RE: [ozmidwifery] Pregnancy and Crohns

[Kirsten Lerstrøm]

The phrase you put so well - "Risk is not a diagnosis; It is to assist in
preventing problems or detecting them early, so they can be minimized" - is
just perfect and will work well in many of life's matters!
Thank you for putting it so nicely: simple and yet complete! May I use that
phrase in my work with Lupus/SLE?
 
Best regards,
Kirsten in Denmark
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Christine
Holliday
Sent: 16. januar 2007 21:20
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Pregnancy and Crohns


Sometimes it can be helpful to ask the person who has said she is high risk
to ask what she is at risk of.  Usually puts it all in perspective and of
course remind the woman that you may be at risk of something but it does not
mean it will happen.  Risk is not a diagnosis it is to assist in preventing
problems or detecting them early so they can be minimized, one of the Drs I
work with does not like risk as a label “either you have a problem or you
don’t”, good advice I feel.
 
Christine
 
 
-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Lisa Barrett
Sent: 16 January 2007 20:59
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Pregnancy and Crohns
 
~thanks for that. I did tell her that I don't believe her to be high risk,
but her health insurance fund has stepped in and said that the only place
she would be safe to birth is at a large tertiary hospital (lucky her). It
is sad to see that a woman who should be excited and cherishing every moment
of her pregnancy has been fed doubt and despair from ill informed
professionals.~
 
That's interesting, how long have insurance companies been dictating terms
of birth here?  
 
Lisa Barrett

RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes

[Kirsten Lerstrøm]

Hi Jayne
It's actually a new - socalled revolutionary vaccine - against cervical
changes. I do not not know that much about the actual compund yet - vague
press info so far, but they do stress making it universal for all girls at
onset of puberty and before sexual beginning, thus 15 years of age.
Here, it's "sold" as an option for these girls without parental consent. So
many issues, that just scream "concern" without/before further knowledge.
We're in the midst of complete governmental change these days, so actions
like this, is really possible to push through without any notice going on.
Best regards,
Kirsten in Denmark

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of jayne/jesse
Sent: 11. januar 2007 02:33
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Article about preterm birth and treatment for
cervical changes


Hi Kirsten,
 
Are you talking about the HPV (genital warts) vaccine?  They say HPV is
responsible for approx 70% of cervical cancer cases although I have seen
that figure stretched beyond the 70% for the sake of advertising of the HPV
vaccine.  I'm not sure where the figure comes from.  I would say money
figures heavily on the agenda :)
 
The vaccine is now available in Australia and the US.  I'm not sure where
else at present.
 
Regards
 
Jayne
 
 

- Original Message - 
From: Kirsten   Lerstrøm 
To: ozmidwifery@acegraphics.com.au 
Sent: Thursday, January 11, 2007 10:19 AM
Subject: RE: [ozmidwifery] Article about preterm birth and treatment for
cervical changes

Dear all
Twice in one night out of two years I feel compelled to answer posts on the
list! 
This study has been used as a propellar for inaugerating new studies
performed on the pregnant here in Denmark!
Actually they claim to have a vaccine given to young girls up to 15 years
old, that would "solve this problem".
I  have great dificulties getting totally convinced a vaccine could solve
this particular cancer problem. 
And this at a moment where the National Health Institute finally has
acknowledged major problems with screening of breast cancer and the like
(a.o. Down's Syndrome), because of poor results as to positive/negative
readings followed by distress due to trauma caused by the readings.
What is really the agenda?
Kirsten in Denmark

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Helen and Graham
Sent: 10. januar 2007 23:04
To: ozmidwifery
Subject: [ozmidwifery] Article about preterm birth and treatment for
cervical changes


Precancerous changes and preterm births 

Issue 01: 8 Jan 2007 
Source: BJOG: An International Journal of Obstetrics and Gynaecology
2007;114:70-80




A study has provided new insights into the association between precancerous
changes in the cervix and the risk of subsequent preterm birth. The findings
suggest that diagnosis of precancerous changes, regardless of the treatment
given, is associated with a significantly increased risk of delivery before
37 weeks’ gestation.




Researchers at centers in Carlton, Australia, conducted a retrospective
cohort study, investigating the records of 5,548 women who:

1.  Were referred to a cervical dysplasia clinic at the Royal Women’s
Hospital in Carlton between 1982 and 2000 for assessment of an abnormality
detected on a routine Pap smear or for evaluation of a cervix that appeared
abnormal; and 

2.  Subsequently had a birth recorded in the Victoria state perinatal
data collection system. The birth studied was the first after the referral,
for women who were untreated, and the first after treatment, for women who
received treatment.

The follow-up period for the women ranged from 2 years to 20 years after
referral.

The researchers report their findings in a new paper published in the BJOG:
An International Journal of Obstetrics and Gynaecology. Overall, there were
533 observed preterm births in the cohort of 5,548 women, significantly
higher than the 312 cases expected based on national figures.

The main findings included the following:

*   The risk of preterm birth (defined as within 37 weeks of gestation)
was significantly higher for both treated and untreated women compared with
the general population. 

*   The risk of preterm birth was significantly higher among the treated
women than among the untreated women. 

*   Other factors significantly associated with an increased risk of
preterm birth were a history of induced or spontaneous abortion, illicit
drug use during pregnancy, and a major maternal medical condition. In terms
of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP),
and diathermy were associated with preterm birth; after adjustment for
potentially confounding factors, only the association between diathermy and
preterm birth remained statistically significant. 

*   Women treated with laser ablation did not have a significantly
increased risk of preterm birth.

Di

RE: [ozmidwifery] Article about preterm birth and treatment for cervical changes

[Kirsten Lerstrøm]

Dear all
Twice in one night out of two years I feel compelled to answer posts on the
list! 
This study has been used as a propellar for inaugerating new studies
performed on the pregnant here in Denmark!
Actually they claim to have a vaccine given to young girls up to 15 years
old, that would "solve this problem".
I  have great dificulties getting totally convinced a vaccine could solve
this particular cancer problem. 
And this at a moment where the National Health Institute finally has
acknowledged major problems with screening of breast cancer and the like
(a.o. Down's Syndrome), because of poor results as to positive/negative
readings followed by distress due to trauma caused by the readings.
What is really the agenda?
Kirsten in Denmark

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Helen and Graham
Sent: 10. januar 2007 23:04
To: ozmidwifery
Subject: [ozmidwifery] Article about preterm birth and treatment for
cervical changes


Precancerous changes and preterm births 

Issue 01: 8 Jan 2007 
Source: BJOG: An International Journal of Obstetrics and Gynaecology
2007;114:70-80




A study has provided new insights into the association between precancerous
changes in the cervix and the risk of subsequent preterm birth. The findings
suggest that diagnosis of precancerous changes, regardless of the treatment
given, is associated with a significantly increased risk of delivery before
37 weeks’ gestation.




Researchers at centers in Carlton, Australia, conducted a retrospective
cohort study, investigating the records of 5,548 women who:

1.  Were referred to a cervical dysplasia clinic at the Royal Women’s
Hospital in Carlton between 1982 and 2000 for assessment of an abnormality
detected on a routine Pap smear or for evaluation of a cervix that appeared
abnormal; and 

2.  Subsequently had a birth recorded in the Victoria state perinatal
data collection system. The birth studied was the first after the referral,
for women who were untreated, and the first after treatment, for women who
received treatment.

The follow-up period for the women ranged from 2 years to 20 years after
referral.

The researchers report their findings in a new paper published in the BJOG:
An International Journal of Obstetrics and Gynaecology. Overall, there were
533 observed preterm births in the cohort of 5,548 women, significantly
higher than the 312 cases expected based on national figures.

The main findings included the following:

*   The risk of preterm birth (defined as within 37 weeks of gestation)
was significantly higher for both treated and untreated women compared with
the general population. 

*   The risk of preterm birth was significantly higher among the treated
women than among the untreated women. 

*   Other factors significantly associated with an increased risk of
preterm birth were a history of induced or spontaneous abortion, illicit
drug use during pregnancy, and a major maternal medical condition. In terms
of treatment, cone biopsy, loop electrosurgical excision procedure (LEEP),
and diathermy were associated with preterm birth; after adjustment for
potentially confounding factors, only the association between diathermy and
preterm birth remained statistically significant. 

*   Women treated with laser ablation did not have a significantly
increased risk of preterm birth.

Discussing their findings, the researchers say the study is the largest to
date examining pregnancy outcomes following diagnosis and treatment for
precancerous changes in the cervix. They conclude: “Women presenting with
precancerous changes in the cervix are at an increased risk for preterm
birth, a risk that appears to be increased by treatments that remove or
destroy substantial amounts of cervical tissue.”

They suggest that, in light of these findings, there needs to be a
re-evaluation of treatment programmes involving a “see and treat” policy for
the management of abnormal Pap smear results. In addition, “the use of
ablative techniques such as laser ablation need revisiting,” the researchers
state.

RE: [ozmidwifery] where has this list gone?

[Kirsten Lerstrøm]

Dear all
It's been quite a while since my last posting on this list. But never the
less, I enjoy reading the posts every day - and forwarding the most
insteresting posts to the communities here in Denmark. Cherished. 
I seem to get all the posts without any problems.
Thank you all for making this list worth while! And off course to you,
Andrea, for making it possible!
Please, please keep it on. In my view the issues presented are all relevant
and the discussions educational. Even though I'm a member of a society, -
Denmark-  you consider being superior to your own. We're nothing of the
kind, and still struggling hard to provide amble midwifery care!
Warm regards

Kirsten in Denmark
C/o Birth Committee Denmark


--
This mailing list is sponsored by ACE Graphics.
Visit  to subscribe or unsubscribe.

RE: [ozmidwifery] Crownprincess Mary of Denmark gave birth naturally

[Kirsten Lerstrøm]

Hi 

Yes, 
your Australian crownprincess Mary gave birth at 01.57 Saturday morning. The 
whole country was esctatic - flags and celebrations all over. A really nice 
thing was a series of bonfires throughout the country. The first started at 
18.30 in Copenhagen, then the next was lit up further away until the last 
bonfire was lit a few hours later at the very northen tip of Jutland. Sending 
important messages (used to be about warnings of enemies entering the country) 
by bonfires "baunebaal" is an ancient tradition. They also fired canons (real 
ones!) from the castle in Copenhagen and from Kronborg in Helsingor (Hamlet's 
castle). 
The 
crownprince met the press 7½ hours afterwards - still high on the birth and 
very, very happy. He made a point about not knowing the sex beforehand, so it 
was a surprise to see the firstborn a boy. "Everybody should try doing that", he 
said. (could be a hint to our presetn practice where all pregnant are scanned). 
He wouldn't say much about the birth itself except that it's an awestriking 
experience, that leaves you humble by natures forces. Mother and child was doing 
well - the little one now sound asleep and not aware of what's coming to him. 
(one of his smirks followed that one).
 
A 
journalist asked him, where the baby will sleep. So Pinky, here's one for you: 
"within an armslength of eather one of us" !!!
 
Questions about the birth were left for the chief of staff, chef obs and 
one of the managing midwives to answer, but only the obs spoke - didn't leave 
the other two a chance. That really bothered me, as I got the notion, that they 
(midwife and obs) didn't quite agree on his answers. When asked by the 
journalists whether "Mary got her Epidural" - he said "off course", but the 
midwife turned her head quickly towards him - her whole face a big question 
mark. I'll see what the grapewine will tell during the days to come. For the 
rest of the day, I heard only a few midwives talking about birth and birth 
naturally. They had a lot of explaining to do. The epidural-thing came up when 
the other princess (sister-in-law to Mary) had her babies five and three years 
ago (actully for the first one, she arrived at the hospital only shortly before 
giving birth, but the doctors gave her an epidural anyway!). Until then 
epidurals were something administered carefully, but again somewhat laxly. But 
the doctors sold the idea in the press and then everybody demanded one during 
birth and it became the only issue in the birth-debate for a long time. As 
midwives didn't fall for that and tried talking people out of having one 
unnessary, midwives were the bitchy witches doing births the old fashioned way, 
and only interested in enhancing their own cause. I hate that. 

 
We 
haven't seen the prince yet, but I guess, as the crownprince said "he looks like 
a newborn".
 
Warm 
regards,
Kirsten in Denmark

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of Susan 
  CudlippSent: 17. oktober 2005 07:07To: 
  ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] 4ft 9 and 
  birthing
  Actually it was me who mailed that - Rachel 
  responded.
  I agree that height is not the only indicator, in 
  this woman's case there were others, and I did not necessarily agree that she 
  should not have been encouraged to try for a normal birth, just making the 
  point that the advice was basically "better a 'good' caesar than a 'bad' 
  vaginal birth"  (his words, not mine)
   
  It is sad and I do hear what you are saying - 
  glad that you at least were able to rise above the negativity, as was I when 
  advised to have elective C/S for my 3rd, but most often "doctor knows best" 
  still rules!
   
  On the positive side - Sounds very much like "our 
  Mary" (crown princess of Denmark) had a normal birth. I have not heard 
  officially but the news said born at 01.30 after a 10 hour labour, so sounds 
  like she gave birth normally.  About time some high profile women 
  did!!
   
  Regards, Sue
  "The only thing necessary for the triumph of evil is for good men to do 
  nothing"Edmund Burke
  
- Original Message - 
From: 
Robyn Dempsey 
To: ozmidwifery@acegraphics.com.au 

Sent: Monday, October 17, 2005 6:01 
AM
Subject: [ozmidwifery] 4ft 9 and 
birthing

Wump fish was saying last week an Ob said a 
primip who was 4ft 9' should have a c-section over natural 
childbirth.
 
Well, that's my height, my husband is 6ft 2! 
I'm a midwife,and was doing my training when I fell pregnant with my first 
baby. I  had sooo many Obs telling me that 'you'll be a c-section', 
that, had I been any other person, it would have totally eroded my 
confidence to birth.
 
I've had 3 babies, all born at 
home..does anyone realize that 1/3 of the worlds population is about 
that height?
 
Robyn Dempsey



No virus found 

RE: [ozmidwifery] MidResearch

[Kirsten Lerstrøm]

Hi 
Denise
Quite 
a lot of research has been done, but it is extremely difficult to deciffer, 
which is good enough to be referenced - exactly what was the study purpose 
(corresponding to the conclusion?), treatment of data, analyzing comparable 
issues etc. Go to the Cochrane Library and check some of the abstracts listed 
there and also check eventual comments from other sources.
 
One of 
the most famous and wellknown studies in this matter are Eksmyr's three studies 
during the 1980's - first one in order to provide documentation on the 
improvement of outcomes, when organizing all births at a central large unit - he 
didn't find the documentation, so the sencond study was launched, this time 
including a larger  and transnational field - Sweden and Finland, again it 
couldn't be proved that a large centralised hospital setting was better than 
smal cliniques, so a Scandinavian study was launched - same conclusion as 
before. Unfortunately these studies are not accesible via 
Cochrane.


  
  
Eksmyr 1986
  
  
Eksmyr R. Two geographically defined populations with different 
  organization of medical care - Cause-specific analysis of early neonatal 
  deaths. Acta Pediatrica Scandinavia 1986;75:10-16.
  
   Links   
  

  Then i 1997 Ole Olsen and 
  MD Jewel did a meta study on home vs hospitals births - 
  http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000352/frame.html
  Look at the comments, as most studies compare mortality, which 
  really isn't the most intersting perspective in this matter (very few 
  deaths) but rather a question of interventions and the women's percieved 
  quality of care.
 
On 
Cochrane today I found this project description to be published next year, 
unfortunately, but includes contact details if that will be a 
help:
 
http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004667/frame.html
 
[Protocol]Midwifery-led 
versus other models of care delivery for childbearing women 
M Hatem, ED Hodnett, D Devane, 
WD Fraser, J Sandall, H Soltani
 
Note in the background section of this protocol, 
the authors state:
 
Available experimental studies suggest some benefit for 
women intending to give birth within midwifery-led models of care compared with 
similar risk women who intend giving birth within traditional or other models of 
care (Hodnett 2003). Lower rates of intrapartum analgesia and 
augmentation of labour and increased mobility during labour have been reported 
(Hodnett 2003). In addition, non-experimental evidence suggests 
rates of spontaneous vaginal deliveries are higher, rates of caesarean section, 
episiotomy and severe perineal injury are lower, as are neonatal admissions to 
special care units (Saunders 2000; Feldman 1987; Fraser 2000; Scupholme 1986). The evidence also suggests increased 
satisfaction for women who are cared for within midwifery models of care 
compared with traditional models of care (Turnbull 1996). However, there is a trend toward higher rates of 
perinatal mortality and neonatal morbidity and mortality (stillbirth and 
requirement for neonatal resuscitation) within models of midwifery-led care, 
which has been suggested may result from a failure to detect deviations from 
norm and/or initiate appropriate action (Fraser 2000; Hodnett 2003).
Happy hunting!
Kirsten in 
Denmark

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of Denise 
  HyndSent: 31. maj 2005 12:04To: 
  ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] 
  MidResearch
  Dear All
   
  Does any one know if Sally Tracy's Australian 
  research on the better outcomes of Smaller local (midwifery) materntiy units 
  has been published yet and if so where??Also has anyone else here or 
  overseas published similar evidence supporting small or midwifery led 
  units??
   
   
  
  The WA  government continues to be set on 
  closing at least 3 metropolitan units where there are less than 1,000 births 
  per year and making the local women travel to birth in larger obstetric 
  units despite MCWA and others trying to get to the  minister 
  and his advisors!!
   
  More submissions and efforts are still required 
  so any updates of the evidence would be appreciated.
   
  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

SV: [ozmidwifery] Poster

[Kirsten Lerstrøm]

Title: Message



Vicki 
- I would to see the poster too. Please mail me directly at [EMAIL PROTECTED]
 
Thanks!
 
kirsten

  -Oprindelig meddelelse-Fra: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]]På vegne af Ricardo 
  Herbert JonesSendt: 10. september 2002 16:59Til: 
  [EMAIL PROTECTED]Emne: [ozmidwifery] 
  Poster
  Vicki :
   
  I would love to receive this 
  poster...
  Can I?
   
  Ricardo Herbert Jones, from Brasil
  [EMAIL PROTECTED]
   
  Thank you !!
  
- Original Message - 
From: 
Vicki Chan 
To: [EMAIL PROTECTED] 
; [EMAIL PROTECTED] 

Sent: Wednesday, September 11, 2002 
3:12 AM
Subject: [ozmidwifery] Poster...for 
better birth!

Dear All
 
Nic Edmondstone and I have developed a poster which 
supports the right of every woman to choose a midwife as her lead maternity 
carer...If you wish to see it, email me direct and I'll send it as an 
attachment. They are selling at cost price (printing and posting that is) to 
promote midwifery care, particularly important now in the lead up to 
NMAP.
Maternity Coalition will be distributing some in 
each state...there are plenty more available by emailing me. 

 
Yours for Better Birth,
Vicki