Re: [ozmidwifery] Frustration

[Michelle Windsor]

Unfortunately at the moment the decision to induce is made by the doctors in 
the antenatal clinics, and often we are only seeing the women when they arrive 
in birthsuite for induction.  I like to discuss the reasons for IOL, and the 
pros and cons but not sure what other midwives do.  Hopefully soon we will have 
a midwifery model of care so that alot of this unnecessary intervention can be 
avoided.

Cheers
Michelle


- Original Message 
From: Janet at home <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, 1 March, 2007 10:20:52 PM
Subject: RE: [ozmidwifery] Frustration


That must be very frustrating. Do you or your other midwife colleagues have any 
strategies for challenging these management decisions given that they are 
clearly not evidence based, are gross overservicing and just plain dangerous? 
J
 
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Michelle Windsor
Sent: Thursday, 1 March 2007 8:50 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Frustration
 
It amazes me that sometimes these doctors just don't seem to learn.  We have 
had a run of inductions and LUSCS for either SGA or LGA lately because 'the 
scan said such & such'.  The SGA's that I've seen have ranged from 2.8-3.1kg 
and the LGA's from 3.4-4.1kg.  One lady recently had a LUCSC for her 4th bub 
because by USS it was 12 pound. Surprise, suprise out came an 8 pounder which 
was less than her last vaginally born baby.   Grr
Michelle
- Original Message 
From: Ken Ward <[EMAIL PROTECTED]>
To: ozmidwifery 
Sent: Thursday, 1 March, 2007 2:46:51 PM
Subject: [ozmidwifery] Frustration
Delightful doctor told his lady that the episi he cut which extended to a
3rd degree tear was so extensive that she would need a C/S next time. Also
she would need to be reviewed, and may need the repair repaired by another
dr. One wonders what he has done. Of course it will all be her and/or the
baby's fault. Gr


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Re: [ozmidwifery] Frustration

[Michelle Windsor]

It amazes me that sometimes these doctors just don't seem to learn.  We have 
had a run of inductions and LUSCS for either SGA or LGA lately because 'the 
scan said such & such'.  The SGA's that I've seen have ranged from 2.8-3.1kg 
and the LGA's from 3.4-4.1kg.  One lady recently had a LUCSC for her 4th bub 
because by USS it was 12 pound. Surprise, suprise out came an 8 pounder which 
was less than her last vaginally born baby.   Grr

Michelle

- Original Message 
From: Ken Ward <[EMAIL PROTECTED]>
To: ozmidwifery 
Sent: Thursday, 1 March, 2007 2:46:51 PM
Subject: [ozmidwifery] Frustration


Delightful doctor told his lady that the episi he cut which extended to a
3rd degree tear was so extensive that she would need a C/S next time. Also
she would need to be reviewed, and may need the repair repaired by another
dr. One wonders what he has done. Of course it will all be her and/or the
baby's fault. Gr


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Re: [ozmidwifery] Reflux

[Michelle Windsor]

Hi All,

I'm not sure if this has come up on the list before but has anyone else 
heard of success for reflux/colic from osteopaths?  When I was working in 
Darwin there was an osteopath who had done further studies in treatment for 
babies, and had had some good success according to the midwives and some of the 
new mums.  Her theory was that the vagus nerve (controls vomiting etc) could be 
affected during the birth and by some very gentle massage/treatment of the back 
of the neck that it could be put right.  She said that generally it took only 4 
treatments and once put right should stay that way. It seems to make sense when 
you think about the stress put on the neck during instrumental and caesar 
births (or even normal births when someone restitutes the head the wrong way 
and then pulls!)  Anyway, some of the mums swear by it, they say they had 
babies that basically didn't sleep and after the first treatment, slept 5 hours 
straight.

Cheers 
Michelle


- Original Message 
From: MHOOK <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Saturday, 3 February, 2007 12:28:39 PM
Subject: Re: [ozmidwifery] Reflux


I don't know about over-diagnosis- my second baby (now 17) had reflux and it 
made her first six months the worst of my life. I'd had a perfectly normal time 
with my first baby, he was unsettled like most and woke at night until over 12 
months but I considered that that was normal and looked forward to my second 
child with pleasure and anticipation. 
 
It was a nightmare- not hte birth, that was fine, but from about 3 weeks of age 
she screamed constantly, vomitted even while attached to the breast, never 
slept for more than 10 minutes at a time day or night- no one understood how 
terrible it was, she was obviously in pain, poor mite; my toddler was seriously 
shortchanged because how can you leave a child who is shrieking with pain to go 
and play with the other one. Just things like the carpet (whole house was 
carpeted, even the kitchen) being simply filthy from her constant vomiting, 
which was not projectile but which managed to defeat the towels etc I had 
strategically placed. The crying got me down dreadfully, this was nothing like 
I'd experienced with my first child. There was just no way to soothe her. I 
still have a colour chart I filled out at that time, showing her behaviour in 
ten minute slots over a week to show the baby health sister- red for unsettled, 
blue for feeding, green for sleeping etc. That sounds
 excessive but truly, I felt I needed evidence for people to believe me; they 
said things like, Oh yes it's difficult with two, in a patronising way as if it 
was just me not coping with an unsettled baby when I knew it was more than that.
 
We tried all the normal things, positioning, Early childhood centre, 
paediatrician, medication, nothing worked. Although she was fully breastfed she 
had the most atrocious constipation, stools like pieces of chalk that had to be 
drawn out when half expelled because she couldn't get it out. Finally I went to 
a homeopathic dr and whatever he gave her (smelt like pure alcohol but I was 
desperate enough to try anything!) fixed the pain overnight. She still vomitted 
and still was very wakeful but without the constant crying and pain behaviour 
it was so much easier to cope with. 
 
I'd been told it would probably get better when she was standing up and it did, 
over about a week all the vomitting etc stopped and life became about a 
thousand times easier. 
 
So I think that 'reflux' is very different from 'unsettled baby' but after what 
I went through I'd be inclined to give any mother who said her baby had reflux 
the benefit of the doubt, and the offer of a little help.
 
Monica
 
 
- Original Message - 
From: Helen and Graham 
To: ozmidwifery 
Sent: Saturday, February 03, 2007 9:22 AM
Subject: [ozmidwifery] Reflux


Just found this article whilst surfing the net.  I feel anecdotally that both 
reflux and colic are overdiagnosed.  I am a midwife but not a MCH nurse.  If it 
is so common maybe it IS a normal variation..what do you think about it?  
It just seems to me that some people aren't happy until they have a label and a 
medicine to treat it with when they have an "unsettled" baby.  Maybe I am being 
too simplistic about this subject.  
 
Interested in the thoughts of some of our online listers.
 
Helen
 
http://www.bubhub.com.au/newsletterdec0601.shtml
 
Reflux is so common it is almost seen as 'normal', or even trivial, and most 
people just don't understand how difficult life can be for many families, or 
understand the impact reflux can have on their lives! They may think of it 
erroneously as 'just a bit of vomiting', or 'just a behavioural issue'. They 
don't see how it impacts on the child's eating, sleeping, growth, behaviour or 
quality of life; or on the family's quality of life, relationships between 
partners, siblings or other children; finances; and even leisure time. Th

Re: [ozmidwifery] co-sleeping

[Michelle Windsor]

There's no doubt that co-sleeping is the norm for indigenous women.  In my 
experience the baby is either in bed with the mother, or on the breast.  Often 
the aboriginal women would be puzzled as to why the other (ie white) babies 
were crying.  It was a bit of an adjustment coming back to work in a mostly 
caucasian setting where distressed mothers and crying babies seem to be the 
norm (especially at night).  As far as instinctive mothering goes, I think we 
can learn alot from the indigenous women.

Cheers
Michelle


- Original Message 
From: Helen and Graham <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, 24 January, 2007 6:36:19 AM
Subject: Re: [ozmidwifery] co-sleeping


This story reminds me of my time working in Gove in the Northern Territory. 
The aboriginal women on the ward would co-sleep from day 1 and also leave 
their babies in their beds when they went outside to escape the 
airconditioning.  You had to be VERY CAREFUL before you went ripping the 
sheets off the bed to make it.  I was always afraid a baby would end up in 
the linen skip one day

Helen

- Original Message - 
From: "Lyle Burgoyne" <[EMAIL PROTECTED]>
To: 
Sent: Wednesday, January 24, 2007 1:22 AM
Subject: Re: [ozmidwifery] co-sleeping


> Hi Raelene,
> We have a policy that allows co-sleeping.We had more concerns about
> babies falling out of bed(did actually happen) rather than them being
> smothered by mums so our policy just makes sure the bed rail is up  on
> which ever side of mum the baby is sleeping with a pillow against the
> bed rail so bub doesnt slip through.We regularly have bubs in bed with
> mums .Works well for both mums and bubs.
> All the best with getting a working policy
> Lyle
>
 [EMAIL PROTECTED] 22/01/2007 1:54 pm >>>
> Hi everyone,
> I need some help! I'm trying to formulate a policy regarding
> co-sleeping and want to offer alternative sleeping arrangements for
> mothers and babies whilst in hospital. Does anyone know of a "special"
> cot that has been developed that allows the baby to sleep with mum but
> in a separate cot that is attached to the main bed. I've seen pictures
> of babies using a biliblanket in a cot attached to the bed in this way,
> but can't find any information. Can you help.
> Regards
> Raelene George
> Maternity Ward
> Kalgoorlie Hospital
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Re: [ozmidwifery] * tough* membranes

[Michelle Windsor]

I haven't heard of this Jo but did read something fairly recently (possibly on 
this list!) that women who took vitamin C were less likely to have pre-labour 
ruptured membranes.  It is interesting that some women's membranes seem to 
break so easily, like when doing a VE and others stay intact until birth.  
Maybe there is a relation between maternal nutrition and the membranes.

Cheers
Michelle


- Original Message 
From: Jo Watson <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Monday, 22 January, 2007 10:07:14 AM
Subject: Re: [ozmidwifery] * tough* membranes

I have absolutely no data on this, but someone once told me it correlates with 
weight gain during pregnancy.  Has anyone else heard of this?  


Jo


On 21/01/2007, at 9:22 PM, Kristin Beckedahl wrote:


Hi all,
Can anyone comment on what makes the membranes 'tough'..ie. hard to break 
(AROM) or *slow* to break naturally ? (hard to measure yes) Does this exist or 
is it just something that happens?
Many thanks,
Kristin




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Re: [ozmidwifery] What happened with this birth?

[Michelle Windsor]

Hi Carolyn,

Just wanted to say thanks too for the excellent advice.  I'll be keeping your 
email for future reference  : )  

Cheers 
Michelle


- Original Message 
From: Heartlogic <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Friday, 29 December, 2006 12:24:40 PM
Subject: Re: [ozmidwifery] What happened with this birth?


Dear Gail,

Firstly, your instincts are spot on.

This is a very distressing story.  It is not a coincidence that these 
women's labours stalled following his VE's, that is absolutely to be 
expected and is the result of a mindless disruption of the women's optimal 
state of neurophyiological functioning. Taylorism, that is an industrial, 
efficiency management model, has no place in the dynamic fluid process of 
birth, sadly it has become merged into the 'health' care system with this 
sort of unconscious abuse becoming more common.

'Discussions' with the doctors at that stage will do nothing except breed 
resistence and further intervention; in mindless individuals it can even 
result in payback situations where intervention will be done just because 
you are the midwife. The right to rule is still endemic in the maternity 
services.

the first thing to understand is that these people really believe they are 
doing the right thing.
the second thing to understand is that they are taught all about the 
abnormalities of birth, they have absolutely no idea about normal physiology 
as applied to birth (gross generalisation, I know)
the third thing is that they are terrified of birth
the fourth thing is that they are taught throughout medical school that they 
are the boss of everything and the government and health departments agree 
and structure everything (I know, there are exceptions) to reinforce that 
idea
the fifth and probably MOST important thing is that they do get taught about 
'patient' autonomy and the need for consent.

So, here is where it gets interesting and where our opportunity lies.

It is vitally important that you use every moment with birthing women to 
help them understand the situation, without making it combatative and 
engendering a siege mentality and ask them what they want to have happen, 
how they would like things to go, so they can say what they want - be left 
alone, checked in another hour a few more hours, more time, a bath, move 
freely, have the baby listened to by doppler in the shower/bath etc if women 
have the information that can help them with the deeply damaging throw away 
lines that get trotted out like 'stillbirth' 'brain damage' etc, then women 
can say what they want and we as midwives can support them in that and 
remember to DOCUMENT what women want.  To do things against rational 
people's will is abuse. To argue about medical intervention with midwives is 
a nuisance and an affront to power beliefs.

Getting strategic is important. Learning tactical support of birthing women 
is a midwifery art form and a very challenging one.  It is crucial that you 
avoid blame, judgement and criticism as these emotional states are damaging 
for everyone and lead to despair.  It is useful to come from the point of 
view that they mean well but are ignorant about birth physiology and are 
taught to look for problems. Neuroscience and quantum physics teaches us we 
find what we are looking for. That also means we make it up if it is not 
there.

Our job is to work with women and their processes, to give women information 
to make their own decisions and to help them actualise their decisions and 
to help doctors know what women want. :-)   makes it so simple really. 
Simple does not, however, mean easy.

Every time you find yourself with a pregnant and/or birthing woman ask 
questions of yourself like 'how can I best inform her of her options?'  ' 
how can I best explain the process of birth so she knows what to expect?' 
'how can I support her with what she wants?' ' how can I best let her know 
how well she is doing so that she can feel secure in asking for more time if 
she needs it?'  " how can I best let her know her rights so she feels 
powerful and in control of her process?'  some women, no matter what doors 
you open, will succumb to medical pressue. That is just the way it is and 
all we can do is support her through her experience with love, compassion 
and kindness.

One last thing, make friends with that doctor. It is not 'sucking up'  it is 
working with integrity. Everyone wants to do a good job. Approach that 
person, say you feel uncomfortable about the interaction - open dialogue. 
We need to be friends with each other. Focus on creating a healthy 
workplace. Over time, you may have more influence as trust deepens between 
you.  We need to focus on the long term with our doctor midwife 
relationships. Remember that he is scared of birth and wants to control it - 
the women get in the way of that and get caught in the melee. He is doing 
the best he can with what he knows. Doctors are not enemies, they are, in 

Re: [ozmidwifery] Dr Jose Villars and pre-eclampsia

[Michelle Windsor]

Hi Janet,

In Ina May Gaskin's latest book she has their stats for pre-eclampsia. just 
off the top of my head I think it was something like 0.2%.  She believed this 
was largely due to the healthy diet of the women, many of them vegans.  I think 
it's facinating and since then have taken more notice of PE and diet and there 
does seem to be a link.

Cheers
Michelle


- Original Message 
From: Janet Fraser <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, 27 December, 2006 5:19:51 PM
Subject: Re: [ozmidwifery] Dr Jose Villars and pre-eclampsia


Lea said: "Even though they are referring to new ways of treating with drugs, I 
think both these articles actually point to nutrition having a huge effect. If 
they are finding that "Evidence suggests that the disorder is triggered when 
the fetus is not able to absorb sufficient amounts of oxygen from the placental 
blood supply..." then what is it that would enable better ability to absorb 
oxygen from the placental blood supply?...good nutrition - which allows a 
healthy placenta to develop. So Dr Tom Brewer's idea that pre-eclampsia can be 
avoided by excellent nutrition during pregnancy still holds true as we find out 
more and more about the condition from studies."
 
Well that's what I think but fans of this doctor stuff keep telling me that all 
it proves is that nutrition is absolutely nothing to do with PE and Brewer is a 
crank. I don't see many women whose surgeons tell them how to eat to avoid PE 
but I see a lot of midwifery input in this.
Very interesting and ta for the articles!!
J

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[ozmidwifery] Haemorroids

[Michelle Windsor]

Hi everyone,

Just needing some help for a friend who is 36/40 with very painful haemorroids. 
Is there anything that can be done apart from symptomatic relief and not 
becoming constipated?  And in your experience how painful do women find them 
when they are pushing?

Thanks in advance
Michelle

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Re: [ozmidwifery] Cord clamping and waterbirth

[Michelle Windsor]

As an aside, I am of the impression that the cord vessels don’t have any valves.

This is a really interesting point Mary.  An article I read some time ago 
believed that the respiratory distress sometimes seen with caesar babies was 
related to hypovolemia, from when the baby was held above the mother and the 
placenta and the blood flowed back to the placenta.  It seems unlikely given 
how quickly they clamp the cord.  However I have seen articles as well that 
recommend resusing a baby with the cord intact, to have the baby at the same 
level or lower than the mother to recieve more blood/oxygen.  I'm yet to work 
out how you could resus with the cord intact at a higher level : )  

On the other hand, there was a case of polycythemia after a waterbirth with was 
contributed to the cord being left intact and the baby recieving too much 
blood.  Anyone else confused??!!

Cheers
Michelle

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Re: [ozmidwifery] Pap smears while pregnant?

[Michelle Windsor]

Hi Sam,

One of our obstetricians said it wasn't worthwhile doing them in pregnancy as 
they are not accurate due to the changes in the cervix.  Even women with CIN I 
did not have repeat paps during their pregnancy.  Not sure how evidence based 
this is.

Cheers
Michelle


- Original Message 
From: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Friday, 17 November, 2006 12:46:41 PM
Subject: Re: [ozmidwifery] Pap smears while pregnant?


Thanks Brenda and Megan.

I recently heard a (first hand) story about a girl in early pregnancy
suffering a miscarriage immediately after a PS was done.  Apparently the
instruments used were smeared with blood and she started to miscarry
immediately? Understandably, she is very upset and believes the GP may
have somehow caused it.  The GP has said it was a very unfortunate
coincidence.  Not being a midwife(yet!), I was unsure about the safety of
PS during preg., and whether it would be possible for a miscarriage to
occur as a result.

Regards,
Sam.

Yes, they are safe to do in pregnancy however if I remember correctly they
> are only performed in the second trimester, or 8 weeks postpartum.
> Megan
>
> - Original Message -
> From: <[EMAIL PROTECTED]>
> To: 
> Sent: Thursday, November 16, 2006 1:18 PM
> Subject: [ozmidwifery] Pap smears while pregnant?
>
>
>> Is it safe to have a PS whilst pregnant and is there any risk with
>> having
>> it done - particularly in early pregnancy?
>>
>> Regards,
>> Sam.
>>
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Re: [ozmidwifery] Delaying synto with active 3rd stage

[Michelle Windsor]

Hi Sue,

I have also read and heard of this practice in America of giving the synto 
after the placenta has been delivered.  One of the obstetricians who used to 
work here went to a conference over there where they were discussing 3rd stage 
management.  When she suggested giving the synto before the placenta was 
delivered, she was absolutely shot down in flames.. "everyone knows that 
giving it before gives you retained placentas"  !!!  

Cheers 
Michelle


- Original Message 
From: Sue Cookson <[EMAIL PROTECTED]>
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, 15 November, 2006 8:17:06 AM
Subject: Re: [ozmidwifery] Delaying synto with active 3rd stage


Hi Andrea,
I am not aware of the practice you have mentioned in America. Have you 
any references for this?
Any idea what occurs if the placenta takes longer to arrive than the 20 
minutes or so??

Sue

> Hello Sue,
>
> The question of third stage management has a cultural aspect as well. 
> In the US, as far as I know, the syntometrine is not given until after 
> the placenta arrives.  It is then given to prevent excessive 
> bleeding.  Interesting to speculate on how this major difference 
> developed, and why  it is acceptable to wait the 20 or so minutes for 
> the placenta to come physiologically in the US when it is unacceptable 
> in the UK/Australia.
>
> Another one of those examples of how habit/routine becomes standard 
> practice and is not questioned.
>
> Regards,
>
> Andrea
>
>
>
> At 11:00 AM 14/11/2006, you wrote:
>
>> Hi,
>> I'm interested if there is any research on delaying synto for say up 
>> to 5 minutes in 'active 3rd stage'.
>> Have been doing actively managed third stage throughout my clinical 
>> placements as a student (nearly finished!!) with some practitioners 
>> cutting the cord immediately, and most at about 10 - 20 seconds.
>> I've just prepared a powerpoint presentation on delayed cord clamping 
>> but know I will get into a discussion around the seeming conflict 
>> between active 3rd stage and delaying the clamping. Obviously if you 
>> don't want the effects of synto's action - strong uterine contraction 
>> with excess blood being pumped into bub, then you need to delay the 
>> entire process of actively managed 3rd stage until the cord is clamped.
>>
>> Does anyone practice delaying the synto injection for those first few 
>> minutes? Any evidence of harm in doing this?
>>
>> Thanks,
>> Sue
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Re: [ozmidwifery] lotus placenta

[Michelle Windsor]

Hi Mary,
 
I can't speak from personal experience on this one but I remember Maggie Banks saying that she often took cord blood from placental vessels about 2 hours after the placenta had been delivered and had never had a problem getting the blood.  I am assuming that these would have been with physiological 3rd stages.
 
Michelle
- Original Message From: Mary Murphy <[EMAIL PROTECTED]>To: ozmidwifery@acegraphics.com.auSent: Sunday, 12 November, 2006 8:55:28 PMSubject: [ozmidwifery] lotus placenta



Hello wise women, I need advice about a lotus birth, (not new to me) who is also Rh neg.  I need to get enough blood for group and coombes.  In your experience, is there sufficient blood in the placental vessels after a physiological 3rd stge ?  What is the best way to hndle this?  I have had lots of Lotus Placentae but not with RH neg. women.  Thanks, MM
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Re: [ozmidwifery] Fully dilated no urge to push

[Michelle Windsor]

Hi Philippa,     This does seem to be unusual as even when women have a dense epidural and don't push, if the contractions are fine then they will often push the baby down anyway.  Did you try a really deep squat?  I've noticed that despite many women wanting to be upright, that not many will instinctively assume a deep squat, but it can really bring results if you are concerned about progress.     I remember a woman (primip) I cared for with a similar scenario and she had a ventouse and the head was born transverse.  None of us (obstetrician & 2 midwives) had ever seen this before.  She did go on to have another baby and had a normal birth.     By the way, just to show what women can do (as we know) a finely built 16 year old recently gave birth to a 4.8kg baby where I work (and intact)!  Cared for by one of the student
 midwives.   Breastfeeding beautifully and home on day 2. Yay!     Cheers  MichellePhilippa Scott <[EMAIL PROTECTED]> wrote:Hi Wise Midwives and others,     I have a question. I attended a birth on Monday of a primip who was fully dilated after 10 hours of mostly 4/10 contractions. Waters broke 15 minutes after VE and then she continued with 4/10. This kept up for about 3.5hrs before Dr felt she should start pushing
 anyway as she was now experiencing prolonged 2nd stage. (Dr words) The Mum had had hip problems during pg and OP baby but at fully baby was LOA but ascinclitic (SP?) and slightly deflexed) We tried numerous things in those couple of hours to help baby straighten up but did not happen. She pushed then with no urge in a supported kneel for about 1.5 hours and could get head to on view but not around the bend. Dr VE’d again said baby has not moved at all, but said there appeared to be sufficient space etc and accepted MW was seeing head with each push. A vacuum was used to straighten baby and then Mum virtually did the work. As it happens after baby was born it was discovered in theatre that she had Placenta accrete but that is another story.     So my question is if fully and no urge why does uterus continue to contract? And does any of this really make sense?     Thank you all,     Philippa ScottBirth Buddies - DoulaAssisting women and their families in the preparation
 towards childbirth and labour.President of Friends of the Birth Centre Townsville    Send instant messages to your online friends http://au.messenger.yahoo.com 

[ozmidwifery] testing

[Michelle Windsor]

Just testing. I don't seem to be getting many ozmid posts and definitely missing some.     Michelle 
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[ozmidwifery] sonotrax doppler

[Michelle Windsor]

Hi All,     Just wondering if anyone has had any experience with this brand of doppler.  It is advertised in the latest ACM journal, $620 (+ GST), waterproof, visual display.  Seems an ok deal.       Thanks  Michelle 
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Re: [ozmidwifery] asthma in labour

[Michelle Windsor]

Hi Janet,     I remember one woman who would go outside for a smoke, come back inside and have a couple of ventolin puffs throughout her labour!  Her labour kept going though.  On the other hand there are two women I can think of that didn't go into labour until they cut back on their Ventolin and they felt this was connected.     Cheers  MichelleJanet Fraser <[EMAIL PROTECTED]> wrote:  Thanks, Mary and Honey. I've learnt that it's via IV in large doses. A woman was told
 by her hb MW she couldn't birth at home and have ventolin via nebuliser as it would stall/halt labour. I can now reassure her that it's not the case.  : )  J- Original Message -   From: Honey Acharya   To: ozmidwifery@acegraphics.com.au   Sent: Friday, October 13, 2006 8:11 AM  Subject: Re: [ozmidwifery] asthma
 in labourThey give injected ventolin before performing some ECV's to relax a uterus do they not?  But perhaps intramuscular or intravenous is different to inhaled???- Original Message -   From: Mary Murphy   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, October 12, 2006 8:58 PM  Subject: RE: [ozmidwifery] asthma in
 labour  Yes, it has been used in a different delivery method, but definitely has been and probably still is, for “calming” contractions.  I am sure some one who is familiar with it will reply. MM     From:
 owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Janet FraserSent: Thursday, 12 October 2006 6:29 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] asthma in labour   Hi all,can bronchodilators, particularly ventolin, for severe asthma cause labour to slow or stall? Would it's action of relaxing smooth muscle have this effect on the uterus or is an inhaled drug (even in strong doses) too little entering the bloodstream for an effect?TIA.JFor home birth information go to:Joyous Birth Australian home birth network and forums.http://www.joyousbirth.info/Or email: [EMAIL PROTECTED] 
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[ozmidwifery] Launceston query

[Michelle Windsor]

Hi,     Last week there was a query regarding midwives etc around Launceston.  This is the web site of the midwives there who do homebirth as well as run a free standing birth centre.  www.birthcentre.org.au      Cheers  Michelle 
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[ozmidwifery] circumstitions

[Michelle Windsor]

Hi,     Has anyone else had a look at this site?  www.circumstitions.com  There is some quite good info on it, some of it quite graphic (photos).  You can go to a link to watch a circumcision, and can also read the autopsy report of a baby who died after haemorrhaging after a circ.  All quite disturbing... made me feel sick.     Cheers  Michelle   
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RE: [ozmidwifery] Sports drinks

[Michelle Windsor]

I too find the whole ketone thing confusing.  When people are on the Atkins diet (high protein, low carbohydrate) they test their urine for ketones which indicates they are breaking down fat.  So despite being well hydrated they may have quite alot of ketones in their urine.  So when a woman is in labour, is it more likely to be the hard work she is doing rather than dehydration?       Cheers  MichelleMary Murphy <[EMAIL PROTECTED]> wrote:I think that there is no doubt about the fact that extra fluids reduces ketonuria, the debate is : Is ketonuria harmful or beneficial or just neutral?  It may be that what is pathological in illness may be a product of normal metabolism in labour.  From what I have read, Ketoacidosis is the harmful state, not ketonuria and ketonuria is not necessarily a symptom of ketoacisosis.  More confused?  MM    
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Re: [ozmidwifery] No Contractions

[Michelle Windsor]

Hi Di,     This reminds me of scenario that a cousin of mine had with her second bub.  Her contractions basically stopped I think when she was fully and she did end up having some synto to get them going again.  But what had happened was that the midwife (who said she could have bitten her tongue as soon as she said it!) said to her that she would probably have to work hard as she had a good size baby on board.  My cousin said that she became really frightened and the contractions just died.  I wonder if there was anything holding your woman back?  Although you said she seemed excited and focussed.     As far as her pushing without contractions, I think if you have a fetal bradycardia and possibly a compromised bub then it becomes priority to get the baby out. It might just be head compression, but it might not.       Cheers  Michelle 
    diane <[EMAIL PROTECTED]> wrote:  Hi Wise women,  Just want to throw this out there for comments/suggestions. Had a birth the other night that was a bit worrying at the time. Good outcome lovely 4200g baby girl. Mum (primip) had SROM at clinic visit at 830 am then went home and established at about 1630, came in contracting moderately at 1900hrs was 4-5cm , I took over her care at 2000hrs. Lovely very motivated mum, well read and attended classes, well supported by partner and mum and mum in law and sister. Ctx hotted up to 3-4 minutely and stronger, was drinking well but had a few small vomits, and next UA showed small ketones and SG 1.030, but was still drinking
 well and ctx remained strong and regular so didnt want to put in a cannula. VE at 1130 showed an anterior lip, still a bit thick. Wasnt able to wee again after that but head was well down.      Was actively pushing with some ctx at 0100 with signs of full dilatation (nice purple line!) Contractions really started to drop off, became about 4minutely and only about 20secs of good strength. Mum getting quite tired at this stage but more focussed and excited than earlier. At this point I did put up some fluids as I thought with the ctx dropping off combined with her fatigue she might need some hydration. She pushed babe up to on view (birth stool) but made little more progress over next 20mins or so. Fluids running in flat out but no sign of increased ctx. Babes HR started to drop to around 80 which at first had good recovery , so I wasn't too worried but after a while were staying there
 for a minute or so each time before climbing back to 100. At this point with encouragement she managed to push bub up to almost crowning and that was the last of the contractions!!! Obviously not easy to get FH at this stage but was quite low and staying there. She had not much strength left as she had done much of the work without help of ctx.      With a few position changes she got a little more head out but then seemed to only move millimeter by millimetercolour was ok eventually after what seemed like 10 minutes I managed to push the peri back to get a chin...then nothing no ctx...mum managed to push a little and I got her to move from kneeling to standing then one leg up on bedstill nothing... went onto bed and there was some movement with maternal effort (the last of it!) the body birthed over almost three minutes, it was a pretty tight fit with the shoulders coming
 in the lateral position, when a shoulder appeared I gave it a push with two fingers to the anterior it moved just a little into the oblique but then was finally out far enough for me to get a little finger under the arm and finally managed to get her out!  Apgars 7 and 10. but as it was so slow and there were no ctx to assist with her being a big bub too, It was a bit hairy for a little while. Lucky she didnt have big enough ears or they might have ended up a little stretched!! LOL.  Second stage was only 1hr 45min but I felt it was just way too slow birthing that head and those shoulders! Perhaps I should have been more trusting?? I hesitated in calling the Doc after an hour of pushing cause was on view at this stage and I thought he would have been too late by the time he came in. Probably would  have been better to have him on standby just in case, I suppose. I just felt quite helpless and know that things ended up quite stressful for everyone in the
 room. I think I would have prefered to deal with a shoulder dystocia at least then I would have had a practiced sequence of events to go through!!     Thought she might get away without a tear as birthed sooo slowly but peri went with the shoulders, 2nd degree peri tear (no too big) and a anterior labial that wasnt too bad either.(thank goodness, was after 3am by then, that time of night where you see double!) Did have synto at birth but needed to get her to squat to get placenta and had a constant trickle and (surprise surprise) a relaxed uterus, which was fine after another shot of Syntometrine (450 loss).     My feelings are I probably should have been a little more pro active in getting

Re: [ozmidwifery] Birth in Launceston

[Michelle Windsor]

Hi Katy,     There was a free standing birth centre in Launceston run by midwives.  I'm not sure if it's still going.  There are independent midwives in Hobart but I'm not sure about Launceston.     MichelleKaty O'Neill <[EMAIL PROTECTED]> wrote:  Dear anyone,    I have just had a call from my niece in Tassie who wanted info on the options for  care in Launceston. She is thinking of taking out private health insurance  as they have heard a few scary stories ( "your wife would have died if I did not step in" ) and are concerned about the amount of care etc she will get with BF amongst other things.  I tried
 not to be too negative about private as it is a con here where I work,  there is no continuity of care with Obs even if they do go private. Is there someone out there that works at Launceston Hosp. or an independent midwife that she could contact to see how the system down there works.  Is there a midwives clinic option?  Feel free to contact me on [EMAIL PROTECTED]  .   Katy. 
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Re: [ozmidwifery] intact peri

[Michelle Windsor]

Hi Paivi,     Where I am working (hospital) at the moment the intact peri rate among midwives is about 70% on average (from our computer stats).  I don't have any figures but having worked in a birth centre previously, I'd say the intact rate was higher.  This is antedotal but it seems that when women gave birth in water or in upright positions they have fewer tears.        Cheers  MichellePäivi <[EMAIL PROTECTED]> wrote:  Hi all,     I am writing an article on episiotomy. I need to know what is the % of intact perineum among homemidwifes or birth centres?
 This is when the mother is having a natural birth.     Does this change if the mother has an epidural and is having the baby in a hospital? What I mean is that how much can the hospital midwife do to save the perineum if the mother has opted for epidural? Is it still mainly to do with the skills of the midwife? Or is it a harder job with a medicated mom?     Do you all practise hot compresses, perineal massage with oil (during birth) / perineal support?     What is the % of intact peri in a waterbirth?     Many questions... Thank you for any ideas or comments.    
 Päivi 
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RE: [ozmidwifery] RE:

[Michelle Windsor]

      Doing midwifery was the biggest learning curve in my life.  This was despite having worked in a country hospital as an enrolled nurse and RN where you were expected to assist the midwife at births and give care to women on the ward when the midwife was with someone in labour.  I had already witnessed about a hundred births, but there is no way the level of knowledge I had before doing mid compared with what I learnt in my training (and am still learning!)       I totally object to RN's doing midwifery care.  It is a specialised area and requires special skills.  Allowing RN's to do midwifery care undervalues the role and skills of midwives.  I have been working in the Northern Territory and have seen first hand the results of non-midwifery care.  While recognising that many of the RN's are doing the best they can (in remote areas) there were often huge gaps in the
 care given.  At the end of the day it is the women and their babies that suffer and this is totally unacceptable.     Cheers  Michelle     Rene and Tiffany <[EMAIL PROTECTED]> wrote:The art of midwifery existed long before the need for ‘qualifications’ existed…funny how I had to do 3 years nursing training (with 6 months of antenatal/womens health training included)
 to become a registered nurse and have had to work as such for 12 months before I could even apply to train as a midwife.  From the original post it appears that they are not suggesting the nurses birth babies, but assist in the care of the woman and the neonate - something new mothers do without the need for specialist training – I personally do not object to this.    From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Lisa BarrettSent: Thursday, 28 September 2006 4:28 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] RE:        Some of the best people I have worked with have been div2's. Their knowledge and understanding put some of the 'midwives' to shame. Just how much nursing care does a newborn need?  Many LC's are not midwives, as are childbirth educators.  Maybe we should be assisting these people to be woman wise, and not judge them on qualifications.  I have no doubt that there are many people other than midwives that have vast knowledge and
 understanding but antenatal and postnatal care is not nursing care at all. It is specific to normal healthy women who are childbearing.  If anyone can be trained to do this in just 8 days why bother with midwifery training.  If we and not judging people on their qualifications some of the brilliant lay midwives out there wouldn't be persecuted and they are way more specialised than nurses.Lisa Barrett-Original Message-From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED]On Behalf Of Ganesha RosatSent: Thursday, 28 September 2006 8:33 AMTo: ozmidwifery@acegraphics.com.auSubject:   Hi all u wonderful women!     Just a quick posting in line with the current debate about maternity services within country areas and who provides services.      The hospital I am currently working in has decided to address our midwife shortage but training division two nurses to work in the maternity department.  These nurses have 3 days of theory, one day of orientation in óbstetric’ and five days of clinical experience.   On completion of their modules these girls will be able to:      Assist in the provision of antenatal
 nursing care to the client      Assist in the provision of nursing care to the healthy newborn baby      Discuss the establishment and maintenance of breastfeeding      Assist in the evaluation of key stage of growth and development of the baby      Assist in the provision of postnatal nursing care to the woman     This again indicates to me the lack of understanding of the needs of women (not clients). Instead of the hospital supporting midwives and creating a working environment that encourages new midwives to come to the area, they find quick fixes that only further add to the fragmentation of care.     Anyway what do u all think? And is
 this happening anywhere else?     Cheers Ganesha             
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RE: [ozmidwifery] RE:

[Michelle Windsor]

      Doing midwifery was the biggest learning curve in my life.  This was despite having worked in a country hospital as an enrolled nurse and RN where you were expected to assist the midwife at births and give care to women on the ward when the midwife was with someone in labour.  I had already witnessed about a hundred births, but there is no way the level of knowledge I had before doing mid compared with what I learnt in my training (and am still learning!)       I totally object to RN's doing midwifery care.  It is a specialised area and requires special skills.  Allowing RN's to do midwifery care undervalues the role and skills of midwives.  I have been working in the Northern Territory and have seen first hand the results of non-midwifery care.  While recognising that many of the RN's are doing the best they can (in remote areas) there were often huge gaps in the
 care given.  At the end of the day it is the women and their babies that suffer and this is totally unacceptable.     Cheers  Michelle     Rene and Tiffany <[EMAIL PROTECTED]> wrote:The art of midwifery existed long before the need for ‘qualifications’ existed…funny how I had to do 3 years nursing training (with 6 months of antenatal/womens health training included)
 to become a registered nurse and have had to work as such for 12 months before I could even apply to train as a midwife.  From the original post it appears that they are not suggesting the nurses birth babies, but assist in the care of the woman and the neonate - something new mothers do without the need for specialist training – I personally do not object to this.    From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Lisa BarrettSent: Thursday, 28 September 2006 4:28 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] RE:        Some of the best people I have worked with have been div2's. Their knowledge and understanding put some of the 'midwives' to shame. Just how much nursing care does a newborn need?  Many LC's are not midwives, as are childbirth educators.  Maybe we should be assisting these people to be woman wise, and not judge them on qualifications.  I have no doubt that there are many people other than midwives that have vast knowledge and
 understanding but antenatal and postnatal care is not nursing care at all. It is specific to normal healthy women who are childbearing.  If anyone can be trained to do this in just 8 days why bother with midwifery training.  If we and not judging people on their qualifications some of the brilliant lay midwives out there wouldn't be persecuted and they are way more specialised than nurses.Lisa Barrett-Original Message-From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED]On Behalf Of Ganesha RosatSent: Thursday, 28 September 2006 8:33 AMTo: ozmidwifery@acegraphics.com.auSubject:   Hi all u wonderful women!     Just a quick posting in line with the current debate about maternity services within country areas and who provides services.      The hospital I am currently working in has decided to address our midwife shortage but training division two nurses to work in the maternity department.  These nurses have 3 days of theory, one day of orientation in óbstetric’ and five days of clinical experience.   On completion of their modules these girls will be able to:      Assist in the provision of antenatal
 nursing care to the client      Assist in the provision of nursing care to the healthy newborn baby      Discuss the establishment and maintenance of breastfeeding      Assist in the evaluation of key stage of growth and development of the baby      Assist in the provision of postnatal nursing care to the woman     This again indicates to me the lack of understanding of the needs of women (not clients). Instead of the hospital supporting midwives and creating a working environment that encourages new midwives to come to the area, they find quick fixes that only further add to the fragmentation of care.     Anyway what do u all think? And is
 this happening anywhere else?     Cheers Ganesha             
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[ozmidwifery] lactation consultant query

[Michelle Windsor]

Hi,     Am posting again as the first one didn't seem to come through. I'm thinking of doing the LC course, but have noticed (in my travels) that lots of LC's let their qualification lapse when the 5 years is up.  Just wondering if anyone can shed some light on this is it the money?  or too hard to attend BF conferences etc?  I'd also be interested in which courses people found to be good.  The Health e-learning has been recommended to me.     Thanks  Michelle    
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RE: [ozmidwifery] FYI news article

[Michelle Windsor]

I could be on the wrong track here. but perhaps at the bottom of all this is some women's desire (maybe subconsciously) for something special (the 5 star hotel) to acknowledge what an amazing person she is to be a mother and to have birthed a baby. Unlike some other cultures, our society as a whole doesn't seem to value mothers very highly.  "What does she do? Oh she just had kids.."    Even women themselves often identify themselves as 'just a mum' or 'just a housewife'.       Maybe if women were acknowledged and celebrated in other ways for the wonderful work they do in birthing and mothering and provided with excellent support, staying in a 5 star hotel wouldn't be so appealing.     Cheers  Michelle"Kelly @ BellyBelly" <[EMAIL PROTECTED]> wrote:I posted the article on my forums, here is what women think of the idea – be it what you agree with or not – this is what THEY think so maybe we can get some ideas or learn something from this: http://www.bellybelly.com.au/forums/showthread.php?p=439579Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support  From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary MurphySent: Thursday, 21 September 2006 8:27 AMTo:
 ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] FYI news articleImportance: High     The Caroline flint you have contacted is a politician, not the midwife.  Try putting midwife in front of the google search. It is confusing to have two high profile people with the same name.  MM     From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Vedrana ValcicSent: Wednesday, 20 September 2006 6:11 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] FYI news article     Where can I find out more about her marketing strategies? Midwives in Croatia would certainly appreciate info about effective marketing strategies. I found this site: http://www.carolineflint.co.uk/news/news.htm, but I don’t know if there is something more detailed.  Vedrana     From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Mary MurphySent: Wednesday, September 20, 2006 11:11 AMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] FYI news article     The woman who best markets midwifery is Caroline Flint in the UK. We should copy her marketing strategies. MM  Kelly says..If we want women to accept and value the midwife then it needs to be marketed better, it needs to be trendy and jazzed up! Not just a choice being two sides of the fence with opposing views as it is now. And they want to know what it will do for THEM and what THEY will get out of it. At the moment there are very many women who do not see birth as something that needs to be in the home or is safe in home – that’s just a fact which we have to work on. 
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Re: [ozmidwifery] re birth story

[Michelle Windsor]

Hi Di,     As far as I'm aware there's nothing like that here (but having just returned after 7 months away I could be wrong!)  Anyway, it's a great idea.  I've just returned from doing some relief work in the Community Midwifery Practice in Darwin which is in a block opposite a shopping centre.  Often people saw the sign and wandered in.  I'm sure it would get off the ground in Mackay.     Cheers  Michellediane <[EMAIL PROTECTED]> wrote:  Hi Michelle,  Is there anything like what Janet and I are talking about around Mackay? Do you think it might get off the ground there. I figure there are lots of bored
 lonley women there who's partners are away in the mines all week, and families are down south.  Cheers,  Di- Original Message -   From: diane   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, September 14, 2006 11:53 AM  Subject: Re: [ozmidwifery] re birth storyThat's right Janet, i
 know these online communities exist for those who seek them out or find them. What Im looking at is a physical presence in the community, where people gather, for info, friendship,access to services and advice. I would love granny to be doing her groceries and spot the shopfront and come in for a look at the products then find out about the services and groups etc that are available , then take her info home to her pregnant grandaughter who will share with her friends. I dont really want a retail style thing but a few product lines like slings etc to draw people in. The more in one physical community that are exposed to normal birth, the more the good stories perpetuate.  Di- Original Message -   From: Janet Fraser   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, September 14, 2006 11:25 AM  Subject: Re: [ozmidwifery] re birth storyDi you're describing Joyous Birth LOL. We have about 600 online members who meet all over Australia regularly and do exactly what you're talking about! But you knew this, I'm sure : )  How lovely!  J- Original Message -   From: diane   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, September 14, 2006 9:18 AM  Subject: Re: [ozmidwifery] re birth storyThat's a great article Pinky. One of my visions is to create a community of women where positive birth stories are told. I'm hoping to develop a 'birthplace' where women can access services, classes, alternate therapies, groups, resources and products, to help change the culture at least at a local level. I attended the Calmbirth course last
 week, which was great. One of the most interesting things was meeting midwives and doulas from all over the country, and hearing their different stories. We have little pockets here and there in this country where natural birth and homebirth is not considered to be too radical. The culture in Melbourne is so different, there are doula's and homebirth midwives everywhere, where in other parts of the country they are unheard of! Places like Bellingen, the north coast of NSW, Toowoomba have their own little sub-cultures that are growing. We need to act locally for a sub - culture to develop, that then becomes part of a wider movement. The more positive stories that hit the 'mainstream' , the more momentum is gained. (thanks Pinky and Kelly, and all of you who vocally and publicly advocate for natural birth!)  Cheers,  Di- Original Message -   From: Pinky McKay   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, September 14, 2006 8:52 AM  Subject: [ozmidwifery] re birth storyHi all, I have just thought some of you may be interested in reading my "column' about my daughters waterbirth - it was published as one of my monthly columns in Practical Parenting a few months ago and is up on my website - every little bit helps, as they
 say.     http://www.pinky-mychild.com/features/pregnancy/family_born.html     Pinky 
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Re: [ozmidwifery] Synto question

[Michelle Windsor]

Hi Shelley,     Sorry have taken awhile to replyhave been away from the net.  I think that there definetly were more PPH's as other midwives from different places had noticed it too.  And I guess it proved it with the amount of low Hb's and blood transfusions that were given.  It is a high risk tertiary referral centre and also very medicalised, so I guess those factors all come into it.     Cheers  Michellemichelle gascoigne <[EMAIL PROTECTED]> wrote:  I have checked my pharmocology for midwives. It says to check the data sheet from the manufacturer. It must be quite some time though because community midwives in the UK. (certainly
 the 3 places I have worked) carry it for home births, not refridgerated. When we do that, we ignore the use by date by the manufacturer and pharmacy put a new one one which is 6 months from being dispensed to us. Have you noticed more PPH's directly? If not maybe they measure differently or do they have a different definition. Has it been happening for a long time or is it just a glitch and could this just be a faulty batch? (everywhere I have ever worked does things slightly differently). In terms of risk having the synt drawn up in advance seems like a bad idea to me.  Shelly- Original Message -----   From: Michelle Windsor   To: Ozmidwifery   Sent: Sunday, September 03, 2006 1:01 PM  Subject: [ozmidwifery] Synto question      Just a quick question does anyone know how long Syntocinon can be out of refrigeration before it starts loosing its effectiveness?  Where I am working at the moment there are an amazing number of PPH's, and also the common practice of drawing up the synto and having it ready often hours before the birth.       Aside from all the other medical intervention which would contribute to PPH, if controlled cord traction is started after a dose of ineffective synto, it's probably
 contributing to the PPH's.     Cheers  Michelle  On Yahoo!7Photos: Unlimited free storage – keep all your photos in one place! Internal Virus Database is out-of-date.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 268.6.1/344 - Release Date: 19/05/2006 
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Re: [ozmidwifery] The Purple Line

[Michelle Windsor]

Great picture!  But actually I've always looked at the dark pigmentation either side, rather than the purple line and it seems to be pretty accurate in indicating dilatation.     Cheers  MichelleJo Watson <[EMAIL PROTECTED]> wrote:  I have had a request to put my butt on photobucket, so I've worked it all out, and there it is:http://i72.photobucket.com/albums/i167/Notchalk/100_5129.jpg :)Jo--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe. 
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Re: [ozmidwifery] RE: RWH - Pain Relief Comment on Website

[Michelle Windsor]

This reminds me of what a woman was told in private antenatal classes that rating pain from 1 to 10 with 10 the worst pain you can imagine, then labour will probably sit at about 20.  How's that for getting the adrenaline going and inhibiting endorphins!  No wonder some of these women walk in at 1cm wanting an epidural.     Michelle "Kelly @ BellyBelly" <[EMAIL PROTECTED]> wrote:Gosh it gets worse…     “The options available for pain relief during labour have increased dramatically since that time but it has only been in the second half of this century that they have been made readily available for women. The reality is that about 2 thirds of normal, healthy pregnant women suffer severe or intolerable pain during labour, and only about 2% of women are fortunate
 enough to describe little or no discomfort. However, despite this many women are still made to feel guilty or inadequate if they ask for pain relief, and if they manage to achieve delivery without any form of pain relief, they receive some mythical 'badge of honour'. In no other situation would anyone deliberately allow someone to suffer so severely for so long without attempting to relieve their pain. It is, of course, always the expectant mother's decision as to whether she will have anything during labour, but this can only be done in an informed fashion if she has been told her options and the pros and cons of each before she goes into labour.”   Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support  From: Kelly @ BellyBelly [mailto:[EMAIL PROTECTED] Sent: Wednesday, 30 August 2006 9:44 PMTo: 'ozmidwifery@acegraphics.com.au'Subject: RWH - Pain Relief Comment on Website     I found this on the RWH website – in the section about the con’s of epidurals:     “6. Some people believe that epidurals may increase the duration of labour, or increase the likelihood of needing forceps or a Caesarean section. The evidence for or against this belief is very controversial. It is almost impossible to do unbiased studies to confirm or deny this belief. Women who have excessive pain and ask for an epidural may be the ones with bigger babies or smaller pelvises and thus be more likely to need forceps or a Caesarean section anyway. In addition, even if labour is prolonged, is it better to have a 9 hour labour in agony, or a 13 hour labour in relative comfort (as long as the baby and mother are monitored and both are well)? I would suspect the latter.     In conclusion I think it is important to stress that no-one can predict how they will feel during labour, and some labours are far more painful than others. Women who ask for pain relief during labour should not be made to feel guilty or inadequate, as if they have failed, but rather reassured and given the pain relief they require. The attitude of '...no, you'll be fine...let's hold of for a few more hours and see how you go...' is no longer appropriate unless the baby is about to pop out any second.”     Eck. Love their choice of wording too.     http://www.rwh.org.au/rwhanaes/whatis.cfm?doc_id=2392  Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support -
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Re: [ozmidwifery] Breastfeeding

[Michelle Windsor]

Go ahead Jo.     Cheers  MichelleJo Watson <[EMAIL PROTECTED]> wrote:  Michelle, can I please post this to another group?  There is some talk in misc.kids.breastfeeding on usenet about 'trying' to breastfeed.  I won't put your name on it at all, if you like.Thanks :)Jo  On 09/08/2006, at 12:58 PM, Michelle Windsor wrote:Hi Gail,     I too wondered why breastfeeding seems so difficult and stressful for so many women... especially once I'd worked with indigenous women and saw how easy they seemed to find it.  So trying to
 figure it out, I noticed a few differences.       Indigenous women have alot of exposure to breastfeeding as they have extended family groups with large families.  They don't speak of 'trying' to breastfeed, it seems they don't even question their own ability that they will be able to do it.  In my experience it is rare to see problems, and they are often associated with separation from their baby (ie prems/sick). Other things I noticed is that indigenous women never look at the clock, there is never the comment   "I only fed 5 minutes ago... " they totally feed on demand and don't put feeds off until they've eaten lunch, or the visitors have gone or whatever.  They aren't ashamed of their breasts or even self-conscious.  For the midwife.it's blissful!       We encourage women to be instinctive with birthing their baby, maybe we should do the same
 with breastfeeding?  (just thinking out loud)     Cheers   MichelleGail McKenzie <[EMAIL PROTECTED]> wrote:  To all you magnificent home birth warrior women out there, could you please tell me if any of your birthing women have problems with breastfeeding. I'm a middy student working on a ward at the present & I'm astounded by how many women have problems with breastfeeding.If your women do not, please enlighten me as to why you think this is. If they do, again, what do you put this down to?--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.  Send instant messages to your online friends http://au.messenger.yahoo.com 
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Re: [ozmidwifery] Breastfeeding

[Michelle Windsor]

Hi Gail,     I too wondered why breastfeeding seems so difficult and stressful for so many women... especially once I'd worked with indigenous women and saw how easy they seemed to find it.  So trying to figure it out, I noticed a few differences.       Indigenous women have alot of exposure to breastfeeding as they have extended family groups with large families.  They don't speak of 'trying' to breastfeed, it seems they don't even question their own ability that they will be able to do it.  In my experience it is rare to see problems, and they are often associated with separation from their baby (ie prems/sick). Other things I noticed is that indigenous women never look at the clock, there is never the comment   "I only fed 5 minutes ago... " they totally feed on demand and don't put feeds off until they've eaten lunch, or the visitors have gone or
 whatever.  They aren't ashamed of their breasts or even self-conscious.  For the midwife.it's blissful!       We encourage women to be instinctive with birthing their baby, maybe we should do the same with breastfeeding?  (just thinking out loud)     Cheers   MichelleGail McKenzie <[EMAIL PROTECTED]> wrote:  To all you magnificent home birth warrior women out there, could you please tell me if any of your birthing women have problems with breastfeeding. I'm a middy student working on a ward at the present & I'm astounded by how many women have problems with breastfeeding.If your women do not, please enlighten me as to why you think this is. If they do, again, what do you put this down to?--This mailing
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Re: [ozmidwifery] Roadside births?

[Michelle Windsor]

Apparently there were 180 roadside births in Qld alone last year (not sure exactly where this figure came from).  By the way, for those who remember the woman who had her breech stillborn baby on the side of the road the hospital has issued a formal apology.  For now Emerald has birthing services available again.     MichelleMary Murphy <[EMAIL PROTECTED]> wrote:Is this happening here?  MM  The reality of resistance: the experiences of rural parturient women - Journal of Midwifery and Women's Health , vol 51, no 4, July/August 2006, pp 260-265 Kornelsen J; Grzybowski S - (2006) The closure of many local maternity services has given rise to contemporary realities of care for many rural parturient women in Canada, which, in turn, determines their experience of birth. To date, we do not have an understanding of the realities influencing the birthing experiences of rural parturient women. This qualitative investigation explored these issues with women from four rural British Columbian communities through semistructured interviews and focus groups. Women in this study articulated four realities that influenced the nature of their experience of birth, including geographic realities, the availability of local health service resources, and the influence
 of parity and financial implications of leaving the community to give birth. When these realities were incongruent with participants' needs in birth, participants developed strategies of resistance to mitigate the dissonance. Strategies included trying to time the birth at the referral hospital by undergoing an elective induction and seasonal timing of pregnancies to minimize the risk of winter travel. Some women showed up at the local hospital in an advanced stage of labor to avoid transfer to a referral center, or in some instances, had an unassisted homebirth. (30 references) (Author) Send instant messages to your online friends http://au.messenger.yahoo.com 

RE: [ozmidwifery] Henci Goer's Article on GD

[Michelle Windsor]

I agree. There seems to be a real misconception even amongst obstetricians that gestational diabetes has the same risks as pre-existing diabetes.  A couple of years ago I did a bit of research on it for my masters and could find no evidence that this was so.  And according to cochrane the  OGT test is not reproducible 50-70% of the time.     Cheers  MichelleMary Murphy <[EMAIL PROTECTED]> wrote:The best way for those who disagree is to find the definitive studies that address all of Henci’s points. If is such an important issue, those studies would be available for us all to read.
 There is harm being done to mothers and babies by the definition of Gestational diabetes.  MM     What are everyone’s thoughts on Henci Goer’s GD article? It’s caused a bit of a stir in my GD forum: http://www.bellybelly.com.au/forums/showthread.php?p=382564 but I don’t feel that I know enough about it to
 comment…  Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support    Send instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] Birth, Trauma & Personality

[Michelle Windsor]

Hi Kelly,     Have you heard of Michel Odent?  He is french surgeon that became interested in birth, became an obstetrician and ended his career doing homebirths.  He has done some excellent work on the effect of birth and has written a number of books.  I remember him saying at a conference once that when he was overseas and wondered how safe a city was, he would look at the birth interference/intervention and that would give him a fair idea as he'd found a correlation between birth interference and crime rates!       Cheers  Michelle"Kelly @ BellyBelly" <[EMAIL PROTECTED]> wrote:Help! Someone started a discussion on my forums about birth and how it shapes the baby as an individual. Of
 course, everyone thought that concept was ludicrous, think studies and percentages are rubbish and must think I am a quack for thinking otherwise LOL J Can anyone else back me up?! I need some support!!! If you aren’t signed up in my forums, please feel free to, or post here any suggestions or comments.      http://www.bellybelly.com.au/forums/showthread.php?t=17144  Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support    Send instant messages to your online friends http://au.messenger.yahoo.com 

[ozmidwifery] Glucose tolerance testing

[Michelle Windsor]

Hi everyone,     Just a query regarding when glucose testing is done in pregnancy.  Does anyone know what is recommended if the woman has had an impaired glucose result prior to pregnancy?  That is, not classed as diabetic but a slightly elevated result.  I have a friend with this scenario who is now (at 14/40) being advised to have a GTT as soon as possible.       Also are other places using Metformin in pregnancy?  Apparently there is new research out and I've seen it used several times recently even from early pregnancy. Thanks in advance.     Michelle 
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Re: [ozmidwifery] Induction due to pulmonary embolism?

[Michelle Windsor]

Hi Kelly,     In my (limited!) experience with this sort of thing, women are usually on Clexane which is an anticoagulant ie 'thins the blood'.  If  the woman went into labour naturally while still on Clexane, obviously her risk of haemorrage would be increased.  But to stop the clexane days before she might go into labour could be risky too if she has a pulmonary embolis or DVT. So what seems to happen is that the clexane will be ceased for 24 hours and then the woman will be induced, and anticoagulants restarted after the birth.  Hope this makes sense!     Cheers  Michelle"Kelly @ BellyBelly" <[EMAIL PROTECTED]> wrote:One of the women on my forum had
 a crisis and was going to have a caesar, but with a bit of encouragement from the others on the site and with the Ob’s back-up she decided against it and was ecstatic, but then said…     “WOW you girls totally rock when a girls in need! I actually have to be induced cause of the pulmonary embolism I got and have to be monitored in labour because I’m on a blood thinning agent”     Could someone please explain? Sorry to be asking such basic questions all the time, I just want to learn! J  Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support    
		 
 
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Re: [ozmidwifery] All vaccines at birth

[Michelle Windsor]

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

[Michelle Windsor]

Hi Nat,     When I was doing my mid training my preceptor and I used to talk about the 'obstetric demons' that sometimes come and sit on your shoulder!!   But if you look into the research on homebirth you will find that in healthy women, the outcomes are comparable or better than hospital birth.  As others have said, it's where you feel most comfortable that counts.  I recently had an email from Sarah Buckley in which she said the same thing. wherever the woman chooses to birth that makes her feel the safest will promote endorphin release, normal labour etc.     All the best     Michelle"Stepney, Natalie Anita - stena001" <[EMAIL PROTECTED]> wrote:
   From: Stepney, Natalie Anita - stena001Sent: Fri 23/06/2006 7:00 PMTo: OZMidwifery@acegraphics.com.auSubject: Birthcentre/ homebirthHi,   I'm a mid student in my last year and 20 weeks pregnant.  I'm planning a homebirth, but since being present at a horrific labour which culminated in the woman having a hysterectomy and two days intubated in ICU following severe bleeding post partumly. Im having second thoughts.  I was honoured to be present at my best friends water birth monday night in a birth centre. I'm thinking that maybe I should go
 that way, as there is back-up.  I would like some professional opinions please.  Cheers Nat    
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Re: [ozmidwifery] Your thoughts on Birth Plans?

[Michelle Windsor]

Hi Kelly,     I'm coming in very late on this discussion but just wanted to add my two cents worth.  I like birth plans for a few reasons:       1. they show the women that they do have a choice in things ... alot of women still assume they have to do whatever they're told    2. my experience is that if the woman states what she wants verbally it is easier for others to ignore it, or it gets lost in change of staff whereas if it's written it's given more respect   3. if a copy of the birth plan is in the woman's notes prior to birth and the staff are able to read it before the woman comes in, sometimes it results in the most appropriate midwife being able to care for that woman.  That is, midwives who aren't comfortable with the birth plan asking for someone else to care for the woman.  (I know this doesn't reflect well on midwives as far as giving woman centred care,
 but the woman benefits if she ends up with a different midwife who will respect her wishes).     Cheers  Michelle"Kelly @ BellyBelly" <[EMAIL PROTECTED]> wrote:I am writing an article as we speak on birth plans (I prefer to say birth intentions or
 birth preferences and hopefully everyone else will too one day!) and I was wondering if anyone would be happy to comment from a midwife perspective?     I’d like to know:    What do you think of birth plans women are writing at the moment  What do you think about it being called birth preferences or intentions instead,  What you like and dislike when you read them – i.e. too long, too unrealistic or whatever springs to your mind      I won’t put your name to the comments so you can feel free to be open and honest about it, I would really love to add your perspectives if you are open to it. Thank-you in advance J  Best Regards,Kelly ZanteyCreator, BellyBelly.com.au Gentle Solutions From Conception to ParenthoodBellyBelly Birth Support - http://www.bellybelly.com.au/birth-support    
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Re: [ozmidwifery] blood loss after 3rd stage

[Michelle Windsor]

Hi Kristin,     Most places I've worked consider a PPH to be a blood loss greater than 500-600ml and treatment would be implemented.  It's hard to define an average normal blood loss, as the majority of women have oxytocics for third stage.  The WHO states that up to 1000ml may be physiological (in healthy, well women).     From my experience the average blood loss in actively managed thirds stages is about 300ml. keeping in mind that this is subjective and alot of the research says we often underestimate blood loss.  It's interesting that you can see some women (with normal Hb prior to birth) become symptomatic with an estimated blood loss of 300-400ml, while others with greater losses are asymptomatic.  Where I've been working a lady had an EBL of 1200 mls but was totally asymptomatic.  Her Hb dropped from 115 to 78.     Cheers 
 MichelleKristin Beckedahl <[EMAIL PROTECTED]> wrote:  I'm wondering whats the average blood loss volume after 3rd stage...? what are the upper & lower ends ? and what amount would require treatment..? Thanks!-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.  Send instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] degrees of high BP in preg

[Michelle Windsor]

Hi Jo,     Where I worked previously the bloods done for high blood pressure were seen to be an indicator of the severity of PIH (or to monitor the progression from PIH to pre-eclampsia) or to distinguish PIH from chronic hypertension from other causes.  As such, if the woman had an elevated BP but bloods were normal, she was kept an eye on while someone with elevated BP and abnormal bloods were treated in some way (depending on the individual scenario).       Lyn mentioned seeing someone fit with a not overly high BP.  I have also heard of this happening, the woman's BP was between 80-90 diastolic.  So the bloods may be a more accurate indicator of the progression of PIH than just BP.  Where this ties in with cerebral edema/irritation I'm not sure (and the textbooks are packed away. moving this week!)        Cheers 
 Michelle  Jo Watson <[EMAIL PROTECTED]> wrote:  Michelle Windsor wrote:>> > By the way with the first woman the doctor insisted that women can > have eclamptic seizures even if their bloods are all normal. Has > anyone heard of this? He did hold off on the mag sulphate when we > were unhappy to give it (in view of normal bloods and BP settled with > pain relief). The woman birthed and had no further problems with BP.> > Cheers> MichelleEclamptic seizures happen, if I remember correctly, due to the oedema on the brain, not necessarily what is in the blood.Please correct me if I"m wrong, anyone!?Jo--This mailing list is sponsored by ACE Graphics.Visit to subscribe or
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Re: [ozmidwifery] degrees of high BP in preg

[Michelle Windsor]

I know the feeling of things changing from week to week!       One week we're were asked to start mag sulphate on a woman with diastolic creeping up (90 - 105) when going into good labour.  2 + protein in urine, mild edema, no increased BP antenatally, bloods all normal.  The next week a woman with increasing BP antenatally (90-105), 3+ protein in urine, no edema, normal bloods was sent home!!  Same doctor.     By the way with the first woman the doctor insisted that women can have eclamptic seizures even if their bloods are all normal.  Has anyone heard of this?  He did hold off on the mag sulphate when we were unhappy to give it (in view of normal bloods and BP settled with pain relief).  The woman birthed and had no further problems with BP.     Cheers  Michellebrendamanning
 <[EMAIL PROTECTED]> wrote:  There is some variation here... but this week ..a diastolic over /90 is watchable & anything over 100 treatable.     Could be different next week      With kind regardsBrenda Manning www.themidwife.com.au- Original Message -   From: Kristin Beckedahl   To: ozmidwifery@acegraphics.com.au   Sent: Thursday, June 01, 2006 8:41 PM  Subject: [ozmidwifery] degrees of high BP in preg  wise women...  At what point does high blood pressure become an issue in preg?  what is a 'normal' reading for a healthy preg woman?  What reading is considered 'high-risk' or requiring action (without proteinuria)...?  Big thanks 
   From: Andrea Quanchi <[EMAIL PROTECTED]>Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] students & learningDate: Thu, 1 Jun 2006 19:57:06 +1000>If the woman invites the student to be there and the MIPP is happy >what prevents them from being there. Surely we are letting them know > what the real world is like and the reality is that MIPP are >working uninsured and having to cope with what that means in >reality. This is no different from when I attend a hospital with
 a >woman and the hospital says that they only recognise me as a >support person. I could let that stop me from going there but I >don't. If students want to be at hom births they will, they will >learn heaps and if they cant write it down on paper for the uni >then dont but dont let it stop them from attending because the >experience is to valuable to waste.>Andrea Quanchi>On 01/06/2006, at 7:03 PM, Stephen & Felicity wrote:>>>I think perhaps you women are the "lucky" ones; I only recently had >> an email from a student midwife in SA, lamenting that she is >>unable to attend homebirths unless the midwife is "publicly >>employed" (ie: not a MIPP). Since the only homebirth midwives >>employed by the Government in SA are part of the Northern Women's >>Community Midwifery Program, anyone not fortunate enough to be in >>that region has zero
 opportunity to work "in all situations". >>This is clearly an insurance issue as well as an educational >>institution issue...but it's all one and the same at the end of >>the day, isn't it? It's all just part of the overall climate for >>midwifery and birthing women in our country.- Original Message - From: "Kirsten Dobbs" >><[EMAIL PROTECTED]>>>To: >>Sent: Thursday, June 01, 2006 5:10 PM>>Subject: RE: [ozmidwifery] students & learning>>>I can back up Kate, (as we attend the same uni!)>>>I have only ever been encouraged and supported to attend births >>>with>>>independent midwives by our uni.>>Kirsten>>-Original Message->>>From:
 [EMAIL PROTECTED]>>>[mailto:[EMAIL PROTECTED] On Behalf Of Kate >>>and/or Nick>>>Sent: Thursday, June 01, 2006 9:57 AM>>>To: ozmidwifery@acegraphics.com.au>>>Subject: RE: [ozmidwifery] students & learning>>>For fyi, student midwives here in SA are *forbidden* to seek >experience>>>of any kind with any independently practicing midwife, on threat >>>of a>>>fail grade for the clinical topic &/or expulsion from the course.>While this is the case at one uni, it does not appear to be at the >>> other>>>uni. We have a lay midwife doing the Bmid who will be doing her >>>practicum>>>with an independent midwife. We believe we are able to participate
 >>>in>>>homebirths, and I am certainly hoping to do just that.>>Kate-->>>This mailing list is sponsored by ACE Graphics.>>>Visit  to subscribe or unsubscribe.>>>-->>>This mailing list is sponsored by ACE Graphics.>>>Visit  to subscribe or unsubscribe.-->>This mailing list is sponsored by ACE Graphics.>>Visit  to subscribe or unsubscribe.>>-->This mailing list is sponsored by ACE Graphics.>Visit  to subscribe or unsubscribe.-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or
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[ozmidwifery] Article FYI

[Michelle Windsor]

Trial finds delay in cord clamping protects babies  (as reported in the Courier Mail recently)     A 30 second delay in clamping a premature newborn's umbilical cord protects against bleeding in the brain and infection, groundbreaking new research shows.     The study, which involved 72 babies, could prompt a reassessment of the standard practice of clamping the cord immediately after birth.     Delayed clamping has been shown to increase the volume of blood transferred to the baby from the placenta.     Researchers from the University of Rhode Island, in the US, followed 36 babies assigned to immediate cord clamping and 36 assigned to delayed cord clamping.     All were less than 32 weeks gestation and their prematurity meant they were at increased risk of brain haemorrhage and infection.     In
 the weeks after birth, 36 percent of the immediate group had suffered bleeding into the brain, compared with 14 per cent of the delayed group.       Nine of the immediate group but none of the delayed group developed infections while in the intensive care.     "It may be that the small amounts of additional blood preterm infants obtain by delaying cord clamping helps to stablise cerebral blood flow and provide additional stem cells to establish adequate immunocompetence" says the report in this month's America Pediatrics journal. Send instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] CTG & stillbirth

[Michelle Windsor]

Hi Sadie,     I guess the thing is that alot of people believe that a normal CTG (not in labour) is reassuring for fetal well being for the next 24 hours.  Obviously this wasn't the case for this baby.      You said about doing emergency C/S for unressuring trace only to have the baby come out screaming don't you think this shows CTG's are unreliable?     Cheers MichelleSadie <[EMAIL PROTECTED]> wrote:  CTG's can only reveal what is happening at that moment and are subjective to interpretation. Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to
 theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is.   Just my thoughts having been through a similar situation..     Sadie- Original Message -   From: Michelle Windsor   To: Ozmidwifery   Sent: Saturday, May 27, 2006 5:15 PM  Subject: [ozmidwifery] CTG & stillbirth      Recently where I work a primip come in at term plus 7 days in early labour about 11pm.  She had a CTG at 3pm which was reactive, good variability etc.  (they do routine CTG's on post-dates women).  The woman wasn't in established labour and the midwife suggested she return home.  The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour.  Apparently after change of shift the next midwife couldn't find a FHR and
 USS confirmed the baby had died within the last couple of hours.  I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal.     To me it just proves again the unreliability of CTG's.  Just interested in what others think.     Cheers  Michelle  On Yahoo!7 360°: Your own space to share what you want with who you want!
		 
 
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[ozmidwifery] CTG & stillbirth

[Michelle Windsor]

      Recently where I work a primip come in at term plus 7 days in early labour about 11pm.  She had a CTG at 3pm which was reactive, good variability etc.  (they do routine CTG's on post-dates women).  The woman wasn't in established labour and the midwife suggested she return home.  The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour.  Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours.  I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal.     To me it just proves again the unreliability of CTG's.  Just interested in what
 others think.     Cheers  Michelle
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Re: [ozmidwifery] working in a private hospital ?

[Michelle Windsor]

Hi Julie,     I worked in a private hospital in Hobart for a short time when working and travelling.  The disadvantages were working within a medical model of care with high intervention rates and the birth being directed by the obstetrician.  I only stayed a short time as I felt I would lose my midwifery skills if I stayed longer.  The obstetricians even did their own VE's most of the time.     The midwives at this hospital were lucky as they got to do the 'catch' with normal births, with the obstetrician present.  I do have some good memories of 3 primips I looked after that birthed how they wanted to.. one squatted to birth her 9 pound baby (intact) and then had a physiological third stage, one stood to birth her OP baby and another laboured in the bath and birthed her baby (out of the bath) with no analgesia.  To me these were a win in a system where most women labour on
 the bed with an epidural.  But it is quite disempowering  for the midwife that after the birth, the obstetrician takes over delivering the placenta, as if the midwife isn't capable.  I would have to agree with others in that it isn't practising midwifery in the truest sense of the word.  You don't get to do any antenatal care or get to meet the women before they are in labour.  Having said that I know that there are many midwives working in this system ( for their own reasons) who are doing their best to work with the women and give them the best birth possible.   Anyway this is just my experience.   Possibly other places are different.. one I can think of is Selangor in Nambour.        Cheers  MichelleJulie Garratt <[EMAIL PROTECTED]> wrote:  Dear wise women,    I'm wanting to get an idea on what the disadvantages and benefits are to working in a private hospital . I must admit, as a direct entry midwife, I probably have a less than positive view of the private system having been told by lecturers that doing clinical placement there would be a waste of time. ( You become very "birth centric"' when you have to catch 40 babies to register). I think I'm asking for a balanced view here if one exists.   Julie, longtime daily lurker :)
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Re: [ozmidwifery] Group G Strep

[Michelle Windsor]

Thanks for pointing that out Barbara.  I'd completely overlooked the date when it was published.       Cheers  MichelleBarbara H Stokes <[EMAIL PROTECTED]> wrote:  Dear List,This article was published July 1979 so is very old.Barbara-- Original Message ---From: "Mike & Lindsay Kennedy" <[EMAIL PROTECTED]>To: ozmidwifery@acegraphics.com.auSent: Tue, 11 Apr 2006 17:21:20 +1000Subject: Re: [ozmidwifery] Group G Strep> Try this link. There is a link to the full text article too.> > Group G streptococcal pneumonia and sepsis in a newborn infant.> > A case of neonatal pneumonia and sepsis caused by a group G> Streptococcus is described. Clinical and microbiological aspects of> group G
 streptococci are compared with those of group B streptococci.> > http://www.pubmedcentral.gov/articlerender.fcgi?artid=273262> > On 4/10/06, Michelle Windsor <[EMAIL PROTECTED]>wrote:> >> > Hi everyone,> >> > Just wondering if anyone has any experience with Group G strep? We recently> > had a woman come through with it and I hadn't heard of it before. Some> > midwives thought it should be treated the same as Group B strep (ie IV ABs> > in labour, obs on bub) and others thought is wasn't a conern. Since then> > I've talked to someone from pathology who assures me it isn't a concern for> > the baby and no need for IV ABs etc. Just interested to know what other> > places do.> >> > Thanks> >> > Michelle> >> >> > > > On
 Yahoo!7> > Messenger: Make free PC-to-PC calls to your friends overseas.> >> >> > --> My photos online @ http://community.webshots.com/user/mike1962nz> My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers> New Photo site@> Mike - http://mikelinz.dotphoto.com> Lindsay - Http://likeminz.dotphoto.com> > "Life is a sexually transmitted condition with 100% mortality and > birth is as safe as it gets." Unknown> --> This mailing list is sponsored by ACE Graphics.> Visit to subscribe or unsubscribe.--- End of Original Message -This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.
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[ozmidwifery] Group G Strep

[Michelle Windsor]

Hi everyone,     Just wondering if anyone has any experience with Group G strep?  We recently had a woman come through with it and I hadn't heard of it before.  Some midwives thought it should be treated the same as Group B strep (ie IV ABs in labour, obs on bub) and others thought is wasn't a conern.  Since then I've talked to someone from pathology who assures me it isn't a concern for the baby and no need for IV ABs etc.  Just interested to know what other places do.     Thanks  Michelle
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Re: [ozmidwifery] birth and the weather

[Michelle Windsor]

Hi Kylie,     My sister-in-law is a vet in the US and she says that when it starts snowing, the cows start calving (great conditions for a newborn!!).  She also believes it is from a change in atmospheric pressure.  There seems to be a link with this and women going into labour on planes too.     Cheers  MichelleKylie Carberry <[EMAIL PROTECTED]> wrote:  Hi all,  I am writing a story about how the weather affects our health and was quite interested when I came across a piece about a change in air pressure and more births occurring.  It jogged my memory to when I had my last child and the hospital was very busy indeed.  Between contractions I can vaguely recall the midwife telling me that her theory was that
 the change in the weather (from clear to stormy) that evening triggered lots of labours.  And, I have come across a website ( intellicast.com) which has a labour/birth index!   I was wondering does on this board have any thoughts on this theory??  cheers  Kylie Carberry Freelance Journalist p: +61 2 42970115 m: +61 2 418220638 f: +61 2 42970747-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. 
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Re: [ozmidwifery] after birth pains

[Michelle Windsor]

I have also known of a woman who had severe after birth pains which she had Pethidine for (after getting through the labour without analgesia).  With her next birth she decided not to have an oxytocic (Syntometrine was used in that hospital routinely) and she noticed a big difference.     Cheers  MichelleSusan Cudlipp <[EMAIL PROTECTED]> wrote:  Hi Lyn  I don't know if this woman had actively managed or physiological 3rd stage with her first 2 but I know of one (now grand) multip whose 2nd birth I attended - she suffered dreadfully with after pains in all hosp births but has had the last couple at home with physiological 3rd stages and told me
 that the after pains have not been a problem .     Sue  "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke- Original Message -   From: lyn lyn   To: ozmidwifery@acegraphics.com.au   Sent: Sunday, April 02, 2006 9:02 AM  Subject: [ozmidwifery] after birth pains 
 Hi all     I am seeing a mother G4P3 now at 36 weeks who has asked me if there is anything she can do about after birth pains.  She had severe suffering after her last two and would like to avoid if possible.      Can they actually be avoided.  and if so could that mean that there is a risk that her uterus will not contract down strongly and therefore she may bleed heavily.     A midwife I know talked about using coosh (not sure if blue or black, i have no experience with either).  Supposed to be an antispasmodic, which may not be ideal if we want a contacted uterus.     Thanks in advance for
 any help you may provide     lynNo virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.385 / Virus Database: 268.3.4/299 - Release Date: 31/03/2006
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Re: [ozmidwifery] hyperthyroidism

[Michelle Windsor]

Thanks for the info Pinky.  I'm not sure of exactly what my friend is taking but she has been seeing a natropath and feels that it has helped her symptoms.  She was on progesterone for awhile, but has stopped that in the lead up to the birth.  She was told that hyperthyroidism can be from a lack of certain minerals, so has been taking some and also feels that it is helping.  Sorry, haven't got the info to be more specific.     Cheers  Michellepinky mckay <[EMAIL PROTECTED]> wrote:  Hi Michelle,  I cant offer any help re risks to baby -I have Graves disease athough being an autoimmune disorder it went away during my last pregnan!
 cy ( 14
 years ago). Darn thing came back almost a year ago.     Hyper thyroid is hell!!! Palpitations/elevated BP/  anxiety/ exhaustion/ extreme hunger with weight loss(you might think this sounds like fun but sadly its a bitch to be up 2 hourly to feed -yourself!). I had never had anxiety/ panic before and wonder how many women who are diagnosed with pnd actually have a thyroid problem - anxiety/ palpitations go when the levels balance.        Proper diagnosis and treatment is important for the mother's health -mine escalated very quickly and required a radioactive scan to diagnose properly. Obviously this cant be done on a pregnant woman so it probably depends on her TSH levels what would be the best choice re induction/ treatment. Is she seeing an endocrinologist? I have found that no!
 t all
 doctors really know their stuff re thyroid.     Recently, despite pleading that my symptoms had returned  was given everything from 24 hr heart monitoring ( yep speeding!).to being advised to take a range of meds from calcium channel blockers to anti deporessants - none of which were necessary once I finally did a blood test and altered my carbimazole (thyroid suppressant) -although this has taken a couple of months of see-sawing. According to Hale thyroid meds are ok during breastfeeding - just monitor baby's levels. However, rest is vital/ hot weather plays havoc and so does stress/ overdoing things.     Thyroid Australia have a website with links to other thyroid info. They seem to need membership to access complete articles but I do know that Raelene, director at Kn!
 ox
 Private recently attended a conf  run by thyroid Austraia re disorders during pregnancy so they should have some info or a name to refer to.      Thyroid Australia HomeProvides personal support, counselling, information and training. Aims to raiseawareness and interest in thyroid conditions.www.thyroid.org.au/      I am interested what alternative treatment she is taking.     Pinky- Original Message -   From: Michelle Windsor   To: Ozmidwifery   Sent: Saturday, February 04, 2006 10:27 PM  Subject: [ozmidwifery] hyperthyroidismHi,     Just wondering if anyone can help.  I have a friend with hyperthyroidism (diagnosed during the pregnancy).  She is using alternative treatments as well as taking some medication, but her levels are still elevated.  The problem is that the doctors now want to induce her (she is 39+ weeks now).  She is keen to av!
 oid
 induction.  Does anyone know what the risks are to the baby (as in percentages)?  The stuff I've read just says there is an increase of still birth but is not specific.  Thanks in advance.     Michelle  Do you Yahoo!?Messenger 7.0: Free worldwide PC to PC calls
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[ozmidwifery] hyperthyroidism

[Michelle Windsor]

Hi,     Just wondering if anyone can help.  I have a friend with hyperthyroidism (diagnosed during the pregnancy).  She is using alternative treatments as well as taking some medication, but her levels are still elevated.  The problem is that the doctors now want to induce her (she is 39+ weeks now).  She is keen to avoid induction.  Does anyone know what the risks are to the baby (as in percentages)?  The stuff I've read just says there is an increase of still birth but is not specific.  Thanks in advance.     Michelle
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[ozmidwifery] PTSD

[Michelle Windsor]

In relation to the previous posts.. I recently attended a lecture by Professor Debra Creedy (from Griffith University, Qld) on PTSD in relation to birth.  She said that psychologists have accused her and her colleagues of making pathology where none exists!!   You can read more of her work at:     www.gu.edu.au/ins/collections/proflects/creedy02.pdf     www.qnc.qld.gov.au/upload/pdfs/research_grants/Research_Report_Creedy.pdf     Cheers   Michelle
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Re: [ozmidwifery] reaction to anti D

[Michelle Windsor]

Hi Lindsay,     I haven't seen a reaction to anti-D but apparently they can have reactions ranging from soreness at the injection site, cold/flu like symptoms to anaphylaxis.       Cheers  MichelleLindsay Kennedy <[EMAIL PROTECTED]> wrote:  HiI wondered if anyone had every had a woman have an reaction to the anti Dinjection?Today I gave a woman her 24 week dose of anti D. This is her secondpregnancy and thus her 4th dose of anti D. She appeared fine and left. Iwent out to the waiting room to discover her swaying on her feet, flushedand looking very unwell. Took her back into the consult room and did obs...she was tachycardic, tachypnoeic with raised BP. She was short of breathand felt 'funny'. Called the doc and we put a cannula i!
 n,
 however she seemedto come right and we didn't do any further treatment, except monitor her forabout 45 minutes. However her husband rang once she got home to say thatshe was feeling unwell and shaky. He brought her back into the hospital...I don't know if she required further treatment. She was feeling a bitunwell before the injection, getting a cold she said. None of the other midwives had ever had a patient react to anti D. Lindsay-- No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.14.25/247 - Release Date: 31/01/2006--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.
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Re: [ozmidwifery] dive reflex

[Michelle Windsor]

Hi Emily,     What I've read of the dive reflex (especially in relation to water birth) is that it is a reflex where the epiglottis stays closed, therefore not letting water enter the lungs.  While there is fluid in the lungs prior to birth, this is secreted by the lungs and some of it is excreted and is a component of the liquor.  The breathing movements that the baby makes prior to birth do not cause the outside fluid to enter the lungs. They say that the dive reflex will stay intact if the baby is not exposed to a different temperature, and the baby is not hypoxic.      A tip passed on to me (in regard to waterbirth) was that if the baby was born and brought to the surface, was in good condition but not breathing, then gently bringing the baby's chin down with your finger and opening the mouth will break the dive reflex.  I remember one waterbirth where the baby was brought to the
 surface, had great heart rate, excellent tone (actively pedalling her legs!) but wasn't breathing.  After a few seconds (and because the parent's were getting anxious) I opened her mouth and she immediately began breathing.       Cheers  MichelleEmily <[EMAIL PROTECTED]> wrote:hi jenny thats not what ive read about it. i have read about the diversion of blood flow to essential areas due to prostaglandin E2 increases around labour time, but think this is separate to the dive reflex'One more important inhibitory reflex is the Dive Reflex, which involves the larynx. ...when a solution hits the back of the throat, passing the larynx, the taste buds interpret what substance it is and the glottis automatically closes. The solution is then swallowed, not
 inhaled...' - Heart and HandsemilyJenny Cameron <[EMAIL PROTECTED]> wrote:  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 FRC!
 NA
 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 reflexYahoo! PhotosRing in the New Year with Photo Calendars. Add photos, events, holidays, whatever. No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.14.2! 0/233 - Release Date:
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[ozmidwifery] testing urine

[Michelle Windsor]

Hi everyone,     Just a query, wondering what other places do with urine testing in pregnancy.  At the moment we are doing first visit MSU's and otherwise only testing (dipstick) if symptomatic, +/- MSU.  Recently there have been a few women admitted with pyleonephritis, one who ended up in ICU in septic shock.  So am wondering if it is worthwhile testing with each visit.  I thought that the thing with pregnancy was that women could have UTI's and be asymptomatic.       Cheers  MichelleSend instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] Let baby decide birth date

[Michelle Windsor]

My sister-in-law is a vet in the States and I've heard the same from her regarding interferring with horses births.. they know that you can't often improve on nature!!     Cheers  MichelleJulie Garratt <[EMAIL PROTECTED]> wrote:  So, I was chatting with a family friend who breeds show horses.> Talking about postdates, etc. He laughed at me. Apparently, any horse> breeder worth his salt knows that 1) the foal initiates birth, 2) any> breeder who induces labor is a fool, 3) foals that come from induced> labors are inferior (have long term health difficulties, etc), 4)> induced labors are hard on both foal and mare, and 5) !
 some
 foals just> take longer, and  gestational dates are just a guess.>> If this is "common knowledge" amongst horse breeders,> fercryingoutloud, why isn't it for human breeders>  Send instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] terms to express practice

[Michelle Windsor]

I'm not sure what they mean by "clinical approach" (? assessment, implementing practices, evaluation etc?) but I would say about the holistic aspects of your care eg. not just providing physical care but addressing the social, emotional, psychological needs of the women which includes their family/partners/significant others and whatever their circumstances are. Hope this makes sense!     Cheers  MichelleMary Murphy <[EMAIL PROTECTED]> wrote:I am needing to address the ACMI competency standards and find it hard to express how I : 2.1 Uses a clinical approach to provide  holisitic midwifery care; How does one express that succinctly and accurately?  Thanks in advance. Mary M  Send instant messages to your online friends http://au.messenger.yahoo.com 

Re: [ozmidwifery] mackay midwives

[Michelle Windsor]

Hi Fiona,
 
Yes I had heard that Kirsten is leaving.  It could be interesting to see what comes out of this.  The two private obs have had a midwife working with them for about 12 months now doing some of the visits because they were so busy.  As far as problems at the birth centre... we seem to be regulary sending out letters to GP's who are totally misinformed about it and then pass that information on to women.  I don't think the women having beautiful natural births where their choices are respected think there is a problem!!  
 
Cheers 
MichelleFIONA AND CRAIG RUMBLE <[EMAIL PROTECTED]> wrote:




Did you know Kirsten Small (one of only two OBS) has resigned, leaving July? Great opportunity to highlight the need for more midwifery care and encouragement for the Birth Centre. I mentioned same to ABC reporter yesterday and a Doctor (my boss) poo hoo-ed me saying there were too many problems at the BC already. All the more reason to push forward 
Regards Fiona Rumble
		  
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Re: [ozmidwifery] Re:cervidil

[Michelle Windsor]

Hi Alesa,
 
We are using cervidil at Mackay Base (Queensland).  I personally haven't had much experience with it as I mostly work at the birth centre, but the feed back from the other midwives that I've heard so far has been positive.  They feel that it is less invasive than Prostins, as it can be put in and left for 12-18hrs (our prostin regimen is every six hours for 3 doses) so less VE's for the woman.  They also think it seems to work quite well with primips, getting them into labour more successfully than prostins.  I'm not sure about the hyperstimulation.  Some of the midwives are putting it in here, but apparently it is quite difficult as you have to make a loop and put the cervidil around the cervix.
 
Cheers
MichelleAlesa Koziol <[EMAIL PROTECTED]> wrote:




Lisa
We (Midwives) currently use prostin but there is a move afoot for us to commence using cervidil. For lots of reasons, we are not keen to go down this track and I am seeking info on what is currently in use around oz so am fully armed in time for our next meeting.and I must thank everyone who has answered this thread so far you have been most helpful. More info always gratefully accepted:)
Cheers
Alesa
 

- Original Message - 
From: Lisa Barrett 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, November 02, 2005 7:51 PM
Subject: Re: [ozmidwifery] Re:cervidil

Midwives insert the cervidil there are no MO's.  Ashford is the biggest private hospital in South Australia. Induction rate is also about 70% maybe more, for all the wrong reasons.  
What sort of results do you get with it? 
Lisa

- Original Message - 
From: Alesa Koziol 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, November 02, 2005 6:47 PM
Subject: Re: [ozmidwifery] Re:cervidil

Thanks Lisa... do the midwives use it or is it inserted by MO?? And which state are you in?
Cheers
Alesa

- Original Message - 
From: Lisa Barrett 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, November 02, 2005 4:58 PM
Subject: Re: [ozmidwifery] Re:cervidil

They use Cervidil at Ashford, It has quite an aggressive action provided it's inserted correctly.  It's not easy to put in however being extremely awkward.  It's almost impossible to place it in the posterior fornix.
One Ob described it to a patient as a tampon.  I found this very amusing as it's Barbie sized!
Lisa

- Original Message - 
From: Larissa Inns 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, November 02, 2005 3:58 PM
Subject: [ozmidwifery] Re:cervidil

I only know of a couple of private OB's who use it at one of our local private hospitals. Most choose not to use it because of the cost.
Hugs,Larissa.

My next question for the list is to ask of any sites where Midwives are using cervidil. 
Cheers
Alesa
 
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Re: [ozmidwifery] Lactation after ART

[Michelle Windsor]

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
 
 

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Re: [ozmidwifery] Mackay

[Michelle Windsor]

Hi Di,
 
I'm sure it will be fine for you to come and have a look through.  The Birth Centre number is: 49 686404.   Our appointment days are Tues-Thurs, but on Mon & Fri we may or may not be there (doing home visits etc).  Hope to catch up with you.
 
Cheers
Michellediane <[EMAIL PROTECTED]> wrote:




Hi to the Mackay Midwives, 
 
I am going to be in Mackay for a few days next month and wondering if I can come and see your Birth Centre. Any suggestions on who to contact to arrange this. I am interested in how different midwifery models arrange their work as we are trying to get a caseload model up and running at Wyong (near Gosford). My husband would love to move there too but Im not sure I could handle the humidity!
Cheers,
 Di.
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Re: [ozmidwifery] birth centres in Australia

[Michelle Windsor]

Hi Sally,
 
As per your request.Mackay Birth Centre, Queensland, ph: 0749686404.
 
Cheers,
Michelle
sally tracy <[EMAIL PROTECTED]> wrote:
Dear allam trying to update a list of birth centres or places that the midwives and women  refer to as birth centres...Denise H. made a list of models of midwifery care a few years ago and many of those are birth centresI'm wondering if there are any more birth centres that we havent got on the list   - it would be useful to have a contact number beside each one  because I would like to contact each birth centre in Australia over the next couple of monthsmany thanks Sally T.If you put the state , name of birth centre, and contact ...would be great 
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Re: [ozmidwifery] Mackay, QLD

[Michelle Windsor]

Hi Janet,
 
There aren't any homebirth midwives in Mackay, or nearby that I'm aware of.
 
Cheers
MichelleJanet Fraser <[EMAIL PROTECTED]> wrote:




Hi all,
any hb midwives in Mackay or nearby? Woman wanting VBA2C has asked me.
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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Re: [ozmidwifery] Induction and third stage labour

[Michelle Windsor]

I have to admit I've never really understood the reasoning behind the baby supposedly receiving a bolus of blood if the cord is not clamped after synto.  If the placenta is separating from the uterus how does that cause excessive blood to transfuse to the baby?  
 
Cheers
Michelle  Susan Cudlipp <[EMAIL PROTECTED]> wrote:






The reason given for hasty cord clamping AFTER (not before) administering synto is not to prevent synto entering baby's circulation, but to prevent over tranfusion due to the excessive contraction thus produced 'pushing' too much blood into baby due to squeezing the placenta.  Synto infusions are given all the time for induction and I have never heard of any concerns about it entering baby's circulation.  The synto bolus injection is justified as a means to prevent PPH, the baby's needs are not apparently considered important!
I realise that IPM's only give synto if needed, and when cord has ceased pulsations, but the policies of most hospitals for ACTIVE management of 3rd stage says: 1). give oxytocic with anterior shoulder, 2). clamp and separate cord as soon as baby delivered, 3). commence controlled cord traction as soon as uterus felt to be contracted.
 
I hasten to add that I do not agree with this, but have had reason to research it quite a bit lately and have found, like Karen, that the textbooks and  policies are not crystal clear and many are very much opposed to each other.  Case in point being Obstetric guidelines vs Midwifery guidelines both in circulation in the KEMH policy manuals.
 
Sue 
"The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke

- Original Message - 
From: Tanya Fleming 
To: ozmidwifery@acegraphics.com.au 
Sent: Wednesday, October 05, 2005 11:03 AM
Subject: Re: [ozmidwifery] Induction and third stage labour

I am taken by surprised of this tooi teach the very same as you Karen.  I also believe that the cord should be cut immediately before giving synto, to prevent passage of syntocinon into baby's circulationif cord is still pulsating, one would think this is possible as synto act quickly.  I am interested to hear everyone elses beleifs and practices too!
Cheers,
Tanya Fleming

- Original Message - 
From: karen shlegeris 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, October 03, 2005 6:21 PM
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] baby poo

[Michelle Windsor]

Hi Mary,
 
Was talking to a friend of mine recently who is a midwife and had twins.  Her boys were fully breastfed and absolutely thriving one always had the typical yellow breastfed poos and one always had green poos!  So perhaps it has something to do with the baby's own digestion?  
 
Cheers
MichelleMary Murphy <[EMAIL PROTECTED]> wrote:





Hi all.  An enquiry from a mother of a 3 week old baby re the colour of baby’s poo.  Baby has never had yellow “breast milk “ poos.  He has always had greeny brown poo, a good one every day, the same consistency of newborn yellow poo, but just never yellow.  He  breast feeds frequently, seems content after feeds, has lots of wet nappies.  Any suggestions?  Thanks, Mary M
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Re: [ozmidwifery] Re: Breech Babies

[Michelle Windsor]

Both our consultants will attempt ECV if the woman wants, provided there is adequate liquor and no cord entanglement etc.  I can't tell you the success rate, but there are definitely those they have turned which have then birthed vaginally.  
 
Cheers
MichelleHelen and Graham <[EMAIL PROTECTED]> wrote:
I had a friend about 8 years ago who was a primip breech and desperately wanted to give birth naturally. She managed to convince her ob to try cephalo-version on the operating table (on a weekday when all the staff were there anyway) so that if there had been a placental abruption or some other complication, she would have been able to have a caesar. It worked. Seems a bit dramatic but not as bad as just giving the nod to a caesar in the first place.Has anyone else had much to do with cephalo-version?Helen Cahill- Original Message - From: "Judy Chapman" <[EMAIL PROTECTED]>To: Sent: Saturday, September 03, 2005 5:34 PMSubject: RE: [ozmidwifery] Re: Breech BabiesI have just been surfing this site, some good stuff. I have amulti with a breech at 36+ wke at!
  the
 moment and I dearly wanther to be able to birth here.CheersJudy--- Vedrana Valèiæ <[EMAIL PROTECTED]>wrote:> A very interesting discussion on breech births and midwives:>> http://www.radmid.demon.co.uk/breech.htm>> Vedrana>> -Original Message-> From: [EMAIL PROTECTED]> [mailto:[EMAIL PROTECTED] On Behalf Of> Miriam Hannay> Sent: Friday, September 02, 2005 6:10 AM> To: ozmidwifery@acegraphics.com.au> Subject: Re: [ozmidwifery] Re: Breech Babies>> I totally understand, Susan about the whole fear of> breech birth. We have a couple of OBs who will 'let'> women birth a breech babe vaginally, but fully> managed, IOL, 16 gauge bores in both arms, hartmann's> up, McRoberts, episi, full extraction. To me this> seems torture. I am a second year Bmid student and> in!
 tending
 to go into independent practice, so am> availing myself of every extra learning opportunity> available.>> A fellow student and I (my lovely partner in crime),> attended Maggie Banks' emergency skills workshop in> Melbourne recently which was SO valuable, and we feel> much more comfortable about the possibility now.>> I have a dear friend whose first 'catch' as an RM was> an undiagnosed breech at home, so it does happen. We> need to be prepared and develop the skills to handle> this situation. What a shame and potential danger it> is if these skills fall by the way.>> Everyone who can should hear Maggie Banks speak, she> dispells fears and demystifies like no-one else.>> Regards, Miriam (FUSA)>> --- Susan Cudlipp <[EMAIL PROTECTED]>wrote:>> > Yes it was Brenda who wrote that, but I have also> > been a midw!
 ife long
 enough> > to have seen many breech births - back in the UK,> > and delivered a few> > myself. Not all good, mostly quite 'managed' but at> > least they were mostly> > seen as being manageable vaginally! My own elective> > C/S (nearly 21 years old> > now!) was for primip breech, although I was given> > the choice of vaginal> > birth, I knew just what that would entail within the> > large unit that I was> > obliged to attend - epidural, forceps, episiotomy,> > and I chose not to go> > there, however at that time there was no question> > that I would not be able> > to have VBAC with the next - nowadays that is not> > so.> >> > A year or so back we had a multi with a breech who> > was lucky enough to see a> > less interventionist OB (as you so rightly guessed> > Melissa :!
 -)) and
 she> > chose to have a vaginal birth. Of course it had to> > be induced on the 'right'> > day, but was very straight forward. Apart from that> > we really don't see> > them anymore, and at least one of the few docs who> > does do them does such a> > horrendous job that I would personally prefer a C/S> > rather than submit to> > his handling.( you can probably guess that one too> > Mel!)> >> > It is sad that student midwives today will not learn> > these essential skills> > within the hospital system. Personally I feel> > confident that I can handle> > an unexpected breech, but cannot see how the next> > generation are going to> > cope with this, there is so much fear of what is> > really only a different> > variety of birth, in the same way that any> > 'different' pre!
 sentation
 is.> > Anyone who has had the pleasure of hearing Maggie> > Banks speak, watched her> > video, or that of Michel Odent's work in Pithiers> > will know that this is> > true> >> > Rachel, I totally empathise with how you are feeling> > having just come to> > Australia from the UK (been here 15 years myself).> > It was a real shock to> > me to see how much all births are seen as being the> > doctor's property. One> > of my first births here was in a small hospital and> > I called the GP as per> > protocol. He arrived as I had the head in my hands> > and proceeded to rush> > in, without even washing his hands and virtually> > pushed me out of the way!> > I looked at him with horror and said quietly " I> > think I 

RE: [ozmidwifery] if mother wants to be directed for pushing

[Michelle Windsor]

I guess the big fear associated with pushing before the woman is fully is that the cervix will either swell up (and then take longer to dilate) or tear.  About the only time I've seen swelling of the cervix is when women are directed to push by staff who have been mistaken in their VE (ie not fully dilated).  I've never seen a problem with multi's who involuntarily push before being fully dilated.  My sister had an ARM at 4 cm (induced) and began pushing almost straight after and 15 mins later had a baby!  Where I work we rarely do VE's so I'm sure that lots of our mums are pushing prior to being fully and so far we haven't had any problems.
 
Cheers
MichelleEmily <[EMAIL PROTECTED]> wrote:
i have been wondering lately about the other side ofthings. i was with a woman last week who was feelingstrong urges to push and was pushing involuntarily atthe peak of each contraction from about 4cm. she onlyhad two VEs - 4cm and 6cm. about half an hour afterthe 6cm one everyone was still talking her throughbreathing through the contractions and trying not topush. she had been doing a lot of poo so i checked herto clean her up again and there i see half a littlehead sitting on her peri. the poor poor lady stilltrying not to push through that.i feel awful that she never got to go with her urges.so what is the alternative? should women go with whattheir body tells them to do if that means pushing waybefore they're fully? she sustained quite a badposterior vaginal wall tear as well - would this berelated at all to!
  pushing
 before full dilation?love to hear your opinions because i really did feelbad for this poor lady having to fight her urges. shehad so much faith in everyone..((anyway after all that she was very satisfied withher birth, had 8 of her family including hergrandfather with her and a lovely baby girl.))love emily--- jo <[EMAIL PROTECTED]>wrote:> InterestingI work with our local homebirth> midwife as a doula and we had> a client a few weeks back who never had the urge to> push, baby was finally> born about 51/2 hours after full dilation. The urge> never came to her, she> actively pushed towards the end - not directed by> anyone...although not> naturally occurring pushes.> > Jo Hunter> > -Original Message-> From: [EMAIL PROTECTED]> [mailto:[EMAIL PROTECTED] On> Beha!
 lf Of
 Päivi> Sent: Thursday, 25 August 2005 7:31 AM> To: ozmidwifery@acegraphics.com.au> Subject: [ozmidwifery] if mother wants to be> directed for pushing> > Hi again,> > Like I told you earlier, I have just started a> childbirth education program.> > One of my students just gave birth and had a quick> and straight forward > unmedicated 1st stage, but ended up pushing for> 1.45minutes. She said she > had no idea, what she had to do and told very> clearly to the midwife to > direct her for pushing. I had promised to be her> doula if she felt she > needed me, but since it all went so quickly, she> never called me. I was just> > wondering how I would have reacted to the situation> if I was there, since > during the training we emphasized spontanious> pushing, waiting for the urge > to push and following!
  your own
 feelings. I noticed> there was discussion > about pushing here a week ago and I read the> wonderful artickle by Gloria > Lemay too. But what if the mom wants to be directed?> Do you ever direct a > woman in 2nd stage and if so, how?> The bag of waters was broken in the end of> transition and water was green. > She was also given syntocin 40 minutes after she> started pushing, because > the contractions were getting less powerful... She> said she never felt a > real urge to push. She was pushing on all-fours and> on the low "birthing > stool". The baby was average size. Do you find, that> not all women get the > powerful urge to push, or is it just a matter of> waiting enaugh?> In my own two births I never found the pushing very> painful, but was not > given syntocin either. Does the syntocin make the> 2nd stage more painfu!
 l?
 > Many questions again... would like to hear about> your experience.> > Paivi> Childbirth educator > > --> This mailing list is sponsored by ACE Graphics.> Visit to subscribe> or unsubscribe.> > > --> This mailing list is sponsored by ACE Graphics.> Visit to subscribe> or unsubscribe.> __Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com --This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.
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Re: [ozmidwifery] Clinical experiences

[Michelle Windsor]

Hi Lindsay,
 
Sorry we can't offer you anything in Mackay at the birth centre.  At present we are unable to have student midwives in the BC or the maternity unit unless they are actually on staff and paid.  Hope something works out for you somewhere else.  Are there still some midwives doing homebirths in Cairns?
 
Cheers
MichelleLindsay Kennedy <[EMAIL PROTECTED]> wrote:
HiFor my Diploma of midwifery I need to do some hours of 'alternativebirthing'. Originally I planned to go to Selangor in Nambour, but amworried about the cost and practicality of this. The other possibility isMareeba as it is closer... can anyone give me some input or ideas? I livein Townsville. Ideally I am looking to do 2 weeks in October as I haveleave booked.ThanksLindsay-- No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.338 / Virus Database: 267.10.10/73 - Release Date: 15/08/2005--This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.
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[ozmidwifery] Midwifery refresher

[Michelle Windsor]

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
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Re: [ozmidwifery] VBAC's and Midwifery led birth centres

[Michelle Windsor]

At the Mackay birth centre we don't do VBACs.  I wasn't there when they developed the exclusion criteria but I'm guessing it came from the obstetricians who would consider VBACs "high risk".  
 
Cheers
MichelleHoney Acharya <[EMAIL PROTECTED]> wrote:




Hi All
Wondering if anyone can tell me about the different policies Midwifery led birth centres have in Australia regarding VBAC's. OR if anyone has STATs etc on this.
I am gathering info for the proposed Townsville Birth Centre. There are many women who feel it is important the birth centre be open to women having VBAC's but we need info to show the doc's and powers to be that it is safe etc. 
So are there any birth centres where it is an option?
Thanks in advance
Honey
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Re: [ozmidwifery] RH - Anti D

[Michelle Windsor]

Having done a bit of research on it recently for our birth centre women it seems that only 1.5% of negative women will become isoimmunized during pregnancy.  And that figure includes a large proportion who are mismanaged and not given Anti-D when potential sensitizing events occur eg. bleeding, ectopics, abdominal trauma.  So the real figure would be much less.  It seems total overkill to treat all women for a problem that 98.5% of them won't encounter.  The other thing is that Anti-D does cross the placenta and there are no studies on the long term effects on the baby.  In Ireland in the 80's (before complete blood screening) there were women who ended up with Hep C through Anti-D.  It makes me wonder if in the future they will detect other blood borne diseases which were transmitted via Anti D.  Just my thoughts
 
Cheers
MichelleTanya Fleming <[EMAIL PROTECTED]> wrote:








I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it.  I must admit...i haven't done a lot of research on it.  What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation?  I suppose these sort of studies won't be around for a while, as this is reletively new practise.  My personal beliefbeing a negative blood group and having had 2 babies beforeboth negative blood groupsanti-d was not given in pregnancy with these babies.I would probably choose not to have it with future pregancy's either unless positive baby after birth.
 
tanya

- Original Message - 
From: brendamanning 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, July 25, 2005 6:10 PM
Subject: Re: [ozmidwifery] RE:RH - Anti D

MM,
 
When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it !
 Just providing the basic rationale.
 
In the local small Mid unit here we have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?).
NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one here ever gave them any grief about declining the Ig, so perhaps instinctually none of us believe it's the 'right ' thing to do !
 
On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's & 90's who lost baby after baby to hydrops & other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ?

- Original Message - 
From: Mary Murphy 
To: ozmidwifery@acegraphics.com.au 
Sent: Tuesday, July 26, 2005 4:42 AM
Subject: [ozmidwifery] RE:RH - Anti D


Brenda wrote: 

so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women don’t know that it is a blood product and one that often comes from Canada as we don’t have enough from Australia.  It is really big business.  I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators.  

There is nothing mandatory about the new “routine” and many women do not follow it for the above reasons.  It really is a big experiment that women are expected to follow because it is seen to be “best”.  We really don’t know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group.   What goes into a pregnant woman’s body also goes into her baby’s. A good book to read is written by  Sara Wickham “Over the last 30 years, anti-D,!
  or
 Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England 2001 “







 
 MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency)
 
 Maybe someone has this book?  I know I read an article by Sara with much the same title, but I can’t track it down.  MM
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Re: [ozmidwifery] DEM's

[Michelle Windsor]

Yes we have a New Zealand DEM working both in the Birth Centre and the hospital at Mackay (Qld).  Have also heard there is a DEM in a Level 3 position in Townsville.
 
Cheers,
Michelle[EMAIL PROTECTED] wrote:
Thanks Cas. Great to hear : ) Anyone know of any others in QLD so far?Holly carole <[EMAIL PROTECTED]>wrote: > In Qld at Caboolture Hosp we currently have one overseas trained DEM. > Started earlier this year to fulfill endorsement requirements (not sure > why/what they were,maybe as she has only just completed her DEM in > europe), anyway, she's fitted in great and is a part of our team. Have > fun. Cas > > --> This mailing list is sponsored by ACE Graphics.> Visit to subscribe or unsubscribe.> --This mailing list is sponsored by ACE Graphics.Visit to subscribe or unsubscribe.Send instant messages to your online friends http://au.messenger.yaho!
 o.com 

Re: [ozmidwifery] Homebirth In Rockhampton/Yeppoon?

[Michelle Windsor]

Hi Justine,
 
As far as I know there aren't any homebirth midwives in Rockhampton/Yeppoon or the Central Qld area.  We do get women from Rockhampton (and other areas) coming to our Birth Centre in Mackay, so maybe this is an option if the woman doesn't want a hospital birth.  
 
Regards
MichelleJustine Caines <[EMAIL PROTECTED]> wrote:
Dear AllDoes anyone know if there are any homebirth midwives in the Rockhampton/Yeppoon area?Kind regardsJustineJustine CainesSecretaryHomebirth AustraliaPO Box 105Merriwa  NSW  2329Ph: (02) 65482248E-Mail : [EMAIL PROTECTED]www.homebirthaustralia.org
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Re: [ozmidwifery] another wonderful birth

[Michelle Windsor]

Julie your birth story reminds me of one that Vicki Chan told last year at a conference, I can't remember all the details but it was something like this.  a woman ('Alice') rings up and says her membranes have ruptured and she's got mec liqnot the average description.yes, Alice is a doctorlaboured with Vicki caring for her, got to fully dilated and the obstetrician is making noises about doing a ventouse.  Vicki got Alice moving her pelvis and she birthed her baby under her own steam.  Afterwards Alice kept saying over and over "I just feel SO good"   And the best part.Alice is also an obstetrician!  
 
CheersMichelleJulie Clarke <[EMAIL PROTECTED]> wrote:







Hi again
I have a bit of a sore back today but a warm heart and a smile in my eyes as I think about the birth I was at yesterday.
The couple had been through my classes and afterwards asked me if I would support them and I said yes.
My motivation was because she is a doctor and I wanted her to have a wonderful birth experience and I thought if I can help this woman who might potentially become another helper of women then that would be terrific.  Do I hear you say “Wow potential risk for big disappointment with such high hopes there!” 
Yes you are quite right but I am a bit like that – I dream and have high hopes and then pour all my energy into achieving it – and you know what?
Luckily so does she! She had undertaken lots of reading, a HypnoBirthing course with a local practitioner, my active birth course and used the epi-no product for her preparation.
 
I watched this woman have a huge amount of excitement in early labour – then feel a bit miserable when it was obviously not going to be easily controlled or “quick and easy” – then she surrendered and went completely within herself and over the course of several hours finally became fully dilated – she met a number of personal challenges along the way and worked her way through them all.
Fear, excitement, anxiety. courage, determination, pride, and energy all mixed together. It is one of the most glorious depictions of humanity being with a woman as she travels the path of the birthing experience.
She had a very small lip of cervix for quite a while – and she worked with her body beautifully to move through it – one fascinating aspect of this was when she was in the bath and she really needed to just be totally primal and “let go” she dropped her face and head under the water which bothered her so I supported her head with both hands right across the back of her head wiped all the water and hair from her face and just held her head for her so she was completely free to move in whatever way she wanted.
Then something within me suggested a firm hand support across the top of her head and she worked her head in a circular motion right deep into the palm of my hand and I felt as if her body was communicating what her baby was trying to do – it was a fascinating moment for me and we didn’t say a word about it – didn’t feel the need to – just simply working together well.
Her partner seemed to find it difficult to support her to begin with and I guess too this was one example of a man who didn’t seem to recall much “information from classes” but he cared for her deeply and simply watched everything and learned much better from me role modeling for him at the time – I handed everything to him at every available opportunity.
I have the impression that the woman may well describe a sense of balance of male and female energy at her birth.
The midwife was brilliant – she was absolutely wonderful and so positive and gave great care to the couple and their baby. Such a beautiful and sensitive person – I believe there is a lot of amazing midwives who are dedicated and skilled in the art of midwifery. The midwife commented to me also that she saw women who have included in their preparation extra strategies such as HypnoBirthing and the use of the Epi-no do really well.
The baby was a little delayed in having a cry and the Dad sat staring and I suggested to him to touch his chest and speak to him which he did and within seconds his son responded to him – that’s the bit that brings tears to my eyes – I feel a welling up in my chest and am so moved by such wonderful experiences.
 
Well it was straight after the birth 6.45pm that I had to leave to come home and do a class at 7pm – I made it home easily and legally within 35 minutes - just very lucky to catch every green light between Randwick and Sylvania.  The group were already all organized (under Geoff’s supervision/my husband of 25 years) and listening to a couple who had been through my classes previously and had come back to tell their story and show off their 2 week old baby – their story was very real of meeting the challenge of natural birth – working as a team and continuing that on at home as a new family – all very inspirational.   They told their story while I went and gave my hands a good wash and brought back with me a well ear

Re: [ozmidwifery] GDM question

[Michelle Windsor]

Hi Jo,
 
As per the Cochrane Data Base, there is no evidence to support glucose testing in pregnancy, and it is not accurate at least 50%-70% of the time. Even if the test was positive, there is no evidence to support treating gestational diabetes.  Treating gestational diabetics with insulin reduced macrosomia (however most macrosomic babies are born to non-diabetic mothers) but there were no improvements in other outcomes such as caesarean section, shoulder dystocia, or perinatal mortality.  So my opinion would be to forget the GTT.
 
Cheers
MichelleJoFromOz <[EMAIL PROTECTED]> wrote:
Hello you intelligent List-Wives...I have decided for various reasons not to have the routine GTT during my pregnancy, and now, at 33 weeks, I have had a small trace of glucose in my urine the last few weeks. Tonight I checked at work at I had a definite plus, not trace, of glucose. I did a BSL at the same time, and it was only 4.2. My question is, was my glucose higher before and my body just got rid of it for me, or is my body just good at getting rid of it via the urine instead of insulin? Or should I stop worrying? OR should I go ahead and do the GTT like my workmates insist I should have done in the first place?Thanks!Otherwise, pregnancy is wonderful apart from the sore hips trying to sleep :)Jo (RM)--This mailing list is sponsored by ACE Graphics.Visit to s!
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[ozmidwifery] Ina May's new book

[Michelle Windsor]

Hi everyone,
 
Has anyone else read Ina May's new book? (Ina May Gaskin's guide to childbirth)  It is just brilliant  very easy to read and is actually as much for pregnant women as for midwives.  The outcomes of "The Farm" are included at the end which just blow you away - all achieved with women who have faith in their bodies, and midwifery care! And the women who go there are not necessarily 'low risk' ie. breeches, twins, grandmulties etc.  Don't mean to rave but it is excellent.
 
Cheers
Michelle
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Re: [ozmidwifery] PPH

[Michelle Windsor]

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.
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Re: [ozmidwifery] Double uterus & cervix

[Michelle Windsor]

Hi Andrea,
 
I don't have any experience myself but a friend of mine told me about her experience, so will pass it on.  My friend Jane was working in a rural area in Southern China (for MSF) and was doing the antenatal care for a woman with a double uterus and cervix.  Apparently there is a much higher incidence of malpresentations.  This lady's baby was a footling breech and so the plan was to transfer her prior to labour.  That was the plan!!  The woman went into labour and they couldn't transfer her out due to the roads being blocked by snow.  The woman progressed well and the baby birthed breech, feet first and was fine.
 
Cheers
Michelle
Andrea Bilcliff <[EMAIL PROTECTED]> wrote:




Does anyone have any experience with a woman who has a double uterus & cervix that they would be willing to share?
Thanks,
Andrea Bilcliff
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Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Michelle Windsor]

Hi Joanne,
 
We were told this in the ALSO course and it can be found in the section on PPH in the readings.  Antepartum risk factors were listed which included nulliparity, no mention of multis or grandmulties. I have read some research on it somewhere since (possibly a MIDIRS) but can't remember where!  If I come across it again I'll let you know.  The ALSO course has multiple references at the end of each chapter, so not sure exactly where they got the info from but they claim it'sg evidence-based.
 
Cheers,
MichelleMrs Joanne M Fisher <[EMAIL PROTECTED]> wrote:




Hi Michelle,
 
I'd love the references of that research on primips if you have them.  Thanks.
 
Cheers, Joanne

- Original Message ----- 
From: Michelle Windsor 
To: ozmidwifery@acegraphics.com.au 
Sent: Friday, February 25, 2005 3:52 PM
Subject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

Hi Leanne,
 
There is some evidence now (as per the ALSO course and other research) to suggest that contrary to what we were taught previously, it is the primips that are more likely to PPH not the multis and grandmultis.  I can't claim alot of homebirth experience, but my feeling would be (like Marilyn) to be well prepared but not have active management unless required.  A friend of mine had 3 homebirths with labours of 12-16 hours (OP babies, last one born direct OP) and she had physiological 3rd stages with normal blood loss.  She took raspberry leaf tea in the last few weeks, so this may have made a difference too.
 
Cheers
Michelle
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Re: [ozmidwifery] ACTIVE Vs EXPECT MAGMT

[Michelle Windsor]

Hi Judy,
 
After reading your post it reminded me of what one of my friends said (she is a midwife and works for MSF).  She was in western Africa and if a person had a Hb over 80 they would use them as a blood donar if they needed one!!
 
Cheers
MichelleMaternity Ward Mareeba Hospital <[EMAIL PROTECTED]> wrote:


Just a comment on why so many PPH deaths in underdeveloped countries. At a symposium I went to in Saudi Arabia many years ago one of the speakers was an African Dr. His subject was anemia in the underprivelaged and he spoke of how severely anaemic many of the women are. As a result PPH is more quickly devastating than in a woman with a normal (or nearly normal) Hb level. 
Cheers
Judy>>> [EMAIL PROTECTED] 02/28/05 07:05am >>>Hi everyone.  Back on the list and great topics abound !!I wrote a critical analysis last yr on active vs expectant management formaglobal perspective.  Interestingly the infamous Hinchinbrook trial didacknowledge the type of labours.  However there were significantdiscrepancies in my observation of the methodology eg: the confidence ofmidwives to support expectant management and no record of home births.I have personally noted a large no of women having a pph following activemanagement (according to the 500 defn) but also following induction oflabour , particularly withg syntocinon. In some areas such as homebirththese drugs are never used for IOL, in addition to countries like Germanywhere I have heard of acupuncture now being offerred for IOL in the hospitalsetting.There are 2 main issues with PPH.  The g!
 lobal
 maternal mortality rate isapprox 600, 000 women die a year (of reported deaths).  Over 90% of thesedeaths are in developing countries and largely due to PPH.  Drugs like syntoare viewed by some authors as problematic as many tropical areas cannotrefridgerate and therefore cannot use synto.  There is move afoot to look atother methods that do not require refridgeration.  One begs the question,why so many deaths ? Is it related to the various experiences of managmentby TBA's who attend to most of the births ? Is it related to the factthousands of women  spend days in labour and on their own ? Is itdehydration ? Malnutrition ? The list goes on... It certainly isrelated to a poor level of care and pathetic govt priorities in my view, tonot ensure as many women as possible have pregnancy birth and postpartumcare.In my view this is where the true crisis of PPH lies.Having said that.&n!
 bsp;
 There is no global or even national standardisedmeasurement of loss (process), nor is there an agreed global standardiseddefinition of pph as many of you have so aptly pointed out.Certainly I think there is need for further research comparing the activeand expectant magmt techniques where there is no confidence bias, thatincorporates accurate defns of labour type also.  Even a RCT looking at IOLwith synto vs No IOL of women 39-42 weeks and comparing their loss could besignificant.Thanks Sue for your insights on your practice and the wonderful knowledge ofJohn's wisdom. In my experience I always keep arnica and the australian bushflower essences on hand and discovered through my kinesiology practice aboutten yrs ago the need for a woman to have a homeopathic known as UstilagoMaidus twice antentally and three times in the immediate postpartum.I have then seen it used on three more occasions and would not hes!
 itate
 tohave it on hand, particularly for remote rural areas.On another note, I have also noted that pph is common for women who have aprecipitous labour. Often these women appear to be in shock after the highof a beautiful, sometimes intense or furious labour.On an emotional and spiritual reflection of practice, I have also noted itis not uncommon for women who have experienced abuse to have a very veryfast or very very long labour also.  And a pph. It is afterall the essenceof the life/death paradigm and I try to remain aware of this particularly ifthe dissasociation and trauma of unrecognised abuse arises in labour.  Ithink it is important when a pph is not obviously drug induced or activelyinduced, we are alert to what the 'triggers' of the emotion around a pphcould be.Again, another reason highlighting the importance of one-to-one midwiferycare.Also a comment re the G10 P9 woman - I would c!
 onsider
 assessing the wishesof the woman, the previous history, the current history and emotionalwellbeing as to whether the synto would be needed. I have also heard andwould be glad to follow up with the cnc who gave me this info that there iscurrent research concluding that the grand multi status is no longer afactor for routine synto.Kind Regards to you allSally-Anne Brown***This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s),

[ozmidwifery] Gestational diabetes

[Michelle Windsor]

Hi,
 
Just wondering if anyone has some good recent research in relation to gestational diabetes.  What I'm looking for is data similar to what is found in ''A guide to effective care in pregnancy"... Enkin et al which states all forms of glucose testing should be reviewed due to the 50%-70% false positives and that there is no clear benefit obtained with treating gestational diabetes.  This is from the cochrane data base but was printed in 2000.  I've just spent a few hours searching the web and I can't find more recent info than this.  We're trying to get good evidence so we can continue to keep well controlled gestational diabetic women in our birth centre program (for over 10 years they have been birthing at the birth centre without any problems).
 
Thanks in advance
Michelle
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Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Michelle Windsor]

Hi Leanne,
 
There is some evidence now (as per the ALSO course and other research) to suggest that contrary to what we were taught previously, it is the primips that are more likely to PPH not the multis and grandmultis.  I can't claim alot of homebirth experience, but my feeling would be (like Marilyn) to be well prepared but not have active management unless required.  A friend of mine had 3 homebirths with labours of 12-16 hours (OP babies, last one born direct OP) and she had physiological 3rd stages with normal blood loss.  She took raspberry leaf tea in the last few weeks, so this may have made a difference too.
 
Cheers
MichelleMarilyn Kleidon <[EMAIL PROTECTED]> wrote:
I would make sure I had a good supply of oxytocics on hand even maybe havethe syntocinon drawn up but unless she has a hx of PPH etc. I would notassume a PPH is destined to happen. Of course if the woman requested activemanagement then that would be fine too. If the woman was confident to waitand see what happens I would be too. I would want to have a recent FBCavailable and IV fluids in my bag.And the woman totally informed of theincreased risk of PPH especially if she were to have a preciptitous orprolonged labour. Definetly would be nice to have a 2nd midwife with me.LOve to hear what others say.marilyn- Original Message - From: "leanne wynne" <[EMAIL PROTECTED]>To: Sent: Thursday, February 24, 2005 2:43 PMSubject: Re: [ozmidwifery] MORE ACTIVE MANGAEMENT&g!
 t; 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 activemanagement> of third stage because she is a grand multip or would you still encouragea> 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 wewere> >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 PPHgreater> >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 alsoergometrine> >both vials and tabs to births as well as herbal remedies. Syntometrinedoes> >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 doingthe> >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 day5,> >for most of the homebirth women I visited in the USA just from me!
 mory
 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 statswould> >not look so appealing for active mgmt. Also as someone stated womenhaving> >a physiological 3 stage tend to lose more in the first few hours after> >birth than those having active mgmt. As far as I a!
 m 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

Re: [ozmidwifery] MORE ACTIVE MANGAEMENT

[Michelle Windsor]

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
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RE: [ozmidwifery] question

[Michelle Windsor]

Hi Susan,
 
I'm not sure if this helps but this is what we were told at the ALSO (Advanced Life Support in Obstetrics) course I went to in 2003.  They recommended that there is either total active management or total physiological management of the third stage.  Active management meant synto given with the anterior shoulder, early cord clamping, then CCT immediately after clamping the cord.  I haven't actually got the workbook here with me to give you more detail but that is what they were recommending.
 
Cheers 
MichelleKen WArd <[EMAIL PROTECTED]> wrote:




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
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RE: [ozmidwifery] epidural research

[Michelle Windsor]

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
f: 02 42970747-- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
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[ozmidwifery] Castor oil

[Michelle Windsor]

Hi,
 
Just wondering if anyone has any info on side effects of women taking castor oil (in relation to the baby) to try and induce labour.  A few of the midwives I work with have noticed that there seems to be a connection with taking castor oil and having mec liquor, ? it is affecting the baby as well.
 
Thanks in advance
Michelle  
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Re: [ozmidwifery] Telemetric (addit)

[Michelle Windsor]

Of course the down side is the cost about $17000 I think!Kim Stead <[EMAIL PROTECTED]> wrote:






 
You'll have to excuse my ignorance butt.. what is a telemetric CTG compared to the standard contraption?
 
 
 
 
 
---Original Message---
 

From: ozmidwifery@acegraphics.com.au
Date: 02/12/05 15:39:09
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Student's support role
 
well, ours doesn't which I think is a shame, so that's why I am asking.
 
marilyn
- Original Message -
From: "shaz42" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, February 10, 2005 1:46 PM
Subject: Re: [ozmidwifery] Student's support role
 
 
> most  hospitals have the telemetric  ctg available it is just the staff
> which dont tend to use this as it can be a bit fiddly.
> - Original Message -
> From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
> To: 
> Sent: Saturday, February 12, 2005 12:07 AM
> Subject: Re: [ozmidwifery] Student's support role
>
>
> > Just a question of interest: how common are telemetric ctg's here in
> > Australia??
> >
> > marilyn
> > - Original Message -
> > From: "shaz42" <[EMAIL PROTECTED]>
> > To: 
> > Sent: Thursday, February 10, 2005 2:01 AM
> > Subject: Re: [ozmidwifery] Student's support role
> >
> >
> >> Kirsten as a newly qualified midwife who has supported women during
birth
> >> when a student I wish you luck. You need to be very strong for both the
> >> woman and her partner in what she wants to get out of her birth. I
> >> suggest
> >> that when you are with the woman and her partner during the birth you
act
> > as
> >> her advocate and speak up for her but at the same time ensure that both
> > the
> >> wom,an and the unborn baby are not in any danger from what you are
> >> suggesting. A woman will adopt a position which she feels comfortable
and
> >> safe in. There are ways around monitoring such as intermittent
monitoring
> > of
> >> the fetus using Doppler or using the telemetric ctg instead of forcing
> >> the
> >> woman to lay on the bed. Good luck with your role as support person.
You
> >> could try reading some of the birthing books that women read to find
out
> >> positions act or speak to the midwives at the clinic when you attend
with
> >> the woman  they are a invaluable source of information.
> >>
> >> Enjoy  your time as a student
> >> - Original Message -
> >> From: "Kirsten Wohlt" <[EMAIL PROTECTED]>
> >> To: 
> >> Sent: Thursday, February 10, 2005 9:17 AM
> >> Subject: [ozmidwifery] Student's support role
> >>
> >>
> >> Hi all,
> >>
> >> As a 2nd year BMid student with very limited experience of being
present
> > at
> >> births, I wonder if I may ask for some tips on how to support women in
> >> labour. I have attended only 3 births, and have contributed to some
> >> degree
> >> by being there to hold a woman's hand or bring her ice or a cool cloth,
> >> or
> >> speak an encouraging word - very much been working on the 'less is
more'
> >> basis and being a quiet support presence.  I have one woman now who is
> >> planning a VBAC and has some specific requests regarding my support
role,
> >> but I don't know where to start, and I don't want to go in there
feeling
> >> nervous and tense!  Her first birth was long and painful, ending in an
> >> emergency c-section following a 'failed' induction. She remembers
> >> essentially lying in the bed the whole time, not walking around, and
> > having
> >> several doses of pethadine.  This time she wants to stay active and
> > upright
> >> and would rather have limited/no drugs.  She says that she knows she
will
> >> not want to walk once she is in labour and wants her husband and I to
be
> >> strong and 'make' her.  She also wants me to think about ways to
> >> encourage
> >> her, or positions that may help.  I don't have any idea how to
> >> start...any
> >> pointers?  Articles, texts, experience?  I will do web research and
look
> >> through my uni texts, but I know there will be an awful lot out there -
> > some
> >> pointers which will help refine the search would be really appreciated.
> >>
> >> Many thanks,
> >>
> >> Kirsten
> >> --
> >> This mailing list is sponsored by ACE Graphics.
> >> Visit  to subscribe or unsubscribe.
> >>
> >>
> >> --
> >> This mailing list is sponsored by ACE Graphics.
> >> Visit  to subscribe or unsubscribe.
> >
> >
> > --
> > This mailing list is sponsored by ACE Graphics.
> > Visit  to subscribe or unsubscribe.
> >
>
>
> --
> This mailing list is sponsored by ACE Graphics.
> Visit  to subscribe or unsubscribe.
 
 
--
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Visit  to subscribe or unsubscribe.

Re: [ozmidwifery] Telemetric?

[Michelle Windsor]

Á telemetric CTG is a cordless CTG.  Mt Isa (Qld) had one (in 2000) and used it.  More recently when I worked in Hobart in a private hospital, they had one.  If you really have to have a CTG on, then these are way ahead of the tradition CTG.  It allows the women to be mobile and the one in Hobart was water proof as well so they were able to use the shower and bath with it on.  It had excellent reception - the birth suites were on the 3rd floor of the hospital and the CTG could still be picked up on the ground floor. I think they're actually safer in that you don't have cords there for the woman or others to trip up in.
 
Cheers
Michelle  Kim Stead <[EMAIL PROTECTED]> wrote:






 
You'll have to excuse my ignorance butt.. what is a telemetric CTG compared to the standard contraption?
 
 
 
 
 
---Original Message---
 

From: ozmidwifery@acegraphics.com.au
Date: 02/12/05 15:39:09
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Student's support role
 
well, ours doesn't which I think is a shame, so that's why I am asking.
 
marilyn
- Original Message -
From: "shaz42" <[EMAIL PROTECTED]>
To: 
Sent: Thursday, February 10, 2005 1:46 PM
Subject: Re: [ozmidwifery] Student's support role
 
 
> most  hospitals have the telemetric  ctg available it is just the staff
> which dont tend to use this as it can be a bit fiddly.
> - Original Message -
> From: "Marilyn Kleidon" <[EMAIL PROTECTED]>
> To: 
> Sent: Saturday, February 12, 2005 12:07 AM
> Subject: Re: [ozmidwifery] Student's support role
>
>
> > Just a question of interest: how common are telemetric ctg's here in
> > Australia??
> >
> > marilyn
> > - Original Message -
> > From: "shaz42" <[EMAIL PROTECTED]>
> > To: 
> > Sent: Thursday, February 10, 2005 2:01 AM
> > Subject: Re: [ozmidwifery] Student's support role
> >
> >
> >> Kirsten as a newly qualified midwife who has supported women during
birth
> >> when a student I wish you luck. You need to be very strong for both the
> >> woman and her partner in what she wants to get out of her birth. I
> >> suggest
> >> that when you are with the woman and her partner during the birth you
act
> > as
> >> her advocate and speak up for her but at the same time ensure that both
> > the
> >> wom,an and the unborn baby are not in any danger from what you are
> >> suggesting. A woman will adopt a position which she feels comfortable
and
> >> safe in. There are ways around monitoring such as intermittent
monitoring
> > of
> >> the fetus using Doppler or using the telemetric ctg instead of forcing
> >> the
> >> woman to lay on the bed. Good luck with your role as support person.
You
> >> could try reading some of the birthing books that women read to find
out
> >> positions act or speak to the midwives at the clinic when you attend
with
> >> the woman  they are a invaluable source of information.
> >>
> >> Enjoy  your time as a student
> >> - Original Message -
> >> From: "Kirsten Wohlt" <[EMAIL PROTECTED]>
> >> To: 
> >> Sent: Thursday, February 10, 2005 9:17 AM
> >> Subject: [ozmidwifery] Student's support role
> >>
> >>
> >> Hi all,
> >>
> >> As a 2nd year BMid student with very limited experience of being
present
> > at
> >> births, I wonder if I may ask for some tips on how to support women in
> >> labour. I have attended only 3 births, and have contributed to some
> >> degree
> >> by being there to hold a woman's hand or bring her ice or a cool cloth,
> >> or
> >> speak an encouraging word - very much been working on the 'less is
more'
> >> basis and being a quiet support presence.  I have one woman now who is
> >> planning a VBAC and has some specific requests regarding my support
role,
> >> but I don't know where to start, and I don't want to go in there
feeling
> >> nervous and tense!  Her first birth was long and painful, ending in an
> >> emergency c-section following a 'failed' induction. She remembers
> >> essentially lying in the bed the whole time, not walking around, and
> > having
> >> several doses of pethadine.  This time she wants to stay active and
> > upright
> >> and would rather have limited/no drugs.  She says that she knows she
will
> >> not want to walk once she is in labour and wants her husband and I to
be
> >> strong and 'make' her.  She also wants me to think about ways to
> >> encourage
> >> her, or positions that may help.  I don't have any idea how to
> >> start...any
> >> pointers?  Articles, texts, experience?  I will do web research and
look
> >> through my uni texts, but I know there will be an awful lot out there -
> > some
> >> pointers which will help refine the search would be really appreciated.
> >>
> >> Many thanks,
> >>
> >> Kirsten
> >> --
> >> This mailing list is sponsored by ACE Graphics.
> >> Visit  to subscribe or unsubscribe.
> >>
> >>
> >> --
> >> This mailin

Re: [ozmidwifery] Birth Centre

[Michelle Windsor]

Thanks Jan, good to hear some positive feedback.  I think there might be some confusion though in regards to where the birth centre is.  It is situated in Mackay.  As far as I know Townsville (which is 3.5 hours north of here) doesn't have a birth centre.  The website is a good idea will have to see what we can do.
 
Cheers
MichelleJan Robinson <[EMAIL PROTECTED]> wrote:
Hi MichelleMackay Birth Centre is certainly on track ... I hear nothing but praise of your work.I'm sure having the centre situated AWAY from the main building makes a huge difference. It seems the closer the Birth Centre is to labour ward the higher the transfer rate the 'partnership' that was with the women begins to include 'other parties' and that certainly influences the woman's decision making when she's most vulnerable.You can be very proud of your efforts in Townsville ... I hope you keep publishing the results of your work.Do you have a Townsville Birth Centre website? There is bound to be a computer whizz amongst your consumer supporters who would set it up for you  that way you can take Townsville Birth Centre to the world and include your consumer feedback. You will be amazed at the number of !
 overseas
 midwives who will 'visit' you. I hope to meet up with some of you at the ICM in Brisbane in July.RegardsJanJan Robinson Independent Midwife PractitionerNational Coordinator Australian Society of Independent Midwives8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350e-mail address: <[EMAIL PROTECTED]>website: www.midwiferyeducation.com.auOn 20 Jan, 2005, at 20:13, Michelle Windsor wrote:> Hi Jan,>  > I agree that there can be a huge difference in what is regarded as a > 'birth centre'.  Here in Mackay we have a birth centre which is a > small house at the back of the maternity unit.  There are four > midwives and we care for women from early pregnancy through to the > birth and beyond.  The postnatal stay is a maximum of 24 hours and > then we follow up with home visits for up to 10 days after the birth. >  &!
 gt; We
 don't make decisions for the women but encourage them to be > informed and take responsibility for decisions relating to the birth > etc.  We have a library (including videos) which the women can borrow > from.  There is no set time limit with appointments, and aside from > antenatal classes we try to do a lot of education with each visit.  > There is strong consumer support and involvement with the birth centre > (including a reference group which helped formulate the original > policies).>  > The whole philosophy of the birth centre and the midwives is that > pregnancy and birth are a normal part of life.  We have many beautiful > natural births here - no routine VE's,  no CTG's in labour, birth in > the place and position that the woman chooses and many physiological > third stages.  The birth centre here has been her!
 e for
 over 10 years > now and has had over 1000 babies born in that time.>  > Cheers,> Michelle>> Jan Robinson <[EMAIL PROTECTED]>wrote:> Hi Di>> There was a Birth Centre Network NSW wholly funded by NSW Health a few> years ago, but not sure that it is still functional.> I can remember a concern of the network at the time that no women from> disadvantaged groups ever used the existing birth centres so a lovely> little pamphlet was designed and distributed (courtesy of NSW Health)> that attempted to define the birth centre concept and explain the> advantages to women who used them.>> cover page was titled ...>> Birthing Place for All Women>> pic of baby inserted here>> BIRTH CENTRES>> inside was >> What is a birth centre?> *A place to have your baby away from Labour Ward but!
  still
 part of the> hospital> *In a birth centre each room has a double bed, chair, curtains and nice> furnishings> *The midwives of the birth centre will see you right throu! gh your> nate-natal care, labour and after birth> *A doctor will be called if problems arise> *Medicare covers costs for birth centre care>> Why use a birth centre?> *You have your baby your way> * It's a relaxed, friendly atmosphere> * You can have your own support - whoever you want> * A natural birth is encouraged with hot showers, baths and hot packs,> but if you want there is the gas or needle for pain (hard to believe> this one!)> * Cultrural practices are respected and encouraged>> Who can use a birth centre?> Almost all women can use a birth centre, but you may need to book in> early>> Who will I see?> Usually the midwives are female> !
 You may
 be able to have shared care with a general pracftitioner,> obstetrician or private midiwfe>> People to talk to>  there followed th

Re: [ozmidwifery] Birth Centre

[Michelle Windsor]

Hi Jan,
 
I agree that there can be a huge difference in what is regarded as a 'birth centre'.  Here in Mackay we have a birth centre which is a small house at the back of the maternity unit.  There are four midwives and we care for women from early pregnancy through to the birth and beyond.  The postnatal stay is a maximum of 24 hours and then we follow up with home visits for up to 10 days after the birth.  
 
We don't make decisions for the women but encourage them to be informed and take responsibility for decisions relating to the birth etc.  We have a library (including videos) which the women can borrow from.  There is no set time limit with appointments, and aside from antenatal classes we try to do a lot of education with each visit.  There is strong consumer support and involvement with the birth centre (including a reference group which helped formulate the original policies).
 
The whole philosophy of the birth centre and the midwives is that pregnancy and birth are a normal part of life.  We have many beautiful natural births here - no routine VE's,  no CTG's in labour, birth in the place and position that the woman chooses and many physiological third stages.  The birth centre here has been here for over 10 years now and has had over 1000 babies born in that time.
 
Cheers,
MichelleJan Robinson <[EMAIL PROTECTED]> wrote:
Hi DiThere was a Birth Centre Network NSW wholly funded by NSW Health a few years ago, but not sure that it is still functional.I can remember a concern of the network at the time that no women from disadvantaged groups ever used the existing birth centres so a lovely little pamphlet was designed and distributed (courtesy of NSW Health) that attempted to define the birth centre concept and explain the advantages to women who used them.cover page was titled ...Birthing Place for All Womenpic of baby inserted hereBIRTH CENTRESinside was What is a birth centre?*A place to have your baby away from Labour Ward but still part of the hospital*In a birth centre each room has a double bed, chair, curtains and nice furnishings*The midwives of the birth centre will see you right throu!
 gh your
 nate-natal care, labour and after birth*A doctor will be called if problems arise*Medicare covers costs for birth centre careWhy use a birth centre?*You have your baby your way* It's a relaxed, friendly atmosphere* You can have your own support - whoever you want* A natural birth is encouraged with hot showers, baths and hot packs, but if you want there is the gas or needle for pain (hard to believe this one!)* Cultrural practices are respected and encouragedWho can use a birth centre?Almost all women can use a birth centre, but you may need to book in earlyWho will I see?Usually the midwives are femaleYou may be able to have shared care with a general pracftitioner, obstetrician or private midiwfePeople to talk to there followed the local birth centres and Social work department contact detaiils as well as aboriginal medical service.Lots of work went into dev!
 eloping
 this pamphlet and as far as I can remember no feedback data was ever collected or the success of it's dissemination evaluated. Shame about that.If you really want a good definition of a Natural BIrth Centre - here is the one I like best .A Natural Birth Centre is* a safe, home-like place to have your baby.* managed by midwives who are specialists in natural birth* for women who plan to have their baby naturally.* located in (or near) a public maternity hospital that facilitates medical referral if necessaryThe Birth Centre midwives provide care for low-risk women throughout pregnancy, labour, birth and afterwards.The Birth Centre education program aims to empower women and their support people with a unique understanding of pregnancy and birth knowledge that facilitates participation in decision making related to the birth of their baby.I don't think any of the so called Birth Ce!
 ntres can
 say they adhere to all the above criteria. I would like to hear from any who think they do.I would like to see the development of Natural Birth Centres attached to each and every public hospital in the country. There would need to be a transfer of staff out into Community Midwifery programs ... The Community premises would become the Natural Birth Centres of the future and the focal point for women who wish to arrange for a home birth as well. Midwives who see their career pathway as becoming specialist in natural births do not rotate through labour and delivery suites and commit themselves to community services and forming partnerships with women rather than be placed on the rotating roster within a maternity unit.This is something that needs discussion at national level - perhaps put on the ACMI executive agenda.CheersJanJan Robinson Independent Midwife PractitionerNational Coordinator Aus!
 tralian
 Society of Independent Midwives8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350e-mail address: <[EMAIL P

Re: [ozmidwifery] Re:cold epidurals

[Michelle Windsor]

I don't want to drag out this discussion on epidurals etc but just had to reply to this.  I think it is a big deal if a woman decides to have an epidural prior to induction of labour.  Look at how long it can take to induce a primip... 3 or 4 lots of Prostin, ARM and then Synto.  So realistically we could be looking at having an epidural in for maybe 24 hours before the woman is in established labour? (DVT here we come!)  What about the women who just have one lots of Prostins or an ARM and go onto labour beautifully without any further intervention?  I don't think induced labour necessarily means that women "need" the most powerful drugs we have available. What about all the non-pharmacological pain relief methods?  I've seen plenty of women induced who choose not to have an epidural.  Sure if that's what they want and they're FULLY informed, then it is their choice and we should support them.  
 
I wonder how many women know that having an epidural doesn't necessarily equal a more positive birth experience.  There was some research done in NSW on this a few years back and women who had epidurals reported less satisfaction with their births 6 months later than those who didn't.  What about the research being done recently about the link with maternal drug use in labour and their offspring's addiction to amphetamines later in life?  Giving potent drugs in labour (whether by epidural or PCA) which affect the mother, her labour and her baby is to me anyway, a big deal.
 
Cheers,
MichelleNicole Cousins <[EMAIL PROTECTED]> wrote:




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 - 






 
 
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[ozmidwifery] Epidurals

[Michelle Windsor]

While on the subject of epidurals I read an article recently about a study involving ewes which had epidurals during their labour.  They wouldn't mother their young.  A new term I learnt this year while doing a short contract in a private hospital was the "cold epidural" - the epidural you have put in prior to the start of your induction!  Not sure how common this is in other places.  Of course if there is any problem getting the epidural in you can always have a PCA of morphine.  You can imagine the results of that - one very "stoned" mother totally uninterested in her narcotised baby.  Sad but true.
 
Cheers 
Michelle
 
 
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[ozmidwifery] indication for ARM?

[Michelle Windsor]

Hi all,
 
I am in complete agreement with all that has been said about the risks of ARM's in normal labour.  But a few cases came to mind where I think that the ARM's were appropriate. To condense:
 
* a woman admitted at 23+ weeks with APH and incompetent cervix.  Made it to 28+ weeks, had a rapid labour and began bleeding (approx 300ml).  An ARM was performed and the baby delivered soon after in good condition.
* a woman with longstanding epilepsy. In well established labour began to feel like she was going to fit.  Decision was made to do ARM to quicken the labour, she gave birth soon after.
* a woman in established labour... intermittently using nitrous oxide, no other drugs.  Suddenly became unresponsive/unconscious for about 10 minutes ? cause.  ARM performed, gave birth soon after.  
 
I'm not in any way advocating for ARM's, but in some abnormal/emergency situations may be they are the least invasive intervention and appropriate?
 
Cheers,
Michelle
 
 
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Re: [ozmidwifery] research question

[Michelle Windsor]

Hi Barb,
 
I agree with what you're saying.  I think as midwives we are often caught between a rock and a hard place.  We know what the evidence is, and we sign our registration renewals saying we will comply with the ACMI code of practice for midwives (which includes evidence based practice) and then we are restricted by 'hospital policy'.  I've been told that as an employee of an institution we are bound to follow their policies and that if we don't then legally we aren't covered.  I guess one way around this sort of thing is to have well informed women who may then refuse to have CTG's etc.  
 
Cheers,
MichelleB & G <[EMAIL PROTECTED]> wrote:


I have a dilemma. CTG's- we all know research has proven admission CTG's are of no benefit however when there has been a verbal workplace directive by the Director of O & G as a litigation risk management that all admissions to Birth Suite have a routine baseline CTG and you have been diligent to carry out this with and made entry in the notes to the effect indication for CTG as per policy. I have since found out that a person doing her masters has been auditing clients charts to see how many CTG's there have been done and now wants to interview the clinicians/midwives to discuss why we did the CTG? "To highlight the lack of clinical knowledge of midwives when they put everyone on a CTG" in Birth Suite she verbally informed me when questioned.
 
I feel now that not only we clinicians are in conflict with the Dr's over being told we have to do a CTG on admission, us clinician are now being treated as bloody mugs from a midwife researcher. It was only when I contacted the researcher for an explanation what her notice on the board that appeared today requesting us to write down the clients UR and our name on a piece of paper did I find out about this research. I feel abused, violated and to be honest so pissed off that a midwife has such little regard to midwives professional conduct and clinical care when we often have little control over medical directives. Another example is IVC for VBAC do we really need it. I have questioned many times why baseline CTG's to the point I was being ignored by registrars and they would go to other midwives to make sure an admission CTG be done. I capitulated as I was subjected to horizontal violence!
  from
 medical staff and other midwives to the point I just do CTG's but always asking what the indication is and noting it in the notes.
 
I do not believe this research is ethical and of no benefit to anyone other to show just how stupid we are in obeying medical directives. If we can have case loading with midwifery led care this question would not come up.
 
Am I over reacting, any suggestion what I can do?
I lock forward to your responses.
 
Barb
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[ozmidwifery] Alfalfa tea

[Michelle Windsor]

Hi everyone,
 
Have been following the discussion about breastfeeding and ways of increasing supply.  Just have a query has anyone had an experience with using alfalfa tea to increase supply?   A friend of mine said she had an oversupply for 6 months which someone told her was due to drinking alfalfa tea.
 
Cheers
Michelle
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[ozmidwifery] caesarean section

[Michelle Windsor]

Hi,
I'm new to the list but had to add a bit to the caesarean section issue.  Doing an assignment last year we had to analyse some perinatal statistics (Qld).  In the last 30 years the maternal mortality rate has slowly and steadily increased (figures up to 1996)  and while they didn't give a breakdown on the maternal deaths, surely this has to be due to the slow but steady increase in caesarean section?  It is unbelievable that in 30 years of medical advances that more women are dying - and no one is looking for the cause.  I didn't see the 60 minutes program, but was there any mention of the increased maternal mortality with caesareans?
 
Michelle
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