Wednesday, November 25, 2009

Medical dominance in birth

Society and cultural beliefs may not always agree with or understand the ‘promotion of normal birth’ which is, by definition, the duty of every midwife (ICM 2005). Many midwives who may have only practised under medical supervision, may not understand or have any skill in the promotion of normal birth. Regardless of the fashion of the day, and a midwife who does not possess skill in promoting normal birth should be challenged and supported in achieving competence, in the same way as a midwife is required to have competence in newborn resuscitation or any other basic midwifery skill. [Continued]

Wednesday, November 18, 2009

Learning from Dr Michel Odent

An excerpt from Michel Odent's Primal Health Research Newsletter Vol17 no3. The obstetrical implications of waterside hypotheses
WWW.WOMBECOLOGY.COM

Learning from birthing pools
In the early 1990s, when we became more familiar with the concept of antagonism between hormones of the adrenaline family (stress hormones) and oxytocin (the key hormone in parturition), I started to investigate the management of a common pathological situation in midwifery and obstetrics. It is the ‘failure to progress’ in the middle of cervical dilation, associated with intense lumbar pain. In this case, the pain appears as an obstacle to cervical dilation. I was considering non-pharmacological methods of pain relief. This is how I introduced the concept of ‘lumbar reflexotherapy’, based on the ‘gate control theory of pain’. Intracutaneous injections of sterile water in a precise zone of the lumbar region innervated by the posterior branch of the twelve dorsal nerve can block the visceral pain coming from the contracting uterus.32 I also proposed immersion in water at body temperature as a way to relieve pain, to reduce the level of stress hormones, and thus achieve more effective uterine contractions.

Taking into account the physiological perspective, and also the strong attraction to water expressed by many labouring women, I eventually bought a blue inflatable garden wading pool. Thus began the history of birthing pools in hospitals.33 As soon as the birthing pool was installed new strategies became possible. When a woman in hard labour was demanding painkillers, we had something else to offer than the injection of an analgesic drug (this was before the age of epidural analgesia). We could introduce the mother-to-be to the aquatic birthing room, so that she could observe and hear beautiful blue water filling the pool. The room was painted blue, with dolphins on the walls. From that time the question was no longer: "When will you give me a pain killer?" It was more often than not: "How long does it take to fill the pool?" The first lesson concerned the importance of the time when the woman in labour is anticipating the bath: the dilation of the cervix can already progress dramatically before water immersion—if the aquatic environment is associated with privacy. It is like the sudden release of brakes . We witnessed one of the many magic effects of water on human beings...a profound power that cannot be easily explained with the language of physiologists.34 At the time of the plastic pool (before we installed a solid pool), women were not influenced by the media or by what they read in books about childbirth. Their behaviour was spontaneous and thus we learned about the genuine effects of a water environment. A the typical scenario (with many possible variations) was the case of a woman entering the pool in hard labour around 5 cm, spending an hour or two in water and then feeling the need to get out of the pool when the contractions were becoming less and less effective. This going back to the dry land often induced a short series of irresistible and powerful contractions so that the baby was born within several minutes.

One day, a mother-to-be had not been in water for long when suddenly she had two irresistible contractions and the baby was born before she felt any need to get out of the pool. While giving birth, this woman was really "on another planet". Clearly, in that altered state of consciousness associated with hard labour, she intuitively knew that her baby could be born safely under water. There was no panic. It is as if a deep-rooted knowing could express itself as soon as the intellect and its knowledge was set aside. Such births happened again.34 From that time many journalists, reporters,and photographers were fascinated by babies being born in water. They were indifferent all other aspects of our unconventional practices. After a short period of surprise and even frustration, I concluded that good journalists are experts in Human Nature. They know how to attract the attention of their readers or their viewers. They have this intuitive knowledge that there is a special relationship between human beings and water. By referring to this historical phase of the use of birthing pools, we offer food for thought in the age of Waterside Hypotheses.

Monday, November 09, 2009

Not happy, Julia!


[Pic: Melissa and I hand over some calling cards to the chap who was manning the front desk at Julia Gillard's office thismorning.]

An estimated 350 ordinary people, predominantly mothers and babies and little children, rallied in the heat thismorning outside Julia Gillard's Werribee office.

The message was clear - SHAME on you, Julia! Australia's first female Deputy Prime Minister, and you are allowing medical dominance over childbirth to be written into the laws of this country in an unprecedented way.

A couple of young police persons were in visible attendance from an hour before the rally commenced. I had a chat with them, and gave them some information about the rally and a link to this blog, and thanked them for looking after us. We also noticed an Australian Federal Police car parked near the rally. Two large men (not in uniform) who were standing on the footpath also kept an eye on us. These two men entered Julia's office after the crowd had left.

There was no melee. By midday there were a few crying children - little ones who are not accustomed to being out in the sun, listening to their mummies talking into loud speakers. They were probably wanting some mummy time, snuggled in her lap, and suckling at her breast.

As a member of this community I am outraged that Australian parents and children and midwives should even consider gathering on a public street to voice our concerns. Yet we have been driven to that extreme by a government that is being directed by the powerful medical union, the AMA, who has proudly claimed responsibility for the latest amendment to legislation.

Julia Gillard spoke to midwives in 2005, when she was the shadow health minister, in election mode. In that speech she said:

there are “limited opportunities [for midwives] to practise as primary carers and provide continuity of care to women”
and
“Unless and until the Government is shocked and shamed into realising that Australian women …"
and
“I believe that midwives … are key heath care professionals whose role in the care of women and their babies has yet to be fully realised in the Australian health care system”

Today we have reminded Julia of what she said before the Australian people voted Labor into office.


ps.
We have heard that about 400 rallied outside Kevin Rudd's Morningside (Qld) office, and 200+ outside Tanya Plibersek’s Surry Hills (NSW) office. The WA rally will be held outside Stephen Smith's office at 11.10 am local time.
pps. Perth had about 100 people. Rachel Siewert, Danielle Senini and Sally Westbury addressed the crowd. Very polite federal police attended. Channel 7 and 10 had news crews there. West Australian and Local papers interviewed and photographed the crowd.

For more pictures, please go to the MIPP blog.

Saturday, November 07, 2009

REMINDER: RALLY ON MONDAY

Monday 9 November 2009 from 10.30am (local time)


Rally points:

Brisbane:
Prime Minister
Kevin Rudd’s office
630 Wynnum Road
Morningside Qld 4170

Werribee:
Deputy Prime Minister
Julia Gillard’s office
Shop 2, 36 Synnot Street
Werribee Vic 3030

Sydney:
Minister for the Status of Women
Tanya Plibersek’s office
111-117 Devonshire Street
Surry Hills NSW 2010

Perth: at 11.10am Perth Only
Office of Stephen Smith (most senior Gov member in WA)
953A Beaufort Street
Inglewood WA 6932




[Our calling cards]

If you are unable to attend, please prepare your 'calling card' - a letter to Kevin, Julia, Tanya, or Stephen (or another member of the government), telling them who you are and why you can not accept maternity reform which prevents midwives from practising midwifery in their own right, and prevents women from giving birth in their homes with their chosen midwife attending them. Please email your letter to your midwife or someone else who is going to the rally, and ask them to give it to the MP concerned.

Anyone who would like their calling card to appear on this blog, please email it to joy@aitex.com.au

Friday, November 06, 2009

Thinking about vaginal breech births

I have put a comment about the screening of this video at the MIPP blog.

A point that was only touched on in the discussion after the showing was the disenfranchising and deskilling of midwives in breech births. It has become an obstetric consultant ‘act’, even though every midwife should be ready and competent in spontaneous breech births. Midwife Fiona Hallinan mentioned that Box Hill hospital is setting up consultant cover for breeches – it’s all about defensive medicine. RWH refuses to support a woman’s choice, and staff will bully her into compliance with their wishes to do an elective Caesar. I was told that this is because they can’t be sure someone is competent at all times. And as Lionel Steinberg pointed out, an obstetrician goes against the current ‘gold standard’ at his own risk. The insurance will pay out for a baby’s brain damage in an undiagnosed breech birth where the midwives haven’t got a clue what to do, but won’t support the obstetrician who goes against the rules.

The video ‘A breech in the system’ made the point that the woman was lucky that the obstetrician on call at the time was competent – had learnt about breeches in India and PNG. There was great rejoicing around that fact. It’s tragic that an obstetrician needs to be given ownership of a spontaneous birth that a midwife could just as well have attended.

There was a lot of padding in ‘A breech in the system’. Beautiful underwater footage, lots of Byron Bay alternative hocus pocus – none of which seemed to make any difference. ECV (external cephalic version) got some bad publicity, and it ‘didn’t work’ either!

In the current climate of serious threat to all midwives’ right to practise on our own authority, breech births are a bit of a distraction. This video is good in that it demonstrates spontaneous birth – something we need to value and hold on to.

Wednesday, November 04, 2009

MOTHERBABY FUND 2009



This page will provide an ongoing tally of gifts that are made to global relief and development charities that assist needy women and their children.

I encourage all readers of this blog to join me in this special venture.

Donations are made directly to the chosen charity, and reported here, without identifying the donor. Please choose a charity that you believe is reputable, minimising overhead costs, and transparent in its reporting to donors. I encourage you to consider donations to the charities listed below. This list will be added to as information is provided to me, Joy Johnston begin_of_the_skype_highlighting     end_of_the_skype_highlighting [joy@aitex.com.au].

The person(s) who donate money will receive a receipt from the charity, and the gift may be tax deductible. Please send me the information if you want your donation to be included in the MOTHERBABY FUND 2009.


MOTHERBABY FUND 2009
$895.00


Donations since 4 November
$200.00 to TEAR for establishing a women's self-help group
$60.00 to TEAR for training a village health worker/birth attendant
$85.00 to TEAR for HIV care and eduction
$35.00 to TEAR for Literacy Skills
$550.00 to TEAR for community school
$20.00 to TEAR
$20.00 to a local women's refuge


Other charities to consider:
Aboriginal Midwives Trust
World Vision
Christmas Child
Oxfam

Sunday, November 01, 2009

discovering enjoyment in breastfeeding

Of all God's wonderful provisions for a healthy relationship between a mother and her child, breastfeeding is enduring and powerful. It's part of the natural physiological continuum. I have a window sticker on my car that sums it up:
"There's no milk like mum's milk."

Breastfeeding, like normal birth, is by no means an easy option - especially in the early days and weeks of a baby's life.

Recently I visited a new mother who was having difficulies feeding her baby, who was about two weeks old. She was expressing her milk, putting it into a bottle, and giving it as well as some of the artificial powdered stuff to the little bloke.

Today I received an email from that mother.

"I just wanted to write and say a huge THANK YOU for teaching me how to enjoy breast-feeding : )

"I no longer see it as a burden or as a scary thing, but something completely natural and wonderful. I've grown more confident with feeding [BABY] in public and am now keen to take him places with me so that he can explore the world outside! Thank you!

"I'm also looking forward to being able to help other mums in future breastfeed their babies."


In a few simple sentences this mother has told me everything I want to know about their progress. I don't know how often the feeds are, or how many times the new parents get up at night. But I do know that this mother-baby pair have discovered enjoyment in breastfeeding. What's more, the mother is looking forward to sharing this wonderful gift with her peers.

I feel priviliged to have had a small part in this new mother's beautiful transformation.