Re: [ozmidwifery] Question re conference at John Hunter
Hello Lyle, The conference will be fantastic! I'm really looking forward to the debate on CTG's. The debate is titled This house believes that the use of EFM in labour should be abandoned For those who would like the conference information and registration form, please email me on: [EMAIL PROTECTED] and I will send it to you. warmly, Carolyn - Original Message - From: Lyle Burgoyne [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Saturday, December 23, 2006 1:08 AM Subject: [ozmidwifery] Question re conference at John Hunter Hi, I have seen a brief email about a conference at John Hunter Hospital on the 9th and 10th Feb 2007 dealing with Midwifery models of care and Electronic fetal monitoring. Does anyone have any more information about this conference and are applicatiuons available online anywhere? Thanks Lyle This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Question re conference at John Hunter
Hi, I have seen a brief email about a conference at John Hunter Hospital on the 9th and 10th Feb 2007 dealing with Midwifery models of care and Electronic fetal monitoring. Does anyone have any more information about this conference and are applicatiuons available online anywhere? Thanks Lyle This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Title: Message Thanks Justine for those kind words - I needed a little boost like that. Yes there are some great ENs working out in rural areas - I think what makes them good is their passion (which is why I doing my BMid). Midwifery is a special field all of its own - I was encouraged to do my RN training, but knew I would never finish because that was not where my passion lay! The other point I would like to add is why can't the powers that be see how economical this option (caseload) is?? Not rocket science either!! Regards Annette -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine CainesSent: Tuesday, September 12, 2006 7:35 PMTo: OzMid ListSubject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctorsDear Barb, Melissa and allI too live in rural Aust and understand the issues esp that there are many good ENs out there. We have a local one who is doing the Bmid at UTS (hooray!).I guess the point is that if the opening up of Medicare Item number 16400 goes through then this will be able to happen.Essentially with Mr Abbotts approach there is no need for midwives to exist. I use the building analogy. It is like saying to an Electrician - Sorry we wont support you doing your trade, and by the way we will also enable Carpenters and Plumbers to do electrical work, after al they are all in the building industry!!These moves affect EVERY midwife, because they totally disregard midwifery expertise (despite many hard-fought wins of recent years to distingusih nursing from midwifery) This goes backwards from what we had before.Remember this will also enable GPs without a Dip Obs to provide antenatal care and essentially oversee a RN without midwifery.Naturally, if midwives were employed on a caseload basis even in small rural areas units could operate. Also managers would be better placed recruiting straight RNs for AE etc etc rather than the RN/RM issue. Get midwives as midwives and RNs as RNs. Not rocket science!!In solidarityJustine
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Title: Message Keep up the good work Annette! I had this discussion with my mum last night (she is a midwife/nurse who has been working contracts in rural areas for a while), her arguement was, "where will they get the midwives to do it?" . I feel that more midwives would move to rural areas if they didnt have to work as nurses, and as Annette has shown, more women will train as midwives if that is where their passion lies. Di - Original Message - From: Tony Annette Rockley To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 13, 2006 8:22 PM Subject: RE: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Thanks Justine for those kind words - I needed a little boost like that. Yes there are some great ENs working out in rural areas - I think what makes them good is their passion (which is why I doing my BMid). Midwifery is a special field all of its own - I was encouraged to do my RN training, but knew I would never finish because that was not where my passion lay! The other point I would like to add is why can't the powers that be see how economical this option (caseload) is?? Not rocket science either!! Regards Annette -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine CainesSent: Tuesday, September 12, 2006 7:35 PMTo: OzMid ListSubject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctorsDear Barb, Melissa and allI too live in rural Aust and understand the issues esp that there are many good ENs out there. We have a local one who is doing the Bmid at UTS (hooray!).I guess the point is that if the opening up of Medicare Item number 16400 goes through then this will be able to happen.Essentially with Mr Abbotts approach there is no need for midwives to exist. I use the building analogy. It is like saying to an Electrician - Sorry we wont support you doing your trade, and by the way we will also enable Carpenters and Plumbers to do electrical work, after al they are all in the building industry!!These moves affect EVERY midwife, because they totally disregard midwifery expertise (despite many hard-fought wins of recent years to distingusih nursing from midwifery) This goes backwards from what we had before.Remember this will also enable GPs without a Dip Obs to provide antenatal care and essentially oversee a RN without midwifery.Naturally, if midwives were employed on a caseload basis even in small rural areas units could operate. Also managers would be better placed recruiting straight RNs for AE etc etc rather than the RN/RM issue. Get midwives as midwives and RNs as RNs. Not rocket science!!In solidarityJustine
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Title: Message Hi, Just had a thought, Justine, has anyone pitched the campaign to Getup? If they were to adopt it , there would be massive coverage. If many of us suggest it to them it might get a look in. Di If you have a good idea for a new GetUp campaign on an important national issue, then we would love to hear about it. If you can, tell us the focus of the campaign and suggest the action the campaign would ask our members to take.Send your campaign ideas to [EMAIL PROTECTED]. - Original Message - From: Tony Annette Rockley To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 13, 2006 8:22 PM Subject: RE: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Thanks Justine for those kind words - I needed a little boost like that. Yes there are some great ENs working out in rural areas - I think what makes them good is their passion (which is why I doing my BMid). Midwifery is a special field all of its own - I was encouraged to do my RN training, but knew I would never finish because that was not where my passion lay! The other point I would like to add is why can't the powers that be see how economical this option (caseload) is?? Not rocket science either!! Regards Annette -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine CainesSent: Tuesday, September 12, 2006 7:35 PMTo: OzMid ListSubject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctorsDear Barb, Melissa and allI too live in rural Aust and understand the issues esp that there are many good ENs out there. We have a local one who is doing the Bmid at UTS (hooray!).I guess the point is that if the opening up of Medicare Item number 16400 goes through then this will be able to happen.Essentially with Mr Abbotts approach there is no need for midwives to exist. I use the building analogy. It is like saying to an Electrician - Sorry we wont support you doing your trade, and by the way we will also enable Carpenters and Plumbers to do electrical work, after al they are all in the building industry!!These moves affect EVERY midwife, because they totally disregard midwifery expertise (despite many hard-fought wins of recent years to distingusih nursing from midwifery) This goes backwards from what we had before.Remember this will also enable GPs without a Dip Obs to provide antenatal care and essentially oversee a RN without midwifery.Naturally, if midwives were employed on a caseload basis even in small rural areas units could operate. Also managers would be better placed recruiting straight RNs for AE etc etc rather than the RN/RM issue. Get midwives as midwives and RNs as RNs. Not rocket science!!In solidarityJustine
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
I agree with the fact that midwives would move to rural areas if they could do only midwifery, however I think that if the RN/Midwives in the rural areas were given the opportunity, support and enthusiasm we would find that there are quite a few Midwives out there who have not used there skill for a long, long time but may be willing to resurrect them again. Cheers Di M
RE: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Title: Message I have seen in a small country private hospital nurses doing sheep herding trick- one nurse puts a woman in one room while the Dr goes into the other room with a woman who has had her BP and urine checked by the nurse and is lying down 'ready' for Dr. After he has finished he goes to the next room and so on. It is the nurse who s left to guide the woman to get bloods or scans or answer her questions which she had heard Dr give advice before. It is also sad to say on one day in our ANC we have two midwives who also do the barn yard sorting. Some of midwives have tried to explain why that is not good practice with no luck. As for birth I would not be without the good EN who is able to attend the birth supporting me as the midwife which many a time was all I had in a small rural hospital. It did take a little time for them to get used to skin to skin and delayed cord clamping as they were so used to birth, cord cut and clamped and over to the resus unit! Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Melissa SingerSent: Tuesday, 12 September 2006 4:46 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Having previously spent many years as a rural and remote nurse and midwife I have NEVER seen a nurse provide antenatal care to women. We worked with a nurse or enrolled nurse to provide guided assistance to ward clients or as a second person attending a birth. Melissa - Original Message - From: D. Morgan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 1:10 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors It'sscary stuff when people in those high places (parliament)making those decisions are not aware of all the facts. However as a Nurse and Midwife from the bush I don't think I have ever seen anynursewho is not a Midwife give antenatal care to women. Cheers Di
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Title: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Dear Barb, Melissa and all I too live in rural Aust and understand the issues esp that there are many good ENs out there. We have a local one who is doing the Bmid at UTS (hooray!). I guess the point is that if the opening up of Medicare Item number 16400 goes through then this will be able to happen. Essentially with Mr Abbotts approach there is no need for midwives to exist. I use the building analogy. It is like saying to an Electrician - Sorry we wont support you doing your trade, and by the way we will also enable Carpenters and Plumbers to do electrical work, after al they are all in the building industry!! These moves affect EVERY midwife, because they totally disregard midwifery expertise (despite many hard-fought wins of recent years to distingusih nursing from midwifery) This goes backwards from what we had before. Remember this will also enable GPs without a Dip Obs to provide antenatal care and essentially oversee a RN without midwifery. Naturally, if midwives were employed on a caseload basis even in small rural areas units could operate. Also managers would be better placed recruiting straight RNs for AE etc etc rather than the RN/RM issue. Get midwives as midwives and RNs as RNs. Not rocket science!! In solidarity Justine
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Sadly I have in the last year seen ante natal care provided by RNs. I was troubled by the practise of an RN who had let her mid rego lapse and had not worked as a midwife for 14 years, and then given the job of providing antenatal care to the women of a remote town. Management saw no problems with this when I spoke of my concerns. The WA nurses board were not concerned, and I thought they were the protectors of the public!! It is imperative that our role be clear to the decision makers. By the way I no longer work in that area. Cath - Original Message - From: Melissa Singer To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 4:45 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Having previously spent many years as a rural and remote nurse and midwife I have NEVER seen a nurse provide antenatal care to women. We worked with a nurse or enrolled nurse to provide guided assistance to ward clients or as a second person attending a birth. Melissa - Original Message - From: D. Morgan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 1:10 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors It'sscary stuff when people in those high places (parliament)making those decisions are not aware of all the facts. However as a Nurse and Midwife from the bush I don't think I have ever seen anynursewho is not a Midwife give antenatal care to women. Cheers Di
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
I too have seen a EN on the ward where my daughter was, telling her to wake her baby because she hadnt been fed for seven hours, A) this was incorrect, B) there was no reason to wake the babe even if it was C) when asked , she said she was just told to make sure babe fed (? from the one midwife on the ward) because "we like them to feed four hourly". Its a difficult position to see young women being made to feel inadequate or unsure of themselves from unqualified care even if it isnt a 'dangerous' situation. As an LC I work hard to encourage women and midwives to let the process unfold naturally. I did lots of training to get where I am and feel that it is an insult for just anyone to be able to provide the care under the guise of government policy. Cheers, Di - Original Message - From: cath nolan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 11:15 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Sadly I have in the last year seen ante natal care provided by RNs. I was troubled by the practise of an RN who had let her mid rego lapse and had not worked as a midwife for 14 years, and then given the job of providing antenatal care to the women of a remote town. Management saw no problems with this when I spoke of my concerns. The WA nurses board were not concerned, and I thought they were the protectors of the public!! It is imperative that our role be clear to the decision makers. By the way I no longer work in that area. Cath - Original Message - From: Melissa Singer To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 4:45 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors Having previously spent many years as a rural and remote nurse and midwife I have NEVER seen a nurse provide antenatal care to women. We worked with a nurse or enrolled nurse to provide guided assistance to ward clients or as a second person attending a birth. Melissa - Original Message - From: D. Morgan To: ozmidwifery@acegraphics.com.au Sent: Tuesday, September 12, 2006 1:10 PM Subject: Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors It'sscary stuff when people in those high places (parliament)making those decisions are not aware of all the facts. However as a Nurse and Midwife from the bush I don't think I have ever seen anynursewho is not a Midwife give antenatal care to women. Cheers Di
[ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
Passing this on from email from Australian Democrates Womens Health Database, Suzi Questions on Notice from Senator Allison that you may be interested in. We will let you know once we receive the answers. QUESTIONS ON NOTICE Senator Allison asks the Minister representing the Minister for Health and Ageing 1. Is the Minister aware that the Rural Doctors Association have been quoted as saying What you'll find is there are many, many nurses who are trained to provide antenatal who may not be current members of the Australian College of Midwives and so I don't think we should see this as limits to people who are currently registered as a midwife. There are many women who have provided antenatal care in the past"? 2. If nurses are not trained as midwives, what other qualifications can they have that would equip them to provide antenatal care? 3. How many nurses without midwifery qualifications are registered as midwives in Australia? 4. How many nurses without midwifery qualifications are currently providing antenatal care in Australia? 5. How many nurses not registered as midwives are currently providing antenatal care? 6. Does the Minister agree that qualification as a midwife, registration as a midwife and membership of the Australian College of Midwives are not the same things? 7. Will the new Medicare item rely on the delegating medical practitioners ability to delegate to appropriately qualified and trained staff? If so, how will the government ensure that medical practitioners are aware of the difference between qualifications in midwifery, registration as a midwife and membership of the Australian College of Midwives? Senator Lyn Allison 21August 2006 Regards Siobhan Siobhan O'MaraOffice Manager and Executive Assistant to Senator Lyn AllisonLeader, Australian Democrats1st Floor, 62 Wellington ParadeEast Melbourne VIC 3002T: 03 9416 1880, Local call: 1300 130 427F: 03 9417 1690E: [EMAIL PROTECTED]W: www.democrats.org.au
Re: [ozmidwifery] Question on Notice to Tony Abbott re antenatal item issue and rural doctors
It'sscary stuff when people in those high places (parliament)making those decisions are not aware of all the facts. However as a Nurse and Midwife from the bush I don't think I have ever seen anynursewho is not a Midwife give antenatal care to women. Cheers Di
Re: [ozmidwifery] Question about midwifery in Australia
Hi Mia, I'm an independent midwife in South Australia but am from Wales and worked as a midwife in England for 14 years before coming here. If you like I'd be happy to email you off list. What part of Australia are you thinking of coming to? Lisa Barrett -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question about midwifery in Australia
You're very welcome to email me off list, thanks! I'm thinking about Sydney, mainly because I've been there and liked it, have some contacts there and think that the opportunities for work are probably greater in a big city - plus I'm used to living in London so I might feel a bit isolated if I went anywhere too quiet. Where are you based? Mia - Original Message - From: Lisa Barrett [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, August 21, 2006 2:10 PM Subject: Re: [ozmidwifery] Question about midwifery in Australia Hi Mia, I'm an independent midwife in South Australia but am from Wales and worked as a midwife in England for 14 years before coming here. If you like I'd be happy to email you off list. What part of Australia are you thinking of coming to? Lisa Barrett -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question of the week.
Pretty much similar. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Mary MurphySent: Friday, 4 August 2006 6:37 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] Question of the week. Would this be any different to a gastrochesis, where loops of bowel are hanging out of the abdominal cavity. A clients baby was born this week with quite a lot of bowel protruding. Other than the need for sterility, it was a normal birth. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken WardSent: Friday, 4 August 2006 2:27 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] Question of the week. I have seen large and small spina bifida's birthed normally. It is important to keep the membrane intact to prevent infection. These babies are usually operated on very quickly. -Original Message-From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Mary MurphySent: Thursday, 3 August 2006 10:03 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida?
Re: [ozmidwifery] Question of the week.
Like all these things we can all tell stories that support both sides of the equation. I personally know of a baby whose spinal defect was at the base of the skull. The a/n ultrasounds showed that the brainstem was herniating into the meningocele and the parents were told it was incompatible with life and 'advised' to terminate the pregnancy. They declined and at term were advised to have an elective LUSCS for the reasons stated. They again declined and when the baby was born she didn't die at birth despite the dire predictions and they took her home. When at 10 days she was thriving they took her to RCH for assessment where they found that the spinal cord and brain stem had been returned to the correct position during the birth process without damaging it. The defect was closed and Alice is now a thriving 5 year old who is defying all odds as to her potential.As in all things the parents need to be given both sides of the story and then their decision respected because no two situations are exactly the same and you dont get to do it both ways and decide which one works best. Most practitioners are biased by their past experiences and often dont make objective recommendations to parentsJust another side to the storyAndrea Quanchi.On 05/08/2006, at 10:45 PM, Susan Cudlipp wrote:Mary, I would say that the meningocele is far more delicate than the bowel and if it is ruptured the long term prognosis for the child with spina bifida is compromised, whereas if it is kept intact the child stands a far better chance of living a normal life. I know of a child, now 7years old, who was born by el C/S with us because of spina bifida. He has done extremely well and you would hardly know that he had been born with a quite large neural tube defect. He has fully functioning motor system, and just a few fairly minor toiletting issues which are improving. He was handled very carefully by a very experienced midwife and doctor and has really had the best outcome possible. I saw him at birth and know his parents so have had opportunity to follow his progress.During vaginal birth it is not possible to guarantee protection of the meningocele, which could easily rupture with the pressure of even the gentlest passage through the birth canal, and therefor, for the child's sake, C/S is probably a better option.Gastrochises I have seen and birthed vaginally are much more robust, while they still require careful handling there is not so much danger of long term, permanent damage. The bowel is not in the same ball game as the spinal cord. Regards, Sue- Original Message -From: Mary MurphyTo: ozmidwifery@acegraphics.com.auSent: Friday, August 04, 2006 4:36 PMSubject: RE: [ozmidwifery] Question of the week.Would this be any different to a gastrochesis, where loops of bowel are hanging out of the abdominal cavity. A clients baby was born this week with quite a lot of bowel protruding. Other than the need for sterility, it was a normal birth. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken WardSent: Friday, 4 August 2006 2:27 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] Question of the week. I have seen large and small spina bifida's birthed normally. It is important to keep the membrane intact to prevent infection. These babies are usually operated on very quickly.-Original Message-From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Mary MurphySent: Thursday, 3 August 2006 10:03 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Question of the week.An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida? No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 3/08/2006
RE: [ozmidwifery] Question of the week.
Two wonderful stories that show how tuff, delicate human beings really are. Thanks for those stories. MM From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Quanchi Sent: Saturday, 5 August 2006 9:27 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question of the week. Like all these things we can all tell stories that support both sides of the equation. I personally know of a baby whose spinal defect was at the base of the skull. The a/n ultrasounds showed that the brainstem was herniating into the meningocele and the parents were told it was incompatible with life and 'advised' to terminate the pregnancy. They declined and at term were advised to have an elective LUSCS for the reasons stated. They again declined and when the baby was born she didn't die at birth despite the dire predictions and they took her home. When at 10 days she was thriving they took her to RCH for assessment where they found that the spinal cord and brain stem had been returned to the correct position during the birth process without damaging it. The defect was closed and Alice is now a thriving 5 year old who is defying all odds as to her potential. As in all things the parents need to be given both sides of the story and then their decision respected because no two situations are exactly the same and you dont get to do it both ways and decide which one works best. Most practitioners are biased by their past experiences and often dont make objective recommendations to parents Just another side to the story Andrea Quanchi. On 05/08/2006, at 10:45 PM, Susan Cudlipp wrote: Mary, I would say that the meningocele is far more delicate than the bowel and if it is ruptured the long term prognosis for the child with spina bifida is compromised, whereas if it is kept intact the child stands a far better chance of living a normal life. I know of a child, now 7years old, who was born by el C/S with us because of spina bifida. He has done extremely well and you would hardly know that he had been born with a quite large neural tube defect. He has fully functioning motor system, and just a few fairly minor toiletting issues which are improving. He was handled very carefully by a very experienced midwife and doctor and has really had the best outcome possible. I saw him at birth and know his parents so have had opportunity to follow his progress. During vaginal birth it is not possible to guarantee protection of the meningocele, which could easily rupture with the pressure of even the gentlest passage through the birth canal, and therefor, for the child's sake, C/S is probably a better option. Gastrochises I have seen and birthed vaginally are much more robust, while they still require careful handling there is not so much danger of long term, permanent damage. The bowel is not in the same ball game as the spinal cord. Regards, Sue - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Friday, August 04, 2006 4:36 PM Subject: RE: [ozmidwifery] Question of the week. Would this be any different to a gastrochesis, where loops of bowel are hanging out of the abdominal cavity. A clients baby was born this week with quite a lot of bowel protruding. Other than the need for sterility, it was a normal birth. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken Ward Sent: Friday, 4 August 2006 2:27 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Question of the week. I have seen large and small spina bifida's birthed normally. It is important to keep the membrane intact to prevent infection. These babies are usually operated on very quickly. -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Mary Murphy Sent: Thursday, 3 August 2006 10:03 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida? No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 3/08/2006
Re: [ozmidwifery] Question of the week.
I think you'll find there's only one piece of research that said this. No others ever backed it up. You should look into it really carefully before the woman decides for herself what is best for her and her baby. Lisa Barrett - Original Message - From: Synnes To: ozmidwifery@acegraphics.com.au Sent: Friday, August 04, 2006 12:04 PM Subject: Re: [ozmidwifery] Question of the week. They need to keep the menigiocele intact, C-section is the best way to ensure this as it is outside the body and is very fragile. They then will perhaps perform an operation to repair it which will help the child to walk and have function in the future. Amanda - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 03, 2006 9:33 PM Subject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida? No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 8/3/2006 No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 8/3/2006
RE: [ozmidwifery] Question of the week.
I have seen large and small spina bifida's birthed normally. It is important to keep the membrane intact to prevent infection. These babies are usually operated on very quickly. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Mary MurphySent: Thursday, 3 August 2006 10:03 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida?
[ozmidwifery] Question of the week.
An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida?
Re: [ozmidwifery] Question of the week.
i think that is so the menigiocele doesnt rupture during birth as it is outside the body of the baby. - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 03, 2006 9:33 PM Subject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida? No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.10.5/406 - Release Date: 2/08/2006
Re: [ozmidwifery] Question of the week.
They need to keep the menigiocele intact, C-section is the best way to ensure this as it is outside the body and is very fragile. They then will perhaps perform an operation to repair it which will help the child to walk and have function in the future. Amanda - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Thursday, August 03, 2006 9:33 PM Subject: [ozmidwifery] Question of the week. An interesting question from Midwifery Today E News. I am 21 weeks pregnant with my third child, which has been diagnosed with spina bifida. This is quite a shock since my other two children were homebirths and the specialists said I would require a c-section. I understand the need to deliver in a hospital where the baby can receive immediate medical treatment soon after birth, but does anyone know if there is any evidence that c-section is better than vaginal birth when delivering a child with spina bifida? No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 8/3/2006 No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.10.5/407 - Release Date: 8/3/2006
[ozmidwifery] question babies/antibiotics
Hi everyone on list, I had a question from a parent (who very unfortunately had a horrible stitches story post C/S - intestines literally falling out after removal of stitches) and of course on a heavy dose of antibiotics. Baby (breastfeeding well till then) is quite unsettled now and it's guts are a bit messed up and is spitting alot up at the end of a feed - doctor suggests gaviscon, is there any merit in looking at pro-biotics suitable for 8 week olds? Regards, Stephanie - coming to Oz soon from UK
Re: [ozmidwifery] question babies/antibiotics
- doctor suggests gaviscon, is there any merit in looking at pro-biotics suitable for 8 week olds? Regards, Stephanie - coming to Oz soon from UK Poor little one. Definitely probiotics, I believe gaviscon would just make things much worse. Mum can dip finger in probiotic powder and place in bubs mouth ( best to get a dairy free one) and also can put it around her nipples before feeds. It also helps if mum takes lots too internally. Could be a good idea for mum and bubs to go and see a homeopath too. I know women and their bubs that homeopathics have helped alot. Love Abby -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] question re funding
Hi everyone, I have just found out I have an abstract accepted for the normal birth conference in June in Cumbria. I would be excited but need to look for funding to be able to get there. Can anyone give me suggestions where to look, i am a PhD student (nearly finished - final chapter on the go) and will look at the uni but am pretty sure time will be an issue. Any suggestions greatly accepted Belinda -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] question
Jennifer Cameron wrote The signs of shoulder dystocia are evident before the head is crowned and then the 'turtle' sign appears and clinches the diagnosis so it is full steam ahead and get that baby born My understanding is that the head retraction on the perineum is the main sign. I realize that a large baby could be one, as is slow 2nd stage in the perineal phase, but these accompany many normal births too. . Could you please list the signs that are evident before the head is crowned and also the reference? Thanks, MM. PS, a grandmultip client of mine recently birthed a 5.3kg, HC 40cm, Length 60 cm, with no problems. Had to stand up to do it tho. Remember the placenta is beginning to separate at the point of the head being born so the baby is dying of hypoxia and acidosis. ALSO are probably correct on not waiting for restitution.. You could wait all day for restitution and end up with a dead baby.
Re: [ozmidwifery] question
Jennifer Cameron wrote The signs of shoulder dystocia are evident before the head is crowned. What are these signs prior to crowning ? Crowning is before any kind of turtling, burrowing or lack of restitution may occur right? Because 'crowning' is before the head is born. I am nowwondering if I've been missing something? I have practised "hand off" birthing for 15 years see many babies corkscrew their way out, I'm often thankful I haven't had my hands on them as I would have interfered with the manoeuvres they initiate to negotiate their way out. I was taught that not waiting for restitution was a major cause of shoulder dystocia, has there been research to prove otherwise since ? I would be really interested to read it. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, November 29, 2005 10:14 PM Subject: RE: [ozmidwifery] question Jennifer Cameron wrote The signs of shoulder dystocia are evident before the head is crowned and then the 'turtle' sign appears and clinches the diagnosis so it is full steam ahead and get that baby born My understanding is that the head retraction on the perineum is the main sign. I realize that a large baby could be one, as is slow 2nd stage in the perineal phase, but these accompany many normal births too. . Could you please list the signs that are evident before the head is crowned and also the reference? Thanks, MM. PS, a grandmultip client of mine recently birthed a 5.3kg, HC 40cm, Length 60 cm, with no problems. Had to stand up to do it tho. Remember the placenta is beginning to separate at the point of the head being born so the baby is dying of hypoxia and acidosis. ALSO are probably correct on not waiting for restitution.. You could wait all day for restitution and end up with a dead baby.
Re: [ozmidwifery] question
I think the only indicator that you "might" get a shoulder dyst is a longer than expected 2nd stage. i.e. with a primip, longer than 2 1/2 hrs, and with a multip, longer than 45 mins. You might want to change strategies and help hydrate the woman that you're seeing with a long 2nd stage. Changing strategies would be getting her out of the water tub, having her get on a birth stool, more upright positions, etc. Of course, medically managed births that foretell a sh. dyst would be the forceps and vaccuum extractions that don't give the uterus time to clamp down for that last big push for the shoulders. Gloria - Original Message - From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Tuesday, November 29, 2005 1:55 PM Subject: Re: [ozmidwifery] question Jennifer Cameron wrote The signs of shoulder dystocia are evident before the head is crowned. What are these signs prior to crowning ? Crowning is before any kind of turtling, burrowing or lack of restitution may occur right? Because 'crowning' is before the head is born. I am nowwondering if I've been missing something? I have practised "hand off" birthing for 15 years see many babies corkscrew their way out, I'm often thankful I haven't had my hands on them as I would have interfered with the manoeuvres they initiate to negotiate their way out. I was taught that not waiting for restitution was a major cause of shoulder dystocia, has there been research to prove otherwise since ? I would be really interested to read it. With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, November 29, 2005 10:14 PM Subject: RE: [ozmidwifery] question Jennifer Cameron wrote The signs of shoulder dystocia are evident before the head is crowned and then the 'turtle' sign appears and clinches the diagnosis so it is full steam ahead and get that baby born My understanding is that the head retraction on the perineum is the main sign. I realize that a large baby could be one, as is slow 2nd stage in the perineal phase, but these accompany many normal births too. . Could you please list the signs that are evident before the head is crowned and also the reference? Thanks, MM. PS, a grandmultip client of mine recently birthed a 5.3kg, HC 40cm, Length 60 cm, with no problems. Had to stand up to do it tho. Remember the placenta is beginning to separate at the point of the head being born so the baby is dying of hypoxia and acidosis. ALSO are probably correct on not waiting for restitution.. You could wait all day for restitution and end up with a dead baby.
RE: [ozmidwifery] question
Title: Message Jenny, Are you referring to partial pressure gradients of O2 and CO2? Simultaneously - when there is no blood flow, placenta to baby cord has stopped pulsating therefore no pressure gradient to push oxygen transfer. Once the baby isexposed to room environment a breath is taken the heart beat of the infant now provides the 'pump' pressure gradient and then you have exchange across the alveolar/capillary membrane. There will always be a oxygen and CO2 level. This was always a very complicated process. Thankfully an understanding of physic principles helps. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of JoFromOzSent: Saturday, 19 November 2005 9:17 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] questionMary Murphy wrote: Jenny, could you give us the reference please? Thanks, MM , one study demonstrated zero oxygen, because there is no longer any utero-placental circulation. This is part of the stimulation for the baby to breathe, but the baby is receiving some circulatory volume. Jennifer Cameron FRCNA FACMEven if there is no oxygen, I am sure it is still beneficial for the baby to have that volume, though.Jo
Re: [ozmidwifery] question - lodging complaints
Jo, You write really well with 3D perspective, Congratulations, few people have that vision, most see in 1D only ! Seeing everybody's perspective isn't easy it's all so subjective. Yet... you know; I am a MW of 25 years am about to give it all away because I feel that we are really in that damned if you do damned if you don't space. We facilitate a woman giving birth vaginally by giving her time to dilate, she feels she laboured too long we are wrong because we didn't leap in recommend a C/S . We recommend a C/S because we feel the labour is going nowhere we are wrong again because she didn't get time to dilate ! We try to give her every chance to achieve her goal we are wrong again because it wasn't as she'd planned. I feel I can't ever be right ! Packing shelves at Coles is looking good ! With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Dean Jo [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, November 20, 2005 2:42 PM Subject: RE: [ozmidwifery] question - lodging complaints This is an interesting thread that I must comment on again: With the consumer support I have been involved with for the many years I have and just in the year I have been a doula, the definition of a negative experience is so varied! What I would deem as a great natural vaginal birth with no tears etc have been described as hideous by a few women. I know women who have had a cs that were totally unwarranted but LOVED themwhat some think (rightly) as abuse can be accepted as others as normal. The point being, people writing in about the trauma they suffered during birth can encompass such a diversity of experiences. Who actually defines what a negative experience is? Is it the care given by the MW or OB or how they deliver that care? They could be a sweet as pie as they cut peris for no more than routine reasons resulting in long term incontinence issues. If the woman trusts them and likes them then is it abuse? What if an arrogant or just a forthright OB or MW comes in and demands a woman to get up off the bed and squat to birth which results in the woman having intense ctx and a baby? Is the way she was spoken to the determining factor or the fact that she was able to birth the baby without the need of any needless medical intervention? Or perhaps the birth I was at last night would be a good example: beautiful natural birth with a first time mum who had a small tear in the vaginal wall and external surface tearing. She required suturing which was done by the birth centre staff. Local was used but this woman was so scarred and traumatized she screamed for 20 minutes like I have never heard anyone scream before. Her pain was amplified by her fear and the gas she used. We were trying to do the right thing by her but never before have I felt like I had been involved with the assault on another human being. She was being told by the two (wonderful) midwives (so no insinuation of them being to blame for this as they were really wonderful women) and her poor husband what to do and so on which scared her and confused her more. I held her hand and let the tears run down my face as she sobbed my name. Did we abuse her? How do we define what is abuse on another? How does the people who we write to evaluate this? How do we define what is unacceptable to me but fine with the woman birthing in the other room? I don’t like any medical person telling me what to do: suggestions and advice is fine. But what about the woman who can not make decisions without firm guidance? Is it guidance or is it authorative? There are times when we all just want someone to make the decision for us as we can not or don’t know everything that we need to know to make the decision. I am not adverse to writing inn with a complaint of a care provider. I am in my eight year of letter writing and responding!! I KNOW that if people don’t write in a and say something then no changes can be made...but again I come back to the diversity of perceptions. How do I know the person reading my letters didn’t have a baby die because no one gave her a cs when needed? How is she going to respond to me bitching about getting a cs for no reason? Sorry, rambling! Still processing last night and also catching up on sleep. Another due last week so could go tonight! Love Jo (B) -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine Caines Sent: Sunday, November 20, 2005 1:19 PM To: OzMid List Subject: Re: [ozmidwifery] question - lodging complaints Hi Jo and All The disclaimer from what you have said was to indemnify the Ob from responsibility of a stuff up and it was as a response to refusal to c/s with that logic he has acted totally against the parents wishes by performing that episiotomy. I think having signed that form they have more to argue, ie they were making the decisions and taking responsibility
RE: [ozmidwifery] question - lodging complaints
PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine Caines Sent: Sunday, November 20, 2005 1:19 PM To: OzMid List Subject: Re: [ozmidwifery] question - lodging complaints Hi Jo and All The disclaimer from what you have said was to indemnify the Ob from responsibility of a stuff up and it was as a response to refusal to c/s with that logic he has acted totally against the parents wishes by performing that episiotomy. I think having signed that form they have more to argue, ie they were making the decisions and taking responsibility. They made it clear what their wishes were, the husband asked him to stop and he did not. I believe he has a case to answer re the evidence of 'cranial haemorrhage' etc etc and what benefit was achieved through such an assault. It may be worthwhile contacting Andrew Bissets at John Hunter Hospital re some facts (from an Ob) re vaginal breech as he has assisted over 400, he may have some ammo re the epis. Let me know if you want his e-mail. I agree with Andrea evey couple up to making a complaint should be supported to. The former HCC Commissioner in NSW agreed with what we said about the broken maternity system and yet said what can I do with 13 complaints for 86,000 births! She had a point. JC xxx -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.12.8/162 - Release Date: 11/5/2005 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.4/175 - Release Date: 11/18/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question - lodging complaints
MM. You have a gift for going straight to the essence of the issue !! You say what I know to be true but think it's just me that's seeing it this way ! Thank you. Birth is a continuum of the rest of our life is something I quote to many clients prenatally. I often think about the statistic that at least 1 in 4 girls have been sexually abused and ponder the rising caesarean rate. The vaginal experiences that women have are not just about birth. During physiological birth they are protected by their hormones to a certain extent. After the hormones wear off, the memory remains. Is it just the birth they are remembering or is it mixed up with other vaginal memories? Sometimes I can sympathize with the Obs for the rigid way they approach their work. At least it is consistent. I think this is the real basic truth in alot of situations ! With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Mary Murphy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, November 21, 2005 11:18 AM Subject: RE: [ozmidwifery] question - lodging complaints Re the previous messages: I totally agree with you that Seeing everybody's perspective isn't easy it's all so subjective. Birth is a continuum of the rest of our life is something I quote to many clients prenatally. I often think about the statistic that at least 1 in 4 girls have been sexually abused and ponder the rising caesarean rate. The vaginal experiences that women have are not just about birth. During physiological birth they are protected by their hormones to a certain extent. After the hormones wear off, the memory remains. Is it just the birth they are remembering or is it mixed up with other vaginal memories? We won't ever know, but lets not beat ourselves up about it. All community midwives have some clients who punish us for their birth experiences by refusing to pay our fee, bad mouthing us, or withdrawing abruptly from the midwife-woman relationship. Sometimes I can sympathize with the Obs for the rigid way they approach their work. At least it is consistent. Don't give up on your wonderful vocation. You are greatly treasured for your role in facilitating so many wonderful births. The babies thank you, MM We facilitate a woman giving birth vaginally by giving her time to dilate, she feels she laboured too long we are wrong because we didn't leap in recommend a C/S . We recommend a C/S because we feel the labour is going nowhere we are wrong again because she didn't get time to dilate ! We try to give her every chance to achieve her goal we are wrong again because it wasn't as she'd planned. I feel I can't ever be right ! This is an interesting thread that I must comment on again: With the consumer support I have been involved with for the many years I have and just in the year I have been a doula, the definition of a negative experience is so varied! What I would deem as a great natural vaginal birth with no tears etc have been described as hideous by a few women. I know women who have had a cs that were totally unwarranted but LOVED themwhat some think (rightly) as abuse can be accepted as others as normal. The point being, people writing in about the trauma they suffered during birth can encompass such a diversity of experiences. Who actually defines what a negative experience is? Is it the care given by the MW or OB or how they deliver that care? They could be a sweet as pie as they cut peris for no more than routine reasons resulting in long term incontinence issues. If the woman trusts them and likes them then is it abuse? What if an arrogant or just a forthright OB or MW comes in and demands a woman to get up off the bed and squat to birth which results in the woman having intense ctx and a baby? Is the way she was spoken to the determining factor or the fact that she was able to birth the baby without the need of any needless medical intervention? Or perhaps the birth I was at last night would be a good example: beautiful natural birth with a first time mum who had a small tear in the vaginal wall and external surface tearing. She required suturing which was done by the birth centre staff. Local was used but this woman was so scarred and traumatized she screamed for 20 minutes like I have never heard anyone scream before. Her pain was amplified by her fear and the gas she used. We were trying to do the right thing by her but never before have I felt like I had been involved with the assault on another human being. She was being told by the two (wonderful) midwives (so no insinuation of them being to blame for this as they were really wonderful women) and her poor husband what to do and so on which scared her and confused her more. I held her hand and let the tears run down my face as she sobbed my name. Did we abuse her? How do we define what is abuse on another? How does the people who we write to evaluate this? How do we define
Re: [ozmidwifery] question
Mary Murphy wrote: Jenny, could you give us the reference please? Thanks, MM , one study demonstrated zero oxygen, because there is no longer any utero-placental circulation. This is part of the stimulation for the baby to breathe, but the baby is receiving some circulatory volume. Jennifer Cameron FRCNA FACM Even if there is no oxygen, I am sure it is still beneficial for the baby to have that volume, though. Jo
RE: [ozmidwifery] question
That is exactly what is happening where I work due to one of our new Drs having been taught not to wait for restitution now we seem to have a "dystocia" every week (sigh) From: "Tania Smallwood" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] questionDate: Thu, 17 Nov 2005 16:11:01 +1030 My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. Tania From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Susan CudlippSent: Thursday, 17 November 2005 3:33 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. RegardsAnne ClarkeQueensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke __ NOD32 1.1289 (20051116) Information __This message was checked by NOD32 antivirus system.http://www.eset.com No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005 -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] question - lodging complaints
Hi Jo and All The disclaimer from what you have said was to indemnify the Ob from responsibility of a stuff up and it was as a response to refusal to c/s with that logic he has acted totally against the parents wishes by performing that episiotomy. I think having signed that form they have more to argue, ie they were making the decisions and taking responsibility. They made it clear what their wishes were, the husband asked him to stop and he did not. I believe he has a case to answer re the evidence of 'cranial haemorrhage' etc etc and what benefit was achieved through such an assault. It may be worthwhile contacting Andrew Bissets at John Hunter Hospital re some facts (from an Ob) re vaginal breech as he has assisted over 400, he may have some ammo re the epis. Let me know if you want his e-mail. I agree with Andrea evey couple up to making a complaint should be supported to. The former HCC Commissioner in NSW agreed with what we said about the broken maternity system and yet said what can I do with 13 complaints for 86,000 births! She had a point. JC xxx -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] question - lodging complaints
This is an interesting thread that I must comment on again: With the consumer support I have been involved with for the many years I have and just in the year I have been a doula, the definition of a negative experience is so varied! What I would deem as a great natural vaginal birth with no tears etc have been described as hideous by a few women. I know women who have had a cs that were totally unwarranted but LOVED themwhat some think (rightly) as abuse can be accepted as others as normal. The point being, people writing in about the trauma they suffered during birth can encompass such a diversity of experiences. Who actually defines what a negative experience is? Is it the care given by the MW or OB or how they deliver that care? They could be a sweet as pie as they cut peris for no more than routine reasons resulting in long term incontinence issues. If the woman trusts them and likes them then is it abuse? What if an arrogant or just a forthright OB or MW comes in and demands a woman to get up off the bed and squat to birth which results in the woman having intense ctx and a baby? Is the way she was spoken to the determining factor or the fact that she was able to birth the baby without the need of any needless medical intervention? Or perhaps the birth I was at last night would be a good example: beautiful natural birth with a first time mum who had a small tear in the vaginal wall and external surface tearing. She required suturing which was done by the birth centre staff. Local was used but this woman was so scarred and traumatized she screamed for 20 minutes like I have never heard anyone scream before. Her pain was amplified by her fear and the gas she used. We were trying to do the right thing by her but never before have I felt like I had been involved with the assault on another human being. She was being told by the two (wonderful) midwives (so no insinuation of them being to blame for this as they were really wonderful women) and her poor husband what to do and so on which scared her and confused her more. I held her hand and let the tears run down my face as she sobbed my name. Did we abuse her? How do we define what is abuse on another? How does the people who we write to evaluate this? How do we define what is unacceptable to me but fine with the woman birthing in the other room? I don’t like any medical person telling me what to do: suggestions and advice is fine. But what about the woman who can not make decisions without firm guidance? Is it guidance or is it authorative? There are times when we all just want someone to make the decision for us as we can not or don’t know everything that we need to know to make the decision. I am not adverse to writing inn with a complaint of a care provider. I am in my eight year of letter writing and responding!! I KNOW that if people don’t write in a and say something then no changes can be made...but again I come back to the diversity of perceptions. How do I know the person reading my letters didn’t have a baby die because no one gave her a cs when needed? How is she going to respond to me bitching about getting a cs for no reason? Sorry, rambling! Still processing last night and also catching up on sleep. Another due last week so could go tonight! Love Jo (B) -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Justine Caines Sent: Sunday, November 20, 2005 1:19 PM To: OzMid List Subject: Re: [ozmidwifery] question - lodging complaints Hi Jo and All The disclaimer from what you have said was to indemnify the Ob from responsibility of a stuff up and it was as a response to refusal to c/s with that logic he has acted totally against the parents wishes by performing that episiotomy. I think having signed that form they have more to argue, ie they were making the decisions and taking responsibility. They made it clear what their wishes were, the husband asked him to stop and he did not. I believe he has a case to answer re the evidence of 'cranial haemorrhage' etc etc and what benefit was achieved through such an assault. It may be worthwhile contacting Andrew Bissets at John Hunter Hospital re some facts (from an Ob) re vaginal breech as he has assisted over 400, he may have some ammo re the epis. Let me know if you want his e-mail. I agree with Andrea evey couple up to making a complaint should be supported to. The former HCC Commissioner in NSW agreed with what we said about the broken maternity system and yet said what can I do with 13 complaints for 86,000 births! She had a point. JC xxx -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.12.8/162 - Release Date: 11/5/2005 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database
Re: [ozmidwifery] question
I can understand not waiting too long when you feel
there is dystocia, however it seems that many Drs are interpreting that as not
waiting for restitution AT ALL. In normal mechanics restitution happens
soon after the birth of the head and internal rotation of shoulders with the
next contraction, unless the contractions are a great time apart i.e. as in
uterine inertia, the healthy baby can certainly afford to wait a minute or two
between head and shoulders, it is usually only that. I do remember
onebirth when the contractions had slowed right down in 2nd stage to about
7 minutes apart and had become quite weak, the ob was in the room and we did get
a bit stuck on the shoulders but he performed manual internal rotation and the
baby came out OK.I thought then that the shoulder dystocia was more
2' to the poor uterine effort in that instance, had the contractions been
expulsive and frequent I don't think it would have happened.
And, as we've been discussing, the placenta may be
beginning to separate, but it is still supplying O2 rich blood.
I found the points about stillborn baby with normal
Ph and -what we have all seen many times- babies with no apparent signs of
distress in labour coming out 'flat' to be very thought provoking.
An interesting thread indeed
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"Edmund Burke
- Original Message -
From:
Jenny
Cameron
To: ozmidwifery@acegraphics.com.au
Sent: Friday, November 18, 2005 10:16
AM
Subject: Re: [ozmidwifery] question
Remember the placenta is beginning to separate at
the point of the head being born so the baby is dying of hypoxia and acidosis.
ALSO are probably correct on not waiting for restitution. The signs of
shoulder dystocia are evident before the head is crowned and then the 'turtle'
sign appears and clinches the diagnosis so it is full steam ahead and get that
baby born. You could wait all day for restitution and end up with a dead baby.
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box
1465Howard Springs NT 083508 8983 19260419 528 717
- Original Message -
From:
Susan
Cudlipp
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005 2:32
PM
Subject: Re: [ozmidwifery]
question
Good point Anne!
I did quite a thorough search last night and
have printed off some good articles which I will pass on. However I
could not find the answer to why EXACTLY babies die in shoulder
dystocia. If it is asphyxia, then (obs point of view) this proves that
the cord is not sustaining them.The ob said to me that if the cord
WERE sustaining them there would be no urgency to deliver the body, also
quoted from the ALSO course that the fetal Ph drops 0.04 (?) per
minute after delivery of head therefor we should not be waiting for
restitution but delivering body ASAP. (I didn't even go
there!!)
My feeling is that it is more to do with
probable cord compression, (although I cannot picture why this should
necessarily be so as the body and hence, presumably, the cord,would
still be above the pelvic brim) and trauma to the neck usually caused by
mis-management (panic) in trying to deliver the shoulders than asphyxia, but
it is true that they become asphyxiated within a short time if truly
stuck. Any answers on that one?
Thanks
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"Edmund Burke
- Original Message -
From:
Anne
Clarke
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005
5:54 AM
Subject: Re: [ozmidwifery]
question
Dear Susan,
You could say to them if this is so why do
they rely so much on cord ph's ? One would thinkwhen the baby
was born and the pulsating cord was still not supplying the baby
effectively the cord blood (venous and arterial) was null and void to
providean estimation of oxygenation for the babe.
RegardsAnne ClarkeQueensland
- Original Message -
From:
Susan Cudlipp
To: midwifery list
Sent: Wednesday, November 16, 2005
9:30 PM
Subject: [ozmidwifery]
question
I have a question for youwise
ozmidders.
I was having a discussion today with one of
our obstetricians regarding cord clamping, and the benefits to the baby
of delaying this until pulsations cease. When I mentioned the
benefit of the baby recieving oxygenated blood via the pulsating cord
which could assist it's transition to independent respiration
particularly if it was compromis
Re: [ozmidwifery] question
Cord pH's reflect circumstances intrauterine not postpartum When the cord blood is collected immediately at birth for pH estimation it is to gauge as accurately as possible the pH at the moment of birth where the baby receives its last lot of oxygentated blood via the utero-placental circulation. After birth the cord does still pulsate and the baby does receive some blood volume but the pH of this blood is probably acidotic and is poor in oxygen, one study demonstrated zero oxygen, because there is no longer any utero-placental circulation. This is part of the stimulation for the baby to breathe, but the baby is receiving some circulatory volume. Jennifer Cameron FRCNA FACMPO Box 1465Howard Springs NT 083508 8983 19260419 528 717 - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 7:24 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. RegardsAnne ClarkeQueensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke__ NOD32 1.1289 (20051116) Information __This message was checked by NOD32 antivirus system.http://www.eset.com Internal Virus Database is out-of-date.Checked by AVG Anti-Virus.Version: 7.0.344 / Virus Database: 267.11.9/70 - Release Date: 29/09/2005
RE: [ozmidwifery] question - lodging complaints
I had a situation 2 days ago with a transferred homebirth. Mum had cholestasis, on arrival to home she was 6 cms and bub was breech. It was mums decision to transfer to hospital. On arrival she was bullied and reprimanded as she refused c/section (they had the theatre ready). Ended up having to sign a disclaimer that she would not sue OB if he facilitated vag breech birth and something went wrong. Baby's shoulders were born, OB jabbed her peri with local and had scissors poised for episiotomy. Father shouted PAUSE and said it has to be mums decision. OB muttered something about cranial haemorrhage and quickly CUT! Father absolutely furious, swore at OB while OB pulled so hard on baby's body to birth head. I've never witnessed anything so brutal, unnecessary and without consent before. Yet parents had signed that disclaimer before hand so I guess there's not much they can do. Any suggestions Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Robertson Sent: Friday, 18 November 2005 4:56 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] question - lodging complaints Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea At 10:29 AM 18/11/2005, you wrote: Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM -- How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told you are a good NURSE Sue, you care too much, that's the problem !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do too sigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania -- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Susan Cudlipp Sent: Thursday, 17 November 2005 3:33 PM
Re: [ozmidwifery] question
Title: Re: [ozmidwifery] question Your sense of frustration is palpable Justine. I totally agree with you butwhen youhave workedthat hard to get your qualifications, youhave a livelihood at stake,and you also have "the Bolam test" that you mentionedthe risks of non conformance or stepping outside the boundaries in a hospital system are too high for most. This conversation reminds me of my frustration with many women who don't want to breastfeed or if they do, they soon give up despite all the evidence suggesting that it is best. Sure there are reasons like sore nipples, "not enough milk", "bad advice" but many times it is just because they don't want to. That is when I think family pressures comes into it. Cultural expectations, peergroup and family pressures, financial pressures to return to work, unrealistic expectations about the personal commitment required to successfully breastfeed etc. Of course, none of these things were a problem to me but I can't place my own values/feelings on others. We all react differently and the wheel turns slowly. Helen Cahill - Original Message - From: Justine Caines To: OzMid List Sent: Friday, November 18, 2005 11:45 AM Subject: Re: [ozmidwifery] question Hi Mary and allI am responding to a few on this thread!Medical Boards seem to only be used in extreme cases as there is such a closed system of protectionism.One of our Premiers told me once he totally believed what I was saying in relation to a broken maternity system as he knew of the huge protection offered by the 4 walls of a hospital (well for Drs, not midwives!). But was he game enough to take it on? No way.The most tragic part is the lies women are told so they not only believe what happened was necessary but that the Dr saved them. I dont have an answer to that one.The other insidious fact is that even when families sue the new civil liability laws now require what is called the Bolam Test and this means if an Ob can determine what they did was custom and practice as evidenced by other practitioners (not proven by best practice evidence) then thats fine. So to me we are stuffed on that count. Few people know this.But yes caseload practice and a real scope of midwifery that determines a boundary that is not interferred with by medicos until a woman or babies condition is outside of it is the answer.What can midwives do? Say they want to work this way!!! UNITE. Despite all our hard work I see so many midwives clutching to the rostered fragmented way of work. I am sick of hearing family responsibilities as the reason. This is fear of change and a resistance to even try. I am sure that caseloading on a part-time basis (with good back-up which is essential) is MORE family friendly. And hey lobbying politicians and meeting the demands of journalists and travelling hundreds of Kms as a consumer advocate aint too family friendly!!We are on the cusp and I reckon we can advance or slide at the moment.Anyway I am going to shut up and try and have a baby or 2!Justine37 +5 __ NOD32 1.1290 (20051117) Information __This message was checked by NOD32 antivirus system.http://www.eset.com
RE: [ozmidwifery] question - lodging complaints
Hi Jo, I feel for this family and for you, because this is such a violent way to bring a child into the world. It would be fairly easy to prove that the release was signed under duress, on the grounds that care would be with-held if it was not signed. I have been in a situation where one of these documents was signed and the ob admitted that it would not mean much in court. The behaviour of the ob could be viewed as battery.However, the parents probably need some time to think about the implications of taking action for them personally both emotionally and financially. They will no doubt need some serious follow up to try to head off PTSD. I think consulting a professional such as a psychologist within this area would be essential (and encourage them to keep receipts).The hospital may have such a service. However, if litigation is likely it would be better to go private due to sharing of medical records. It may be that mediation is the least risky to the couple. The outcome might not be that anyone wins, but if people do take obs to mediation they are going to be inconvenienced and embarrassed, and may be less likely to behave in a way that would land them there again. I don't know what state you are in, but in Victoria there is a health commissioner where you can make a complaint and it is dealt with in a non adversorial manner. It might be worth making general enquiries to see what the options are, and to think about what sort of outcomes the family want. If they want to make the ob aware of the impact of his actions and perhaps get an apology, this may be appropriate. Kind regards, Nicole Carver. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of jo Sent: Saturday, November 19, 2005 12:19 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] question - lodging complaints I had a situation 2 days ago with a transferred homebirth. Mum had cholestasis, on arrival to home she was 6 cms and bub was breech. It was mums decision to transfer to hospital. On arrival she was bullied and reprimanded as she refused c/section (they had the theatre ready). Ended up having to sign a disclaimer that she would not sue OB if he facilitated vag breech birth and something went wrong. Baby's shoulders were born, OB jabbed her peri with local and had scissors poised for episiotomy. Father shouted PAUSE and said it has to be mums decision. OB muttered something about cranial haemorrhage and quickly CUT! Father absolutely furious, swore at OB while OB pulled so hard on baby's body to birth head. I've never witnessed anything so brutal, unnecessary and without consent before. Yet parents had signed that disclaimer before hand so I guess there's not much they can do. Any suggestions Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Robertson Sent: Friday, 18 November 2005 4:56 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] question - lodging complaints Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea At 10:29 AM 18/11/2005, you wrote: Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM -- How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told you are a good NURSE Sue, you care too much, that's the problem !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm
RE: [ozmidwifery] question
Jenny, could you give us the reference please? Thanks, MM , one study demonstrated zero oxygen, because there is no longer any utero-placental circulation. This is part of the stimulation for the baby to breathe, but the baby is receiving some circulatory volume. Jennifer Cameron FRCNA FACM
Re: [ozmidwifery] question - lodging complaints
It is good to hear that you were able to receive some personal satisfaction from the medication process at RHW. If every women (or at least, a whole lot more) wrote in with similar stores to yours, then they will not be able to keep saying the It has never happened before - there will be a file building up. It is easy to fob off one person with these kinds of excises, but then the numbers mount up, it is harder to ignore. Ask anyone that you know who suffered as you did to also write in, with cc copies to several different departments - the Head of Midwifery, Director of Nursing/Midwifery, Chairman of the Board, etc. It is also hard for them to file a letter or an issue of they know others have also received copies. Letter writing campaigns can have an impact... Best wishes, Andrea At 06:23 PM 18/11/2005, you wrote: Speaking as a consumer who has used the HSC, it was a useful process for my healing but it didn't achieve a single concrete gain for women at RWH at all. The hospy reps apologised constantly, said things like Oh that's NEVER happened before! and Yes, but Home Birthing Mothers like a lot more explanation than Hospital Birthing Mothers do and we're too understaffed to talk anyway! or my personal favourite, But it happens to everyone! as an excuse for why no one asked my permission for a heap of stuff done to my body. All I got was a letter summing up (poorly and showing an obviously naive belief that hospitals listen to consumers!) from the mediator who was a lovely woman. The meeting meant squat. I hope they have the capacity to do more when professionals complain because absolutely nothing came from my massive, and well evidenced complaint. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] question - lodging complaints
Hi Jo, Yes. Fill in an incident report and file it with the relevant people (plural) at the hospital. Send a copy to the Consumer Complaints Tribunal in your capital city. Send a copy of that letter to the Head of Midwifery, Head of Obstetrics, and Chairman of the Board at the Hospital. If you can get the father to write as well, so these same people, someone will have to take notice. None of this involves taking any kind of legal action and will not cost anything, other than time. The parents could also write a letter to the local newspaper, not naming anyone, but just stating that their wishes were not heeded, they were manhandled and abused (or whatever) and felt assaulted/attacked etc. Try to keep this letter unemotional (not easy!) and base it on facts - this is a freedom issue, one about human rights, dignity and respect. As well, the parents may need to de-brief and a counsellor may help - choose someone not associated with the hospital. If no-one speaks up about these incidents, then nothingn will happen and they will go on Best wishes, Andrea At 12:19 AM 19/11/2005, you wrote: I had a situation 2 days ago with a transferred homebirth. Mum had cholestasis, on arrival to home she was 6 cms and bub was breech. It was mums decision to transfer to hospital. On arrival she was bullied and reprimanded as she refused c/section (they had the theatre ready). Ended up having to sign a disclaimer that she would not sue OB if he facilitated vag breech birth and something went wrong. Baby's shoulders were born, OB jabbed her peri with local and had scissors poised for episiotomy. Father shouted PAUSE and said it has to be mums decision. OB muttered something about cranial haemorrhage and quickly CUT! Father absolutely furious, swore at OB while OB pulled so hard on baby's body to birth head. I've never witnessed anything so brutal, unnecessary and without consent before. Yet parents had signed that disclaimer before hand so I guess there's not much they can do. Any suggestions Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Robertson Sent: Friday, 18 November 2005 4:56 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] question - lodging complaints Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea At 10:29 AM 18/11/2005, you wrote: Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM -- How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told you are a good NURSE Sue, you care too much, that's the problem !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb My goodness me not wait for restitution, strikes me
Re: [ozmidwifery] question - lodging complaints
Hello Diane, Anyone can access the Consumer Health Complaints Commission. Send them a letter stating the facts and making it clear what was said and done. You could also write to the hospital itself, setting out similar facts. Make sure you send the letter to several people within the hospital. Your daughter can also write these letters. Best of luck! Andrea At 06:05 PM 18/11/2005, you wrote: After meeting with a friend of mine (head of theatre) she informed me that the OB that my daughter attended has a CS rate of 70 - 80% in her particular private hospital and induces almost all clients except those who beat him to it (like my daughter did), but I certainly witnessed the preparing for induction, you know the old story this is one very large baby and I won't let you pass your due date! My daughter birthed my grandson very gently and I wondered at the time why the midwife didn't call the OB. I now fully understand why. I don't think my grandson would have have the beautiful entry into the world if he had been present. By the way he weighed 6lb 14ozs! It has been so on my mind to write to someone. It was suggested to also cc it to Bronwyn Pike. I think this is such an assult on birth and feel if it is allowed to continue so many more women will feel the brunt of that assult. It is so sad that they are not informed of choices. My clients are astounded that they actually have choices! Andrea, is it appropriate to write to the Consumer Health Complaints Commission on this practice? Diane Gardner www.dianegardner.com.au - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, November 18, 2005 4:56 PM Subject: RE: [ozmidwifery] question - lodging complaints Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] question
. And then theres that tricky little stop at the hips that those water babies tend to do toosigh,´ Yes, what about that! I wonder why this happens? Very interesting Questions. MM
RE: [ozmidwifery] question
Title: Message We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Tania SmallwoodSent: Thursday, 17 November 2005 3:41 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] question My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do toosigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Susan CudlippSent: Thursday, 17 November 2005 3:33 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. RegardsAnne ClarkeQueensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which co
Re: [ozmidwifery] question
Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue >From what I remember being taught, the reason SD causes such a problem is because the chest is compressed, and the heart cannon function properly. I can't see the cord being a problem, as if the shoulder(s) are behind the symphysis pubis, then the cord would be further into the uterus, and therefore protected - unless there is a nuchal cord? Jo
Re: [ozmidwifery] question
Title: Message Among my search last night was some comments on this thread from the ob/gyn list archives. One stated that "restitution is called a 'cardinal' mechanism - therefore it is vital to wait for it" (can't find the actual thread just now) How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told " you are a good NURSE Sue, you care too much, that's the problem" !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: B G To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 7:06 PM Subject: RE: [ozmidwifery] question We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Tania SmallwoodSent: Thursday, 17 November 2005 3:41 PMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] question My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do too sigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Susan CudlippSent: Thursday, 17 November 2005 3:33 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue "The only thing necessary for the triumph
Re: [ozmidwifery] question
That makes sense also Jo - Thanks "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: JoFromOz To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 8:04 PM Subject: Re: [ozmidwifery] question Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue From what I remember being taught, the reason SD causes such a problem is because the chest is compressed, and the heart cannon function properly. I can't see the cord being a problem, as if the shoulder(s) are behind the symphysis pubis, then the cord would be further into the uterus, and therefore protected - unless there is a nuchal cord?Jo No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005
RE: [ozmidwifery] question
Title: Message Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told you are a good NURSE Sue, you care too much, that's the problem !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do toosigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Susan Cudlipp Sent: Thursday, 17 November 2005 3:33 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. Regards Anne Clarke Queensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I
RE: [ozmidwifery] question
Title: Message I had advicebut basically I was told that this not waiting for restitution is now a RANZCOG policy therefore midwife against OB practice.recently this OB just smiled at me and said 'this is where we disagree in the birth' as one of these mums is back for her second. A student midwife was asking him in ANCwhy he was suggesting a LSCS to which he said 'shoulder dystocia' to which I replied it was because of operator error by your inexperienced registrar rushing the birth, because I was there. So we cannot win against this SOTB. The only way is to bring in case loading let midwives do their bit and the Ob be there for the higher risk clients, hopefully there will still be midwives available to support those women. Probably experienced midwives who will be trapped into a lesser role with this move to Midwife Practitioner level of practice! There needs to be a fundamental review of managing births that is evidence based and without questions as active management of third stage is also now being rushed and fiddled with. The last 3 years I have never seen so many PPH's and shoulder dystocia's. We are now getting ACMI Guidelines on Referral and Consultation being reviewed by the Ob's because it isn't RANZCOG. Where are our Midwifery Leaders within management structures? Where are our academics supporting our practice in the clinical coalface. the other day I had a midwife say to me 'I feel I need to present my own CV to a midwifery student before they believe what I say'. Clinicians I have spoken to are feeling isolated and unsupported by both management and academics when they are trying to do the right things for clients in a changing environment. No wonder midwives are leaving or cutting down their hours! Frustration, think I will walk the beach now. Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary MurphySent: Friday, 18 November 2005 9:29 AMTo: ozmidwifery@acegraphics.com.auSubject: RE: [ozmidwifery] question Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told " you are a good NURSE Sue, you care too much, that's the problem" !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do toosigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in
Re: [ozmidwifery] question
I agree with you Andrea. I think many babies are literally strangled during true shoulder dystocias. As for cord ph - I can clearly remember a baby having a lovely normal cord ph following his death during a shoulder dystocia (). Provided me with yet more ammunition against the hospital's policy of routine cord gas analysis following all births. Rachel From: Andrea Quanchi [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Date: Thu, 17 Nov 2005 17:22:52 +1100 You only have to watch the colour change to the head to know whether circulation is compromised or not. Some ( most ) babies stay pink and or only slightly dusky but others go almost navy blue and even get subconjuntival haemorrhages similar to those that occur in hanging victims which to me indicates that circulation to the head has been compromised for at least some time. Babies can tolerate this for a period but eventually it must have an effect. Just from observation I would say this has little to do with cord compression but compression of the foetal neck by maternal structures which would occur more severely in true shoulder dystocia. Of course prevention is better than cure and encouraging 25% increase in space within the maternal pelvis is likely to reduce the number of cases where this will be a problem. Andrea Quanchi On 17/11/2005, at 4:02 PM, Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would think when the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to provide an estimation of oxygenation for the babe. Regards Anne Clarke Queensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for you wise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke __ NOD32 1.1289 (20051116) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005 _ MSN Messenger 7.5 is now out. Download it for FREE here. http://messenger.msn.co.uk -- This mailing list is sponsored
RE: [ozmidwifery] question
Rachel, i am preparing to do a talk to the midwives and possible obs at my hospital at the moment on early vs delayed cord clamping, and one of the main reasons they use to back up their routine practice of early cord clamping is the need for routine cord blood analysis after EVERY birth. do you know where i could get any info that might help back up the argument against this? i have lots of info on the benefits of delayed cord clamping but i know there will be lots of counter arguments... Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of wump fish Sent: Friday, 18 November 2005 11:49 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question I agree with you Andrea. I think many babies are literally strangled during true shoulder dystocias. As for cord ph - I can clearly remember a baby having a lovely normal cord ph following his death during a shoulder dystocia (). Provided me with yet more ammunition against the hospital's policy of routine cord gas analysis following all births. Rachel From: Andrea Quanchi [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Date: Thu, 17 Nov 2005 17:22:52 +1100 You only have to watch the colour change to the head to know whether circulation is compromised or not. Some ( most ) babies stay pink and or only slightly dusky but others go almost navy blue and even get subconjuntival haemorrhages similar to those that occur in hanging victims which to me indicates that circulation to the head has been compromised for at least some time. Babies can tolerate this for a period but eventually it must have an effect. Just from observation I would say this has little to do with cord compression but compression of the foetal neck by maternal structures which would occur more severely in true shoulder dystocia. Of course prevention is better than cure and encouraging 25% increase in space within the maternal pelvis is likely to reduce the number of cases where this will be a problem. Andrea Quanchi On 17/11/2005, at 4:02 PM, Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would think when the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to provide an estimation of oxygenation for the babe. Regards Anne Clarke Queensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for you wise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything
Re: [ozmidwifery] question
Remember the placenta is beginning to separate at
the point of the head being born so the baby is dying of hypoxia and acidosis.
ALSO are probably correct on not waiting for restitution. The signs of shoulder
dystocia are evident before the head is crowned and then the 'turtle' sign
appears and clinches the diagnosis so it is full steam ahead and get that baby
born. You could wait all day for restitution and end up with a dead baby.
Jenny
Jennifer Cameron FRCNA FACMPresident NT branch ACMIPO Box
1465Howard Springs NT 083508 8983 19260419 528 717
- Original Message -
From:
Susan
Cudlipp
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005 2:32
PM
Subject: Re: [ozmidwifery] question
Good point Anne!
I did quite a thorough search last night and have
printed off some good articles which I will pass on. However I could not
find the answer to why EXACTLY babies die in shoulder dystocia. If it is
asphyxia, then (obs point of view) this proves that the cord is not sustaining
them.The ob said to me that if the cord WERE sustaining them there would
be no urgency to deliver the body, also quoted from the ALSO course that the
fetal Ph drops 0.04 (?) per minute after delivery of head therefor we
should not be waiting for restitution but delivering body ASAP. (I
didn't even go there!!)
My feeling is that it is more to do with probable
cord compression, (although I cannot picture why this should necessarily be so
as the body and hence, presumably, the cord,would still be above the
pelvic brim) and trauma to the neck usually caused by mis-management (panic)
in trying to deliver the shoulders than asphyxia, but it is true that they
become asphyxiated within a short time if truly stuck. Any answers on
that one?
Thanks
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"Edmund Burke
- Original Message -
From:
Anne
Clarke
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005 5:54
AM
Subject: Re: [ozmidwifery]
question
Dear Susan,
You could say to them if this is so why do they
rely so much on cord ph's ? One would thinkwhen the baby was
born and the pulsating cord was still not supplying the baby effectively the
cord blood (venous and arterial) was null and void to providean
estimation of oxygenation for the babe.
RegardsAnne ClarkeQueensland
- Original Message -
From:
Susan
Cudlipp
To: midwifery list
Sent: Wednesday, November 16, 2005
9:30 PM
Subject: [ozmidwifery] question
I have a question for youwise
ozmidders.
I was having a discussion today with one of
our obstetricians regarding cord clamping, and the benefits to the baby of
delaying this until pulsations cease. When I mentioned the benefit
of the baby recieving oxygenated blood via the pulsating cord which could
assist it's transition to independent respiration particularly if it was
compromised (etc etc) the obs was of the view that the pulsations
could NOT be providing oxygenated blood because the uterus would have
contracted down and the placenta could no longer be getting oxygen from
mother's circulation.
Now I know that I have read reams on this and
this is stated to be one of the benefits, but I could not answer that
particular question physiologically and convincingly.
The point was also raised that in shoulder
dystocia, babies die of asphyxiation, which (obs opinion) would not happen
if they were recieving oxygen via the cord.
I did print off George Morley's excellent
papers for this Dr to read but would very much welcome anything that can
show that the baby would still be receiving oxygenated blood post
birth.
TIA
Sue
"The only thing necessary for the triumph of
evil is for good men to do nothing"Edmund
Burke__ NOD32 1.1289 (20051116) Information
__This message was checked by NOD32 antivirus
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No virus found in this incoming message.Checked by AVG Free
Edition.Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date:
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RE: [ozmidwifery] question
Hi Barb, How awful that they were able to bully you out of Birth Suite. You can always report this OB direct to the medical board who are then obliged to fully investigate; you can also discuss anonymity with them as you have been bullied for your efforts. Perhaps your union or the Nurses Board may give you some assistance here and shame on your colleagues for turning a blind eye to such obvious and intentional negligence. You go girl, as all of your observations are well supported in your documentation. Cheers, Kate
RE: [ozmidwifery] question
I cannot find any such RANZCOG policy (i.e. not waiting for restitution) on their website perhaps you could ask the OB to produce it for you to read for yourself??? Ill bet it wont be forthcoming. Kate
Re: [ozmidwifery] question
Dear Susan,
My understanding was with true shoulder dystocia
(which is a bony problem not a soft tissue problem) the outcome of the babe was
influenced by cord compression. This of course does vary depending on how
long the cord compression lasts. I believe also that the acidocsis
increases during the 2nd stage however well healthy babes a quite capable and
have adequate reservesin coping. I also think that after the babes
head is born there is a drop in ph (don't know the average rate though) as I
remember reading about it somwhere. Maybe someone else can enlighten
us.
However,well, full termbabies have a
remarkable store froma highhaemaglobinlevel that is saturated
with oxygen - unless there has been an assault that has not revealed
itself.
Breech's are the same -it is usuallydue
to cord compression, but they all seem to bounce back very quickly
(breech/shoulder dystocia) inmy experience unless there has been that
underlying problem that had notrevealed itself at any other
time.
I am sure that we all have a story that a baby was
born without any obvious problem during labour and second stage but is flat as a
tack when born and takes sometime to respond to resucitation. I remember
an intensive care nurse saying to methat there may have been an assault,
who knows days, weeks, months before and therefore this baby has been fine
during labour and 2nd stage but when they have to do it all by themselves after
birth they cannot cope, as the normal birth process has taken so much of their
'non' reserves due to a previous assault.
RegardsAnne ClarkeQueensland
- Original Message -
From:
Susan
Cudlipp
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005 3:02
PM
Subject: Re: [ozmidwifery] question
Good point Anne!
I did quite a thorough search last night and have
printed off some good articles which I will pass on. However I could not
find the answer to why EXACTLY babies die in shoulder dystocia. If it is
asphyxia, then (obs point of view) this proves that the cord is not sustaining
them.The ob said to me that if the cord WERE sustaining them there would
be no urgency to deliver the body, also quoted from the ALSO course that the
fetal Ph drops 0.04 (?) per minute after delivery of head therefor we
should not be waiting for restitution but delivering body ASAP. (I
didn't even go there!!)
My feeling is that it is more to do with probable
cord compression, (although I cannot picture why this should necessarily be so
as the body and hence, presumably, the cord,would still be above the
pelvic brim) and trauma to the neck usually caused by mis-management (panic)
in trying to deliver the shoulders than asphyxia, but it is true that they
become asphyxiated within a short time if truly stuck. Any answers on
that one?
Thanks
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"Edmund Burke
- Original Message -
From:
Anne
Clarke
To: ozmidwifery@acegraphics.com.au
Sent: Thursday, November 17, 2005 5:54
AM
Subject: Re: [ozmidwifery]
question
Dear Susan,
You could say to them if this is so why do they
rely so much on cord ph's ? One would thinkwhen the baby was
born and the pulsating cord was still not supplying the baby effectively the
cord blood (venous and arterial) was null and void to providean
estimation of oxygenation for the babe.
RegardsAnne ClarkeQueensland
- Original Message -
From:
Susan
Cudlipp
To: midwifery list
Sent: Wednesday, November 16, 2005
9:30 PM
Subject: [ozmidwifery] question
I have a question for youwise
ozmidders.
I was having a discussion today with one of
our obstetricians regarding cord clamping, and the benefits to the baby of
delaying this until pulsations cease. When I mentioned the benefit
of the baby recieving oxygenated blood via the pulsating cord which could
assist it's transition to independent respiration particularly if it was
compromised (etc etc) the obs was of the view that the pulsations
could NOT be providing oxygenated blood because the uterus would have
contracted down and the placenta could no longer be getting oxygen from
mother's circulation.
Now I know that I have read reams on this and
this is stated to be one of the benefits, but I could not answer that
particular question physiologically and convincingly.
The point was also raised that in shoulder
dystocia, babies die of asphyxiation, which (obs opinion) would not happen
if they were recieving oxygen via the cord.
I did print off George Morley's excellent
papers for this Dr to read but would very much welcome anything that can
RE: [ozmidwifery] question
Liz There is lots of research about cord gas analysis. Vast majority of it suggests it provides a good indication of how hypoxic a baby was at birth. Many hospitals use it to protect themselves against litigation. This is why the hospital I worked in had it as a policy - to reduce their insurance payments. So, you will be unlikely to argue that it is not an accurate measurement. BUT - you can argue that it does not protect against litigation. For example, a baby is born with apgars of 9 and at age 5 the parents decide that the childs learning disabilities are due to birth asphyxia. If the notes are dug out and the apgars are good and the birth was uncomplicated - they have no case. However, if there is a cord gas result indicating hypoxia = a different story. I have caught babies who have come out screaming and had bad cord gases and babies who required resus but had good gases. It is normal for a baby to get stressed. It depends on the individual baby as to how much hypoxia is too much. I dread to think what my sons cord gases were - 1 hour of pathological ctg, resus and grunting. But, he is fine. It is also an invasive procedure and parents should give consent for it. How many parents make an informed choice about this procedure? Bearing in mind that if we identify your baby was hypoxic we can't go back and change anything. I found that cord gas results became kind of 'practitioner test'. Some one else would put the blood through the computer and give you your exam results. If the result was poor - every one got to know and your practice was questioned. I gave up trying to argue the point in the end. In my own practice I would only take cord blood if I felt it was clinically indicated eg. complicated birth or baby requiring resus. The following article may help you: Routine cord blood gas analysis: an overreaction? - Practising Midwife , vol 7, no 10, November 2004, pp 20-23 Quek S - (2004) Good luck Rachel From: Elizabeth and Mark Bryant [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] question Date: Fri, 18 Nov 2005 12:31:43 +1100 Rachel, i am preparing to do a talk to the midwives and possible obs at my hospital at the moment on early vs delayed cord clamping, and one of the main reasons they use to back up their routine practice of early cord clamping is the need for routine cord blood analysis after EVERY birth. do you know where i could get any info that might help back up the argument against this? i have lots of info on the benefits of delayed cord clamping but i know there will be lots of counter arguments... Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of wump fish Sent: Friday, 18 November 2005 11:49 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question I agree with you Andrea. I think many babies are literally strangled during true shoulder dystocias. As for cord ph - I can clearly remember a baby having a lovely normal cord ph following his death during a shoulder dystocia (). Provided me with yet more ammunition against the hospital's policy of routine cord gas analysis following all births. Rachel From: Andrea Quanchi [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Date: Thu, 17 Nov 2005 17:22:52 +1100 You only have to watch the colour change to the head to know whether circulation is compromised or not. Some ( most ) babies stay pink and or only slightly dusky but others go almost navy blue and even get subconjuntival haemorrhages similar to those that occur in hanging victims which to me indicates that circulation to the head has been compromised for at least some time. Babies can tolerate this for a period but eventually it must have an effect. Just from observation I would say this has little to do with cord compression but compression of the foetal neck by maternal structures which would occur more severely in true shoulder dystocia. Of course prevention is better than cure and encouraging 25% increase in space within the maternal pelvis is likely to reduce the number of cases where this will be a problem. Andrea Quanchi On 17/11/2005, at 4:02 PM, Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more
RE: [ozmidwifery] question - lodging complaints
Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea At 10:29 AM 18/11/2005, you wrote: Is there anywhere midwives can go for help in situations like this? ACMI? ANF? Or Clinical advisory committees? M/W s are scrutinized so harshly when anything goes wrong . where is the scrutinizing mechanism for the doctors? Any one know? MM -- How crazy it is that they ignore this in the hurry to 'get the baby out' I get so discouraged by the lack of simple wisdom and respect for the natural process of labour. Barb, it is so true that we are unable to speak out when we see such terrible mis-management, those of us that do are indeed subjected to incredible bullying. During my recent confrontation over some issues I was told you are a good NURSE Sue, you care too much, that's the problem !!! WE may avoid the bullying by not working in the area, but the women are still being bullied and babies still being damaged. We have an OB who does not wait for restitution, instead is now training the Registrars before even looking at the way the head has come out to pull downward on the head, put their hand beside the head in the vagina and sweep the anterior arm forward. I have seen a run of 4 # humerus and/or clavicles. I have made efforts to address this at staff meetings because I have been documenting what I see and specifically stating 'not shoulder dystocia' in the notes. The result from this and for commenting on the second twin we lost from the same SOTB OB was that I have experienced the most incredible medical bullying/harassment. I now do not work in Birth Suite and thankfully the bullying has stopped. This is due to the Morris/Davies Royal commission and Forster review. I had my private say on bullying. However why can't I get other midwives to stand up for what they see and the damage that is done? Barb My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do too sigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania -- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Susan Cudlipp Sent: Thursday, 17 November 2005 3:33 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing
Re: [ozmidwifery] question - lodging complaints
After meeting with a friend of mine (head of theatre) she informed me that the OB that my daughter attended has a CS rate of 70 - 80% in her particular private hospital and induces almost all clients except those who beat him to it (like my daughter did), but I certainly witnessed the preparing for induction, you know the old story this is one very large baby and I won't let you pass your due date! My daughter birthed my grandson very gently and I wondered at the time why the midwife didn't call the OB. I now fully understand why. I don't think my grandson would have have the beautiful entry into the world if he had been present. By the way he weighed 6lb 14ozs! It has been so on my mind to write to someone. It was suggested to also cc it to Bronwyn Pike. I think this is such an assult on birth and feel if it is allowed to continue so many more women will feel the brunt of that assult. It is so sad that they are not informed of choices. My clients are astounded that they actually have choices! Andrea, is it appropriate to write to the Consumer Health Complaints Commission on this practice? Diane Gardner www.dianegardner.com.au - Original Message - From: Andrea Robertson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, November 18, 2005 4:56 PM Subject: RE: [ozmidwifery] question - lodging complaints Every State has a Consumer Health Complaints Commission. Anyone can use this service, not just consumers. Midwives can lodge details of shoddy or dangerous practise, quite anonymously, and if there are enough complaints, then the Commission is obliged to investigate. If an incident report was written each time one of these situations occurred, then a quiet word in the ear of the risk management team at the hospital should surely trigger some action, especially if they are concerned about the possibility of later litigation. Perhaps the parents should be alerted as well, perhaps in the de-brief after the birth or soon after they get home. They might then ask some questions of the hospital, which would require them to review the notes. These situations and practitioners are terrible and we must find a way of stopping them Andrea -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question - lodging complaints
Speaking as a consumer who has used the HSC, it was a useful process for my healing but it didn't achieve a single concrete gain for women at RWH at all. The hospy reps apologised constantly, said things like Oh that's NEVER happened before! and Yes, but Home Birthing Mothers like a lot more explanation than Hospital Birthing Mothers do and we're too understaffed to talk anyway! or my personal favourite, But it happens to everyone! as an excuse for why no one asked my permission for a heap of stuff done to my body. All I got was a letter summing up (poorly and showing an obviously naive belief that hospitals listen to consumers!) from the mediator who was a lovely woman. The meeting meant squat. I hope they have the capacity to do more when professionals complain because absolutely nothing came from my massive, and well evidenced complaint. J -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] question
I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke
Re: [ozmidwifery] question
Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. RegardsAnne ClarkeQueensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke__ NOD32 1.1289 (20051116) Information __This message was checked by NOD32 antivirus system.http://www.eset.com
Re: [ozmidwifery] question
Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. RegardsAnne ClarkeQueensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue "The only thing necessary for the triumph of evil is for good men to do nothing"Edmund Burke__ NOD32 1.1289 (20051116) Information __This message was checked by NOD32 antivirus system.http://www.eset.com No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005
RE: [ozmidwifery] question
My goodness me not wait for restitution, strikes me as someone trying to redefine the mechanism of normal birth to suit their own fears and prejudices - Wow! So if in fact a baby needs to restitute to birth the shoulders comfortably and in the best position, and were going to cut that part of the birth out, are we not going to see a marked increase in the incidence of shoulder dystocia? Might be one to look out for with these hasty practitioners. I can only imagine how they would cope at the majority of water births Ive been at, where the head is fully crowned, and its usually a matter of minutes, sometimes up to 5 or 6 before the body follows. And then theres that tricky little stop at the hips that those water babies tend to do toosigh, why is there so much fear and ignorance surrounding what has been happening for so many years? Is it just an insane need to control everything, or am I just naïve in my belief that mother nature knows what shes doing? Tania From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Susan Cudlipp Sent: Thursday, 17 November 2005 3:33 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them.The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord,would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would thinkwhen the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to providean estimation of oxygenation for the babe. Regards Anne Clarke Queensland - Original Message - From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for youwise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke __ NOD32 1.1289 (20051116) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005
Re: [ozmidwifery] question
You only have to watch the colour change to the head to know whether circulation is compromised or not. Some ( most ) babies stay pink and or only slightly dusky but others go almost navy blue and even get subconjuntival haemorrhages similar to those that occur in hanging victims which to me indicates that circulation to the head has been compromised for at least some time. Babies can tolerate this for a period but eventually it must have an effect. Just from observation I would say this has little to do with cord compression but compression of the foetal neck by maternal structures which would occur more severely in true shoulder dystocia. Of course prevention is better than cure and encouraging 25% increase in space within the maternal pelvis is likely to reduce the number of cases where this will be a problem. Andrea Quanchi On 17/11/2005, at 4:02 PM, Susan Cudlipp wrote: Good point Anne! I did quite a thorough search last night and have printed off some good articles which I will pass on. However I could not find the answer to why EXACTLY babies die in shoulder dystocia. If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?) per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP. (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck. Any answers on that one? Thanks Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke x-tad-bigger- Original Message -/x-tad-bigger x-tad-biggerFrom:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-biggerAnne Clarke/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerTo:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-biggerozmidwifery@acegraphics.com.au/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerSent:/x-tad-biggerx-tad-bigger Thursday, November 17, 2005 5:54 AM/x-tad-bigger x-tad-biggerSubject:/x-tad-biggerx-tad-bigger Re: [ozmidwifery] question/x-tad-bigger Dear Susan, You could say to them if this is so why do they rely so much on cord ph's ? One would think when the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to provide an estimation of oxygenation for the babe. Regards Anne Clarke Queensland x-tad-bigger- Original Message -/x-tad-bigger x-tad-biggerFrom:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-biggerSusan Cudlipp/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerTo:/x-tad-biggerx-tad-bigger /x-tad-biggerx-tad-biggermidwifery list/x-tad-biggerx-tad-bigger /x-tad-bigger x-tad-biggerSent:/x-tad-biggerx-tad-bigger Wednesday, November 16, 2005 9:30 PM/x-tad-bigger x-tad-biggerSubject:/x-tad-biggerx-tad-bigger [ozmidwifery] question/x-tad-bigger I have a question for you wise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease. When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc) the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord. I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth. TIA Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke __ NOD32 1.1289 (20051116) Information __ This message was checked by NOD32 antivirus system. http://www.eset.com No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005
RE: [ozmidwifery] question from Year 10 student
The fluid and equal pressure theory and the fetal circulatory system which is different to ours both sound logical to me. Other ideas occurred to me as well - if you look at the size of baby's head in comparison to the body, the proportion is so different than it is in an adult, all that extra blood which rushes to baby's head in theory is nowhere near extra blood which rushes to adult's head (in proportion). Also, even as an adult (who practises yoga for example :) ), you can do a headstand and stay in the position for a long time without problems. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrea Quanchi Sent: Tuesday, November 08, 2005 5:57 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] question from Year 10 student I have searched through Maternal, Fetal and Neonatal Physiology (Blackburn Loper) and cant find anything helpful Andrea Q On 08/11/2005, at 9:54 AM, wump fish wrote: This made me laugh. It is just the kind of question my son (year 9) would come up with. I haven't even thought about it! I would go with the fluid and equal pressure theory. Being upside down in water at an adult (try it) does not result in the same pressure as being upside down outside water. However, if we go with this theory - what happens when women rupture their membranes. We know it has a variety of effects on labour and the baby. But, does it also make it less comfortable for baby due to being upside down? Just thinking aloud. I would love someone to find some evidence on this. Rachel From: Bowman Family [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] question from Year 10 student Date: Mon, 7 Nov 2005 20:10:21 +1100 I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of the boys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and said I would get back to him. It possibly is obvious but I have asked a few peers and no-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda _ The new MSN Search Toolbar now includes Desktop search! http://toolbar.msn.co.uk/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] question from Year 10 student
I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of theboys asked "how come the blood doesn't rush to the baby's head like it does for us if we are upside down" I didn't know the correct answer and saidI would get back to him. It possibly is obvious but I have asked a few peers andno-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda
RE: [ozmidwifery] question from Year 10 student
I am sure someone more knowledgeable will have the precise answer, but it has t do with the fact that the uterus is a fluid filled vacuum with pressures equal all throughout. Therefore there is no up or down like in the atmosphere. Is that right? MM. From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Bowman Family Sent: Monday, 7 November 2005 5:10 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] question from Year 10 student I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of theboys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and saidI would get back to him. It possibly is obvious but I have asked a few peers andno-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda
Re: [ozmidwifery] question from Year 10 student
Mary Murphy wrote: I am sure someone more knowledgeable will have the precise answer, but it has t do with the fact that the uterus is a fluid filled vacuum with pressures equal all throughout. Therefore there is no up or down like in the atmosphere. Is that right? MM. Sounds good, but surely the law of gravity still exists in utero? Maybe it has something to do with pressure in vessels, or the fact that the brain needs more blood to it - but then what about breech presentation... That *is* a tough question! :) MM you have my text books, you look it up! ;) Jo
Re: [ozmidwifery] question from Year 10 student
Perhaps the pressure exerted on the baby's headby the contracting uterus aids venous return andkeeps the blood from pooling in the brain? Regards Fiona Rumble - Original Message - From: Bowman Family To: ozmidwifery@acegraphics.com.au Sent: Monday, November 07, 2005 7:10 PM Subject: [ozmidwifery] question from Year 10 student I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of theboys asked "how come the blood doesn't rush to the baby's head like it does for us if we are upside down" I didn't know the correct answer and saidI would get back to him. It possibly is obvious but I have asked a few peers andno-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda
Re: [ozmidwifery] question from Year 10 student
I would take a punt at the even pressure of the fluid filled uterus along with the baby's blood pressure adjusting naturally to that position. Cheers Judy --- Bowman Family [EMAIL PROTECTED] wrote: I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of the boys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and said I would get back to him. It possibly is obvious but I have asked a few peers and no-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda Do you Yahoo!? Find a local business fast with Yahoo! Local Search http://au.local.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] question from Year 10 student
This made me laugh. It is just the kind of question my son (year 9) would come up with. I haven't even thought about it! I would go with the fluid and equal pressure theory. Being upside down in water at an adult (try it) does not result in the same pressure as being upside down outside water. However, if we go with this theory - what happens when women rupture their membranes. We know it has a variety of effects on labour and the baby. But, does it also make it less comfortable for baby due to being upside down? Just thinking aloud. I would love someone to find some evidence on this. Rachel From: Bowman Family [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] question from Year 10 student Date: Mon, 7 Nov 2005 20:10:21 +1100 I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of the boys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and said I would get back to him. It possibly is obvious but I have asked a few peers and no-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda _ The new MSN Search Toolbar now includes Desktop search! http://toolbar.msn.co.uk/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question from Year 10 student
how about the fact that fetal circulatory system very different to mature (ie born already) system? fetal haemoglobin also very different? but yeah, I go with the 'upside down in water' theory! jennifairy wump fish wrote: This made me laugh. It is just the kind of question my son (year 9) would come up with. I haven't even thought about it! I would go with the fluid and equal pressure theory. Being upside down in water at an adult (try it) does not result in the same pressure as being upside down outside water. However, if we go with this theory - what happens when women rupture their membranes. We know it has a variety of effects on labour and the baby. But, does it also make it less comfortable for baby due to being upside down? Just thinking aloud. I would love someone to find some evidence on this. Rachel From: Bowman Family [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] question from Year 10 student Date: Mon, 7 Nov 2005 20:10:21 +1100 I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of the boys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and said I would get back to him. It possibly is obvious but I have asked a few peers and no-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda _ The new MSN Search Toolbar now includes Desktop search! http://toolbar.msn.co.uk/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question from Year 10 student
I have searched through Maternal, Fetal and Neonatal Physiology (Blackburn Loper) and cant find anything helpful Andrea Q On 08/11/2005, at 9:54 AM, wump fish wrote: This made me laugh. It is just the kind of question my son (year 9) would come up with. I haven't even thought about it! I would go with the fluid and equal pressure theory. Being upside down in water at an adult (try it) does not result in the same pressure as being upside down outside water. However, if we go with this theory - what happens when women rupture their membranes. We know it has a variety of effects on labour and the baby. But, does it also make it less comfortable for baby due to being upside down? Just thinking aloud. I would love someone to find some evidence on this. Rachel From: Bowman Family [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] question from Year 10 student Date: Mon, 7 Nov 2005 20:10:21 +1100 I am involved in the CoreOf Life Program for Year 10 students. It is a fun and interactive program run over a double period and is about the journey through pregnancy, labour birth and parenting. Last week when I was demonstrating positioning with doll pelvis one of the boys asked how come the blood doesn't rush to the baby's head like it does for us if we are upside down I didn't know the correct answer and said I would get back to him. It possibly is obvious but I have asked a few peers and no-one is definite they have the correct answer. I thought I would throw it open to OzMidwifery for discussion. Linda _ The new MSN Search Toolbar now includes Desktop search! http://toolbar.msn.co.uk/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question....
Thank You Philippa, I have passed on your details to Natalie! She is in Sunnybank, QLD. -Original Message- From: Philippa Scott [mailto:[EMAIL PROTECTED] Sent: Friday, 7 October 2005 5:38 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question I dont know if this is what she is looking for but if she wants to talk be phone I am open to that. I had a VBAC 10mths ago and support women with it. I also have talked to a bunch of women about what they are looking for in their VBAC and what that means. Anyway I guess I am trying to say I have been there have been there with other women too. My numbers are 0747734075 and 0407648349. My personal choices however are not relevant to her situation, so you may choose what you tell her, she may only need to know that I had a c/s first time. Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 4:48 PM Subject: RE: [ozmidwifery] Question She would be really interested in both types but I think she would really benefit from speaking with other women who have gone through the same experience She is due to give birth in a few weeks and she is 'scared' her body will not cope with a VBAC and she is also worried her Dr will not give her a 'good' chance to give birth although she is supportive of a VBAC but Dr has also hinted it may be 'safer' to go for a repeat C section... :( Thanks for the web link and I will give her this site and any other info I come across.. Thanks, Carol. -Original Message- From: Philippa Scott [mailto:[EMAIL PROTECTED] Sent: Friday, 7 October 2005 4:17 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question Where in Queensland? Does she want face to face or a email group like the one www.birthrites.org has? Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 3:20 PM Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question....
Thanks Lynne, I have also passed on your message to Natalie -Original Message- From: Lynne Staff [mailto:[EMAIL PROTECTED] Sent: Saturday, 8 October 2005 8:56 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question We have a VBAC education session on at Selangor next weekend (Sat 9-12.30) and I have 8 couples planning a VBAC booked in. If she is intersted, she could call me there on 07 5450 4359 Cheers, Lynne - Original Message - From: Philippa Scott [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 4:16 PM Subject: Re: [ozmidwifery] Question Where in Queensland? Does she want face to face or a email group like the one www.birthrites.org has? Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 3:20 PM Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question....
Where in Queensland? Does she want face to face or a email group like the one www.birthrites.org has? Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 3:20 PM Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question....
If she has access to email, there are a few good email lists run by/for VBAC women. She hasn’t given herself much time to address the issues surrounding vbacs though...37 weeks is leaving it a bit late to work through issues. Her best bet is to get a doula or a midwife who will help her get over the hurdles/issues from the last birth which WILL surface during the labour of this one. If she was an induced woman resulting in an emerg cs the refrase the term to a failed induction rather than a failure to progress...let her have the chance to let go of 'responsibility' for 'failing' by phrasing things differently. Keep referring to the last birth as a caesarean birth not caesarean section (HATE THE TERM!!!) reassure her that each birth paves the way for the next and her bosy will know what to do this time if she is supported and has the chance to gain trust in herself. Reading vbac birth stories can be good -or bad depending on how emotionally vulnerable she is. AS she has no time to really work threw things at this point in her pregnancy, information on normal birth and positive reinforcments are the best thing to do... www.cares-sa.org.au www.birthrites.org www.vbac.com There are lots of sites dedicated to vbac. Cheers Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carolina.Sequeida Sent: Friday, October 07, 2005 2:50 PM To: 'ozmidwifery@acegraphics.com.au' Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.11.13/123 - Release Date: 10/6/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.11.13/123 - Release Date: 10/6/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question....
She would be really interested in both types but I think she would really benefit from speaking with other women who have gone through the same experience She is due to give birth in a few weeks and she is 'scared' her body will not cope with a VBAC and she is also worried her Dr will not give her a 'good' chance to give birth although she is supportive of a VBAC but Dr has also hinted it may be 'safer' to go for a repeat C section... :( Thanks for the web link and I will give her this site and any other info I come across.. Thanks, Carol. -Original Message- From: Philippa Scott [mailto:[EMAIL PROTECTED] Sent: Friday, 7 October 2005 4:17 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question Where in Queensland? Does she want face to face or a email group like the one www.birthrites.org has? Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 3:20 PM Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question....
These are great links, thanks for your help! -Original Message- From: Dean Jo [mailto:[EMAIL PROTECTED] Sent: Friday, 7 October 2005 4:42 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Question If she has access to email, there are a few good email lists run by/for VBAC women. She hasn’t given herself much time to address the issues surrounding vbacs though...37 weeks is leaving it a bit late to work through issues. Her best bet is to get a doula or a midwife who will help her get over the hurdles/issues from the last birth which WILL surface during the labour of this one. If she was an induced woman resulting in an emerg cs the refrase the term to a failed induction rather than a failure to progress...let her have the chance to let go of 'responsibility' for 'failing' by phrasing things differently. Keep referring to the last birth as a caesarean birth not caesarean section (HATE THE TERM!!!) reassure her that each birth paves the way for the next and her bosy will know what to do this time if she is supported and has the chance to gain trust in herself. Reading vbac birth stories can be good -or bad depending on how emotionally vulnerable she is. AS she has no time to really work threw things at this point in her pregnancy, information on normal birth and positive reinforcments are the best thing to do... www.cares-sa.org.au www.birthrites.org www.vbac.com There are lots of sites dedicated to vbac. Cheers Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carolina.Sequeida Sent: Friday, October 07, 2005 2:50 PM To: 'ozmidwifery@acegraphics.com.au' Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.11.13/123 - Release Date: 10/6/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.11.13/123 - Release Date: 10/6/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question....
I dont know if this is what she is looking for but if she wants to talk be phone I am open to that. I had a VBAC 10mths ago and support women with it. I also have talked to a bunch of women about what they are looking for in their VBAC and what that means. Anyway I guess I am trying to say I have been there have been there with other women too. My numbers are 0747734075 and 0407648349. My personal choices however are not relevant to her situation, so you may choose what you tell her, she may only need to know that I had a c/s first time. Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 4:48 PM Subject: RE: [ozmidwifery] Question She would be really interested in both types but I think she would really benefit from speaking with other women who have gone through the same experience She is due to give birth in a few weeks and she is 'scared' her body will not cope with a VBAC and she is also worried her Dr will not give her a 'good' chance to give birth although she is supportive of a VBAC but Dr has also hinted it may be 'safer' to go for a repeat C section... :( Thanks for the web link and I will give her this site and any other info I come across.. Thanks, Carol. -Original Message- From: Philippa Scott [mailto:[EMAIL PROTECTED] Sent: Friday, 7 October 2005 4:17 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question Where in Queensland? Does she want face to face or a email group like the one www.birthrites.org has? Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville - Original Message - From: Carolina.Sequeida [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Friday, October 07, 2005 3:20 PM Subject: [ozmidwifery] Question Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Question....
Hello, I would like to ask you all a question, a lady who is currently 37 weeks pregnant and lives in QLD would like to try for a VBAC I am looking for any information as she would really benefit from a support group as she mentioned to me that she felt like she had failed because she had an emerg c/section with her first baby. Any information will be greatly appreciated! Thanks, Carol. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question
Sonja, I answered this question a few posts ago. I'll cut and paste it again for you .. In the two places I have worked over here: First = I could suture once the drs deemed me competent. It was private, so fair enough but I will not be assessed by a dr. Second is a public hospital and I have been told that currently I am not allowed to suture. They are waiting for the head obstrician to agree to midwives suturing. Then I will be required to complete a learning pack and pass competencies (the jr drs do not have to do this and have far less experience of suturing than me). Anyhow, I have said that I will suture if the women wants me to, and will suffer the consequences. However I am on the postnatal/antenatal ward for the forseeable future so can't test the system ; ) Rachel From: Sonja [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question Date: Wed, 21 Sep 2005 21:09:46 +1000 what do you mean you are not allowed to suture in Australia, or do you mean within the hospital you work? Sonja - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 21, 2005 10:09 AM Subject: RE: [ozmidwifery] Question I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ The new MSN Search Toolbar now includes Desktop search! http://toolbar.msn.co.uk/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question
Why aren't you allowed to suture Rachel ? BM - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 21, 2005 10:09 AM Subject: RE: [ozmidwifery] Question I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question
In the two places I have worked over here: First = I could suture once the drs deemed me competent. It was private, so fair enough but I will not be assessed by a dr. Second is a public hospital and I have been told that currently I am not allowed to suture. They are waiting for the head obstrician to agree to midwives suturing. Then I will be required to complete a learning pack and pass competencies (the jr drs do not have to do this and have far less experience of suturing than me). Anyhow, I have said that I will suture if the women wants me to, and will suffer the consequences. However I am on the postnatal/antenatal ward for the forseeable future so can't test the system ; ) Rachel From: brendamanning [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Question Date: Wed, 21 Sep 2005 16:31:52 +1000 Why aren't you allowed to suture Rachel ? BM - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 21, 2005 10:09 AM Subject: RE: [ozmidwifery] Question I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question
Surely, that would be obvious that any midwife would only suture tears that are within her ability to do so whether they be whatever degree. of course the dr. suturing it would have many years of experience before he would attempt to suture a serious tear(tongue in cheek) Travelling to hospital after birthing at home no more increases the chance of infection than any injured person traveling to hospital for care they need and most women birthing at home think that the benefits of labouring and birthing at home outweigh the risks? and inconvenience of making the journey. Andrea Q On 21/09/2005, at 7:59 AM, Philippa Scott wrote: This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville
Re: [ozmidwifery] Question
what do you mean you are not allowed to suture in Australia, or do you mean within the hospital you work? Sonja - Original Message - From: wump fish [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, September 21, 2005 10:09 AM Subject: RE: [ozmidwifery] Question I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Question
This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth?Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems?I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa ScottDoulaBirth BuddiesSupporting Women ~ Creating LifePresident - Friends of the Birth Centre Townsville
Re: [ozmidwifery] Question
The only experience I have had of this is as the admitting midwife when a woman came in from a home birth with a 4th degree tear. She fed babe while waiting for OR, had the repair and went home again when she had recovered from the anaesthetic. As I saw her around town many times later I found that she had no problems with it. Cheers Judy --- Philippa Scott [EMAIL PROTECTED] wrote: This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville Do you Yahoo!? Find a local business fast with Yahoo! Local Search http://au.local.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question
I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question
Mrs. Lynne Slater, Lecturer RW 2-39, Richardson Wing School of Nursing and Midwifery, Faculty of Health University of Newcastle Callaghan 2308 Phone 02 49217707 Fax 02 49216301 Mobile 0408 882554 The information contained in this message and any annexures is confidential and intended only for the named recipient(s). If you have received this message in error, you are prohibited from reading, copying, distributing and using the information. If you have received this message in error, please contact the sender immediately by return email and destroy the original message. [EMAIL PROTECTED] 21/09/05 10:09:55 I wouldn't suture a 3rd or 4th degree tear at all - at home or in hospital for a number of reasons. A 3rd+ degree is not within my expertise and can lead to long term complications if not done properly. I would rather it was done by someone with expertise and experience in a well lit theatre. Also you would need really good analgesia (ie. a spinal block) to effectively suture without causing agony. There is no reason that partner and baby can't be in theatre with the woman during the suturing, and she can have skin to skin and breastfeed. Our hospital guidelines in the UK were that all 2nd degree tears should be sutured. This was based on the fact that there was no evidence to support not suturing, and that you would suture an arm or leg injury if it involved muscle. I have a few problems accepting this standpoint (too long to go into). In practice I leave it up to the woman do decide. I explain the guidelines and the theory behind them. Give her an explanation about her tear (and show her with a mirror if she wants). Explain any concerns I have - if a vessel is bleeding, or tissues are poorly aligned. Then ask her what she wants me to do. It was quite interesting to follow up these women in the community. Some who declined suturing (who I thought probably needed it) healed really well. A colleague had a woman who did not want to be sutured following an epis - her perineum healed perfectly. I caught her second baby at home and I would never have guessed she had had a previous epis (intact this time). My best friend declined my suturing at her homebirth even though she described her perineum as an exploded mattress (5th baby and bad tears + stitches with all). A year on and she still raves about how much better healed and less painful her perineum was unsutured. So, I guess what I am saying is that perhaps we suture too much. Perhaps the perineum is designed to tear and heal. Anyhow, I am not 'allowed' to suture here in Australia, so I will probably lose the skill anyway. Rachel From: Philippa Scott [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question Date: Wed, 21 Sep 2005 07:59:02 +1000 This question/assumption was put forward on another list I wondered whether you wonderful women would be able to answer it for me as I have no idea really. What happens if the mother sustains a 3rd or 4th degree tear at a homebirth? Do they then have to travel to a hospital to get it all repaired? Surely this would increase the possibility of infections and post birth problems? I know there is NO WAY a midwife could stitch up that serious a tear so was just curious about what would happen in that situation (if anyone knows??) Cheers Philippa Scott Doula Birth Buddies Supporting Women ~ Creating Life President - Friends of the Birth Centre Townsville _ Be the first to hear what's new at MSN - sign up to our free newsletters! http://www.msn.co.uk/newsletters -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question
Hi everyone Was there n article coming up on Insight on SBS, on Homebirth I am sure I got it off this list that it would be on, but tuned in tonight and no homebirth story..any one able to shed any light on the subject.. Thanks Katrina -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] question
Title: Message Could anyone resend that information about not being able to conceive in relation to D C's. I deleted it and then my husband deleted everything in the deleted folder! Thanks in advance Sylvia Boutsalis Childbirth Educator Infant Massage Instructor Adelaide
Re: [ozmidwifery] Question about engagement
Hi Jo It's really important that the fetal head does not enter the cavity of the pelvis too early, otherwise the bladder would be unable to fill and the rectum unable to hold onto the required amount of faecies. The connective tissues around the pelvic floor muscles do not soften until the last few weeks of pregnancy to allow the head to engage. It is important that this happens at the same time that the symphysial and sacro- iliac joints of the pelvis soften to allow the pelvic girdle to expand. If all this softening occurred earlier in the pregnancy the growing uterus would be bulging downwards into the pelvis with great discomfort to the mother, and probably a cervical prolapse to boot. Not what a woman wants during what should be the happiest time of her life. The kicks in the diaphragm alerts the mother to the necessity of sitting upright with a good posture so that the lungs can expand for maximal oxygenation all these physiological events are planned to occur at just the right time to meet the mother's and baby's changing needs. Just short of miraculous isn't it ? and we take it all for granted. Good luck with your studies Jan Jan Robinson Independent Midwife Practitioner National Coordinator Australian Society of Independent Midwives 8 Robin Crescent South Hurstville NSW 2221 Phone/Fax: 02 9546 4350 e-mail address: [EMAIL PROTECTED]> website: www.midwiferyeducation.com.au On 24 Mar, 2005, at 22:05, Julie Clarke wrote: Hi Jo I always have a little hopeful thought when I hear of a midwife who is pregnant that she will give herself a wholesome opportunity to intuitively experience her pregnancy - her growing belly, changing body and boobs, enjoy the swirls and kicks of her growing baby and cherish the secrets of pregnancy like the feeling of communicating with her baby and knowing things that you can't put into words or explain to someone else. It is such a beautiful opportunity to gain insights and understanding that no Maggie Myles textbook can convey. I hope you get the chance to read some of the wonderful classics Sheila Kitzinger's books, Janet Balaskas Active Birth, Claudia Panuthos Transformation through Birth, Ina May Gaskin Spiritual Midwifery, None of them are nurses or midwives all of them are women who are mothers. There is something unique about each of their books detailing their work and understanding. I think there can be lots of reasons why babies engage or don't engage. On one level we can discuss the mechanics of it all can't we? Such as the baby's head being the heaviest part and so gravity will encourage it downwards, or when the baby starts to be a bigger size it will naturally try to fit more comfortably between mum's ribs and pelvis. Or it could be that the baby begins to come to some realization that it will have to commence working on it's exit and begins to strategise on the most suitable way out. Perhaps it's the increasing Braxton hicks (practicing) contractions of the uterus that are letting the baby know that soon it will be born and with that gentle warning the baby begins to prepare more seriously for it's role in the birth and recognizes that becoming engaged into the pelvis is a clever little thing to do. I think there is quite a bit of quiet unrecognized communication between the woman and the baby. Childbirth Without Fear by Read and Ideal Birth by Sondra Ray and Birth Without Violence by Frederick Leboyer are more fascinating books to seek out too. Jo, I wish for you a wonderful journey through your pregnancy, labour, birth and loving your little one. Embrace the experience. Warm hug Julie Julie Clarke CBE Independent Childbirth and Parenting Educator HypnoBirthing (R) Practitioner ACE Grad Dip Supervisor NACE Advanced Educator and Trainer NACE National Journal Editor Transition into Parenthood Sessions 9 Withybrook Place Sylvania NSW 2224 Telephone 9544 6441 Mobile: 0401 2655 30 email: [EMAIL PROTECTED] visit Julie's website: www.transitionintoparenthood.com.au -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of JoFromOz Sent: Thursday, 24 March 2005 8:09 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question about engagement ... no, not the romantic kind... We were discussing pregnancy on night duty last night (as you do when you are a Midwife, and pregnant!), and I was wondering if anyone knew why babies don't 'engage' earlier than they do? I mean, at 32 weeks, my baby's head is pretty small, so why wouldn't gravity allow the head to go deep into my pelvis, instead of having a butt and legs right up under my rib cage already? One suggestion was that it is because the foetus floats, but I don't see why... None of us really had any ideas - do any of you? Ta :) Jo (RM) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visi
Re: [ozmidwifery] Question about engagement
Thanks, Jan - that makes a lot of sense. I trust that my body knows what it's doing ;) Jo (RM) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Question about engagement
Hi Jo I always have a little hopeful thought when I hear of a midwife who is pregnant that she will give herself a wholesome opportunity to intuitively experience her pregnancy - her growing belly, changing body and boobs, enjoy the swirls and kicks of her growing baby and cherish the secrets of pregnancy like the feeling of communicating with her baby and knowing things that you can't put into words or explain to someone else. It is such a beautiful opportunity to gain insights and understanding that no Maggie Myles textbook can convey. I hope you get the chance to read some of the wonderful classics Sheila Kitzinger's books, Janet Balaskas Active Birth, Claudia Panuthos Transformation through Birth, Ina May Gaskin Spiritual Midwifery, None of them are nurses or midwives all of them are women who are mothers. There is something unique about each of their books detailing their work and understanding. I think there can be lots of reasons why babies engage or don't engage. On one level we can discuss the mechanics of it all can't we? Such as the baby's head being the heaviest part and so gravity will encourage it downwards, or when the baby starts to be a bigger size it will naturally try to fit more comfortably between mum's ribs and pelvis. Or it could be that the baby begins to come to some realization that it will have to commence working on it's exit and begins to strategise on the most suitable way out. Perhaps it's the increasing Braxton hicks (practicing) contractions of the uterus that are letting the baby know that soon it will be born and with that gentle warning the baby begins to prepare more seriously for it's role in the birth and recognizes that becoming engaged into the pelvis is a clever little thing to do. I think there is quite a bit of quiet unrecognized communication between the woman and the baby. Childbirth Without Fear by Read and Ideal Birth by Sondra Ray and Birth Without Violence by Frederick Leboyer are more fascinating books to seek out too. Jo, I wish for you a wonderful journey through your pregnancy, labour, birth and loving your little one. Embrace the experience. Warm hug Julie Julie Clarke CBE Independent Childbirth and Parenting Educator HypnoBirthing (R) Practitioner ACE Grad Dip Supervisor NACE Advanced Educator and Trainer NACE National Journal Editor Transition into Parenthood Sessions 9 Withybrook Place Sylvania NSW 2224 Telephone 9544 6441 Mobile: 0401 2655 30 email: [EMAIL PROTECTED] visit Julie's website: www.transitionintoparenthood.com.au -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of JoFromOz Sent: Thursday, 24 March 2005 8:09 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Question about engagement ... no, not the romantic kind... We were discussing pregnancy on night duty last night (as you do when you are a Midwife, and pregnant!), and I was wondering if anyone knew why babies don't 'engage' earlier than they do? I mean, at 32 weeks, my baby's head is pretty small, so why wouldn't gravity allow the head to go deep into my pelvis, instead of having a butt and legs right up under my rib cage already? One suggestion was that it is because the foetus floats, but I don't see why... None of us really had any ideas - do any of you? Ta :) Jo (RM) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Question about engagement
Julie, thank you so much for you thoughtful reply :) I have read some of Sheila Kitzinger's books, and definitely Spiritual Midwifery. I do love being pregnant, and the feeling of this lil boy rearranging his position whenever he feels like it is wonderful. I love knowing that his hearing is fine too... he jumps when I drop something, and he gets all excited when I turn the water on for the shower. I can't wait to meet him, yet I still want to experience the whole pregnancy for the next 8 or so weeks. Thanks again for your reply, and your well wishes. I AM looking forward to the labour and birth, and the babymoon ;) I trust that my body and baby know what they're doing, even if *I* don't ;) I need to try not to be so 'technical' about the whole thing :) Love Jo -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] question
Jeannie Minnis wrote: As a red head, I am curious about the evidence for the active management of third stage for red heads! Jeannie Minnis Not sure about the 'evidence'... but most likely anecdote. Apparently red-heads 'bleed more', something to do with platelets?? Not sure. I don't work with the private patients/doctors much... Jo (RM)
