[ozmidwifery] caesareans
Preventing first time mothers having an induction for non or dubious medical reasons would go a long way to preventing complicated labours and C/S for lack of progress and/or fetal distress. There seems to be an epidemic of inductions, as tho this is the best way for women to go in to labour. Much more controlled. It is just that artificial control that causes the problems. Like opening an egg with a hammer instead of letting the chicken hatch. MM AS 1 OB colleague states: if we could just prevent the first CS happeningshe wouldn't be faced with this awful dilemma now ie to VBAC or not.
[ozmidwifery] Caesareans in the news in New Zealand ....
In the news in New Zealand from: http://www.stuff.co.nz/stuff/0,2106,2843494a7144,00.html New guidelines for caesarean births 12 March 2004 New guidelines recommending safe alternatives to caesareans in cases where breech births are expected or where woman have already had a caesarean were launched today. A Health Ministry maternity services report published last year said 22 per cent of hospital births in 2001 were by caesarean section, and the rate of caesareans had grown by 1 per cent annually over the previous four years. The New Zealand Guidelines Group (NZGG), which issued the new guidelines, said today that while a caesarean section, in which a baby is surgically removed from the womb, could be life-saving in emergency situations there were risks and the operation should be avoided if possible. Women were often told they needed a caesarean when a breech birth was expected or if they had previously had a caesarean. But Professor Cindy Farquhar, chairwoman of the guideline team, said in those situations there were now safe alternatives that could be used to help women have a natural birth, removing the risks associated with surgery. This means that they (the mother) will recover from the birth faster, and the chance of infection from surgery and risks of blood transfusion will be reduced, she said in a statement. Babies born vaginally will also be spared the health problems associated with caesarean birth. She said the group's research had identified that that many pregnant women and their families did not understand the risks associated with surgical birth. Prof Farquhar said the group strongly recommended that all midwives, general practitioners and obstetricians give full, good quality evidence-based information about the risks associated with surgical birth. Health Ministry Acting Deputy Director-General, Clinical Services Pat Tuohy said the ministry would actively promote the new guidelines. Over the next few months we are keen to work with professional organisations and district health boards to promote the guidelines to health professionals so that they understand the reasons for this advice, he said in a statement. We are developing brochures for pregnant women and their families which will clearly describe the alternatives, risks and benefits of surgical birth, and we want to reassure them that often there are alternatives that will be safe for both the baby and the mother. The guidelines were produced by the NZGG, which is an independent charitable organisation set up to promote evidence-based health care. Their development was funded by the Health Ministry. For the full guidelines: http://www.nzgg.org.nz/download/files/040310_ENDORSEMENT_Full_Caesarean.pdf?
Re: [ozmidwifery] Caesareans
Belinda, I'd love to read that article. Do you know the reference? Cheers, JenBelinda Maier [EMAIL PROTECTED] wrote: what is interesting is the RCT in the BMJwhich showed water was effective in decreasing the need for intervention/augmentation in women with 'dystocia'. So in these cases maybe getting the women i to water would have encouraged their labour to progress and avoid CS altogether Belinda Find local movie times and trailers on Yahoo! Movies.
[ozmidwifery] Caesareans
From the USA- An Agency for Healthcare Research and Quality (AHRQ) retrospective study of 733 women who delivered fullterm, nonbreech infants by unplanned cesarean found that as many as 24% of c-sections for "lack of progress in labor" are performed too early. This group comprises women who undergo a c-section when their cervix has dilated 0 to 3 centimeters. The American College of Obstetrics and Gynecology (ACOG) guidelines recommend that dilation should be 4 cm or more before a failure to progress diagnosis is made. The researchers postulated that many doctors are more comfortable with the risks of c-section than they are with labors that do not progress as rapidly as expected. In addition, many doctors either do not agree with ACOG guidelines or interpret them differently. - Obstetrics and Gynecology, April 1, 2000
Re: [ozmidwifery] Caesareans
what is interesting is the RCT in the BMJwhich showed water was effective in decreasing the need for intervention/augmentation in women with 'dystocia'. So in these cases maybe getting the women i to water would have encouraged their labour to progress and avoid CS altogether Belinda - Original Message - From: Mary Murphy To: list Sent: Wednesday, March 03, 2004 7:24 PM Subject: [ozmidwifery] Caesareans From the USA- An Agency for Healthcare Research and Quality (AHRQ) retrospective study of 733 women who delivered fullterm, nonbreech infants by unplanned cesarean found that as many as 24% of c-sections for "lack of progress in labor" are performed too early. This group comprises women who undergo a c-section when their cervix has dilated 0 to 3 centimeters. The American College of Obstetrics and Gynecology (ACOG) guidelines recommend that dilation should be 4 cm or more before a failure to progress diagnosis is made. The researchers postulated that many doctors are more comfortable with the risks of c-section than they are with labors that do not progress as rapidly as expected. In addition, many doctors either do not agree with ACOG guidelines or interpret them differently. - Obstetrics and Gynecology, April 1, 2000
Re: [ozmidwifery] Caesareans
What I find interesting is that it has 'always' been said that the best time to get in the water is after 5cms dilated. Personally, I have always encouragedlabouring women to use the water for releif of pain /or fatigue whenever they wanted. I don't believe there is a magic number. In view of the BMJ report, maybe I have been doing the right thing all the time? MM what is interesting is the RCT in the BMJwhich showed water was effective in decreasing the need for intervention/augmentation in women with 'dystocia'. So in these cases maybe getting the women i to water would have encouraged their labour to progress and avoid CS altogether Belinda - Original Message - From: Mary Murphy To: list Sent: Wednesday, March 03, 2004 7:24 PM Subject: [ozmidwifery] Caesareans From the USA- An Agency for Healthcare Research and Quality (AHRQ) retrospective study of 733 women who delivered fullterm, nonbreech infants by unplanned cesarean found that as many as 24% of c-sections for "lack of progress in labor" are performed too early. This group comprises women who undergo a c-section when their cervix has dilated 0 to 3 centimeters. The American College of Obstetrics and Gynecology (ACOG) guidelines recommend that dilation should be 4 cm or more before a failure to progress diagnosis is made. The researchers postulated that many doctors are more comfortable with the risks of c-section than they are with labors that do not progress as rapidly as expected. In addition, many doctors either do not agree with ACOG guidelines or interpret them differently. - Obstetrics and Gynecology, April 1, 2000
[ozmidwifery] Caesareans Put Next Child At Double The Risk of Stillbirth
This article appeared on page 3 of the Weekend Australian (29-30 Nov 03) - Food for thought in the VBAC/csec decision as this is potentially applicable to any woman who has a csec (1st or not) and then a subsequent pregnancy. Caesareans Put Next Child At Risk by Helen Tobler Medical Reporter Women who give birth to their first baby by caesarean section could have double the risk of an unexplained stillbirth in their next pregnancy.new research to be published today prompted experts to warm women to reconsider having a caesarean section if the procedure was not necessary.One in four Australian women give birth by caesarean - one of the highest rates in the developed world and higher than the World Health Organisation's recommendation of 15 per cent.A study of more than 120 600 second births in Scotland between 1992 and 1998 found the proportion of stillbirths in second pregnancies was almost double amont the women who had had caesareans.The risk of stillbirth was 2.4 per 10 000 per week among those who had had caesareans compared with 1.4 per 10 000 per week for those who had vaginal births.The researchers, whose study appears in The Lancet, said the link could be explained by damage to blood vessels in the uterus or placental abnormaliti! es caused by surgery.Head researcher Gordon Smith, from the University of Cambridge, said the results were unlikely to change the decision to have a caesarean for a breech baby."However if women are being counselled about caesarean birth with no clear obstetric advantage, such as caearean section for maternal request, the possible effect on the risk of unexplained stillbirth in future pregnancies should be discussed", he said.Michael Bennett, professor of obstetrics and gynaecology at the University of NSW and Sydney's Royal Hospital for Women, said most caesarean were done for health reasons.Professor Bennett said only 3 per cent to 5 per cent of women who have caesareans do so by choice."The majority don't actually have a choice," he said.The added risk of stillbirth that the study showed was "an extra tiny fraction" of the overall risks.Judith Lumley, director of the centre for study of mothers' and children's health at La Trobe Universi! ty worte a commentary for The Lancet."The finding that caesare an increases the risk of unexplained stillbirth before labour in the next pregnancy has the potential to redefine the nature of the debate about the place of caesarean delivery in maternity care."Hot chart ringtones and polyphonics. Click here -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Caesareans!
Dear List, Wasn't caesar's palace?Or has this hospital now a rival for that title?Friends from Singapore have told me in Singapore the induction rate is almost 100% and the c/section rate is 80%.I am not surprised with an attitude of Mon-Fri 9-5 obst/ics.Ann--- Pinky McKay [EMAIL PROTECTED] wrote: Hi , Yesterday I had a wee chat to Bruce Sutherland - he started the Hawthorn Birth Centre and still has a few births there each month as well as his other obstetric practice. He was telling me - utterly mortfied - that the previous day a well known private hospital in Melbourne had a busy day, according the the midwives there . Yes, they said - 13 births!!! - TEN of these births were caesareans!! Bruce was beside himself - Thats 70 percent - what IS going on?? He also told me how he had refused to do a caesarean for a mum having her 3rd baby =apparently the woman had two straightforwod births previously but her 'friends' had convinced her a csection would be the 'easy way'. Eventually he 'compromised' and gave this woman an epidural and induction that she was demanding - she had a 3 hr labour and easy birth. Bruce is a legend but I am thinking he must be utterly baffled by the present trends for intervention He would have seen so many changes over the years - he is now helping women whose mothers went to him! He has fought enormously hard to give women natural births - introducing Leboyer births, then later setting up Hawthorn Birth Centre and including a large Birthing pool so women could labour/birth in water as he wasnt comfortable with the mother/ baby separation when Leboyer babies were put into a bath - mothers and babies (and partners/ support people) can be together in the tub at the birth Centre . An interesting 'chat'. Pinky __ Do You Yahoo!? Everything you'll ever need on one web page from News and Sport to Email and Music Charts http://uk.my.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Caesareans!
Hi , Yesterday I had a wee chat to Bruce Sutherland - he started the Hawthorn Birth Centre and still has a few births there each month as well as his other obstetric practice. He was telling me - utterly mortfied - that the previous day a well known private hospital in Melbourne had a busy day,according the the midwives there . Yes, they said - 13 births!!! - TEN of these births were caesareans!! Bruce was beside himself - "Thats 70 percent - what IS going on??" He also told me how he had refused to do a caesarean for a mum having her 3rd baby =apparently the woman had two straightforwod births previously but her 'friends' had convinced her a csection would be the 'easy way'. Eventually he 'compromised' and gave this woman an epidural and induction that she was demanding - she had a 3 hr labour and easy birth. Bruce is a legend but I am thinking he must be utterly baffled by the present trends for intervention He would haveseen so many changes over the years - he is now helping women whose mothers went to him! He hasfought enormously hard to give women natural births - introducing Leboyer births, then later setting up Hawthorn Birth Centre and includinga large Birthing poolso women could labour/birth in water as he wasnt comfortable with the mother/ baby separation when Leboyer babies were put into a bath - mothers and babies (andpartners/ support people)can be together in the tub at the birth Centre . An interesting 'chat'. Pinky
Re: [ozmidwifery] Caesareans!
Hey, Pinky, Bruce Sutherland was at Rosie's birth in Vaucluse! I'd have had a homebirth, only I didn't have a home. Peter Lucas was to have been there, but wastrekking in Nepal. Bruce was excellent...did virtually nothing but respect my wishes. Please say hello to him for me, not that he'd probably remember, unless you remind him about my work with Kerry Gray CEA. Love, Aviva - Original Message - From: Pinky McKay To: [EMAIL PROTECTED] Sent: Saturday, December 07, 2002 9:38 PM Subject: [ozmidwifery] Caesareans! Hi , Yesterday I had a wee chat to Bruce Sutherland - he started the Hawthorn Birth Centre and still has a few births there each month as well as his other obstetric practice. He was telling me - utterly mortfied - that the previous day a well known private hospital in Melbourne had a busy day,according the the midwives there . Yes, they said - 13 births!!! - TEN of these births were caesareans!! Bruce was beside himself - "Thats 70 percent - what IS going on??" He also told me how he had refused to do a caesarean for a mum having her 3rd baby =apparently the woman had two straightforwod births previously but her 'friends' had convinced her a csection would be the 'easy way'. Eventually he 'compromised' and gave this woman an epidural and induction that she was demanding - she had a 3 hr labour and easy birth. Bruce is a legend but I am thinking he must be utterly baffled by the present trends for intervention He would haveseen so many changes over the years - he is now helping women whose mothers went to him! He hasfought enormously hard to give women natural births - introducing Leboyer births, then later setting up Hawthorn Birth Centre and includinga large Birthing poolso women could labour/birth in water as he wasnt comfortable with the mother/ baby separation when Leboyer babies were put into a bath - mothers and babies (andpartners/ support people)can be together in the tub at the birth Centre . An interesting 'chat'. Pinky --- Checked by AVG anti-virus system (http://www.grisoft.com).Version: 6.0.426 / Virus Database: 239 - Release Date: 2/12/02
