RE: [ozmidwifery] was supplements during pregnancy - now "A Midwife's Handboook"

[Julia Vaughan]

Hi
Nicole,

 

I just
googled this book and it looks like a good one.  Is it on uni reading
lists or just one that you came across?  Any other suggestions - Nicole or
anyone else - for good foundation books for a beginning BMid student?  I
don’t have our book list yet…

 

Julia - who
is keen to purchase a few carefully chosen midwifery titles.

 

 

-Original
Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Nicole Carver
Sent: Wednesday,
 22 February 2006 11:33
 AM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery]
supplements during pregnancy

 



Hi
Paivi,





I looked
up the dose in 'A Midwife's Handbook' by Constance Sinclair, 2004. She
recommends 400ug folic acid daily from 6-8 weeks prior to conception
(presumably continue to 14 weeks post conception) and 4mg for women who have a
past or family history of neural tube defects. I think it would be an important
product to have in your store.





Nicole.  

RE: [ozmidwifery] supplements during pregnancy

[Julia Vaughan]

Yes this is certainly very interesting.  A
friend of mine is pregnant and self-prescribed Blackmore’s pregnancy and breastfeeding
supplement.  
Doing the shared care option and GP advised that she change to Elevit (which
she did) as “it is the only supplement that has been researched to be of
benefit to baby”.  This suggested to me that any “research”
that was indeed done on Elevit would have been done by its big rich
pharmaceutical manufacturer.  What are the benefits of Elevit over say
Blackmore’s or any other supplement?  Are they necessary at all in the
course of a healthy pregnancy?  I read in some of Elevit’s own
advertising that other supplements contain fish oil which has not been proven
to be safe during pregnancy so Elevit does not contain fish oil…

 

Julia

(1st year BMid Student as of
next week! Yay!)

 

-Original
Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Päivi Laukkanen
Sent: Wednesday, 22 February 2006
9:57 AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery]
supplements during pregnancy

 



Very interesting Lieve.
This is exactly why I love this list. I would never get these answers anywhere
else...





 





Päivi







- Original Message
- 





From: Lieve
Huybrechts 





To: ozmidwifery@acegraphics.com.au 





Sent:
Wednesday, February 22, 2006 12:32 AM





Subject:
RE: [ozmidwifery] supplements during pregnancy





 



Hoi Païvi,

 

What I read through the time about folic acid is that only women
that took chemical anticonception for a long time need folic acid. They
don’t absorb it well and have low levels when they stop with the
anticonception. So you can make a difference with women who didn’t take
anticonception  for a while.

 

I also read, but don’t ask me where J that taking folic acide doesn’t reduce the incidence of
neural tube defects, but with normal levels a womens body works better, so also
the natural selection, so the affected foetus is spontaneously aborted.

So I stimulate women that took oral anticonception to wait a while
before getting pregnant and to supplement with folic acid. If thay come on
preconceptional consultation I do a blood test and test for folic acid an iron
and never give supplements without reason.

 

In the books of Michel Odent you also can find that a drop in hb
level and iron after 28 weeks is very normal. It seems that women who
don’t have the drop are more at risk for premature delivery. So I never
give supplementation of iron, except there is a real severe anaemia. You always
have to keep in mind that also bacteries grow on iron. Around birth a woman is
vulnarable to infections so it is normal for a body to protect itself by
lowering the iron reserves. 

I recommend healthy food, walking and swimming and it works.

 

Kind regards

Lieve

 



Lieve
Huybrechts

vroedvrouw

0477740853

 

 



 

-Oorspronkelijk
bericht-
Van:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Namens
Päivi Laukkanen
Verzonden: dinsdag 21 februari
2006 22:39
Aan:
ozmidwifery@acegraphics.com.au
Onderwerp: Re: [ozmidwifery]
supplements during pregnancy

 



Thank you for the
information. Here in finland you can't get just folic acid on it's own. It
always comes in a multivitamin or ironsupplement I guess. I would like to
provide a reasonable product for Finnish women, so do you think, that I should
seek for a plain folic acid product, and sell that in my store? Can you
remember the daily recommendations for folic acid?





 





Päivi







- Original Message
- 





From: Nicole
Carver 





To: ozmidwifery@acegraphics.com.au 





Sent:
Tuesday, February 21, 2006 11:00 PM





Subject:
RE: [ozmidwifery] supplements during pregnancy





 





Hi Paivi,





 





Iron should only be taken by women who are anaemic, or you can see
they are heading that way (ie Hb going down.) Of course these women need full
investigation too, with iron studies and a medical examination and history.
There has been some question that giving iron to women who don't need it can
lead to blood which is more viscid, and reduces the blood flow through the
placenta.





 





Folic acid on the other hand, drastically reduces the incidence of
neural tube defects such as spina bifida and anencephaly, with a possible side
effect of a small increase in the possibility of having twins. Women who have a
history of a previous baby with a neural tube defects are prescribed higher
doses. Folic acid should be taken pre-conception and for the first fourteen
weeks.





 





I don't see the need for any other supplementation than folic acid,
unless the woman has a demonstrated deficiency or they are strict vegans, in
which case I believe supplementation with B12 is recommended.





 





Regards,





Nicole.





-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On
Behalf Of Päivi Laukkanen
Sent: Wednesday, February 22, 2006
6:35 AM
To: ozmidwifery@acegraphics.com.au
Subject

RE: [ozmidwifery] Re :Politics

[Julia Vaughan]

Hubby and I got a congratulatory card from our local member after the birth
of our last baby.  Neither of us filled out a form or notified her office so
we don't know how she knew we had had a baby.  It seemed a bit weird at the
time.  Just like "sucking up" to the constituents...



-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lyle Burgoyne
Sent: Sunday, 12 February 2006 8:49 AM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Re :Politics

Hi,
I work in a NSW public hospital as a midwife and our local state member
has given us consent  forms to get the mothers to fill in to give him
permission to to send them a congratulatory card after the birth of
there baby.He is a member of the current government party and holds his
seat by a very slim margin .Am I being cynical in thinking this is
politics sinking to another low to get votes ?Or is he just being nice
and geting to know his new constituents???
Is it happenning at any other hospitals?
 I really dont think it is my job to do this for him or any other
politician .What do others think??
Thanks 
Lyle

 
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RE: [ozmidwifery] baby poo

[Julia Vaughan]

Title: Message









No-one else seems to have replied so I
will jump in… In my opinion it is probably the baby’s physical
reaction to the abrupt change in diet.  If baby was weaned slowly and
formula replaced gradually i.e one feed at a time over a period of weeks then
the reaction would probably not be as obvious.  Formula-babies’ poos
are usually clay-like in consistency and bub may well be constipated on top of
this.  Formula-fed bubs are prone to constipation – breast-fed
babies are almost never constipated.  I agree that changing formula will
most probably not help in this instance – it is most probably a reaction
to formula in general as apposed to a specific type or brand.  It is
probably best that if mum does decide to change that she goes with a
whey-dominant formula as these have been “humanised” as apposed to
a casein dominant formula which is more like cow’s milk (S26 is whey
dominant).

 

 

HTH,

Julia.

 

 

-Original
Message-
From: owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au]
On Behalf Of Sylvia Boutsalis
Sent: Tuesday,
 6 September 2005 10:12
 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] baby poo

 



Hi there,





 





I have a question regarding baby
poo.   This baby is 6 1/2 months old, was fully breast fed until 3
weeks ago when her mother put her on straight formula (S26 premium), no
weaning.  The baby is not eating any form of solids as yet.  She is
apparently over 70 cms (which I think the mum said was the normal height for a
9month old).  She looks like she is gaining weight normally. 





 





Her poo has been clay-like from the
beginning of formula feeding, greenish/grey mostly with some specks of yellow
occasionally.  It is causing her so much distress when she is trying to
poo, with her going red, holding her breath for ages and even sweating so much
I had to wipe her face with a tissue.  Is this normal???  I have seen
this baby try to do a poo before and there was a never ending stream of clay
coming out of her bottom.  I wiped it away and then saw some more, wiped
that, then more etc etc.  It's not a bowel motion I've ever seen before
and I'm a bit concerned.  I told the mother to change formula but a health
nurse (phone call to a service) told her not to change the formula and that it
takes babies ages to adjust.  That doesn't ring true to me, so I wanted
another opinion.





 





I told the mother to take the baby
to a paediatrician pronto just to be sure, as this baby's distress was
alarming.  





 





Any advice?





 





Thanks in advance





 





Sylvia Boutsalis





Infant Massage Instructor





Childbirth Educator





Adelaide

[ozmidwifery] Differences in midwifery training

[Julia Vaughan]

So true Rachel...

As registered nurse (aspiring to be a midwife) who only studied nursing with
the intention of becoming a midwife I worry that I have already been too
socialised into the medical model of care that is still the norm in
Australia.  And that goes for all health care - not just maternity services.
It will be a great day indeed if and when Australia catches up to the UK in
its approach to maternity care.

It is great that there are Bmid courses available now but they are still
relatively new and not available in all states yet (to my knowledge).  Here
in NSW we only have 1 available to us at UTS and it is in its first year!
Had the Bmid been available when I first decided to become a midwife I would
have done that course instead of Bnursing...  But change is slow - I was
told that they (UTS) were working on a Bmid course in 1997 when I applied
for Bnursing and I could transfer when it was up and running.  We have a
long way to go when the vast majority of midwives working in Oz are
registered nurses also.  And yes, people do refer to midwives as "nurses in
maternity"...

Julia.



-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of wump fish
Sent: Wednesday, 31 August 2005 10:32 AM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Fw: 'Higher risk' in midwife deliveries
(http://theaustralian.com.au report)

Even if it is the same curriculum in Australia - it is set within a 
different context.

Correct me if I am wrong (still getting to grips with the system here). A 
student midwife in Australia is 'mentored' by midwives working in the public

health system. Because these midwives are limited in their autonomy and 
skills, the student will also be limited.

Students are also subject to the cultural and social perceptions of 
midwifery where they train. If most people perceive midwives as nurses 
working in maternity - it is difficult to develop an identity as a midwife 
(I am struggling to maintain my own professional identity).

In the UK the midwives I trained with were 'midwives', they did not also 
work as nurses, nor refer to themselves as nurses. Women in the UK called us

midwives and had an understanding and respect for our role. During my 
practice as a team midwife - women would ring us to tell us they were 
pregnant. We would send a letter to their GP to let them know (out of 
courtesy), then provide all the woman's care until 6wks postnatal. Women 
refer to midwives as 'my midwife' and ask each other 'who is your midwife'.

Are Australian students exposed to this kind of reciprocal relationship with

women?

Midwifery is not just about clinical skills - it is about philosophy, 
culture, experience, politics etc etc.

Rachel
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RE: [ozmidwifery] Men at births

[Julia Vaughan]

Yes it is interesting stuff indeed.  Call me callous but I do think that
childbirth is a fact of life and if a couple has decided (after exploring
all the issues) that hubby/male partner will be present for the birth then
he needs to get over it!

I too have read information by Michael Odent regarding men being present at
birth.  I think though that in our society, rightly or wrongly, it is the
expectation that the father will be present for the birth and most men say
things like "wouldn't have missed it for the world".  There is plenty of
time during pregnancy to decide these things although in an ideal world we
would all know where we stood before preg.

JMHO,

Julia.



-Original Message-
 
This is an interesting report in today's Sydney Morning Herald. I remember 
Michel Odent talking about research done in the US that explored the effect 
on a couple's sexual relationship when the man had been exposed to the 
birth process. Michel was advocating that women might want to retain some 
of their "sexual mystery" by excluding men from the birth room. I have been 
at births where I wondered how the father was taking the sight of a 
practitioner cutting an episiotomy.

What does everyone think about this?

http://www.smh.com.au/articles/2005/08/30/1125302566185.html

Regards,

Andrea
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[ozmidwifery] Ultrasound, size of baby

[Julia Vaughan]

All of the previous posts
(below) are interesting personal anecdotes and simply reinforce the fact that
ultrasound is merely a tool to be used as part of the clinical decision-making
process.  Like any medical service the skill of the operator as well as
the equipment used can vary enormously. At my local public hospital, the
midwives do not particularly like the ultrasound clinic that the hospital has
its bulk-billing agreement with and often recommend that pregnant mums consider
going to the (private) specialist women’s u/sound clinic if a non-routine
u/sound is indicated (if they can afford it).  Like all private medical
services it is horrendously expensive and the benefit paid by medicare does not
go anywhere near covering the costs incurred. 

 

Julia.

 

-

 

 

I
personally had an ultrasound at 37 weeks last pregnancy (at a specialist
women’s ultrasound clinic) and the estimate of bub’s weight was
actually spot on (if you allow approx a 1oz a day foetal weight gain).  At
the time I was told that the estimate could be as much as + or – 10%
which is huge when you are talking about 4500+ grams of baby!

 

 

I had ultrasounds on the day of birth of
my last two babies, I was overdue both times and had to see Obstetrician. 
These were my 4th and 5th children.  Number 4 he
said would be large.  At least 9lbs.  He was 7lb 3oz.  Number 5,
I think he was remembering his previous error and said this was not a big
baby.  He was 9lb 1oz.  I have little faith in USS.  Keeping in
mind that my twins were also missed on USS and picked up on Abdo palp.

Lindsay

 

 

 

I can't speak to quality of guestimating
baby sizes but I can tell you there is a world of difference between ultrasound
machines and technicians. I seem to be averaging about 2-3 pelvic ultrasounds a
month at the moment, quite often it is that many per week, and I would have
great faith in my favourite clinic's ability to measure just about anything and
almost no faith in various other clinics ability to measure anything.

 

RE: [ozmidwifery] 3rd degree tears

[Julia Vaughan]

No experience of vaginal birth following 4th
degree tear (thankfully!).  But I personally had an ultrasound at 37 weeks
last pregnancy (at a specialist women’s ultrasound clinic) and the
estimate of bub’s weight was actually spot on (if you allow approx a 1oz
a day foetal weight gain).  At the time I was told that the estimate could
be as much as + or – 10% which is huge when you are talking about 4500+
grams of baby!

 

HTH,

Julia

 

-Original
Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Kim Stead
Sent: Tuesday, 30 August 2005 9:19
AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] 3rd
degree tears

 


 
  
  
  Out of curiosity.. does anyone have any experiences of
  vaginal birth following previous 4th degree tear?  I've just recently
  met a woman who wants to give vaginal birth a go - has new partner (says old
  one was huge!).  She is smallish person - 60kg, last babe 10lbs (1st
  baby).  What do you think.  She will be birthing in hospital. 
  I've asked her to get a copy of her obstetric records from previous
  hospital.  Still in early pregnancy so can't gauge size yet.  Is a
  later ultrasound a good idea for a gestimate on the weight?  I know they
  can be so inaccurate.
  
  
   
  
  
  Kiwi Kim,
  
  
   
  
  
   
  
  
 
 
  
  
   

 


 


 

   
  
  
  
 

RE: [ozmidwifery] 3rd degree tears

[Julia Vaughan]

Yes Sue, that is scary stuff indeed. 
Makes me think that manufacturers of incontinence products will be delighted. 
Those statistics are appalling.  Think how many people will need theses
products based on the information below!  You know – “1 in 3
women over the age of 35 who have had a baby will suffer from occasional
bladder weakness”…”nothing to be ashamed about”…”best
handled with Poise” etc etc…

 

A very cynical Julia.

 

-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Sue Cookson
Sent: Monday, 29 August 2005 11:05
AM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] 3rd degree
tears

 

Hi,
I've just returned from a clinical placement in SA where I spent a mindblowing
three hours in an incontinence clinic in an outpatients unit at a major
hospital.
The mindblowing element was the following statistics (copied from one of the
handouts):

·
39-49% women tear or have an episiotomy needing
sutures

·
0.5 - 2.5% have a 3rd or 4th degree tear after
vaginal childbirth that is visible

·
25-35% after first vaginal delivery have a
concealed or closed 3rd degree tear, not visible

Listed as contributing factors
were:

·
1st vaginal birth

·
forceps/instrumental delivery

·
long second stage  >1 hour

·
big baby    >4kgs

·
tissue type, short perineum, epidural, uncontrolled
pushing, rapid delivery, midline tear or episiotomy


The nurse practitioner stated this was all evidence-based information and
recommended c/sections to women who had had previous 3rd degree repairs - these
were the ones who knew about their tears obviously.
The handouts do not give references and as yet I have not had time to begin
researching.

Are you all as mindblown as I am??
What do you think - are 1/4 - 1/3 of us walking around with damaged anal
sphincters and not aware of it??
Where does this sort of information lead us - if our bodies are so inept at
giving birth then all first babies and subsequently all babies should be born
by c/section.

Sue

RE: [ozmidwifery] Routine collection and testing of cord blood - ABO incompatibility

[Julia Vaughan]

IMO testing for group and coombs etc may
be beneficial.  I know of more than one case where there was ABO
incompatibility (mum O pos and bub A pos) and it was only when bub turned
bright yellow (one born yellow, one turned within 12 hrs of birth) that bloods
were done and phototherapy commenced with the threat of exchange transfusion if
SBR reached over ^400.  How common is exchange transfusion anyway? 
What are some of the protocols out there re ABO incompatibility?  Just
curious as we were all told how “very rare” it is.

 

Thanks,

 

Julia V.

 

-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of JoFromOz
Sent: Wednesday, 24 August 2005
10:31 AM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Routine
collection and testing of cord blood

 

Helen and Graham wrote: 



 





 





At the place I now
work, we are still collecting it on every patient and they are all being
tested for group and coombs etc.  This seems a total waste of time and money
to me as well as an unnecessary occupational safety risk to staff.



Helen, we collect cord
blood on each baby for the same reason, but it is kept in the fridge for
(however  long) incase the baby has early jaundice.  Only then is it
sent off.

HTH

Jo

RE: [ozmidwifery] when to cut an episiotomy

[Julia Vaughan]

Here is a quick story about my personal
experience.  When I was birthing my beautiful 4560 gram baby (now 16
months old) my midwife was concerned that my peri had stretched as far as it
was going to  (i.e. not far enough) and was about to perform an episiotomy. 
She was only able to make “a very slight nic” as the scissors were
blunt and I had one almighty contraction at just the right time!   Bub’s
head was out and she was then very quickly born with my peri basically intact
except for some slight grazing.  How lucky was I?  I am just so
thankful for this outcome.  So I tell everyone who is remotely interested
in birth that I was saved by a pair of blunt scissor and one contraction. 
Of course I KNEW (after giving birth to 2 other babies 4440 and 4320 grams
without episiotomy) that I did NOT NEED one of these things anyway!

 

Cheers,

 

Julia V. (Aspiring Midwife)

 

 

 

-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Nicole Carver
Sent: Sunday, 21 August 2005 7:56
 PM
To: [EMAIL PROTECTED]
Subject: RE: [ozmidwifery] when to
cut an episiotomy

 



I will only do an episiotomy if I am really concerned about getting
the baby out quickly. I have done one on a peri that was really tight, and
didn't stretch  up. I think I have done three in my career,





 

 

Nicole C.

 

RE: [ozmidwifery] UTS Bachelor of Midwifery

[Julia Vaughan]

UTS is University of Technology, Sydney – opposite end of
Oz to Perth L

 

-Original
Message-
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of The Fairbairn Family
Sent: Friday, 5 August 2005 8:27
PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] UTS
Bachelor of Midwifery

 



Hi,





I would be interested to hear where
UTS is!! - I am planning to be in Perth next year and am considering a
midwifery course myself - anyone got any advice for a course in the Perth metro
area?





Stephanie currently in the UK

[ozmidwifery] UTS Bachelor of Midwifery

[Julia Vaughan]

Hi all,

 

My name if Julia and I am an aspiring midwife. I am new to
the list and am enjoying lurking thus far.  However, I am wondering if
there is anyone out there who is currently enrolled in the Bachelor of
Midwifery at UTS as I am hoping to get into this course next year. 
Specifically how are you finding it in general?  Also work/uni/family
balance issue?  What does the timetable look like?  How are the
midwives on prac treating you?  Please email me off list if you think it
is not interesting to majority of group (it probably isn’t…).

 

 

Cheers, 

 

Julia Vaughan

 

[EMAIL PROTECTED]