subsequently diagnosed as epileptic. The actual seizure is not a problem for 
the woman (we need to protect her from physical injury). It is certainly a 
problem if the baby is still in utero as he will be anoxic for the period of 
the seizure. The major morbidity for the woman arises from the ischaemic 
cerebral damage and possible stroke from the hypertension. Never, ever 
underestimate pre-eclampsia. Beware of the woman with upper epigastric pain 
and be very wary of the 'twitchy' woman. New grads don't be afraid but be 
vigilant. Women rarely become eclamptic without some warning. Medical 
science is very good at detecting pre-eclampsia. The management of 
pre-eclampsia has changed dramatically over the period of time I have been a 
midwife. It so much better now.

As far as midwifery responsibility, if a woman seizures, you need to
1) Call for urgent medical help
2) Protect her from injury
3) Take BP.
4) Prepare for medication to lower hypertension..
5) Monitor the baby...N.B.mother takes priority. If she is well oxygenated 
the baby will be. Therefore sort her out first.
Happy midwifing
Jenny

Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, November 17, 2004 2:02 PM
Subject: [ozmidwifery] seizure at birth


--- Graham & Wende Smith <[EMAIL PROTECTED]>
wrote:
Sunday night an asymptomatic primip had a seizure
with >a head on view.
Wende, do  you mind sharing more with me/us about this
experience?  I'm an about-to-graduate BMid student &
this sounds really scary!
If someone has a seizure during late pregnancy,
labour, birth do you always assume it's eclampsia even
if she's asymptomatic & treat accordingly?
Cheers, Jen
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Re: [ozmidwifery] what professional say...

[Jenny Cameron]

Hello Jo
The booklet is available online from 
NHMRC.
http://www7.health.gov.au/nhmrc/publications/pdf/cp66.pdf
Also Bandolier have some useful articles on 
ways to present risk etc to consumers and how to understand concepts like odds 
ratios and confidence intervals for us. Lots of interesting info on the 
Bandolier site.
http://www.jr2.ox.ac.uk/bandolier/band45/b45-5.html
Cheers
Jenny
 
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Dean 
  & Jo 
  To: [EMAIL PROTECTED] 
  
  Sent: Thursday, November 11, 2004 10:48 
  AM
  Subject: RE: [ozmidwifery] what 
  professional say...
  
  
  Sorry for the 
  delay…thanks for your post Jenny, it was most interesting.  I would love to get my hands on this 
  booklet from NHMRC.  There is no 
  easy answer on this issue but it is a serious one.  Again thanks for your 
  post!
  Cheers 
  
  Jo
   
  -Original 
  Message-From: [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Jenny CameronSent: Sunday, November 07, 2004 10:43 
  AMTo: 
  [EMAIL PROTECTED]Subject: Re: [ozmidwifery] what 
  professional say...
   
  
  Common decency should prevail. It 
  is unethical for health professionals to bully or coerce. I know it is tricky 
  accusing someone of bullying and probably most people don't realise they have 
  intimidated someone but it is important that it is brought to their notice. 
  Consumers have the right to make a formal complaint but it is better to 
  resolve it at the coalface. The process of lodging a formal complaint is 
  stressful on both the accuser & the accused. 
  
  
  Healthcare professionals must 
  learn to present information in an understandable and unbiased manner. The 
  NHMRC has a good booklet on "How to present the evidence to consumers'. It is 
  available from the NHMRC or govt bookshops. It is not easy to do this and it 
  does take time to explain. Many healthcare professionals, both midwives and 
  obs/gp's cannot read a research report & evaluate the evidence for 
  themselves. The Cochrane consumer section is useful but healthcare profs have 
  to get real & learn how to read a research report & how to pass this 
  on to their clients. 
  
  Jenny
  
  Jennifer Cameron FRCNA FACMProMid 
  Professional Midwifery Education  Service0419 528 
  717
  

- Original Message - 


From: Dean 
& Jo 

To: [EMAIL PROTECTED] 


Sent: Friday, 
November 05, 2004 4:24 PM

Subject: 
[ozmidwifery] what professional say...

 
The topic/issue of what doctors 
and some midwives say to women in the context of 
arrogance/disrespect/etc is something being discusses in a few forums.  I think it is important for this 
concern to be addressed but short of taping all that is said to a 
pregnant/labouring/new mother how do we prove that someone is in the 
wrong?  Women say the doc was 
really rude and offensive and the doc says the women misheard/is over 
sensitive and the doc is ‘let off’ and the woman feels degraded/abused or at 
least dissatisfied.
 
Giving women information is 
imperative but how and who determines the most appropriate way to give this 
information?  

 
I don’t know the answer…just 
wanting to generate discussion.
 
Love to all 

Jo 
Bainbridge
CARES 
SA
Bloomin Good 
Birth
 
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Re: [ozmidwifery] Re:cold epidurals

[Jenny Cameron]

The book "Birthing From Within. An extraordinary Guide to 
Childbirth Preparation" (1998;Partera Press) by Pam England and Rob Horowitz 
could be useful for your friend. Best Wishes.
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Kate 
  &/or Nick 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, November 07, 2004 3:41 
  PM
  Subject: Re: [ozmidwifery] Re:cold 
  epidurals
  
  My closest friend is pregnant with her 
  first. Because of various psych issues, including fairly spectacular panic 
  attacks, she has always been adamant that the only way she can birth is c/s 
  with GA. She's now 15 weeks along and I have got her prepared to attempt a 
  cold epidural induction. I hope to improve on that in the next few months, but 
  I figure we already have a vast improvement. 
   
  Kate 
   
   
   
  
- Original Message - 
From: 
Callum 
& Kirsten 
To: [EMAIL PROTECTED] 

Sent: Sunday, November 07, 2004 2:16 
PM
Subject: Re: [ozmidwifery] Re:cold 
epidurals

I don't think the disgust was aimed at the 
woman choosing epidurals. 
It was to the OB's and the way they were in the 
said situations, blatantly using their power to undermine and misinform 
these woman. I am all for informed choice, not scaring woman half to death 
about the idea of pain and the suggestion that they cannot cope with the 
pain by the OB. Thats whats sickening to me.
 
Kirsten
Darwin
 
 
 
~~~start life with a midwife~~~

  - Original Message - 
  From: 
  Nicole Cousins 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, November 07, 2004 11:21 
  AM
  Subject: Re: [ozmidwifery] Re:cold 
  epidurals
  
  Im not sure what the big deal is.  If a woman 
  decides that she would like an epidural before an induction is started why 
  shouldn't she have it.  Are we not here to surpport women in there 
  wishes and if their wish is for a pain free labour shouldn't we try to do 
  that for them.  Not everyone is the same and should we not try to 
  meet everyones needs.  And a PCA during labour, what a great idea if 
  thats what she wants, then she is than incontrol of her own pain 
  relief.  Women in control of their of their labour and their 
  needs.  
  Nicole
  
- Original Message - 
From: 
Kim 
Stead 
To: [EMAIL PROTECTED] 

Sent: Friday, November 05, 2004 
4:21 PM
Subject: Re: [ozmidwifery] Re:cold 
epidurals


  
  

  This is terrible.  What next!  "Would 
  you like to come in at 35 weeks because I'm going on a golf 
  convention and my colleague is fully booked with inductions, 
  epidurals and post-partum haemorrhages for the next 3 
  months!!  Makes you wonder doesn't it!
   
  Kim.
  ---Original 
  Message---
   
  
  From: [EMAIL PROTECTED]
  Date: 5/11/2004 
  3:34:27 p.m.
  To: [EMAIL PROTECTED]
  Subject: Re: 
  [ozmidwifery] Re:cold epidurals
   
  Larissa
  thats exactly the same reason as the Ob stated up here, not 
  once, but to
  many woman i saw him with. "The anaesthetist isn't always 
  available or at
  work on certain days, so if you go into labour naturally you 
  won't be
  guaranteed any pain relief BUT if we induce you on Monday 
  when hes available
  and give you an epidural at the same time, you will get the 
  pain relief and
  won't have to worry about going into labour when hes not 
  on.
   
  What the OB said to MANY woman.I was nearly sick.
   
  Kirsten
  Darwin
   
   
  ...~~~start life with a midwife~~~
  - Original Message -
  From: "Larissa Inns" <[EMAIL PROTECTED]>
  To: <[EMAIL PROTECTED]>
  Sent: Friday, November 05, 2004 1:38 PM
  Subject: [ozmidwifery] Re:cold epidurals
   
   
  >I just looked after a woman  who had one 
  (epidural) booked prior to
  > induction - reason given was that "the anaesthetist will 
  be in surgery and
  > it's not convenient for him to come and give you an 
  epidural when you'll
  > need one"
  > And the women are paying how much for this 
  "service"?!?!? The mind
  > 

Re: [ozmidwifery] PROM

[Jenny Cameron]

Actually it means Prelabour Rupture of the 
Membranes. Usually it is expressed as PROM-T which is Prelabour ROM at Term or 
PROM-P, which is prelabour ROM Preterm. 
Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Deliverywoman 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, November 07, 2004 2:44 
  PM
  Subject: Re: [ozmidwifery] PROM
  
  Hello Ping,
   
  Have you ever had a 'Homer' moment DOH. I just have.. Of course 
  it is prolonged. DOH
   
  Thank you.
  Rita
  DeliverywomanPing Lerchbacher <[EMAIL PROTECTED]> 
  wrote:
  



Hi Rita, 
I believe PROM stands for Prolonged Rupture of 
Membrane especially if it is mentioned in relation to Term.
Ping
  
  
  Find local movie times and trailers on Yahoo! Movies.

Re: [ozmidwifery] what professional say...

[Jenny Cameron]

Common decency should prevail. It is unethical for 
health professionals to bully or coerce. I know it is tricky accusing someone of 
bullying and probably most people don't realise they have intimidated someone 
but it is important that it is brought to their notice. Consumers have the right 
to make a formal complaint but it is better to resolve it at the coalface. The 
process of lodging a formal complaint is stressful on both the accuser & the 
accused. 
Healthcare professionals must learn to present 
information in an understandable and unbiased manner. The NHMRC has a good 
booklet on "How to present the evidence to consumers'. It is available from the 
NHMRC or govt bookshops. It is not easy to do this and it does take time to 
explain. Many healthcare professionals, both midwives and obs/gp's cannot read a 
research report & evaluate the evidence for themselves. The Cochrane 
consumer section is useful but healthcare profs have to get real & learn how 
to read a research report & how to pass this on to their clients. 

Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

  - Original Message - 
  From: 
  Dean 
  & Jo 
  To: [EMAIL PROTECTED] 
  
  Sent: Friday, November 05, 2004 4:24 
  PM
  Subject: [ozmidwifery] what professional 
  say...
  
  
  The topic/issue of what doctors 
  and some midwives say to women in the context of 
  arrogance/disrespect/etc is something being discusses in a few forums.  I think it is important for this 
  concern to be addressed but short of taping all that is said to a 
  pregnant/labouring/new mother how do we prove that someone is in the 
  wrong?  Women say the doc was 
  really rude and offensive and the doc says the women misheard/is over 
  sensitive and the doc is ‘let off’ and the woman feels degraded/abused or at 
  least dissatisfied.
   
  Giving women information is 
  imperative but how and who determines the most appropriate way to give this 
  information?  
   
  I don’t know the answer…just 
  wanting to generate discussion.
   
  Love to all 
  
  Jo 
  Bainbridge
  CARES 
  SA
  Bloomin Good 
  Birth
  ---Outgoing mail is certified Virus Free.Checked by 
  AVG anti-virus system (http://www.grisoft.com).Version: 6.0.788 / Virus 
  Database: 533 - Release Date: 
11/1/2004

[ozmidwifery] epidurals

[Jenny Cameron]

We do live in a 'fix it' culture. I think most women still do not believe 
they can labour & birth without pharmacological help. Even 'well informed' 
women who have attended the classes and read it all have probably mostly been 
educated on how to behave 'in the system'. Midwives & obs need to 
demonstrate their deep belief in the ability of women to birth their baby 
without pharmacological pain relief. In my experience as a midwife holding that 
belief, women sense your committment & if you (the midwife/obs) act as 
though everything is normal & give tons of positive feedback & support, 
she will do it herself. I believe it is so unfair to offer a strongly labouring 
woman an epidural when she is vulnerable and it is wicked to use the argument of 
'the anaesthetist will be busy later' to talk women into an early epidural. 

Jenny
Jennifer Cameron FRCNA FACMProMid Professional Midwifery 
Education  Service0419 528 717

<><>

Re: [ozmidwifery] Re:cold epidurals

[Jenny Cameron]

Gee, I hope she doesn't have a reaction to the epidural while he is busy.
Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
- Original Message - 
From: "Larissa Inns" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Friday, November 05, 2004 3:08 PM
Subject: [ozmidwifery] Re:cold epidurals


I just looked after a woman  who had one (epidural) booked prior to
induction - reason given was that "the anaesthetist will be in surgery and
it's not convenient for him to come and give you an epidural when you'll
need one"
And the women are paying how much for this "service"?!?!? The mind
boggles.
Hugs,Larissa
FUSA 2nd yr student
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